Oral nitazoxanide treatment of experimental neurocysticercosis induces gluconeogenesis in Taenia crassiceps cysticerci

Neurocysticercosis is the most frequent helminthiasis of the central nervous system and is caused by the presence of Taenia solium cysticerci. Nitazoxanide (NTZ) is an antifolate containing the pyrrolopyrimidine-based nucleus that exerts its antiprotozoal activity due to interference with the pyruvate:ferredoxin oxidoreductase (PFOR) enzyme which is essential to anaerobic energy metabolism. The aim of this work was to determine the effect of NTZ on the energetic metabolism of Taenia crassiceps cysticerci intracranially inoculated BALB /c mice. The infected animals were treated with a single oral dose of NTZ 30 days after the inoculation. Analysis of the organic acids was performed through high performance liquid chromatography. Glucose was detected only in the treated groups, alongside with a significant decrease in lactate, pyruvate and oxaloacetate concentrations which indicate an increase in gluconeogenesis. The non-detection of alpha-ketoglutarate indicated the use of the fumarate reductase pathway in all groups. It was possible to confirm the drugs mode of action due to the non-detection of acetate in the treated groups. There was an increase in the fatty acids oxidation. Therefore it was possible to observe that NTZ induces gluconeogenesis as well as the increase of alternative energetic pathways such as fatty acids oxidation in T. crassiceps cysticerci.

Albendazole and Corticosteroids for the Treatment of Solitary Cysticercus Granuloma: A Network Meta-analysis

Background

Solitary cysticercus granuloma (SCG) is the commonest form of neurocysticercosis in the Indian subcontinent and in travelers. Several different treatment options exist for SCG. We conducted a Bayesian network meta-analysis of randomized clinical trials (RCTs) to identify the best treatment option to prevent seizure recurrence and promote lesion resolution for patients with SCG.

Methods and Principal Findings

PubMed, EMBASE and the Cochrane Library databases (up to June 1, 2015) were searched for RCTs that compared any anthelmintics or corticosteroids, alone or in combination, with placebo or head to head and reported on seizure recurrence and lesion resolution in patients with SCG. A total of 14 RCTs (1277 patients) were included in the quantitative analysis focusing on four different treatment options. A Bayesian network model computing odds ratios (OR) with 95% credible intervals (CrI) and probability of being best (P_best) was used to compare all interventions simultaneously. Albendazole and corticosteroids combination therapy was the only regimen that significantly decreased the risk of seizure recurrence compared with conservative treatment (OR 0.32, 95% CrI 0.10–0.93, P_best 73.3%). Albendazole and corticosteroids alone or in combination were all efficacious in hastening granuloma resolution, but the combined therapy remained the best option based on probability analysis (OR 3.05, 95% CrI 1.24–7.95, P_best 53.9%). The superiority of the combination therapy changed little in RCTs with different follow-up durations and in sensitivity analyses. The limitations of this study include high risk of bias and short follow-up duration in most studies.

Conclusions

Dual therapy of albendazole and corticosteroids was the most efficacious regimen that could prevent seizure recurrence and promote lesion resolution in a follow-up period of around one year. It should be recommended for the management of SCG until more high-quality evidence is available.

Neurocysticercosis is an infection of the central nervous system by the larva of Taenia solium (pork tapeworm). It is a leading cause of epilepsy in the world. The disease takes many different forms, each with different optimal treatment. In this study, we focused on the treatment of solitary cysticercus granuloma (SCG), previous evidence on which is inconclusive. Since many different regimens have been compared in clinical trials of SCG, we conducted a network meta-analysis. This method is powerful as it can analyze quantitatively all of the data from all comparisons together. The result can tell us how different treatments perform against each other and how treatments should be ranked. The outcomes of our meta-analysis suggest that the combination of albendazole and corticosteroids is the most efficacious regimen to control seizures in affected patients and to promote the total disappearance of the lesion, compared with albendazole alone, corticosteroids alone, and conservative treatment.

[Clinical application of diagnostic therapy of praziquantel for suspected cere- bral cysticercosis]

OBJECTIVE

To explore the clinical application value of diagnostic therapy of praziquantel for suspected cerebral cysticercosis.

METHODS

The suspected cerebral cysticercosis patients were collected and treated with the diagnostic therapy [praziquantel, 50 mg/(kg · d)], and followed up for 1-2 years.

RESULTS

Totally 94 suspected cerebral cysticercosis patients were collected. After the diagnostic therapy, 78 (82.98%) cases were confirmed as cerebral cysticercosis, 13 (13.83%) were diagnosed as other diseases, and 3 (3.19%) were not definitely diagnosed.

CONCLUSION

The diagnostic therapy for suspected cerebral cysticercosis can reduce or avoid the missed diagnosis and misdiagnosis in some atypical cerebral cysticercosis patients.

In vitro killing action of auranofin on Taenia crassiceps metacestode (cysticerci) and inactivation of thioredoxin-glutathione reductase (TGR)

Control of cellular redox homeostasis is a central issue for all living organisms. Glutathione and thioredoxin enzymatic redox systems are the usual mean used to achieve such a control. However, parasitic platyhelminths studied to date possess a nicotinamide adenine dinucleotide phosphate-dependent thioredoxin-glutathione reductase (TGR) as the sole redox control system. Thus, TGR is considered as a potential therapeutic target of parasitic platyhelminths, and based on this assumption, the gold compound auranofin is a potent inhibitor of TGR. The aim of this research was to investigate the effect of auranofin on metacestode (cysticerci) of Taenia crassiceps in culture. Accordingly, the time course for viability and respiration of cysticerci in culture was evaluated in the presence of this compound. After 4 h at 10 microM auranofin, 90% of cysticerci were alive, but respiration activity had declined by 50%. After 12 h, neither survivors nor respiration was detected; a LD(50) for auranofin of 3.8 microM was calculated. Interestingly, crude extracts of cysticerci pretreated with 3 microM auranofin nearly nil TGR activity (IC(50) = 0.6 microM). Zymography for TGR in polyacrylamide gel electrophoresis was conducted because the previously mentioned extracts clearly showed a dose-response inactivation of TGR toward auranofin. The killing of cysticerci by this gold compound is most likely related with TGR inactivation. Therefore, further research on the suitability of auranofin as a therapeutic tool in the treatment of cysticercosis in animals and humans is sustained.

Gonadectomy and progesterone treatment induce protection in murine cysticercosis

The effects of progesterone on castrated mice of both sexes infected with Taenia crassiceps cysticerci were studied. Gonadectomy and treatment with progesterone before infection decreased parasite loads by 100% compared with intact uninfected mice. mRNA levels of IFN-gamma and IL-2 (typically associated to Th1-like profiles) were markedly decreased in infected gonadectomized (Gx) mice, whereas progesterone treatment of infected Gx mice did not affected its expression. mRNA levels of IL-4, and IL-10 (typically associated with Th2-like profiles) were reduced by gonadectomy, whereas restitution with progesterone did not affected this pattern in infected Gx progesterone-treated mice. Infection markedly induced expression of progesterone receptor isoform A in splenocytes of Gx mice (5-fold), whereas isoform B had no changes. Progesterone metabolism to dehydroepiandrosterone (DHEA) in Gx animals was increased 3-fold only in infected progesterone-treated uninfecteds of both sexes, but was not detectable in infected Gx progesterone-treated mice. Conversely, DHEA levels increased 100-fold in infected Gx progesterone-treated mice. However, androgen receptor expression in splenocytes of male mice showed a reduction by gonadectomy, and by infection, whereas in females AR expression showed no changes in the different mouse groups. These results suggest that progesterone, through its metabolism to DHEA, negatively affects the establishment, growth, and reproduction of Taenia crassiceps, by a mechanism that does not implicate a classic genomic pathway involving a nuclear androgen receptor.

[Effect of gamma-interferon on hepatic granuloma formation in mice infected by cysticerci of Taenia saginata asiatica]

Immunohistochemical streptavidin biotin-peroxidase complex method was used to investigate the effect of gamma-interferon (IFN-gamma) on the hepatic granuloma formation and liver fibrosis in mice infected with Taenia saginata in Duyun area of Guizhou Province. The results reveal contrary relation between the level of IFN-gamma in the liver and the degree of liver fibrosis (p<0.01). The injection of IFN-gamma considerably decreased (p<0.01) the area and size of granuloma (p<0.01).

Cysteine proteinase inhibitors in murine cysticercosis

We explored the prophylactic efficacies of two novel protease inhibitors in murine cysticercosis. Our results demonstrated a 95% and 80% reduction in parasite burden for mice injected with Z-LLL-FMK and Z-LLY-FMK, respectively. Further studies are merited on the role of cysteine proteinase inhibitors in treatment of cysticercosis.

Effect of some chemical agents on the viability of Cysticercus bovis

The effect of eight chemicals; vinegar, Allium sativum (crude garlic), Acacia auriculiformis, lemon juice, praziquantel, pumpkin, perosan and yomesan on the viability of cysticerci of Taenia saginata in vitro was investigated. The minimum exposure time required for cysticerci to be non-evaginable for the eight chemicals were 5, 10, 25, 40, 55, 75, 90 and 105 minutes respectively. The best one was vinegar and the least effective was yomesan.

Human case management and treatment of cysticercosis

Disease manifestations due to neurocysticercosis vary markedly and depend upon the location, size and number of cysts as well as the viability or degeneration of cysts and presence, type and degree of host response. Accordingly, the clinical management for each patient should be individualized. Treatment modalities include: (1) larvicidal drugs such as albendazole or praziquantel in patients with viable cysts; (2) corticosteroids or other agents to suppress or prevent the host's immune response; (3) anti-seizure medication(s) to treat or prevent recurrent seizures; (4) surgical interventions; and (5) the use of supportive family, social or health agencies in impaired individuals. Although it is known that larvicidal treatment kills viable cysts that commonly resolve or calcify, the clinical benefit of this treatment in the most common presentations is unproven. However, medical treatment of giant subarachnoid cysts, large parenchymal cysts or orbital cysts causing mass effect has led to definite clinical improvement in uncontrolled trials. Whether there is faster radiological improvement and/or clinical benefit in the treatment of cysts showing signs of inflammation by magnetic resonance imaging (enhancement and/or edema) is like-wise controversial. There is no general understanding when or how to use corticosteroids to suppress natural or treatment-induced inflammation around cysts although their use when inflammation contributes or could be expected to cause undue morbidity or mortality is reasonable. Anti-seizure medication should usually be employed in patients with seizures or patients who may likely develop seizures. Surgical intervention is required to alleviate mass effect, remove some cysts causing obstruction of the ventricles, shunt placement for hydrocephalus, and sometimes for removal and/or decompression of large or critically located cysts before larvicidal treatment.

Do interleukin-6 and macrophage-migration inhibitory factor play a role during sex-associated susceptibility in murine cysticercosis?

In murine Taenia crassiceps cysticercosis, females sustain larger intensities of infection than males. However, during chronic infection, this difference disappears and males show a feminization process. To further study the role of two cytokines, interleukin-6 (IL-6) and macrophage-migration inhibitory factor (MIF), known to be involved in immunoendocrinological processes during sex-associated susceptibility in cysticercosis, IL-6 and MIF gene knockout (KO) mice were infected, and the number of parasites and serum sex-steroid levels were measured. Results show that IL-6 and MIF KO mice of both genders infected with T. crassiceps cysticerci harbor similar numbers of parasites, with no change in sex-hormone levels. However, in wild-type strains, females have twice as many parasites as males. At the same time, there is a decrease of 80% in testosterone and dihydrotestosterone serum levels, and a 100-fold increase in the levels of estradiol in infected male mice. These results suggest a role for both IL-6 and MIF genes in sex-associated susceptibility in murine T. crassiceps cysticercosis.

Failure of one-day praziquantel treatment in patients with multiple neurocysticercosis lesions

A recently described one-day regimen of praziquantel (PZQ) therapy for neurocysticercosis (NCC), three doses of 25 mg/k given at 2 h intervals, was applied in eight patients with viable NCC cysts without any evidence of inflammation. Resolution of lesions in computed tomography (CT) was observed in all five patients with a single cyst, whereas all cysts survived in three patients with multiple brain parasites. One-day praziquantel is a good regimen for patients with a single viable brain cysticercus but is poorly effective for multiple cysts.

Time-response curve of oxfendazole in the treatment of swine cysticercosis

Human Taenia solium cysticercosis is a major cause of epilepsy in developing countries, and porcine infection causes widespread economic losses because of infested pork. Recently, the use of oxfendazole (OFZ) for porcine cysticercosis provided, for the first time, an effective, single-dose treatment. We performed a controlled study to determine the time required between treatment with a single dose of OFZ and the death of cysticerci to define its applicability as preslaughter treatment or as a field control measure. Twenty naturally infected pigs were included in this study. Sixteen received a single dose (30 mg/kg) of OFZ, and were killed in groups of four at one, two, four, and 12 weeks after treatment. Four untreated controls were killed at week 12. No adverse reactions to OFZ were noted. A clear decrease in viability and number of cysts was evident after the first week after therapy, but even at week 4 some viable cysticerci were found in all samples. Twelve weeks after treatment, all meat appeared clear and only minuscule scars remained, except in one animal that had viable brain cysts. This study confirms the efficacy of a single dose of 30 mg/kg of OFZ for porcine cysticercosis but demonstrates that preslaughter treatment of pigs with OFZ will not be useful in controlling cysticercosis. The inclusion of porcine treatment with OFZ in mass cysticercosis control programs is, however, highly promising because it is a simple, effective, inexpensive, and potentially sustainable method for decreasing the porcine reservoir of cysticercosis in disease-endemic countries.

Observations on the effects of cysticercosis immune sera on cysticercosis by scanning electronmicroscopy

Two antigens of Taenia solium cysticercus, cystic fluid antigen (CFA) and the culture medium antigen (CMA), were used respectively to immunize rabbits in order to obtain immunosera. The CMA immunoserum added to culture medium with cysticerci limited the activities of the bladder worms. By using the scanning electronmicroscope, we could observe particulate deposits on the surface of the scolices, suckers and necks of the worms. The CFA immunoserum group showed similar changes but the deposit was less than that on the worms in the former group and appeared mainly on the cystic wall. After adding complement to the two groups mentioned above, we found that the microcilia on the surface of the worms were swollen and were seriously damaged. The worms treated with praziquantel were damaged over large area of their surfaces and were affected deep into their tissues. The damaged parts of the worms were quite different between the two groups. CMA is secreted by the living worms and therefore the serum antibodies are more effective than CFA in anti-parasite activity.

[Electron microscopic observation on cysticercus cellulosae treated with mienangling in vitro]

OBJECTIVE

To observe the effect of Mienangling (MNL) in treating cysticercus cellulosae in vitro.

METHODS

The changes of cysticercus cellulosae treated in vitro with the MNL extracts, praziquantel (PQT) and albendazole (ALB) were studied under the transmission and scanning electron microscopes.

RESULTS

Under the scanning electron microscope, the authors can see that all of the cysticercus's scoleces did not grow in the MNL and PQT groups, cyst walls shrivelled, tegument's ectoplasts were damaged, microtriches's ultrastructures were not clear or exfoliated, some corpuscular matter densely was distributed in the surface; 46.7% of cysticercus cellulosaes in the ALB group had been excystated, the rostellar hooks of rostella developed normally, four sucker's surface wrer hollow, the necks were eroded, and grooves of sonite disappeared. Under the transmission electron microscope, we can see that the tegument, basement membrane, muscular layer and parenchyma in the groups of MNL and PQT were all clearly damaged, but the harmful effect of MNL to parenchyma's nerve cords is more serious than the PQT. The damage of all layers of the cysticercus cellulosae in the ALB group is smaller in degree than the MNL and the PQT.

CONCLUSION

The MNL has marked damaging effect to cysticercus cellulosae.

Effective, single-dose treatment or porcine cysticercosis with oxfendazole

The pig is a vital link in the transmission cycle of Taenia solium, the cestode responsible for human-porcine cysticercosis. Infected pigs also represent an important source of economic loss to farmers in developing countries. Past efforts to find an adequate therapeutic regimen to treat this parasite disease in swine have failed because of low efficacy, high cost, side effects, or the need for multiple doses. In this randomized, no treatment-controlled study, the efficacy and safety of oxfendazole and praziquantel for the treatment of porcine cysticercosis were evaluated in 16 naturally infected pigs. Four groups of four pigs were treated with oxfendazole, praziquantel, oxfendazole plus praziquantel, or untreated. The pigs were humanely killed 12 weeks post-treatment, the number of cyst was counted, and parasite viability was assessed by cyst evagination. No detectable side effects were seen in any of the pigs. Praziquantel treatment alone appeared to reduce the number of cysts, but did not decrease the viability of the remaining parasites. Treatment with oxfendazole alone or oxfendazole plus praziquantel killed all of the parasites, and left only microcalcifications in the meat. Oxfendazole provides, for the first time, a practical, effective, inexpensive, and single-dose therapy for porcine cysticercosis.

Evaluation of the efficacy of albendazole against the larvae of Taenia solium in experimentally infected pigs, and kinetics of the immune response

Cysticercosis, a disease of economic and public health importance, is caused by Cysticercus cellulosae, the metacestode stage of Taenia solium. Experimental induction of cysticercosis was achieved in young pigs by feeding an optimum dose of 20,000 T. solium (Indian strain) eggs after immunosuppression, to assess the effect of albendazole and development of the immune response to cysticercus antigens before and after treatment. Histopathological studies revealed the presence of cysticerei in liver, lungs and muscles. Treatment with albendazole at 15 mg kg-1 body weight daily for 30 days starting from day 0 or 15 days post-infection resulted in 100% cure rates. Increases in antibody titre to crude soluble extract and a Sephadek G-200 purified antigenic fraction of Cysticercus cellulosae were found on days 25, 40 and 55 post-infection in untreated pigs and those in which treatment started on day 15 post-infection, whereas no increase in antibody response was observed in pigs in which treatment started on day 0.

Treatment of porcine cysticercosis with albendazole

In a randomized, controlled study, the efficacy and safety of two different schemes of albendazole therapy for treatment of porcine cysticercosis were tested. Seventeen naturally infected pigs were divided into three groups and treated per os with albendazole (50 mg/kg single dose), albendazole (30 mg/kg every day for three days), or given no treatment, respectively. Serologic responses were monitored with the enzyme-linked electroimmunotransfer blot assay. Pigs were humanely killed 12 weeks after treatment, necropsied, and the number of parasites was recorded. Scolex evagination was used to assess viability of the cysts. Both albendazole-treated groups had significant side effects (anorexia, lethargy). Only a single viable cyst was recovered from the brain of one animal after therapy in the multiple-dose group, and the single-dose therapy left 11% of the cysts viable. In contrast, more than 90% of muscle cysts were found to be viable in the untreated group. Although albendazole therapy for three days was found to be highly effective, side effects and the need for multiple doses would still prevent its widespread use.

Immunological mediation of gonadal effects on experimental murine cysticercosis caused by Taenia crassiceps metacestodes

Female BALB/c mice are naturally more susceptible than males to intraperitoneal experimental infection with Taenia crassiceps metacestodes. Gonadectomy tends to equalize susceptibility between sexes by reducing in half the mean individual intensity of females and by tripling that of males. The effect of gonadectomy is seen only in mice with intact immune systems but not in irradiated mice. Purified sex hormones (17-beta estradiol, testosterone, and progesterone) do not affect cysticercus reproduction or growth in vitro. Thus, gonadal effect on mouse susceptibility to cysticercosis appears to be mediated via the immune system, and it is probably not the consequence of the major sex steroids acting directly upon the parasites. Because sublethal irradiation increases the intensity in gonadectomized females and intact males, whereas that of gonadectomized males and intact females remains unchanged, irradiation results are consistent with the hypothesis that immunological events that participate in controlling the growth of cysticerci are inhibited by ovaries and stimulated by testes.

Substituted methyl benzimidazole carbamate: efficacy against experimental cysticercosis

Methyl [5-([4-(2-pyridinyl)-1-piprazinyl] carbonyl)-1H benzimidazole-2-yl] carbamate, a broad spectrum anthelmintic, was tested against Cysticercus fasciolaris in rats and the cysticercoids of Hymenolepis nana in beetles. A dose of 50 mg kg-1, given intraperitoneally (i.p.) to infected rats on 10 alternate days, was found most effective, killing all mature cysticerci. The same dose, given on each of five days, either from the fifth day prior to infection or the sixth day following infection, fully arrested the establishment of cysticerci. A single prophylatic dose of 500 mg kg-1, given intramuscularly (i.m.), protected rats against challenge with Taenia taeniaeformis eggs for 10 days. The test compound, mebendazole and praziquantel were all totally ineffective against mature cysticercoids in grain beetles but, of the beetles fed the drugs in flour, 66.3%, 50% and 83.8%, respectively, failed to support the development of immature cysticercoids. The effective cysticidal action of the compound makes it a candidate medical anthelmintic.

The effect of different chemical and physical agents on the viability of Cysticercus bovis: a preliminary report

The in vitro comparative effect of 23 chemicals and 5 physical agents on the viability of Cysticerci of Taenia saginata was investigated. Accordingly the effects of Vinegar, "Kosso-Araki", "Senafitch", "Dagim-Araki", "Datta", Gin, Lemon-juice, Cognac, Fernet Whisky, Bitter, Brandy, Kilikil, "Feto", ArakiUzo, Araki-Double Uzo, Vermouth, Metta Beer, Pilsner Beer, "Awazie", "Tella", "Tej", and Sarris Wine Red and White; was assessed on the basis of minimum exposure time (in minutes) required to render viable cysticerci nonevaginable, and was found to be 5, 20, 20, 25, 40, 40, 45, 50, 55, 75, 80, 90, 90, 90, 105, 105, 110 respectively with the remaining showing no deleterious effects on the cysts up to 180 minutes of exposure. Similarly, viable bovine cysticerci were subjected to the physical forces of x-ray radiation, electricity, UV light radiation, centrifugation and vibration, and the effect of the individual agent on the cysts was assessed on the basis of minimum applicable force required to render bovine cysticerci non-evaginable. And it was found that, whereas 500 grays (Gy) of absorbed xray radiation dose and electric current measuring 0.1 mA applied for 1/2 a minute were required to render cysts nonviable. A relative decrease in evagination time and increased viger and motility of the evaginated cysticerci was observed with the other physical forces. On the basis of these results, it is suggested that an attempt to understand the mechanism of action and may be elucidation of the active principle of the more potent agents will be a step forward towards a successful break in the life cycle of the parasite.

[Effect of alcohol-extract from scorpion on checking externally active cysticerus cellulosae]

Putting the alcohol-extract from scorpion in the ordinary aqueous solution of 15% pork bile and having it cultured at the temperature of 37 degrees C have proved for the first time that in contrast with the chemical albendazole, Scorpion has a conspicuous effect on the external killing of the cysticercus cellulosae, The action of killing cysticercus cellulosae has almost nothing to do with the difference of processed products or of the parts used in medicine.

Praziquantel treatment of muscle Taenia solium cysticercosis. 4. Reversible in vitro effect

The in vitro effect of Praziquantel (PZQ) on Taenia solium cysticerci was analyzed. The oxygen consumption rate of the parasites was inhibited and the release of proteins was enhanced, but no statistically significant differences were found between the control group and the experimental groups. The drug had a significant, dose-dependent negative effect on the evagination ability of the larvae; 50% effect was seen at concentrations of between 10(-9) and 10(-8) M PZQ. The drug also induced morphological disturbances in the tegument of the worm and of the bladder wall. Finally, a very drastic effect was the induction of spastic paralysis in evaginated cysticerci at high drug doses and of flaccid paralysis at lower PZQ concentrations. The dose inducing these effects was various orders of magnitude lower than that inhibiting the evagination ability of intact cysts. Moreover, the latter effect was reversible after had been washed out the drug and the parasites had been cultured. We suggest that PZQ alters the Ca2+ flux in T. solium as it does in other helminths. Furthermore, we corroborated the protective role of the bladder for the invaginated worm. Finally, we think that in vivo the drug must act synergistically with the immune system components so as to eliminate the parasite.

Praziquantel treatment of porcine brain and muscle Taenia solium cysticercosis. 1. Radiological, physiological and histopathological studies

Porcine Taenia solium cysticercosis, recognized as a model of the human disease, was used to analyze the effect of the anthelminthic drug praziquantel on hosts and parasites. The drug (50 mg/kg daily) was given over 15 days in the feed of 13 cysticercotic and 9 control pigs. Changes in the number, size and appearance of brain parasites were seen by computerized tomography immediately after the last dose of praziquantel, although not all cysticerci had disappeared by day 47 following the end of the treatment. Muscle parasites became small and hyperdense shortly after treatment and disappeared from tomographic images afterwards. No alterations were found in EEGs or in brain-stem auditory and somatosensory evoked potentials. Muscle cysticerci showed increasing degrees of degeneration with time after treatment, and an augmented inflammatory reaction was concomitantly observed. In contrast, more heterogeneous results were obtained in parasites lodged in the brain, since viable cysts and less intense inflammatory reactions were found in the brain at different times after treatment. Physiological evaluation of the parasites showed that evagination was inhibited immediately after treatment and that oxygen consumption decreased with time. The results of this investigation suggest that praziquantel damages cysticerci and that the inflammatory reaction destroys and eliminates them.

Respiratory changes associated with the in vitro evagination of Taenia solium cysticerci

The metabolic adaptability of Taenia solium cysticerci was studied in vitro, by measuring their respiratory rate before, during, and after trypsin-induced evagination. Under aerobic conditions, the oxygen consumption increased about 40% during evagination of the cysticeri and returned to basal rates after the process was completed. The percentage of evagination induced by trypsin was not affected under anaerobic conditions or in the presence of respiratory poisons such as cyanide and carbon monoxide. These data indicate that cysticerci use either aerobic or anaerobic pathways according to oxygen availability in the environment. Results from experiments of irreversible respiratory poisoning using cyanide suggest the presence of an alternative respiratory chain. Proteolytic action of trypsin on a fibrous layer surrounding the invaginated larvae is suggested by histological evidence.

Synthesis of 2,5-disubstituted benzimidazoles, 1,3,4-thiadiazoles and 3,5-diiodosalicylanilides as structural congeners of rafoxanide and closantel

The synthesis of a series of 2,5-disubstituted benzimidazoles (8-10, 13), substituted 3,5-diodosalicylanilides (6, 7, 11, 12, 16-29), 2-(4-substituted phenyl)-4-aroylamino-1,3,4-thiadiazoles (33-38) and benzoxazines (14, 30, 31) has been carried out as the structural congeners of rafoxanide and closantel. All the compounds have been tested for their anthelmintic activity against Ancylostoma ceylanicum, Nippostrongylus brasiliensis, Hymenolepis nana and Cysticecus fasciolaris in rodents. Compounds 8, 22 and 23 exhibited 90-100% elimination of the hookworms A. ceylanicum and tapeworms H. nana from hamsters and rats, respectively, at an oral dose 50-250 mg/kg body mass.

Methyl 5(6)-(alpha-hydroxyphenyl methyl) benzimidazole-2-carbamate and cysticercosis: chemotherapeutic and electron microscopic studies

Methyl 5(6)-(alpha-hydroxyphenyl methyl) benzimidazole-2-carbamate, a major metabolite of mebendazole was evaluated against Cysticercus fasciolaria (larval form of Taenia taeniaeformis) in rats. The metabolite was assessed in various doses. A regimen of 50 mg/kg x 10 (ip), given one day apart, was found to be most effective and killed all the mature cysticerci. On developing cysts, the treatment was initiated in two schedules; 5 days prior to (d-5 to d-1) and 5 days after (d + 6 to d + 10) administration of T. taeniaeformis eggs to rats. The later protocol with 100 mg/kg x 5 dose (ip) resulted in 95% inhibition in the establishment of cysticerci. Activity of mebendazole against mature cysts was parallel to metabolite whereas against developing cysts, it was inferior. The time related topographical changes that occurred in mature C. fasciolaris after treatment with metabolite (50 mg/kg x 10, ip, one day apart) were observed by scanning electron microscopy. There was loss of contractivity, gradual disappearance of microtriches and progressive degeneration of tegument. Similar changes were noticed with mebendazole. The possession of better efficacy and higher safety range [Indian J Exp. Biol, 25 (1987) 871], suggests that the metabolite can be a potential anthelmintic for man and animals.

Neurocysticercosis: treatment with albendazole and dextrochloropheniramine

We evaluated the use of albendazole in combination with dextrochloropheniramine for the treatment of neurocysticercosis. Forty patients were treated from September 1984 to December 1987; each was diagnosed on the basis of clinical, epidemiological, cerebrospinal fluid and tomographic data. Patients were divided into 3 groups according to the albendazole treatment schedule. Group I received 10-15 mg/kg albendazole daily; group II received 15-25 mg/kg/d; group III received 15-30 mg/kg/d. Each patient also received simultaneously 18 mg/d of dextrochloropheniramine. Clinical improvement was observed in 4 patients in group I (50.0%), 10 patients in group II (83.3%) and 18 patients in group III (94.7%). Three patients in group II, and one in group III, died. Group III patients showed a significant improvement in quality of life compared to the other 2 groups. Side effects were insignificant in all groups. The combination of albendazole and dextrochloropheniramine seems to be a promising treatment for neurocysticercosis, especially at the doses used for group III, i.e. 15 mg/kg/d of albendazole for 21 d followed by 20-30 mg/kg/d for 30 d after a one-week interval, in combination with 18 mg/d of dextrochloropheniramine.

[5 cases of cysticercosis in Rwanda]

Five cases of cysticercosis are reported. They were diagnosed by microscopic examination of the sub-cutaneous nodules in which T. Solium larvae were found. Results of the treatment by Praziquantel are reported, with regard to the symptomatology of the patients after one year of observation. Necrosis of cysticerci larvae few month after starting the treatment was observed in three cases by microscopical anatomy test. Three doses of Praziquantel of 20 mg/kg at four hours of interval are efficient against sub-cutaneous and muscular cysticercosis. Such a treatment presents the advantage very important in some rural zones in Africa, of a single dose in one day.

Taenia crassiceps: basic mechanisms of endocytosis in the cysticercus

The effects of glucose, yeast extract, fetal bovine serum albumin, and ruthenium red on endocytosis of smooth micropinocytotic vesicles (pinosomes) in the tegument of the cysticercus of Taenia crassiceps have been investigated stereologically. Glucose has been shown to stimulate pinocytosis, whether it was used alone or in combination with yeast extract or bovine serum albumin. Yeast extract was a stimulant of endocytosis. Bovine serum albumin was the most potent stimulant of all the substances investigated in this study. Although the time of incubation in ruthenium red was the same for all incubation experiments, varied numbers of ruthenium red-containing pinosomes were observed in different experiments. The role of ruthenium red as a stimulant and/or initiator of endocytosis and the possible explanations for differences in ruthenium red uptake are discussed.

Taenia crassiceps: temperature, polycations, polyanions, and cysticercal endocytosis

The effect of various temperatures, poly-L-lysine, and poly-L-glutamic acid on endocytosis of smooth micropinocytotic vesicles (pinosomes) in the tegument of the cysticercus of Taenia crassiceps has been investigated stereologically. The temperature regimes used were 0, 5, 10, 20, 30, and 40 C. Maximum volume, surface density, and number per unit volume were found at 40 C, and minimum surface-to-volume ratio and numbers at 10 C. At 10 C, mean pinosome volume and mean surface area per pinosome were maximal, but volume and surface density did not differ significantly from 40 C. It is proposed that this anomalous finding for 10 C incubations was due to this being a critical temperature at which a slower rate of pinosome formation was compensated for by the formation of larger individual pinosomes. Poly-L-lysine was shown to be a stimulant of pinosome formation, leading to a significant increase in numbers per unit volume. However, volume and surface density, surface-to-volume ratio, mean volume, and mean surface area per pinosome were not significantly different in poly-L-lysine-incubated samples, when compared to controls (fresh from the mouse) or incubations in medium only or samples returned to medium after poly-L-lysine incubation, the only exception being surface to volume ratio and mean volume of pinosomes in the 75-min incubation. These anomalous results were explained by a marked reduction in the form ellipse values, which indicated the production of more elliptical-shaped pinosomes under poly-L-lysine stimulation. Incubation in poly-L-glutamine acid did not have any significant effect at any incubation time.

Duration of immunity and absorption of cysticerci in calves after treatment of Taenia saginata cysticercosis with praziquantel

Calves were first infected with 5000 Taenia saginata eggs at six to 10 weeks old and treated with praziquantel 12 weeks later. Complete immunity against challenge lasted for at least 12 weeks following anthelmintic treatment. Six months after drug treatment over 90 per cent of the cysticerci had been completely absorbed but some were still detectable especially in the heart. An increase was observed in the ELISA values of sera from infected calves following treatment with praziquantel, but no such rise was detected in sera from resistant calves after challenge infection.

Effect of flubendazole on Cysticercus cellulosae in pigs

The effect of flubendazole on Cysticercus cellulosae was tested in 15 pigs. In doses o 8.3 mg/kg body weight or more daily for 10 days the drug was lethal to the cysticerci, causing both macroscopic and microscopic morphological alterations. An in vitro test showed 0% viability of cysticerci in most of the treated pigs, whereas in 90-100% of 11 control pigs they were viable.

Scanning electron microscopic observations of Cysticercus fasciolaris (=Taenia taeniaeformis) after treatment of mice with mebendazole

The time-related topographical changes in mature cysticerci of Taenia taeniaformis induced after medication of infected mice with 250 ppm of mebendazole are described. The changes included the gradual disappearance of microtriches and progressive degeneration of the tegment resulting in an irregular surface with grooves, holes, and craterlike structures. Host cells adhered to the altered areas and the number of these cells increased when more severe changes became apparent. Finally the necrotized cysticerci, which lost their tegument completely, were almost entirely covered with adhesive host cells. A difference in the time sequence of the reported changes occurred between the scolex, the pseudoproglottids, and the bladder. This difference in susceptibility towards the drug between the three parts of the parasite in relation to the morphology of their microtrichous covering is discussed.

Morphological changes in cysticerci of Taenia taeniaeformis after mebendazole treatment

The progressive micromorphological changes in Taenia taeniaeformis cysticerci, induced by a single parenteral treatment of the infected mice with mebendazole, are described. The time-related alterations concerned the tegument and tegumental cells and were successively: disappearance of microtubules, accumulation of secretory substances in the Golgi areas, decrease in number to complete loss of microtriches, "ballooning" of all tegumental cells with subsequent burst, vacuolization and degeneration of the tegument, and finally necrosis of the pseudoproglottids. Similar but less pronounced injuries were seen in the scolices, although microtubules disappeared as early as in the pseudoproglottids. Microtubules from the host tissues remained intact. The meaning of the apparent primary interference of mebendazole with the microtubular system in relation to the subsequently observed death of the cysticercoids is discussed.