Investigação de terapia combinada própolis vermelha de Alagoas - antimonial para tratamento de Leishmaniose Tegumentar

Abstract

Cutaneous Leishmaniasis (CL) is a neglected disease that can culminate in destructive and even disfiguring lesions. The treatment of leishmaniasis is carried out with reduced choice of chemotherapy and systemically. The pentavalent antimonials (in Brazil, Glucantime®) are the first choice treatment, but their use is accompanied by high toxicity, such as cardiac, hepatic, pancreatic and/or renal changes. Some drug combinations are described as highly efficient and have been adopted and indicated by WHO. Thus, considering the leishmanicidal and cicatrizant activities of propolis, the present work aimed to evaluate in vitro and in vivo the effect of Alagoas red propolis extract (RPA) by topical and oral route in co-therapy with Glucantime® on the lesions of CL. For this, the RPA extract was previously characterized according to the Ministry of Agriculture, Livestock and Food Supply (MAPA), and the crude extract was incorporated into a base ointment. To evaluate the stability of the topical formulation, we analyzed: organoleptic characteristics, pH and viscosity. In vivo analyzes were performed in pre-clinical stages in infected BALB/c mice for evaluation of parasite load, lesion size and histological analysis of spleen, kidneys and liver. The antioxidant activity of the RPA extract was also evaluated. Regarding the MAPA parameters, the extract met the minimum requirements, except the oxidation activity. The hydroalcoholic extract presented antioxidant activity. No changes in ointment stability were observed during the 8-month evaluation. Regarding the parasitic load and the size of the lesions, there was no significant difference between the group that used only conventional treatment with antimonial (control) and co-therapy. However, histological analysis revealed the preservation of spleen, kidney and liver characteristics, demonstrating a protective effect on these organs when topical use of crude propolis extract. In view of the above, it is concluded that co-therapy between ointment with extract and Glucantime® may contribute to reducing the side effects of conventional treatment. The hydroalcoholic extract did not meet all the parameters of MAPA, but presented antioxidant activity by the DPPH method and will continue for new tests.