title: Antileishmanial activity of antiretroviral drugs combined with miltefosine.
abstract: Co-infection of Leishmaniasis, a neglected tropical disease, with human immunodeficiency virus (HIV) has hindered treatment efficacy. In this study, we aim to evaluate the antileishmanial activity of two protease inhibitors (darunavir and atazanavir) and four reverse transcriptase inhibitors (tenofovir, efavirenz, neviraprine, and delavirdine mesylate) on Leishmania infantum. The activity of different antiretrovirals combinations and of antiretroviral with miltefosine, a drug used on leishmaniasis treatment, was also evaluated. Only two non-nucleoside reverse transcriptase inhibitors (NNRTIs) were active on L. infantum. Efavirenz showed the best antileishmanial activity on promastigotes cells with IC50 value of 26.1 μM followed by delavirdine mesylate with an IC50 value of 136.2 μM. Neviraprine, tenofovir, atazanavir, and darunavir were not active at the concentrations tested (IC50 > 200 μM). The efavirenz also showed high antileishmanial activity on intramacrophage amastigotes with IC50 of 12.59 μM. The interaction of efavirenz with miltefosine improved antileishmanial activity on promastigotes and intracellular amastigotes (IC50 values of 11. 8 μM and 8.89 μM, respectively). These results suggest that combined-therapy including efavirenz and miltefosine could be alternative options for treating Leishmaniasis and Leishmania/HIV co-infections.
authors.affiliation: Programme in Experimental Biology and Biomedicine, Centre for Neurosciences and Cell Biology, and Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal.|CNC -Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, Portugal.
authors.forename: Sonya
authors.initials: S
authors.lastname: Costa
authors.affiliation: CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra, PRD, Portugal.|CIBIO-UP, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, InBIO, Vairão, Portugal.
authors.forename: Marisa
authors.initials: M
authors.lastname: Machado
authors.affiliation: CNC -Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, Portugal.|Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde - Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal.
authors.forename: Cláudia
authors.initials: C
authors.lastname: Cavadas
authors.affiliation: CNC -Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, Portugal. mcsousa@ci.uc.pt.|Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde - Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal. mcsousa@ci.uc.pt.
authors.forename: Maria
authors.initials: M
authors.lastname: do Céu Sousa
mesh_terms: D000480:Alkynes; D000818:Animals; D044966:Anti-Retroviral Agents / Q000494:pharmacology*; D000981:Antiprotozoal Agents / Q000494:pharmacology*; D000069446:Atazanavir Sulfate / Q000494:pharmacology; D048588:Benzoxazines / Q000494:pharmacology; D060085:Coinfection; D003521:Cyclopropanes; D000069454:Darunavir / Q000494:pharmacology; D020008:Delavirdine / Q000494:pharmacology; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D018314:Leishmania infantum / Q000187:drug effects*; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000188:drug therapy* / Q000469:parasitology; D008264:Macrophages / Q000469:parasitology / Q000821:virology; D008297:Male; D008807:Mice, Inbred BALB C; D019829:Nevirapine / Q000494:pharmacology; D010767:Phosphorylcholine / Q000031:analogs & derivatives* / Q000494:pharmacology; D011480:Protease Inhibitors / Q000494:pharmacology; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology; D000068698:Tenofovir / Q000494:pharmacology
chemical_list: D000480:Alkynes; D044966:Anti-Retroviral Agents; D000981:Antiprotozoal Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D011480:Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D010767:Phosphorylcholine; D000069446:Atazanavir Sulfate; C039128:miltefosine; D019829:Nevirapine; D000068698:Tenofovir; D020008:Delavirdine; C098320:efavirenz; D000069454:Darunavir
keywords: Delavirdine mesylate; Efavirenz; Leishmania infantum; Leishmania/HIV co-infection; Miltefosine