Response to: Bustamante JM, Tarleton RL. Potential new clinical therapies for Chagas disease. Expert Rev. Clin. Pharmacol. 7(3), 317–325 (2014).
We read with curiosity a recent article published in The Expert Review of Clinical Pharmacology by Bustamante et al., entitled ‘Potential new clinical therapies for Chagas disease’ Citation[1]. The authors expertly reviewed the literature on the recent advances and treatment failures of the Chagas disease. This review is helpful in showing the new clinical therapies for the Chagas disease. The author is to be congratulated for focusing on the fundamental role of the combined usage of vitamins B12 and C in improving the pathological effect of the Chagas disease according to the results gleaned from the following studies.
Some studies have shown that ascorbate-dependent antioxidative enzymes that use ascorbic acid existing in infected tissues are decreased by some parasites, and therefore protect themselves from the oxidizing action of reactive nitrogen species (RNS) and reactive oxygen species (ROS), which are produced by the host inflammatory cells Citation[2,3].
In the study of Marim et al. Citation[4], high-dose oral administration of vitamin C caused propagated clearance of trypanosomes, especially trypomastigotes. On the other hand, Ciccarelli et al. Citation[5] showed that cyanocobalamin (vitamin B12) produced a marked decrease in motility and growth rate of Trypanosoma cruzi epimastigotes. Cytotoxic action of vitamin B12 on the parasite is through the generation of ROS. Moreover, ascorbate peroxidase activity is significantly increased by vitamin B12, and ascorbic acid intensifies the antiparasitic activity that is associated with vitamin B12. This mechanism of action is probably because of the prooxidant’s well-known effect of these compounds, which is combined with transition metal ions (Co, Cu and Fe), making themselves evident via the generation of ROS Citation[6].
It was previously shown that the combined use of ascorbic acid, light to sterilize blood infected with T. cruzi and gentian violet effectively inhibited transfusion-based transmission of the Chagas disease Citation[7].
As is obvious from the above discussion, the combined use of ascorbic acid and vitamin B12 might play a fundamental role in the treatment of the Chagas disease.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
References
- Bustamante JM, Tarleton RL. Potential new clinical therapies for Chagas disease. Expert Rev Clin Pharmacol 2014;7(3):317-25
- Logan FJ, Taylor MC, Wilkinson SR, et al. The terminal step in vitamin C biosynthesis in Trypanosoma cruzi is mediated by a FMN-dependent galactonolactone oxidase. Biochem J 2007;407(3):419-26
- Monteiro G, Horta BB, Pimenta DC, et al. Reduction of 1-Cys peroxiredoxins by ascorbate changes the thiol-specific antioxidant paradigm, revealing another function of vitamin C. Proc Natl Acad Sci USA 2007;104(12):4886-91
- Marim RG, Gusmao AS, Castanho RE, et al. Effects of vitamin C supplementation on acute phase Chagas disease in experimentally infected mice with Trypanosoma cruzi QM1 strain. Rev Inst Med Trop Sao Paulo 2012;54(6):319-23
- Ciccarelli AB, Frank FM, Puente V, et al. Antiparasitic Effect of Vitamin B12 on Trypanosoma cruzi. Antimicrob Agents Chemother 2012;56(10):5315-20
- Solovieva ME, Soloviev VV, Akatov VS. Vitamin B12b increases the cytotoxicity of short-time exposure to ascorbic acid, inducing oxidative burst and iron-dependent DNA damage. Eur J Pharmacol 2007;566(1-3):206-14
- Ramirez LE, Lages-Silva E, Pianetti GM, et al. Prevention of transfusion-associated Chagas’ disease by sterilization of Trypanosoma cruzi-infected blood with gentian violet, ascorbic acid, and light. Transfusion 1995;35(3):226-30