Topical Delivery of Artemisone, Clofazimine and Decoquinate Encapsulated in Vesicles and Their In vitro Efficacy Against Mycobacterium tuberculosis.

Vesicles are widely investigated as carrier systems for active pharmaceutical ingredients (APIs). For topical delivery, they are especially effective since they create a "depot-effect" thereby concentrating the APIs in the skin. Artemisone, clofazimine and decoquinate were selected as a combination therapy for the topical treatment of cutaneous tuberculosis. Delivering APIs into the skin presents various challenges. However, utilising niosomes, liposomes and transferosomes as carrier systems may circumvent these challenges. Vesicles containing 1% of each of the three selected APIs were prepared using the thin-film hydration method. Isothermal calorimetry, differential scanning calorimetry and hot-stage microscopy indicated no to minimal incompatibility between the APIs and the vesicle components. Encapsulation efficiency was higher than 85% for all vesicle dispersions. Vesicle stability decreased and size increased with an increase in API concentration; and ultimately, niosomes were found the least stable of the different vesicle types. Skin diffusion studies were subsequently conducted for 12 h on black human female skin utilising vertical Franz diffusion cells. Transferosomes and niosomes delivered the highest average concentrations of clofazimine and decoquinate into the skin, whereas artemisone was not detected and no APIs were present in the receptor phase. Finally, efficacy against tuberculosis was tested against the Mycobacterium tuberculosis H37Rv laboratory strain. All the dispersions depicted some activity, surprisingly even the blank vesicles portrayed activity. However, the highest percentage inhibition (52%) against TB was obtained with niosomes containing 1% clofazimine.

Formulation of Natural Oil Nano-Emulsions for the Topical Delivery of Clofazimine, Artemisone and Decoquinate.

PURPOSE: The aim of this study was to formulate nano-emulsions comprising natural oils and the active pharmaceutical ingredients (APIs) clofazimine (CLF), artemisone (ATM) and decoquinate (DQ) in order to determine effectiveness of the nano-emulsions for topical delivery of the APIs. The APIs alone do not possess suitable physicochemical properties for topical drug delivery. METHODS: Nano-emulsions were formulated with olive and safflower oils encapsulating the APIs. Skin diffusion and tape stripping studies were performed. By using the lactate dehydrogenase (LDH) assay, in vitro toxicity studies were carried out on immortalized human keratinocytes (HaCaT) cell line to determine cytotoxicities due to the APIs and the nano-emulsions incorporating the APIs. RESULTS: The nano-emulsions were effective in delivering the APIs within the stratum corneum-epidermis and the epidermis-dermis, were non-cytotoxic towards HaCaT cell lines (p < 0.05) and inhibited Mycobacterium tuberculosis in vitro. CONCLUSION: Natural oil nano-emulsions successfully deliver CLF, ATM and DQ and in principle could be used as supplementary topical treatment of cutaneous tuberculosis (CTB). Graphical Abstract ᅟ.

Nanoparticle formulations of decoquinate increase antimalarial efficacy against liver stage Plasmodium infections in mice.

Decoquinate has potent activity against both Plasmodium hepatic development and red cell replication when tested in vitro. Decoquinate, however, is practically insoluble in water. To achieve its maximal in vivo efficacy, we generated nanoparticle formulations of decoquinate with a mean particle size less than 400 nm. Three separate preparations at doses of decoquinate 0.5-5 mg/kg were examined in mice infected with Plasmodium berghei. Oral administration of nanoparticle decoquinate at a dose of 1.25 mg/kg effectively inhibited the liver-stage parasite growth and provided complete causal prophylactic protection. This efficacy is 15 fold greater than that observed for microparticle decoquinate, which requires minimal dose of 20 mg/kg for the same inhibitory effect. Further in vitro studies utilizing dose-response assays revealed that decoquinate nanoformulation was substantially more potent than decoquinate microsuspension in killing both liver and blood stage malarial parasites, proving its potential for therapeutic development. FROM THE CLINICAL EDITOR: In this study, a nanoparticle formulation of decoquinate is shown to have superior bioavailability and efficacy in a mouse model of malaria, paving the way to the development of novel, potentially less toxic and more effective therapeutics to combat a disease that still has an enormous impact on a global scale despite the available partially effective therapies.

Herd-level risk factors associated with fecal shedding of Shiga toxin-encoding bacteria on dairy farms in Minnesota, USA.

This study aimed to identify herd-level risk factors associated with fecal shedding of Shiga toxin-encoding bacteria (STB) on dairy cattle farms in Minnesota, USA. After adjustment for farm size, risk factors included: use of total mixed ration (TMR) for lactating dairy cows [odds ratio (OR) = 3.0; 95% confidence interval (CI): 1.8 to 5.1], no use of monensin for weaned calves (OR = 4.8, 95% CI: 2.5, 9.3), and no use of decoquinate for preweaned calves (OR = 2.2, 95% CI: 1.4, 3.6). Fecal shedding of STB was more common in small herds (< 100 cows, OR = 3.6, 95% CI: 2.1, 6.2) than in large herds (≥ 100 cows). Herd management factors related to cattle feeding practices were associated with fecal shedding of STB.

Facteurs de risque au niveau du troupeau associés à l'excrétion fécale des bactéries encodant la toxine de Shiga dans les fermes laitières du Minnesota, États-Unis. Cette étude avait pour but d'identifier les facteurs de risque au niveau du troupeau associés à l'excrétion fécale de bactéries encodant la shiga-toxine dans les fermes de bovins laitiers au Minnesota, États-Unis. Après un ajustement pour la taille de la ferme, les facteurs de risque incluaient : l'utilisation de la ration mixte totale (RMT) pour les vaches laitières en lactation [rapport de cotes (RC) = 3,0; intervalle de confiance (IC) de 95 % : de 1,8 à 5,1], pas d'utilisation de monensin pour les veaux sevrés (RC = 4,8, IC de 95 % : 2,5, 9,3) et pas d'utilisation de décoquinate pour les veaux présevrés (RC = 2,2, IC de 95 % : 1,4, 3,6). L'excrétion fécale de la bactérie encodant la shiga-toxine était plus commune dans les petits troupeaux (< 100 vaches, RC = 3,6, IC de 95 % : 2,1, 6,2) que dans les grands troupeaux (≥ 100 vaches). Des facteurs de gestion du troupeau se rapportant aux pratiques d'alimentation du bétail ont été associés à l'excrétion fécale de la bactérie encodant la shiga-toxine.(Traduit par Isabelle Vallières).

Residue depletion of decoquinate in chicken tissues after oral administration.

A rapid, sensitive, and reliable high-performance liquid chromatography tandem mass spectrometry (LC-MS/MS) method was developed and validated for the analysis of decoquinate in chicken tissues. The compounds were extracted using acetonitrile by liquid-liquid extraction (LLE) and purified with an Oasis(™) HLB solid-phase extraction (SPE) cartridge. Chromatographic separation was performed on an XTerra C18 reversed-phase column with a mobile phase of water containing 0.1% formic acid and acetonitrile. The analyte was detected by tandem quadrupole mass spectrometry after positive electrospray ionization by multiple reaction monitoring. The detection and quantitation limits were 1 and 2.5 µg/kg, respectively. The recoveries of edible tissues ranged from 85.3% to 104.9%, with relative standard deviations (RSD) lower than 10.4%. The depletion profile of decoquinate was studied in healthy chickens after oral administration of feed containing 27.2 mg/kg decoquinate for 10 consecutive days. The residue concentrations of decoquinate in chicken muscle and liver were detected using the developed method. The highest residue concentrations were attained 0.25 day post-treatment, and decoquinate residues were still detected 5 days postmedication in the tissues examined. The developed method has been successfully applied to the depletion study of decoquinate in chicken tissues. The recommended withdrawal period with oral administration based on our research is 3 days.

A chemical genomic analysis of decoquinate, a Plasmodium falciparum cytochrome b inhibitor.

Decoquinate has single-digit nanomolar activity against in vitro blood stage Plasmodium falciparum parasites, the causative agent of human malaria. In vitro evolution of decoquinate-resistant parasites and subsequent comparative genomic analysis to the drug-sensitive parental strain revealed resistance was conferred by two nonsynonymous single nucleotide polymorphisms in the gene encoding cytochrome b. The resultant amino acid mutations, A122T and Y126C, reside within helix C in the ubiquinol-binding pocket of cytochrome b, an essential subunit of the cytochrome bc(1) complex. As with other cytochrome bc(1) inhibitors, such as atovaquone, decoquinate has low nanomolar activity against in vitro liver stage P. yoelii and provides partial prophylaxis protection when administered to infected mice at 50 mg kg(-1). In addition, transgenic parasites expressing yeast dihydroorotate dehydrogenase are >200-fold less sensitive to decoquinate, which provides additional evidence that this drug inhibits the parasite's mitochondrial electron transport chain. Importantly, decoquinate exhibits limited cross-resistance to a panel of atovaquone-resistant parasites evolved to harbor various mutations in cytochrome b. The basis for this difference was revealed by molecular docking studies, in which both of these inhibitors were shown to have distinctly different modes of binding within the ubiquinol-binding site of cytochrome b.

Prophylactic use of decoquinate for infections with Cryptosporidium parvum in experimentally challenged neonatal calves.

OBJECTIVE: To evaluate the effect of daily oral administration of decoquinate to neonatal calves experimentally challenged with various numbers of Cryptosporidium parvum oocysts. DESIGN: Clinical trial. ANIMALS: 75 calves. PROCEDURE: Calves were purchased from a commercial dairy during a 5-week period. Calves were housed in individual hutches and fed milk replacer with or without decoquinate (2 mg/kg [0.9 mg/lb per day]). Calves were randomly assigned to treatment and 1 of 5 challenge groups (0, 50, 100, 1000, or 10,000 C. parvum oocysts in 60 mL of saline [0.9% NaCl] solution administered p.o. on the day after arrival). Calves were maintained in the study for as long as 28 days. Calves were clinically assessed for diarrhea and dehydration. Fecal samples were submitted for oocyst enumeration 3 times each week. RESULTS: Treatment did not affect number of days to first watery feces (diarrhea), number of days to first oocyst shedding, or duration of diarrhea or oocyst shedding. Duration of oocyst shedding was significantly associated with challenge dose of oocysts administered to calves and number of days to first oocyst shedding. Duration of diarrhea and number of days to first oocyst shedding were significantly associated with week of arrival and number of days to first watery diarrhea. CONCLUSIONS AND CLINICAL RELEVANCE: Daily treatment with decoquinate at the dosage used in this study did not affect oocyst shedding or clinical signs associated with cryptosporidiosis. However, there was an indication that if the number of oocysts calves received could be reduced, then the duration of oocyst shedding and, hence, environmental loading of C. parvum oocysts could be reduced.

Efficacy of selected oral chemotherapeutants against Ichthyophthirius multifiliis (Ciliophora: Ophyroglenidae) infecting rainbow trout Oncorhynchus mykiss.

The chemotherapeutic efficacy of 6 in-feed compounds against Ichthyophthirius multifiliis Fouquet, 1876 was assessed using experimental infections of rainbow trout Oncorhynchus mykiss (Walbaum) fingerlings. Trial doses of 104 ppm amprolium hydrochloride or 65 ppm clopidol fed to fish for 10 d prior to infection significantly reduced the number of trophonts establishing in trout fingerlings by 62.0 and 35.2% respectively. In-feed treatments of infected trout with either 63 or 75 ppm amprolium hydrochloride, 92 ppm clopidol, or 38, 43 or 47 ppm salinomycin sodium for 10 d also significantly reduced the number of surviving trophonts by 77.6 and 32.2% for amprolium, 20.1% for clopidol and 80.2, 71.9 and 93.3% respectively for salinomycin sodium.

Treatment of dogs infected with Hepatozoon americanum: 53 cases (1989-1998).

OBJECTIVE: To determine clinical and pathologic findings before and after short-term (group 1) and long-term (group 2) treatment in dogs with Hepatozoon americanum infection. DESIGN: Retrospective study. ANIMALS: 53 dogs with H. americanum infection. PROCEDURE: Medical records of dogs that were treated for hepatozoonosis diagnosed on the basis of meront or merozoite stages in skeletal muscle were reviewed. RESULTS: Circulating gametocytes of H. americanum were identified in 12 of 53 dogs. Dogs were treated with various drugs, including toltrazuril, trimethoprim-sulfadiazine, clindamycin, pyrimethamine, and decoquinate. Mean WBC counts prior to treatment were 85,700 and 75,200 cells/microl in groups 1 and 2, respectively, and 1 month after initiation of treatment were 12,600 and 14,600 cells/microl, respectively. Initial response to treatment was excellent in all dogs. Twenty-three of 26 dogs in group 1 relapsed at least once and died within 2 years; mean (+/- SD) survival time was 12.6+/-2.2 months. Twenty-two of 27 group-2 dogs survived; 11 dogs had no clinical signs and were still receiving decoquinate (mean duration of treatment, 21 months), 11 dogs had no clinical signs after treatment for 14 months (range, 3 to 33 months; mean survival time, 39 months [range, 26 to 53 months]), 2 dogs were lost to follow-up, and 3 dogs were euthanatized because of severe disease. CONCLUSIONS AND CLINICAL RELEVANCE: Although no treatment effectively eliminated the tissue stages of H. americanum, treatment with trimethoprim-sulfadiazine, clindamycin, and pyrimethamine followed by long-term administration of decoquinate resulted in extended survival times and excellent quality of life.

Activity of decoquinate against Cryptosporidium parvum in cell cultures and neonatal mice.

Cryptosporidium parvum is an apicomplexan parasite that is an important cause of diarrhea in neonatal calves and humans. No treatment is currently available for neonatal calves. We have recently learned from colleagues in the pharmaceutical industry that dairy practitioners are sometimes using decoquinate for the treatment of neonatal bovine cryptosporidiosis. Therefore, the present study was undertaken to determine whether the clinical observations in calves can be substantiated by laboratory investigation. Oocysts of the KSU-1 isolate of C. parvum were used to infect human ileocecal epithelial cells in vitro to measure the efficacy of treatment using an ELISA based assay. No activity was observed at 10 or 50microM decoquinate, but at 100microM an 8% inhibition of development was seen. Oocysts of the AUCp-1 isolate of C. parvum were then used to infect suckling mice. The numbers of oocysts observed in suckling mice treated with 2.5 or 5.0mg/kg decoquinate were not significantly different from untreated control suckling mice (p0.05). The results of our study suggest that decoquinate should have little efficacy for treatment of neonatal bovine cryptosporidiosis if administered once per day and that any clinical improvement observed in treated calves may be due to factors unrelated to decoquinate's effect on C. parvum.

Decoquinate and the control of experimental ovine toxoplasmosis.

Decoquinate was tested for its ability to reduce the effect of experimentally induced toxoplasmosis in pregnant ewes. Sheep were given decoquinate in their feed daily at either 2 mg or 1 mg/kg bodyweight from 10 days before an oral challenge with Toxoplasma gondii oocysts at 90 days of gestation, until lambing. Feeding decoquinate at the higher rate caused a delay in the onset of the febrile response to infection, reduced the overall severity of the fever and delayed the production of antibodies to the parasite. This treatment also reduced the placental damage caused by the parasite, lengthened the mean gestation period and increased the number and weight of live lambs, in comparison with ewes not fed decoquinate but challenged with T gondii oocysts. The treatment with 1 mg of decoquinate had smaller effects.

In vivo expression of in vitro anticoccidial activity.

Large-scale screening has led to the identification of several experimental compounds that have very potent intrinsic activity against coccidia, but the lack of translation to in vivo efficacy has been a major hurdle in developing such leads into effective new drugs. We developed methods to explore the impact of oral availability and appropriate distribution in tissue, both of which are potentially important factors in the expression of activity in vivo. For the compounds that we examined, neither oral absorption nor distribution to the site of infection appeared to be the critical barrier to in vivo expression of intrinsic anticoccidial activity. Elucidation of the nature of additional factors that might be involved could assist greatly in the identification of useful new anticoccidial agents.

Effects of intermittent and continuous administration of decoquinate on bovine coccidiosis in male calves.

Male Holstein calves were each inoculated with 350,000 sporulated oocysts of Eimeria bovis. Two calves were given decoquinate (0.5 mg/kg of body weight) continuously in dry feed for 29 days, and 2 calves each were given 0.5, 1, or 1.5 mg of decoquinate/kg on an every 2nd-or 3rd-day schedule for 29 days. Calves given decoquinate continuously did not discharge oocysts but had slightly loose feces. In general, the number of oocysts discharged increased and fecal consistency decreased as the time between feeding of medicated feed increased. Calves given 0.5 or 1.5 mg of decoquinate/kg every 3rd day discharged more oocysts and had more diarrhea than did calves given 1 mg of decoquinate/kg every 3rd day. At postinoculation day 29, calves were euthanatized. At necropsy, intestinal tissues of calves given decoquinate were mostly normal. Apparently, reduced infections along with the elapsed time were sufficient to resolve most intestinal lesions caused by the coccidia. Decoquinate was most effective when fed continuously at 0.5 mg/kg. However, when fed at 1 or 1.5 mg of decoquinate/kg every 2nd day or 1.5 mg of decoquinate/kg every 3rd day, oocyst production was reduced and clinical coccidiosis was prevented.

Effect of decoquinate on the control of coccidiosis in young ruminating calves.

Twenty-five 6-week-old Holstein male calves were each inoculated with 500,000 sporulated oocysts of Eimeria bovis. Two nontreated (control) and 3 treated calves (1.5 mg of decoquinate/kg of body weight in feed) were necropsied 7 days after inoculation. Similar groups of calves were necropsied at 12, 18, 22, and 28 days after inoculation. Treated calves were started on medicated feed 2 days before inoculation or at 7, 12, or 15 days after inoculation or were on continuous medication from the day of inoculation. Control calves were not given medication. Early schizonts were in the small intestines of control calves at 7 days after inoculation, but none was in the treated calves that were started on medicated feed 2 days before inoculation. Schizonts were present in the small intestine of both treated and control calves at 12 days after inoculation. At 18 days after inoculation, control calves had schizonts in the small intestine and gamonts and oocysts in the cecum and large intestines, but treated calves only had schizonts in the small intestine. At 22 days, control calves had schizonts in the small intestine and gamonts and oocysts in the large intestine; treated calves had schizonts in the small intestine. At 28 days, controls still had schizonts in the small intestine and gamonts and oocysts in the cecum and large intestine; the treated calves that had been on continuous medication did not have schizonts, gamonts, or oocysts in the tissues. Decoquinate apparently kills sporozoites or arrests development and release of merozoites from the schizonts when fed at 1.5 mg/kg of body weight in the feed.

Development of immunity to coccidiosis in chickens administered anticoccidials in feed.

New combinations of techniques were employed for comparing the development of immunity of Eimeria tenella in chickens being medicated with 12 different anticoccidials. Broiler-type birds in batteries received a daily measured dose of E. tenella oocysts for 15 consecutive days while the drug was administered at the manufacturer's recommended level. Two or more tests of each drug gave the following ratings: strong suppression, monensin (121 ppm), salinomycin (80 ppm), lasalocid (75 ppm); moderate suppression, monensin (100 ppm), decoquinate (30 ppm), clopidol (125 ppm), and narasin (80 ppm); slight suppression, arprinocid (70 ppm), nicarbazin (125 ppm), and amprolium (125 ppm + ethopabate (4 ppm); no effect, robenidine (33 ppm), zoalene (125 ppm), and aklomide (250 ppm).

Decoquinate in the control of experimentally induced coccidiosis of calves.

Decoquinate administered orally in a grain mix at dosages of 0.5, 0.538, 0.7, and 0.8 mg/kg of body weight suppressed oocyst discharge and bloody diarrhea in calves inoculated 3 days later with 100,000 oocysts of Eimeria bovis (experiment 1, n = 12 calves) or with 100,000 oocysts each of E bovis and Eimeria zuernii (experiment 2, n = 16 calves). Doses of 0.1, 0.163, 0.243, 0.3, and 0.362 mg/kg of body weight gave only partial suppression of oocyst discharge and diarrhea. Clinical signs of coccidiosis did not recur for 23 days after the treatment was discontinued.