A review of current treatments strategies based on paromomycin for leishmaniasis

Abstract

Leishmaniasis is a neglected disease caused by protozoan parasites of the Leishmania genus, which affects many people in several countries. This disease has three major clinical forms: cutaneous, mucocutaneous and visceral. The current treatments consist of an intravenous, intralesional or intramuscular administration of pentavalent antimonials, but other drugs can be used, among them, amphotericin B, pentamidine, paromomycin and miltefosine. However, these therapies have many side effects. Hence, there is an increase of studies searching for new formulations using different technologies and different routes of administration for leishmaniasis treatment. Paromomycin sulfate (PM) is an aminoglycoside antibiotic, belonging to class III of biopharmaceutical classification system, used intravenously and topically with leishmanicidal activity. This review will provide a general overview of PM current leishmaniasis treatments and new PM formulations. Treatments using PM are available in ointments or creams for topical administration and PM solution for intramuscular administration. The topical treatment with PM presents low efficacy, probably related to low drug permeability across the skin. To improve PM permeability and efficacy, researchers are establishing micro and nanotechnologies. However, further studies are still required to investigate more physicochemical properties and in vitro/in vivo parameters.

Total Phenolic Fraction (TPF) from Extra Virgin Olive Oil: Induction of apoptotic-like cell death in Leishmania spp. promastigotes and in vivo potential of therapeutic immunomodulation

“…The pentavalent antimony compounds, firstly introduced in the 1940s, have been used as the first line drugs against cutaneous or visceral leishmaniasis, despite the long lasting parenteral route of administration and high toxicity [ 2 ]. Paromomycin is an aminoglycoside antibiotic, discovered in the 1960s, with leishmanicidal activity, also administered by the parenteral route with varying efficacy in different Leishmania species [ 3 , 4 ]. Miltefosine is the only oral drug approved for leishmaniasis treatment since 2002 but the emergence of a relevant relapse rate possesses the ultimate use of miltefosine as an option mainly for combination therapy [ 5 , 6 ].…”

2-aminobenzimidazoles for leishmaniasis: From initial hit discovery to in vivo profiling

“…[ 7 , 8 ] Co-infection with HIV is a common complication and is a significant additional threat to patients health. [ 9 ]…”

Efficacy and Safety of Paromomycin for Visceral Leishmaniasis: A Systematic Review

“…e mechanism of PM against Leishmania is not completely understood yet. However, it is proposed that PM causes inhibition of translocation and recycling of ribosome subunits as well as modification in mitochondrial membrane potential leading to protein synthesis inhibition in Leishmania parasite [17]. is mechanism of action of PM against Leishmania is shown in Figure 1.…”