Improving the miltefosine efficacy against leishmaniasis by using different nanoassemblies made from surfactants or amphiphilic antimony (V) complex

Abstract Leishmaniasis is a neglected tropical disease caused by intracellular parasites from the genus Leishmania. This neglected tropical disease is responsible for significant morbidity and mortality worldwide. One of the most important challenges for the treatment of leishmaniasis is the oral administration of drugs. Such need combined to the predicted high bioavailability of miltefosine prompted its validation. Its antileishmanial activity was better than that of the intravenous sodium stibogluconate. In 2002, it was approved as the first oral drug against leishmaniasis. Miltefosine is being an attractive drug for leishmaniasis due to its cost-effective and oral administration. On the other hand, nanocarriers drug delivery systems used to enhance activity and reduce side effects of antileishmanial drugs. This chapter reviews the most common nanocarriers used for miltefosine, focusing on polymeric micelles, characterized for their core-shell structure. Micelles formed with PEO-PPO block copolymers (Pluronics and Tetronics) and TPGS (PEGylated derivative of vitamin E) are described, as well as their composition, biological activity, and interaction with miltefosine. Promising systems, based on this drug, are reported by the combination of several copolymers, forming polymeric mixed micelles, and the further organization of some PEO-PPO block copolymers micelles into hydrogels.