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Antimicrobial Agents and Chemotherapy, February 2009, p. 839-842, Vol. 53, No. 2
0066-4804/09/$08.00+0 doi:10.1128/AAC.00062-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
Antileishmanial Activity of 1,3,4-Thiadiazolium-2-Aminide in Mice Infected with Leishmania amazonensis
Raquel F. Rodrigues,1
Karen S. Charret,1
Edson F. da Silva,2
Áurea Echevarria,2
Verônica F. Amaral,3
Leonor L. Leon,1 and
Marilene M. Canto-Cavalheiro1*
Laboratório de Bioquímica de Tripanosomatídeos, Instituto Oswaldo Cruz/Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil CEP 21045-900,1
Departamento de Química, Instituto de Ciências Exatas, Universidade Federal Rural do Rio de Janeiro, RJ, Brazil,2
Departamento de Imunobiologia, Instituto de Biologia, Universidade Federal Fluminense—Niterói, RJ, Brazil3
Received 15 January 2008/
Returned for modification 22 March 2008/
Accepted 9 November 2008

ABSTRACT
The efficacy of two mesoionic derivatives (MI-H-H and MI-4-OCH
3)
was evaluated in CBA/J mice infected with
Leishmania amazonensis.
Treatment with these compounds demonstrated that the MI-4-OCH
3 derivative and the reference drug meglumine antimoniate (Glucantime)
presented significant activity relative to an untreated control.
No apparent hepatic or renal toxicity due to these mesoionic
compounds was found.

INTRODUCTION
The World Health Organization considers leishmaniasis one of
the most serious diseases worldwide caused by protozoan parasites
(
24). However, the control of this disease remains a problem;
the available antileishmanial drugs still rely on the highly
toxic pentavalent antimonials (meglumine antimoniate [Glucantime]
and sodium stibogluconate [Pentostam]), which cause serious
side effects and require long-term treatment (
5,
19). Second-line
drugs include pentamidine and amphotericin B, but these drugs
have not experienced widespread use because of toxicity and
cost. Recently, the oral drug miltefosine was approved for the
treatment of human visceral
Leishmania infections and oral fluconazole
was also shown experimentally to be effective against cutaneous
leishmaniasis (
1). Although extensive studies of new molecules
with antileishmanial activity, including natural and synthetic
compounds, have been undertaken (
4), the problems of drug resistance
and the side effects of the chemotherapies used at present have
not been solved.
Our previous studies have proven that mesoionic derivatives of the 1,3,4-thiadiazolium-2-aminide class (Fig. 1) inhibit the in vitro growth of Leishmania amazonensis, L. brasiliensis, and L. chagasi promastigotes (6, 21). The chemistry of mesoionic rings, especially their use as masked dipoles, has been a fruitful area of research since the late 1950s. Their structures, having well-separated regions of positive and negative charge associated with a polyheteroatomic system, enable them to interact with biomolecules (14). These characteristics have been revealed by interesting biological activities including anti-inflammatory, analgesic, antibacterial, antifungal, and antitumor activities (22). In addition, this class of mesoionic compounds is known to have nitric oxide (NO)-releasing properties (11).
The present study was undertaken to investigate the in vivo
efficacy of two mesoionic derivatives (MI-H-H and MI-4-OCH
3)
in the mouse
L. amazonensis cutaneous infection model. To examine
the therapeutic efficacy of these mesoionic derivatives, CBA/J
mice 6 to 8 weeks of age were infected subcutaneously with 1.2
x 10
6 promastigotes. In this experiment, MI-H-H (24 mg/kg/day),
MI-4-OCH
3 (22 mg/kg/day), and the reference drug meglumine antimoniate
(100 mg/kg/day with 28 mg pentavalent antimonial) (
2,
22) were
administered by the subcutaneous route 27 days after the experimental
infection at 5 doses a week for 4 weeks. Animals in the control
group received the same volume of vehicle (dimethyl sulfoxide/phosphate-buffered
saline). Progression of the lesion was monitored until week
12 by measurement of footpad swelling.
At the end of drug administration (week 8), there was a slight difference between groups of mice treated with both the test compounds and the reference drug and untreated infected mice (Fig. 2). However, at week 12 postinfection, the animals treated daily with MI-4-OCH3 or MI-H-H showed significantly reduced footpad thickness, as did those treated with meglumine antimoniate, compared with that of the control group. It is important to note that, at that time, no significant differences in lesion size were observed in the groups treated with mesoionic compounds or meglumine antimoniate.
In order to evaluate the toxicity of these compounds in mice,
body weight was determined and samples of blood were taken at
different times during compound administration from the tails
of both uninfected and infected mice left untreated or treated.
The total number of leukocytes was estimated by counting in
a Neubauer chamber. The sera collected were assayed colorimetrically
for alanine aminotransferase (ALT), aspartate aminotransferase
(AST), and creatinine with commercial kits (Labtest Diagnostica,
Brazil). No apparent signs of drug toxicity, weight loss, or
lymphocyte, monocyte, or neutrophil alterations were observed
in any experiment, and AST, ALT, and creatinine concentrations
showed no apparent hepatic or renal toxicity after the treatment
with mesoionic compounds (Table
1), compared with uninfected
mice left untreated or treated with these compounds (data not
shown).
View this table:
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TABLE 1. Hematological values and toxicological aspects for uninfected mice left untreated or treated with mesoionic compounds at week 4 of treatment
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At 4 weeks after the end of treatment (week 12 of infection),
the animals were killed and their popliteal lymph nodes and
spleens were aseptically removed, weighed, and then homogenized
in Schneider's medium supplemented with 10% fetal calf serum.
Briefly, under sterile conditions, eight serial dilutions (1:10)
were prepared and distributed in 96-well microtiter plates in
triplicate. After incubation at 26°C, the wells were examined
with an inverted microscope. The final titer was the last dilution
at which the well contained at least one parasite (Fig.
3) (
3).
The parasite loads in both the popliteal lymph nodes and spleens
of animals treated with the mesoionic derivatives or meglumine
antimoniate were significantly reduced compared to those of
untreated control animals (Fig.
3;
P 
0.0001). However, the
reduction of the parasite loads in both organs after mesoionic
derivative treatment was greater than that observed after meglumine
antimoniate treatment (
P 
0.001).
In order to elucidate possible NO induction in infected CBA/J
mice, we measured the concentrations of nitrites present in
the supernatant of the lymph node and spleen cell cultures as
described by Green et al. (
10). The results are expressed as
micromolar concentrations of NO
2 based on a standard curve derived
from known concentrations of sodium nitrite (NaNO
2) dissolved
in cell culture medium. We observed a significant increase in
NO production in lymph node cell culture supernatants of infected
mice after treatment with MI-4-OCH
3 compared to those of untreated
mice (Fig.
4). These results could suggest that mesoionic derivatives
modulate infection by
L. amazonensis in vivo, activating mechanisms
that positively affect the host's capacity to eliminate the
parasites from infected cells, thus controlling parasite dissemination.
Further studies to evaluate this phenomenon would be interesting.
From studies concerning structure-activity relationships, especially
those based on the nature of the group at position 4 of the
phenyl ring (Fig.
1), the compounds with the best in vitro activity
were selected as promising drug candidates (
6). Of the two compounds
selected, the mesoionic with a 4-OCH
3 substituent was more effective
than the one with no substitution (MI-H-H). MI-4-OCH
3 administered
subcutaneously to mice for 4 weeks controlled the infection
induced by
L. amazonensis in the paws, resulting in lesions
smaller than those seen in mice treated with the reference drug
(meglumine antimoniate) or in control animals (
P < 0.001).
This study also demonstrates that both mesoionic derivative treatment decreased parasite loads (P < 0.0001) in the regional popliteal lymph nodes and in the spleen, which suggests that there is control of infection progression and that dissemination is limited. Because of the mesoionic treatment, the lymph node and spleen weights also decreased compared to those of untreated control mice. This could be correlated with the decreasing parasite loads in these groups. No renal or hepatic alterations occurred, as evidenced by normal levels of creatinine, AST, and ALT in infected mice treated with mesoionic compounds and meglumine antimoniate. The toxicity of meglumine antimoniate was also evaluated by Henao et al. (12) in the cutaneous leishmaniasis hamster model, and no hazard to the animals was observed (7). Moreover, increased NO production was observed in lymph node cell culture supernatants of infected mice treated with MI-4-OCH3 (P < 0.01). The function of NO in the leishmanicidal activity of activated macrophages has been demonstrated both in vitro and in vivo (13, 15-18). The in vitro experiments done by our group clearly revealed that mesoionic derivatives can modulate macrophage infection by NO released by L. amazonensis (data not shown). In contrast, the in vitro production of NO by L. amazonensis alone (8, 9) was decreased by MI-4-OCH3 and MI-3-OCH3 addition (23).
Furthermore, NO production by macrophages alone does not fully explain the inhibitory effect of mesoionic compounds on lesions induced by L. amazonensis in vivo. Thus, while macrophages are one of the main sources of NO, this radical may also be released by other cells involved in the infection process, including Leishmania parasites (8). Cytokines and other mediators released from activated cells that modify macrophage functions underscore the complexity of the process.
It is already known that meglumine antimoniate is usually parenterally administered and that it irritates the intestinal mucosa, causing a low absorption rate in the gastrointestinal tract, and for that reason this drug could not be used by the oral route (20). However, mesoionic derivatives should be tested orally in future research. These compounds are able to interact with biomolecules; although the compounds are internally charged, they are neutral overall and therefore can cross biological membranes in vivo (6). These properties could allow other routes of treatment with mesoionic derivatives, meaning advantages over antimonials.
Given these considerations, further studies are necessary to elucidate the mechanism of action of mesoionic compounds in the defense of the organisms against infection, creating new perspectives for the investigation of other mediators.
In conclusion, the lack of apparent toxicity of this compound, as attested by the blood and serum pathology of treated mice and its protective in vivo effect during murine leishmaniasis encourage further studies of mesoionic derivatives such as MI-OCH3 as new antileishmanial drugs and as modifiers of the immunological response to combat infections with intracellular pathogens, as well as tissue histology.

ACKNOWLEDGMENTS
This work was supported by grants from CNPq, CAPES, PDTIS, and
FIOCRUZ and fellowships from CNPq and CAPES.

FOOTNOTES
* Corresponding author. Mailing address: Laboratório de Bioquímica de Tripanosomatídeos, Instituto Oswaldo Cruz/Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil CEP 21045-900. Phone: 55 21 38658225. Fax: 55 21 22900479. E-mail:
mcantocavalheiro{at}hotmail.com 
Published ahead of print on 17 November 2008. 

REFERENCES
1 - Alrajhi, A. A., E. B. De Vol, and J. H. Maguire. 2002. Fluconazole for the treatment of cutaneous leishmaniasis. N. Engl. J. Med. 346:891-895.[Abstract/Free Full Text]
2 - Barão, S. C., and S. Giorgio. 2003. Efficacy of 8-bromoguanosine against murine cutaneous leishmaniasis induced with Leishmania amazonensis. Chemotherapy 49:159-162.[Medline]
3 - Bertho, A. L., M. A. Santiago, and S. G. Coutinho. 1994. An experimental model of the production of metastases in murine cutaneous leishmaniasis. J. Parasitol. 80:93-99.[Medline]
4 - Croft, S. L., and G. H. Coombs. 2003. Leishmaniasis—current chemotherapy and recent advances in the search for novel drugs. Trends Parasitol. 19:502-508.[CrossRef][Medline]
5 - Croft, S. L., K. Seifert, and V. Yardley. 2006. Current scenario of drug development for leishmaniasis. Indian J. Med. Res. 123:399-410.[Medline]
6 - da Silva, E. F., M. M. Canto-Cavalheiro, V. R. Braz, L. Cysne-Finkelstein, L. L. Leon, and A. Echevarria. 2002. Synthesis and biological evaluation of new 1,3,4-thiadiazolium-2-phenylamine derivatives against Leishmania amazonensis promastigotes and amastigotes. Eur. J. Med. Chem. 37:979-984.[Medline]
7 - Deps, P. D., M. C. Vianna, A. Falqueto, and R. Dietze. 2000. Evaluation of the efficacy and toxicity of N-methyl-glucamine vs BP88 sodium stibogluconate in the treatment of localized cutaneous leishmaniasis. Rev. Soc. Bras. Med. Trop. 33:535-543.[Medline]
8 - Géigel, L. F., and L. L. Leon. 2003. Cyclic 3'-5' guanosine monophosphate-dependent activity in Leishmania amazonensis. Mem. Inst. Oswaldo Cruz 98:499-500.[Medline]
9 - Genestra, M. S., W. J. Souza, L. Cysne-Finkelstein, and L. L. Leon. 2003. Comparative analysis of nitric oxide production by Leishmania sp. Med. Microbiol. Immunol. 192:217-223.[Medline]
10 - Green, L. C., D. A. Wagner, J. Glogowski, P. L. Skipper, J. S. Wishnok, and S. R. Tannenbaum. 1982. Analysis of nitrate, nitrite and [15N]nitrate in biological fluids. Anal. Biochem. 126:131.[CrossRef][Medline]
11 - Gryglewski, R. J., E. Marcinkiewicz, J. Robak, Z. Michalska, and J. Madej. 2002. Mesoionic oxatriazoles (MOTA): NO-donating characteristics and pharmacology. Curr. Pharm. Des. 8:167-176.[Medline]
12 - Henao, H. H., Y. Osorio, N. G. Saravia, A. Gomes, and B. Travi. 2004. Efficacy and toxicity of pentavalent antimonials (Glucantime and Pentostam) in an American cutaneous leishmaniasis animal model: luminometry application. Biomedica 24:393-402.[Medline]
13 - Kavoosi, G., S. K. Ardestani, A. Kariminia, and Z. Tavakoli. 2006. Production of nitric oxide by murine macrophages induced by lipophosphoglycan of Leishmania major. Korean J. Parasitol. 44:35-41.[Medline]
14 - Kier, L. B., and E. B. Roche. 1967. Medicinal chemistry of the mesoionic compounds. J. Pharm. Sci. 56:149-168.[Medline]
15 - Lemos de Souza, V., J. A. Souza, T. M. C. Silva, and P. S. T. Veras. 2000. Different Leishmania species determine distinct profiles of immune and histopathological responses in CBA mice. Microbes Infect. 2:1807-1815.[CrossRef][Medline]
16 - Li, J., C. A. Hunter, and J. P. Farrel. 1999. Anti-TGF-β treatment promotes rapid healing of Leishmania major infection in mice by enhancing in vivo nitric oxide production. J. Immunol. 162:974-979.[Abstract/Free Full Text]
17 - Liew, F. Y., L. Yun, and S. Millott. 1990. Tumor necrosis factor
synergizes with INT-
in mediating killing of Leishmania major through the induction of nitric oxide. J. Immunol. 145:4306-4310.[Abstract] 18 - Liew, F. Y., Y. Li, D. Moss, C. Parkinson, M. V. Rogers, and S. Moncada. 1991. Resistance to Leishmania major infection correlates with the induction of nitric oxide synthase in murine macrophages. Eur. J. Immunol. 21:3009-3014.[Medline]
19 - Ouellette, M., J. Drummelsmith, and B. Papadopoulou. 2004. Leishmaniasis: drugs in the clinic, resistance and new developments. Drug Resist. Updates 7:257-266.[CrossRef][Medline]
20 - Pintado, V., and R. Lopez-Velez. 2001. HIV-associated visceral leishmaniasis. Clin. Microbiol. Infect. 7:291-300.[CrossRef][Medline]
21 - Rodrigues, R. F., E. F. da Silva, A. Echevarria, R. Fajardo-Bonin, V. F. Amaral, L. L. Leon, and M. M. Canto-Cavalheiro. 2007. A comparative study of mesoionic compounds in Leishmania sp and toxicity evaluation. Eur. J. Med. Chem. 42:1039-1043.[Medline]
22 - Senff-Ribeiro, A., A. Echevarria, E. F. da Silva, S. S. Veiga, and M. B. M. Oliveira. 2003. Effect of a new 1,3,4-thiadiazolium mesoionics compound (MI-D) on B16-F10 murine melanoma. Melanoma Res. 13:465-471.[Medline]
23 - Soares-Bezerra, R. J., E. F. da Silva, A. Echevarria, L. Gomes-da-Silva, L. Cysne-Finkelstein, F. P. Monteiro, L. L. Leon, and M. Genestra. 2008. Effect of mesoionic 4-phenyl-5-(cinnamoyl)-1,3,4-thiadiazolium-2-phenylamine chloride derivative salts on the activities of the nitric oxide synthase and arginase of Leishmania amazonensis. J. Enzyme Inhib. Med. Chem. 23:328-333.[Medline]
24 - World Health Organization. 1999. Tropical disease research: progress in international research, 1997-1998. World Health Organization, Geneva, Switzerland.
Antimicrobial Agents and Chemotherapy, February 2009, p. 839-842, Vol. 53, No. 2
0066-4804/09/$08.00+0 doi:10.1128/AAC.00062-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.