Can Amphotericin B-mediated effects be limited using intranasal versus intravenous route?

Aim: CNS infections due to parasites often prove fatal. In part, this is due to inefficacy of drugs to cross the blood-brain barrier. Methods: Here, we tested intranasal and intravenous route and compared adverse effects of Amphotericin B administration, through blood biochemistry, liver, kidney and brain histopathological evidence of toxicities in vivo post-administration. Results: It was observed that intranasal route limits the adverse side effects of Amphotericin B, in contrast to intravenous route. Conclusion: As parasites such as Naegleria fowleri exhibit unequivocal affinity toward the olfactory bulb and frontal lobe in the central nervous system, intranasal administration would directly reach amoebae bypassing the blood-brain barrier selectivity and achieve the minimum inhibitory concentration at the target site. Plain language summary: Brain infections due to parasites are often fatal. One of the reasons is the inability of drugs to get to the brain. When given in large dose to reach the brain, the drug can cause serious side effects. Here, we tested the side effects of Amphotericin B (drug of choice against brain-eating amoebae), when given intranasally versus intravenous. Our findings clearly show that intranasal route limits the side effects of Amphotericin B. These are important findings and should serve as an important step in the development of effective therapy against parasitic infections affecting the brain. Tweetable abstract: Targeting brain-eating amoebae: Amphotericin B-mediated host tissue toxicity can be limited when given intranasally. [GRAPHICS.]