Sleeping sickness treatment

Nowadays, treatment of African sleeping sickness with the prevailing drugs faces three major problems ... 

Acetarsol An organic arsenic compound, being therapeutically active when administered orally, that might be of value in the treatment of spirochaetal or protozoal diseases, for instance syphilis, yaws, relapsing fever, sleeping sickness and amoebic dysentiy. 

Bisser S et al Equivalence trial of melarsoprol and nifurtimox monotherapy and combination therapy for the treatment of second-stage Trypanosoma brucei gambiense sleeping sickness. J Infect Dis 2007 195 322. [PMID 17205469]... 

The following drug shown is suramin, used for the treatment of sleeping sickness which is caused by the protozoan trypanosomiosis. 

Human African trypanosomiasis (African sleeping sickness) around 60 million people at risk In sub-Saharan Africa, resulting annually in around 500,000 cases and 50,000 deaths. Fatal if not treated. Most drugs are old and difficult to administer. Until recently the only treatment available for the second-stage of the disease was Melarsoprol, an arsenic-based drug that kills 5 per cent of patients. 

Trichomoniasis. Infection by protozoa usually affecting the genitourinary system. Trypanosomiasis. Infection of the blood of man or animals in tropical countries by protozoa transmitted by blood sucking insects. Examples are African sleeping sickness and Chagas disease. Trypanocide a drug for the treatment of trypanosomiasis. Vasomotor relaxation. Relaxation of the walls of blood vessels. 

Children with ADHD are inattentive, impulsive, and hyperactive. The areas of their brains that control attention and restraint do not function properly. Stimulant drugs, specifically amphetamines, have been used in the United States to treat children with inattention and hyperactivity disorders since the 1930s. MPH was also discovered to have a calming effect on hyperactive children and a focusing effect on those with attention deficit disorder (ADD). However, it was not until the 1960s that the U.S. Food and Drug Administration (FDA) approved methylphenidate for the treatment of ADHD. At the turn of the twenty-first century, approximately 90% of all methylphenidate was prescribed for ADHD children. Most of the rest was prescribed to treat adults with a sleeping sickness known as narcolepsy. 

Although now essentially obsolete for the treatment of human diseases because of their toxicities, organoarsenic compounds were the first synthetic organic pharmaceutical agents and were widely used in the early 1900s. The first pharmaceutical application was that of atoxyl (the sodium salt of 4-aminophenylarsinic acid), which was used to treat sleeping sickness. The synthesis of Salvarsan by Dr. Paul Ehrlich in 1907 was a development that may be considered the beginning of modem chemotherapy (chemical treatment of disease). Salvarsan was widely used for the treatment of syphilis. Toxic effects of Salvarsan included jaundice and encephalitis (brain inflammation). 

Pearce L (1925) Tryparsamide treatment of African sleeping sickness. Science 61 90-92... 

Hawking F (1941) Drug resistance acquired during the treatment of sleeping sickness with tryparsamide and with Bayer 205. Am J Trop Med 21 469-475... 

Watson HJC (1962) Mel W A field trial in the treatment of Trypanosoma gambiense sleeping sickness. Trans R Soc Trop Med Hyg 56 231-235... 

Friedheim EAH (1951) Mel B in the treatment of tryparsamide resistant T. gambiense sleeping sickness observations on drug resistance in the trypanosomes of the French Cameroon. Am J Trop Med Hyg 31 218-226... 

Burri C, Nkunku S, Merolle A et al (2000) Efficacy of new, concise schedule for melarsoprol in treatment of sleeping sickness caused by Trypanosoma brucei gambiense a randomised trial. Lancet 355 1419-1425... 

Pepin J, Ethier L, Kazadi C et al (1992) The impact of human immunodeficiency virus infection on the epidemiology and treatment of Trypanosoma bmcei gambiense sleeping sickness in Nioki, Zaire. Am J Trop Med Hyg 47 133-140... 

Blum J, Burri C. Treatment of late stage sleeping sickness caused by T.b. gambiense. a new approach to the use of an old drug. Swiss Med Wkly 2002 132(5-6) 51-6. 

Tissue penetration of the drug docs not (Kcur, apparently because of its high molecular weight and highly ionic character. Thus, an injected dose remains in the plasma for a very long period. Newer, more effective drugs are now available for short-term treatment and prophylaxis of African sleeping sickness. Suramin is also used for prophylaxis of onchocerciasis. It is available from the CDC. 

---