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Zdesenko G, Mutapi F. Drug metabolism and pharmacokinetics of praziquantel: A review of variable drug exposure during schistosomiasis treatment in human hosts and experimental models. PLoS Negl Trop Dis 2020; 14:e0008649. [PMID: 32976496 PMCID: PMC7518612 DOI: 10.1371/journal.pntd.0008649] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Schistosomiasis control is heavily reliant on the drug praziquantel (PZQ), which is used as preventive chemotherapy as part of national helminth control strategies. Given the heavy reliance on PZQ for mass drug administration, there has been considerable research on the potential of parasites developing resistance to the drug, resulting in decreased drug efficacy. However, there have been comparatively fewer studies of other factors that can potentially alter PZQ efficacy. Here, we investigate whether host PZQ metabolism contributes towards variable cure rates. We evaluate factors that can influence the metabolism of PZQ and the resultant effect on the efficacy of PZQ treatment to determine factors that potentially influence an individual's response to the drug. The literature search was directed at published studies from three online databases: Web of Science, PubMed, and EMBASE. The search terms for the review comprised of ([praziquantel OR PZQ] AND [schistosom* OR bilharzia] AND [pharmaco*]) and included studies evaluating PZQ metabolism. Publications were categorised into pharmacokinetics, drug-drug interactions, pharmacogenetics, and metabolite analysis. Forty publications describing human and experimental studies fitted the inclusion criteria and were subjected to data extraction and analysis. The analyses showed that variable exposure to PZQ was associated with alterations in the liver's capacity to metabolise PZQ and observed drug-drug interactions. Other factors influencing the efficacy of PZQ were brand, formulation, and co-administered food. Although some work has been performed on metabolite identification, there was minimal information on PZQ's metabolic pathway, and no pharmacogenetics studies were identified. The study indicated that in both human and experimental studies alterations in the liver's capacity to metabolise PZQ as well as drug-drug interactions affected systemic levels of PZQ that could result in variable cure rates. The study confirmed previous findings of higher antischistosomal activity of (R)-PZQ enantiomer when administered alone compared to the racemate at the same dose as well as improved efficacy when the drug is administered with food. The study also highlighted the need for more comprehensive studies of the PZQ metabolic pathway and PZQ pharmacogenetic studies in humans.
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Affiliation(s)
- Grace Zdesenko
- Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, King’s Buildings, Edinburgh, United Kingdom
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), University of Edinburgh, Ashworth Laboratories, King’s Buildings, Edinburgh, United Kingdom
| | - Francisca Mutapi
- Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, King’s Buildings, Edinburgh, United Kingdom
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), University of Edinburgh, Ashworth Laboratories, King’s Buildings, Edinburgh, United Kingdom
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Botanical Products in the Treatment and Control of Schistosomiasis: Recent Studies and Distribution of Active Plant Resources According to Affected Regions. BIOLOGY 2020; 9:biology9080223. [PMID: 32823660 PMCID: PMC7464741 DOI: 10.3390/biology9080223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/01/2020] [Accepted: 08/10/2020] [Indexed: 11/21/2022]
Abstract
Schistosomiasis, a parasitic disease caused by trematodes of the genus Schistosoma, is the second most prevalent parasitic disease in the world. It affects around 200 million people. Clinical treatment, prophylaxis, and prevention are performed in countries susceptible to schistosomiasis. In the pharmacological treatment for an acute form of schistosomiasis, the use of antiparasitics, mainly praziquantel, is more common. As an alternative way, prevention methods such as reducing the population of intermediate hosts (mollusks) with molluscicides are important in the control of this disease by interrupting the biological cycle of this etiological parasite. Despite the importance of pharmacological agents and molluscicides, they have side effects and environmental toxicity. In addition, they can lead to the development of resistance enhancing of parasites, and lead to the search for new and effective drugs, including resources of vegetal origin, which in turn, are abundant in the affected countries. Thus, the purpose of this review is to summarize recent studies on botanical products with potential for the control of schistosomiasis, including anti-Schistosoma and molluscicide activities. In addition, species and plant derivatives according to their origin or geographical importance indicating a possible utility of local resources for countries most affected by the disease are presented.
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Zhang T, Zhang Y, Jiang N, Zhao X, Sang X, Yang N, Feng Y, Chen R, Chen Q. Dihydroartemisinin regulates the immune system by promotion of CD8 + T lymphocytes and suppression of B cell responses. SCIENCE CHINA-LIFE SCIENCES 2019; 63:737-749. [PMID: 31290095 DOI: 10.1007/s11427-019-9550-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/18/2019] [Indexed: 01/06/2023]
Abstract
Artemisia annua is an anti-fever herbal medicine first described in traditional Chinese medicine 1,000 years ago. Artemisinin, the extract of A. annua, and its derivatives (dihydroartemisinin (DHA), artemether, and artesunate) have been used for the treatment of malaria with substantial efficacy. Recently, DHA has also been tested for the treatment of lupus erythematosus, indicating that it may function to balance the immune response in immunocompromised individuals. In the present study, the regulatory effect of artemisinin on the murine immune system was systematically investigated in mice infected with two different protozoan parasites (Toxoplasma gondii and Plasmodium berghei). Our results revealed that the mouse spleen index significantly increased (spleen enlargement) in the healthy mice after DHA administration primarily due to the generation of an extra number of lymphocytes and CD8+ T lymphocytes in both the spleen and circulation. DHA could increase the proportion of T helper cells and CD8+ T cells, as well as decrease the number of splenic and circulatory B cells. Further, DHA could reduce the production of proinflammatory cytokines. Our study revealed that apart from their anti-parasitic activity, artemisinin and its derivatives can also actively modulate the immune system to directly benefit the host.
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Affiliation(s)
- Ting Zhang
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, Key Laboratory of Zoonosis, Shenyang Agricultural University, Shenyang, 110866, China
| | - Yiwei Zhang
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, Key Laboratory of Zoonosis, Shenyang Agricultural University, Shenyang, 110866, China
| | - Ning Jiang
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, Key Laboratory of Zoonosis, Shenyang Agricultural University, Shenyang, 110866, China
| | - Xu Zhao
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, Key Laboratory of Zoonosis, Shenyang Agricultural University, Shenyang, 110866, China
| | - Xiaoyu Sang
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, Key Laboratory of Zoonosis, Shenyang Agricultural University, Shenyang, 110866, China
| | - Na Yang
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, Key Laboratory of Zoonosis, Shenyang Agricultural University, Shenyang, 110866, China
| | - Ying Feng
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, Key Laboratory of Zoonosis, Shenyang Agricultural University, Shenyang, 110866, China
| | - Ran Chen
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, Key Laboratory of Zoonosis, Shenyang Agricultural University, Shenyang, 110866, China
| | - Qijun Chen
- Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, Key Laboratory of Zoonosis, Shenyang Agricultural University, Shenyang, 110866, China.
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Aruleba RT, Adekiya TA, Oyinloye BE, Masamba P, Mbatha LS, Pretorius A, Kappo AP. PZQ Therapy: How Close are we in the Development of Effective Alternative Anti-schistosomal Drugs? Infect Disord Drug Targets 2019; 19:337-349. [PMID: 30599112 PMCID: PMC7046992 DOI: 10.2174/1871526519666181231153139] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 12/24/2018] [Accepted: 12/25/2018] [Indexed: 11/22/2022]
Abstract
Today schistosomiasis, caused mainly by the three major schistosome species (S. mansoni, S. haematobium and S. japonicum), has for many decades and still continues to be on a rapid and swift rise globally, claiming thousands of lives every year and leaving 800 million people at the risk of infection. Due to the high prevalence of this disease and the steady increase in the infection rates, praziquantel (PZQ) remains the only effective drug against this acute disease although it has no effect on the juvenile schistosome parasite. However, no significant approaches have been made in recent years in the discovery of new or alternative drugs and unfortunately, resistance to this drug has been reported in some parts of the world. Therefore, it is imperative to develop a new drug for this debilitating disease. In this review, a brief history of past, present, and new promising anti-schistosomal drugs is presented.
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Affiliation(s)
- Raphael Taiwo Aruleba
- Biotechnology and Structural Biology (BSB) Group, Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa 3886, South Africa
| | - Tayo Alex Adekiya
- Biotechnology and Structural Biology (BSB) Group, Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa 3886, South Africa
| | - Babatunji Emmanuel Oyinloye
- Biotechnology and Structural Biology (BSB) Group, Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa 3886, South Africa
- Department of Biochemistry, Afe Babalola University, PMB 5454, Ado-Ekiti 360001, Nigeria
| | - Priscilla Masamba
- Biotechnology and Structural Biology (BSB) Group, Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa 3886, South Africa
| | - Londiwe Simphiwe Mbatha
- Biotechnology and Structural Biology (BSB) Group, Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa 3886, South Africa
| | - Ashley Pretorius
- Bioinformatics Research Group (BRG), DST/Mintek Nanotechnology Innovation Centre, Biolabels Node, Department of Biotechnology, University of the Western Cape, Bellville 7535, South Africa
| | - Abidemi Paul Kappo
- Biotechnology and Structural Biology (BSB) Group, Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa 3886, South Africa
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Mitsui Y, Kato K. Application of Non-Fluorescent Dyes to Assess the Antischistosomal Effect of Antimalarial Drugs on Schistosoma mansoni Adult Worms. Jpn J Infect Dis 2018; 71:382-387. [PMID: 29848845 DOI: 10.7883/yoken.jjid.2018.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The possible emergence of praziquantel (PZQ)-tolerant and/or -resistant schistosomes requires the study and development of new antischistosomal drugs as alternatives to PZQ. The present study investigates the capability of 3 dyes-methylene blue (MB), neutral red (NR), and trypan blue (TB)-to assess the in vitro antischistosomal effect of antimalarial drugs on Schistosoma mansoni adult worms. S. mansoni adult worms were incubated in the medium alone as the control or in the medium supplemented with 10 μg/ml primaquine (PQ), artesunate (AR), or amodiaquine (AQ) for 5 days. Viabilities of the worms were observed following staining with MB, NR, or TB. The disparity of MB and NR staining among male and female adult worms treated with PQ, AR, and AQ correlated with the various levels of damage to the male and female worms. Furthermore, the severity of the damage to the adult worms treated with the 3 drugs appeared to be reflected in the TB staining status. The results indicate that the 3 non-fluorescent dyes can serve as useful complementary tools to assess the antischistosomal effect of antimalarial drugs.
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Affiliation(s)
- Yoshinori Mitsui
- Department of Parasitology, Institute of Tropical Medicine, Nagasaki University
| | - Kentaro Kato
- Department of Eco-epidemiology, Institute of Tropical Medicine, Nagasaki University
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Gouveia MJ, Brindley PJ, Gärtner F, Costa JMCD, Vale N. Drug Repurposing for Schistosomiasis: Combinations of Drugs or Biomolecules. Pharmaceuticals (Basel) 2018; 11:E15. [PMID: 29401734 PMCID: PMC5874711 DOI: 10.3390/ph11010015] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/19/2018] [Accepted: 01/31/2018] [Indexed: 12/17/2022] Open
Abstract
Schistosomiasis is a major neglected tropical disease. Control of schistosomiasis currently relies on a single drug, praziquantel, and despite its efficacy against the all schistosome species that parasitize humans, it displays some problematic drawbacks and alone is ineffective in counteracting adverse pathologies associated with infection. Moreover, due to the development of the potential emergence of PZQ-resistant strains, the search for additional or alternative antischistosomal drugs have become a public health priority. The current drug discovery for schistosomiasis has been slow and uninspiring. By contrast, repurposing of existing approved drugs may offer a safe, rapid and cost-effective alternative. Combined treatment with PZQ and other drugs with different mode of action, i.e., antimalarials, shows promise results. In addition, a combination of anthelminthic drugs with antioxidant might be advantageous for modulating oxidative processes associated with schistosomiasis. Herein, we review studies dealing with combination therapies that involve PZQ and other anthelminthic drugs and/or antioxidant agents in treatment of schistosomiasis. Whereas PZQ combined with antioxidant agents might or might not interfere with anthelminthic efficacy, combinations may nonetheless ameliorate tissue damage and infection-associated complications. In fact, alone or combine with other drugs, antioxidants might be a valuable adjuvant to reduce morbidity and mortality of schistosomiasis. Therefore, attempting new combinations of anthelmintic drugs with other biomolecules such as antioxidants provides new avenues for discovery of alternatives to PZQ.
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Affiliation(s)
- Maria João Gouveia
- UCBIO/REQUIMTE, Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo, 228, 4050-313 Porto, Portugal.
- Center for the Study of Animal Science, ICETA, University of Porto, Praça Gomes Teixeira, Apartado 55142, 4031-401 Porto, Portugal.
- Department of Molecular Pathology and Immunology, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal.
| | - Paul J Brindley
- Department of Microbiology, Immunology & Tropical Medicine, and Research Center for Neglected Diseases of Poverty, School of Medicine & Health Sciences, George Washington University, Washington, DC 20037, USA.
| | - Fátima Gärtner
- Department of Molecular Pathology and Immunology, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal.
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Júlio Amaral de Carvalho, 45, 4200-135 Porto, Portugal.
- Institute of Investigation and Innovation in Health (i3s), Rua Alfredo Allen, 4200-135 Porto, Portugal.
| | - José M Correia da Costa
- Center for the Study of Animal Science, ICETA, University of Porto, Praça Gomes Teixeira, Apartado 55142, 4031-401 Porto, Portugal.
- Department of Infectious Diseases, INSA-National Health Institute Dr. Ricardo Jorge, Rua Alexandre Herculano 321, 4000-055 Porto, Portugal.
| | - Nuno Vale
- UCBIO/REQUIMTE, Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo, 228, 4050-313 Porto, Portugal.
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Gold D, Alian M, Domb A, Karawani Y, Jbarien M, Chollet J, Haynes RK, Wong HN, Buchholz V, Greiner A, Golenser J. Elimination of Schistosoma mansoni in infected mice by slow release of artemisone. INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE 2017; 7:241-247. [PMID: 28511056 PMCID: PMC5430492 DOI: 10.1016/j.ijpddr.2017.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/01/2017] [Accepted: 05/04/2017] [Indexed: 12/16/2022]
Abstract
The current treatment of schistosomiasis is based on the anti-helminthic drug praziquantel (PZQ). PZQ affects only the adult stages of schistosomes. In addition, resistance to PZQ is emerging. We suggest a drug, which could serve as a potential alternative or complement to PZQ, and as a means of treating infections at earlier, pre-granuloma stage. Derivatives of the peroxidic antimalarial drug artemisinin have been indicated as alternatives, because both plasmodia and schistosomes are blood-feeding parasites. The mechanism of action of artemisinins is related to oxidative effects of the artemisinins on intracellular reductants leading to formation of cytotoxic reactive oxygen species. We used artemisone, which has improved pharmacokinetics and anti-plasmodial activity, and reduced toxicity compared to other artemisinins in clinical use against malaria. We infected adult mice by subcutaneous injection of S. mansoni cercariae (about 200) and treated them at various times post infection by the following methods: i. artemisone suspension administered by gavage (400-450 mg/kg); ii. subcutaneous injection of a gel containing a known concentration of artemisone (115-120 mg/kg); iii. subcutaneous insertion of the drug incorporated in a solid polymer (56-60 mg/kg); iv. intraperitoneal injection of the drug solubilized in DMSO (115-120 mg/kg). Drug administration in polymers was performed to enable slow release of the artemisone that was verified in vivo and in vitro bioassays using drug-sensitive malaria parasites. We found superior strong anti-schistosome effects up to a total reduction of worm number, mainly following repetitive treatments with the drug absorbed in the polymers (73.1% and 95.9% reduction in mice treated with artemisone in gel 7 and 14, and 21, 28 and 35 days post infection, respectively). The results indicate that artemisone has a potent anti-schistosome activity. Its main importance in this context is its effectiveness in treating hosts harboring juvenile schistosomes, before egg-deposition and induction of deleterious immune responses.
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Affiliation(s)
- Daniel Gold
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Mohammed Alian
- School of Pharmacy, Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Avraham Domb
- School of Pharmacy, Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Yara Karawani
- The Kuvin Center for the Study of Infectious and Tropical Diseases, The Department of Microbiology and Molecular Genetics, Hebrew University of Jerusalem-Hadassah Medical School, Israel
| | - Maysa Jbarien
- The Kuvin Center for the Study of Infectious and Tropical Diseases, The Department of Microbiology and Molecular Genetics, Hebrew University of Jerusalem-Hadassah Medical School, Israel
| | - Jacques Chollet
- Swiss Tropical Institute, P.O. Box, CH-4002 Basel, Switzerland
| | - Richard K Haynes
- Centre of Excellence for Pharmaceutical Sciences, School of Health Sciences, North-West University, Potchefstroom 2520, South Africa
| | - Ho Ning Wong
- Centre of Excellence for Pharmaceutical Sciences, School of Health Sciences, North-West University, Potchefstroom 2520, South Africa
| | - Viola Buchholz
- Macromolecular Chemistry II, University of Bayreuth, Germany
| | - Andreas Greiner
- Macromolecular Chemistry II, University of Bayreuth, Germany
| | - Jacob Golenser
- The Kuvin Center for the Study of Infectious and Tropical Diseases, The Department of Microbiology and Molecular Genetics, Hebrew University of Jerusalem-Hadassah Medical School, Israel.
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Kang NX, Zhu YJ, Zhao JP, Zhu WF, Liu YL, Xu QM, Zhuge HX, Khan IA, Yang SL. Antischistosomal activity of hederacochiside C against Schistosoma japonicum harbored in experimentally infected animals. JOURNAL OF ASIAN NATURAL PRODUCTS RESEARCH 2017; 19:402-415. [PMID: 27454107 DOI: 10.1080/10286020.2016.1208181] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 06/28/2016] [Indexed: 06/06/2023]
Abstract
The present study was undertaken to investigate whether hederacochiside C (HSC) possesses antischistosomal effects and anti-inflammatory response activities in Schistosoma japonicum-infected mice. Different concentrations of HSC were administrated to the mice infected by schistosomula or adult worm by intravenous injection twice a day for five consecutive days. The total worm burden, female worm burden, and the egg burden in liver of mice treated with 400 mg/kg HSC were fewer than those in non-treated ones. Murine immune responses following HSC treatment were investigated using enzyme-linked immunosorbent assays (ELISA). Our results indicated that 200 mg/kg HSC could reduce the expression of IgG, tumor necrosis factor (TNF)-α, interleukin (IL)-4 and IL-17 in comparison to infected group, exhibiting best immunomodulatory effects. In addition, scanning electron microscopical examination revealed that male worms treated with HSC lost their normal surface architecture since its surface showed extensive swelling, erosion, and peeling in tegumental regions. Remarkable amelioration was noticed in histopathological investigations, and 200 mg/kg HSC treatment could reduce the size of granulomatous inflammatory infiltrations in the liver which was reflected in nearly normalization of liver architecture. These results suggested that HSC had potential antischistosomal activity and provided a basis for subsequent experimental.
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Affiliation(s)
- Nai-Xin Kang
- a School of Biology & Basic Medical Science , Soochow University , Suzhou 215123 , China
- e College of Pharmaceutical Science, Soochow University , Suzhou 215123 , China
| | - Yuan-Jian Zhu
- a School of Biology & Basic Medical Science , Soochow University , Suzhou 215123 , China
| | - Jian-Ping Zhao
- b National Center for Natural Products Research, School of Pharmacy , University of Mississippi , Oxford 38677 , USA
- c Department of Pharmacognosy, School of Pharmacy, Research Institute of Pharmaceutical Sciences , University of Mississippi , Oxford 38677 , USA
| | - Wei-Feng Zhu
- d College of Pharmaceutical Science , Jiangxi College of Traditional Chinese Medicine , Nanchang 330006 , China
| | - Yan-Li Liu
- e College of Pharmaceutical Science, Soochow University , Suzhou 215123 , China
| | - Qiong-Ming Xu
- e College of Pharmaceutical Science, Soochow University , Suzhou 215123 , China
| | - Hong-Xiang Zhuge
- a School of Biology & Basic Medical Science , Soochow University , Suzhou 215123 , China
| | - Ikhlas A Khan
- b National Center for Natural Products Research, School of Pharmacy , University of Mississippi , Oxford 38677 , USA
- c Department of Pharmacognosy, School of Pharmacy, Research Institute of Pharmaceutical Sciences , University of Mississippi , Oxford 38677 , USA
- e College of Pharmaceutical Science, Soochow University , Suzhou 215123 , China
| | - Shi-Lin Yang
- d College of Pharmaceutical Science , Jiangxi College of Traditional Chinese Medicine , Nanchang 330006 , China
- e College of Pharmaceutical Science, Soochow University , Suzhou 215123 , China
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The Role of Natural Products in Drug Discovery and Development against Neglected Tropical Diseases. Molecules 2016; 22:molecules22010058. [PMID: 28042865 PMCID: PMC6155950 DOI: 10.3390/molecules22010058] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 12/23/2016] [Accepted: 12/27/2016] [Indexed: 12/20/2022] Open
Abstract
Endemic in 149 tropical and subtropical countries, neglected tropical diseases (NTDs) affect more than 1 billion people annually, including 875 million children in developing economies. These diseases are also responsible for over 500,000 deaths per year and are characterized by long-term disability and severe pain. The impact of the combined NTDs closely rivals that of malaria and tuberculosis. Current treatment options are associated with various limitations including widespread drug resistance, severe adverse effects, lengthy treatment duration, unfavorable toxicity profiles, and complicated drug administration procedures. Natural products have been a valuable source of drug regimens that form the cornerstone of modern pharmaceutical care. In this review, we highlight the potential that remains untapped in natural products as drug leads for NTDs. We cover natural products from plant, marine, and microbial sources including natural-product-inspired semi-synthetic derivatives which have been evaluated against the various causative agents of NTDs. Our coverage is limited to four major NTDs which include human African trypanosomiasis (sleeping sickness), leishmaniasis, schistosomiasis and lymphatic filariasis.
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Antischistosomal activity of artemisinin derivatives in vivo and in patients. Pharmacol Res 2016; 110:216-226. [DOI: 10.1016/j.phrs.2016.02.017] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/07/2016] [Accepted: 02/16/2016] [Indexed: 11/20/2022]
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Repurposing pharma assets: an accelerated mechanism for strengthening the schistosomiasis drug development pipeline. Future Med Chem 2016; 7:727-35. [PMID: 25996066 DOI: 10.4155/fmc.15.26] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Schistosomiasis, one of 17 diseases deemed to be neglected by the World Health Organization, has received little attention from the biopharmaceutical industry. Due to this, only a handful of drugs have been developed to treat schistosomiasis, with only one, praziquantel, used in most endemic regions. Growing concern over resistance coupled with praziquantel's incomplete efficacy across all stages of the Schistosoma platyhelminth life cycle highlights the urgent need for new drugs. The WIPO Re:Search consortium is a platform whereupon biopharmaceutical company compounds are being repurposed to efficiently and cost-effectively develop new drugs for neglected diseases such as schistosomiasis. This article summarizes recent clinical-stage efforts to identify new antischistosomals and highlights biopharmaceutical company compounds with potential for repurposing to treat schistosomiasis.
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Protective capacity of cercarial transformation fluid alone or in combination with crude cercarial antigen against challenge infections of Schistosoma mansoni in mice. J Helminthol 2016; 91:35-42. [PMID: 26817577 DOI: 10.1017/s0022149x1600002x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Schistosomiasis is the second major parasitic disease in the world after malaria. It affects 201.5 million cases in Africa alone. The aim of this research was to explore alternative vaccination strategies against experimental schistosomiasis mansoni. We assessed the effect of cercarial transformation fluid (CTF) singly and in combination with crude cercarial antigen (CCA) using alum as an adjuvant. The combined antigens gave the best results, as evidenced by a significant reduction in the worm load (62.07%), tissue egg count (78.16%, 86.46%) in liver and intestine respectively, and hepatic granuloma size (29.96%). Scanning electron microscopy revealed changes in the tegument, in the form of roughness and appearance of vesicles and furrows between the tegumental tubercles. Also, resorption of the ventral sucker and dimples replacing its spines were observed. The female tegument was irregular and its posterior end showed loss of spines and sensory bulbs. Moreover, there was a significant decrease in liver enzymes (alanine transaminase (ALT) and aspartate transaminase (AST)) compared to infected control mice. A significant elevation in CD4+T-lymphocytes, denoting amelioration of the immune status, in mice that received combined antigens was also observed. It can be concluded that combined antigens demonstrate potential as a vaccine against Schistosoma mansoni.
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Yepes E, Varela-M RE, López-Abán J, Rojas-Caraballo J, Muro A, Mollinedo F. Inhibition of Granulomatous Inflammation and Prophylactic Treatment of Schistosomiasis with a Combination of Edelfosine and Praziquantel. PLoS Negl Trop Dis 2015; 9:e0003893. [PMID: 26191954 PMCID: PMC4507859 DOI: 10.1371/journal.pntd.0003893] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 06/09/2015] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Schistosomiasis is the third most devastating tropical disease worldwide caused by blood flukes of the genus Schistosoma. This parasitic disease is due to immunologic reactions to Schistosoma eggs trapped in tissues. Egg-released antigens stimulate tissue-destructive inflammatory and granulomatous reactions, involving different immune cell populations, including T cells and granulocytes. Granulomas lead to collagen fibers deposition and fibrosis, resulting in organ damage. Praziquantel (PZQ) is the drug of choice for treating all species of schistosomes. However, PZQ kills only adult Schistosoma worms, not immature stages. The inability of PZQ to abort early infection or prevent re-infection, and the lack of prophylactic effect prompt the need for novel drugs and strategies for the prevention of schistosomiasis. METHODOLOGY/PRINCIPAL FINDINGS Using in vitro and in vivo approaches, we have found that the alkylphospholipid analog edelfosine kills schistosomula, and displays anti-inflammatory activity. The combined treatment of PZQ and edelfosine during a few days before and after cercariae infection in a schistosomiasis mouse model, simulating a prophylactic treatment, led to seven major effects: a) killing of Schistosoma parasites at early and late development stages; b) reduction of hepatomegaly; c) granuloma size reduction; d) down-regulation of Th1, Th2 and Th17 responses at late post-infection times, thus inhibiting granuloma formation; e) upregulation of IL-10 at early post-infection times, thus potentiating anti-inflammatory actions; f) down-regulation of IL-10 at late post-infection times, thus favoring resistance to re-infection; g) reduction in the number of blood granulocytes in late post-infection times as compared to infected untreated animals. CONCLUSIONS/SIGNIFICANCE Taken together, these data suggest that the combined treatment of PZQ and edelfosine promotes a high decrease in granuloma formation, as well as in the cellular immune response that underlies granuloma development, with changes in the cytokine patterns, and may provide a promising and effective strategy for a prophylactic treatment of schistosomiasis.
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Affiliation(s)
- Edward Yepes
- IBSAL-CIETUS (Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
- Instituto de Biología Molecular y Celular del Cáncer, Centro de Investigación del Cáncer, CSIC-Universidad de Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Rubén E. Varela-M
- Instituto de Biología Molecular y Celular del Cáncer, Centro de Investigación del Cáncer, CSIC-Universidad de Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Julio López-Abán
- IBSAL-CIETUS (Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Jose Rojas-Caraballo
- IBSAL-CIETUS (Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Antonio Muro
- IBSAL-CIETUS (Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Faustino Mollinedo
- Instituto de Biología Molecular y Celular del Cáncer, Centro de Investigación del Cáncer, CSIC-Universidad de Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Hospital Universitario de Salamanca, Salamanca, Spain
- * E-mail:
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Vimieiro ACS, Araújo N, Katz N, Kusel JR, Coelho PMZ. Schistogram changes after administration of antischistosomal drugs in mice at the early phase of Schistosoma mansoni infection. Mem Inst Oswaldo Cruz 2015; 108:881-6. [PMID: 24271044 PMCID: PMC3970651 DOI: 10.1590/0074-0276130135] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 06/12/2013] [Indexed: 01/22/2024] Open
Abstract
Mice infected with Schistosoma mansoni were treated with oxamniquine, praziquantel, artesunate at the pre-patent phase, aiming at observing schistogram alterations. Half of the animals were perfused five days post-treatment for counting and classification of immature worms, based on pre-established morphological criteria (schistogram); the remaining animals were evaluated 42 or 100 days after infection and perfusion of the portal-system was performed for collection and counting of adult worms and oogram. It was observed that oxamniquine and artesunate treatment administered at the pre-postural phase causes significant reduction in the number of immature and adult worms. However, there was little reduction with praziquantel when used at the dose of 400 mg/kg for treatments administered 14, 15, 21 or 23 days post-infection. Artesunate was responsible for significant alterations in development of young worms, as well as for a higher number of worms presenting intestinal damages. Immature adult worms were detected in mice treated with artesunate or oxamniquine at the pre-patent phase of infection and recovered by perfusion 100 days after infection. Schistogram proved to be a very useful tool for experimental evaluation of the activity of antischistosomal drugs and a good model to identify the most sensitive stages to drugs.
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Dong L, Duan W, Chen J, Sun H, Qiao C, Xia CM. An artemisinin derivative of praziquantel as an orally active antischistosomal agent. PLoS One 2014; 9:e112163. [PMID: 25386745 PMCID: PMC4227710 DOI: 10.1371/journal.pone.0112163] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 10/13/2014] [Indexed: 12/21/2022] Open
Abstract
Background Schistosomiasis is a major health problem in tropical and sub-tropical areas caused by species of trematode belonging to the genus Schistosoma. The treatment and control of this disease has been relying on the use of a single drug praziquantel. However, the drug resistance concern urged the development of new drugs against schistosoma. Here, we report our systematic biological evaluation of DW-3-15, a new lead compound developed based on our conjugation design rationale as an effective anti-schistosomal agent. Methodology/Principal Findings The antischistosomal activity of DW-3-15 was systematically evaluated in S. japonicum infected mouse model for its stage-sensitivity and dose response. The results revealed that DW-3-15 exhibited 60–85% worm reduction rate against different development stage of worm. Scanning electron microscopy (SEM) observation indicated that DW-3-15 may damage to the tegument of male schistosomes. Conclusions/Significance Our results demonstrated that DW-3-15 showed potent anti-schistosomal activities in vivo. The results strongly support our conjugation design strategy of artemisinin analogs and further development of DW-3-15 as a new lead compound as anti-schistosomal agent.
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Affiliation(s)
- Lanlan Dong
- College of Medical Science, Soochow University, Suzhou, China
| | - Wenwen Duan
- College of Medical Science, Soochow University, Suzhou, China
| | - Jinglei Chen
- College of Medical Science, Soochow University, Suzhou, China
| | - Huan Sun
- College of Medical Science, Soochow University, Suzhou, China
| | - Chunhua Qiao
- College of Medical Science, Soochow University, Suzhou, China
- * E-mail: (CQ); (CX)
| | - Chao-ming Xia
- College of Medical Science, Soochow University, Suzhou, China
- * E-mail: (CQ); (CX)
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Yepes E, Varela-M RE, López-Abán J, Dakir ELH, Mollinedo F, Muro A. In vitro and in vivo anti-schistosomal activity of the alkylphospholipid analog edelfosine. PLoS One 2014; 9:e109431. [PMID: 25302497 PMCID: PMC4193788 DOI: 10.1371/journal.pone.0109431] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 09/01/2014] [Indexed: 12/20/2022] Open
Abstract
Background Schistosomiasis is a parasitic disease caused by trematodes of the genus Schistosoma. Five species of Schistosoma are known to infect humans, out of which S. haematobium is the most prevalent, causing the chronic parasitic disease schistosomiasis that still represents a major problem of public health in many regions of the world and especially in tropical areas, leading to serious manifestations and mortality in developing countries. Since the 1970s, praziquantel (PZQ) is the drug of choice for the treatment of schistosomiasis, but concerns about relying on a single drug to treat millions of people, and the potential appearance of drug resistance, make identification of alternative schistosomiasis chemotherapies a high priority. Alkylphospholipid analogs (APLs), together with their prototypic molecule edelfosine (EDLF), are a family of synthetic antineoplastic compounds that show additional pharmacological actions, including antiparasitic activities against several protozoan parasites. Methodology/Principal Findings We found APLs ranked edelfosine> perifosine> erucylphosphocholine> miltefosine for their in vitro schistosomicidal activity against adult S. mansoni worms. Edelfosine accumulated mainly in the worm tegument, and led to tegumental alterations, membrane permeabilization, motility impairment, blockade of male-female pairing as well as induction of apoptosis-like processes in cells in the close vicinity to the tegument. Edelfosine oral treatment also showed in vivo schistosomicidal activity and decreased significantly the egg burden in the liver, a key event in schistosomiasis. Conclusions/Significance Our data show that edelfosine is the most potent APL in killing S. mansoni adult worms in vitro. Edelfosine schistosomicidal activity seems to depend on its action on the tegumental structure, leading to tegumental damage, membrane permeabilization and apoptosis-like cell death. Oral administration of edelfosine diminished worm and egg burdens in S. mansoni-infected CD1 mice. Here we report that edelfosine showed promising antischistosomal properties in vitro and in vivo.
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Affiliation(s)
- Edward Yepes
- IBSAL-CIETUS (Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
- Instituto de Biología Molecular y Celular del Cáncer, Centro de Investigación del Cáncer, CSIC-Universidad de Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Rubén E. Varela-M
- Instituto de Biología Molecular y Celular del Cáncer, Centro de Investigación del Cáncer, CSIC-Universidad de Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Julio López-Abán
- IBSAL-CIETUS (Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - E. L. Habib Dakir
- Instituto de Biología Molecular y Celular del Cáncer, Centro de Investigación del Cáncer, CSIC-Universidad de Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Faustino Mollinedo
- Instituto de Biología Molecular y Celular del Cáncer, Centro de Investigación del Cáncer, CSIC-Universidad de Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Antonio Muro
- IBSAL-CIETUS (Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
- * E-mail:
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17
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Liu YX, Wu W, Liang YJ, Jie ZL, Wang H, Wang W, Huang YX. New uses for old drugs: the tale of artemisinin derivatives in the elimination of schistosomiasis japonica in China. Molecules 2014; 19:15058-74. [PMID: 25244286 PMCID: PMC6271675 DOI: 10.3390/molecules190915058] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 09/09/2014] [Accepted: 09/10/2014] [Indexed: 11/16/2022] Open
Abstract
Artemisinin (qinghaosu), extracted from the Chinese herb Artemisia annua L. in 1972, and its three major derivatives--artemether, artesunate and dihydroartemisinin--were firstly identified as antimalarials and found active against all species of the malaria parasite. Since the early 1980s, artemisinin and its derivatives have been found efficacious against Schistosoma spp., notably larval parasites, and artemisinin derivatives have played a critical role in the prevention and treatment of human schistosomiasis in China. Currently, China is moving towards the progress of schistosomiasis elimination. However, the potential development of praziquantel resistance may pose a great threat to the progress of elimination of schistosomiasis japonica in China. Fortunately, these three major artemisinin derivatives also exhibit actions against adult parasites, and reduced sensitivity to artemether, artesunate and dihydroartemisinin has been detected in praziquantel-resistant S. japonicum. In this review, we describe the application of artemisinin derivatives in the prevention and treatment of schistosomiasis japonica in China, so as to provide tools for the global agenda of schistosomiasis elimination. In addition to antimalarial and antischistosomal actions, they also show activities against other parasites and multiple cancers. Artemisinin derivatives, as old drugs identified firstly as antimalarials, continue to create new stories.
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Affiliation(s)
- Yi-Xin Liu
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, China.
| | - Wei Wu
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, China.
| | - Yue-Jin Liang
- Department of Microbiology and Immunology, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USA.
| | - Zu-Liang Jie
- Department of Microbiology and Immunology, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USA.
| | - Hui Wang
- Department of Integrative Biology and Pharmacology, The University of Texas Health Science Center at Houston, 6431 Fannin St, Houston, TX 77030, USA.
| | - Wei Wang
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, China.
| | - Yi-Xin Huang
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, China.
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18
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Artemisinins: Pharmacological actions beyond anti-malarial. Pharmacol Ther 2014; 142:126-39. [DOI: 10.1016/j.pharmthera.2013.12.001] [Citation(s) in RCA: 309] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 11/26/2013] [Indexed: 12/23/2022]
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19
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Xiao SH. Mefloquine, a new type of compound against schistosomes and other helminthes in experimental studies. Parasitol Res 2013; 112:3723-40. [PMID: 23979493 DOI: 10.1007/s00436-013-3559-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 07/24/2013] [Indexed: 12/23/2022]
Abstract
Up to date, schistosomiasis is still prevalent worldwide. It is estimated that more than 200 million individuals are infected, and 120 million suffer from clinical morbidity. Facing such huge cases of schistosomiasis, only heavy reliance on a single praziquantel for schistosomiasis control does not adapt and may promote the selection and spread of drug-resistant parasites. Therefore, it is an urgent need to develop the new antischistosomal drug. In 2008-2009, the antimalarial drug mefloquine, an arylaminoalcohol compound, has been found to be effective against schistosomes. According to the experimental studies, the deepest impression on the antischistosomal properties of mefloquine can be summarized as following points: (1) single dose of mefloquine possesses potential effect against three major species of schistosomes (Schistosoma mansoni, Schistosoma haematobium, and Schistosoma japonicum) infecting humans; (2) the drug displays similar effects against developing stages of juvenile and adult schistosomes, which are superior to that of artemisinins and praziquantel; (3) in vitro mefloquine exerts direct killing effect on juvenile and adult schistosomes, while in vivo, the efficacy of the drug is independent to host immune response, (4) mefloquine causes extensive and severe morphological, histopathological, and ultrastructural damage to adult and juvenile schistosomes, particularly, the worm tegument, musculature, gut, and vitelline glands of female worms are the key sites attacked by the drug; (5) combined treatment with mefloquine and praziquantel, or artemisinins shows synergistic effect against schistosome in experimental therapy,while in initially clinical trial, mefloquine in combination with artesunate also exhibits higher cure rates against schistosomiasis hematobia and schistosomiasis mansoni, and (6) several mefloquine-related arylmethanols exhibit potential effect against schistosomes in vivo, which is a useful clue helpful for development of new antischistosomal compound. In the present review, we have summarized the major results published in recent years, and the significance as well as the prospect for the future study of mefloquine have been discussed briefly.
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Affiliation(s)
- Shu-hua Xiao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, MOH, WHO Collaborating Centre for Malaria, Schistosomiasis, and Filariasis, Shanghai, 200025, People's Republic of China,
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20
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Thétiot-Laurent SAL, Boissier J, Robert A, Meunier B. Chemotherapie gegen Schistosomiasis. Angew Chem Int Ed Engl 2013. [DOI: 10.1002/ange.201208390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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21
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Thétiot-Laurent SAL, Boissier J, Robert A, Meunier B. Schistosomiasis chemotherapy. Angew Chem Int Ed Engl 2013; 52:7936-56. [PMID: 23813602 DOI: 10.1002/anie.201208390] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Indexed: 01/08/2023]
Abstract
After malaria, schistosomiasis (or bilharzia) is the second most prevalent disease in Africa, and is occurring in over 70 countries in tropical and subtropical regions. It is estimated that 600 million people are at risk of infection, 200 million people are infected, and at least 200,000 deaths per year are associated with the disease. All schistosome species are transmitted through contact with fresh water that is infested with free-swimming forms of the parasite, which is known as cercariae and produced by snails. When located in the blood vessels of the host, larval and adult schistosomes digest red cells to acquire amino acids for growth and development. Vaccine candidates have been unsuccessful up to now. Against such devastating parasitic disease, the antischistosomal arsenal is currently limited to a single drug, praziquantel, which has been used for more than 35 years. Because the question of the reduction of the activity of praziquantel was raised recently, it is thus urgent to create new and safe antischistosomal drugs that should be combined with praziquantel to develop efficient bitherapies.
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Affiliation(s)
- Sophie A-L Thétiot-Laurent
- Laboratoire de Chimie de Coordination du CNRS, 205 route de Narbonne, BP 44099, 31077 Toulouse cedex 4, France
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Haemin enhances the in vivo efficacy of artemether against juvenile and adult Schistosoma mansoni in mice. Parasitol Res 2013; 112:2005-15. [DOI: 10.1007/s00436-013-3358-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 02/15/2013] [Indexed: 11/25/2022]
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23
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de Oliveira RB, Senger MR, Vasques LM, Gasparotto J, dos Santos JPA, Pasquali MADB, Moreira JCF, Silva FP, Gelain DP. Schistosoma mansoni infection causes oxidative stress and alters receptor for advanced glycation endproduct (RAGE) and tau levels in multiple organs in mice. Int J Parasitol 2013; 43:371-9. [PMID: 23369670 DOI: 10.1016/j.ijpara.2012.12.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 12/08/2012] [Accepted: 12/10/2012] [Indexed: 12/31/2022]
Abstract
Schistosomiasis is a parasitic disease caused by trematode worms from the Schistosoma genus and is characterized by high rates of morbidity. The main organs affected in this pathology, such as liver, kidneys and spleen, are shifted to a pro-oxidant state in the course of the infection. Here, we compared oxidative stress parameters of liver, kidney and spleen with other organs affected by schistosomiasis - heart, brain cortex and lungs. The results demonstrated that mice infected with Schistosoma mansoni had altered non-enzymatic antioxidant status in lungs and brain, increased carbonyl levels in lungs, and a moderate level of oxidative stress in heart. A severe redox imbalance in liver and kidneys and decreased non-enzymatic antioxidant capacity in spleen were also observed. Superoxide dismutase and catalase activities were differently modulated in liver, kidney and heart, and we found that differences in Superoxide dismutase 2 and catalase protein content may be responsible for these differences. Lungs had decreased receptor for advanced glycation endproduct expression and the brain cortex presented altered tau expression and phosphorylation levels, suggesting important molecular changes in these tissues, as homeostasis of these proteins is widely associated with the normal function of their respective organs. We believe that these results demonstrate for the first time that changes in the redox profile and expression of tissue-specific proteins of organs such as heart, lungs and brain are observed in early stages of S. mansoni infection.
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Affiliation(s)
- Ramatis Birnfeld de Oliveira
- Universidade Federal do Rio Grande do Sul, Departamento de Bioquímica, Centro de Estudos em Estresse Oxidativo, Porto Alegre, RS, Brazil
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El Ridi RAF, Tallima HAM. Novel therapeutic and prevention approaches for schistosomiasis: review. J Adv Res 2012; 4:467-78. [PMID: 25685454 PMCID: PMC4293887 DOI: 10.1016/j.jare.2012.05.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Revised: 05/12/2012] [Accepted: 05/15/2012] [Indexed: 01/23/2023] Open
Abstract
Schistosomiasis is a debilitating disease affecting approximately 600 million people in 74 developing countries, with 800 million, mostly children at risk. To circumvent the threat of having praziquantel (PZQ) as the only drug used for treatment, several PZQ derivatives were synthesized, and drugs destined for other parasites were used with success. A plethora of plant-derived oils and extracts were found to effectively kill juvenile and adult schistosomes, yet none was progressed to pre- and clinical studies except an oleo-gum resin extracted from the stem of Commiphora molmol, myrrh, which action was challenged in several trials. We have proposed an essential fatty acid, a component of our diet and cells, the polyunsaturated fatty acid arachidonic acid (ARA) as a remedy for schistosomiasis, due to its ability to activate the parasite tegument-bound neutral sphingomyelinase, with subsequent hydrolysis of the apical lipid bilayer sphingomyelin molecules, allowing access of specific antibody molecules, and eventual worm attrition. This concept was convincingly supported using larval and adult Schistosoma mansoni and Schistosoma haematobium worms in in vitro experiments, and in vivo studies in inbred mice and outbred hamsters. Even if ARA proves to be an entirely effective and safe therapy for schistosomiasis, it will not prevent reinfection, and accordingly, the need for developing an effective vaccine remains an urgent priority. Our studies have supported the status of S. mansoni calpain, glutathione-S-transferase, aldolase, triose phosphate isomerase, glyceraldehyde 3-phosphate dehydrogenase, enolase, and 2-cys peroxiredoxin as vaccine candidates, as they are larval excreted-secreted products and, contrary to the surface membrane molecules, are entirely accessible to the host immune system effector elements. We have proposed that the use of these molecules, in conjunction with Th2 cytokines-inducing adjuvants for recruiting and activating eosinophils and basophils, will likely lead to development and implementation of a sterilizing vaccine in a near future.
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Affiliation(s)
- Rashika A F El Ridi
- Zoology Department, Faculty of Science, Cairo University, Cairo 12613, Egypt
| | - Hatem A-M Tallima
- Zoology Department, Faculty of Science, Cairo University, Cairo 12613, Egypt
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Boissier J, Portela J, Pradines V, Coslédan F, Robert A, Meunier B. Activity of trioxaquine PA1259 in mice infected by Schistosoma mansoni. CR CHIM 2012. [DOI: 10.1016/j.crci.2011.11.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Li HJ, Wang W, Qu GL, Li YZ, Tao YH, Xing YT, Wang XT, Dai Y, Wei JY, Dai JR, Coles GC, Liang YS. Effect of the in vivo activity of dihydroartemisinin against Schistosoma mansoni infection in mice. Parasitol Res 2011; 110:1727-32. [DOI: 10.1007/s00436-011-2692-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 10/06/2011] [Indexed: 11/24/2022]
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27
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Li HJ, Wang W, Qu GL, Tao YH, Xing YT, Li YZ, Wei JY, Dai JR, Liang YS. In-vivo activity of dihydroartemisinin against Schistosoma japonicum. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2011; 105:181-5. [PMID: 21396254 PMCID: PMC4084662 DOI: 10.1179/136485911x12899838683287] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 12/03/2010] [Accepted: 12/09/2010] [Indexed: 12/28/2022]
Affiliation(s)
- H-J Li
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China, and, Key Laboratory on Technology for Parasitic Disease Prevention and Control, Ministry of Health, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China
| | - W Wang
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China, and, Key Laboratory on Technology for Parasitic Disease Prevention and Control, Ministry of Health, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China
| | - G-L Qu
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China, and, Key Laboratory on Technology for Parasitic Disease Prevention and Control, Ministry of Health, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China
| | - Y-H Tao
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China, and, Key Laboratory on Technology for Parasitic Disease Prevention and Control, Ministry of Health, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China
| | - Y-T Xing
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China, and, Key Laboratory on Technology for Parasitic Disease Prevention and Control, Ministry of Health, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China
| | - Y-Z Li
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China, and, Key Laboratory on Technology for Parasitic Disease Prevention and Control, Ministry of Health, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China
| | - J-Y Wei
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China, and, Key Laboratory on Technology for Parasitic Disease Prevention and Control, Ministry of Health, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China
| | - J-R Dai
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China, and, Key Laboratory on Technology for Parasitic Disease Prevention and Control, Ministry of Health, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China
| | - Y-S Liang
- Jiangsu Institute of Parasitic Diseases, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China, and, Key Laboratory on Technology for Parasitic Disease Prevention and Control, Ministry of Health, 117 Yangxiang, Meiyuan, Wuxi 214064, Jiangsu Province, China
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Abdul-Ghani R, Loutfy N, Sheta M, Hassan A. Chemotherapeutic efficacy of a natural combination in the treatment of mansonic schistosomiasis: an experimental study. Res Rep Trop Med 2011; 2:1-7. [PMID: 30881175 DOI: 10.2147/rrtm.s15608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Combination chemotherapy of schistosomiasis mansoni has been studied previously, with praziquantel being the basis of combination. Artemether and myrrh are compounds of a natural origin that have been investigated experimentally and clinically against schistosomiasis. Artemether is used as an antimalarial drug, and has been used as a chemoprophylactic drug against Schistosoma japonicum in China whereas myrrh extract is manufactured and prescribed as an antischistosomal drug in Egypt. The present study investigated the experimental efficacy of combining artemether and myrrh using three different protocols in mice infected with the Egyptian strain of S. mansoni. Methods Experiments were performed on 40 eight-week-old female Swiss albino mice divided into three experimental groups and one control group. Assessment of efficacy was based on a suite of parasitologic and histopathologic parameters. Parasitologic parameters included reductions in total and female worm burdens, reductions in hepatic and intestinal wall tissue egg loads, and alterations in oogram patterns in the experimental groups compared to the infected untreated control. Histopathologic parameters comprised microscopic examination of liver sections stained with hematoxylin and eosin to study the reductions in the mean counts and diameters of hepatic granulomas as well as their healing ratios compared to the control. Results Reductions of 43.9%-58.2% in total worm burdens and 42.4%-63.7% in female worm burdens were induced. Meanwhile, significant reductions of 63.1%-77.8% in eggs per gram of small intestinal tissue and of 56.5%-66.3% in eggs per gram of liver tissue were also observed. The combination also caused alterations in the oogram pattern as well as amelioration of hepatic lesions as evidenced by increased ratios of healed granulomas in the treated groups compared to the control. Conclusion The experimental efficacy of the artemether-myrrh combination against the Egyptian strain of S. mansoni was evident, but not to an extent that would warrant clinical trials in humans.
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Affiliation(s)
- Rashad Abdul-Ghani
- Department of Medical Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen,
| | - Naguiba Loutfy
- Tropical Health Department, High Institute of Public Health
| | - Manal Sheta
- Department of Pathology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Azza Hassan
- Tropical Health Department, High Institute of Public Health
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Garcia-Perez I, Angulo S, Utzinger J, Holmes E, Legido-Quigley C, Barbas C. Chemometric and biological validation of a capillary electrophoresis metabolomic experiment of Schistosoma mansoni infection in mice. Electrophoresis 2010; 31:2338-48. [PMID: 20583011 DOI: 10.1002/elps.200900523] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Metabonomic and metabolomic studies are increasingly utilized for biomarker identification in different fields, including biology of infection. The confluence of improved analytical platforms and the availability of powerful multivariate analysis software have rendered the multiparameter profiles generated by these omics platforms a user-friendly alternative to the established analysis methods where the quality and practice of a procedure is well defined. However, unlike traditional assays, validation methods for these new multivariate profiling tools have yet to be established. We propose a validation for models obtained by CE fingerprinting of urine from mice infected with the blood fluke Schistosoma mansoni. We have analysed urine samples from two sets of mice infected in an inter-laboratory experiment where different infection methods and animal husbandry procedures were employed in order to establish the core biological response to a S. mansoni infection. CE data were analysed using principal component analysis. Validation of the scores consisted of permutation scrambling (100 repetitions) and a manual validation method, using a third of the samples (not included in the model) as a test or prediction set. The validation yielded 100% specificity and 100% sensitivity, demonstrating the robustness of these models with respect to deciphering metabolic perturbations in the mouse due to a S. mansoni infection. A total of 20 metabolites across the two experiments were identified that significantly discriminated between S. mansoni-infected and noninfected control samples. Only one of these metabolites, allantoin, was identified as manifesting different behaviour in the two experiments. This study shows the reproducibility of CE-based metabolic profiling methods for disease characterization and screening and highlights the importance of much needed validation strategies in the emerging field of metabolomics.
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Affiliation(s)
- Isabel Garcia-Perez
- Faculty of Pharmacy, San Pablo-CEU, Campus Monteprincipe, Boadilla del Monte, Madrid, Spain
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A golden phoenix arising from the herbal nest — A review and reflection on the study of antimalarial drug Qinghaosu. ACTA ACUST UNITED AC 2010. [DOI: 10.1007/s11458-010-0214-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Research and Development of Antischistosomal Drugs in the People's Republic of China. ADVANCES IN PARASITOLOGY 2010; 73:231-95. [DOI: 10.1016/s0065-308x(10)73009-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Efficacy of artesunate + sulfamethoxypyrazine/pyrimethamine versus praziquantel in the treatment of Schistosoma haematobium in children. PLoS One 2009; 4:e6732. [PMID: 19802383 PMCID: PMC2749939 DOI: 10.1371/journal.pone.0006732] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2008] [Accepted: 07/21/2009] [Indexed: 11/30/2022] Open
Abstract
Background This study was conducted to determine the efficacy of the antimalarial artemisinin-based combination therapy (ACT) artesunate +sulfamethoxypyrazine/pyrimethamine (As+SMP), administered in doses used for malaria, to treat Schistosoma haematobium in school aged children. Methodology/Principal Findings The study was conducted in Djalakorodji, a peri-urban area of Bamako, Mali, using a double blind setup in which As+SMP was compared with praziquantel (PZQ). Urine samples were examined for Schistosoma haematobium on days −1, 0, 28 and 29. Detection of haematuria, and haematological and biochemical exams were conducted on day 0 and day 28. Clinical exams were performed on days 0, 1, 2, and 28. A total of 800 children were included in the trial. The cure rate obtained without viability testing was 43.9% in the As+SMP group versus 53% in the PZQ group (Chi2 = 6.44, p = 0.011). Egg reduction rates were 95.6% with PZQ in comparison with 92.8% with As+SMP, p = 0.096. The proportion of participants who experienced adverse events related to the medication was 0.5% (2/400) in As+SMP treated children compared to 2.3% (9/399) in the PZQ group (p = 0.033). Abdominal pain and vomiting were the most frequent adverse events in both treatment arms. All adverse events were categorized as mild. Conclusions/Significance The study demonstrates that PZQ was more effective than As+SMP for treating Schistosoma haematobium. However, the safety and tolerability profile of As+SMP was similar to that seen with PZQ. Our findings suggest that further investigations seem justifiable to determine the dose/efficacy/safety pattern of As+SMP in the treatment of Schistosoma infections. Trial Registration ClinicalTrials.gov NCT00510159
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Xiao SH, Mei JY, Jiao PY. Further study on mefloquine concerning several aspects in experimental treatment of mice and hamsters infected with Schistosoma japonicum. Parasitol Res 2009; 106:131-8. [PMID: 19798511 DOI: 10.1007/s00436-009-1640-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Accepted: 09/14/2009] [Indexed: 12/20/2022]
Abstract
Antischistosomal properties of mefloquine against Schistosoma japonicum have been further studied. A total of 260 mice were divided into four batches, and three batches of them were infected percutaneously with 40 S. japonicum cercariae. In the remaining batch, mice were infected with 20, 40, or 80 S. japonicum cercariae. Other 45 hamster, divided into two batches, were each infected two or three times with 50 S. japonicum cercariae at days 0 and 7 or 0, 14, and 21. The infected mice and hamsters were treated orally with single doses of mefloquine or praziquantel at various intervals post-infection, while infected but untreated mice and hamsters served as control. All treated animals were killed 4 weeks post-treatment for assessment of effect. In hamsters concurrently infected with 14- and 21-day-old or 14-, 21-, and 35-day-old schistosomes and treated orally with mefloquine at a single dose of 100 and 200 mg/kg, the total worm burdens were significantly lower than that of control (P < 0.05 or P < 0.01) with worm burden reductions of 45.4% and 89.9% as well as 82.5% and 90.6%, respectively. In the first batch of mice treated with mefloquine and four structurally related amino alcohol antimalarials 5 weeks post-infection at a single dose of 400 mg/kg, mefloquine, quinine, and quinidine possessed similar potential effect with total worm burden reductions of 80.9-90.3%, while halofantrine and lumefantrine showed moderate and poor effect with total worm burden reductions of 67.5% and 38.4%, respectively. In the second batch of mice infected with 20, 40, and 80 S. japonicum cercariae and treated orally with mefloquine at a single dose of 200 and 400 mg/kg 5 weeks post-infection, similar effects were seen in groups of mice with various infection intensity, the total worm burden reductions were 59.9-73.0% (200 mg/kg) and 85.0-89.1% (400 mg/kg). In the other two batches of mice infected with various stages of schistosomes and treated orally with mefloquine and praziquantel at a single dose of 200 or 400 mg/kg, potential and moderate effects of praziquantel against d0 worms (3-h-old) and adult worms (28- and 35-day-old) with total worm burden reductions of 83.6-95.6% and 42.4-69.3% were observed, but no effect against various stages of juvenile schistosome was seen. Under the two single doses used, mefloquine exhibited no effect against d0 worms, but showed moderate or potential effect against various stages of juvenile and adult schistosomes with total worm burden reductions of 56.3-89.1% (200 mg/kg) and 81.1-100% (400 mg/kg). The results indicate that mefloquine shows potential effect on hamsters concurrently infected with various stages of juvenile and adult S. japonicum; among the four structurally related amino alcohol antimalarials tested, quinine and its isomer quinidine exhibit potential effect against adult S. japonicum similar to that of mefloquine, while halofantrine and lumefantrine posses moderate and poor effect; no impact of infection intensity on the effect of mefloquine against schistosomes was observed in mice; under the same dose level, the effect of mefloquine against development stages of juvenile and adult S. japonicum is superior to that of praziquantel.
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Affiliation(s)
- Shu-hua Xiao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.
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Abdul-Ghani R, Loutfy N, el-Sahn A, Hassan A. Current chemotherapy arsenal for schistosomiasis mansoni: alternatives and challenges. Parasitol Res 2009; 104:955-65. [PMID: 19255786 DOI: 10.1007/s00436-009-1371-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Accepted: 02/04/2009] [Indexed: 11/25/2022]
Abstract
Schistosomiasis still represents a major health problem in many tropical and subtropical countries despite continuing control efforts. Due to the unavailability of a vaccine that is practically applicable to humans, the use of chemotherapy is the mainstay of schistosomiasis-associated morbidity control. This paper attempts to review the antischistosomal drugs currently used in the treatment of intestinal schistosomiasis caused by Schistosoma mansoni. Their antischistosomal properties, advantages, and disadvantages as well as issues regarding the evidence for drug resistance and combination studies are reviewed in a simple manner. The recent trends towards the identification of specific chemotherapeutic targets for the treatment of schistosomes are also discussed briefly.
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Affiliation(s)
- Rashad Abdul-Ghani
- Department of Medical Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
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35
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In vitro effects of artesunate on the survival of worm pairs and egg production of Schistosoma mansoni. J Helminthol 2009; 83:7-11. [DOI: 10.1017/s0022149x08070235] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThe effect of artesunate (ART) on the survival time of adult worm pairs of Schistosoma mansoni and on their egg output during in vitro culture was assessed. ART significantly decreased the survival time of both paired male and female worms at concentrations of 5, 10, 20 and 40 mg l− 1 during in vitro cultivation. An inhibitory effect of ART on the daily egg output of paired female worms during in vitro cultivation was also observed.
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Ferreira JFS, Gonzalez JM. Analysis of underivatized artemisinin and related sesquiterpene lactones by high-performance liquid chromatography with ultraviolet detection. PHYTOCHEMICAL ANALYSIS : PCA 2009; 20:91-7. [PMID: 18980258 DOI: 10.1002/pca.1101] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
INTRODUCTION Although high-performance liquid chromatography with ultraviolet detection (HPLC-PAD) is widely available, it has not been used for artemisinin (1) analysis because of the lack of UV absorption reported for this lactone. Increased Artemisia annua cultivation for production of 1 requires an affordable and reliable method to analyse 1 and its precursors dihydroartemisinic acid (2) and artemisinic acid (3) simultaneously from underivatized plant extracts. OBJECTIVE To validate HPLC-PAD for the quantification of underivatized artemisinin from A. annua and artemisinin-based drugs. METHODOLOGY Dried A. annua leaves were extracted with petroleum ether, dried, reconstituted in acetonitrile, and analysed by HPLC-PAD at 192 nm using an isocratic mobile phase (60:40, acetonitrile:0.1% acetic acid). HPLC-PAD was evaluated through accuracy, precision, recovery and comparison with HPLC with evaporative light scattering detection (HPLC-ELSD). RESULTS HPLC-PAD proved accurate, precise and reproducible for the direct quantification of 1 and related compounds, and was more sensitive than ELSD for most of the compounds tested. The limit of quantification of 1-3 from plants was 0.048, 0.024 and 0.008 g/100 g dry weight, respectively. Recoveries were over 98%, with good intra- and inter-day repeatability. HPLC-PAD correlated significantly (r(2 )= 0.99, p < 0.001) with HPLC-ELSD for artemisinin analysis. HPLC-PAD was also reliable for the analysis of dihydroartemisinin, artesunate and artelinic acid. CONCLUSION HPLC with ultraviolet detection was validated for the quantification of underivatized 1, 2, and 3 from crude plant samples, and is readily applicable for the quality control of herbals and artemisinin-related pharmaceutical compounds.
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Affiliation(s)
- Jorge F S Ferreira
- Appalachian Farming Systems Research Center, U.S. Department of Agriculture Agricultural Research Service, 1224 Airport Road, Beaver, WV 25813, USA.
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Hou XY, McManus DP, Gray DJ, Balen J, Luo XS, He YK, Ellis M, Williams GM, Li YS. A randomized, double-blind, placebo-controlled trial of safety and efficacy of combined praziquantel and artemether treatment for acute schistosomiasis japonica in China. Bull World Health Organ 2009; 86:788-95. [PMID: 18949216 PMCID: PMC2649525 DOI: 10.2471/blt.08.053041] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2008] [Accepted: 06/05/2008] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To evaluate the safety and efficacy of combining artemether (AM) and praziquantel (PZQ) in different regimens for treating acute schistosomiasis japonica. METHODS We undertook a randomized, double-blind, placebo-controlled trial within four specialized schistosomiasis hospitals in the Dongting Lake region, Hunan province, China, between May 2003 and December 2005. Study participants were randomized into one of four treatment regimes: group A received 60 mg/kg PZQ + 6 mg/kg AM; group B received 60 mg/kg PZQ + AM placebo; group C received 120 mg/kg PZQ + 6 mg/kg AM; and group D received 120 mg/kg PZQ + AM placebo. All participants were followed up over a 45-day period. The primary endpoint of the trial was human infection status (determined by positive stool examination). Secondary endpoints involved clinical observations and blood biochemistry, including monitoring haemoglobin and alanine aminotransferase levels over time. FINDINGS Treatment efficacies of the four different treatment regimens were 98.0%, 96.4%, 97.7% and 95.7% for group A, B, C, and D respectively (P > 0.05). The group B had a greater treatment efficacy (96.4%) than the group D (95.7%) (P > 0.05). Group A treatment was better for clearance of fever (P < 0.05) and resulted in a shorter hospitalization time (P < 0.05). CONCLUSION This is the first report of a randomized, double-blind, placebo-controlled trial for evaluating combined chemotherapy with AM and two different dosages (60 mg/kg and 120 mg/kg) of PZQ in the treatment of acute schistosomiasis japonica in China. The combination of AM and PZQ chemotherapy did not improve treatment efficacy compared with PZQ alone. PZQ given as a dosage of 60 mg/kg (1 day, 3 x 20 mg/kg doses at 4-5 hour intervals) may be as effective as a dosage of 120 mg/kg (6 days, 20 mg/kg for each day split into 3 doses at 4-5 hour intervals).
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Affiliation(s)
- Xun-Ya Hou
- Hunan Institute of Parasitic Diseases, WHO Collaborating Centre for Research and Control on Schistosomiasis in Lake Region, Yueyang, China
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Van Nassauw L, Toovey S, Van Op den Bosch J, Timmermans JP, Vercruysse J. Schistosomicidal activity of the antimalarial drug, mefloquine, in Schistosoma mansoni-infected mice. Travel Med Infect Dis 2008; 6:253-8. [PMID: 18760248 DOI: 10.1016/j.tmaid.2008.06.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2008] [Accepted: 06/18/2008] [Indexed: 12/16/2022]
Abstract
Therapeutic effects of racemic mefloquine were assessed in Schistosoma mansoni-infected mice, and evaluated by recording worm burden, the status of egg maturation and viability, and intestinal mast cell recruitment. Age-matched mice were divided into four groups, of which two were infected. At 8 weeks postinfection, one group of infected and one group of uninfected mice were treated with a single dose of mefloquine (150 mg/kg). Ten days after treatment, all animals were killed. Mefloquine at 150 mg/kg had no effect on worm burden, but significantly reduced the number of eggs in the first three developmental egg stages. Analysis of intestinal mast cell numbers showed that mefloquine induced mastocytosis both in infected and control animals. In conclusion, mefloquine significantly reduces egg production in S. mansoni-infected mice, suggesting a therapeutic potency in schistosomiasis therapy. Mefloquine also exerts a significant proinflammatory effect on the intestine. Through its effect on egg production, mefloquine may be a cause of silent schistosomiasis in travelers using mefloquine for malaria chemoprophylaxis. Further study of the anti-schistosomal activity of mefloquine is warranted, as its activity against other helminths.
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Affiliation(s)
- Luc Van Nassauw
- Laboratory of Histology and Cell Biology, Department of Veterinary Sciences, University of Antwerp, Groenenborgerlaan 171, B-2020 Antwerpen, Belgium.
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Laurent SAL, Boissier J, Coslédan F, Gornitzka H, Robert A, Meunier B. Synthesis of “Trioxaquantel”® Derivatives as Potential New Antischistosomal Drugs. European J Org Chem 2008. [DOI: 10.1002/ejoc.200700975] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Keiser J, Utzinger J. Advances in the discovery and development of trematocidal drugs. Expert Opin Drug Discov 2007; 2:S9-S23. [DOI: 10.1517/17460441.2.s1.s9] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Botros SS, Mahmoud MR, Moussa MM, Nosseir MM. Immunohistopathological and biochemical changes in Schistosoma mansoni-infected mice treated with artemether. J Infect 2007; 55:470-7. [PMID: 17868901 DOI: 10.1016/j.jinf.2007.07.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Revised: 07/25/2007] [Accepted: 07/31/2007] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate immune mechanisms possibly involved in the amelioration of histopathological changes in livers of Schistosoma mansoni-infected mice treated with artemether (ART), including liver functions and apoptotic changes. METHODS Male CD-1 Swiss albino mice were infected with Schistosoma mansoni and treated with praziquantel (PZQ) 6 weeks post-infection (PI) (500 mg/kg/day x2) and/or ART in double dose (each of 400 mg/kg) 4 and 6 weeks PI. Parasitological parameters, liver functions and histopathological changes including T-lymphocyte profile and apoptotic changes were assessed. RESULTS Eight weeks PI, although the reduction in worm burden in mice treated with ART plus PZQ was comparable to that in PZQ-treated mice, yet there was complete absence of eggs and typical granulomas. The ratio of T-helper/cytotoxic cells was in favor of T-helper in infected control and in mice treated with both drugs. This ratio was 0.9:1 and 0.7:1 in PZQ and ART-treated groups, respectively, with moderate apoptotic changes in the latter. All biochemical parameters expressing liver function were improved with all treatment regimens. CONCLUSIONS Administration of ART in addition to PZQ resulted in absence of eggs and typical granulomas with less apoptotic changes than in ART-treated mice. Improved liver functions with higher apoptosis in ART-treated mice may suggest enhanced necrotic cell death/regenerative changes.
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Affiliation(s)
- Sanaa S Botros
- Pharmacology Department, Theodor Bilharz Research Institute, P.O. Box 30, Imbaba, 12411 Giza, Egypt
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Ferreira JFS. Nutrient deficiency in the production of artemisinin, dihydroartemisinic acid, and artemisinic acid in Artemisia annua L. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2007; 55:1686-94. [PMID: 17295513 DOI: 10.1021/jf063017v] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Artemisia annua became a valuable agricultural crop after the World Health Organization recommended artemisinin as a component of ACT (artemisinin-combination based therapies) for malaria in 2001. A cloned, greenhouse-grown, A. annua (Artemis) subjected to an acidic soil and macronutrient deficit was evaluated for artemisinin production. Lack of lime (L) and macronutrients (N, P, and K) reduced leaf biomass accumulation. When L was provided (pH 5.1), the highest average leaf biomass was achieved with the "complete" (+N, +P, +K, and +L) treatment (70.3 g/plant), and the least biomass was achieved with the untreated (-N, -P, -K, and -L) treatment (6.18 g/plant). The nutrient least required for biomass accumulation per plant (g) was K (49.0 g), followed by P (36.5 g) and N (14.3 g). The artemisinin concentration (g/100 g) was significantly higher (75.5%) in -K plants when compared to plants under the complete treatment (1.62 vs 0.93%). Although the artemisinin total yield (g/plant) was 21% higher in -K plants, it was not significantly different from plants under the complete treatment (0.80 vs 0.66 g/plant). There were no marked treatment effects for concentration (g/100 g) or yield (g/plant) of both dihydroartemisinic acid and artemisinic acid, although higher levels were achieved in plants under the complete or -K treatments. There was a positive and significant correlation between artemisinin and both artemisinic acid and dihydroartemisin acid, in g/100 g and g/plant. This is the first report where potassium deficiency significantly increases the concentration (g/100 g) of artemisinin. Thus, under a mild potassium deficiency, A. annua farmers could achieve similar gains in artemisinin/ha, while saving on potassium fertilization, increasing the profitability of artemisinin production.
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Affiliation(s)
- Jorge F S Ferreira
- Appalachian Farming Systems Research Center, Agricultural Research Service, U.S. Department of Agriculture, 1224 Airport Road, Beaver, West Virginia 25813, USA.
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Southgate VR, Rollinson D, Tchuem Tchuenté LA, Hagan P. Towards control of schistosomiasis in sub-Saharan Africa. J Helminthol 2007; 79:181-5. [PMID: 16153310 DOI: 10.1079/joh2005307] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AbstractApproximately 80% of the 200 million people infected with schistosomiasis inhabit sub-Saharan Africa, and the annual mortality is estimated to be 280,000. Praziquantel is the drug of choice in the treatment of schistosomiasis and pregnant women may now be treated. It was agreed at the World Health Assembly in 2001 that at least 75% of school-aged children in high burden areas should be treated for schistosomiasis and soil-transmitted helminth infections by 2010 to reduce morbidity. A grant from the Bill and Melinda Gates Foundation to the Schistosomiasis Control Initiative, Imperial College of Science, Technology and Medicine, London has enabled control programmes to be initiated in Uganda, Tanzania, Zambia, Burkina Faso, Niger and Mali. Additional programmes have recently commenced in Zanzibar with a grant from the Health Foundation to The Natural History Museum, London and in Cameroon. Combination treatment for schistosomiasis, gastrointestinal helminths and filariasis reduces costs of control programmes. The EC Concerted Action Group on ‘Praziquantel: its central role in the chemotherapy of schistosome infection’ met in Yaoundé Cameroon in 2004 to discuss recent developments in laboratory and field studies. The use of standard operating procedures will enable data on drug action on schistosomes produced in different laboratories to be compared. With the ever increasing use of praziquantel there is a possibility of the development of resistance by schistosomes to the drug, hence the necessity to explore the activities of other compounds. Artemether, unlike praziquantel, is effective against immature schistosomes. The effectiveness of mirazid, an extract of myrrh, is controversial as data from different laboratories are equivocal. It is suggested that an independent body such as the World Health Organization should determine whether mirazid should be used in the treatment of schistosomiasis.
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Affiliation(s)
- V R Southgate
- Parasitology Division, Wolfson Wellcome Biomedical Laboratories, Department of Zoology, The Natural History Museum, South Kensington, London SW7 5BD, UK.
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Keiser J, Shu-Hua X, Jian X, Zhen-San C, Odermatt P, Tesana S, Tanner M, Utzinger J. Effect of artesunate and artemether against Clonorchis sinensis and Opisthorchis viverrini in rodent models. Int J Antimicrob Agents 2006; 28:370-3. [PMID: 16973335 DOI: 10.1016/j.ijantimicag.2006.08.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2006] [Revised: 06/13/2006] [Accepted: 06/14/2006] [Indexed: 10/24/2022]
Abstract
Food-borne trematodiasis is an emerging public health problem and there is a need to develop novel treatment options. We examined the in vivo efficacy of single oral doses of artesunate and artemether administered to rodents experimentally infected with either Clonorchis sinensis or Opisthorchis viverrini. Rats infected with adult C. sinensis were administered artesunate or artemether at doses of 75, 150 or 300 mg/kg. Hamsters infected with adult O. viverrini were administered artesunate or artemether at doses of 200, 400 or 600 mg/kg. Treatment efficacy was assessed according to reductions in worm burden compared with infected but untreated control animals. Worm burden reductions of 98.6-100% were found in C. sinensis-infected rats after a single dose of artesunate and artemether at 150 mg/kg. Administration of artesunate and artemether at a dose of 400mg/kg to O. viverrini-infected hamsters resulted in worm burden reductions of 77.6% and 65.5%, respectively. However, both drugs showed toxic effects when administered to O. viverrini-infected hamsters at a dose > or =400mg/kg. Our study demonstrates that artesunate and artemether possess excellent clonorchicidal activities in vivo. These findings provide a foundation for subsequent clinical trials. More laboratory investigations are warranted to investigate further the opisthorchicidal properties of the artemisinins.
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Affiliation(s)
- Jennifer Keiser
- Swiss Tropical Institute, P.O. Box, CH-4002 Basel, Switzerland.
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Li YS, Chen HG, He HB, Hou XY, Ellis M, McManus DP. A double-blind field trial on the effects of artemether on Schistosoma japonicum infection in a highly endemic focus in southern China. Acta Trop 2005; 96:184-90. [PMID: 16112071 DOI: 10.1016/j.actatropica.2005.07.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To further strengthen the evidence-base of artemether for the control of schistosomiasis japonica, a randomised controlled trial was carried out in the Poyang Lake region, a highly endemic area in southern China. A total of 783 individuals, aged 6-60 years, were enrolled. They were first given a single oral dose of praziquantel (50 mg/kg). Then, they were randomly assigned oral artemether (6 mg/kg) or placebo, administered once every 2 weeks for 9-11 doses, covering the entire transmission season for Schistosoma japonicum in 2004. Stool examination 1 month after the final dosing revealed eggs of S. japonicum in 3/373 (0.8%) of the artemether recipients and 56/361 (15.0%) in placebo recipients (chi2=53.69, P<0.001). Compared to the baseline, the geometric mean intensity of S. japonicum infection had decreased by 96.1% in the artemether group, and increased by 50.8% in the placebo group. No acute cases of schistosomiasis japonica were observed in the artemether group, whereas three such cases were reported from the placebo group. Compliance with regard to multi-doses of artemether and placebo was 84.9, and 77.9%, respectively. This study confirms that repeated oral artemether produces no drug-related adverse effects, significantly reduces incidence and intensity of patent S. japonicum infection and results in high compliance. Hence it can be used as an additional tool for the control of schistosomiasis japonica in the lake regions of China.
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Affiliation(s)
- Yue-Sheng Li
- Hunan Institute of Parasitic Diseases, WHO Collaborating Centre for Research and Control on Schistosomiasis in Lake Region, Yueyang, Hunan 414000, China.
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46
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Xiao SH. Development of antischistosomal drugs in China, with particular consideration to praziquantel and the artemisinins. Acta Trop 2005; 96:153-67. [PMID: 16112072 DOI: 10.1016/j.actatropica.2005.07.010] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Remarkable achievements have been made in the control of schistosomiasis in China, with chemotherapy playing a seminal role. From the early 1950s through the early 1980s, Chinese scientists made considerable progress in discovery and development of compounds with antischistosomal properties, including antimonials, non-antimonials and various effective principles stemming from traditional herbs. However, only few compounds entered clinical testing, while others were abandoned mainly due to their toxicity and poor efficacy. The advent of praziquantel in the 1970s changed the landscape of research and development of drugs for treatment and morbidity control of schistosomiasis. The main Chinese contributions to enhance the understanding of the antischistosomal drug praziquantel are reviewed here, including issues of metabolism, antibody-dependency, host immune factors, stage-specific susceptibility and resistance. Over the past 25 years, researchers from China successfully developed artemether and artesunate, two derivatives from the antimalarial artemisinin, as promising drugs against Schistosoma japonicum. Laboratory investigations showed that the artemisinins display their highest activity against the juvenile stages of the parasite. These findings were consistently confirmed in randomised controlled trials; repeated oral administration of artemether or artesunate was safe and efficacious in the prevention of patent S. japonicum infections. The key findings are reviewed here, and emphasis is placed on how it stimulated research outside of China on other human schistosome species.
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Affiliation(s)
- Shu-Hua Xiao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China.
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Jiraungkoorskul W, Sahaphong S, Sobhon P, Riengrojpitak S, Kangwanrangsan N. Effects of praziquantel and artesunate on the tegument of adult Schistosoma mekongi harboured in mice. Parasitol Int 2005; 54:177-83. [PMID: 15925540 DOI: 10.1016/j.parint.2005.04.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2005] [Accepted: 04/19/2005] [Indexed: 10/25/2022]
Abstract
The effects of praziquantel and artesunate on the tegument of adult Schistosoma mekongi harboured in mice were compared using scanning electron microscopy (SEM). Forty-two mice infected with S. mekongi for 49 days were treated intragastrically with either 300 mg/kg praziquantel or 300 mg/kg artesunate. Mice were sacrificed 1 or 3 days post-treatment. Worms were collected by perfusion and examined by SEM. One to 3 days after administration of artesunate, the tegument of S. mekongi showed severe swelling, vacuolization, fusion of the tegumental ridges and loss or shortening of the spines on the trabeculae, collapse and peeling. Praziquantel induced similar tegumental alterations as those observed after administration of artesunate, but they were less severe. Three days post-treatment, there was evidence of recovery only in the case of praziquantel. The results of our study suggest that artesunate is more effective than praziquantel in causing tegumental damage in adult S. mekongi, and provides a basis for subsequent clinical trials.
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Affiliation(s)
- Wannee Jiraungkoorskul
- Department of Pathobiology, Faculty of Science, Mahidol University, Rama VI road, Bangkok 10400, Thailand.
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Mahmoud MR, Botros SS. ARTEMETHER AS ADJUVANT THERAPY TO PRAZIQUANTEL IN MURINE EGYPTIAN SCHISTOSOMIASIS MANSONI. J Parasitol 2005; 91:175-8. [PMID: 15856895 DOI: 10.1645/ge-322r] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
We investigated the activity of artemether (ART) against different developmental stages of schistosomes alone and in addition to praziquantel (PZQ). ART was administered orally (400 mg/kg) 4 and 6 wk postinfection (PI), 4 and 5 wk PI, or 4 or 6 wk PI alone and in addition to oral PZQ (500 x 2 mg/kg) 6 wk PI. Mice were killed in parallel to infected untreated controls 8 wk PI. Parasitological parameters and histological changes in the liver were studied. ART given 4 and 6 wk PI reduced worm burdens by 59 and 55% and tissue egg load by 96 and 90%, respectively. Moreover, eggs in different developmental stages were not found. The reduction in worm and egg burden (63 and 58%, and 96 and 99%, respectively) in mice treated with ART 4 and 5 wk or 4 and 6 wk PI was comparable with that in ART-treated mice at 4 or 6 wk PI. Compared with PZQ alone, combined treatment of PZQ and ART (4 and 5 wk or 4 and 6 wk PI) did not enhance worm eradication, but there was a complete absence of parasite eggs. Livers revealed no granulomata when ART was given 4 and 5 wk or 4 and 6 wk PI, with minimal central necrosis in those treated 4 and 6 wk PI. In conclusion, combined treatment of ART (4 and 6 wk PI) and PZQ resulted in >90% worm eradication and amelioration of Schistosoma mansoni eggs from the tissues, with minor histological changes in the liver.
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Affiliation(s)
- M R Mahmoud
- Pharmacology Department, Theodor Bilharz Research Institute, Giza 12411, Egypt
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Utzinger J, Keiser J, Shuhua X, Tanner M, Singer BH. Combination chemotherapy of schistosomiasis in laboratory studies and clinical trials. Antimicrob Agents Chemother 2003; 47:1487-95. [PMID: 12709312 PMCID: PMC153321 DOI: 10.1128/aac.47.5.1487-1495.2003] [Citation(s) in RCA: 144] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jürg Utzinger
- Office of Population Research, Princeton University, Princeton, New Jersey 08544, USA.
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50
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N'Goran EK, Gnaka HN, Tanner M, Utzinger J. Efficacy and side-effects of two praziquantel treatments against Schistosoma haematobium infection, among schoolchildren from Côte d'Ivoire. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2003; 97:37-51. [PMID: 12662421 DOI: 10.1179/000349803125002553] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Praziquantel is the current drug of choice for the control of schistosome-attributable morbidity and is likely to remain so for several years. However, as there is concern that schistosomes might develop resistance to the drug, the monitoring of praziquantel's efficacy in different epidemiological settings is recommended. Here, the results of an innovative study of the drug's effectiveness, in an area in Côte d'Ivoire that is highly endemic for Schistosoma haematobium, are reported. Each of the subjects (354 schoolchildren aged 5-15 years) was given two oral doses of praziquantel (each of 40 mg/kg) 4 weeks apart. The numbers of schistosome eggs in urine samples collected over several consecutive days prior to the first and after the second treatment were then determined. High cure and egg reduction 'rates', of 93.0% and 96.6%, respectively, were found. Although mild and transient side-effects were frequently observed after the first treatments, no severe systemic complaints were recorded. When the 20 children who remained egg-positive after the second dose were each given a third dose of praziquantel, 16 (80%) of them responded and became egg-negative. Unfortunately, the schistosome strains infecting the remaining four children could not be investigated in detailed laboratory studies, because of the failure of eggs to hatch. There were therefore no unambiguous signs of resistance to praziquantel in this epidemiological setting. The benefits and disadvantages, compared with single-dose treatments, of administering praziquantel twice within a few weeks are discussed. It is anticipated that this approach might prove efficacious in areas of high infection intensity. The integration of such pharmaceutical measures with other readily available control tools is likely to mitigate the current, intolerable burden of schistosomiasis.
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Affiliation(s)
- E K N'Goran
- Unité de Formation et de Recherche: Biosciences, Université de Cocody, 22 BP 770, Abidjan 22, Côte d'Ivoire
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