Nanomedicine & Drug Delivery Systems Group Research Institute for Medicines and Pharmaceutical Sciences (imed.ul)

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Faculty of Pharmacy of the University of Lisbon Nanomedicine & Drug Delivery Systems Group Research Institute for Medicines and Pharmaceutical Sciences (imed.ul)

Leishmania in southern Europe. (Duiardin, 2008) Endemic in all southern European countries. Most of the reported cases are due to zoonotic VL; The dog is a reservoir of the disease; Transmitted from reservoirs to humans by female sand flies; Low levels at site of infection Degradation before reaching target tissues Low drug penetration through infected tissues Toxic effects (intolerance, organ damage) Long course treatment Acquired resistance Search for new antileishmanial compounds Search for new active molecules Chemical modification of existing molecules Target drugs to the site of infection Association to drug delivery systems

have to overcome major structural barriers to reach Leishmania parasites that live inside mammalian in different anatomical areas of the host Penetration through cell membranes Cellular environment Sub cellular localization of pathogen Sensitivity of the pathogen Low selectivity Repeated administrations Higher doses High toxicity Poor patient compliance Emergence of resistance Kayser et al., Parasitol Res (2003) 90: S63 S70

The main goal of a is to carry the Bioactive Agent specifically and safely from the site of administration to the desired therapeutic target in a controlled manner.

Vesicular concentric bilayer structures mainly made of phospholipids that present a hydrophilic (polar) head and hydrophobic (non polar) fatty acid tail. Biocompatible; Biodegradable; Non immunogenic. Drug carriers for a great variety of molecules: small drug molecules, proteins, nucleotides and plasmids Incorporation of bioactive agents with different properties Highly flexible systems Penetrate and fuse with cells Attachment of specific labels Biodegradable/ low toxicity Large scale production Long term stability (2 years) Solubilization Hydrophilic : Hydrophobic drug Bioactive Agent Protection : Hydrophilic Bioactive Agent Hydrophobic drug Tailor made systems Antibody Cellular internalization of the bioactive agent Change PEG the biodistribution Pharmaceutically Other target acceptable ligands Pharmaceutically acceptable Pharmaceutically acceptable

CH 3 CH 2 H 2 C CH 2 CH 2 CH 3 N O 2 N NO 2 CH 3 CH 2 H 2 C CH 2 CH 2 CH 3 N O 2 N NO 2 Specifically bind to plant and parasites tubulins O S O Do not bind to mammalian tubulins CF 3 NH 2 CH 3 CH 2 CH 2 H 2 C CH 2 CH 3 N O 2 N NO 2 CH 3 CH 2 CH CH 2 CH 3 NH O 2 N NO 2 CH 3 CF 3 CH 3 Inhibition of promastigote proliferation; Decrease promastigote-to-amastigote transformation; Interference with amastigote replication; Reduction in infectivity of amastigotes. Promastigotes Amastigotes Trifluralin 34,2 19,1 Oryzalin 11,1 11,8 Benfluralin 26,2 17,7 Pendimethalin 23,3 12,6 Dinitroanilines therapeutic use is limited Aqueous solubility Vapour pressure

Macrophages infected with Leishmania parasites (Liver; Spleen; Bone Marrow) Dinitroanilines Commercial (TFL) Chemically modified (TFL-D) Liposomes Conventional (capture by the MPS) Long Circulating (extravasate vasculature)

NO 2 N Formulate is for a dinitroaniline systemic application with demonstrated without the in need vivo efficacy of toxic in solvents murine and models at of cutaneous Leishmaniasis when applied topically therapeutic as an ointment doses (Chan et al., 1993) F 3 C NO 2 F1 - PC F2 - PC:Chol (4:1) F3 - PC:Chol (2:1) F4 - DMPC F5 - DMPC:Chol (4:1) F6 - DMPC:Chol (2:1) F7 - DPPC:Chol (4:1) F8 - DPPC:Chol (2:1) F9 - DSPC:Chol (4:1) F10 - DSPC:Chol (2:1) F11 - PC:Chol:SA (10:5:1) F12 - PC:Chol:PI (10:5:1) F13 - PC:Chol:PG (10:5:1) F14 - PC:PG (7:3) F15 - DOPC:DOPG (7:3) F16 - DPPC:DPPG (7:3) F17 - PC:PG:DSPE-PEG (12:3:1) L.C. = Loading Capacity I.E. = Incorporation Efficiency F18 - PG:DSPE-PEG (15:1) F19 - PC:DSPE-PEG (15:1) F20 - PC:Chol:DSPE-PEG (12:3:1)

L. donovani MHOM/ET/67/L82 Infection 2x10 7 amast/mouse Female BALB/c Treatment 5x i.v.; 15 mg TFL/kg/day 1 s.c.; 15mg Sbv /kg Liver Amastigote counting 68% F9 = DSPC:Chol F14 = PC:PG F15 = DOPC:DOPG Liposomal TFL reduces parasite load [*]-Significantly different from Neg Control and TFL [**]-Significantly different from Sb V

L. major MHOM/SA/85/JISH 118 Infection 2 X 10 7 prom/mouse Female BALB/c 7 days Nodule sizing Treatment 6 doses Nodule sizing F15 = DOPC:DOPG F19 = PC:DSPE-PEG Sb v = 400 mg/kg/day F15 and F19 = 6 mg/kg/day s.c. route most promising and consistent [*]- Statistically different from negative control (p< 0.001) [**]- Not statistically different between values (p>0.05)

Female beagle (3 years old, 12 Kg) (10 6 L. infantum (MCAN/PT/03/IMT335) amastigotes) Treatment : 10 i.v. administrations of 10 mg TFL/kg/day (F15 = DOPC:DOPG) (1 to 3 month after treatment) Remission of clinical signs Reduction of parasite load (ulcerative lesions) (month) Bone Marrow Lymph Nodes 5 after infection 1000 64000 1 after treatment Negative 16000 3 after treatment 4000 16000

Compounds with improved physicochemical properties easier to administer in vivo (free or liposomal form) (in vitro) Cytotoxicity (IC 50 > 50 µm) Haemolytic activity (HC 50 < 10 µm) Intracellular activity (IC 50 < 10 µm) *Bioorganic & Medicinal Chemistry 18 (2010) 274 281

2-((2,6-Dinitro-4-trifluoromethyl-phenyl)-butylamino)-ethanol 4-(2,6-Dinitro-4-trifluoromethyl-phenylamino)-phenol Lipid compositions with different membrane rigidity Effect of [TFL-D/Lip] i on incorporation parameters Stability studies of freeze-dried TFL-D formulations Efficient incorporation of TFL-D L.C. higher than TFL (molar ratio) (molar ratio) (g/mol) (%) (nm) (mv) 7:3 1:4 77 ± 3 73 ± 3 186 ± 11-45 ± 5 9:1 1:5 75 ± 9 91 ± 4 185 ± 14-31 ± 2

IC50 (μm) HC50 (μm) L. infantum, IC50 (μm) 29 ± 3 38 ± 3 2.7 40 >500 1.8 ± 1.3 >50 >500 3.2 ± 0.9 >50 >500 1.2 ± 0.4 >50 >500 1.4 ± 0.2 >50 >100 >50 *Data from Esteves et al., 2010, Bioorganic & Medicinal Chemistry 18, 274 281. Low cytotoxicity Not haemolytic Anti-leishmanial activity

L. Infantum MHOM/PT/89/IMT151 Infection 10 7 promast/mouse (i.p.) BALB/c Treatment 45 to 56 days post-infection Spleen LDA 15 days post-treatment Promastigote counting 96% 77% 48% Liposomal TFL-D more active than the free compounds Treatment = 10 i.p. administrations of 25 mg TFL-D/kg/day

Visceral leishmaniasis (70% parasite load inhibition); Cutaneous leishmaniasis (58% reduction of lesions); In experimentally infected dogs (improved their clinical condition; reduced the parasite load) In vitro: Reduction of cytotoxicity; Maintenance of intracellular activity; Absence of haemolysis In vivo: Enhancement of anti-leishmanial activity Higher than free TFL-D Close to 100% parasite load inhibition Overcome difficulties of handling and administering problematic new drugs; Increase water concentration; Systemic administration without the need of toxic solvents Provide efficient delivery to MPS cells in different tissues

Simon Croft Effie Scoulica Gabriela Santos-Gomes Alexandra Esteves João Jorge Manuela Gaspar Carla Eleutério Rui Lopes Cláudia Sousa Filipa Pinhal Jorge Faustino POCTI/2000/FCB/35249 POCI/CVT/56995/2004