Preclinical evaluation of combined therapy with amiodarone and low-dose benznidazole in a mouse model of chronic Trypanosoma cruzi infection.

Chagasic chronic cardiomyopathy (CCC) is the primary clinical manifestation of Chagas disease (CD), caused by Trypanosoma cruzi. Current therapeutic options for CD are limited to benznidazole (Bz) and nifurtimox. Amiodarone (AMD) has emerged as most effective drug for treating the arrhythmic form of CCC. To address the effects of Bz and AMD we used a preclinical model of CCC. Female C57BL/6 mice were infected with T. cruzi and subjected to oral treatment for 30 consecutive days, either as monotherapy or in combination. AMD in monotherapy decreased the prolonged QTc interval, the incidence of atrioventricular conduction disorders and cardiac hypertrophy. However, AMD monotherapy did not impact parasitemia, parasite load, TNF concentration and production of reactive oxygen species (ROS) in cardiac tissue. Alike Bz therapy, the combination of Bz and AMD (Bz/AMD), improved cardiac electric abnormalities detected T. cruzi-infected mice such as decrease in heart rates, enlargement of PR and QTc intervals and increased incidence of atrioventricular block and sinus arrhythmia. Further, Bz/AMD therapy ameliorated the ventricular function and reduced parasite burden in the cardiac tissue and parasitemia to a degree comparable to Bz monotherapy. Importantly, Bz/AMD treatment efficiently reduced TNF concentration in the cardiac tissue and plasma and had beneficial effects on immunological abnormalities. Moreover, in the cardiac tissue Bz/AMD therapy reduced fibronectin and collagen deposition, mitochondrial damage and production of ROS, and improved sarcomeric and gap junction integrity. Our study underlines the potential of the Bz/AMD therapy, as we have shown that combination increased efficacy in the treatment of CCC.

Pyridoxamine improves metabolic and microcirculatory complications associated with nonalcoholic fatty liver disease.

OBJECTIVE: We investigated the protective effects of pyridoxamine against metabolic and microcirculatory complications in nonalcoholic fatty liver disease. METHODS: Nonalcoholic fatty liver disease was established by a high-fat diet administration over 28 weeks. Pyridoxamine was administered between weeks 20 and 28. The recruitment of leukocytes and the number of vitamin A-positive hepatic stellate cells were examined by in vivo microscopy. Laser speckle contrast imaging was used to evaluate microcirculatory hepatic perfusion. Thiobarbituric acid reactive substances measurement and RT-PCR were used for oxidative stress and inflammatory parameters. advanced glycation end products were evaluated by fluorescence spectroscopy. RESULTS: The increase in body, liver, and fat weights, together with steatosis and impairment in glucose metabolism observed in the nonalcoholic fatty liver disease group were attenuated by pyridoxamine treatment. Regarding the hepatic microcirculatory parameters, rats with high-fat diet-induced nonalcoholic fatty liver disease showed increased rolling and adhesion of leukocytes, increased hepatic stellate cells activation, and decreased tissue perfusion, which were reverted by pyridoxamine. Pyridoxamine protected against the increased hepatic lipid peroxidation observed in the nonalcoholic fatty liver disease group. Pyridoxamine treatment was associated with increased levels of tumor necrosis factor alpha (TNF-α) mRNA transcripts in the liver. CONCLUSION: Pyridoxamine modulates oxidative stress, advanced glycation end products, TNF-α transcripts levels, and metabolic disturbances, being a potential treatment for nonalcoholic fatty liver disease-associated microcirculatory and metabolic complications.

Cerebral microvascular dysfunction in metabolic syndrome is exacerbated by ischemia-reperfusion injury.

BACKGROUND: Metabolic syndrome (MetS) is associated with an increased risk of cerebrovascular diseases, including cerebral ischemia. Microvascular dysfunction is an important feature underlying the pathophysiology of cerebrovascular diseases. In this study, we aimed to investigate the impacts of ischemia and reperfusion (IR) injury on the cerebral microvascular function of rats with high-fat diet-induced MetS. RESULTS: We examined Wistar rats fed a high-fat diet (HFD) or normal diet (CTL) for 20 weeks underwent 30 min of bilateral carotid artery occlusion followed by 1 h of reperfusion (IR) or sham surgery. Microvascular blood flow was evaluated on the parietal cortex surface through a cranial window by laser speckle contrast imaging, functional capillary density, endothelial function and endothelial-leukocyte interactions by intravital videomicroscopy. Lipid peroxidation was assessed by TBARs analysis, the expression of oxidative enzymes and inflammatory markers in the brain tissue was analyzed by real-time PCR. The cerebral IR in MetS animals induced a functional capillary rarefaction (HFD IR 117 ± 17 vs. CTL IR 224 ± 35 capillary/mm2; p < 0.05), blunted the endothelial response to acetylcholine (HFD IR -16.93% vs. CTL IR 16.19% from baseline inner diameter p < 0.05) and increased the endothelial-leukocyte interactions in the venules in the brain. The impact of ischemia on the cerebral microvascular blood flow was worsened in MetS animals, with a marked reduction of cerebral blood flow, exposing brain tissue to a higher state of hypoxia. CONCLUSIONS: Our results demonstrate that during ischemia and reperfusion, animals with MetS are more susceptible to alterations in the cerebral microcirculation involving endothelial dysfunction and oxidative stress events.

Hepatic microvascular dysfunction and increased advanced glycation end products are components of non-alcoholic fatty liver disease.

BACKGROUND: This study aimed to investigate the pathophysiology of hepatic microcirculatory dysfunction in non-alcoholic fatty liver disease (NAFLD). METHODS: In Wistar rats, NAFLD model was induced by 20 weeks of high-fat diet (HFD) feeding. Rolling and adhesion of leukocytes and tissue perfusion in hepatic microcirculation were examined using in vivo microscopic and laser speckle contrast imaging (LSCI), respectively. Oxidative stress and inflamatory parameters were analysed by TBARs, catalase enzyme activity, RT-PCR and ELISA. The participation of advanced glycation end-products (AGE) and its receptor RAGE was evaluated by the measurement of gene and protein expression of RAGE by RT-PCR and Western-blot, respectively and by liver and serum quantification of fluorescent AGEs. RESULTS: Wistar rats fed high-fat diet (HFD) showed increase in epididymal and abdominal fat content, systolic arterial blood pressure, fasting blood glucose levels, hepatic triglycerides and cholesterol, and impairment of glucose and insulin metabolisms. Liver histology confirmed the presence of steatosis and ultrasound analysis revealed increased liver size and parenchymal echogenicity in HFD-fed rats. HFD causes significant increases in leukocyte rolling and adhesion on hepatic microcirculation and decrease in liver microvascular blood flow. Liver tissue presented increase in oxidative stress and inflammtion. At 20 weeks, there was a significantly increase in AGE content in the liver and serum of HFD-fed rats and an increase in RAGE gene expression in the liver. CONCLUSION: The increase in liver AGE levels and microcirculatory disturbances could play a role in the pathogenesis of liver injury and are key components of NAFLD.

The impact of early aerobic exercise on brain microvascular alterations induced by cerebral hypoperfusion.

The therapeutic potential of early exercise training following cerebral hypoperfusion was investigated on brain perfusion and inflammation in rats with permanent bilateral occlusion of the common carotid arteries (2VO). Wistar rats were subjected to 2VO or sham surgery and each group was then subdivided randomly into sedentary or exercise groups. Early exercise training was initiated after three days of 2VO or sham surgery and consisted of seven days of treadmill training (30min/day at ∼60% of maximal exercise test), composing four groups: 1) Sham sedentary (Sham-Sed), 2) Sham exercised (Sham-Ex), 3) 2VO sedentary (2VO-Sed) and 4) 2VO exercised (2VO-Ex). Microvascular cerebral blood flow (MCBF) and NADPH oxidase and eNOS gene expression were evaluated by laser speckle contrast imaging and RT-PCR, respectively, and brain functional capillary density and endothelial-leukocyte interactions were evaluated by fluorescence intravital video-microscopy. The 2VO-Sed group presented a decrease in MCBF (Sham-Sed: 230.9±12.2 vs. 2VO-Sed: 183.6±10.6 arbitrary perfusion units, P<0.05) and in functional capillary density (Sham-Sed: 336.4±25.3 vs. 2VO-Sed: 225.5±28.1capillaries/mm2, P<0.05). Early intervention with physical exercise was able to prevent the cerebral microvascular inflammation by decreasing endothelial-leukocyte interactions (2VO-Ex: 0.9±0.3 vs. 2VO-Sed: 5±0.6cells/min/100µm, P<0.0001) and reducing brain NADPH oxidase gene expression (2VO-Ex: 1.7±0.1 arbitrary units, P<0.05). Cerebral microcirculatory and inflammatory alterations appear to be triggered during the first days after 2VO surgery, and early intervention with physical exercise may represent a means of preventing the microvascular alterations induced by chronic cerebral hypoperfusion.

Atividade, seletividade e mecanismos de ação de diamidinas aromáticas e análogos sobre Trypanosoma cruzi: um enfoque sobre o kDNA / Activity, selectivity and mechanism of action of aromatic and diamidinas analogues on Trypanosoma cruzi: a focus on the kDNA

A doença de Chagas, causada pelo Trypanosoma cruzi, é endêmica na América Latina, afetando mais de 15 milhões de pessoas. Como seu tratamento apresenta eficácia limitada e considerável toxicidade novas drogas são necessárias. Neste contexto, com a colaboração de grupos de química medicinal, nosso objetivo é a investigação da atividade tripanocida, seletividade, alvos celulares e mecanismos de ação de diamidinas aromáticas (DAs) e análogos. Inicialmente avaliamos o efeito tripanocida de onze Das sobre as formas tripomastigotas e amastigotas intracelulares, assim como sua toxidade para células de mamíferos e localização intracelular no parasito. Entre estes onze compostos, 2, 5 e 7 foram os mais ativos, com valores de IC50 na faixa micromolar e um alto índice de seletividade sobre as duas formas de T. cruzi. Através de microscopia de fluorescência (MF) foi possível localizar todos os compostos em organelas ricas em DNA, núcleo e mitocôndria (kDNA) e a análise utraestrutural utilizando os compostos 5 e 7 revelou que estes compostos levam a danos mitocondriais, incluindo desorganização do kDNA em formas tripomastigotas. O acúmulo das diamidinas foi maior no kDNA do que no núcleo, porém tam acúmulo não está correlacionado a uma maior atividade tripanocida. A seguir, visando um melhor entendimento do mecanismo de ação de diamidinas e análogos, investigamos uma possível correlação entre as propriedades de ligação ao kDNA de treze compostos com a atividade tripanocida, através de estudos de desnaturação térmica (Tm) e dicroísmo circular (DiC). Nossos resultados mostram tanto com kDNA purificado de epimastigotas como com uma seqüência conservada de 22-mer presente em minicírculos de T. cruzi, que a forte interação de amidinas ao kDNA não é o fator determinante para desencadear sua atividade tripanocida.Estes dados sugerem fortemente que outros fatores podem estar envolvidos no mecanismo de ação destes compostos, operando de modo primário ou secundário a interação composto: kDNA. Outros estudos serão necessários para melhor identificar os mecanismos envolvidos na ação destes compostos, visando contribuir para o desenho racional de compostos líderes para o tratamento da doença de Chagas.

The biological in vitro effect and selectivity of aromatic dicationic compounds on Trypanosoma cruzi

Trypanosoma cruzi is a parasite that causes Chagas disease, which affects millions of individuals in endemic areas of Latin America. One hundred years after the discovery of Chagas disease, it is still considered a neglected illness because the available drugs are unsatisfactory. Aromatic compounds represent an important class of DNA minor groove-binding ligands that exhibit potent antimicrobial activity. This study focused on the in vitro activity of 10 aromatic dicationic compounds against bloodstream trypomastigotes and intracellular forms of T. cruzi. Our data demonstrated that these compounds display trypanocidal effects against both forms of the parasite and that seven out of the 10 compounds presented higher anti-parasitic activity against intracellular parasites compared with the bloodstream forms. Additional assays to determine the potential toxicity to mammalian cells showed that the majority of the dicationic compounds did not considerably decrease cellular viability. Fluorescent microscopy analysis demonstrated that although all compounds were localised to a greater extent within the kinetoplast than the nucleus, no correlation could be found between compound activity and kDNA accumulation. The present results stimulate further investigations of this class of compounds for the rational design of new chemotherapeutic agents for Chagas disease.

Experimental chemotherapy for Chagas disease: 15 years of research contributions from in vivo and in vitro studies

Chagas disease, which is caused by the intracellular parasite Trypanosoma cruzi, is a neglected illness with 12-14 million reported cases in endemic geographic regions of Latin America. While the disease still represents an important public health problem in these affected areas, the available therapy, which was introduced more than four decades ago, is far from ideal due to its substantial toxicity, its limited effects on different parasite stocks, and its poor activity during the chronic phase of the disease. For the past 15 years, our group, in collaboration with research groups focused on medicinal chemistry, has been working on experimental chemotherapies for Chagas disease, investigating the biological activity, toxicity, selectivity and cellular targets of different classes of compounds on T. cruzi. In this report, we present an overview of these in vitro and in vivo studies, focusing on the most promising classes of compounds with the aim of contributing to the current knowledge of the treatment of Chagas disease and aiding in the development of a new arsenal of candidates with anti-T. cruzi efficacy.

Caracterização bioquímica e molecular de possíveis alvos terapêuticos do metabolismo de aminoácidos em Tripanossomatídeos / Biochemical and molecular characterization of possible tarepeutic targets against Trypanosomatids in the amino acid metabolism

Trypanosoma cruzi e Leishmania spp. são parasitas de grande relevância médica nas Américas e em países da Europa e Ásia. Esses organismos apresentam um ciclo de vida heteroxeno infectando hospedeiros vertebrados e invertebrados e, portanto, precisam se adaptar às diferentes condições ambientais. Dessa forma, diversas enzimas metabólicas, proteínas e transportadores participam no ajuste do metabolismo às condições ambientais e flutuações na disponibilidade de nutrientes do meio. Nesse aspecto, os aminoácidos são de importância vital para o metabolismo de tripanossomatídeos, porém pouco se sabe da dinâmica do transporte desses nutrientes para dentro da célula e existem algumas lacunas no estudo de algumas enzimas envolvidas no metabolismo de aminoácidos. Portanto, uma dos objetivos desse trabalho foi caracterizar bioquimicamente o transporte de L- glutamato, um aminoácido importante para o ciclo de vida desses organismos e as formas presentes no inseto de diversos tripanossomatídeos utilizam L-glutamato no metabolismo energético. A incorporação de glutamato ao longo do tempo foi estudada em formas promastigotas de Leishmania amazonensis, foi possível observar que a incorporação é saturável e apresenta uma faixa de linearidade durante os primeiros 120 segundos de incubação com aminoácido radioativamente marcado, atingindo um platô após 15 minutos...Os tripanossomatídeos são capazes de metabolizar L-glutamato para produção de energia, o fato de L. amazonensis incorporar L-glutamato com eficiência é um indicativo da relevância desse aminoácido no metabolismo desses parasitas. O outro objetivo do trabalho, se relaciona com a busca de alvos terapeêuticos em potencial no metabolismo de aminoácidos em Trypanosoma cruzi. A asparagina é de importância vital para a síntese correta de protéinas e para processos de modificações pós-traducionais como N-glicosilação...Além disso, também identificamos uma sequência codificante correspondente a enzima L-Asparaginase (L-Asp)...