Article
Review on Experimental Treatment Strategies Against Trypanosoma cruzi
Registro en:
MAZZETTI, Ana Lia et al. Review on Experimental Treatment Strategies Against Trypanosoma cruzi. Journal of Experimental Pharmacology, v, 13, p. 409-432, 2021.
1179-1454
10.2147/JEP.S267378
Autor
Mazzetti, Ana Lia
Oliveira, Patricia Capelari
Bahia, Maria Terezinha
Mosqueira, Vanessa Carla Furtado
Resumen
Chagas disease is a neglected tropical disease caused by the protozoan
Trypanosoma cruzi. Currently, only nitroheterocyclic nifurtimox (NFX) and benznidazole
(BNZ) are available for the treatment of Chagas disease, with limitations such as variable
efficacy, long treatment regimens and toxicity. Different strategies have been used to discover
new active molecules for the treatment of Chagas disease. Target-based and phenotypic
screening led to thousands of compounds with anti-T. cruzi activity, notably the nitroheterocyclic
compounds, fexinidazole and its metabolites. In addition, drug repurposing, drug
combinations, re-dosing regimens and the development of new formulations have been
evaluated. The CYP51 antifungal azoles, as posaconazole, ravuconazole and its prodrug
fosravuconazole presented promising results in experimental Chagas disease. Drug combinations
of nitroheterocyclic and azoles were able to induce cure in murine infection. New
treatment schemes using BNZ showed efficacy in the experimental chronic stage, including
against dormant forms of T. cruzi. And finally, sesquiterpene lactone formulated in nanocarriers
displayed outstanding efficacy against different strains of T. cruzi, susceptible or
resistant to BNZ, the reference drug. These pre-clinical results are encouraging and provide
interesting evidence to improve the treatment of patients with Chagas disease.