RESUMO
BACKGROUND: Dogs are natural reservoir of Chagas disease (CD) and leishmaniasis and have been used for studies of these infections as they develop different clinical forms of these diseases similar to humans. OBJECTIVE: This article describes publications on the dog model relative to CD and leishmaniasis chemotherapy. METHODS: The search of articles was based on PubMed, Scopus and MESH using the keywords: dog, Trypanosoma cruzi, treatment (T. cruzi chemotherapy analysis), Leishmania chagasi, Leishmania infantum, canine visceral leishmaniasis, treatment (Leishmania chemotherapy evaluation). RESULTS: Benznidazole and nifurtimox were used as a reference in the treatment of CD and in combination with other compounds. Eleven out of the fifteen studies have authors from the same team, using similar protocols and post-treatment evaluations, which assured more reproducibility and credibility. Twenty leishmaniasis studies, especially on visceral leishmaniasis, presenting at least one parasitological analysis tested in distinct monochemotherapy and polychemotherapy approaches were accessed. Data demonstrated that polychemotherapy was more effective in improving the clinical signs and parasitism control. CONCLUSION: The benefits of treatment in terms of reducing or eliminating lesions and/or cardiac dysfunctions were demonstrated at acute and/or chronic phases relative to parasite load and/or the T. cruzi strain resistance to treatment. BZ presented better therapeutic results than the two EBI compounds evaluated. Although treatment of the canine visceral leishmaniasis was not able to induce complete parasite clearance, it can improve clinical recovery. Thus, the dog is a good model for CD and leishmaniasis studies of chemotherapy and may be indicated for pre-clinical trials of new treatments.
Assuntos
Doença de Chagas , Leishmania infantum , Leishmaniose , Animais , Doença de Chagas/tratamento farmacológico , Cães , Leishmaniose/tratamento farmacológico , Leishmaniose/veterinária , Reprodutibilidade dos TestesRESUMO
Chagas disease (CD) is a serious public health problem in Latin America and its treatment remains neglected. Benznidazole (BZ), the only drug available in Brazil, presents serious side effects and low therapeutic efficacy, especially at the chronic phase. The last clinical trials demonstrated that the first generation of azole compounds were less successful than BZ in CD chemotherapy, which stimulated studies of these compounds associated to BZ and nifurtimox (NF). This study evaluated the therapeutic efficacy of BZ, itraconazole (ITZ) and their combination (BZ + ITZ) in dogs infected with the VL-10 T. cruzi strain in the acute phase of the disease. Twenty young mongrel dogs were inoculated with 2.0â¯×â¯103 blood trypomastigotes/kg and divided into four groups: treated with BZ, ITZ and BZ + ITZ for 60 days, and control group (INT). The parasitemia of the BZ + ITZ and BZ groups were similar and showed significant reduction compared to the INT group. The group treated with ITZ also showed significant parasitemia reduction compared to the INT group. The global analysis of hemoculture (HC), blood PCR, conventional serology (CS-ELISA), heart qPCR and histopathology techniques, used in the post-treatment evaluation, revealed that BZ + ITZ combination lead to a more reduction of parasitemia during the acute phase and heart qPCR positivity, less cardiac damage (inflammation and fibrosis in the left ventricle) and total survival. According to the classical cure criteria one animal treated with BZ + ITZ can be considered cured in its final evaluation and two other dogs, one of this group and one treated with ITZ were in process of cure. At least for BZ-resistant T. cruzi strains such as VL-10, BZ + ITZ was not effective to induce parasitological cure or a profound and sustained reduction of the parasite burden in blood and infected organs.
Assuntos
Doença de Chagas/tratamento farmacológico , Itraconazol/uso terapêutico , Nitroimidazóis/uso terapêutico , Tripanossomicidas/uso terapêutico , Doença Aguda , Animais , Doença de Chagas/sangue , DNA de Protozoário/isolamento & purificação , Cães , Quimioterapia Combinada , Ensaio de Imunoadsorção Enzimática , Feminino , Coração/parasitologia , Humanos , Masculino , Miocárdio/química , Miocárdio/patologia , Parasitemia/sangue , Parasitemia/tratamento farmacológico , Reação em Cadeia da Polimerase , Distribuição AleatóriaRESUMO
Chagas disease (CD) is a serious public health problem in Latin America and its treatment remains neglected. Benznidazole (BZ) available in Brazil, presents serious side effects and low therapeutic efficacy at chronic phase. This study evaluated the therapeutic efficacy of BZ, itraconazole (ITZ) and BZâ¯+â¯ITZ in dogs infected with VL-10â¯T. cruzi strain in the acute phase (Ethic protocol number 2013/28). Twenty young mongrel dogs were inoculated with 2.0â¯×â¯103 blood trypomastigotes/kg and divided into four groups: treated with BZ, ITZ and BZâ¯+â¯ITZ for 60 days, and control group (INT-infected not treated). The parasitemia of the BZâ¯+â¯ITZ and BZ groups were similar and showed significant reduction compared to the INT group. The ITZ group also showed significant parasitemia reduction compared to the INT group. For cure control the global analysis of hemoculture (HC), blood PCR, conventional serology (CS-ELISA), heart qPCR and histopathology revealed that BZâ¯+â¯ITZ lead to more reduction of parasitemia during the acute phase and heart qPCR positivity, less cardiac damage and total survival than BZ or ITZ. Moreover, two other dogs, one treated with ITZ and other treated with BZâ¯+â¯ITZ, were always negative in all parasitological tests what indicates parasitological cure or that these dogs are in process of cure. â¢BZâ¯+â¯ITZ lead to more reduction of parasitemia, total survival, less heart qPCR positivity and cardiac damage.â¢According to the classic cure criterion cure was observed only in one dog submitted to BZâ¯+â¯ITZ treatment.â¢Two dogs, one treated with ITZ and other treated with BZâ¯+â¯ITZ were always parasitologically negative.