Novel cruzipain inhibitors for the chemotherapy of chronic Chagas disease

Int J Antimicrob Agents. 2016 Jul;48(1):91-95. doi: 10.1016/j.ijantimicag.2016.02.018. Epub 2016 Apr 22.

Abstract

Despite current efforts worldwide to develop new medications against Chagas disease, only two drugs are available, nifurtimox and benznidazole. Both drugs require prolonged treatment and have multiple side effects and limited efficacy on adult patients chronically infected with Trypanosoma cruzi. Recently, computer-guided drug repositioning led to the discovery of the trypanocidal effects of clofazimine and benidipine. These compounds showed inhibitory effects on cruzipain, the major cysteine protease of T. cruzi, of different parasite stages and in a murine model of acute Chagas disease. The aim of this work was to determine the efficacy of these novel cruzipain inhibitors when administered in a murine model of chronic Chagas disease. Benidipine and clofazimine were able to reduce the parasite burden in cardiac and skeletal muscles of chronically infected mice compared with untreated mice as well as diminish the inflammatory process in these tissues. Further studies should be performed to study the synergism with benznidazole and nifurtimox in view of combined therapies.

Keywords: Benidipine; Chagas disease; Chronic phase; Clofazimine; Drug repositioning; Trypanosoma cruzi.

MeSH terms

  • Adult
  • Animals
  • Antiprotozoal Agents / administration & dosage*
  • Antiprotozoal Agents / isolation & purification
  • Chagas Disease / drug therapy*
  • Chagas Disease / parasitology
  • Chagas Disease / pathology
  • Chronic Disease / drug therapy
  • Clofazimine / administration & dosage*
  • Clofazimine / isolation & purification
  • Cysteine Endopeptidases / metabolism*
  • Cysteine Proteinase Inhibitors / administration & dosage*
  • Cysteine Proteinase Inhibitors / isolation & purification
  • Disease Models, Animal
  • Drug Therapy / methods
  • Humans
  • Male
  • Mice, Inbred C3H
  • Muscles / parasitology
  • Nifedipine / administration & dosage
  • Nifedipine / analogs & derivatives*
  • Nifedipine / isolation & purification
  • Parasite Load
  • Protozoan Proteins
  • Trypanosoma cruzi / drug effects
  • Trypanosoma cruzi / enzymology*

Substances

  • Antiprotozoal Agents
  • Cysteine Proteinase Inhibitors
  • Protozoan Proteins
  • benidipine hydrochloride
  • Clofazimine
  • Cysteine Endopeptidases
  • cruzipain
  • Nifedipine