Amiodarone, a drug long used for treating irregular heart rhythms, can also be effective against Chagas disease and leishmaniasis skin lesions, according to Alberto Paniz-Mondolfi at Columbia University in New York, N.Y., and his collaborators in Venezuela. Both these parasitic diseases are endemic in Central and South America, affecting millions. Moreover, cases in which patients are coinfected with these parasites are on the rise, the clinical researchers report.
Trypanosoma cruzi, a protozoan parasite that is transmitted by reduviid bugs, causes Chagas disease, which was discovered 100 years ago. During the chronic phase of an infection, these parasites can affect organs such as the heart, damaging muscle tissue and causing arrhythmias. Drugs that target this parasite show limited effectiveness, and toxic side effects restrict their use. Meanwhile, sand flies transmit Leishmania spp., another type of protozoan parasite. They cause leishmaniasis, which develops in several forms. For example, cutaneous leishmaniasis causes skin ulcers, whereas visceral leishmaniasis affects organs such as the liver and spleen. Here again, available therapy is unsatisfactory. For example, widely used pentavalent antimonials can damage the heart, kidneys, and liver. Thus, better drugs are needed for treating individuals infected with either or both these parasites. Vaccines are also needed.