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Novel phospholipid microspheres were prepared from polylactic-co-glycolic acid (PLGA) and phosphatidyl ethanol amine in the molar ratio 1:71, to deliver drugs to macrophages in experimental leishmaniasis. Liposomes, well known as drug carrier systems, made from phosphatidylethanolamine, cholesterol and dicetyl phosphate in the molar ratio 7:2:1, were used as control, in order to compare the efficacies of the two carriers. As such, the membrane fluidity of the two carriers was kept at comparable levels by adjusting chemical composition. Moreover, because of the presence of mannosyl fucosyl receptors on macrophages, attempts were made to target an optically active synthetic compound dihydroindolo [2,3-a] indolizine, an antileishmanial agent, intercalated in both mannose-grafted liposomes and mannose-grafted microspheres. When tested for efficacy in lowering parasite load in the spleen, as well as in reducing the hepatic and renal changes associated with infection, the drug intercalated mannose-grafted microspheres were found to be the most active in comparison to drug intercalated liposomes or to the free drug. Thus, mannose-grafted microspheres may have possible application in the clinics not only in visceral leishmaniasis, but also in other macrophage-associated disorders.

Bacopasaponin C, an indigenous glycoside, was isolated from Indian medicinal plant Bacopa monniera (b. brahmi) and was tested for antileishmanial properties both in free and in various delivery modes, e.g., niosomes, microspheres, and nanoparticles that are used now as alternatives to more commonly used liposomes. The different vesicles were prepared by published protocols. The percent intercalation of Bacopasaponin C in liposomes, niosomes, and micropspheres determined at its absorption maximal (lambda(max) = 238 nm, epsilon = 8.6 x 10(3) M(-1) x cm(-1)) was found to be 30; for nanoparticles it was 50. At equivalent dose of 1.75 mg/kg body weight, every third day for a total of 6 doses in 15 days, Bacopasaponin C in all the vesicular forms was found to be very active. An inverse linear relationship between the efficacy and the size of the vesicles was established. As analyzed from tissue histology, blood pathology, and specific tests related to normal liver and kidney functions, Bacopasaponin C in each of the four vesicular forms was found to be without any side effects. Thus, because of its indigenous origin and non-toxic nature, Bacopasaponin C could very well be considered for application in the clinic through these alternative delivery modes.

The effect of oxidants and the anti-inflammatory steroid dexamethasone on the attachment and internalization of virulent and avirulent Leishmania donovani promastigotes by the macrophage mannosyl fucosyl receptor was examined. Oxidants and dexamethasone are known to down- and upregulate the expression of the mannose receptor. Macrophages, when treated with 500 microM H2O2 at 37 C for 30 min, stimulate about 45% inhibition in uptake of an avirulent strain (UR6), and 30 and 25% inhibition for virulent strains AG-83 and GE-I, respectively. Treatment of macrophages with dexamethasone for 20 hr resulted in a stimulation in uptake of the parasite. When UR6 was used, a 3-fold increase in uptake was observed compared with the controls. Parasite uptake was also inhibited by the H2O2-generating system, glucose/glucose oxidase; inhibition was blocked by catalase. Treatment of macrophages either with H2O2 or dexamethasone did not affect the binding of the advanced glycosylation end product-bovine serum albumin (AGE-BSA), the ligand for AGE receptor of macrophages. Similarly, indirect evidence also shows that both types 1 and 3 complement receptors (CR1, CR3) are not affected by these treatments, indicating that, besides the mannosyl fucosyl receptor, other receptors are minimally altered in the identified condition. These results suggest that the up- and downregulation of the mannose receptor of macrophages may play a role in affecting L. donovani infection.

The fMLP receptor of peritoneal macrophages stimulated by fMLP grafted liposomes as ligand, was analysed and compared with respective controls for its ability to promote killing of intracellular Leishmania parasites. fMLP grafted liposomes show greater efficacy in killing intracellular L. donovani (MHOM/IN/1983/AG83) parasites in a time dependent manner than free fMLP. fMLP grafted liposomes also release more active oxygen intermediates and reactive nitrogen intermediates (O2-, H2O2, NO) than free fMLP. The key enzymes PKC and PTK for the respiratory burst and nitric oxide generation were found to be important in this fMLP receptor mediated signaling process as the enzyme specific inhibitors viz. staurosporine, genistein and AG126 suppressed the leishmanicidal effect of fMLP grafted liposomes. The above findings suggest that the fMLP receptor of macrophages activates PKC and PTK mediated signalling that is responsible for the intracellular parasite killing.

Despite the rapid development in medicinal and pharmaceutical technology, the targeting of drugs to phagocytic cells in macrophage-related diseases still remains a major unsolved problem. By using the mannosyl-fucosyl receptors on macrophages, attempts were made to target antileishmanial drugs encapsulated in mannosylated or fucosylated liposomes to treat experimental leishmaniasis in the hamster model. Mannosylated liposomes were found to be more potent in delivering antileishmanial drugs to phagocytic cells. Liposomes loaded with an indigenous drug, andrographolide, a labdane diterpenoid isolated from Indian medicinal plant Andrographis paniculata, were prepared and tested against experimental leishmaniasis in a hamster model. Mannosylated liposomes loaded with the drug were found to be most potent in reducing the parasitic burden in the spleen as well as in reducing the hepatic and renal toxicity. In addition, mannosylated drug-loaded liposome-treated animals showed a normal blood picture and splenic tissue histoarchitecture when compared with those treated with free drug or regular liposomal drug. Such a drug-vehicle formulation may be considered for clinical trials.

Fc receptors are known to express on the surface of mature monocytes, macrophages and lymphocytes. In this study a ligand e.g. liposomal IgG (human IgG coupled to PE-liposome via carbodimide reaction) was developed to ligate the Fc receptor of macrophages. When liposomal IgG was incubated with macrophages at 37 degrees C for 5 min, it induced the macrophage activation which suppress the parasite burden approximately to an extent of 60%, 50% and 45%, when macrophages were infected with UR6, AG83 and GE1 strains of L-donovani respectively. Superior efficacy of liposomal IgG were achieved compared to the treatment with free IgG and free liposomes. The activity of protein kinase C (PKC) has been found to be higher in the Fc receptor targeted macrophage membrane fraction, suggesting its translocation from the cytosol. Staurosporine, a potent inhibitor of the enzyme protein kinase C (PKC) has been found to protect the parasite inside the macrophage indicating the role of PKC in the signaling process. The liposomal IgG treatment has been found to induce the generation of significant amount of superoxide and hydrogen peroxide which helped to suppress the parasite burden. Further when liposomal IgG were incubated with IFN-gamma primed, LPS activated macrophages, a significant amount of NO release was also noticed, indicating its role in parasite killing. The above results suggest that Fc receptor mediated activation by liposomal IgG may be used as an alternative approach to kill parasites intracellularly.

Pretreatment of macrophages with, an agonist of PKC, showed diverse effects on degradation and survival of two virulent strains of Leishmania donovani promastigotes. Treatment of macrophages with PMA for 45 min at 37 degrees C generated significant amounts of superoxide anions and reduced the parasite burden of macrophages by up to 48 and 43% when AG83 and GE-1 strains were used for infection. Staurosporine, an inhibitor of PKC, inhibited PMA-dependent killing of the parasites, while tyrphostin AG 126, an inhibitor of protein tyrosine kinase, showed very little effect. Depletion of PKC by prolonged incubation with PMA drastically reduced the superoxide anion generation and increased the uptake and multiplication of the parasites. Finally, to understand the mechanism of higher uptake of the parasites by PKC-depleted macrophages, membrane microviscosity was measured by fluorescence depolarization. Membrane microviscosity was found to be approximately 40% lower in PKC-depleted macrophages than in normal macrophages, indicating the role of membrane fluidity in the infection process. Together, these data suggest PKC activation, superoxide generation, and membrane fluidity are essential factors in the efficient regulation of leishmanial infection.

The antileishmanial property of amarogentin, a secoiridoid glycoside isolated from the Indian medicinal plant Swertia chirata, was examined in a hamster model of experimental leishmaniasis. The therapeutic efficacy of amarogentin was evaluated in free and two different vesicular forms, liposomes and niosomes. The amarogentin in both liposomal and niosomal forms was found to be a more active leishmanicidal agent than the free amarogentin; and the niosomal form was found to be more efficacious than the liposomal form at the same membrane microviscosity level. Toxicity studies involving blood pathology, histological staining of tissues and specific enzyme levels related to normal liver function showed no toxicity. Hence, amarogentin incorporated in liposomes or niosomes may have clinical application in the treatment of leishmaniasis.

Antisense oligonucleotides have been considered as inhibitors of growth of intracellular parasites such as Leishmania, but only limited inhibition has been observed in vitro. We have encapsulated an antisense oligonucleotide, complementary to the Leishmania universal miniexon sequence, in cationic liposomes. Low concentrations (4 microM) of encapsulated oligonucleotides specifically reduced the amastigote burden within cultured macrophages by 80%. This result illustrates the importance of effective delivery for efficient antiparasitic activity of antisense oligonucleotides.

The interaction of leishmania parasites with macrophages is known to be receptor mediated. Previous study from this laboratory (J. Parasitol. 82:632, 1996) showed the significant involvement of LPG and gp63 receptors in the recognition of virulent strains onto the macrophages. The role of carbohydrate receptors the other major receptors besides LPG and gp63 receptors, in the recognition of both virulent (strains AG83 and GE1) and avirulent (strain UR6) leishmania onto the host macrophages has been the major focus of the present investigation. Various neoglycoproteins were used as efficient ligands to preblock the carbohydrate receptors on the macrophage surface. Similarly, various sugar specific lectins were used to preblock the corresponding carbohydrate ligands on the parasite surface. When these preblocked macrophages or parasites were used to study their mode of recognition, it was obvious from the findings that avirulent leishmania promastigotes possibly use the mannosyl fucosyl receptors (MFR) more avidly for their initial attachment and subsequent internalization into the macrophages whereas the virulent leishmania exhibits limited use of this receptor. When a macrophage-like cell line (J774), lacking in MFR, was purposely selected to test the previous findings, as expected, the attachment of avirulent promastigotes (UR6) onto the cell line was found to be negligible when compared to the peritoneal macrophages. Thus, it appears that avirulent leishmania promastigotes probably utilize MFR significantly for their initial recognition and subsequent internalization by macrophages.

Specific receptors may be involved in the process of attachment of Leishmania donovani promastigotes to macrophage surfaces and their subsequent internalization. Two virulent strains of Indian L. donovani (AG83 and GE-I) were found to enter into macrophages much faster than the avirulent ones (UR6). These virulent promastigotes express surface glycoprotein (gp63) and lipophosphoglycan (LPG) to a greater extent than avirulent strains. We examined their interaction with macrophages as a function of time by preblocking the macrophage receptors with the exogenous addition of gp33 or LPG. In experiments where gp63 was used as the blocking agent, the entry of one virulent strain (GE-I) was affected. In other experiments where LPG was used, the entry of another virulent strain (AG83) was affected. Entry of the avirulent strain (UR6) was unaffected by either of these treatments. Exposed LPG or gp63 on the surface of promastigotes thus appear to expedite their recognition and entry into the host cell. To assess the role of gp63 further in the entry of Leishmania into the macrophages, an avirulent UR6 strain was transfected with the gp63 gene cloned from L. amazonensis. The transfected UR6 as expected expressed more GP63 at a faster rate and entered into the macrophages like the virulent strain when compared to the nontransfected UR6 or UR6 transfected with vector alone. Thus, the expression of the gp63 gene is involved in the recognition and intracellular entry of visceral Leishmania into the macrophages in addition to the cutaneous species demonstrated previously.

Different sugar-grafted liposomes were prepared and tested against experimental leishmaniasis in vivo using the classical drug pentamidine isethionate and its methoxy derivative. Both the drugs, when encapsulated in sugar-grafted liposomes were found to be more potent in comparison to normal liposome-encapsulated drug or to the free drug. Moreover, the mannose-grafted liposomes were adjudged to be the best in lowering of spleen parasite load in comparison with those bearing glucose or galactose. When encapsulated in mannose-grafted liposomes the therapeutic efficacy of pentamidine isethionate was found to be better than that of its methoxy derivative, although the latter seemed to be less toxic than the pentamidine isethionate itself.

Peritoneal macrophages pretreated with different stimulants were analysed and compared with their respective controls for their ability to kill intracellular pathogenic L. donovani, (MHOM/IN/1983/AG83) an isolate from Indian subcontinent. Stimulation of macrophages by zymosan showed a higher microbicidal activity as compared to that by PMA. A correlation between microbicidal activity of the macrophages and the parameters related to respiratory burst activity such as liberation of O2-, production of H2O2 and consumption of O2 was sought. All the parameters showed a decrease in case of infected macrophages in comparison to those of the non-infected ones. Thus, it is possible that the impairment of macrophage activation by intracellular Leishmania contributes to their survival in the toxic environment of the host.

Receptors interacting with terminal sugars as ligands are involved in the binding of Leishmania donovani promastigotes to the macrophage surface and their subsequent internalization. Mannose and glucose are specifically involved in the binding process. Decreased binding occurs to macrophages already infected with L. donovani either in vivo or in vitro. When mannose- or glucose-bearing liposomes are used as ligands the binding shows similar trends and the percentage inhibition of binding with mannose-bearing liposomes increases when compared to that for the glucose-bearing ones. The decreased binding of the ligand seems to be due to a decrease in the number of receptors after infection. The affinity of the ligands for the binding sites either on the normal macrophages or on the infected macrophages apparently remains the same. The results based on the incorporation of [3H]phenyl alanine and supported by the binding of glycosylated liposomes to both infected and non-infected macrophages suggest that protein synthesis, in general, is suppressed in L. donovani-infected macrophages thus affecting also mannose/glucose receptor protein synthesis, resulting in fewer receptors on the macrophage surface.

Normal hepatic microsomal membranes when exposed in vitro to different free radicals, cause membrane damage by lipid peroxidation which could be monitored by the analysis of malonaldehyde formation and measurement of membrane microviscosity. Lipid peroxidation in vivo, when examined in hepatic microsomal membranes in experimental Leishmaniasis, reveals a direct relationship between membrane microviscosity and the extent of lipid peroxidation. Scavengers of free radicals and peroxides such as superoxide dismutase (SOD) for O2.-, mannitol for (OH.) and catalase for H2O2 in modest amounts were used for preventing the membrane damage caused by lipid peroxidation.

The state of the lipid phase of the membrane plays a key role in the exposure of various receptors, antigens and enzymes on the membrane surface. The fluidity of membranes of Leishmania donovani promastigotes was monitored by two independent methods, i.e. influx of sterol from liposomes and removal of phospholipids by treatment with phospholipase C. The altered sterol/phospholipid ratio, in both cases, provided evidence that the activity of the functionally important membrane-bound enzyme Mg2(+)-ATPase is modulated by the state of the lipid phase of the membrane.

Superoxide dismutase (SOD), a metal containing enzyme is present in parasite Leishmania donovani as well as in host macrophages both resident and activated in a detectable amount, although the level is much higher in the latter case. It is observed that at any particular protein concentration, the SOD activity is highest in the case of parasite infected macrophages and lowest in the case of normal resident macrophages; the SOD activity of thioglycolate activated macrophages lies in between the two. It is also noticed that formalin-killed Leishmania donovani neither attach to macrophages nor do they increase the SOD activity of the host. Thus, the processes, e.g. attachment of the parasite to the host membrane, subsequent membrane perturbation and thus activation of membrane bound enzyme NADPH oxidase leading to respiratory burst, may be responsible for an enormous increase in the SOD level in macrophages during infection. Moreover, the chemical nature of the SOD found in infected macrophages has been investigated by using an inhibitor, e.g. NaCN, which specifically inhibits Cu-Zn SOD but not Fe-SOD. A considerable inhibition of SOD activity by NaCN in infected macrophages confirms the chemical nature of the increased SOD to be of Cu-Zn type, usually found in host. Presumably, Cu-Zn SOD or host SOD plays a protective role at the time of parasite infection although the role of parasitic SOD or some other mechanisms for the survival of the parasite within the toxic phagolysosome environment of the macrophage cannot be ruled out.

Host macrophage infection by the parasite Leishmania donovani is heterogeneous, but it is not clear which factors are responsible for parasite recognition within the macrophages. One possible factor may be the alteration of the microviscosity of the macrophage membrane. This in turn may affect receptor expression and hence parasite infection. In this paper we describe alteration of the lipid composition and hence the microviscosity of the macrophage membrane in a controlled manner using liposome fusion technique. At a higher macrophage membrane microviscosity a larger number of parasites have been found to adhere to the macrophage surface. However, the proportion of parasites finally internalized when compared to parasites adhering to macrophages is inversely correlated with the artificially altered macrophage membrane microviscosity. The process of endocytosis has been examined in both native and lipid modified macrophages in the presence of several sugar antagonists. The results indicate (i) glucose and mannose are specifically involved in the binding process, and (ii) the microviscosity has a key role in controlling the macrophage parasite interaction. The results obtained so far support a model of endocytosis where expression of the receptor is a critical initial process dependent on the microviscosity of the membrane.