Drug delivery systems for the topical treatment of cutaneous leishmaniasis.
BACKGROUND
The parenteral administration of pentavalent antimonials for the treatment of all forms of leishmaniasis, including cutaneous leishamniasis (CL), has several limitations. Therapy is long, requiring repeated doses and the adverse reactions are frequent. Topical treatment is an attractive alternative for CL, offering significant advantages over systemic therapy: fewer adverse effects, ease of administration, and lower costs.


METHODS
This review covers, from 1984 to the present, the progress achieved for the development of topical treatment for CL, using different drugs such as paromomycin (PA), imiquimod, amphotericin B (AmB), miltefosine, and buparvaquone. PA is the most commonly studied drug, followed by AmB and Imiquimod. These drugs were incorporated in conventional dosage forms or loaded in lipid nanocarries, which have been used mainly for improved skin delivery and antileishmanial activity.


CONCLUSIONS
Developing an effective topical treatment for CL using these antileishmanial drugs still remains a great challenge. Insights into the most promising delivery strategies to improve treatment of CL with PA and AmB using conventional dosage forms, lipid nanocarriers, and combined therapy are presented and discussed. The results obtained with combined therapy and alternative delivery systems are promising perspectives for improving topical treatment of CL.
Federal University of Minas Gerais, Faculty of Pharmacy, Belo Horizonte, Minas Gerais, Brazil.
Guilherme
G
Carneiro
Marta Gontijo
MG
Aguiar
Ana Paula
AP
Fernandes
Lucas Antônio Miranda
LA
Ferreira
D000279:Administration, Cutaneous; D000634:Aminoquinolines / Q000008:administration & dosage; D000666:Amphotericin B / Q000008:administration & dosage; D000818:Animals; D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D016503:Drug Delivery Systems; D006801:Humans; D000077271:Imiquimod; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy*; D009285:Naphthoquinones / Q000008:administration & dosage; D010303:Paromomycin / Q000008:administration & dosage; D010767:Phosphorylcholine / Q000008:administration & dosage / Q000031:analogs & derivatives; D012869:Skin Absorption
D000634:Aminoquinolines; D000981:Antiprotozoal Agents; D009285:Naphthoquinones; C046326:buparvaquone; D010767:Phosphorylcholine; C039128:miltefosine; D010303:Paromomycin; D000666:Amphotericin B; D000077271:Imiquimod