Over a billion individuals worldwide suffer from neglected diseases. This equates to approximately one-sixth of the human population. These infections are often endemic in remote tropical regions of impoverished populations where vectors can flourish and infected individuals cannot be effectively treated due to a lack of hospitals, medical equipment, drugs, and trained personnel. The few drugs that have been approved for the treatments of such illnesses are not widely used because they are riddled with inadequate implications of cost, safety, drug availability, administration, and resistance. Hence, there exists an eminent need for the design and development of improved new therapeutics. Influential world-renowned scientists in the Consortium for Parasitic Drug Development (CPDD) have preformed extensive biological testing for compounds active against parasites that cause neglected diseases. These data were acquired through several collaborations and found applicable to computational studies that examine quantitative structure-activity relationships through the development of predictive models and explore structural relationships through docking. Both of these in silico tools can contribute to an understanding of compound structural importance for specific targets. The compilation of manuscripts presented in this dissertation focus on three neglected diseases: trypanosomiasis, Chagas disease, and leishmaniasis. These diseases are caused by kinetoplastid parasites Trypanosoma brucei, Trypanosoma cruzi, and Leishmania spp., respectively. Statistically significant predictive devices were developed for the inhibition of the: (1) T. brucei P2 nucleoside transporter, (2) T. cruzi parasite at two temperatures, and (3) two species of Leishmania. From these studies compound structural importance was assessed for the targeting of each parasitic system. Since these three parasites are all from the Order Kinetoplastida and the kinetoplast DNA has been determined a viable target, compound interactions with DNA were explored to gain insight into binding modes of known and novel compounds.

The purpose of this study was to perform a cost-benefit analysis of an intervention to treat all the children in Bolivia (under 15 years of age) who are infected with Chagas disease. This research was carried out in La Paz, Bolivia where the author lived for a year collecting data in collaboration with the National Chagas Control Program, Bolivian Ministry of Health. Operational costs were based on current prices for laboratory testing and pharmaceuticals, average hourly wages for health care workers, and the number of children who would be treated. The benefit of the program was estimated as the sum of direct and indirect costs associated with chronic cardiac disease caused by Chagas infection. Direct costs were calculated as the minimum amount needed for adequate medical treatment summed over the patients life span. Indirect costs were measured in Disability-Adjusted Life Years (DALYs) multiplied by average yearly salary to more fully account for the true burden of disease. Implementation cost was estimated to be approximately $35 million. This intervention would prevent over 279,000 DALYs and alleviate $123 million in direct and $632 million in indirect costs. Clearly, such a program would be extremely cost-effective. Thus, with an initial investment of less than $135 per infected child, approximately $2,900 worth of future costs would be prevented, in addition to improvements in quality of life not captured by DALYs. A sensitivity analysis showed that even while assuming a high variability of the data, the cost and benefit of this intervention were significantly different (p-value < 0.001).

Thesis (M.S.)--University of Texas at El Paso, 2007. / Title from title screen. Vita. CD-ROM. Includes bibliographical references. Also available online.

Diss. (sammanfattning) Stockholm : Karol inst., 2003. / Härtill 5 uppsatser.

Lic.-avh. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 2 uppsatser.

Thesis (M.S.)--Baylor University, 2007. / Includes bibliographical references (p. 1-6 [second group]).

Orientador: João Aristeu da Rosa / Coorientador: Sergio de Albuquerque / Banca: Mara Cristina Pinto / Banca: Carlos Eugenio Cavasini / Banca: Ana Amélia Carraro Abrahão / Banca: Maria Tercilia Vilela Azeredo de Oliveira / Resumo: A atividade de 92 extratos etanólicos de espécies de Annonaceae, Apiaceae, Cucurbitaceae, Lauraceae, Moraceae, Nyctaginaceae, e Verbenaceae foi avaliada sobre formas epimastigotas das cepas Y e Bolívia de Trypanosoma cruzi, nas concentrações de 500, 350, 250 e 100 µg/ml. Quinze extratos de Lippia salviaefolia, L. sidoides, L. laciocalycina, L. lupulina, L. balansae, L. velutina e suas frações hexânicas, de acetato de etila, n-butanólicas e aquosas foram avaliados sobre formas epimastigotas do clone B5 da cepa CL Brener de T. cruzi, nas concentrações de 32, 8, 2 e 0,5 µg/ml. Adicionalmente, as amostras mais promissoras de Lippia sp foram avaliadas, in vitro, sobre as formas tripomastigotas e amastigotas de T. cruzi e, in vivo, em camundongos BALB/c. A citotoxicidade foi avaliada em fibroblastos da linhagem LLCMK2 e o benzonidazol foi utilizado como controle positivo. Todos os 92 extratos etanólicos, testados sobre as formas epimastigotas da cepa Y de T. cruzi, foram inativos. Os melhores resultados entre as 92 amostras avaliadas foram obtidos com o extrato etanólico de Ocotea paranapiacabensis, por apresentar atividade tripanocida sobre as formas epimastigotas da cepa Bolívia e toxicidade moderada, e com o extrato de Aegiphilla lhotzkyana, que demonstrou atividade tripanocida moderada sobre a cepa Bolívia e moderada citotoxicidade. Dentre os extratos etanólicos de Lippia sp avaliados, o de folhas de L. velutina apresentou a maior atividade tripanocida sobre as formas epimastigotas e toxicidade moderada, mas foi inativo contra as formas tripomastigotas e amastigotas de T. cruzi. Os melhores resultados foram obtidos da sua fração de acetato de etila que apresentou atividade, sobre formas epimastigotas, 42 vezes maior do que o benzonidazol, com Índice de Seletividade (IS) de 371,0, além de atividade moderada sobre as formas tripomastigotas. Esta amostra foi inativa contra... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Trypanocidal activity of 92 ethanol extracts of species of Annonaceae, Apiaceae, Cucurbitaceae, Lauraceae, Moraceae, Nyctaginaceae, and Verbenaceae was evaluated using the epimastigote forms of the Y and Bolivia strains of Trypanosoma cruzi at a concentration of 500, 350, 250, and 100 µg/ml. Fifteen extracts of Lippia salviaefolia, L. sidoides, L. laciocalycina, L. lupulina, L. balansae, L. velutina, their liquid-liquid extraction fractions of hexane, ethyl acetate, n-butanol and water were evaluated using the epimastigote forms of B5 clone of CL Brener strain of T. cruzi at a concentration of 32, 8, 2, 0.5 µg/ml. Additionally, samples of the most promising of Lippia sp were evaluated, in vitro, using trypomastigote and amastigote forms of T. cruzi and, in vivo, in BALB/c. The cytotoxic activity was evaluated on fibroblasts of lineage LLCMK2 and benznidazole was used as positive control. All the 92 ethanol extracts tested against epimastigote forms of the Y strain of T. cruzi are inactive. The best results among the 92 samples evaluated were obtained with ethanol extracts of Ocotea paranapiacabensis, for showing trypanocidal activity against epimastigote forms of the Bolivia strain and being moderately toxic, and the extracts of Aegiphilla lhotzkyana, which showed moderate trypanocidal activity against the Bolivia strain and moderate toxicity. Among the 15 ethanol extracts of Lippia sp assayed, the one from of leaves of L. velutina showed the highest trypanocidal activity on epimastigote forms and moderate toxicity, but was inactive against trypomastigote and amastigote forms of T. cruzi. Best results were obtained for its ethyl acetate fraction, which showed activity in epimastigote forms, 42 times more than benznidazole, with Selectivity Index (SI) of 371.0 and moderate activity on trypomastigote forms. This sample was inactive against the amastigote forms of the parasite... (Complete abstract click electronic access below) / Doutor

The objective of this thesis is to analyze how existing data can address Chagas disease transmission risk in South America given data availability. A literature review was conducted to determine prominent variables that models use to assist with Chagas disease mitigation efforts, followed by a Web search to collect publicly available spatial data pertaining to these variables. The data were then used to create maps of data availability and in an agent-based model to identify which variables are most associated with disease transmission risk. Data availability varied widely across South America, and model results indicate that datasets related to household size and spatial housing arrangement are most important to Chagas disease infection in urban areas. Governments can use this information to better direct their resources to collect data and control the spread of triatomine vectors and Chagas disease more effectively, and potentially identify more cost-effective strategies for vector elimination.

Made available in DSpace on 2014-06-11T19:25:26Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-02-18Bitstream added on 2014-06-13T18:53:21Z : No. of bitstreams: 1 nogueirafilho_maf_me_arafcf.pdf: 498252 bytes, checksum: d20af41ad3c23eecfd5204ddd0e9510e (MD5) / O pró-fármaco hidroximetilnitrofural (NFOH) apresenta atividade antichagásica com grande diminuição da toxicidade e maior atividade contra formas amastigotas do T. cruzi quando comparadas ao seu fármaco matriz nitrofural (NF). Essas vantagens tornam o pró-fármaco uma possível alternativa terapêutica tanto para o tratamento da fase aguda, quanto da fase crônica da doença de Chagas. Nesse trabalho foi investigado o perfil farmacocinético do NFOH em modelo animal não roedor, estudo necessário para a continuidade do desenvolvimento do pró-fármaco. O NF foi administrado por via intravenosa e oral nas doses de 6,35 e 63,5 mg/kg, respectivamente, e o NFOH 8,05 e 80,5 mg/kg respectivamente; em coelhos albinos (n=20). Após a administração foram realizadas coletas seriadas de sangue dos animais por punção venosa. As amostras foram processadas e analisadas por método bioanalítico validado, utilizando-se um sistema MS. O sistema operou em modos positivo e negativo para as leituras dos compostos - NF e NFOH- e do padrão interno (diclofenaco 5ug/mL em metanol), sob eluição de fase móvel composta por água:metanol (50:50). As médias dos parâmetros farmacocinéticos foram calculadas pelas curvas de concentração plasmática versus tempo e comparadas pelo teste de Mann-Whitney (p<0,05). O NF apresentou biodisponibilidade oral de 114,97% no modelo animal e na administração oral este composto apresentou meia-vida de eliminação de 276,09 minutos, estatisticamente diferente da meia vida apresentada na administração intravenosa (17,32 minutos). A administração do NFOH permitiu o cálculo dos parâmetros farmacocinéticos tanto do pró-fármaco quanto do NF liberado pelo mesmo. O perfil farmacocinético do NF administrado comparado ao do NF obtido do pró-fármaco não foi estatisticamente diferente. A biodisponibilidade oral relativa do NF a partir do pró-fármaco administrado foi de 60,1% / The prodrug hydroximethylnitrofurzone (NFOH) presents antichagasic activity with greatly reduced toxicity compared to its drug matrix nitrofurazone (NF). Besides these new characteristics, the prodrug was more active against the parasite T. cruzi amastigotes. These advantages make the prodrug a possible therapeutic alternative for the treatment of both acute and the chronic phase of Chagas disease. Male albino rabbits (n=20) were divided into four groups and subjected to single administration of NF and NFOH. NF was administered intravenously and orally in doses of 6.35 and 63.5 mg / kg respectively, and NFOH, in doses 8.05 and 80.5 mg / kg respectively. After administration, serial blood samples were collected by venipuncture. The samples were processed and the final product was analyzed by MS. The system operated in positive and negative modes for the determination of compounds and internal standard, under elution of the mobile phase 50:50 water: methanol. The NF presented an oral bioavailability of 114.97% in the albino rabbits and oral administration showed half-life of 276.09 minutes due to the absorption process against 17.32 obtained in the intravenous administration. The administration of NFOH allowed the calculation of pharmacokinetic parameters of the prodrug, and the NF obtained from NFOH administration. Comparing the behavior of NF administered orally and obtained from the prodrug was not evidenced significant changes in the pharmacokinetic profiles. The relative oral bioavailability of NF obtained from the NFOH was 60,1%.

Made available in DSpace on 2014-06-11T19:31:27Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-02-01Bitstream added on 2014-06-13T19:20:29Z : No. of bitstreams: 1 bosquesi_pl_dr_arafcf.pdf: 1593785 bytes, checksum: 3477969063f7684f4832aaebfb59c1a0 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Há mais de um século de sua descrição, a doença de Chagas continua sendo um dos maiores problemas de saúde pública. Resultante da infecção pelo protozoário hemoflagelado Trypanosoma cruzi, a doença é endêmica nos 21 países da América Latina e estima-se que 10 milhões de pessoas estejam infectadas e aproximadamente 100 milhões estão sob o risco de contaminação. Apenas dois fármacos são disponíveis para tratamento da doença, nifurtimox e benznidazol. Ambos são ativos somente na fase aguda da doença, além de causarem efeitos colaterais graves. No Brasil apenas o benznidazol é comercializado. Neste sentido, a desenvolvimento de fármacos tripanossomicidas é de extrema importância. Estudos mostraram que derivados nitrofurânicos inibem a tripanotiona redutase, considerada enzima chave do metabolismo antioxidativo do T. cruzi. Pesquisas com o hidroximetilnitrofural (NFOH) tem demonstrado maior atividade in vitro e in vivo contra T. cruzi com menor toxicidade quando comparado ao fármaco matriz, nitrofural. Um amplo espectro de atividades biológicas tem sido relatada para compostos furoxânicos (N-óxido-1,2,5-oxadiazol) e benzofuroxânicos (N-óxido-benzo[1,2-c]1,2,5-oxadiazol), sendo assim, foi obtida uma série de derivados isósteros de nitrofural, substituindo o anel nitrofurano pelos respectivos furoxanos e benzofuroxanos. Os compostos obtidos foram avaliados quanto à atividade tripanossomicida in vitro em formas epimastigotas e amastigotas de T. cruzi, capacidade de doação de óxido nítrico e mutagenicidade in vivo. Foram sintetizados, identificados e caracterizados oito compostos. Os derivados benzofuroxânicos (compostos 20 e 21) foram os mais ativos contra as formas epimastigotas de T. cruzi, entretanto no ensaio contra as formas amastigotas, sete apresentaram... / For more than a century of his description, Chagas disease remains a major public health problems. Resulting from infection flagellate protozoan Trypanosoma cruzi, is endemic in 21 Latin American countries and it is estimated that 10 million people are infected and about 100 million are at risk of contamination. Only two drugs are available for treating the disease, nifurtimox and benznidazole. Both are active only during the acute phase of the disease, and cause serious side effects. In Brazil only benznidazole is marketed. In this sense, the development of drugs trypanosomicide is extremely important. Studies demonstrated that nitrofurans derivatives inhibit the trypanothione reductase, the key enzyme in the metabolism considered antioxidant T. cruzi. Research with hydroxymethylnitrofurazone (NFOH) has shown greater activity in vitro and in vivo against T. cruzi with less toxicity when compared to the drug matrix, nitrofurazone (NF). A wide spectrum of biological activities have been reported for compounds furoxans (1,2,5-oxadiazol-2-N-oxide) and benzofuroxans (benzo[1,2-c]-1,2,5-oxadiazol-1-N-oxide) and thus was obtained a series of derivatives of Nitrofural isosteres, nitrofuran ring by replacing the respective furoxans and benzofuroxans. The compounds were evaluated for in vitro trypanocidal activity in epimastigotes and amastigotes of T. cruzi, ability to donate nitric oxide and mutagenicity in vivo. Were synthesized, characterized and identified eight compounds. Benzofuroxans derivatives (compounds 20 and 21) were the most active against epimastigotes of T. cruzi, however the assay against amastigotes, seven showed IC50 higher than or equal to a drug used as reference (benznidazole) and less mutagenic potential when compared with the results obtained for the drugs nitrofurazone... (Complete abstract click electronic access below)