title: Antileishmanial efficacy of fluconazole and miltefosine in combination with an immunomodulator--picroliv.
abstract: The chemotherapy of visceral leishmaniasis (VL) has several limitations including resistance and toxicity of the existing drugs. Downregulation of immune system further aggravates the problems. To combat this situation, leishmanicidal efficacy of already marketed standard antifungal drug, fluconazole under the approach of "therapeutic switching" in combination with standard antileishmanial drug, miltefosine, and a potent immunomodulator agent, picroliv, were evaluated in hamsters infected with Leishmania donovani. Animals treated with fluconazole (50 mg/kg × 5 days, oral (p.o.)) + miltefosine (5 mg/kg × 5 days, p.o.) showed enhancement in antileishmanial efficacy (77%), reactive nitrogen species, reactive oxygen species, hydrogen peroxide, and phagocytosis index as compared to those treated with individual drugs. Addition of picroliv to this combination further increased the antileishmanial efficacy from 77% to 88%. Upregulation of cell-mediated immunity was also observed in animals of this group which strengthens the immunomodulatory role of picroliv. These findings suggest a new option for antileishmanial chemotherapy at lower cost and toxicity.
authors.affiliation: Division of Parasitology, Central Drug Research Institute (CSIR), Chattar Manzil Palace, M.G. Road, Lucknow, 226001, Uttar Pradesh, India.
authors.forename: Nishi
authors.initials: N
authors.lastname: Shakya
authors.forename: Shraddha A
authors.initials: SA
authors.lastname: Sane
authors.forename: Suman
authors.initials: S
authors.lastname: Gupta
mesh_terms: D000818:Animals; D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D002934:Cinnamates / Q000008:administration & dosage*; D006224:Cricetinae; D004359:Drug Therapy, Combination / Q000379:methods; D015725:Fluconazole / Q000008:administration & dosage*; D006027:Glycosides / Q000008:administration & dosage*; D006861:Hydrogen Peroxide / Q000378:metabolism; D007111:Immunity, Cellular / Q000187:drug effects; D007893:Leishmania donovani / Q000187:drug effects*; D007898:Leishmaniasis, Visceral / Q000188:drug therapy*; D010587:Phagocytosis; D010767:Phosphorylcholine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D017382:Reactive Oxygen Species / Q000378:metabolism; D016896:Treatment Outcome; D014641:Vanillic Acid / Q000008:administration & dosage*
chemical_list: D000981:Antiprotozoal Agents; D002934:Cinnamates; D006027:Glycosides; D017382:Reactive Oxygen Species; D010767:Phosphorylcholine; C057463:kutkin; C039128:miltefosine; D015725:Fluconazole; D006861:Hydrogen Peroxide; D014641:Vanillic Acid