Leishmaniasis is a group of neglected
tropical diseases (NTDs)
caused by about 20 species of obligate intracellular protozoan parasites
of the genus Leishmania, which occurs
in cutaneous, mucocutaneous, and visceral forms. Many researchers
have sought to utilize natural products for novel and effective treatments
to combat many infectious diseases, including leishmaniasis. Holarrhena pubescens Wall. ex G. Don (Apocynaceae)
bark is a rich source of bioactive steroidal alkaloids. The total
alkaloidal extract (IC50 6.12 ± 0.117 μg/mL),
and the isolated alkaloid, holanamine, showed significant antileishmanial
activity (IC50 2.66 ± 0.112 μM against AG83
and 3.80 ± 0.126 μM against BHU-575) against the Leishmania donovani parasite, better than miltefosine
(IC50 19.61 ± 0.093 μM against AG83 and 23.20
± 0.094 μM against BHU-575). Holanamine inhibited the L. donovani topoisomerase 1B (LdToP1B) in a non-competitive
manner (IC50 2.81 ± 0.105 μM), indicating that
it interacts with the free enzyme and enzyme–DNA complex without
inhibiting human topoisomerase. Hydrogen bonding and hydrophobic interactions
of holanamine with the N-terminal and hinge region of the large subunit
of LTop1B is responsible for its potent antileishmanial activity,
as shown by docking studies. Treatment with holanamine causes apoptotic-like
cell death by generating cellular and mitochondrial reactive oxygen
species, disrupting the mitochondrial membrane potential and inducing
ultrastructural alterations in the promastigotes. Holanamine effectively
clears intracellular amastigotes but minimally affects host macrophages
with no significant cytotoxicity in HEK 293 and L929 cell lines. Thus,
our studies show that holanamine can further be used to develop effective
antileishmanial agents against evolving drug-resistant parasites.