Chemical composition, efficacy and safety of Pistacia vera (var. Fandoghi) to inactivate protoscoleces during hydatid cyst surgery

Comparison of the Scolicidal Activity of Two Leaves Extracts of Myrtus communis from Algeria Against Echinococcus granulosus Sensu Lato Protoscoleces

PURPOSE

During cystic echinococcosis surgery, the use of scolicidal agents such as hypertonic saline (20%) aims to reduce the risk of infection recurrence, but most of the used agents are associated with undesirable side effects. Therefore, the use of natural scolicidal agents such as medicinal plant extracts could reduce these medical issues. The present study aimed to compare in vitro the scolicidal activity between two extracts of the medicinal plant Myrtus communis from Algeria against Echinococcus granulosus sensu lato protoscoleces.

METHODS

The ethanolic and aqueous extraction of plant leaves was performed. Phytochemical analysis by gas chromatography-tandem mass spectrometry (GC-MS/MS), determination of total phenolic and flavonoid contents, and in vitro antioxidant activity by DPPH were evaluated for both extracts. Finally, the in vitro scolicidal activity was tested by different concentrations. The viability was evaluated by the eosin exclusion test.

RESULTS

The phytochemical analysis revealed 28 components for the ethanolic extract and 44 components for the aqueous extract. The major components were 2'-hydroxy-5'-methoxyacetophenone and 4-amino-2-methylphenol, respectively. The total phenolic and flavonoid contents were 45.9 ± 0.085 mg of gallic acid equivalent per g of extract (GAE/g E) and 16.5 ± 0.004 mg of quercetin equivalent per g (QE/g E) for the ethanolic extract, and 36.5 ± 0.016 mg GAE/g E and 18.2 ± 0.023 mg QE/g E for the aqueous extract, respectively. Furthermore, ethanolic and aqueous extracts of M. communis gave a value of IC50 = 0.009 ± 0.0004 mg/ml and IC50 = 0.012 ± 0.0003 mg/ml for the antioxidant activity, respectively. The in vitro scolicidal activity with concentrations of 50, 75, 100, and 150 mg/ml was tested for 5, 10, 15, and 30 min, and 5, 10, 15, 30, 60, 90, and 120 min for ethanolic and aqueous extracts, respectively. The mortality rate of protoscoleces at concentrations of 100 and 150 mg/ml was 98.8 and 100%, respectively, after 5 min of exposure to the ethanolic extract, while this rate was 100% at the same concentrations only after 60 min of exposure to the aqueous extract.

CONCLUSIONS

The ethanolic extract showed a stronger scolicidal activity against E. granulosus s.l protoscoleces than the aqueous extract. In the future, other investigations are necessary to elucidate the mechanism of action and the possible toxicity on human cells. Moreover, experimental animal studies are required to investigate the efficacy of different extracts of this plant and its components as natural anti-parasitic alternatives for the treatment of human cystic echinococcosis.

Al-Awthan Y, Muhammad N, Mukarram Shah M, Mitra S, Bin Emran T, Bahattab O, S. Mubarak M. Pharmacological Investigation of Genus Pistacia

Several plants in the genus Pistacia are used in the treatment of various pathogenic and non-pathogenic disorders. Especially important are the major species belonging to this genus such as Pistacia lentiscus, Pistacia atlantica, Pistacia vera, Pistacia terebinthus, and Pistacia khinjuk, among others; these have been reported for their potential benefits both in medical and commercial purposes. In addition, members of this genus exhibit numerous ethnomedicinal uses, such as analgesic, anti-inflammatory, anticancer, antimicrobial, antihypertension, antihyperlipidemic, antiviral, and antiasthma. In light of these potential uses, the present chapter aimed to collect and summarize the literature about all of this medicinal information. Accordingly, this chapter focuses on the pharmacological uses and benefits of the genus Pistacia, especially those related to health issues.

Herbal Medicines against Hydatid Disease: A Systematic Review (2000-2021)

Echinococcosis is a serious public health issue that affects people and livestock all over the world. Many synthetic and natural products have been examined in vitro and in vivo on Echinococcus species but only a few are used clinically, however, they may cause some complications and side effects. To overcome these limitations, new horizons of herbal drugs to cure echinococcosis are opening with every passing day. To summarize the developments during the last 21 years, we conducted this review of the literature to identify medicinal herbs utilized throughout the world that have anti-Echinococcus activity. From 2000 to 2021, data were carefully obtained from four English databases: Science Direct, PubMed, Scopus, and OpenGrey. Botanical name, extraction technique, extract quantities, efficacy, duration of treatment, year of publication, and half-maximal inhibitory concentration (IC50) values were all well noted. Ninety-one published papers, with 78 in vitro and 15 in vivo, fulfilled our selection criteria. Fifty-eight different plant species were thoroughly tested against Echinococcus granulosus. Zataria multiflora, Nigella sativa, Berberis vulgaris, Zingiber officinale (ginger), and Allium sativum were the most often utilized anti-Echinococcus herbs and the leaves of the herbs were extensively used. The pooled value of IC50 was 61 (95% CI 60−61.9) according to the random effect model and a large degree of diversity among studies was observed. The current systematic study described the medicinal plants with anti-Echinococcus activity, which could be investigated in future experimental and clinical studies to identify their in vivo efficacy, lethal effects, and mechanisms of action.

In vitro efficacy of Capparis spinosa extraction against larvae viability of Echinococcus granulosus sensu stricto

Cystic echinococcosis (CE) is a chronic zoonotic parasitic disease caused by infection with the larvae of the Echinococcus granulosus sensu lato (s.l.) cluster. Currently, new drugs are urgently required due to the poor therapeutic effect of the existing drugs albendazole and mebendazole. Capparis spinosa, a traditional medicinal plant, has potential therapeutic effects on various diseases based on extracts from its fruit and other parts. The results of this study demonstrated that the water-soluble and ethanolic extracts of C. spinosa fruit had in vitro killing effects on the larvae of E. granulosus sensu stricto (s.s.) and disrupted the ultrastructure of protoscoleces and metacestodes. In vitro cytotoxicity assays showed that the water-soluble and ethanolic extracts of C. spinosa fruit were not significantly toxic to primary mouse hepatocytes at an effective dose to CE. In conclusion, water-soluble and ethanolic extracts of C. spinosa fruit have great potential for the development of new drugs for the treatment of CE.

Evaluation of the scolicidal activities of eugenol essential oil and its nanoemulsion against protoscoleces of hydatid cysts

BACKGROUND

Cystic echinococcosis caused by the cestode Echinococcus granulosus remains a serious helminthic zoonosis affecting humans and animals in many endemic developing countries. Surgical intervention is the best management choice, although it is associated with high recurrence rates and serious complications. Also, the commonly used chemotherapeutics exhibited serious side effects. This study aimed to evaluate the protoscolicidal effects of eugenol (Eug) essential oil and its nanoemulsion (Eug-NE) against protoscoleces (PCs) of hydatid cysts in vitro.

METHODS

Eug-NE was prepared and characterized. Their cytotoxicity on macrophages was assessed by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. E. granulosus PCs were treated with various concentrations of Eug and Eug-NE at different exposure times. The viability of protoscoleces was evaluated by the eosin exclusion test, and the changes in the morphology of protoscoleces were assessed. Albendazole (ABZ) was used as a positive control.

RESULTS

The cellular cytotoxicity of Eug and Eug-NE on macrophage cells, in minimum and maximum concentrations (0.2 and 1 μl/mL), were nearly negligible ranging from 4.7% to 8.3% and 3.7% to 7.2%, respectively. The results showed highly significant activity of Eug-NE and Eug against hydatid PCs compared to ABZ (P < 0.05). Eug and Eug-NE have similar protoscolicidal effects at all used concentrations. Their highest scolicidal activity (100% mortality rate) was recorded at 1 μl/ml after 30 min incubation (LC50 = 0.298-LC90 = 0.521 and LC50 = 0.309-LC90 = 0.646, respectively). Both formulations showed time- and dose-dependent effects.

CONCLUSIONS

This study suggested the potent scolicidal activities of Eug and Eug-NE as promising alternative scolicidal agents. Future studies are recommended to explore the mechanism of action and treatment response in vivo and clinical settings.

In vitro scolicidal effects of Sideritis perfoliata extract against Echinococcus granulosus

BACKGROUND

Cystic echinococcosis, caused by helminths within the genus Echinococcus, is mainly localised in the liver and lungs of affected hosts. Surgery has been the best choice for the treatment of hydatidosis and using effective scolicidal agents during hydatid surgery is required to prevent secondary infection. Several plant extracts have been shown to exert scolicidal efficacy. This study was designed to investigate the in vitro scolicidal activity of methanol extract of Sideritis perfoliata against the protoscolices of hydatid cysts.

METHODS

The protoscolices were collected from a liver of a sheep slaughtered in Adiyaman city slaughter, Turkey. Three concentrations of the aerial part extract of S perfoliata (0.1, 0.2 and 0.4 mg/mL) were assessed at three different exposure periods. All tests were carried in duplicate. The viability of protoscolices was assessed by the eosin exclusion test (0.1% eosin staining).

RESULTS

Scolicidal effect of S perfoliata extract at exposure periods of 10, 20 and 30 minutes was 29.6%, 32.5% and 43.6% at the concentration of 0.1%, 37.8%, 50% and 58.1% at concentration of 0.2 mg/mL, and 57.9%, 71.8% and 79.1% at the concentration of 0.4 mg/mL, respectively; indicating a longer time is required to display protoscolicidal effects. LC-MS/MS analysis showed that some phenolic acids, such as fumaric acid (260.13 mg/L), syringic acid (27.92 mg/L) and caffeic acid (26.84 mg/L), and a flavonoid, luteolin (11.23 mg/L) were detected in high concentrations in the extract.

CONCLUSIONS

This study has demonstrated that the methanol extract of S perfoliata has high scolicidal activity in vitro. However, research on the in vivo efficacy of S perfoliata extract and its potential side effects is required.

Silybum marianum ethanolic extract: in vitro effects on protoscolices of Echinococcus granulosus G1 strain with emphasis on other Iranian medicinal plants

BACKGROUND

Cystic echinococcosis (CE), is a parasitic zoonosis caused by Echinococcus granulosus (E. granulosus) larvae in liver and lungs of both humans and animals. Surgical intervention is the mainstay for CE treatment, using scolicidal agents that inactivate live protoscolices. This study evaluated the scolicidal effects of Silybum marianum ethanolic extract and its combination with albendazole in vitro for the first time. Moreover, in a literature review, we investigated the effects of a wide range of Iranian medicinal plants on protoscolices of E. granulosus.

METHODS

S. marianum ethanolic extract was prepared and high-performance liquid chromatography (HPLC) analysis was used to establish the proportions of its component compounds in the extract. Cytotoxicity was evaluated in mouse macrophage cells (J774A.1 cell line) using MTT method. Next, the scolicidal activity of the extract alone and combined with albendazole was tested as triplicate at various concentrations incubated for 5, 10, 20, 30, and 60 min. Finally, protoscolex viability was determined using 0.1% eosin as a vital stain. PCR-RFLP and DNA sequencing techniques were used to characterize the genotype of E. granulosus.

RESULTS

HPLC analysis showed that S. marianum ethanolic extract contained mostly silydianin (14.41%), isosilybin A (10.50%), and silychristin (10.46%). The greatest scolicidal effects were obtained with the combination of S. marianum with albendazole (79%), S. marianum ethanolic extract alone (77%) and albendazole (69%), at a concentration of 500 μg/ml for 60 min, respectively (P < 0.05). Molecular analysis showed that all the cysts used were G1 genotype.

CONCLUSION

The data suggest that S. marianum ethanolic extract is a potential scolicide in vitro; however, further investigations are required to determine its efficacy in vivo.

Lethal in vitro effects of optimized chitosan nanoparticles against protoscoleces of Echinococcus granulosus

Cystic Echinococcosis (CE) is a parasitic infection caused by the larval stage of Echinococcus granulosus. Exploring safe and effective scolicidal agents for the surgery is an urgent need for the successful treatment of CE. This study aimed to determine scolicidal activity of the synthesized chitosan nanoparticles. Physicochemical properties of synthesized nanoparticles were determined by using DLS, FTIR, and SEM. Different concentrations of chitosan nanoparticles from 125 to 1000 μg/ml were examined at different incubation times (10, 60, 120, and 180 min). Scolicidal and cytotoxic activity of chitosan nanoparticles were confirmed by eosin exclusion and hemolysis activity tests. FTIR spectra, zeta potential (+42 ± 2.08) and PDI (0.388 ± 0.034) value revealed that the chitosan nanoparticles were synthesized. Significant differences among the scolicidal effects of chitosan nanoparticles were observed in comparison to the control treatments and highest scolicidal activity was observed at 1000 μg/ml after 180 min exposure time. Hemolytic activity was not significant at all concentrations of chitosan nanoparticles. Our findings support the hypothesis that Chitosan nanoparticles have the potential to be a safe and efficient scolicidal agent candidate at very low concentrations and in a wide range of exposure time. Further in vivo studies are recommended to evaluate chitosan nanoparticle efficacy before clinical application.

A systematic review of medicinal plants used against Echinococcus granulosus

Cystic echinococcosis (CE) is a zoonotic helminthiasis caused by different species of the genus Echinococcus, and is a major economic and public health concern worldwide. Synthetic anthelmintics are most commonly used to control CE, however, prolonged use of these drugs may result in many adverse effects. This study aims to discuss the in vitro/in vivo scolicidal efficacy of different medicinal plants and their components used against Echinococcus granulosus. Google Scholar, ScienceDirect, PubMed and Scopus were used to retrieve the published literature from 2000-2020. A total of 62 published articles met the eligibility criteria and were reviewed. A total of 52 plant species belonging to 22 families have been reported to be evaluated as scolicidal agents against E. granulosus worldwide. Most extensively used medicinal plants against E. granulosus belong to the family Lamiaceae (25.0%) followed by Apiaceae (11.3%). Among various plant parts, leaves (36.0%) were most commonly used. Essential oils of Zataria multiflora and Ferula asafetida at a concentration of 0.02, and 0.06 mg/ml showed 100% in vitro scolicidal activity after 10 min post application, respectively. Z. multiflora also depicted high in vivo efficacy by decreasing weight and size while also causing extensive damage to the germinal layer of the cysts. Plant-based compounds like berberine, thymol, and thymoquinone have shown high efficacy against E. granulosus. These plant species and compounds could be potentially used for the development of an effective drug against E. granulosus, if further investigated for in vivo efficacy, toxicity, and mechanism of drug action in future research.

Scolicidal effects of Cassia fistula and Urtica dioica extracts on protoscoleces of hydatid cysts

Echinococcosis is among the most underestimated parasitic diseases that have universal distribution. The primary treatment is surgery. Hence, the development of new and more effective scolicidal agents with lower side effects is crucial. This study evaluated the therapeutic effects of Urtica dioica and Cassia fistula extracts as a scolicidal herbal drug in vitro. Suspension of protoscoleces was obtained from the infected livers of sheep in Khorramabad, Iran. Hydro-alcoholic solution was extracted from the leaves and stems of Urtica dioica and the fruit of Cassia fistula. Echinococcus granulosus protoscoleces were treated with the essential oils at concentrations of 10, 25, 50, and 100 mg/mL for 10, 20, 30, and 60 min and their viability was evaluated by the eosin staining test. The extract of Urtica dioica at a concentration of 100 mg/mL killed 90.51% of protoscoleces after 60 min. Cassia fistula also killed 67.74% of protoscoleces after 60 min. This study obtained satisfactory results. Urtica dioica and Cassia fistula extracts are promising protoscolicides and can be used in the treatment of hydatid cysts and pre-surgically to prevent secondary infections.

Green Synthesis and Characterization of Copper Nanoparticles and Their Effects on Liver Function and Hematological Parameters in Mice

Objectives

The present investigation is based on the green synthesis of copper nanoparticles (CuNPs) from aqueous extract of Capparis spinosa L. fruit. Their effects on liver function and hematological parameters in mice were evaluated.

Materials and Methods

The green synthesis of CuNPs by means of C. spinosa extract was achieved. Ultraviolet-visible spectroscopy, fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy were used to identify the synthesized nanoparticles. BALB/c mice were orally administrated CuNPs at doses of 1000, 2000, and 5000 μg/kg for 2 weeks. Later, the effects of CuNPs on liver function in the treated mice were evaluated by measuring the serum levels of enzymes such as alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and bilirubin as well as hematological parameters including hemoglobin, hematocrit, white blood cell, red blood cell, and platelet counts.

Results

A maximum peak at wavelength 414 nm confirmed the biosynthesis of CuNPs. FTIR spectrum analysis revealed that the factor groups shaped a coating extract on the surface of the nanoparticles. SEM images demonstrated a particle size between 17 and 41 nm. Although some liver enzymes and hematological parameters increased with increasing dose of extract, there was no significant difference (p>0.05) between oral administrations of CuNPs at doses of 1000, 2000, and 5000 μg/kg and the control group.

Conclusion

The findings revealed that CuNPs biosynthesized from aqueous extract of C. spinosa fruit have no toxic effects on the liver functions and hematological parameters of mice. However, more studies are needed for evaluation of the hepatoprotective effects of CuNPs.

Effect of Nectaroscordum koelzi Methanolic Extract on Acute and Chronic Inflammation in Male Mice

INTRODUCTION

The present study deals with the effect of Nectaroscordum koelzi fruit extract on acute and chronic inflammation.

METHODS

A total of 84 NMRI mice were used in this study. The effect of the extract on acute inflammation was analyzed by increasing vascular permeability via acetic acid and xylene induced ear edema among mice. The extract was evaluated in terms of effects on chronic inflammation by means of the cotton pellet test among mice. For the assessment of inflammation degree, the mice paw edema volume was measured by the plethysmometric test.

RESULTS

The findings showed that the extract was effective on acute inflammation induced by acetic acid in mice. In the xylene ear edema, N. koelzi extract indicated a significant activity in mice. In the cotton pellet method, the methanol extract produced a significant reduction in comparison with the control and dexamethasone. Mice paw edema volume decreased with the extract.

CONCLUSION

In general, the data from the experiments indicated that the methanol extract of N. koelzi has an anti-inflammatory effect on acute and chronic inflammation. However, the exact contributing mechanisms have not been investigated for the pharmacological effects.

In vitro efficacy study of Cinnamomum zeylanicum essential oil and cinnamaldehyde against the larval stage of Echinococcus granulosus

Hydatidosis or cystic echinococcosis is a disease caused by the larval stage of Echinococcus granulosus sensu lato. Chemotherapy can be used alone or in combination with surgery or percutaneous treatment. Benzimidazoles are the only agents used and approved for treatment, but their efficacy is extremely variable. Therefore, it is necessary to find new drugs to improve the treatment of this disease. In the last decades, the biological properties of essential oils and their components began to be investigated as alternatives in the treatment of different ailments. The aim of the present work was to evaluate the in vitro efficacy of the essential oil of Cinnamomum zeylanicum (cinnamon) and cinnamaldehyde against protoscoleces and metacestodes of E. granulosus. The essential oil and cinnamaldehyde, its major component, showed a dose and time dependent effect against protoscoleces. However, cinnamaldehyde showed a greater protoscolicidal effect than the essential oil. The maximum protoscolicidal effect was found with 50 μg/mL of cinnamaldehyde. Viability decreased by 1.7 ± 0.8% after 4 days of incubation and reached 0% at 8 days. Interestingly, there were no significant differences between the activity of cinnamaldehyde at the concentrations of 25 and 10 μg/mL and the efficacy observed with the essential oil at 200 and 50 μg/mL, respectively. Cinnamaldehyde also had a strong in vitro effect against murine cysts, while only the higher concentration of the essential oil caused ultrastructural alterations. Working with components instead of with essential oils has some advantages, particularly in relation to the reproducibility of the formulations and their effectiveness. For this reason, the results obtained in this work are promising in the search for pharmaceutical alternatives for the treatment of cystic echinococcosis.

Antiparasitic effects of Zataria multiflora essential oil nano-emulsion on larval stages of Echinococcus granulosus

Various protoscolicidal agents are indicated for the prevention of recurrence of cystic echinococcosis caused by the larval stage of Echinococcus granulosus; however, most of these chemicals have adverse side effects. This study evaluated the effects of Zataria multiflora essential oil (ZEO) nano-emulsion and emulsion at the concentrations of 1, 2, 5, 10, 15, and 20 µl/ml on E. granulosus protoscoleces. Albendazole (5 mg/ml), normal saline, and nano-emulsion without ZEO served as control groups. Optimal concentrations of ZEO nano-emulsion and emulsion on the microcysts were also investigated. ZEO emulsion at a concentration of 20 µl/ml for the duration of 15 min and nano-emulsion for the duration of 10 min resulted in the death of 100% of the protoscoleces. Additionally, densely packed aggregates were formed inside the microcysts treated with ZEO nano-emulsion and emulsion at a concentration of 20 µl/ml after 40 min, but the complete destruction of laminated layers did not occur. The results indicate that ZEO nano-emulsions have a higher protoscolicidal effect than its emulsion, but these two compounds had similar effects on microcysts.

Efficacy and safety of Curcuma longa essential oil to inactivate hydatid cyst protoscoleces

Background

One of the most important ways to cure hydatid cysts is surgery. Today, available chemical drugs have shown severe complications during hydatid cyst surgery. Here we investigated theefficacy and safety of Curcuma longa (C. longa) essential oil (CLEO) against hydatid cysts protoscoleces.

Methods

Here, the collected protoscoleces from fertile hydatid cysts were exposed to different concentrations of the CLEO (50–200 μl/mL) for 5–30 min in vitro and ex vivo. In addition, male NIH mice (48 mice) were applied to examine the safety of CLEO.

Results

All protoscoleces were completely killed in 5th min of treatment to the doses of 200 μl /mL of CLEO. On the other hand, in the 10th min of treatment, CLEO entirely killed 100% of protoscoleces at the dose of 100 μL/mL. Other doses of CLEO, but, revealed a postponed activity. Although CLEO at the doses of 50, and 100 μL/mL exhibited no similar effect in the ex vivo analysis; but, at the dose of 200 μL/mL and an exposure time of 5 min, approximately 100% of protoscoleces were destroyed into the cyst. We found that after intra-peritoneal injection of the CLEO for 14 days, although blood and biochemical parameters were changed; but there was no significant difference in comparison with the control group (p > 0.05).

Conclusion

This research demonstrated that C. longa revealed the promising scolicidal effects against protoscoleces in vitro and in vivo, of course, after additional tests; it might be considered as an herbal scolicidal drug in order to decrease the threat of discharge of protoscoleces through hydatid cyst surgery. Nevertheless, supplementary studies will be desired to prove the current findings by examination the essential oil in a clinical setting.

Toxoplasma Serology Status and Risk of Miscarriage, A Case-Control Study among Women with A History of Spontaneous Abortion

Background

Toxoplasma gondii is one of the major causes of abortion in pregnant women. Most cases of abortion occur in the acute phase of infection and early pregnancy. The purpose of this study was to investigate the association between spontaneous abortion and seropositive status of toxoplasmosis in women with first-time spontaneous abortion.

Materials and Methods

This research is a case-control study on 240 serum samples from women experiencing spontaneous abortion for the first time as the case group, and 240 serum samples from women who had a normal delivery with no history of abortion as the control group. The level of anti-Toxoplasma gondii IgM and IgG antibodies were assessed in serum samples using ELISA. To separate the acute and chronic infections, all IgM-positive samples in both groups and IgG-positive samples of the case group were examined using IgG avidity.

Results

The toxoplasmosis IgM antibody was detected in 3.3% (8/240) of the case group and 0.4% (1/240) of the control group, which was a statistically significant difference between the two groups [P=0.019, odds ratio (OR)=10.266]. Of all samples 47.5% and 46.3% of the case and control groups were positive for toxoplasmosis IgG antibody, respectively. Seven out of 8 (87.5%) IgM-positive serum samples from the case group had low IgG avidity, indicating acute infections, whereas all IgG-positive sera and 1 IgM-positive serum, which was related to the control group, showed a high IgG avidity, indicating chronic infections.

Conclusion

Maternal acute toxoplasmosis during pregnancy is raised as one of the factors that increase the chance of spontaneous abortion. The necessary health training, especially on the parasite transmission ways to women before marriage, as well as the serological test in women before and during pregnancy is recommended. Polymerase chain reaction (PCR) and IgG avidity assays should be performed in the medical diagnostic laboratories for accurate distinguishing of the initial infection of toxoplasmosis in the pregnant women.

In vitro and ex vivo scolicidal effects of Olea europaea L. to inactivate the protoscolecs during hydatid cyst surgery

Background

Nowadays, surgery is considered as one of the most important treatments for hydatidosis. Due to laceration, the cyst and spread of the content within it (protoscoleces) during the surgery that can put the patient at the risk of re-infection, anaphylaxis shock and even death, surgeons use some chemical drugs as protoscolicidal agents. The study is aimed to evaluate the scolicidal effects of olive (Olea europaea L.) leaf extract on hydatid cyst protoscoleces in vitro and ex vivo.

Methods

After the collection of protoscoleces from sheep livers infected with fertile hydatid cysts, they were treated with various concentrations of olive leave extract (75–300 mg/mL) for 5–30 min in vitro and ex vivo. Finally, the mortality of protoscoleces was assessed by the eosin exclusion test (0.1% eosin staining).

Results

The mean of the mortality of protoscoleces was 100% after 10 min of incubation with the concentration of 300 mg/ml of O. europaea leaves extract. On the other hand, the mean of the mortality of protoscoleces after 20 min of incubation with the concentration of 150 mg/ml of O. europaea leaves extract was 100%. After injection of O. europaea leaves extract directly into the hydatid cyst (ex vivo), the mean of the mortality of protoscoleces was 100% after 12 and 25 min of incubation with the concentration of 300 and 150 mg/ml of O. europaea leaves extract, respectively; indicating that the extract requiring a further time to display a potent protoscolicidal effects.

Conclusion

Based on the findings of the study, it can be concluded that the extract of olive leaf had a significant scolicidal activity on hydatid cyst protoscoleces. However, further research, especially in human and animal subjects, are required to reach this conclusion.

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Scolicidal effects of olive extract on hydatid cyst protoscoleces in vitro and ex vivo.

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Protoscoleces were treated with various concentrations olive extract (75–300 μl/ml) for 5–30 min.

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100% of protoscoleces were killed after 10 min incubation with the of 300 mg/ml.

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Ex vivo, olive extracts requiring a further time to display a potent protoscolicidal effects.

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Olive leaf may be used as a scolicidal agent in hydatid cyst surgery.

In vitro evaluation of the protoscolicidal effect of Eucalyptus globulus essential oil on protoscolices of hydatid cyst compared with hypertonic saline, povidone iodine and silver nitrate

OBJECTIVE

There are various protoscolicidal agents for inactivation of protoscoleces of hydatid cysts before and during surgical operation. The present study was aimed to evaluate the protoscolicidal effect of two concentrations of Eucalyptus globulus on protoscoleces of Echinococcus granulosus sensu lato under in vitro condition and to compare its efficacy with hypertonic saline, povidone iodine and silver nitrate.

METHODS

Live protoscoleces obtained from the liver of naturally infected sheep were exposed to 0.5% and 1% of Eucalyptus globulus essential oil, 5% hypertonic saline, 10% povidone iodine and 0.5% silver nitrate for 1 and 3minutes. Phosphate buffered saline was used as a negative control. One percent eosin staining method was used to test the viability of protoscoleces in different groups.

RESULTS

While the mean percentage of dead protoscoleces was 6.08% in the control group, the scolicidal power of 5% hypertonic saline was only 6.54% and 6.60% after 1 and 3min respectively. 0.5% E. globulus EO demonstrated 97.38% and 100% scolicidal activity after 1 and 3min respectively. The mean protoscolicidal power of 1% E. globulus EO, 10% povidone iodine and 0.5% silver nitrate was 100% after one minute.

CONCLUSIONS

According to the results of this study, E. globulus EO demonstrated high scolicidal power in a short period of time. Hence, this herbal product could be considered as a potent natural scolicidal agent that could be used before and during surgery of hydatid disease.

Echinococcosis: Advances in the 21st Century

Echinococcosis is a zoonosis caused by cestodes of the genus Echinococcus (family Taeniidae). This serious and near-cosmopolitan disease continues to be a significant public health issue, with western China being the area of highest endemicity for both the cystic (CE) and alveolar (AE) forms of echinococcosis. Considerable advances have been made in the 21st century on the genetics, genomics, and molecular epidemiology of the causative parasites, on diagnostic tools, and on treatment techniques and control strategies, including the development and deployment of vaccines. In terms of surgery, new procedures have superseded traditional techniques, and total cystectomy in CE, ex vivo resection with autotransplantation in AE, and percutaneous and perendoscopic procedures in both diseases have improved treatment efficacy and the quality of life of patients. In this review, we summarize recent progress on the biology, epidemiology, diagnosis, management, control, and prevention of CE and AE. Currently there is no alternative drug to albendazole to treat echinococcosis, and new compounds are required urgently. Recently acquired genomic and proteomic information can provide a platform for improving diagnosis and for finding new drug and vaccine targets, with direct impact in the future on the control of echinococcosis, which continues to be a global challenge.

Could beta-myrcene be an alternative to albendazole for the treatment of experimental cystic echinococcosis?

Echinococcus granulosus causes hydatidosis or cystic echinococcosis in humans and livestock. In humans, this disease can be managed with surgery, percutaneous treatment, chemotherapy and/or observation. The chemotherapeutic agents used and approved for treatment of hydatidosis are benzimidazoles. Because of the difficulties in achieving successful treatment, considerable efforts have been made to find new natural compounds against hydatid disease. Beta-myrcene is a monoterpene presented in the essential oils of different plants. It is the principal component of essential oil of Rosmarinus officinalis (rosemary). The goal of the present study was to evaluate the in vitro effects of beta-myrcene against germinal cells, protoscoleces and murine cyst of E. granulosus, as well also, investigate its chemoprophylactic activity in a murine model of cystic echinococcosis. For the in vitro assays, the parasites were incubated with beta-myrcene at 10, 5 and 1 μg/mL. The treatments were dose and time-dependent, and consistent with the observed morphological alterations. In the chemoprophylactic efficacy study, the effect of beta-myrcene was similar to albendazole, the reference drug for human echinococcosis treatment.

In vitro Protoscolicidal Effects of Cinnamomum zeylanicum Essential Oil and Its Toxicity in Mice

BACKGROUND

This study investigates the scolicidal effects of Cinnamomum zeylanicum essential oil against the protoscoleces of hydatid cysts and its toxicity in the mice model.

MATERIALS AND METHODS

Gas chromatography/mass spectroscopy analyses were used to identify the constituents of essential oil. Protoscoleces were treated with different concentrations of the essential oil (6.25-100 µL/mL) in each test tube for 5-30 min. The viability of protoscoleces was confirmed using eosin exclusion test (0.1% eosin staining). Forty-eight male NMRI mice were also used to determine the toxicity of C. zeylanicum essential oil (0.5-4 mL/kg).

RESULTS

The main components were found to be cinnamaldehyde (91.8%), ρ metoxicinamate (1.57%), and α pinene (1.25%). Findings indicate that C. zeylanicum essential oil with the concentrations of 100 and 50 µL/mL killed 100% of protoscoleces after 5 min of exposure. Also, the lower concentrations of C. zeylanicum essential oil motivated a late protoscolicidal effect. The LD50 value of intraperitoneal injection of C. zeylanicum essential oil was 2.07 mL/kg body weight after 48 h, and the maximum nonfatal dose was 1.52 mL/kg body weight. The results also showed that there was no significant toxicity following oral administration of C. zeylanicum essential oil for 2 weeks.

CONCLUSION

The results exhibited the favorable scolicidal activity of C. zeylanicum, which could be applied as a natural scolicidal agent in hydatid cyst surgery.

SUMMARY

We evaluated the efficacy of Cinnamomum zeylanicum essential oil against hydatid cyst protoscolecesThe viability of protoscoleces was confirmed using eosin exclusion test (0.1% eosin staining)Forty-eight male NMRI mice were also used to determine the toxicity of C. zeylanicum essential oilC. zeylanicum with potent scolicidal activity could be applied as a natural scolicidal agent in surgery. Abbreviations used: GC/MS: Gas chromatography/mass spectrometry analysis; CE: Cystic echinococcosis; LD50: Lethal dose 50%; I.p: Intraperitoneally.

Efficacy and Safety of Bunium Persicum (Boiss) to Inactivate Protoscoleces during Hydatid Cyst Operations

BACKGROUND

Current scolicidal agents, which have been used for inactivation of protoscoleces during surgical procedures, are associated with adverse side effects including sclerosing cholangitis. This investigation aimed to evaluate the scolicidal effects of Bunium persicum (Boiss) essential oil against protoscoleces of hydatid cysts and also its toxicity in a mice model.

METHODS

Protoscoleces were aseptically aspirated from sheep livers having hydatid cysts. Various concentrations of the essential oil (3.125-50 mcL/mL) were used for 5-30 min. The viability of protoscoleces was confirmed using the eosin exclusion test (0.1% eosin staining). Further, 48 male NMRI mice were used to determine the acute and sub-acute toxicity of B. persicum essential oil.

RESULTS

The obtained results revealed that the B. persicum essential oil at the concentrations of 25 and 50 mcL/mL after 5 min of exposure killed 100% protoscoleces. The mean mortality rate of protoscoleces after 10 min of exposure to the concentration of 12.5 mcL/mL was 100%. Lower concentrations (6.25 and 3.125 mcL/mL) of B. persicum essential oil, however, indicated a delayed protoscolicidal effects. The LD₅₀ value of intra-peritoneal injection of the B. persicum essential oil was 1.96 mL/kg body wt. No significant difference (p > 0.05) was observed in the clinical chemistry and hematologic parameters after oral administrations of B. persicum essential oil at the doses 0.05, 0.1, 0.2, and 4 mL/kg for 14 d.

CONCLUSION

Our findings demonstrated the potent scolicidal activity of B. persicum with no significant toxicity; it might be used as a natural scolicidal agent in hydatid cyst surgery.