4.5 Review

Chagas Disease Chemotherapy: What Do We Know So Far?

Journal

CURRENT PHARMACEUTICAL DESIGN
Volume 27, Issue 38, Pages 3963-3995

Publisher

BENTHAM SCIENCE PUBL LTD
DOI: 10.2174/1381612827666210216152654

Keywords

Benznidazole; chagas disease; chemotherapy; drug design; synthesis; Trypanosoma cruzi

Funding

  1. Brazilian agency Conselho Nacional de Desenvolvimento Cientifco e Tecnologico (CNPq)
  2. Brazilian agency Fundacao Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro (FAPERJ)

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Chagas disease is a Neglected Tropical Disease affecting around 6-7 million people worldwide, predominantly in Latin America. Current treatments, benznidazole and nifurtimox, have limited effectiveness and can cause side effects, especially in the chronic phase. Studies have shown potential new drugs with equivalent or superior efficacy to benznidazole, highlighting the need for further research to improve treatment options.
Chagas disease is a Neglected Tropical Disease (NTD), and although it is endemic in Latin America, it affects around 6-7 million people worldwide. The treatment of Chagas disease is based on benznidazole and nifurtimox, which are the only available drugs. However, they are not effective during the chronic phase and cause several side effects. Furthermore, BZ promotes cure in 80% of the patients in the acute phase, but the cure rate drops to 20% in adults in the chronic phase of the disease. In this review, we present several studies published in the last six years, which describe the antiparasitic potential of distinct drugs, from the synthesis of new compounds, aiming to target the parasite, as well as the repositioning and the combination of drugs. We highlight several compounds that have shown equivalency or superiority to BZ, which means that they should be further studied, either in vitro or in vivo. Furthermore, we highlight the differences in the effects of BZ on the same strain of T. cruzi, which might be related to methodological differences, such as parasite and cell ratios, host cell type, and the time of adding the drug. In addition, we discussed the wide variety of strains and also the cell types used as host cells, making it difficult to compare the trypanocidal effect of the compounds.

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