Ruthenium tetrammines as a carrier of nitric oxide and benznidazole and their action on Trypanosoma cruzi

Uma nova e promissora alternativa quimioterápica para o tratamento da doença de Chagas usando tetraaminas de rutênio (II) como transportadoras de óxido nítrico (NO) ou Benznidazol (Bz) são apresentados aqui. Os resultados mostraram que os complexos do tipo trans-[Ru(NO)(NH3)4L]n+ e cis-[Ru(NO)(bpy)2L] n+ são mais eficientes para tratar casos agudos da doença (modelo murino) que o Bz livre. Os nitrosilos trans-[Ru(NO)(NH3)4isn](BF4)3, trans-[Ru(NO)(NH3)4imN](BF4)3, cis-[Ru(NO)(bpy) 2imN](PF6)3 e cis-[Ru(NO)(bpy) 2SO3]PF6 são capazes de eliminar in vivo as formas extracelulares e intracelulares do T. cruzi tanto na corrente sanguínea quanto no tecido miocárdio, assegurando a sobrevida de 60-100% dos animais infectados em doses de 900 (400 nmol kg-1) até 3.850 vezes menores (100 nmol kg-1) que a dose considerada ótima para o Bz (385 µmol kg-1 = 100 mg kg-1). Além disso, uma concentração de trans-[Ru(NO)(NH3)4imN](BF4)3 ou cis-[Ru(NO)(bpy) 2imN](PF6)3 dez vezes menor que a recomendada pela Organização Mundial de Saúde (OMS) para tratar sangue infectado com o violeta de genciana (Vg) é capaz de eliminar 100% dos parasitos após 1 hora de incubação a 37 oC. Os experimentos conduzidos in vitro demonstraram que o NO liberado após redução ou reativos intermediários do NO são os responsáveis pelo efeito anti-proliferativo ou tripanocida. O nitrosilo trans-[Ru(NO)(NH3)4isn](BF4)3 (IC50epi = 67 µmol L-1) foi mais ativo que o nitroprussiato de sódio (SNP) (IC50epi = 244 µmol L-1) e o trans-[Ru(NO)(NH3)4imN](BF4)3 e o cis-[Ru(NO)(bpy) 2imN](PF6)3 (IC50tri = 52 e 58 µmol L-1, respectivamente) foram mais eficientes que o Vg (IC50tri = 536 µmol L-1). O transportador do Bz, trans-[Ru(Bz)(NH3)4S(IV)]n+, S(IV) = SO2, HSO3- ou SO32- (RuBz), é mais hidrosolúvel e mais ativo (IC50tri/1h = 79 ± 3 µmol L-1) que o Bz livre (IC50tri/1h = 4,800 ± 70 µmol L-1). Este complexo exibiu baixa citotoxicidade in vitro (IC50esplenócitos > 1 mmol L-1) e in vivo (400 µmol kg-1 < LD50 < 600 µmol kg-1) e a formação do derivado hidroxilamínico é mais favorável no RuBz que no Bz em 9,6 Kcal mol-1. Em diversos modelos murinos de infecção aguda, o RuBz também foi mais ativo que o Bz ainda quando somente uma dose foi administrada. Analogamente, o RuBz a uma dose 1.000 vezes que a dose ótima para o Bz provou ser suficiente para proteger todos os animais infectados, eliminando os ninhos de amastigotas nos seus corações, fígados e músculos esqueléticos. Em experimentos conduzidos com células Vero, os nitrosilos trans-[Ru(NO)(NH3)4imN](BF4)3, cis-[Ru(NO)(bpy)2imN](PF6)3 e o RuBz foram capazes de eliminar as formas intracelulares do T. cruzi e reduzir a porcentagem de células infectadas. Portanto, todos os dados observados sugerem a maior solubilidade em água somada à acessibilidade do potencial de redução do par NO2/NO3.- no RuBz são os responsáveis pela maiores atividades anti-proliferativa e tripanocida com respeito ao Bz ou Vg. Adicionalmente, cis-[Ru(NO)(bpy)2imN](PF6)3, cis-[Ru(NO)(bpy) 21-miN](PF6)3 e cis-[Ru(NO)(bpy) 2SO3]PF6 provaram ser capazes de inibir a atividade catalítica da gGAPDH de 89-97% a uma concentração de 260 µmol L-1, enquanto os complexos da série trans-[Ru(NO)(NH3)4L]n+, os precursores cis-[Ru(bpy) 2L(NO2)]n+, cis-[Ru(H2O)(bpy) 2L]n+ bem como os complexos RuBz, cis-[Ru(NO)(NH3)4 (NO2)]Cl2 não exibiram atividade inibitória significativa.A novel and promising chemotherapeutic alternatives for the treatment of Chagas\' disease by use of ruthenium tetraammnine complexes as a carrier of nitric oxide (NO) or Benznidazole (Bz) are presented herein. The results showed that the trans- [Ru(NO)(NH3)4L]n+ and cis-[Ru(NO)(bpy) 2L] n+ compounds are more efficient in the treatment of acute cases of the disease (mouse model) than free Bz. The trans- [Ru(NO)(NH3)4isn](BF4)3, trans-[Ru(NO)(NH3)4imN](BF4)3, cis- [Ru(NO)(bpy) 2imN](PF6)3, and cis-[Ru(NO)(bpy) 2SO3]PF6 are able to eliminate, in vivo, extracelullar as well as intracellular forms of T. cruzi in the bloodstream and myocardium tissue and to assure the survival of 60-100% of infected mice at doses of 900 (400 nmol kg-1) up to 3,850 fold smaller (100 nmol kg-1) than that considered the optimal dose for Bz (385 µmol kg-1 = 100 mg kg-1). Furthermore, a dose of trans-[Ru(NO)(NH3)4imN](BF4)3 or cis-[Ru(NO)(bpy) 2imN](PF6)3 ten-fold smaller than that recommended by World Health Organization (WHO) for gentian violet, Vg, a phenyl methane currently recommended by WHO in the treatment of blood banks in endemic and non-endemic areas to prevent the transmission of Chagas\' disease by blood transfusion, is able to lyses 100% of the parasites after 1 hour of incubation. The tests conducted in vitro demonstrated that the NO liberated upon reduction of these nitrosyls is responsible for the observed antiproliferative and trypanocidal activities. The trans-[Ru(NO)(NH3)4isn](BF4)3 (IC50epi = 67 µmol L-1) was found to be more efficient than the classic NO-donor, sodium nitroprusside (SNP) (IC50epi = 244 µmol L-1) and trans-[Ru(NO)(NH3)4imN](BF4)3 and cis-[Ru(NO)(bpy) 2imN](PF6)3 (IC50try = 52 and 58 µmol L-1, respectively) were more efficient than the gentian violet (IC50try = 536 µmol L-1). The Bz carrier, trans-[Ru(Bz)(NH3)4S(IV)] n+, S(IV) = SO2, HSO3 - or SO3 -2 (RuBz), is more hydrosoluble and more active (IC50try/1h = 79 ±?3 µmol L-1) than free Bz (IC50try/1h = 4,800 ±?70 µmol L-1). This complex exhibits low acute citotoxicity in vitro (IC50trysplenocytes > 1 mmol L-1) and in vivo (400 µmol kg-1 < LD50try < 600 µmol kg-1) and the formation of hydroxylamine is more favorable in RuBz than in Bz by 9.6 Kcal mol-1. In murine acute models of Chagas\' disease, RuBz also was more active than Bz even when only one dose was administrated. Moreover, RuBz at a thousand-fold smaller concentration than the considered optimal dose for Bz proved to be sufficient to protect all infected mice, eliminating the amastigotes nests in their hearts, livers, and skeletal muscles as observed in H?E micrographics. Experiments conduced with infected Vero cells, the trans- [Ru(NO)(NH3)4imN](BF4)3, cis-[Ru(NO)(bpy) 2imN](PF6)3, and RuBz are able to eliminate the intracellular forms of T. cruzi and to reduce the percentage of infected cells. In all, the observed data strongly suggest that the higher solubility in water and accessibility for reduction of NO2/NO2 .- couple in RuBz are responsible for higher antriproliferative and trypanocidal activities regarding to Bz or Vg. Additionally, the cis- [Ru(NO)(bpy) 2imN](PF6)3, cis-[Ru(NO)(bpy) 21-miN](PF6)3, and cis- [Ru(NO)(bpy) 2SO3]PF6 proved to be able to inhibit the catalytic activity of gGAPDH of 89-97% at a concentration of 260 µmol L-1, whereas their precursors cis- [Ru(bpy) 2L(NO2)]n+ and cis-[Ru(H2O)(bpy) 2L]n+ and the trans-[Ru(NO)(NH3)4L] 3+ and cis-[Ru(NO)(NH3)4 (NO2)]Cl2 nitrosyls and RuBz complex do not exhibited significative inhibition

Complexation of the anti-Trypanosoma cruzi drug benznidazole improves solubility and efficacy

The ruthenium complex,trans-[Ru(Bz)(NH3)(4)SO2](CF3SO3)(2) 1, Bz = benznidazole (N-benzyl-2-(2-nitro-1H-imidazol-1-yl)acetamide), is more hydrosoluble and more active (IC50try/1 h = 79 +/- 3 mu M) than free benznidazole 2 (IC50try/1 h > 1 mM). 1 also exhibits low acute toxicity in vitro (IC50macrophages > 1 mM) and in vivo (400 mu mol/kg < LD50 < 600 mu mol/kg) and the formation of hydroxylamine is more favorable in 1 than in 2 by 9.6 kcal/mol. In murine acute models of Chagas` disease, 1 was more active than 2 even when only one dose was administrated. Moreover, 1 at a thousand-fold smaller concentration than the considered optimal dose for 2 (385 mu mol/kg/day = 100 mg/kg/day), proved to be sufficient to protect all infected mice, eliminating the amastigotes in their hearts and skeletal muscles as observed in H&E micrographics

The effects of nitric oxide on the immune response during giardiasis

Nitric oxide (NO) is a free radical synthesized from L-arginine by different isoforms NO-synthases. NO possesses multiple and complex biological functions. NO is an important mediator of homeostasis, and changes in its generation or actions can contribute or not to pathological states. The knowledge of effects of NO has been not only important to our understanding of immune response, but also to new tools for research and treatment of various diseases. Knowing the importance of NO as inflammatory mediator in diverse infectious diseases, we decided to develop a revision that shows the participation/effect of this mediator in immune response induced against Giardia spp. Several studies already demonstrated the participation of NO with microbicidal and microbiostatic activity in giardiasis. On the other hand, some works report that Giardia spp. inhibit NO production by consuming the intermediate metabolite arginine. In fact, studies in vitro showed that G. lamblia infection of human intestinal epithelial cells had reduced NO production. This occurs due to limited offer of the crucial substrate arginine (essential aminoacid for NO production), consequently reducing NO production. Therefore, the balance between giardial arginine consumption and epithelial NO production could contribute to the variability of the duration and severity of infections by this ubiquitous parasite

Experimental Chemotherapy in Paracoccidioidomycosis Using Ruthenium NO Donor

Paracoccidioidomycosis (PCM) is a granulomatous disease caused by a dimorphic fungus, Paracoccidioides brasiliensis (Pb). To determine the influence of nitric oxide (NO) on this disease, we tested cis-[Ru(bpy)2(NO)SO3](PF6), ruthenium nitrosyl, which releases NO when activated by biological reducing agents, in BALB/c mice infected intravenously with Pb 18 isolate. In a previous study by our group, the fungicidal activity of ruthenium nitrosyl was evaluated in a mouse model of acute PCM, by measuring the immune cellular response (DTH), histopathological characteristics of the granulomatous lesions (and numbers), cytokines, and NO production. We found that cis-[Ru(bpy)2(NO)SO3](PF6)-treated mice were more resistant to infection, since they exhibited higher survival when compared with the control group. Furthermore, we observed a decreased influx of inflammatory cells in the lung and liver tissue of treated mice, possibly because of a minor reduction in fungal cell numbers. Moreover, an increased production of IL-10 and a decrease in TNF-alpha levels were detected in lung tissues of infected mice treated with cis-[Ru(bpy)2(NO)SO3](PF6). Immunohistochemistry showed that there was no difference in the number of VEGF- expressing cells. The animals treated with cis-[Ru(bpy)2(NO)SO3](PF6) showed high NO levels at 40 days after infection. These results show that NO is effectively involved in the mechanism that regulates the immune response in lung of Pb-infected mice. These data suggest that NO is a resistance factor during paracoccidioidomycosis by controlling fungal proliferation, influencing cytokine production, and consequently moderating the development of a strong inflammatory response.Fundacao Araucaria/SETI-PRCoordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)WHO/TDR - Special Program for Research and Training in Tropical Disease

Nitric Oxide and Brazilian Propolis Combined Accelerates Tissue Repair by Modulating Cell Migration, Cytokine Production and Collagen Deposition in Experimental Leishmaniasis

<div><p>The fact that drugs currently used in the treatment of <i>Leishmania</i> are highly toxic and associated with acquired resistance has promoted the search for new therapies for treating American tegumentary leishmaniasis (ATL). In this study, BALB/c mice were injected in the hind paw with <i>Leishmania (Leishmania) amazonensis</i> and subsequently treated with a combination of nitric oxide (NO) donor (cis-[Ru(bpy) ₂imN(NO)](PF₆)₃) (Ru-NO), given by intraperitoneal injection, and oral Brazilian propolis for 30 days. Ru-NO reached the center of the lesion and increased the NO level in the injured hind paw without lesion exacerbation. Histological and immunological parameters of chronic inflammation showed that this combined treatment increased the efficacy of macrophages, determined by the decrease in the number of parasitized cells, leading to reduced expression of proinflammatory and tissue damage markers. In addition, these drugs in combination fostered wound healing, enhanced the number of fibroblasts, pro-healing cytokines and induced collagen synthesis at the lesion site. Overall, our findings suggest that the combination of the NO donor Ru-NO and Brazilian propolis alleviates experimental ATL lesions, highlighting a new therapeutic option that can be considered for further <i>in vivo</i> investigations as a candidate for the treatment of cutaneous leishmaniasis.</p></div

Antileishmanial Activity and Inducible Nitric Oxide Synthase Activation by RuNO Complex

Parasites of the genus Leishmania are capable of inhibiting effector functions of macrophages. These parasites have developed the adaptive ability to escape host defenses; for example, they inactivate the NF-κB complex and suppress iNOS expression in infected macrophages, which are responsible for the production of the major antileishmanial substance nitric oxide (NO), favoring then its replication and successful infection. Metal complexes with NO have been studied as potential compounds for the treatment of certain tropical diseases, such as ruthenium compounds, known to be exogenous NO donors. In the present work, the compound cis-[Ru(bpy)2SO3(NO)]PF6, or RuNO, showed leishmanicidal activity directly and indirectly on promastigote forms of Leishmania (Leishmania) amazonensis. In addition, treatment with RuNO increased NO production by reversing the depletion of NO caused by Leishmania. We also found increased expression of Akt, iNOS, and NF-κB in infected and treated macrophages. These results demonstrated that RuNO was able to kill the parasite by NO release and modulate the transcriptional capacity of the cell

Effect of Ru-NO and propolis treatment on lesion development and parasite load of BALB/c mice infected with <i>L</i>. <i>amazonensis</i>.

<p>Animals were inoculated in the right hind paw with 1 x 10⁵ promastigote forms. <b>A)</b> After eight weeks of infection, mice were treated with saline (i.p.) (■), Glucantime (33 μmol.kg^-1 day^-1, i.p.) (□), propolis (5 mg.kg^-1 day^-1, p.o.) (▼),Ru-NO (0.385 μmol.kg^-1 day^-1, i.p.) (◆) or Ru-NO plus propolis (0.385μmol.kg^-1 day^-1, i.p. + 5 mg.kg^-1 day^-1, p.o.) (◯) for 30 days, and the lesion was measured once a week. <b>B)</b> At the end of treatment, the number of <i>Leishmania</i> kDNA was determined by real-time quantitative PCR. The results represent the mean ± SEM of lesion size for each group (n = 5). Significant difference relative to the infected control * <i>P</i><0.05 and ** <i>P</i><0.01, unpaired t-test.</p

Ru-NO by intraperitoneal injection is able to reach the center of the lesion.

<p>Animals were inoculated with 1 x 10⁵<i>L</i>. <i>amazonensis</i> promastigote forms in the right hind paw, and after lesion appearance, they were treated intraperitoneally with Ru-NO (0.385 μmol.kg^-1 day^-1). <b>A)</b> EDS analysis of paw sections was performed in infected control and <b>B)</b> RuNO treated group, to identify the elements present at the lesion site.</p