Wijnant, G-J;
Van Bocxlaer, K;
Fortes Francisco, A;
Yardley, V;
Harris, A;
Alavijeh, M;
Murdan, S;
(2018)
Local Skin Inflammation in Cutaneous Leishmaniasis as a Source of Variable Pharmacokinetics and Therapeutic Efficacy of Liposomal Amphotericin B.
Antimicrobial Agents and Chemotherapy
, 62
(10)
, Article e00631-18. 10.1128/AAC.00631-18.
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Abstract
Disfiguring skin lesions caused by several species of the Leishmania parasite characterize cutaneous leishmaniasis (CL). Successful treatment of CL with intravenous (IV) liposomal amphotericin B (LAmB) relies on the presence of adequate antibiotic concentrations at the dermal site of infection within the inflamed skin. Here, we have investigated the impact of the local skin inflammation on the pharmacokinetics (PK) and efficacy of LAmB in two murine models of localized CL (Leishmania major and Leishmania mexicana) at three different stages of disease (papule, initial nodule and established nodule). Twenty-four hours after administration of 1 x 25 mg/kg LAmB (IV) to infected BALB/c mice (n=5), drug accumulation in skin was found to be dependent on the causative parasite species (L. major > L. mexicana) and the disease stage (papule > initial nodule > established nodule > healthy skin). Elevated tissue drug levels were associated with increased vascular permeability (Evans Blue assay) and macrophage infiltration (histomorphometry) in the infected skin, two pathophysiological parameters linked to tissue inflammation. After identical treatment of CL in the two models with 5 x 25 mg/kg LAmB (IV), intralesional drug concentrations and reductions in lesion size and parasite load (qPCR) were all ≥ 2-fold higher for L.major compared to L. mexicana In conclusion, drug penetration of LAmB into CL skin lesions could depend on the disease stage and the causative Leishmania species due to the influence of local tissue inflammation.
| Type: | Article |
|---|---|
| Title: | Local Skin Inflammation in Cutaneous Leishmaniasis as a Source of Variable Pharmacokinetics and Therapeutic Efficacy of Liposomal Amphotericin B |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1128/AAC.00631-18 |
| Publisher version: | http://dx.doi.org/10.1128/AAC.00631-18 |
| Language: | English |
| Additional information: | Copyright © 2018 Wijnant et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license. (https://creative commons.org/licenses/by/4.0/). |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Pharmaceutics |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10054906 |
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