Literature DB >> 18702118

Developmental toxicity of artesunate in the rat: comparison to other artemisinins, comparison of embryotoxicity and kinetics by oral and intravenous routes, and relationship to maternal reticulocyte count.

Robert L Clark1, Steven A Lerman, Estella M Cox, William E Gristwood, Tacey E K White.   

Abstract

BACKGROUND: The antimalarial, artesunate, is teratogenic and embryolethal in rats, with peak sensitivity on Days 10 and 11 postcoitum (pc).
METHODS: We compared the developmental toxicity of structurally related artemisinins, dihdyroartemisinin (DHA), artemether (ARTM), and arteether (ARTE) to that of artesunate after oral administration to rats on Day 10 pc. In separate studies, embryolethality was characterized after single intravenous (IV) administration of artesunate on Day 11 pc, and toxicokinetic parameters following oral and IV administration were compared. Lastly, to determine whether maternal hematologic effects occurred at doses that affect embryonic erythroblasts, artesunate was orally administered on Day 11 pc at a dose that caused 100% embryolethality.
RESULTS: All artemisinins caused the same pattern of embryolethality and fetal cardiovascular and skeletal abnormalities as previously shown for artesunate. In the IV study, marked postimplantation loss occurred at 1.5 and 3 mg/kg artesunate, but not at 0.75 mg/kg. Among the toxicokinetic parameters evaluated, only the DHA AUC(0-t) was similar at embryolethal oral and IV doses of artesunate. An embryolethal dose of artesunate caused a 15% decrease in maternal reticulocyte counts and no other hematologic effects.
CONCLUSIONS: Several structurally related artemisinins cause similar developmental toxicity, suggesting an artemisinin class effect. Equally embryotoxic oral and IV treatments of one artemisinin compound (artesunate) produced similar systemic exposure to the artesunate metabolite, DHA, suggesting that DHA may be the proximate developmental toxicant. Embryolethal doses of artesunate only caused minor changes in maternal reticulocyte counts indicating that adult hematology parameters are not as sensitive as embryonic erythroblasts. Copyright 2008 Wiley-Liss, Inc.

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Year:  2008        PMID: 18702118     DOI: 10.1002/bdrb.20165

Source DB:  PubMed          Journal:  Birth Defects Res B Dev Reprod Toxicol        ISSN: 1542-9733


  10 in total

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Journal:  Travel Med Infect Dis       Date:  2015-07-09       Impact factor: 6.211

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Review 3.  A systematic review of the safety and efficacy of artemether-lumefantrine against uncomplicated Plasmodium falciparum malaria during pregnancy.

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Journal:  Malar J       Date:  2012-05-01       Impact factor: 2.979

4.  Pattern of the Antimalarials Prescription during Pregnancy in Bangui, Central African Republic.

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Review 5.  Treating severe malaria in pregnancy: a review of the evidence.

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6.  Exposure to artemether-lumefantrine (Coartem) in first trimester pregnancy in an observational study in Zambia.

Authors:  Christine Manyando; Eric M Njunju; Mailis Virtanen; Kamal Hamed; Melba Gomes; Jean-Pierre Van Geertruyden
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7.  First-trimester artemisinin derivatives and quinine treatments and the risk of adverse pregnancy outcomes in Africa and Asia: A meta-analysis of observational studies.

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Journal:  PLoS Med       Date:  2017-05-02       Impact factor: 11.069

8.  Advances in the treatment of malaria.

Authors:  Francesco Castelli; Lina Rachele Tomasoni; Alberto Matteelli
Journal:  Mediterr J Hematol Infect Dis       Date:  2012-10-03       Impact factor: 2.576

Review 9.  Safety, pharmacokinetics and efficacy of artemisinins in pregnancy.

Authors:  Veronica Ades
Journal:  Infect Dis Rep       Date:  2011-05-27

Review 10.  Safety of Artemisinin Derivatives in the First Trimester of Pregnancy: A Controversial Story.

Authors:  Sarah D'Alessandro; Elena Menegola; Silvia Parapini; Donatella Taramelli; Nicoletta Basilico
Journal:  Molecules       Date:  2020-07-31       Impact factor: 4.411

  10 in total

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