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Antimicrobial Agents and Chemotherapy, March 2008, p. 1150-1152, Vol. 52, No. 3
0066-4804/08/$08.00+0 doi:10.1128/AAC.01019-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Sección de Parasitología, Departamento de Bioquímica, Biología Celular y Molecular, Facultad de Farmacia, Universidad San Pablo CEU, Urbanización Montepríncipe, Ctra. Boadilla del Monte km 5,300, 28668 Madrid, Spain,1 Departamento de Parasitología, Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain2
Received 2 August 2007/ Returned for modification 24 October 2007/ Accepted 16 December 2007
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The molecular mechanism involved in the initial interaction between C. parvum sporozoites and epithelial cells is still unclear. One of the mechanisms of C. parvum attachment is the interaction between galactose-N-acetylgalactosamine (Gal/GalNAc) epitopes on the epithelial apical membrane and Gal/GalNAc-specific sporozoite surface lectins (3). Invasion by and intracellular development of the parasite lead to the destruction of epithelial cells, resulting in blunting of intestinal villi, crypt hyperplasia, and cytoskeletal remodeling. In addition, there are decreased sodium absorption, epithelial chemokine production, and increased prostaglandin production (16), which are directly related to the notable inflammatory response that follows Cryptosporidium infection and characterizes its pathology (9).
To further the improvement of treatment against cryptosporidiosis, we studied the anticryptosporidial activity of Bobel-24 (2,4,6-triiodophenol). This compound is able to inhibit lectin expression (11). In addition, Bobel-24 is considered a dual inhibitor of lipoxygenase and cyclooxygenase, which are involved in the resolution of inflammatory diseases (10, 13).
The C. parvum IOWA bovine isolate used for this study was kindly provided by M. J. Arrowood (Centers for Disease Control and Prevention, Atlanta, GA). Bobel-24 is a nonsteroidal antiinflammatory compound (Fig. 1) (6, 10, 11). It is under clinical development as a potent leukotriene B4 synthesis inhibitor (17). For in vitro studies, Bobel-24, used as a pure compound (purity of 99.6%, obtained from Chemical Iberica SL, Salamanca, Spain), was first dissolved in dimethyl sulfoxide (DMSO) and then diluted with phosphate-buffered saline. In an MTT cytotoxicity assay (5), viability percentages (>95%) of HCT-8 cells with Bobel-24 concentrations lower than 100 µM were observed. To study in vitro activity of Bobel-24, 8 x 105 excysted oocysts/ml (1) were inoculated in confluent HCT-8 cell monolayers as previously described (2). To assess the effect on sporozoite attachment to HCT-8 cells, we incubated sporozoite suspensions with Bobel-24 (90 µM) before use, we incubated HCT-8 cells with Bobel-24 (90 µM) before infection, and to evaluate the effect of Bobel-24 on C. parvum development in HCT-8, we incubated infected cells afterwards with 90 µM Bobel-24 for 48 h. Paromomycin (PRM) (2 mg/ml) and mucin (0.2 mg/ml) were used as treatment controls. Infected HCT-8 cells were also incubated with DMSO and with medium as controls. To study the effect of the dose on the response to Bobel-24 treatment, HCT-8 cells were inoculated with 8 x 105 oocysts/ml and then incubated with 90, 45, or 22 µM Bobel-24.
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FIG. 1. Chemical structure of Bobel-24.
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SCID mice are useful in evaluating new drugs against cryptosporidiosis (12). Thirty female C.B-17 scid/scid (SCID) mice, aged 7 weeks, were orally infected with 1 x 107 oocysts in 100 µl phosphate-buffered saline. Animals in individualized cages were allowed to develop chronic cryptosporidiosis for 25 days. For in vivo studies, Bobel-24 suspension with polyvinylpyrrolidone (PVP) was performed. Infected mice were paired and divided as follows. Treatment A mice (n = 10) received 250 mg/kg/day of Bobel-24, treatment B mice (n = 10) received 125 mg/kg/day of Bobel-24, control PVP mice (n = 4) received PVP diluted in water, and infection control group mice (n = 6) received no treatment. All animals were treated orally for 2 weeks and euthanized 3 to 7 days after treatment ceased. Oocyst shedding was determined every 3 days by IIF from each group of paired infected animals. Concentrated fecal samples were examined by IIF (4). Results are shown as the number of oocysts per 50-µl concentrated fecal sample.
Data were analyzed by analyses of variance and least significant differences (14).
A significant (P < 0.05) inhibitory activity of Bobel-24 on C. parvum development was first observed when the infected HCT-8 cells were treated with 90 µM Bobel-24, with rates of growth inhibition reaching 99.6% (Table 1). No significant differences were found between Bobel-24 and PRM activities. However, treatment of sporozoite suspensions with Bobel-24 before using them to infect cells and previous treatment of noninfected cells showed IS of 0 and 1, respectively, suggesting that the effect of the compound on the C. parvum attachment and invasion processes was weaker. A dose-dependent inhibitory effect of Bobel-24 on C. parvum development was also observed (Table 2), and an IS of 4 was noted at concentrations between 45 and 90 µM, with growth inhibition rates of 99.5 to 96.5%.
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TABLE 1. Inhibition of C. parvum forms in cell culture by prophylactic and therapeutic treatments with Bobel-24
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TABLE 2. Dose-dependent inhibitory effect of Bobel-24 on C. parvum development
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FIG. 2. C. parvum oocyst shedding during 2 weeks of treatment with Bobel-24.
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Bobel-24 is a compound with an antiinflammatory activity similar to those of other nonsteroidal antiinflammatory drugs (10). It is a dual inhibitor of lipoxygenase and cyclooxygenase, which play an important role in inflammatory response during diarrheic disease. For this reason, it would be reasonable to suppose that inhibition of those enzymes might result in an increase in fluid absorption, an important part of treatment for cryptosporidial infection. Moreover, Bobel-24 is considered an inhibitor of L-selectin, a molecule with the same origin as the sporozoite surface lectin (3). This lectin is considered a mediator of the initial interaction process between the parasite and the host cell, confirmed because exposure of C. parvum sporozoites to Gal/GalNAc and to bovine mucin reduced C. parvum attachment to biliary and intestinal epithelia up to 70% (3). Even though no antiprotozoal activity has been described for this compound to date, due to its action mechanisms described above, it may constitute a novel approach for treating cryptosporidiosis. To date, Bobel-24 is under clinical development as a potent leukotriene B4 synthesis inhibitor (17). Furthermore, Parreño et al. have synthesized three derivates of Bobel-24 (Bobel-4, Bobel-16, and Bobel-30) and have tested their activities as putative antileukemic agents (13). These authors found that Bobel-24 and Bobel-16 were dual inhibitors of cyclooxygenase and 5-lipoxygenase, whereas Bobel-4 and Bobel-30 were selective against 5-lipoxygenase.
In the present study, Bobel-24 showed notable and significant therapeutic activity in vitro, reaching 99.6% growth inhibition at a concentration of 90 µM. A dose-dependent inhibitory activity was also observed. There was no significant difference from the activity of PRM in vitro. This is outstanding, because PRM is a well-recognized drug with anticryptosporidial activity that is currently used to compare the activities of new candidates for cryptosporidiosis treatment. However, the in vitro prophylactic activity of Bobel-24 did not exceed an IS of 1. In contrast, the in vitro prophylactic activity of mucin was higher than when it was used for prophylactic treatment (IS of 2) but significantly lower (P < 0.05) than that of therapeutic treatment with 90 µM Bobel-24.
When the anticryptosporidial activity of Bobel-24 was studied in an animal model, a significant reduction in the number of oocysts excreted in the feces of infected SCID mice was only observed in animals treated with 125 mg/kg/day. However, Bobel-24 was not able to eradicate the parasite. Since lower doses of Bobel-24 showed higher anticryptosporidial activity, it is feasible that a problem in compound bioavailability may have occurred, as Bobel-24 is a poorly water-soluble agent that needs to be formulated with a polymer.
It must be pointed out that the doses used in this study are expected to be well tolerated on the basis of the general information provided by the manufacturers, who have studied the mutagenic potential of the drug in vitro and have conducted in vivo safety studies with rodents and beagle dogs (product profile; Farma-Cros Ibérica, S.A., Madrid, Spain). Furthermore, a preliminary phase I clinical trial has been conducted with humans (17) with the only finding a slight, transient, and not clinically relevant hypothyroidism that agrees with a previous report of T3 receptor blockade at high concentrations in Xenopus laevis (8).
It is known that demonstration of the activity of a drug in vitro does not guarantee its function in in vivo models. However, it is generally accepted that drugs are unlikely to inhibit C. parvum in vivo without inhibiting it in vitro. Moreover, nitazoxanide, considered to date a very promising drug for human cryptosporidiosis treatment, was highly effective in cell culture, partially effective in the piglet diarrhea model, and ineffective in the anti-gamma interferon-conditioned SCID mouse model (15). Thus, Bobel-24 merits consideration and further investigation as a therapeutic option in the treatment of cryptosporidiosis.
This work was supported by grants from the Fundación San Pablo-CEU (11/03) and FEDER (1FD97-1168-CO3-03) and by the Agencia de Desarrollo Económico de Castilla y Leon (04/04/SA/0003).
Published ahead of print on 26 December 2007. ![]()
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