Milena Botelho Pereira Soares

CEP America, Emeryville, California, United States

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Publications (149)458.25 Total impact

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    ABSTRACT: Abstract This study reports on the design, synthesis and antiparasitic activity of three new semi-synthetic naphthoquinones structurally related to the naturally-occurring lapachol and lapachone. Of the compounds tested, 3-(3-methylbut-1-en-1-yl)-1,4-dioxo-1,4-dihydronaphthalen-2-yl acetate (1) was the most active against Plasmodium falciparum among both natural and semi-synthetic naphthoquinones, showing potent and selective activity. Compound 1 was able to reduce the in vitro parasite burden, in vitro parasite cell cycle, as well as the blood parasitemia in Plasmodium berghei-infected mice. More importantly, infection reduction under compound 1-treatment was achieved without exhibiting mouse genotoxicity. Regarding the molecular mechanism of action, this compound inhibited the hemozoin crystal formation in P. falciparum treated cells, and this was further confirmed by observing that it inhibits the β-hematin polymerization process similarly to chloroquine. Interestingly, this compound did not affect either mitochondria structure or cause DNA fragmentation in parasite treated cells. In conclusion, we identified a semi-synthetic antimalarial naphthoquinone closely related to isolapachol, which had stronger antimalarial activity than lapachol.
    Journal of Enzyme Inhibition and Medicinal Chemistry 11/2014; · 1.50 Impact Factor
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    ABSTRACT: The administration of stem cells holds promise as a potential therapy for spinal cord injury (SCI). Mesenchymal stem cells have advantages for clinical applications, since they can be easily obtained, are suitable for autologous transplantation and have been previously shown to induce regeneration of the spinal cord in experimental settings. Here we evaluated the feasibility, safety and potential efficacy of autologous transplantation of mesenchymal stem cells in subjects with chronic complete SCI. We conducted a phase I, non-controlled study in 14 subjects of both genders aging between 18 to 65 years, with chronic traumatic SCI (>6 months), at thoracic or lumbar levels, classified as American spinal injury association (ASIA) A - complete injury. Baseline somatosensory evoked potentials (SSEP), spinal magnetic resonance imaging (MRI) and urodynamics were assessed before and after treatment. Pain rating was performed using the McGill Pain Questionnaire and a visual analogue score scale. Bone marrow-derived mesenchymal stem cells were cultured and characterized by flow cytometry, cell differentiation assays and G-band karyotyping. Mesenchymal stem cells were injected directly into the lesion following laminectomy and durotomy. Cell transplantation was an overall safe and well-tolerated procedure. All subjects displayed variable improvements in tactile sensitivity and eight subjects developed lower limbs motor functional gains, principally in the hip flexors. Seven subjects presented sacral sparing and improved American spinal injury association impairment scale (AIS) grades to B or C - incomplete injury. Nine subjects had improvements in urologic function. One subject presented changes in SSEP 3 and 6 months after mesenchymal stem cells transplantation. Statistically significant correlations between the improvements in neurological function and both injury size and level were found. Intralesional transplantation of autologous mesenchymal stem cells in subjects with chronic, complete spinal cord injury is safe, feasible, and may promote neurological improvements.Trial registration: ClinicalTrials.gov NCT01325103 - Registered 28 March 2011.
    Stem cell research & therapy. 11/2014; 5(6):126.
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    ABSTRACT: Pain is the most common reason a patient sees a physician. Nevertheless, the use of typical painkillers is not completely effective in controlling all pain syndromes; therefore further attempts have been made to develop improved analgesic drugs. The present study was undertaken to evaluate the antinociceptive properties of physalins B (1), D (2), F (3), and G (4) isolated from Physalis angulata in inflammatory and centrally mediated pain tests in mice. Systemic pretreatment with 1-4 produced dose-related antinociceptive effects on the writhing and formalin tests, traditional screening tools for the assessment of analgesic drugs. On the other hand, only 3 inhibited inflammatory parameters such as hyperalgesia, edema, and local production of TNF-α following induction with complete Freund's adjuvant. Treatment with 1, 3, and 4 produced an antinociceptive effect on the tail flick test, suggesting a centrally mediated antinociception. Reinforcing this idea, 2-4 enhanced the mice latency reaction time during the hot plate test. Mice treated with physalins did not demonstrate motor performance alterations. These results suggest that 1-4 present antinociceptive properties associated with central, but not anti-inflammatory, events and indicate a new pharmacological property of physalins.
    Journal of natural products. 11/2014;
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    ABSTRACT: Betulinic acid (BA) is a lupane-type triterpene with a number of biological activities already reported. While potent anti-HIV and antitumoral activities were attributed to BA, it is considered to have a moderate anti-inflammatory activity. Here we evaluated the effects of BA in a mouse model of endotoxic shock. Endotoxemia was induced through intraperitoneally LPS administration, nitric oxide (NO) and cytokines were assessed by Griess method and ELISA, respectively. Treatment of BALB/c mice with BA at 67mg/kg caused a 100% survival against a lethal dose of lipopolysaccharide (LPS). BA treatment caused a reduction in TNF-α production induced by LPS but did not alter IL-6 production. Moreover, BA treatment increased significantly the serum levels of IL-10 compared to vehicle-treated, LPS-challenged mice. To investigate the role of IL-10 in BA-induced protection, wild-type and IL-10(-/-) mice were studied. In contrast to the observations in IL-10(+/+) mice, BA did not protect IL-10(-/-) mice against a lethal LPS challenge. Addition of BA inhibited the production of pro-inflammatory mediators by macrophages stimulated with LPS, while promoting a significant increase in IL-10 production. BA-treated peritoneal exudate macrophages produced lower concentrations of TNF-α and NO and higher concentrations of IL-10 upon LPS stimulation. Similarly, macrophages obtained from BA-treated mice produced less pro-inflammatory mediators and increased IL-10 when compared to non-stimulated macrophages obtained from vehicle-treated mice. In conclusion, we have shown that BA has a potent anti-inflammatory activity in vivo, protecting mice against LPS by modulating TNF-α production by macrophages in vivo through a mechanism dependent on IL-10.
    International immunopharmacology. 09/2014;
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    ABSTRACT: The cis-[RuCl(NO2)(dppb)(5,5' -mebipy)] ( 1: ), cis-[Ru(NO2)2(dppb)(5,5' -mebipy)] ( 2: ), ct-[RuCl(NO)(dppb)(5,5' -mebipy)](PF6)2 ( 3: ) and cc-[RuCl(NO)(dppb)(5,5' -mebipy)]PF6 ( 4: ) complexes, where 5,5' -mebipy = 5,5' -dimethyl-2,2' -bipyridine and dppb = 1,4-bis(diphenylphosphino)butane, were synthesized and characterized. The structure of the cis-[Ru(NO2)2(dppb)(5,5' -mebipy)] ( 2: ) complex was determined by X-ray crystallography. These complexes exhibited a higher anti-T. cruzi activity than benznidazole, the current antiparasitic drug. Complex ( 3: ) was the most potent, displaying EC50 = 2.1±0.6 μM against trypomastigotes and IC50 = 1.3±0.2 μM against amastigotes, while it displayed a CC50 of 51.4±0.2 μM in macrophages. It was observed that the nitrosyl complex ( 3: ), but not its analog lacking the nitrosyl group, releases nitric oxide into parasite cells. This release has a diminished effect on the trypanosomal protease cruzain, but induces substantial parasite autophagy, which is followed by a series of irreversible morphological impairments to the parasites and finally results in cell death by necrosis. In infected mice, orally administered complex ( 3: ) (5 x 75 μmol/kg) reduced blood parasitemia and increased the survival rate of the mice. Combination index analysis of complex ( 3: ) indicated that its in vitro activity against trypomastigotes is synergic with benznidazole. In addition, drug combination enhanced efficacy in infected mice, suggesting that ruthenium- nitrosyl complexes are potential constituents for drug combinations.
    Antimicrobial Agents and Chemotherapy 08/2014; · 4.57 Impact Factor
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    Bioorganic & Medicinal Chemistry Letters. 08/2014; 24(15):3315–3320.
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    ABSTRACT: New therapeutic options are necessary for patients with chronic Chagas disease, a leading cause of heart failure in Latin American countries. Stem cell therapy focused on improving cardiac function is a promising approach for heart diseases. Here we evaluated the therapeutic effects of cardiac mesenchymal stem cells (CMSC) in a mouse model of chronic Chagas disease.
    Stem cell research & therapy. 07/2014; 5(4):81.
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    ABSTRACT: This work describes a novel ent-kaurane diterpene, ent-3β-hydroxy-kaur-16-en-19-al along with five known ent-kaurane diterpenes, ent-3β,19-dihydroxy-kaur-16-eno, ent-3β-hydroxy-kaur-16-eno, ent-3β-acetoxy-kaur-16-eno, ent-3β-hydroxy-kaurenoic acid and kaurenoic acid, as well as caryophyllene oxide, humulene epoxide II, β-sitosterol, stigmasterol and campesterol from the stem bark of Annona vepretorum Mart. (Annonaceae). Cytotoxic activities towards tumor B16-F10, HepG2, K562 and HL60 and non-tumor PBMC cell lines were evaluated for ent-kaurane diterpenes. Among them, ent-3β-hydroxy-kaur-16-en-19-al was the most active compound with higher cytotoxic effect over K562 cell line (IC50 of 2.49μg/mL) and lower over B16-F10 cell line (IC50 of 21.02μg/mL).
    Bioorganic & medicinal chemistry letters. 06/2014;
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    ABSTRACT: Infection by Trypanosoma cruzi, the aetiological agent of Chagas disease, causes an intense inflammatory reaction in several tissues, including the myocardium. We have previously shown that transplantation of bone marrow cells (BMC) ameliorates the myocarditis in a mouse model of chronic Chagas disease. We investigated the participation of BMC in lesion repair in the heart and skeletal muscle, caused by T. cruzi infection in mice. Infection with a myotropic T. cruzi strain induced an increase in the percentage of stem cells and monocytes in the peripheral blood, as well as in gene expression of chemokines SDF-1, MCP1, 2, and 3 in the heart and skeletal muscle. To investigate the fate of BMC within the damaged tissue, chimeric mice were generated by syngeneic transplantation of green fluorescent protein (GFP+) BMC into lethally irradiated mice and infected with Trypanosoma cruzi. Migration of GFP+ BMC to the heart and skeletal muscle was observed during and after the acute phase of infection. GFP+ cardiomyocytes and endothelial cells were present in heart sections of chimeric chagasic mice. GFP+ myofibres were observed in the skeletal muscle of chimeric mice at different time points following infection. In conclusion, BMC migrate and contribute to the formation of new resident cells in the heart and skeletal muscle, which can be detected both during the acute and the chronic phase of infection. These findings reinforce the role of BMC in tissue regeneration.
    International Journal of Experimental Pathology 06/2014; · 2.04 Impact Factor
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    ABSTRACT: The nonpolar fraction of an aqueous ethanol extract of the roots of Arrabidaea brachypoda, a Brazilian medicinal plant, demonstrated significant in vitro activity against Trypanosoma cruzi, the parasite responsible for Chagas disease. Targeted isolation of the active constituents led to the isolation of three new dimeric flavonoids (1-3), and their structures were elucidated using UV, NMR, and HRMS analysis, as well as by chemical derivatization. The anti-T. cruzi activity and cytotoxicity toward mammalian cells were determined for these substances. Compound 1 exhibited no activity toward T. cruzi, while flavonoids 2 and 3 exhibited selective activity against these trypomastigotes. Compounds 2 and 3 inhibited the parasite invasion process and its intracellular development in host cells with similar potencies to benznidazole. In addition, compound 2 reduced the blood parasitemia of T. cruzi-infected mice. This study has revealed that these two dimeric flavonoids represent potential anti-T. cruzi lead compounds for further drug development.
    Journal of natural products. 05/2014;
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    ABSTRACT: Investigation by GC-FID and GC-MS of the essential oil (LPOE) from the leaves of Lippia pedunculosa revealed, as the major compounds, the monoterpenes rotundifolone (71.7%) and (R)-limonene (21.8%). These two compounds and the minor constituent piperitenone (1.2%) were also isolated from the leaves and identified by spectrometric analysis. LPOE and isolated compounds were evaluated for their trypanocidal activity against epimastigote and trypomastigote forms of Trypanosoma cruzi. Significant results with IC50 values lower than 34.0 μg.mL-1 were observed against these forms of T. cruzi for LPOE and isolated compounds. Rotundifolone was the most active compound with an IC50 lower than 10.0 μg.mL-1 for both forms of T. cruzi. The effects of LPOE and isolated compounds were also evaluated in cultures of macrophages infected with T. cruzi. Treatment with (R)-limonene and rotundifolone caused a moderate reduction in the percentage of macrophages infected by T. cruzi and in the number of intracellular parasites at concentrations non-toxic to macrophages.
    Natural product communications 04/2014; 9(6):737-739. · 0.96 Impact Factor
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    ABSTRACT: The present study describes the synthesis, characterization, antileishmanial and antiplasmodial activities of novel diimine/(2,2'-bipyridine (bipy), 1,10-phenanthroline (phen), 4,4'-methylbipyridine (Me-bipy) and 4,4'-methoxybipyridine (MeO-bipy)/phosphine/ruthenium(II) complexes containing lapachol (Lap, 2-hydroxy-3-(3-33 methyl-2-buthenyl)-1,4-naphthoquinone) as bidentate ligand. The [Ru(Lap)(PPh3)2(bipy)]PF6 (1), [Ru(Lap)(PPh3)2(Me-bipy)]PF6 (2), [Ru(Lap)(PPh3)2(MeO-bipy)]PF6(3) and[Ru(Lap)(PPh3)2(phen)]PF6 (4) complexes, PPh3=triphenylphospine, were synthesized from the reactions of cis-[RuCl2(PPh3)2(X-bipy)] or cis-[RuCl2(PPh3)2(phen)], with lapachol. The [RuCl2(Lap)(dppb)] (5) [dppb=1,4-bis(diphenylphosphine)butane] was synthesized from the mer-[RuCl3(dppb)(H2O)] complex. The complexes were characterized by elemental analysis, molar conductivity, infrared and UV-vis spectroscopy, (31)P{(1)H} and (1)H NMR, and cyclic voltammetry. The Ru(III) complex, [RuCl2(Lap)(dppb)], was also characterized by the EPR technique. The structure of the complexes [Ru(Lap)(PPh3)2(bipy)]PF6 and [RuCl2(Lap)(dppb)] was elucidated by X-ray diffraction. The evaluation of the antiparasitic activities of the complexes against Leishmania amazonensis and Plasmodium falciparum demonstrated that lapachol-ruthenium complexes are more potent than the free lapachol. The [RuCl2(Lap)(dppb)] complex is the most potent and selective antiparasitic compound among the five new ruthenium complexes studied in this work, exhibiting an activity comparable to the reference drugs.
    Journal of inorganic biochemistry 03/2014; 136C:33-39. · 3.25 Impact Factor
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    ABSTRACT: Guatteria blepharophylla Mart. (synonym Guatteriopsis blepharophylla Mart.) and Guatteria hispida (R.E. Fr.) Erkens & Maas (synonym Guatteriopsis hispida R.E. Fr.) belong to the Annonaceae family and are found in the Brazilian and Colombian Amazon basin. Both species are popularly known as ‘envira’ or ‘envireira’. In the present study, the leaf essential oils of G. blepharophylla (EOGB) and G. hispida (EOGH) were selected to investigate their cytotoxic effects. Tumour cell lines were treated with increasing concentrations of both essential oils for 72 h and analysed by a methyl-[3H]thymidine incorporation assay. The pro-apoptotic effect of these essential oils was assessed in HepG2 cells by morphological analysis (using haematoxylin/eosin staining and acridine orange/ethidium bromide staining), flow cytometry (cell membrane integrity and internucleosomal DNA fragmentation analysis) and a caspase-3 activation assay after 24 h incubation. Both essential oils displayed potent cytotoxicity in different tumour cell lines. EOGB showed IC50 values from 6.03 to 16.46 µg/ml for HepG2 and K562 cell lines, and EOGH showed IC50 values from 5.45 to 24.89 µg/ml for HepG2 and K562 cell lines, respectively. Cell morphologies consistent with apoptosis and a remarkable activation of caspase-3 were observed in the HepG2 cells treated with essential oils for 24 h. Significant increases in internucleosomal DNA fragmentation without altered membrane integrity were also found. In conclusion, both essential oils investigated were able to inhibit tumour cell proliferation and induce cell death by apoptosis pathways. Copyright © 2014 John Wiley & Sons, Ltd.
    Flavour and Fragrance Journal 03/2014; · 1.82 Impact Factor
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    ABSTRACT: Undernourished mice infected (UI) submitted to low and long-lasting infections by Schistosoma mansoni are unable to develop the hepatic periportal fibrosis that is equivalent to Symmers' fibrosis in humans. In this report, the effects of the host's nutritional status on parasite (worm load, egg viability and maturation) and host (growth curves, biology, collagen synthesis and characteristics of the immunological response) were studied and these are considered as interdependent factors influencing the amount and distribution of fibrous tissue in hepatic periovular granulomas and portal spaces. The nutritional status of the host influenced the low body weight and low parasite burden detected in UI mice as well as the number, viability and maturation of released eggs. The reduced oviposition and increased number of degenerated or dead eggs were associated with low protein synthesis detected in deficient hosts, which likely induced the observed decrease in transformation growth factor (TGF)-β1 and liver collagen. Despite the reduced number of mature eggs in UI mice, the activation of TGF-β1 and hepatic stellate cells occurred regardless of the unviability of most miracidia, due to stimulation by fibrogenic proteins and eggshell glycoproteins. However, changes in the repair mechanisms influenced by the nutritional status in deficient animals may account for the decreased liver collagen detected in the present study.
    Memórias do Instituto Oswaldo Cruz 02/2014; · 1.36 Impact Factor
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    ABSTRACT: A terpyridine ligand Fctpy was reacted with divalent metals (Cu, Co, Mn, Ni and Zn), yielding five complexes of general formula [Metal(Fctpy)2][PF6]2. The structure of Fctpy was determined by single crystal X-ray diffraction studies. The complexes characterized using various spectroscopic techniques suggested an octahedral geometry around the central metal ion. These complexes were screened for their antiamoebic, trypanocidal and antimalarial activities. It was found that, complexes 2 and 3 showed better IC50 values than metronidazole against HM1:IMSS strain of Entamoeba histolytica. A substantial parasitic inhibition was not observed for the trypanocidal activity. However, for the erythrocytic stage of W2 strain of Plasmodium falciparum, the complexes inhibited β-hematin formation. At the concentration of 10 μg/mL, these complexes did not display toxicity.
    European Journal of Medicinal Chemistry 01/2014; 75C:203-210. · 3.43 Impact Factor
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    ABSTRACT: In earlier studies, we reported that a heterologous prime-boost regimen using recombinant plasmid DNA followed by replication-defective adenovirus vector, both containing Trypanosoma cruzi genes encoding trans-sialidase (TS) and amastigote surface protein (ASP) 2, provided protective immunity against experimental infection with a reticulotropic strain of this human protozoan parasite. Herein, we tested the outcome of genetic vaccination of F1 (CB10XBALB/c) mice challenged with myotropic parasite strains (Brazil and Colombian). Initially, we determined that the coadministration during priming of a DNA plasmid containing the murine IL-12 gene improved the immune response and was essential for protective immunity elicited by the heterologous prime-boost regimen in susceptible male mice against acute lethal infections with these parasites. The prophylactic or therapeutic vaccination of resistant female mice led to a drastic reduction in the number of inflammatory infiltrates in cardiac and skeletal muscles during the chronic phase of infection with either strain. Analysis of the electrocardiographic parameters showed that prophylactic vaccination reduced the frequencies of sinus arrhythmia and atrioventricular block. Our results confirmed that prophylactic vaccination using the TS and ASP-2 genes benefits the host against acute and chronic pathologies caused by T. cruzi and should be further evaluated for the development of a veterinary or human vaccine against Chagas disease.
    Mediators of Inflammation 01/2014; 2014:605023. · 3.88 Impact Factor
  • Despina Smirlis, Milena Botelho Pereira Soares
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    ABSTRACT: Trypanosomatid parasites are a group of flagellated protozoa that includes the genera Leishmania and Trypanosoma, which are the causative agents of diseases (leishmaniases, sleeping sickness and Chagas disease) that cause considerable morbidity and mortality, affecting more than 27 million people worldwide. Today no effective vaccines for the prevention of these diseases exist, whereas current chemotherapy is ineffective, mainly due to toxic side effects of current drugs and to the emergence of drug resistance and lack of cost effectiveness. For these reasons, rational drug design and the search of good candidate drug targets is of prime importance. The search for drug targets requires a multidisciplinary approach. To this end, the completion of the genome project of many trypanosomatid species gives a vast amount of new information that can be exploited for the identification of good drug candidates with a prediction of "druggability" and divergence from mammalian host proteins. In addition, an important aspect in the search for good drug targets is the "target identification" and evaluation in a biological pathway, as well as the essentiality of the gene in the mammalian stage of the parasite, which is provided by basic research and genetic and proteomic approaches. In this chapter we will discuss how these bioinformatic tools and experimental evaluations can be integrated for the selection of candidate drug targets, and give examples of metabolic and signaling pathways in the parasitic protozoa that can be exploited for rational drug design.
    Sub-cellular biochemistry 01/2014; 74:43-76.
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    ABSTRACT: Five ruthenium–lapachol complexes were synthesized and evaluated against Leishmania amazonensis and Plasmodium falciparum. The metal complexes are promising antiparasite metallodrug candidates, in which they are more potent than lapachol free and the reference drugs.
    Journal of Inorganic Biochemistry. 01/2014; 136:33–39.
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    ABSTRACT: Hecogenin is a steroidal sapogenin largely drawn from the plants of the genus Agave, commonly known as 'sisal', and is one of the important precursors used by the pharmaceutical industry for the synthesis of steroid hormones. Hecogenin acetate (HA) is a steroidal sapogenin-acetylated that produces antinociceptive activity. Thus, we evaluate the antihyperalgesic profile of HA in mice in inflammatory models, as well as its possible involvement with c-fos expression on spinal cord area and cytokines to produces analgesic profile. Acute pretreatment with HA (5, 10, or 20 mg/kg; i.p.) inhibited the development of mechanical hyperalgesia induced by carrageenan, TNF-α, dopamine and PGE2. Additionally, the immunofluorescence data demonstrated that acute pretreatment with HA, at all doses tested, significantly inhibited Fos-like expression in the spinal cord dorsal horn normally observed after carrageenan-inflammation. Moreover, HA did not affect the motor performance of the mice as tested in the Rota rod test. This antinociceptive profile seems to be related, at least in part, to a reduction of pro-inflammatory cytokines, as IL-1β. The present results suggest that HA attenuates mechanical hyperalgesia by blocking the neural transmission of pain at the spinal cord levels and by cytokines-inhibitory mechanisms.
    Molecules (Basel, Switzerland). 01/2014; 19(6):8303-8316.
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    ABSTRACT: N-Acylhydrazones derived from 7-chloro-4-piperazin-1-yl-quinoline were synthesized and evaluated for blood-stage of Plasmodium falciparum, Entamoeba histolytica trophozoites, and cytotoxicity assay in mammalian cells.
    European Journal of Medicinal Chemistry 01/2014; 75:67–76. · 3.43 Impact Factor

Publication Stats

1k Citations
458.25 Total Impact Points

Institutions

  • 2013–2014
    • CEP America
      Emeryville, California, United States
    • Harvard Medical School
      Boston, Massachusetts, United States
    • Universidade Federal de Sergipe
      • Department of Chemistry
      São Cristóvão, Estado de Sergipe, Brazil
  • 2007–2014
    • Hospital São Rafael
      Bahia, Estado de Bahía, Brazil
  • 2001–2014
    • Fundação Oswaldo Cruz
      Rio de Janeiro, Rio de Janeiro, Brazil
  • 2011–2013
    • Universidade Federal da Bahia
      • Faculdade de Farmácia
      Salvador, Estado da Bahia, Brazil
    • Irmandade da Santa Casa da Misericórdia de Santos
      Santos, São Paulo, Brazil
  • 2006–2013
    • Federal University of Pernambuco
      • • Departamento de CIências Farmacêuticas
      • • Department of Chemical Engineering
      Arrecife, Pernambuco, Brazil
  • 2012
    • Universidade Estadual de Feira de Santana
      Feira de Sant'Anna, Estado de Bahía, Brazil
  • 2004–2011
    • Santa Izabel Hospital
      Bahia, Estado de Bahía, Brazil
  • 2010
    • Jamia Millia Islamia
      • Department of Chemistry
      New Delhi, NCT, India
  • 2005
    • Fundação Salvador Arena
      San Paulo, São Paulo, Brazil
  • 2002–2003
    • Federal University of Rio de Janeiro
      • Instituto de Biofísica Carlos Chagas Filho (IBCCF)
      Rio de Janeiro, Rio de Janeiro, Brazil
  • 1998
    • Harvard University
      • Department of Immunology and Infectious Diseases
      Boston, MA, United States
  • 1997
    • Massachusetts Department of Public Health
      Boston, Massachusetts, United States