학술논문

The anti-tubercular drug delamanid as a potential oral treatment for visceral leishmaniasis.
Document Type
Article
Source
eLife. 2016, p1-21. 21p.
Subject
*VISCERAL leishmaniasis
*LEISHMANIA donovani
*ANTITUBERCULAR agents
*MULTIDRUG-resistant tuberculosis
*METABOLIC detoxification of drugs
*TREATMENT effectiveness
*DOSE-effect relationship in pharmacology
*THERAPEUTICS
Language
ISSN
2050-084X
Abstract
There is an urgent requirement for safe, oral and cost-effective drugs for the treatment of visceral leishmaniasis (VL). We report that delamanid (OPC-67683), an approved drug for multi-drug resistant tuberculosis, is a potent inhibitor of Leishmania donovani both in vitro and in vivo. Twice-daily oral dosing of delamanid at 30 mg kg-1 for 5 days resulted in sterile cures in a mouse model of VL. Treatment with lower doses revealed a U-shaped (hormetic) dose-response curve with greater parasite suppression at 1 mg kg-1 than at 3 mg kg-1 (5 or 10 day dosing). Dosing delamanid for 10 days confirmed the hormetic dose-response and improved the efficacy at all doses investigated. Mechanistic studies reveal that delamanid is rapidly metabolised by parasites via an enzyme, distinct from the nitroreductase that activates fexinidazole. Delamanid has the potential to be repurposed as a much-needed oral therapy for VL. [ABSTRACT FROM AUTHOR]