Title of Invention

A COMPOSITION USEFUL FOR THE TREATMENT OF LEISHMANIASIS

Abstract The present invention relates to a composition useful for the treatment of leishmaniasis , said composition essentially comprising 10 mM of methyl-beta-cyclodextrin and pharmaceutically acceptable additives wherein said additives are selected from a group of nutrients comprising proteins, carbohydrates, sugar, talc, magnesium stearate, cellulose, calcium carbonate, starch-gelatin paste, and/or pharmaceutically acceptable carrier, excipient, diluent, or solvent.
Full Text Field of the present invention
The present invention relates to a composition useful for the treatment of leishmaniasis said composition comprising pharmaceutically effective amount of methyl-beta-cyclodextrin, along with other anti-leishmanial agent(s) and / or pharmaceutically acceptable additives, and a method thereof, wherein the said method reduces the cholesterol levels of the plasma membrane of the infected host cells by about 50%.
Background and prior art of the present invention
Leishmania are protozoan parasites that are responsible for substantial public health problems, especially in tropical and subtropical regions. In a recent survey, 88 countries have been declared as leishmaniasis-endemic. The current increase in leishmaniasis throughout the world to epidemic proportion coupled with increasing incidence of the disease in developed countries, and emergence of visceral leishmaniasis as an important opportunistic infection among people with human immunodeficiency-1 (HIV- 1) infection have created an urgency to provide treatment for this intracellular infection.
Studies on the molecular mechanisms of parasite entry have led to the identification of several candidate receptors facilitating multiple routes of entry and thus highlighting the redundancy in the entry process. These include macrophage cell surface receptors such as the CR1 and CR3, the mannose-fucose receptor, the fibronectin receptor, the receptor for advanced glycosylation end products, the Fc receptor and the C-reactive protein receptor. However, the large number of different receptors responsible for the attachment and internalization of the parasite to macrophages have contributed to the fact that no single panacea has yet been developed for the treatment of leishmaniasis. Objects of the present invention
The main object of the present invention is to develop a method of treating leishmaniasis.
Another main object of the present invention is to develop a method of treating leishmaniasis, using methyl-beta-cyclodextrin.
Yet another object of the present invention is to develop a method of using methyl-beta-cyclodextrin for the treatment of leishmaniasis.
Still another object of the present invention is to develop a composition comprising methyl-beta-cyclodextrin for the treatment of leishmaniasis. Still another object of the present is to develop a treatment regimen for animals including humans, for the management of leishmaniasis.
Still another object of the present invention is to develop a safe and efficient composition for the management of leishmaniasis.
Still another object of the present invention is to develop a safe and efficient composition comprising methyl-bet -cyclodextrin for the management of leishmaniasis.
Summary of the present invention
The present invention relates to a composition useful for the treatment of leishmaniasis said composition comprising pharmaceutically effective amount of methyl-beta - cyclodextrin, optionally along with other anti-leishmanial agent(s) and/or pharmaceutically acceptable additives, and a method thereof, wherein the said method reduces the cholesterol levels of the plasma membrane of the infected host cells by about 50%. Detailed description of the present invention
Accordingly, the present invention provides a composition useful for the treatment of leishmaniasis said composition essentially comprising 10 mM of methyl-beta-cyclodextrin and pharmaceutically acceptable additives wherein said additives are
selected from a group of nutrients comprising proteins, carbohydrates, sugar, talc, magnesium stearate, cellulose, calcium carbonate, starch-gelatin paste, and/or pharmaceutically acceptable carrier, excipient, diluent, or solvent.
The main embodiment of the present invention is a method of treating leishmaniasis said method consisting of step of administering a composition comprising pharmaceutically effective amount of methyl-beta-cyclodextrin optionally along with other anti-leishmanial agent(s) and/or pharmaceutically acceptable additives, to a subject in need thereof.
In another main embodiment of the present invention, wherein the said method reduces the cholesterol levels of the plasma membrane of the infected host cells by about 50%.
In still another embodiment of the present invention, wherein said additives are selected from a group of nutrients comprising proteins, carbohydrates, sugar, talc, magnesium stearate, cellulose, calcium carbonate, starch-gelatin paste, and/or pharmaceutically acceptable carrier, excipient, diluent, or solvent.
In still another main embodiment of the present invention, wherein the composition is administered orally, inhaled, or implanted.
In still another main embodiment of the present invention, wherein the composition for the oral route is in form of capsule, tablet, syrup, concentrate, powder, granule, aerosol, and/or beads.
In still another main embodiment of the present invention, wherein the subject is useful animals or human beings.
In still another main embodiment of the present invention, wherein saidmethod shows no adverse effect on subject.
In still another main embodiment of the present invention, wherein the said method shows no effect on the other forms of lipids.
In still another main embodiment of the present invention, wherein the anti-leishmanial effect increase with an increase in the amount of methyl-beta-cyclodextrin administered to a subject.
In still another main embodiment of the present invention, wherein the anti-leishmanial effect encreases with an increase in the time duration of exposure of methyl-beta-cyclodextrin to a subject.
In another main embodiment of the present invention, wherein a composition useful for the treatment of leishmaniasis said composition comprising pharmaceutically for the treatment of leishmaniasis said composition comprising pharmaceutically effective amount of methyl-beta-cyclodextrin, optionally along with other anti-leishmanial agent(s) nd/or pharmaceutically acceptable additives.
In still another main embodiment of the present invention, wherein said additives are selected from a group of nutrients comprising proteins, carbohydrates, sugar, talc, magnesium stearate, cellulose, calcium carbonate, starch-gelatin paste, and/or pharmaceutically acceptable carrier, excipient, diluent, or solvent.
In still another main embodiment of the present , invention wherein the composition is administered orally, inhaled, or implanted.
In still another main embodiment of the present invention, wherein the composition for the oral route is in form of capsule, tablet, syrup, concentrate, powder, granule, aerosol, and/or beads.
Accordingly, the present invention relates to a method of treating leishmaniasis, using methyl-beta-cyclodextrin wherein said cyclodextrin depletes
cholesterol from the plasma membrane of the cells infected with Leishmania donovani.
In an embodiment of the present invention wherein cholesterol is a major constituent of eukaryotic membranes and plays a crucial role in cellular membrane organization, dynamics, function and sorting. It is often found distributed non-randomly in domains in membranes. Recent observations suggest that cholesterol exerts many of its actions by maintaining a specialized type of membrane domain, termed "lipid rafts", in a functional state. The lipid rafts have been implicated as platforms through which signal transduction is coordinated and pathogens gain entry to infect host cells.
In another embodiment of the present invention, wherein Leishmania donovani is an obligate intracellular parasite that infects macrophages of the vertebrate host resulting in visceral leighmaniasis in humans which is usually fatal if untreated. The estimated annual number of new cases of leishmaniasis is thought to be 2 million and visceral leishmaniasis is about 5,00,000. The molecular mechanisms involved in parasite-host interaction leading to attachment and internalization are poorly characterized. We report here that cholesterol depletion from macrophage plasma membranes using methyl-b-cyclodextrin results in a significant reduction in the extent of leishmanial infection. Our results show that plasma membrane cholesterol plays a crucial role in efficient attachment and internalization of the parasite to macrophage cells.
In yet another embodiment of the present invention, wherein the objective of the present study was to determine the role of cholesterol in bringing about a productive leishmanial infection in mammalian host cells. The murine macrophage cell line J774A.1 was used as a host to a virulent Leishmania donovani strain AG83 (MHOM/IN/1983/AG83). Selective cholesterol depletion from the plasma
membranes of the host macrophages was achieved by treatment with methyl-b-cyclodextrin, a compound that specifically extracts cholesterol from the plasma membranes leaving other lipids intact and disrupts lipid rafts.
In still another embodiment of the present invention, the extent of leishmanial infection in control cells and macrophages that were depleted of cholesterol using methyl-p-cyclodextrin (MbCD) was assessed at the levels of (i) parasite interaction with the host cell surface as monitored by ligand binding assays using metabolically radiolabeled promastigotes, the extracellular form of the parasites and confirmed by flow cytometric analysis using fluorescently labeled promastigotes and (ii) the eventual presence of the intracellular amastigote form of the parasite in macrophages.
Brief description of the accompanying drawings
Figure 1 shows estimation of cholesterol in control and cholesterol-depleted macrophages. Total cellular cholesterol was estimated using the Amplex Red cholesterol assay kit and shows a concentration- dependent reduction upon treatment with MpCD. The data points shown are the means ± standard error of triplicate points from two independent experiments.
Figure 2 shows effect of cholesterol depletion using 10 mM MpCD on binding of radiolabeled promastigotes to J774A.1 macrophages. Radiolabeling was carried out as described in Methods and multiplicity of infection was maintained at 10:1 of parasite to macrophage. Comparison of binding of radiolabeled promastigotes between control (white bars) and cholesterol-depleted ( black bars macrophages reveals a reduction in extent and kinetics of binding monitored up to 90 min duration. The data points shown are the means of three independent experiments. The error bars represent the standard error.
Figure 3 shows effect of cholesterol depletion on binding of FITC-labeled promastigotes to J774A.1 macrophages monitored by flow cytometry. The concentration of M(3CD used was 10 mM. FITC labeling of parasites was carried out as described in Methods. Parasites were added onto the macrophages at a ratio of 10:1. Analysis of representative fluorescence data from macrophages exposed to FITC- labeled parasites for the indicated time periods reveal a pronounced reduction in fluorescence associated with cholesterol-depleted macrophages (black bars) as compared to control macrophages (white bars) especially after 90 min. The gray bar represents fluorescence associated with untreated macrophages exposed to unlabeled parasites.
Figure 4 shows effect of cholesterol depletion on internalization of the parasite assessed by the amastigote count in enfected J774A.1 macrophages. Macrophages depleted of cholesterol using 5 and 10 mM M(3CD exposed to parasites at multiplicity of infection of 10:1 for 3 hr show a reduction ( nearly 50% in the case of 10 mM MpCD treatment) in the number of intracellular amastigotes as revealed by Giemsa staining. The data points shown are the means of six independent experiments. The error bars represent the standard error. In still another embodiment of the present invention, Cholesterol depletion by treatment with methyl-(3 - cyclodextrin resulted in a concentration - dependent specific decrease in total cellular cholesterol levels in J774A.1 macrophages as assessed using the Amplex Red cholesterol assay kit with a reduction of ~40% cellular cholesterol when 10mM methyl -P -cyclodextrin was used (Figure 1) . The concentration of methyl - (3 - cyclodextrin used for all subsequent experiments was 10 mM except in Figure 4.
In still another embodiment of the present invention, to analyze the effects of cholesterol depletion on the ability of Leishmania parasites to interact with
[HJthymidine labeled promastigotes (Figure 2). Figure 2 shows a reduction in kinetics and extent of the host-parasite interaction (attachment) for cholesterol-depleted macrophages compared to control cells when infectivity was assayed till 90 min. Depletion of cholesterol resulted in ~ 45% reduction in macrophage-parasite interaction when compared to control cells.
In still another embodiment of the present invention, these results were further confirmed by carrying out flow cytometric analysis of FITC-labeled promastigotes Fluorescent derivatization of promastigotes with FITC has previously been used as convenient method to accurately monitor host-parasite interaction and provides and ideal means for studying cell surface interaction phenomena since each cell is analyzed individually for its ability to bind to a fluorescent ligand which in this case is FITC-labeled promastigote. Representative data of the fluorescence associated with the macrophages after infection by the parasite is shown in Figure 3. The date shown in Figure 3 is representative of two separate experiments with similar results.
In still another embodiment of the present invention, this data supports the earlier conclusions from Figure 2 that there is time-dependent reduction in the ability of leishmania promastigotes to interact with host cells that are depleted of cholesterol with the effects becoming pronounced as the time of infection is prolonged. Acute cholesterol depletion effects seen in this relatively short time of exposure of the parasites to the macrophages might reflect a phenomenon occurring between the parasite and host cell surfaces like altering recognition or binding events that would have otherwise led to a productive infection. Results from Figures 2 and 3 therefore demonstrate that such a loss in cholesterol content is associated with a corresponding loss of attachment and binding of the parasite to host macrophages.
In still another embodiment of the present invention, the above results conclusively demonstrate that cholesterol depletion leads to a reduction in the ability of promastigotes to interact with and bind to host macrophages. For efficient infection, binding of the parasite should be followed by internalization. During the course of infection, the reduced binding of the promastigotes should manifest as a reduction in the intracellular load of amastigotes, the intracellular forms of the parasite present in macrophages. The number of amastigotes was determined visually in infected macrophages that were depleted of cholesterol after staining them with Giemsa. As shown in Figure 4, treatment of macrophages with methyl -(3- cyclodextrin ( 5 and 10 mM) caused a concomitant reduction in the number of amastigotes present ( compared to control cells) in the macrophages with only 50% amastigotes present when depletion was carried out with 10 mM methyl-p-cyclodextrin.
In still another embodiment of the present invention, taken together, our results clearly show that plasma membrane cholesterol plays a crucial role in leishmanial infection and cholesterol depletion from macrophages by methyl-p-cyclodextrin results in a significant reduction in the extent of leishmanial infection. We demonstrate this by ligand binding assay using metabolically radiolabeled promastigotes and also by flow cytometric analysis of fluorescently labeled promastigotes. This reduction in binding of the promastigotes to the macrophages is accompanied by a concomitant reduction in the number of the intracellular amastigote form of the parasite.
In still another embodiment of the present invention, the involvement of multipled membrane-bound receptors in the entry of the parasite into host cells has been mentioned earlier. The modulatory role of cholesterol, an essential
component in the plasma membranes of eukaryotic cells, on the function of membrane receptors such as the oxytocin receptor, galanin receptor, and the serotonin receptor has been previously demonstrated. These results show that cholesterol depletion may lead to perturbation of receptor-cholesterol interaction leading to loss of receptor function. The reduction in the extent of infectivity of the parasite that is accompanied with cholesterol depletion could be due to such alteration of interaction of receptors responsible for leishmania entry into host cells with membrane cholesterol.
In still another embodiment of the present invention, the role of lipid rafts in general and cholesterol in particular is being increasingly recognized in signal transduction and entry of pathogens to infect host cells. The involvement of rafts has earlier been shown to control the infection of HIV type 1, infection of erythrocytes by the malaria parasite Plasmodium falciparum, and entry and internalization of mycobacteria and Brucella suis into macrophages. However, the nature of infection and the mechanism involved in the management of infection are totally distinct.
The source of infections is different and the modes of infecting the host are also totally different. The manifestations of the infection are also distinct. The systems infected by the infection are also distinct. The modes management of the infections is also very distinct. Most importantly, there is no clue to motivate a person skilled in the art to use methyl-beta - cyclodextrin for the management of all the diseases would have been that straight and simple then the management of all the diseases would have been through methyl-beta-cyclodextrin. The inventors have put in effort of years and have come out with an innovative method for the management of Leishmaniasis.
In still another embodiment of the present invention Cholesterol-mediated entry of Leishmania into host cells and reduction in infection may lead to novel therapeutic strategies against leishmaniasis. Cyclodextrin-like molecules have earlier been shown to be pharmacologically important in treating unstable atherosclerotic plaques due to their ability to remove cholesterol from macrophage foam cells. Very recently, topical application of b-cyclodextrin, a compound analogous to methyl-b-cyclodextrin and which selectively extracts cholesterol from plasma membranes, has been shown to block the transmission of cell-associated HIV - 1. This is based on earlier observations on the involvement of cholesterol in the infection of HIV - type 1. Such an application of methyl-b-cyclodextrin may block or significantly reduce leishmanial infection and further studies in the preclinical and clinical settings are needed to fully explore this issue.
Methods
Cells and cell culture: A murine macrophage cell line J7743A.1 (American Type Culture Collection, Rockville, Maryland) was used. The cells were maintained at 37°C in RPMI-1640 medium containing 10% heat inactivated fetal calf serum (PCS) (Biological Industries, Israel) in a CO2 incubator (5% CO2) as described previously. The macrophages wer seeded onto tissue culture plates (60 mm) at a density of 1 x 105 cells/plate and grown for 48 hrs before use.
Parasite culture: Leishmania donovani strain AG83 (MHOM/IN/1983/AG83) promastigotes were maintained at 24°C in modified M-199 medium (Gibco/BRL) supplemented with 100 units/ml penicillin (Sigma, U.S.A.), 100 mg/ml streptomycin (Sigma,U.S.A.), and 10% heat inactivated PCS.
Cholesterol depletion and estimation: J774A.1 cells grown on culture dishes were depleted of cholesterol by incubating for 30 min with 5 or 10 mM methyl- 0-cyclodextrin (Sigma) at 37°C in serum free medium . Total cellular cholesterol was
estimated using Amplex Red cholesterol assay kit (Molecular Probes). Cholesterol values were normalized to protein levels estimated using BCA assay reagent kit (Pierce).
Infecting macrophages with Leishmania: Promastigotes were added onto the macrophage monolayers (both control and cholesterol - depleted) at a parasite: macrophage ratio of 10:1. The parasite-macrophage interaction was allowed to progress for 15, 30 and 90 min at 37°C. At the end of incubation, monolayers were washed with phosphate buffered saline (PBS) to remove free parasites and placed on ice to loosen adherent cells from the plates. The monolayers were gently scraped to re suspend the macrophage-parasite complexes and the resulting cell suspension was analyzed either for radiolabel incorporation or macrophage-associated fluorescence. The percentage of infected macrophages was > 95% after 3 hr with 5-8 amastigotes per macrophage as determined by Giemsa staining.
Labeling L. donovani AG83 promastigotes with tritium or FITC for binding studies. Parasites were metabolically radiolabeled with tritium as described earlier with some modifications. Radiolabel incorporation was carried out at a density of 1 x 107 cells / 2 ml of M - 199 medium in the presence of 8 mCi/ml [H] -labeled promastigotes were coOcultured with the macrophages at a ratio of ( 10:1) as described above. FITC labeling of parasites was carried out essentially as described previously with minor modifications. Labeling was carried out at 37°C in PBS. The fluorescence from the FITC - labeled parasites associated with the macrophages was analyzed with a Beckman Coulter ELITE ESP flow cytometer (Miami, Florida) using EXPO 32 software.





We Claim:
1. A composition useful for the treatment of leishmaniasis said composition
essentially comprising 10 mM of methyl-beta-cyclodextrin and
pharmaceutically acceptable additives wherein said additives are selected
from a group of nutrients comprising proteins, carbohydrates, sugar, talc,
magnesium stearate, cellulose, calcium carbonate, starch-gelatin paste,
and/or pharmaceutically acceptable carrier, excipient, diluent, or solvent.
2. A composition as claimed in claims 1 wherein the composition is in form of
capsule, tablet, syrup, concentrate, powder, granule, aerosol, and/or beads.



Documents:

991-DEL-2003-Abstract.pdf

991-DEL-2003-Claims.pdf

991-del-2003-complete specificaation (granted).pdf

991-del-2003-correspondence-others.pdf

991-del-2003-correspondence-po.pdf

991-DEL-2003-Description (Complete).pdf

991-DEL-2003-Drawings.pdf

991-DEL-2003-Form-1.pdf

991-del-2003-form-19.pdf

991-DEL-2003-Form-2.pdf

991-DEL-2003-Form-3.pdf


Patent Number 242180
Indian Patent Application Number 991/DEL/2003
PG Journal Number 34/2010
Publication Date 20-Aug-2010
Grant Date 18-Aug-2010
Date of Filing 12-Aug-2003
Name of Patentee COUNCIL OF SCIENTIFIC AND INDUSTRIAL RESEARCH
Applicant Address RAFI MARG, NEW DELHI-110001,INDIA
Inventors:
# Inventor's Name Inventor's Address
1 AMITABHA CHATTOPADHYAY CCMB, HYDERABAD
2 RENTALA MADHUBALA JNU, NEW DELHI
PCT International Classification Number A61P 33/02
PCT International Application Number N/A
PCT International Filing date
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 NA