title: In vitro susceptibilities of Leishmania donovani promastigote and amastigote stages to antileishmanial reference drugs: practical relevance of stage-specific differences.
abstract: The in vitro susceptibilities of the reference strain Leishmania donovani MHOM/ET/67/L82 to sodium stibogluconate, amphotericin B, miltefosine, and the experimental compound PX-6518 were determined for extracellular log-phase promastigotes, established axenic amastigotes, fresh spleen-derived amastigotes, and intracellular amastigotes in primary mouse peritoneal macrophages. Susceptibility to amphotericin B did not differ across the various axenic models (50% inhibitory concentrations [IC50], 0.6 to 0.7 microM), and amphotericin B showed slightly higher potency against intracellular amastigotes (IC50, 0.1 to 0.4 microM). A similar trend was observed for miltefosine, with comparable efficacies against the extracellular (IC50, 0.4 to 3.8 microM) and intracellular (IC50, 0.9 to 4.3 microM) stages. Sodium stibogluconate, used either as Pentostam or as a crystalline substance, was inactive against all axenic stages (IC50, >64 microg SbV/ml) but showed good efficacy against intracellular amastigotes (IC50, 22 to 28 microg SbV/ml); the crystalline substance was about two to three times more potent (IC50, 9 to 11 microg SbV/ml). The activity profile of PX-6518 was comparable to that of sodium stibogluconate, but at a much higher potency (IC50, 0.1 microg/ml). In conclusion, the differential susceptibility determines which in vitro models are appropriate for either drug screening or resistance monitoring of clinical field isolates. Despite the more complex and labor-intensive protocol, the current results support the intracellular amastigote model as the gold standard for in vitro Leishmania drug discovery research and for evaluation of the resistance of field strains, since it also includes host cell-mediated effects. Axenic systems can be recommended only for compounds for which no cellular mechanisms are involved, for example, amphotericin B and miltefosine.
authors: Laboratory for Microbiology, Parasitology, and Hygiene (LMPH), Faculty of Pharmaceutical, Biomedical, and Veterinary Sciences, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium.
authors: Marieke
authors: M
authors: Vermeersch
authors: Raquel Inocêncio
authors: RI
authors: da Luz
authors: Kim
authors: K
authors: Toté
authors: Jean-Pierre
authors: JP
authors: Timmermans
authors: Paul
authors: P
authors: Cos
authors: Louis
authors: L
authors: Maes
mesh_terms: D000666:Amphotericin B / Q000494:pharmacology; D000818:Animals; D000967:Antimony Sodium Gluconate / Q000494:pharmacology; D000981:Antiprotozoal Agents / Q000494:pharmacology*; D002478:Cells, Cultured; D020128:Inhibitory Concentration 50; D007893:Leishmania donovani / Q000187:drug effects* / Q000254:growth & development* / Q000648:ultrastructure; D007896:Leishmaniasis / Q000188:drug therapy; D051379:Mice; D046529:Microscopy, Electron, Transmission; D021261:Parasitic Sensitivity Tests; D010767:Phosphorylcholine / Q000031:analogs & derivatives / Q000494:pharmacology; D012503:Saponins / Q000494:pharmacology / Q000627:therapeutic use; D014315:Triterpenes / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000981:Antiprotozoal Agents; C481665:PX-6518; D012503:Saponins; D014315:Triterpenes; D010767:Phosphorylcholine; C039128:miltefosine; D000666:Amphotericin B; D000967:Antimony Sodium Gluconate