Technological innovation strategies for the specific treatment of Chagas disease based on Benznidazole.

Abstract

Caused by Trypanosoma cruzi, Chagas disease is responsible for public health problems greater in magnitude than those attributed to malaria, schistosomiasis, or leishmaniasis. A factor in the socioeconomic development of poor countries, Chagas disease can cause death due to a high parasitic burden during its acute phase due and irreversible damage in organs such as the heart, esophagus, and colon during its chronic phase, even when the number of parasites is minimal. For treating Chagas disease, benznidazole (BNZ) remains the drug of choice and, in Latin America, the only drug on the market for treating the disease. However, BNZ has exhibited insufficient activity in the chronic phase of Chagas disease, required administration in large doses, prolonged treatment, and shown a high incidence of adverse reactions (vomiting, rash, peripheral neuropathy, and spinal cord depression), toxicity, and low solubility in water. As an antidote, pharmaceutical technologies have been introduced that can improve BNZ's solubility and dissolution, as well as reduce side effects in light of its bioavailability, all of which can enhance therapy for Chagas disease. In response to that trend, by conducting a literature review, we sought to identify current pharmaceutical technologies used in tandem with BNZ to improve therapy for Chagas disease. Documented techniques include emulsion and microemulsion formation, solutions, parenteral formulas, micronization, and drug delivery systems supported by the development of nanoparticles and cyclodextrins, solid dispersions, and the use of metal-organic frameworks as innovative excipients. Such technologies increase the water solubility of BNZ by 4-25-fold on dissolution and an 85% release with efficacy in only a few minutes, as recorded during a viability experiment with nanoparticle suspensions. That experiment demonstrated the need for a lower concentration of BNZ to kill 50% of trypomastigote forms of T. cruzi, described in terms of the formation of BNZ-cyclodextrin complexes, and modulating and vectoring of the antichagasic by using metal-organic frameworks. Altogether, the promising results of research identified can enable strategies to improve solubility and efficacy of BNZ, as well as therapy for Chagas disease.

• Authors: Leslie Raphael de Moura Ferraz, Alinne Élida Gonçalves Alves, Débora Dolores Souza da Silva Nascimento, Isabela Araújo E Amariz, Aline Silva Ferreira, Salvana Priscylla Manso Costa, Larissa Araújo Rolim, Ádley Antonini Neves de Lima, Pedro José Rolim Neto
• Journal: Acta tropica (Acta Trop) Vol. 185 Pg. 127-132 (Sep 2018) ISSN: 1873-6254 [Electronic] Netherlands
• PMID: 29452113 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2018. Published by Elsevier B.V.

Chemical References

• Drug Carriers
• Nitroimidazoles
• Trypanocidal Agents
• benzonidazole

Topics

• Biological Availability
• Chagas Disease (drug therapy, parasitology)
• Drug Carriers
• Drug Delivery Systems
• Humans
• Nanoparticles
• Nitroimidazoles (administration & dosage, adverse effects, therapeutic use)
• Solubility
• Trypanocidal Agents (administration & dosage, adverse effects, therapeutic use)
• Trypanosoma cruzi (drug effects)