25mars
Amiodarone (Cordaron) protects against malaria
Because it contains iodine
Amiodarone which is used to control irregular heartbeat also has a protective effect in malaria. It triggers eryptosis and the clearance of malaria infected erythrocytes. In Plasmodium berghei infected mice amiodarone injections increased the survival. It is interesting to note that amiodarone is also active against other tropical diseases like Chagas or Leishmaniasis, both in vitro and in vivo, probably by disrupting the parasites' Ca(2+) homeostasis,
Bobbala D, Alesutan I, Föller M, Protective effect of amiodarone in malaria. Acta Trop 2010. Acta Trop. 2010 Oct;116(1):39-44. doi: 10.1016/j.actatropica.2010.05.005. Epub 2010 May 27.
JR Piccotti, MS LaGattuta. Induction of apoptosis by cationic amphphilic drugs amiodarone and imipramine. Drugs and Chemical Toxicology, 2005, 28-1, 117-133
E Lang, F Lang, Triggers, inhibitors, mechanisms and significance of eryptosis: the suicidal erythrocyte death. Hindawi BioMed Research Internat, 2015, ID 513518.
Benaim G, Sanders JM, Amiodarone has intrinsic anti-Trypanosoma cruzi activity and acts synergistically with posaconazole. J Med Chem. 2006.
Gustavo Benaim, Paola Casanova, Dronedarone, an Amiodarone Analog with Improved Anti-Leishmania mexicana Efficacy, 2014 , 58 , 4 Antimicrobial Agents and Chemotherapy p. 2295–2303
The antimalarial effect of iodine had already been discovered in 1923. Amiodarone contains two iodine atoms. It is estimated that amiodarone metabolism in the liver releases approximately 3 mg of inorganic iodine into the systemic circulation per 100 mg of amiodarone ingested. This is another proof that Plasmodium is killed by oxidative stress.
JJA Bracchio. Iodine in the treatment of malaria, Kala-Azar and small-pox. Ind Med Gaz, 1923 58, 311-313
Iodine was extensively used as antimalarial before world war II as “nascent iodine” under the tradename Atomidine. It is difficult to find scientific papers documemting this use. Except a more recent paper from India.
Jagadish G, Chakradhar MV. Clinical study of efficacy of nascent iodine as therapeutic and chemoprophylaxis agent in tropical malaria. Townsend Letter, December 2012.
This clinical trial would hardly satisfy WHO requirement for such a study. It involves several hundreds of patients, and reports one interesting detail. The efficacy was 91.2 % for men and 77.7 % only for women.