Praziquantel-encapsulated niosomes against Schistosoma mansoni with reduced sensitivity to praziquantel

Impact of nanostructured formulations for schistosomiasis treatment: a systematic review of in vivo preclinical evidence

BACKGROUND

Schistosomiasis is a neglected tropical disease caused by Schistosoma sp., and praziquantel (PZQ) is the first-line treatment. However, traditional PZQ formulations have low solubility and fast metabolism, limiting its effectiveness. Thus, nanoparticles have been proposed to improve the bioavailability and efficacy of poorly soluble antischistosomal drugs.

AIMS

This systematic review used in vivo preclinical studies to map the available evidence and compare the efficacy of free PZQ and PZQ-based nanostructured formulations (N-PZQ) for schistosomiasis treatment.

METHODS

PubMed, Embase, Scopus, and Web of Science were searched, and 1186 experimental studies published between 1974 and 2024 were screened. Parasitological, histopathological, pharmacokinetic, and toxicological outcomes were evaluated.

RESULTS

Twelve relevant studies were identified exploring N-PZQ formulations based on liposomes, nanoliposomes, and nanocrystals. N-PZQ demonstrated better therapeutic efficacy than free PZQ, reducing parasite load, modifying oogram profiles, and down-regulating liver granuloma development (number and size). N-PZQ also exhibited improved pharmacokinetic profile, with enhanced bioavailability and longer half-life, as well as reduced toxicity (cytotoxicity, genotoxicity, and hepatotoxicity) compared to free PZQ.

CONCLUSION

PZQ-based nanostructured formulations represent a promising strategy to enhance schistosomiasis treatment by improving chemotherapy efficacy, optimizing antiparasitic responses, pharmacokinetics, and reducing drug toxicity.

Innate and putative adaptive immunological responses of schistosome-parasitized snails

Schistosomiasis is a neglected tropical disease caused by digenetic trematode from Schistosoma genus, as an etiological agent that uses snails as an intermediate host. In mollusc-trematode relationships, the miracidia attract in the aquatic media to a specific snail as an intermediate hosts, then penetrate its integument in the sporocyst form thereafter, the invasive sporocysts produce secreted/excreted products in order to survive and avoid the snails' immune system. The next larval stage is the cercariae that developed by sporocysts. Subsequently, the snail intermediate host suffers from biological, physiological, biochemical and immunological changes during the development of these parasite larval stages within their tissues. Snails and their parasites engage in an interactive innate and putative adaptive immune response that involves many immune mechanisms, such as the production of nitric oxide, lysozymes, phagocytosis, lectin formation and phenol oxidase activity. Schistosomes have developed a variety of strategies to evade and counteract these deliberate host reactions. These strategies include the secretion of many strong proteases, the use of an immune-resistant outer tegument, the molecular mimicry of host antigens, and the controlled release of certain immunomodulatory substances that influence immune cell activities. This review aims to characterize these important immune evasion mechanisms in order to comprehend the many immunological molecular determinants in the snail/schistosome interaction and to develop alternate management measures for schistosomiasis control.

Nanotechnological approaches in the treatment of schistosomiasis: an overview

Schistosomiasis causes over 200,000 deaths annually. The current treatment option, praziquantel, presents limitations, including low bioavailability and resistance. In this context, nanoparticles have emerged as a promising option for improving schistosomiasis treatment. Several narrative reviews have been published on this topic. Unfortunately, the lack of clear methodologies presented in these reviews leads to the exclusion of many important studies without apparent justification. This integrative review aims to examine works published in this area with a precise and reproducible method. To achieve this, three databases (i.e., Pubmed, Web of Science, and Scopus) were searched from March 31, 2022, to March 31, 2023. The search results included only original research articles that used nanoparticles smaller than 1 µm in the treatment context. Additionally, a search was conducted in the references of the identified articles to retrieve works that could not be found solely using the original search formula. As a result, 65 articles that met the established criteria were identified. Inorganic and polymeric nanoparticles were the most prevalent nanosystems used. Gold was the primary material used to produce inorganic nanoparticles, while poly(lactic-co-glycolic acid) and chitosan were commonly used to produce polymeric nanoparticles. None of these identified works presented results in the clinical phase. Finally, based on our findings, the outlook appears favorable, as there is a significant diversity of new substances with schistosomicidal potential. However, financial efforts are required to advance these nanoformulations.

Immuno-molecular profile for Biomphalaria glabrata/Schistosoma mansoni interaction

The complex innate immune defense of Biomphalaria glabrata, the intermediate host of Schistosoma mansoni, governs the successful development of the intramolluscan stages of the parasite. The interaction between the snail and the parasite involves a complex immune molecular crosstalk between several parasite antigens and the snail immune recognition receptors, evoking different signals and effector molecules. This work seeks to discuss the immune-related molecules that influence compatibility in Biomphalaria glabrata/Schistosoma mansoni interaction and the differential expression of these molecules between resistant and susceptible snails. It also includes the current understanding of the immune molecular determinants that govern the compatibility in sympatric and allopatric interactions, and the expression of these molecules after immune priming and the secondary immune response. Herein, the differences in the immune-related molecules in the interaction of other Biomphalaria species with Schistosoma mansoni compared to the Biomphalaria glabrata model snail are highlighted. Understanding the diverse immune molecular determinants in the snail/schistosome interaction can lead to alternative control strategies for schistosomiasis.

Antischistosomal effects of green and chemically synthesized silver nanoparticles: in vitro and in vivo murine model

Schistosomiasis is one of the most important neglected tropical diseases in Africa, caused by blood fluke, Schistosoma sp. The use of nanotechnology in the treatment of this type of disease is urgently important to avoid the unwanted side effects of chemotherapy. The present study aimed to evaluate the efficacy of green silver nanoparticles (G-AgNPs), fabricated by (Calotropis procera), comparing with both chemically prepared silver ones (C-AgNPs) and Praziquantel (PZQ) treatments. The study included in vitro and in vivo evaluations. In in vitro study, 4 groups of schistosome worms were exposed to treatments as follows: the first one with a dose of PZQ (0.2 µg/ml), the 2^nd and 3^rd groups with different concentrations of G-AgNPs and C-AgNPs, respectively and the last one act as a negative control group. In in vivo study, six groups of mice were infected and then treated as follows: the first one with a dose of PZQ, the second with G-AgNPs, the third with C-AgNPs, the fourth with G-AgNPs plus a half dose of PZQ, the fifth with C-AgNPs accompanied by a half dose of PZQ, and the last group acted as a positive control group. The parasitological (worm burden, egg count & oogram) and histopathological parameters (hepatic granuloma profile) were used to evaluate antischistosomal activities in experimental groups. Additionally, the subsequent ultrastructural alterations were observed in adult worms using scanning electron microscopy (SEM). Transmission electron microscopy analysis showed that G-AgNPs and C-AgNPs have 8-25 and 8-11 nm in diameter, respectively, besides, fourier transform infrared analysis (FTIR) revealed the presence of organic compounds (aromatic ring groups) which act as capping agents around the surfaces of biogenic silver nanoparticles. In in vitro experiment, adult worms incubated either with G-AgNPs or C-AgNPs at concentrations higher than 100 µg/ml or 80 µg/ml, respectively, showed full mortality of parasites after 24 h. In the infected treated groups (with G-AgNPs plus PZQ & C-AgNPs plus PZQ) showed the most significant reduction in the total worm burdens (92.17% & 90.52%, respectively). Combined treatment with C-AgNPs and PZQ showed the highest value of dead eggs (93,6%), followed by G-AgNPs plus PZQ-treated one (91%). This study showed that mice treated with G-AgNPs plus PZQ significantly has the highest percentage of reduction in granuloma size and count (64.59%, 70.14%, respectively). Both G-AgNPs plus PZQ-treated & C-AgNPs plus PZQ treated groups showed the highest similar values of reduction percentage of total ova count in tissues (98.90% & 98.62%, respectively). Concerning SEM, G-AgNPs-treated worms showed more variability in ultrastructural alterations than G-AgNPs plus PZQ-treated one, besides, worms treated with C-AgNPs plus PZQ exhibited the maximum level of contractions or (shrinkage) as a major impact.

Delivery of Adriamycin Loaded Niosomes for Liver Cancer Treatment

The delivery efficiency of Adriamycin is crucial for the therapy of hepatocellular carcinoma. Niosome is a promising carrier that can be used for targeted drug delivery. However, the therapeutic effect of Adriamycin loaded niosome is still unclear. In this study, Adriamycin loaded niosomes were constructed as a promising drug carrier system. The morphological determination of niosomes was conducted by transmission electron microscopy. Cell fluorescence was used for cellular uptake analysis. Western blotting was used to estimate the apoptosis-related protein expression in HepG2 cells. 3-(4,5)-di-methylthiahiazo(-z-y1)-3,5-di-phenytetrazolium bromide assay was used for estimating the apoptosis of cancer cells. The in vivo anti-cancer effect and safety of Adriamycin loaded niosomes were analyzed in tumor-bearing mice. Adriamycin loaded niosomes improved the cellular uptake of Adriamycin. The anti-cancer effect of Adriamycin in vivo was enhanced. The responsive release of Adriamycin loaded niosomes under acidic conditions reduced the toxicity of Adriamycin to normal cells and the mortality of tumor-bearing mice. Together, Adriamycin loaded niosomes improved its anti-cancer effect and safety for liver cancer treatment.

A single oral dose of celecoxib-loaded solid lipid nanoparticles for treatment of different developmental stages of experimental schistosomiasis mansoni

Schistosomiasis, a neglected tropical parasitic disease, is associated with severe pathology, mortality and economic loss. The treatment and control of schistosomiasis depends mainly on a single dose of praziquantel (PZQ). Drug repurposing and nanomedicine attract great attention to improve anti-schistosomal therapy. Previously, we reported that celecoxib (CELE), the non-steroidal anti-inflammatory drug, showed potent anti-schistosomal efficacy in an oral dose of 20 mg/kg/day for five days against different developmental stages of Schistosoma mansoni (S. mansoni) infection in mice. The aim of the current study was to shorten the duration of CELE treatment to reach an effective single oral dose against different developmental stages of S. mansoni infection using solid lipid nanoparticles (SLNs) as nano-carriers. The latter enhance the solubility, bioavailability and drug delivery and hence can decrease the frequency of administration which is of great clinical value. CELE-loaded SLNs showed good colloidal properties, high entrapment efficiency and drug loading, sustained biphasic release pattern with excellent storage stability. The used regimen was efficient against different developmental stages of S. mansoni infection with the most pronounced effect against the juvenile stage where the worm load, the hepatic egg count and the intestinal egg count were reduced by 86.39%, 91.45% and 90.11%, respectively. Meanwhile, when targeting the invasive and the adult stages, it induced reduction in the worm load by 73.55% and 78.22%, the hepatic egg count by 69.99% and 75.39% and the intestinal egg count by 77.57% and 79.89%, respectively. Additionally, CELE-loaded SLNs caused extensive tegumental damage of adult worms and marked improvement in the liver pathology.