title: Evaluation of the efficacy of systemic miltefosine associated with photodynamic therapy with liposomal chloroaluminium phthalocyanine in the treatment of cutaneous leishmaniasis caused by Leishmania (L.) amazonensis in C57BL/6 mice.
abstract: BACKGROUND
  The shortage of drugs is a concern and has become the object of studies to discover effective alternatives for cutaneous leishmaniasis (CL) treatment. A topical formulation has been sought due to its low toxicity. Development of alternative therapies, such as multimodal ones, is important in confronting drug resistance. This study aims to compare the in vivo efficacy of topical photodynamic therapy (PDT) using liposomal chloroaluminium phthalocyanine (AlClPC) in the treatment of CL, isolated and associated with systemic therapy with miltefosine.
  
  
  METHODS
  Five groups were adopted, each one with six isogenic adult female mice C57BL/6: (1) Negative Control-non-infected and non-treated; (2) Positive Control (PBS)-infected and non-treated; (3) Miltefosine-infected and treated with oral miltefosine 200 mg/kg/day; (4) Infected and treated with PDT with topical AlClPC (500 μL) on alternate days; (5) Oral Miltefosine 200 mg/kg/day and PDT with topical AlClPC (500 μL) on alternate days. Therapeutic schemes lasted 20 days. Infection was confirmed by culture in Nove-McNeal-Nicolle medium (NNN) of lymph collected from the animal paw, and animals were evaluated by paw measurement and parasitological criteria.
  
  
  RESULTS
  Miltefosine associated with PDT with AlClPC promoted a significant reduction in parasite number and viability when compared to the other infected groups, also returning the paw diameter to a size similar to the negative control group after 20 days of treatment.
  
  
  CONCLUSIONS
  Association of miltefosine with PDT mediated by topical AlClPC represents hopes for CL treatment, an increasing dermatological disease in some countries.
authors: Faculdade de Medicina, Laboratório de Dermatomicologia, Universidade de Brasília, Campus Universitário Darcy Ribeiro, 70910-900 Brasília/DF, Brazil.
authors: Jefferson Bruno Pereira
authors: JBP
authors: Ribeiro
authors: Instituto de Ciências Biológicas, Departamento de Genética e Morfologia, Universidade de Brasília, Campus Darcy Ribeiro, 70910-900 Brasília/DF, Brazil; Faculdades Integradas da União Educacional do Planalto Central (Faciplac), Curso de Medicina, Campus Gama, 72460-000 Gama/DF, Brazil. Electronic address: analuisamv@uol.com.br.
authors: Ana Luisa
authors: AL
authors: Miranda-Vilela
authors: Faculdade de Medicina, Laboratório de Dermatomicologia, Universidade de Brasília, Campus Universitário Darcy Ribeiro, 70910-900 Brasília/DF, Brazil.
authors: Daniel
authors: D
authors: Graziani
authors: Faculdade de Medicina, Laboratório Farmacognosia, Universidade de Brasília, Campus Darcy Ribeiro, 70910-900 Brasília/DF, Brazil.
authors: Misléia Rodrigues de Aguiar
authors: MRA
authors: Gomes
authors: Faculdade de Medicina, Laboratório de Dermatomicologia, Universidade de Brasília, Campus Universitário Darcy Ribeiro, 70910-900 Brasília/DF, Brazil.
authors: Ana Angélica Santarem
authors: AAS
authors: Amorim
authors: Faculdade de Medicina, Laboratório de Dermatomicologia, Universidade de Brasília, Campus Universitário Darcy Ribeiro, 70910-900 Brasília/DF, Brazil.
authors: Rafaela Debastiani
authors: RD
authors: Garcia
authors: Instituto de Ciências Biológicas, Departamento de Genética e Morfologia, Universidade de Brasília, Campus Darcy Ribeiro, 70910-900 Brasília/DF, Brazil.
authors: José
authors: J
authors: de Souza Filho
authors: Departamento de Química, Laboratório de Fotobiologia e Fotomedicina, Centro de Nanotecnologia e Engenharia Tecidual, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, 14040-901 Ribeirão Preto-SP, Brazil.
authors: Antônio Cláudio
authors: AC
authors: Tedesco
authors: Departamento de Química, Laboratório de Fotobiologia e Fotomedicina, Centro de Nanotecnologia e Engenharia Tecidual, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, 14040-901 Ribeirão Preto-SP, Brazil.
authors: Fernando Lucas
authors: FL
authors: Primo
authors: Faculdades Projeção, Núcleo de Desenvolvimento Científico (NDC), 72115-700 Taguatinga/DF, Brazil.
authors: Jonathan Rosa
authors: JR
authors: Moreira
authors: Instituto Brasileiro de Segurança no Trânsito, SRTVS Quadra 701 Bloco 3, Cobertura, Edificio Palácio do Rádio I, Asa Sul, 70340-901 Brasília/DF, Brazil.
authors: Alexandre Vasconcelos
authors: AV
authors: Lima
authors: Faculdade de Medicina, Laboratório de Dermatomicologia, Universidade de Brasília, Campus Universitário Darcy Ribeiro, 70910-900 Brasília/DF, Brazil.
authors: Raimunda Nonata Ribeiro
authors: RNR
authors: Sampaio
mesh_terms: D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage; D005260:Female; D007211:Indoles / Q000008:administration & dosage*; D007891:Leishmania / Q000187:drug effects* / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy* / Q000382:microbiology* / Q000473:pathology; D008081:Liposomes / Q000737:chemistry; D051379:Mice; D008810:Mice, Inbred C57BL; D009942:Organometallic Compounds / Q000008:administration & dosage*; D010767:Phosphorylcholine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D007211:Indoles; D008081:Liposomes; D009942:Organometallic Compounds; D017319:Photosensitizing Agents; D010767:Phosphorylcholine; C044797:chloroaluminum phthalocyanine; C039128:miltefosine
keywords: Cutaneous leishmaniasis; Liposomal chloroaluminium phthalocyanine; Miltefosine; Nanodrug; Photodynamic therapy