Efficient treatment of experimental cerebral malaria by an artemisone-SMEDDS system: impact of application route and dosing frequency.

Artemisone (ART) has been successfully tested in vitro and in animal models against several diseases. However, its poor aqueous solubility and limited chemical stability are serious challenges. We developed a self-microemulsifying drug delivery system (SMEDDS) that overcomes these limitations. Here, we demonstrate the efficacy of this formulation against experimental cerebral malaria in mice and the impact of its administration using different routes (gavage, intranasal delivery and parenteral injections) and frequency on the efficacy of the treatment. The minimal effective oral dose was 20 mg/kg. We found that splitting a dose of 20 mg/kg ART given every 24 hours, by administering two doses of 10 mg/kg each every 12 hours, was highly effective and gave far superior results compared to 20 mg/kg once daily. We obtained the best results with nasal treatment, oral treatment was ranked second and the least effective route of administration was intraperitoneal injection. A complete cure of experimental cerebral malaria could be achieved through choosing the optimal route of application, dose and dosing interval. Altogether, the developed formulation combines easy manufacturing with high stability, and is a successful and very versatile carrier for the delivery of ART in treatment of human severe malaria.