Looking for combination of benznidazole and Trypanosoma cruzi-triosephosphate isomerase inhibitors for Chagas disease treatment

Mem Inst Oswaldo Cruz. 2018 Mar;113(3):153-160. doi: 10.1590/0074-02760170267.

Abstract

Background: The current chemotherapy for Chagas disease is based on monopharmacology with low efficacy and drug tolerance. Polypharmacology is one of the strategies to overcome these limitations.

Objectives: Study the anti-Trypanosoma cruzi activity of associations of benznidazole (Bnz) with three new synthetic T. cruzi-triosephosphate isomerase inhibitors, 2, 3, and 4, in order to potentiate their actions.

Methods: The in vitro effect of the drug combinations were determined constructing the corresponding isobolograms. In vivo activities were assessed using an acute murine model of Chagas disease evaluating parasitaemias, mortalities and IgG anti-T. cruzi antibodies.

Findings: The effect of Bnz combined with each of these compounds, on the growth of epimastigotes, indicated an additive action or a synergic action, when combining it with 2 or 3, respectively, and an antagonic action when combining it with 4. In vivo studies, for the two chosen combinations, 2 or 3 plus one fifth equivalent of Bnz, showed that Bnz can also potentiate the in vivo therapeutic effects. For both combinations a decrease in the number of trypomastigote and lower levels of anti-T. cruzi IgG-antibodies were detected, as well clear protection against death.

Main conclusions: These results suggest the studied combinations could be used in the treatment of Chagas disease.

MeSH terms

  • Animals
  • Antibodies, Protozoan / blood
  • Chagas Disease / drug therapy*
  • Drug Combinations
  • Drug Synergism
  • Drugs, Investigational
  • Immunoglobulin G / blood
  • Male
  • Mice
  • Mice, Inbred BALB C
  • Nitroimidazoles / pharmacology*
  • Triose-Phosphate Isomerase / antagonists & inhibitors
  • Triose-Phosphate Isomerase / chemistry
  • Triose-Phosphate Isomerase / pharmacology*
  • Trypanocidal Agents / pharmacology*
  • Trypanosoma cruzi / drug effects*
  • Trypanosoma cruzi / immunology

Substances

  • Antibodies, Protozoan
  • Drug Combinations
  • Drugs, Investigational
  • Immunoglobulin G
  • Nitroimidazoles
  • Trypanocidal Agents
  • Triose-Phosphate Isomerase
  • benzonidazole