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PubMed1985

High continuous antimony therapy in two patients with unresponsive mucosal leishmaniasis.

The treatment of two patients with severe mucosal leishmaniasis due to Leishmania braziliensis braziliensis is described. Both patients had received much prior antimonial therapy and one had relapsed after a total dose of 2.5 g of Amphotericin B. Both patients responded to prolonged continuous Pentostam therapy at a daily dose of 20 mg Sbv/kg/day for 62 days in one case and for 85 days in the other. Pentavalent antimonials can be curative in such protracted courses in selected patients unresponsive to standard chemotherapy.

Adult↗
PubMed2004

Use of 1,5-bis(di-2-pyridyl)methylene thiocarbohydrazide immobilized on silica gel for automated preconcentration and selective determination of antimony(III) by flow-injection electrothermal atomic absorption spectrometry.

Selective sorption of Sb(III) on a microcolumn packed with 1,5-bis(di-2-pyridyl)methylene thiocarbohydrazide immobilized on silica gel (DPTH-gel) has been used for determination of Sb(III). A flow-injection system comprising a microcolumn connected to the tip of the autosampler was used for preconcentration. The sorbed antimony was eluted with nitric acid directly into the graphite furnace and determined by AAS. The detection limit for antimony under the optimum conditions was 0.3 ng mL(-1). This procedure was used for determination of antimony in natural water, soil, vegetation, and a certified sample of a city waste incineration ash (BCR 176).

Journal Article↗
PubMed2002

Experimental and theoretical characterization of cationic, neutral, and anionic binary arsenic and antimony azide species.

Cationic, neutral, and anionic arsenic and antimony halides formed binary arsenic and antimony azide species M(N(3))(4)(+), M(N(3))(4)(-), and M(N(3))(6)(-) (M = As, Sb) upon reaction with trimethylsilyl azide or sodium azide. The compounds were obtained as pure substances or salts, and their identity was established by vibrational spectroscopy and multinuclear NMR spectroscopy and partially by elemental analysis. Attempts to synthesize pentaazides, M(N(3))(5) (M = As, Sb), failed due to spontaneous decomposition of the compounds. Density functional theory (B3LYP) was applied to calculate structural and vibrational data. Vibrational assignments of the normal modes for the isolated azide compounds were made on the basis of their vibrational spectra in comparison with computational results. The molecular structures and vibrational spectra of the arsenic and antimony pentaazides have been investigated theoretically. These calculations (B3LYP) show minima structures (NIMAG = 0) for all reported compounds. It is shown that the M(N(3))(4)(+) (M = As, Sb) cations exhibit ideal S(4) symmetry and the M(N(3))(6)(-) anions (M = As, Sb) ideal S(6) symmetry. The structure of the hexaazidoarsenate(V) has been determined by X-ray diffraction as its pyridinium salt. [py-H][As(N(3))(6)] crystallizes in the triclinic space group P with a = 6.8484(7), b = 7.3957(8), and c = 8.0903(8) A, alpha = 91.017(2), beta = 113.235(2), and gamma = 91.732(2) degrees, V = 376.29(7) A(3), and Z = 1. The structure of the As(N(3))(6)(-) anion exhibits only S(2) symmetry but shows approximately S(6) symmetry. The calculated and experimentally observed structure as well as the calculated and observed IR and Raman frequencies for all azide species (except M(N(3))(5)) are in reasonable agreement.

Journal Article↗
PubMed2002

Antimony ethylene glycolate and catecholate compounds: structural characterization of polyesterification catalysts.

Antimony compounds are widely used as catalysts for the synthesis of the commercially important polymer poly(ethyleneterephthalate) by polycondensation of bis(hydroxyethyl)terephthalate. The precise nature of the antimony catalysts is, however, unknown. The present study has been conducted with a view to determining the nature of the catalytic species by structurally characterizing antimony ethylene glycolate compounds and related catecholate derivatives, namely [Sb(2)(OCH(2)CH(2)O)(3)](n), [Sb(OCH(2)CH(2)O)(OAc)](n), [pySb(1,2-O(2)C(6)H(4))](2)O, and [pyH][Sb(1,2-O(2)C(6)H(4))(2)].

Journal Article↗
PubMed1998

Sulfur-Bridged Sandwich Cubane-Type Molybdenum-Antimony Cluster. Synthesis, X-ray Structure, and (121)Sb Mössbauer Spectra of [(H(2)O)(9)Mo(3)S(4)SbS(4)Mo(3)(H(2)O)(9)](CH(3)C(6)H(4)SO(3))(8).24H(2)O.

A sulfur-bridged sandwich cubane-type molybdenum-antimony cluster [(H(2)O)(9)Mo(3)S(4)SbS(4)Mo(3)(H(2)O)(9)](8+) (2) has been synthesized through the reaction of incomplete cubane-type molybdenum cluster [Mo(3)S(4)(H(2)O)(9)](4+) (1) with antimony metal, and has been isolated as 2(pts)(8).24H(2)O (2.pts) (Hpts = p-toluenesulfonic acid), whose structure has been characterized by X-ray crystallography. Crystal data of 2.pts: triclinic, space group P&onemacr;, a = 14.468(3) Å, b = 18.531(5) Å, c = 13.713(6) Å, alpha = 105.26(2) degrees, beta = 119.71(1) degrees, gamma = 72.48(3) degrees, V = 3016(1) Å(3), Z = 1, D(calcd) = 1.696 g cm(-)(3), D(obsd) = 1.72 g cm(-)(3), R (R(w)) = 4.7 (7.5) for 6593 reflections (I > 2.0sigma(I)). The Mo-Sb distances (3.68[2]) Å) are much longer than the Mo-Mo (2.717[7] Å) distances. Peak positions and epsilon values (lambda(max), nm (epsilon, M(-)(1) cm(-)(1))) of the electronic spectrum of 2.pts in 2 M HCl are 384 (13 220), 625 (10 440), and 700 (10 080). The (121)Sb Mössbauer parameters (delta = -2.64 mm s(-)(1), e(2)qQ = 18.1 mm s(-)(1), eta = 0.29), and the binding energies (eV) and full widths at half-maximum (in parentheses, eV) obtained from XPS spectrum (Sb(3d3/2), 540.3(2.3); Mo(3d3/2), 233.2(2.1); Mo(3d5/2), 230.2(1.9); (C(1s) = 285.0)) of 2.pts indicate that the oxidation number of antimony is III, and the mean oxidation number of molybdenum is +3.5.

Journal Article↗
PubMed2004

What is the weighing form in gravimetric determination of antimony(III) with oxine?

The gravimetric analysis of antimony(III) with oxine (8-quinolinol, Hox) was studied. The amount of antimony left in filtrate and washing solutions was corrected with the results of atomic absorption spectrometry. The weighing form, which had not been conclusive before the present study, was determined to be SbO(ox)(Hox)2. The result (purity of antimony(II) oxide: 99.84 +/- 0.05% (m/m)) of the gravimetric analysis was in good agreement with that of coulometric titration with electrogenerated iodine.

Journal Article↗
PubMed1985

Leishmania mexicana: enzyme activities of amastigotes and promastigotes and their inhibition by antimonials and arsenicals.

A major difference between the metabolism of Leishmania species amastigotes and cultured promastigotes was found in the area of CO2 fixation and phosphoenolpyruvate metabolism. Malate dehydrogenase (EC 1.1.1.37) and phosphoenolpyruvate carboxykinase (EC 4.1.1.49) were at much higher activities in amastigotes than promastigotes of both L. m. mexicana and L. donovani, whereas the reverse was true of pyruvate kinase (EC 2.7.1.40). Pyruvate carboxylase (EC 6.4.1.1) and malic enzyme (carboxylating) (EC 1.1.1.40) could not be detected in L. m. mexicana amastigotes. Promastigotes of L. m. mexicana had a high NAD-linked glutamate dehydrogenase activity in comparison to amastigotes, whereas NADP-linked glutamate dehydrogenase activity was detected only in amastigotes. Leishmania m. mexicana culture promastigotes were killed in vitro by the trivalent antimonial Triostam (LD50, 20 micrograms/ml) and the trivalent arsenical melarsen oxide (LD50, 20 micrograms/ml), but they were unaffected by Pentostam. Neither antimonial drug significantly inhibited leishmanial hexokinase (EC 2.7.1.2), phosphofructokinase (EC 2.7.1.11), pyruvate kinase, malate dehydrogenase or phosphoenolpyruvate carboxykinase, whereas melarsen oxide was a potent inhibitor of all the enzymes tested except phosphoenolpyruvate carboxykinase.

Animals↗
PubMed2005

Canine visceral leishmaniasis: comparison of in vitro leishmanicidal activity of marbofloxacin, meglumine antimoniate and sodium stibogluconate.

The control of canine leishmaniasis largely depends on the success of treatment. Drugs currently available to treat this disease are toxic and partially effective. The curative effect of marbofloxacin, a third-generation fluoroquinolone developed for veterinarian individual treatment, was evaluated in vitro in the presence of Leishmania infantum promastigotes and dog-monocyte-derived macrophages; meglumine antimoniate and sodium stibogluconate were used as comparative treatments. We observed that the killing of Leishmania promastigotes and intracellular amastigotes by marbofloxacin was dose-dependent. We demonstrated that successful treatment of canine infected macrophages for 48 h was possible with 500 microg/ml of marbofloxacin. Leishmanicidal activity acted through a TNF-alpha and nitric oxide pathway and correlated with the generation of nitric oxide (NO(2)) production by monocytes derived macrophages from infected (23+/-5 microM) or healthy (21+/-6 microM) dogs, in comparison with NO(2) concentration in infected/non-treated macrophages (< 3 microM, P<0.01). This significant induced parasiticidal effect correlated with extensive elimination of amastigotes by macrophages derived from infected (11+/-5) and healthy dogs (6+/-2), when compared to infected/non-treated macrophages (530+/-105 and 472+/-86 amastigotes, respectively, P< 0.01). Marbofloxacin was shown to be non-toxic at 500 microg/ml in vitro and no cell apoptosis was observed. The molecule was able to induce a parasitic process after significant elimination of amastigotes in leishmania-infected dog macrophages. We propose that marbofloxacin, compared to standard chemotherapeutic agents (meglumine antimoniate and sodium stibogluconate), could be an effective and pragmatic oral route alternative to treat canine leishmaniasis.

Animals↗
PubMed1998

Axenically grown amastigotes of Leishmania infantum used as an in vitro model to investigate the pentavalent antimony mode of action.

The mechanism(s) of activity of pentavalent antimony [Sb(V)] is poorly understood. In a recent study, we have shown that potassium antimonyl tartrate, a trivalent antimonial [Sb(III)], was substantially more potent than Sb(V) against both promastigotes and axenically grown amastigotes of three Leishmania species, supporting the idea of an in vivo metabolic conversion of Sb(V) into Sb(III). We report that amastigotes of Leishmania infantum cultured under axenic conditions were poorly susceptible to meglumine [Glucantime; an Sb(V)], unlike those growing inside THP-1 cells (50% inhibitory concentrations [IC50s], about 1.8 mg/ml and 22 microg/ml, respectively). In order to define more precisely the mode of action of Sb(V) agents in vivo, we first induced in vitro Sb(III) resistance by direct drug pressure on axenically grown amastigotes of L. infantum. Then we determined the susceptibilities of both extracellular and intracellular chemoresistant amastigotes to the Sb(V)-containing drugs meglumine and sodium stibogluconate plus m-chlorocresol (Pentostam). The chemoresistant amastigotes LdiR2, LdiR10, and LdiR20 were 14, 26, and 32 times more resistant to Sb(III), respectively, than the wild-type one (LdiWT). In accordance with the hypothesis described above, we found that intracellular chemoresistant amastigotes were resistant to meglumine [Sb(V)] in proportion to the initial level of Sb(III)-induced resistance. By contrast, Sb(III)-resistant cells were very susceptible to sodium stibogluconate. This lack of cross-resistance is probably due to the presence in this reagent of m-chlorocresol, which we found to be more toxic than Sb(III) to L. infantum amastigotes (IC50s, of 0.54 and 1.32 microg/ml, respectively). Collectively, these results were consistent with the hypothesis of an intramacrophagic metabolic conversion of Sb(V) into trivalent compounds, which in turn became readily toxic to the Leishmania amastigote stage.

Animals↗
PubMed2005

Role of the ABC transporter MRPA (PGPA) in antimony resistance in Leishmania infantum axenic and intracellular amastigotes.

Antimonial compounds are the mainstay for the treatment of infections with the protozoan parasite Leishmania. We present our studies on Leishmania infantum amastigote parasites selected for resistance to potassium antimonyl tartrate [Sb(III)]. Inside macrophages, the Sb(III)-selected cells are cross-resistant to sodium stibogluconate (Pentostam), the main drug used against Leishmania. Putative alterations in the level of expression of more than 40 genes were compared between susceptible and resistant axenic amastigotes using customized DNA microarrays. The expression of three genes coding for the ABC transporter MRPA (PGPA), S-adenosylhomocysteine hydrolase, and folylpolyglutamate synthase was found to be consistently increased. The levels of cysteine were found to be increased in the mutant. Transfection of the MRPA gene was shown to confer sodium stibogluconate resistance in intracellular parasites. This MRPA-mediated resistance could be reverted by using the glutathione biosynthesis-specific inhibitor buthionine sulfoximine. These results highlight for the first time the role of MRPA in antimony resistance in the amastigote stage of the parasite and suggest a strategy for reversing resistance.

ATP-Binding Cassette Transporters↗
PubMed2002

Antimonial therapy induces circulating proinflammatory cytokines in patients with cutaneous leishmaniasis.

The objective of this study was to evaluate the association between antimonial therapy and circulating levels of proinflammatory cytokines in patients with cutaneous leishmaniasis (CL). Patients were treated with conventional chemotherapy by using pentavalent antimonium salts (Glucantime) for 3 weeks. Circulating plasma levels of the proinflammatory cytokines interleukin-1beta (IL-1beta), IL-6, IL-8, and tumor necrosis factor alpha (TNF-alpha) were determined for CL patients and healthy subjects before and 3 weeks after the treatment was started. Plasma IL-1beta, IL-6, IL-8, and TNF-alpha levels were significantly higher for pretreatment CL patients than for healthy subjects. Proinflammatory cytokines significantly increased after 21 days postinfection compared to levels for the pretreatment patients. These increments were approximately 3-fold for IL-1beta and TNF-alpha levels, 10-fold for IL-6 levels, and 20-fold for IL-8 levels in patients with CL. Taken together these results indicate that circulating proinflammatory cytokine levels were increased in patients with CL as a consequence of host defense strategies, and antimonial therapy may induce these cytokines by affecting the macrophage or other components of the host defense system.

Adolescent↗
PubMed2003

Treatment of Old World cutaneous leishmaniasis with intralesionally injected meglumine antimoniate using a Dermojet device.

Pentavalent antimonial compounds, the mainstay in the treatment of the various forms of leishmaniasis, have considerable toxicity, are difficult to administer and expensive. We describe a safe and efficient therapeutic modality using a spring-loaded and air-powered device for the intralesional injection of a high-velocity meglumine antimoniate microspray in a patient with cutaneous leishmaniasis.

Adolescent↗
PubMedDate not supplied

[The evaluation of the tolerance and nephrotoxicity of pentavalent antimony administered in a dose of 40 mg Sb V/kg/day, 12/12 hr, for 30 days in the mucocutaneous form of leishmaniasis].

The renal function of eleven patients with mucocutaneous leishmaniasis was analyzed in a prospective study realized at the School Hospital of University of Brasília. The patients were treated with doses of 40 mg/kg/day of pentavalent antimony (Sb V), in a continuous scheme during thirty days. In this study three patients were excluded, one patient with reversible renal failure and two patients with hepatic and cardiac malfunctions. In the other eight patients, severe nephrotoxic effects were observed, like reduction of glomerular filtration rate, reduction of the urinary concentration capacity, evaluated by a sixteen hours hydric fasting and an increase of sodium fractional excretion. An increase in the number of leucocytes and cylinders were observed at the urinary sediment exam. Finally, the results shows that the treatment with pentavalent antimony in doses of 40 mg Sb/kg/day was less tolerated on account of its renal toxic effects. This scheme seems not be superior than the currently preconized scheme of 20 mg of Sb V/kg/day during 30 days.

Adolescent↗
PubMed1990

Quantitative in vitro drug potency and drug susceptibility evaluation of Leishmania ssp. from patients unresponsive to pentavalent antimony therapy.

Quantitative in vitro drug sensitivity of 32 Leishmania isolates (16 from patients failing pentavalent antimony [SbV] therapy) was determined using a radiorespirometric microtechnique (RAM). Of 30 isolates with histories, 22 (73%) RAM tests agreed with patient history; the remaining 8 (27%) did not. There was no difference in RAM drug sensitivity: clinical correlation between 15 isolates tested blindly and 15 with known clinical history (4 did not agree with clinical history in both). Test sensitivity appeared to be limited only by the sensitivity of the Leishmania to SbV and could be detected at 2 micrograms/ml Sb (about 10% of serum drug level). An isolate from a patient with untreated self-healing cutaneous disease was drug resistant. Using RAM, parasite drug sensitivity can be quantified apart from patient physiologic and immunologic variables intrinsic to clinical data. Potency differed a maximum of 100% (weight% Sb:weight% Sb) among drug lots and also between Glucantime and Pentostam. Potency changes between drug lots were not explainable based on Sb content or test-to-test variability. This microtest offers a rapid method for evaluating the drug sensitivity of patient isolates and for determining of the activity of pentavalent antimonials and other candidate anti-leishmanials prior to the initiation of therapy.

Adenosine↗
PubMed1996

Pentavalent antimony-mannan conjugate therapy of experimental visceral leishmaniasis.

Pentavalent antimony-mannan (Sb[V]-mannan) was 10-fold more potent than sodium stibogluconate in a murine model of visceral leishmaniasis. Liver antimony concentrations were six-fold higher after Sb[V]-mannan therapy compared with a dose of sodium stibogluconate that was equipotent in reducing liver parasite burdens. Murine toxicity of Sb[V]-mannan was variable, with a 50% lethal dose (LD50) for one preparation that was well above the concentration that killed 90% of the parasites, and for another preparation was only modestly higher than the concentration that killed 90% of the parasites.

Animals↗
PubMed1999

High frequency of serious side effects from meglumine antimoniate given without an upper limit dose for the treatment of visceral leishmaniasis in human immunodeficiency virus type-1-infected patients.

Organic pentavalent antimonials are one of the mainstays of treatment for visceral leishmaniasis (VL). Few data are available on the toxicity and efficacy of these drugs at the dosing schedule recommended by the Centers for Disease Control and Prevention (CDC) (Atlanta, GA). We analyzed 25 VL episodes in human immunodeficiency virus (HIV)-infected patients who were treated with meglumine antimoniate (MA) at the CDC-recommended dose in southern Spain. Adverse effects were observed in 14 (56%) VL episodes. In 7 (28%), treatment with MA was permanently discontinued due to serious adverse effects that included acute pancreatitis, acute renal failure, and leukopenia. Three (12%) patients died during therapy due to severe acute pancreatitis attributable to MA. The dosing regimen of MA currently recommended for treating VL is associated with a high rate of serious side effects in HIV-1-infected patients.

Adult↗
PubMed2001

Electrocardiographic findings in Ethiopians on pentavalent antimony therapy for visceral leishmaniasis.

BACKGROUND: The old short course regimens of pentavalent antimonial (sb(v)) therapy of visceral leishmaniasis (VL) have largely been abandoned worldwide as they are associated with increasing problems of relapse and unresponsiveness. In Ethiopia, some hospitals still use the old interrupted and short course regimen partly because of fear of drug toxicity. OBJECTIVE: To evaluate the safety of the WHO recommended uninterrupted therapy at a dose of 20 mg sb(v)/kg for up to thirty days. DESIGN: A prospective study. SETTING: Patients were recruited from Addis Ababa hospitals and from Konso VL endemic area in southern Ethiopia. SUBJECTS: Forty nine patients who included, ten HIV-positive and 39 HIV-negative, were enrolled for the study. RESULTS: Twenty three HIV-negative patients got treatment for 20 days and the rest, 16 HIV-negative and 10 HIV-positive, were treated for 28 to 30 days. Among HIV-seronegatives, the mean QT interval corrected for heart rate (QTc) at the end of therapy in patients treated for 20 days and 28-30 days was comparable (0.419 +/- 0.031 seconds versus 0.424 +/- 0.027 seconds, respectively). Among patients treated for 28-30 days, the mean QTc in HIV co-infected patients was comparable to that of HIV-negatives (0.416 +/- 0.018 seconds versus 0.424 +/- 0.027). Comparable rates of new ECG changes involving the T waves were observed in two HIV-positive (20%) and two HIV-negative (12.5%) patients treated for 28-30 days, and in seven (30.4%) HIV-negative patients treated for 20 days. Overall, only two (4.1%) patients (all HIV-negative males) had QTc interval > or = 0.50 seconds at the end of therapy. In one patient, the prolonged QTc was noted on the twentieth day with bradycardia of 44/minute. CONCLUSIONS: In Ethiopian VL patients with normal renal function, sb(v) therapy at a daily dose of 20 mg/kg for up to 30 days is safe and only rarely associated with clinically significant bradycardia which resolves after temporary cessation of therapy. Furthermore, in areas with limited facilities, monitoring the pulse rate during antimonial therapy may help detect impending cardiotoxicity.

Adolescent↗
PubMed1991

Development of Leishmania (Viannia) panamensis lesions and relationship of numbers of amastigotes to lesion area on antimony-treated and untreated hamsters.

Young adult (60-70-g) male golden hamsters (Mesocricetus auratus) each were injected intradermally at the dorsal base of the tail with 15 x 10(6) promastigotes of Leishmania (Viannia) panamensis (MHOM/PA/83/WR539), and progression and regression of subsequent lesions were evaluated for up to 17 wk postinfection (PI) as to area, weight, and number of amastigotes within lesions in untreated hamsters and in hamsters treated with meglumine antimoniate (Glucantime). In untreated hamsters total area of lesion, weight, and numbers of amastigotes generally increased rapidly and concomitantly up to 3-4 wk PI. Amastigote numbers tended to decrease from 4 to 11 wk PI and subsequently the numbers of amastigotes within the lesions decreased rapidly, whereas relatively little change occurred in the area and weight of the lesions. Meglumine antimoniate treatment of cutaneous hamster lesions resulted in marked concomitant decrease in size of the lesions and numbers of amastigotes within the lesions examined 1 wk after treatment. Measurement of the area of cutaneous leishmanial lesions thus would appear to be a valid method of evaluating the efficacy of promising compounds against L. panamensis in hamsters when measurements are taken 3-5 wk after experimental infection and reflects the number of amastigotes present in the lesion.

Animals↗