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At least 19 recordsLinked to original sources
PubMed2001

Glutathione-induced conversion of pentavalent antimony to trivalent antimony in meglumine antimoniate.

The standard treatment of human leishmaniases involves the use of pentavalent antimony [Sb(V)] compounds, including meglumine antimoniate. The mode of action of these compounds has not been fully elucidated. The possibility that Sb(III) is involved has been suggested; however, the biomolecule that may induce the conversion of Sb(V) to Sb(III) has not yet been identified. In the present study, we investigated both the ability of reduced glutathione (GSH) to promote the reduction of Sb(V) into Sb(III) in meglumine antimoniate and the effects of pH and temperature on this transformation. GSH did promote the reduction of Sb(V) into Sb(III) in a dose-dependent manner. When GSH and meglumine antimoniate were incubated together at a GSH/Sb molar ratio superior or equal to 5:1, all antimony was encountered in the reduced form, indicating a stoichiometry of 5:1 between GSH and Sb(V) in the reaction. The reaction between Sb(V) and GSH was favored at an acidic pH (pH 5) and an elevated temperature (37 degrees C), conditions found within the phagolysosome, in which Leishmania resides. For instance, about 30% of the Sb(V) (concentration, 2mM) was converted to Sb(III) following incubation for 3 days with 10 mM GSH at pH 5 and 37 degrees C. Our data support the hypothesis that Sb(V) would be converted by GSH, or a related thiol compound, to more toxic Sb(III) in the phagolysosome of macrophages.

Antimony↗
PubMed1981

Potent heme-degrading action of antimony and antimony-containing parasiticidal agents.

The ability of antimony and antimony-containing parasiticidal agents to enhance the rate of heme degradation in liver and kidney was investigated. Trivalent antimony was shown to be an extremely potent inducer of heme oxygenase, the initial and rate-limiting enzyme in heme degradation, in both organs, whereas the pentavalent form was a weak inducer of this enzyme. The ability of antimony to induce heme oxygenase was dose-dependent, independent of the salt used, and not a result of a direct activation of the enzyme in vitro. Concomitant with heme oxygenase induction by antimony, microsomal heme and cytochrome P-450 contents decreased, the cyto-chrome P-450-dependent mixed function oxidase system was impaired, and delta-ami-nolevulinate synthase (ALAS), the rate-limiting enzyme of heme synthesis, underwent the sequential changes-initial inhibition followed by rebound induction-usually associated with the administration of transition elements such as cobalt. Antimony induction of heme oxygenase however, unlike the enzyme induction elicited by cobalt, was not prevented either by cysteine administered orally or as a cysteine metal complex, or by simultaneous zinc administration. Desferoxamine also did not block heme oxygenase induction by antimony, but this chelator did prevent the rebound increase in ALAS activity associated with antimony or cobalt treatment. Antimony-containing parasiticidal drugs were also potent inducers of heme oxygenase in liver and kidney. The heme degradative action of these drugs may be related in part to the jaundice commonly associated with the prolonged therapeutic use of these agents. The heme-oxygenase-inducing action of antimony-containing parasiticidal drugs is a newly defined biological property of these compounds. The relation between the parasiticidal and the heme-oxygenase-inducing actions of such drugs is unknown. However, certain parasites contain hemoproteins or require heme compounds during their life cycle. It may therefore be useful to explore the possibility that the heme-degrading and the parasiticidal actions of certain metals or metal-containing therapeutic agents are in some way related.

5-Aminolevulinate Synthetase↗
PubMed2002

In vitro susceptibility to pentavalent antimony in Leishmania infantum strains is not modified during in vitro or in vivo passages but is modified after host treatment with meglumine antimoniate.

BACKGROUND: Leishmaniasis is a common parasitic disease in Southern Europe, caused by Leishmania infantum. The failures of current treatment with pentavalent antimonials are partially attributable to the emergence of antimony-resistant Leishmania strains. This study analyses the in vitro susceptibility to pentavalent antimony of intracellular amastigotes from a range of L. infantum strains, derived from the same infected animal, during in vitro and in vivo passages and after host treatment with meglumine antimoniate. RESULTS: SbV-IC50 values for strains from two distinct isolates from the same host and one stock after two years of culture in NNN medium and posterior passage to hamster were similar (5.0 +/- 0.2; 4.9 +/- 0.2 and 4.4 +/- 0.1 mgSbV/L, respectively). In contrast, a significant difference (P < 0.01, t test) was observed between the mean SbV-IC50 values in the stocks obtained before and after treatment of hosts with meglumine antimoniate (4.7 +/- 0.4 mgSbV/L vs. 7.7 +/- 1.5 mgSbV/L). Drug-resistance after drug pressure in experimentally infected dogs increased over repeated drug administration (6.4 +/- 0.5 mgSbV/L after first treatment vs. 8.6 +/- 1.4 mgSbV/L after the second) (P < 0.01, t test). CONCLUSIONS: These results confirm previous observations on strains from Leishmania/HIV co-infected patients and indicate the effect of the increasing use of antimony derivatives for treatment of canine leishmaniasis in endemic areas on the emergence of Leishmania antimony-resistant strains.

Animals↗
PubMedDate not supplied

Combination allopurinol and antimony treatment versus antimony alone and allopurinol alone in the treatment of canine leishmaniasis (96 cases).

The aim of the present study was to evaluate the long-term clinical outcome for dogs with leishmaniasis that were treated with 3 different protocols: combined treatment with antimony and allopurinol, antimony alone, or allopurinol alone. Ninety-six dogs included in this study were determined to have leishmaniasis on the basis of (1) clinical features, (2) identification of the parasite in smears of lymph node, bone marrow aspirates, or skin biopsies, and (3) specific immunofluorescent assay. Three groups of dogs were defined: 45 dogs (group 1) were treated with antimony (100 mg/kg s.c. q24h) given concurrently for 1 month with allopurinol (15 mg/kg p.o. q12h), and then allopurinol alone for 8 months at the same dosage; 40 dogs (group 2) were treated with antimony alone according to the manufacturer's instructions (200 mg/kg s.c. q24h at 2-day intervals for 3-6 months); and 11 dogs (group 3) were treated with allopurinol alone (15 mg/kg p.o. q12h for 1-20 months). Information concerning signalment, history, physical examination findings, serologic testing and number of dogs becoming seronegative, outcome for each treated dog (clinical cure versus failure), and long-term survival were recorded. The numbers of the clinical cures versus failures were significantly different among the 3 groups (chi2 = 17.77, P < .001), between groups 1 and 2 (chi2 = 8.02, P < .01), between groups 2 and 3 (chi2 = 11.00, P < .01), and between groups 1 and 3 (chi2 = 16.52, P < .001). No significant difference between groups 1 and 2 was noted in the type of failure (relapse or death), serologic test results, and number of survival years (chi2 = 2.79, P > .05). The results of the present study indicate that antimony in combination with allopurinol produces better results than antimony alone or allopurinol alone for the treatment of the canine leishmaniasis. With combination treatment, duration of treatment with antimony is shorter and long-term administration of allopurinol is well tolerated.

Allopurinol↗
PubMed1996

Disposition of antimony after the administration of N-methylglucamine antimoniate to dogs.

A study was carried out in dogs to define the pharmacokinetic profile of antimony and to define a better therapeutic protocol for the treatment of canine leishmaniasis. Six healthy beagle dogs received 100 mg/kg of N-methylglucamine antimoniate containing 27.2 per cent of antimony intravenously, intramuscularly and subcutaneously. After intravenous administration the plasma concentration of antimony decreased rapidly and after 240 minutes it was lower than the ED50 values suggested for Leishmania donovani. The pharmacokinetic parameters and bioavailability of antimony were calculated after each route of administration in each dog. The curves of plasma concentrations vs time were best described by a triexponential open model with a mean (sd) half life t1/2 alpha of 9.4 (4.4) min, a t1/2 beta of 45.3 (4.5) min and a t1/2 gamma of 618.0 (93.5) min. The mean volume of distribution at steady state was 0.25 (0.03) litres/kg and the total body clearance was 0.25 (0.04) litres/h/kg. The peak plasma concentration (Cmax) after intramuscular administration was 27.2 (3.1) micrograms/ml, and after subcutaneous administration it was 25.5 (4.5) micrograms/ml; they were reached after 73.6 (11.9) min and 85.6 (11.3) min, respectively. The bioavailabilities after intramuscular and subcutaneous administration were 91.7 (7.1) and 92.2 (7.1) per cent, respectively. More than 80 per cent of the antimony was excreted in the urine in the first nine hours.

Animals↗
PubMed2000

Speciation of antimony(III) and antimony(V) in cell extracts by anion chromatography/inductively coupled plasma mass spectrometry.

An analytical method for the separation and quantification of Sb(III) and Sb(V) using anion chromatography with ICP-MS is presented. The optimum conditions for the separation of the antimony species were established with 15 mmol/L nitric acid at pH 6 as eluent system on a PRP-X100 column. The retention times for antimony(V) and antimony(III) were 85 s and 300 s with detection limits of 0.06 microg/L and 0.29 microg/L, respectively. The proposed method was applied to cell extracts of Leishmania donovani, which were incubated with antimony(III) and antimony(V). Some metabolism seemed to occur within the cells.

Animals↗
PubMed2002

The MRP1-mediated effluxes of arsenic and antimony do not require arsenic-glutathione and antimony-glutathione complex formation.

Arsenic trioxide is an effective treatment for acute promyelocytic leukemia, but resistance to metalloid salts is found in humans. Using atomic absorption spectroscopy, we have measured the rate of uptake of arsenic trioxide and of antimony tartrate in GLC4 and GLC4/ADR cells overexpressing MRP1 and the rate of their MRP1-mediated effluxes as a function of the intracellular GSH concentration. In sensitive cells, after 1 h, a pseudosteady state is reached where intra- and extracellular concentrations of metalloid are the same. This precludes the formation, at short term, of complexes between arsenic or antimony with GSH. In resistant cells reduced intracellular accumulation of arsenic (or antimony), reflecting an increased rate of arsenic (or antimony) efflux from the cells, is observed. No efflux of the metalloid is observed in GSH depleted cells. The two metalloids and GSH are pumped out by MRP1 with the same efficiency. Moreover for the three compounds 50% of the efflux is inhibited by 2 microM MK571. This led us to suggest that As- and Sb-containing species could be cotransported with GSH.

Antimony↗
PubMed2000

Antimony excretion in a patient with renal impairment during meglumine antimoniate therapy.

Meglumine antimoniate was administered to a patient with visceral leishmaniasis with normal renal function. Soon after the first intramuscular administration of meglumine antimoniate 20 mg/kg, equivalent to 510 mg antimony (Sb), the patient developed septic shock with oliguria. Creatinine clearance decreased to 23 ml/minute. Treatment was discontinued, and Sb urinary excretion was measured. After the initial dose, 500.25 mg Sb was recovered in urine over 8 days, corresponding to 98% of the amount of Sb given intramuscularly (66% eliminated within first 48 hrs). Nine days after the dose, meglumine antimoniate was reintroduced at a dosage of 11.7 mg/kg (equivalent to 300 mg Sb) every 48 hours with good tolerance. At that time creatinine clearance had returned to 87.8 ml/minute. By day 14 of therapy the interval was reduced to daily administration of the same dose; the dosage was increased to 16.6 mg/kg/day (equivalent to 425 mg Sb) from day 17 to day 31. The patient eventually completely recovered and was discharged with normal renal function. Although no specific guidelines exist for dosage adjustment in renal failure, monitoring of Sb urinary excretion indicates that the kidneys are the almost exclusive route of elimination.

Antimony↗
PubMed2003

Thiol-induced reduction of antimony(V) into antimony(III): a comparative study with trypanothione, cysteinyl-glycine, cysteine and glutathione.

Gluthathione (GSH) has been previously shown to promote the reduction of pentavalent antimony (Sb(V)) into the more toxic trivalent antimony (Sb(II)) in the antimonial drug, meglumine antimonate. However, this reaction occurred at acidic pH (pH 5) but not at the pH of the cytosol (pH 7.2) in which GSH is encountered. The aim of the present study was to further characterize the reaction between thiols and antimonial drugs, addressing the following aspects: (i) the reducing activity of cysteine (Cys) and cysteinyl-glycine (Cys-Gly), expected to be the predominant thiols in the acidic compartments of mammalian cells; (ii) the reducing activity of trypanothione (T(SH)2), the main intracellular thiol in Leishmania parasites; (iii) the influence of the state of complexation of Sb(V) on the rate of Sb(V) reduction. We report here that Cys, Cys-Gly and T(SH)2 did promote the reduction of Sb(V) into Sb(III) at 37 degrees C. Strikingly, the initial rates of reduction of Sb(V) were much greater in the presence of Cys-Gly, Cys and T(SH)2 than in the presence of GSH. These reactions occurred at both pH 5 and pH 7 but were favored at acidic pH. Moreover, our data shows that Sb(V) is reduced more slowly in the form of meglumine antimonate than in its non-complexed form, indicating that the complexation of Sb(V) tends to slow down the rate of its reduction. In conclusion, our data supports the hypothesis that Sb(V) is reduced in vivo by T(SH)2 within Leishmania parasites and by Cys or Cys-Gly within the acidic compartments of mammalian cells.

Antimony↗
PubMed2003

Antimony uptake systems in the protozoan parasite Leishmania and accumulation differences in antimony-resistant parasites.

The first line drug against leishmaniasis consists of pentavalent antimony [Sb(V)], but there is general belief that the active form of the metal is the trivalent form [Sb(III)]. In this study, we have quantified the accumulation of Sb(V) and Sb(III) in Leishmania by using inductively coupled plasma mass spectrometry. The accumulation was studied in three Leishmania species at various life stages, sensitive or resistant to antimony. Both Sb(III) and Sb(V) are accumulated in promastigote and amastigote parasites, but through competition experiments with arsenite, we found that the routes of entry of Sb(V) and Sb(III) are likely to differ in Leishmania. The level of accumulation of either Sb(III) or Sb(V), however, was not correlated with the susceptibility of wild-type Leishmania cells to antimony. This suggests that other factors may also be implicated in the mode of action of the drugs. In contrast to metal susceptibility, resistance to Sb(III) correlated well with decreased antimony accumulation. This phenotype was energy dependent and highlights the importance of transport systems in drug resistance of this protozoan parasite.

2,4-Dinitrophenol↗
PubMed2003

The efficacy of treatment with intralesional meglumine antimoniate alone, compared with that of cryotherapy combined with the meglumine antimoniate or intralesional sodium stibogluconate, in the treatment of cutaneous leishmaniasis.

It would be very useful to have a more effective and more rapid method available for the treatment of cutaneous leishmaniasis (CL). The main aim of the present, Iranian study, was to see if the combination of cryotherapy and intralesional injections with meglumine antimoniate (C + MA) would be more effective than the injections given alone (MA) or the combination of cryotherapy plus intralesional sodium stibogluconate (C + SS). Forty patients (with 67 lesions) were treated with C + MA, another 40 (with 65 lesions) were treated with C + SS and 100 patients (with 180 lesions) were treated with MA. Follow-up for 6 months after the final treatment indicated that 89.5% of the lesions treated with C + MA, 92.3% of those treated with C + SS but only 50% of the lesions treated with MA only were completely cured. The frequencies of cure in the two cryotherapy groups were similar, both being significantly higher than that in the MA group (P < 0.05). The combination of cryotherapy with intralesional injections of meglumine antimoniate or sodium stibogluconate, which is much more effective than the use of intralesional meglumine antimoniate alone, should be promoted.

Adolescent↗
PubMed2003

Reduction of pentavalent antimony by trypanothione and formation of a binary and ternary complex of antimony(III) and trypanothione.

Several pentavalent antimony compounds have been used for the treatment of leishmaniasis for decades. However, the mechanism of these antimony drugs still remains unclear. One of their targets is thought to be trypanothione, a major low molecular mass thiol inside the parasite. We show that pentavalent antimony (Sb(V)) can be rapidly reduced to its trivalent state by trypanothione at mildly acidic conditions and 310 K ( k=4.42 M(-1) x min(-1) at pH 6.4), and that Sb(III) can be bound to trypanothione to form an Sb(III)-trypanothione complex. NMR data demonstrate that Sb(III) binds to trypanothione at the two thiolates of the cysteine residues, and that the binding is pH dependent and is strongest at biological pH with a stability constant log K=23.6 at 298 K (0.1 M NaNO(3)). The addition of low molecular monothiol ligands such as glutathione and cysteine to the Sb(III)-trypanothione complex results in the formation of a ternary complex. Thiolates from both trypanothione and monothiol bind to the Sb(III) center. The formation of the ternary complex is important, as the antileishmanial properties of the drugs are probably due to a complex between of Sb(III)-trypanothione and enzymes. Although thermodynamically stable, the complex is kinetically labile and the free and bound forms of thiolates exchange on the (1)H NMR timescale. Such a facile exchange may be crucial for the transport of Sb(III) within parasites.

Antimony↗
PubMed2003

American cutaneous leishmaniasis unresponsive to antimonial drugs: successful treatment using combination of N-methilglucamine antimoniate plus pentoxifylline.

BACKGROUND: American cutaneous leishmaniasis is characterized by single or multiple ulcerations. Cytokines, among other factors, have been shown to influence lesion development and tumoral necrosis factor-alpha is a major cytokine implicated in pathogenesis of ulcers. OBSERVATIONS: We tested oral pentoxifylline, a known tumoral necrosis factor-alpha inhibitor, at doses of 400 mg (2-3x/day), associated to N-methylglucamine antimoniate (15 mg/kg/day) in two patients with American cutaneous leishmaniasis unresponsive to antimonial drugs. We observed a satisfactory response with quick cure of skin lesions of these patients. CONCLUSIONS: Our results suggest that oral pentoxifylline in association to N-methylglucamine antimoniate should be consider in refractory cutaneous leishmaniasis patients.

Administration, Oral↗
PubMed2001

[Direct determination of selenium and bismuth in antimony and antimony compound by hydride generation-atomic fluorescence spectrometry].

The interference of Sb in determination of Se and Bi in antimony powder and antimony compound has been studied in different acidity, it is found that the interference of antimony has been reduced apparently in high acidity. Simultaneously, according to the difference of hydride generation reaction between Sb5+ and Sb3+, a sensitive and rapid method has been developed and used to determine Se and Bi in real samples. The recovery of the method is 95%-105% for practical samples. Detection limits are 0.00004 x 10(-2) (content) for Se and 0.0001 x 10(-2) mg.L-1 (content) for Bi respectively. The relative standard deviations of Se are 2.4% (content = 0.00169 x 10(-2) mg.L-1) and 5.4% (content = 0.00056 x 10(-2) mg.L-1). The relative standard deviations of Bi are 5.0% (content = 0.00024 x 10(-2) mg.L-1) and 1.3% (content = 0.00229 x 10(-2) mg.L-1). The method has been applied to determination of Se and Bi in practical samples with satisfactory results.

Antimony↗
PubMed1988

Pharmacokinetics of antimony during treatment of visceral leishmaniasis with sodium stibogluconate or meglumine antimoniate.

5 patients with visceral leishmaniasis were treated with sodium stibogluconate (2 patients) or meglumine antimoniate (3 patients) given intramuscularly at a dose of 10 mg antimony (Sb) per kg body weight daily for 30 d. Blood samples were obtained at intervals during treatment and blood Sb concentrations measured by anodic stripping voltametry. The pharmacokinetics of both drugs were remarkably similar, with peak concentrations of approximately 10 mg/litre occurring 2 h after the initial dose. Most of the Sb was eliminated rapidly, but nadir Sb concentrations increased gradually during treatment from 0.04-0.08 mg/litre 24 h after the first dose to 0.19-0.33 mg/litre 24 h after the 30th dose. For both drugs, the data were best described by a two compartment, three term pharmacokinetic model representing an initial absorption phase with a mean half-life of 0.85 h, a rapid elimination phase with a mean half-life of 2.02 h, and a slow elimination phase with a mean half-life of 76 h. The slow terminal elimination phase may be related to in vivo conversion of pentavalent Sb to trivalent Sb, which could contribute to the toxicity associated with long-term high dose therapy.

Antimony↗
PubMed2001

Two successive single crystal phase transitions involving the coordination sphere of antimony in PhSb(dmit), the first organo-antimony(III) dithiolene complex.

PhSb(dmit) (dmit(2)(-), 4,5-dithiolato-1,3-dithiole-2-thione), the first neutral organo-antimony dithiolene complex, has been synthesized by addition of PhSbCl(2) on a suspension of Na(2)(dmit). The complex was characterized by spectroscopic ((1)H and (13)C NMR and IR) methods and elemental analysis. Its crystal structure was determined by X-ray diffraction at room temperature in the monoclinic P2(1)/c space group, with a = 12.580(3), b = 8.9756(18), c = 15.905(3) A, beta = 109.06(3) degrees, V = 1697.5(6) A(3), Z = 4. A coordinating THF molecule was found in the structure and the coordination geometry around the antimony atom is of distorted pseudopentagonal bipyramid type, if taking into account the Sb.O and secondary Sb.S interactions, as well as the stereochemically active 5s(2) lone pair. The intermolecular Sb.S and S.S contacts, shorter than the sum of van der Waals radii of corresponding atoms, lead to the formation of a three-dimensional polymeric network in the solid state. A second X-ray diffraction experiment, performed at 85 K, revealed a very similar monoclinic unit cell with the noncentrosymmetrical space group P2(1) with a = 12.613(3), b = 8.9876(18), c = 15.109(3) A, beta = 107.01(3) degrees, V = 1637.8(6), Z = 4. The structural differences with the first one are basically due to the rotation of the THF ligand in the coordination sphere of the antimony center, leading to the loss of every inversion center found at room temperature. A temperature variable X-ray diffraction study on a PhSb(dmit) single-crystal allowed the detection, with a remarkable accuracy, of two successive first-order phase transitions, the first occurring at T = 162.5 K, while the second was observed at T = 182.5 K. Subsequently, a third set of X-ray data was collected at 180 K and the resulting structure (monoclinic, P2(1)/c, a = 16.736(3), b = 8.9653(18), c = 33.132(7) A, beta = 91.98(3) degrees, V = 4968.2(17), Z = 12) derives from the two others by a common b axis, a 3-fold cell volume increase, and the presence of only one-third of the inversion centers present at room temperature. A DSC analysis, showing two endothermic peaks at the expected temperatures, confirms the occurrence of the two structural phase transitions, also in agreement with preliminary Raman data.

Journal Article↗