Amphotericin
B (AmB) is a highly hydrophobic drug with significant
leishmanicidal activity whose use is limited by its poor water solubility
and adverse effects. Polymer-drug conjugates are proposed as a delivery
system designed to overcome those limitations while improving drug
bioavailability, safety, and activity. Here, AmB was covalently linked
to periodate-oxidized hyaluronic acid (HA) (oxidation degree of 30.1
± 5.6%) via a Schiff base (HA-AmB imine). The conjugate presents
high water solubility and self-assembles into particles with a mean
size of 88.2 ± 17.6 nm, a negative charge (−28.3 ±
0.9 mV), and a drug content of 17.8 ± 1.4%. Spectroscopic studies
revealed the presence of AmB in aggregate and super-aggregated forms
in the conjugate, which could explain the significant reduction of
the in vitro cytotoxicity and hemolytic activity.
The formulation showed not only in vitro anti-leishmanial
activity against L. infantum-infected
macrophages (IC50 = 0.023 μM) but also against an in vivo infected mouse model, promoting a 1.32- and a 4.98-log10 suppression of the L. infantum burden in the spleens and liver, respectively, without toxic effects.
In summary, this study describes the safe and effective use of water-soluble
HA-AmB imine conjugates for leishmaniasis treatment.