The emerging role of amiodarone and dronedarone in Chagas disease


Chagas disease has emerged as an important health problem in the Americas and, with globalization, in other parts of the world. Drug therapy for this parasitic infection has remained largely ineffective, especially in chronic stages of the disease. However, developments in experimental therapy might signal an important advance for the management of patients with Chagas disease. Herein, we review studies on the potential use of the benzofuran derivatives amiodarone and dronedarone in patients with Chagas disease. These agents have a dual role, not only as primary antiarrhythmic drugs, but also as antiparasitic agents. We believe that this 'kill two birds with one stone' approach represents a new tactic for the treatment of Chagas disease using currently approved drugs.

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Figure 1
Figure 2: Amiodarone disrupts intracellular Ca2+ homeostasis in T. cruzi.
Figure 3: Effects of amiodarone on the ultrastructure of intracellular T. cruzi (Y strain) amastigotes.
Figure 4: Comparison of amiodarone and dronedarone structure and function.


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This work was supported by grant 2011000884 from the Consejo Nacional de Investigaciones Científicas y Tecnológicas (FONACIT), Venezuela (to G. Benaim), grant PI 03-00-7380-2008/2 from the Consejo de Desarrollo Científico y Humanístico from the Universidad Central de Venezuela (C.D.C.H.-U.C.V), Venezuela (to G. Benaim), and grant IVSS-430-06-14/05/2007 from the Instituto Venezolano de los Seguros Sociales, Venezuela (to A. E. Paniz Mondolfi). The authors would like to thank Dr Emilia Mia Sordillo (Senior Attending Physician, Division of Infectious Diseases and Epidemiology, Department of Medicine, St Luke's-Roosevelt Hospital Center, New York, NY, USA) for critically reviewing the manuscript.

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The authors contributed equally to researching data, discussion of content, writing, and reviewing and editing the manuscript.

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Benaim, G., Paniz Mondolfi, A. The emerging role of amiodarone and dronedarone in Chagas disease. Nat Rev Cardiol 9, 605–609 (2012).

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