RESUMEN En Paraguay, así como en las Américas, la leishmaniasis constituye una de las problemáticas de salud pública importante, debido a su complejidad tanto epidemiológica, clínica y biológica, afectando especialmente a los más pobres y en los países en vía de desarrollo. Polygonum punctatum Elliot. pertenece a la familia Polygonaceae, la medicina popular le atribuye varias propiedades, por medio de estudios anteriores se confirma que diferentes extractos de esta planta presentan actividad antibacteriana, antiinflamatoria y antifúngica. En este trabajo, se evaluó la actividad citotóxica del extracto etanólico de Polygonum punctatum de la familia Polygonaceae en concentraciones de 100, 50 y 25 µg/ml en células de macrófagos de ratones, en los cuales no se encontró actividad citotóxica. Además, se evaluó la actividad leishmanicida por medio de estudios experimentales in vitro a concentraciones de 100, 75, 50, 25, 20 y 10 µg/ml frente a tres cepas de parásitos: Leishmania infantum, L. amazonensis y L. braziliensis, en los cuales se observó una actividad de 58 y 56% de lisis de parásitos con el extracto de 100µg/ml frente a las cepas de L. braziliensis y L. infantum, respectivamente y 51% para L. amazonensis. Estos resultados son prometedores, y aportan una base para el desarrollo y búsqueda de nuevos tratamientos para la leishmaniasis, sin embargo, son necesarios estudios posteriores en cuanto a aislamiento e identificación del compuesto y evaluación en modelos animales in vivo.

ABSTRACT In Paraguay, as well as in the Americas, leishmaniasis constitutes one of the important public health problems, due to its epidemiological, clinical, and biological complexity, especially affecting the poorest and developing countries. Polygonum punctatum Elliot belongs to the Polygonaceae family, and popular medicine attributes several properties to it. Previous studies confirmed that different extracts of this plant have antibacterial, anti-inflammatory and antifungal activity. In this work, the cytotoxic activity of the ethanolic extract of Polygonum punctatum was evaluated at concentrations of 100, 50 and 25 µg/ml in mouse macrophage cells, in which no cytotoxic activity was found. In addition, the leishmanicidal activity was evaluated through experimental in vitro studies at concentrations 100, 75, 50, 25, 20 and 10 µg/ml against three strains of parasites: Leishmania infantum, L. amazonensis and L. braziliensis. Activities of 58 and 56% of parasite lysis were observed with the 100 µg/ml extract against strains of L. braziliensis and L. infantum, respectively, and 51% for L. amazonensis. These results are promising and provide a basis for the development and search of a new treatment for leishmaniasis. However, further studies are necessary regarding the isolation and identification of the compound and its evaluation in in vivo animal models.

Resumen Introducción. Trypanosoma cruzi, agente causal de la enfermedad de Chagas, exhibe una sustancial heterogeneidad fenotípica y genotípica que puede influir en las variaciones epidemiológicas y clínicas de la enfermedad, así como en la sensibilidad a los fármacos utilizados en el tratamiento. Objetivo. Evaluar la sensibilidad in vitro al benznidazol, el nifurtimox y el posaconazol de 40 cepas clonadas de T. cruzi de Paraguay, con distintos genotipos, huéspedes y localidades de origen. Materiales y métodos. En su estado epimastigote, los parásitos se incubaron en medio de cultivo LIT (Liver Infusion Tryptose) con diferentes concentraciones de cada fármaco en ensayos por triplicado. El grado de sensibilidad se estimó a partir de las concentraciones inhibitorias del 50 y el 90% (IC50 e IC90) y se obtuvieron los valores promedio y la desviación estándar de cada cepa y fármaco. La significación estadística entre grupos se determinó mediante análisis de varianzas con el test no paramétrico de Wilcoxon/Kruskal-Wallis y valores de p<0,05. Resultados. Se observó un amplio rango de respuesta a los fármacos. Se identificaron dos grupos de parásitos (A y B) con diferencias significativas en la sensibilidad al benznidazol (p<0,0001), y tres grupos (A, B, C) en cuanto a la sensibilidad al nifurtimox y el posaconazol (p<0,0001). Conclusiones. En general, las cepas fueron más sensibles al nifurtimox que al benznidazol y el posaconazol. Estas diferencias evidencian la heterogeneidad de las poblaciones de T cruzi que circulan en Paraguay, lo que debe considerarse en el tratamiento y el seguimiento de las personas afectadas.

Abstract Introduction: Trypanosoma cruzi, the causative agent of Chagas disease, shows substantial phenotypic and genotypic heterogeneity, which can influence the epidemiological and clinical variations of the disease and the sensitivity to the drugs used in the treatment. Objective: To assess the in vitro susceptibility to benznidazole, nifurtimox, and posaconazole of 40 cloned strains of T. cruzi isolated in Paraguay belonging to different genotypes, hosts, and localities. Materials and methods: We incubated the parasites in their epimastigote stage in LIT culture medium with different concentrations of each drug in triplicate assays. The degree of susceptibility was estimated by the inhibitory concentrations of 50 and 90% (IC50 and IC90) to obtain the average values and the standard deviation for each strain and drug. We determined the statistical significance between groups by analysis of variances with the Wilcoxon/Kruskal-Wallis non-parametric test and values of p<0.05. Results: A wide range of drug response was observed. Two groups of parasites (A and B) were identified as having significant differences in susceptibility to benznidazole (p<0.0001), and three groups (A, B, C) to nifurtimox and posaconazole (p<0.0001). Conclusions: Overall, the isolates were more susceptible to nifurtimox than benznidazole and posaconazole. Such differences highlight the heterogeneity of T. cruzi populations circulating in Paraguay, an aspect to consider in the treatment and follow up of patients.

ABSTRACT American trypanosomiasis and leishmaniasis are relevant public health problems in Latin America. The drugs currently used to treat these diseases have severe toxic side effects. Several research groups are dedicated to the search of natural and synthetic products to find new effective therapeutic agents that do not present adverse collateral reactions. In the evaluation of compounds of the plant species Zanthoxylum chiloperone (Rutaceae), it was shown that isolated compounds of the extract had leishmanicidal, trypanocidal and antifungal in vivo activities. Based on these results, the genotoxic and cytotoxic effects of canthin-6-one and 5-methoxycanthin-6-one, molecules isolated from the plant, on bone marrow cells of treated mice were evaluated in the present study. The study of genotoxic effects was made through the test of modifications in the frequency of micronuclei and the cytotoxic effects by modifications in the relationship between polychromatic erythrocytes and normochromic erythrocytes. Two independent assays were performed and in each assay the animals were divided into three treatment groups: GROUP I: negative control that received 200 µL of water and 2.1% of DMSO, orally, GROUP II: compound to be evaluated (canthin-6 -one or 5-methoxycanthin-6-one) with 2.1% DMSO, and GROUP III: positive control that received cyclophosphamide 50mg /kg animal weight, intraperitoneal. Statistical analysis showed that both compounds had neither genotoxic nor cytotoxic effects. These results allow these molecules to be proposed as candidates to be subjected to more detailed studies as potential drugs against these two diseases.

RESUMEN La tripanosomiasis americana y la leishmaniasis son problemas de salud pública relevantes en Iberoamérica. Las drogas utilizadas actualmente para el tratamiento de estas enfermedades poseen efectos colaterales tóxicos severos. Varios grupos de investigación están abocados a la búsqueda de productos naturales y sintéticos para encontrar nuevos agentes terapéuticos efectivos que no presenten reacciones colaterales adversas. En la evaluación de compuestos de la especie vegetal Zanthoxylum chiloperone (Rutaceae), se demostró que compuestos aislados del extracto presentaban actividad leishmanicida, tripanocida y antifúngica in vivo. Teniendo como antecedentes estos resultados, en el presente estudio se evaluaron los efectos genotóxico y citotóxico del cantín-6-ona y del 5-metoxicantin-6-ona, moléculas aisladas de la planta, en células de médula ósea de animales tratados. El estudio de los efectos genotóxicos se hizo a través del ensayo de modificaciones en la frecuencia de micronúcleos y el efecto citotóxico por modificaciones en la relación entre eritrocitos policromáticos y eritrocitos normocromáticos. Se realizaron 2 ensayos independientes y en cada ensayo los animales fueron divididos en tres grupos de tratamiento: GRUPO I: control negativo que recibió 200 uL de agua y 2.1% de DMSO, vía oral, GRUPO II: compuesto a ser evaluado (canthin-6-ona o 5-methoxicantin-6-ona) con 2.1% de DMSO, y GRUPO III: control positivo que recibió ciclofosfamida 50mg/kg/peso del animal, vía intraperitoneal. El análisis estadístico mostró que ambos compuestos no presentaron efectos genotóxicos ni citotóxicos. Estos resultados permiten proponer a estas moléculas como candidatas a ser sometidas a estudios más detallados como potenciales fármacos contra estas dos enfermedades.

BACKGROUND The current chemotherapy for Chagas disease is based on monopharmacology with low efficacy and drug tolerance. Polypharmacology is one of the strategies to overcome these limitations. OBJECTIVES Study the anti-Trypanosoma cruzi activity of associations of benznidazole (Bnz) with three new synthetic T. cruzi-triosephosphate isomerase inhibitors, 2, 3, and 4, in order to potentiate their actions. METHODS The in vitro effect of the drug combinations were determined constructing the corresponding isobolograms. In vivo activities were assessed using an acute murine model of Chagas disease evaluating parasitaemias, mortalities and IgG anti-T. cruzi antibodies. FINDINGS The effect of Bnz combined with each of these compounds, on the growth of epimastigotes, indicated an additive action or a synergic action, when combining it with 2 or 3, respectively, and an antagonic action when combining it with 4. In vivo studies, for the two chosen combinations, 2 or 3 plus one fifth equivalent of Bnz, showed that Bnz can also potentiate the in vivo therapeutic effects. For both combinations a decrease in the number of trypomastigote and lower levels of anti-T. cruzi IgG-antibodies were detected, as well clear protection against death. MAIN CONCLUSIONS These results suggest the studied combinations could be used in the treatment of Chagas disease.

American trypanososmiasis and Leishmaniasis are relevant public health problems in Ibero America. The in vitro antiparasitic activity of barks and leaves extracts of Erythrina crista-galli L., E. dominguezii Hassl and E. falcate Benth was evaluated on Trypanosoma cruzi tripomastigotes forms and Leishmania amazonensis, L. infantum and L. braziliensis promatigotes. The IC50s of the bark extract of E. dominguezii Hassl with two T. cruzi strains, Ypsilon and Cl Brener, were 11.7 µg/ml and 14.9 µg/ml. Leaf extract showed IC50 higher than 250 µg/ml. Bark extract of E. falcate Benth had IC50s of 11.29 µg/ml and 7.37 µg/ml with Ypsilon and Cl Brener strains and its leaf extract showed IC50s of 37.2 µg/ml and 25.68 µg/ml. Leaf extract of E. crista-galli L. showed IC50 higher than 250 µg/ml while bark extract had IC50s of 11.2µg/ml and 7.1 µg/ml with Ypsilon and Cl Brener strains. Bark extract of E. dominguezii Hassl showed IC50s of 3.22 µg/ml 6.94 µg/ml and 1.9 µg/ml for L. amazonensis, L. infantum and L. braziliensis and in leaf extract IC50 was higher than 100 µg/ml. Bark extract of E. crista-galli L. had IC50s of 2.1 µg/ml, 2.09 µg/ml and 1.6 µg/ml for the three species. Its leaf extract had IC50 higher than 100 µg/ml. Bark extracts of E. falcate Benth had IC50s of 2.17 µg/ml, 2.09 µg/ml and 1.52 µg/ml with the three Leishmania species and the leaf extract showed IC50s of 14.9 µg/ml, 10.4 µg/ml and 11.6µg/ml. Bark extracts could be an alternative for the treatment of these parasitic diseases previous confirmation by in vivo and toxicity studies.

La tripanosomiasis americana y la leishmaniosis son problemas de salud pública relevantes en Iberoamérica. Se evaluó la actividad antiparasitaria in vitro de extractos de cortezas y hojas de Erythrina crista-galli L., E. dominguezii Hassl y E. falcata Benth sobre formas tripomastigotas de Trypanosoma cruzi y promastigotas de Leishmania amazonensis, L. infantum L. braziliensis. El extracto de corteza de E. dominguezii Hassl presentó CI50 de 11,7 µg/ml y 14,9 µg/ml con dos cepas de T. cruzi, Ypsilon y Cl Brener. El extracto de hoja presentó CI50 mayor a 250 µg/ml. La corteza de E. falcata Benth tuvo CI50 de 11,29 µg/ml y 7,37 µg/ml con Ypsilon y Cl Brener y el extracto de hojas CI50 de 37,2 µg/ml y 25,68 µg/ml. El extracto de hojas de E. crista-galli L. presentó CI50 mayor a 250 µg/ml, y el de corteza CI50 11,2µg/ml y 7,1µg/ml con Ypsilon y Cl Brener. El extracto de corteza de E. dominguezii Hassl presentó CI50 de 3,22 µg/ml, 6,94 µg/ml y 1,9 µg/ml para L. amazonensis, L. infantum y L. braziliensis y en hojas la CI50 fue mayor a 100 µg/ml. La corteza de E. crista-galli L. tuvo CI50 de 2,1 µg/ml, 2,09 µg/ml y 1,6 µg/ml para las tres especies. El extracto de hoja tuvo una CI50 mayor a 100 µg/ml. El extracto de corteza de E. falcata Benth tuvo CI50 de 2,17 µg/ml, 2,09 µg/ml y 1,52 µg/ml con las tres especies de Leishmania y el de hoja CI50 de 14,9 µg/ml, 10,4 µg/ml y 11,6 µg/ml. Los extractos de corteza podrían ser una alternativa para el tratamiento de estas enfermedades parasitarias, previa confirmación con estudios in vivo y toxicidad.

Extracts from the Argentinean herb Tagetes mendocina Phil. (Asteraceae) were tested for antimicrobial activity against fungi, bacteria and protozoa. The different extracts (PE, DCM, MeOH and EtOAc) and the essential oil displayed activity mainly against dermatophytes, a group of fungi that produces skin infections. The bioassay-guided fractionation of PE, DCM and EtOAc extracts led to the isolation of eight compounds including two thiophenes, two acetophenone derivatives, dihydrorosefuran and three flavonoids. ITie thiophenes 5-(4-hydroxy- l-butynyl)-2,2'-bithienyl (BBTOH) (1) and its acetate (BBTOAc) (2) proved to be highly active against the dermatophytes Microsporum gypseum, Trichophyton rubrum and T. mentagrophytes with MIC values of 3.12, 3.12 and 6.25 µg/mL for compound 1 and 25, 3.12 and 6.25 µg/mLfor compound 2, respectively. In turn, the essential oil displayed a weak to modérate antifungal effect against M. gypseum with MIC = 250 µg/mL. ITie essential oil was examined by GC and GC-MS and 21 constituents (97.3%) were identified. (E) p-ocimene, (Z)-tagetone, (ii)-tagetone, (Z)-ocimenone, á-pinene and (E)-ocimenone were the major components. In addition, thiophenes 1 and 2 and 2-hydroxyacetophenone 3 showed antiprotozoal activity against Leishmania amazonensis, L. brasiliensis andi. infantum promastigotes with 100% lysis at 100 µg/mL.

Chagas disease is becoming a public health problem in Latin America due to the wide distribution, the high prevalence, the magnitude of the damage caused and the difficulties to control it. In Paraguay, the disease is mainly distributed in the departments of Paraguari, Cordillera and Central. Prevalence in marginal zones, where migrations from rural populations and endemic areas make possible the urbanization of the disease, has no been studied yet. This is a descriptive study with a cross-sectional sampling and a probabilistic system recruitment carried out in school aged children from marginal zones of Asuncion to determine the prevalence of Chagas' disease. Serological methods, parasite isolation and questionnaires were used to achieve the goals. Nine hundred and fifty three children were studied to determine the prevalence of Chagas' disease in marginal zones which was 1.4%.

La enfermedad de Chagas es un problema de salud pública en América Latina debido a su amplia distribución, elevada prevalencia, por la magnitud del daño que produce y las dificultades para lograr su control. En Paraguay la enfermedad se encuentra distribuída principalmente en los departamentos de Paraguarí , Cordillera y Central. La prevalencia en zonas marginales de Asunción, donde las migraciones de poblaciones rurales y de áreas endémicas hacen posible la urbanización de la enfermedad, no ha sido estudiada aún. Este es un estudio descriptivo con muestreo de corte transversal y reclutamiento por sistemas probabilísticos, llevado a cabo en niños en edad escolar de zonas marginales de Asunción para determinar la prevalencia de la enfermedad de Chagas en este grupo. Métodos serológicos, aislamiento de parásitos y cuestionarios fueron utilizados para alcanzar los objetivos. Novecientos cincuenta y tres niños fueron estudiados para determinar la prevalencia de la enfermedad de Chagas en zonas marginales dando como resultado el 1,4%.