Praziquantel: its use in control of schistosomiasis in sub-Saharan Africa and current research needs

Treatment with praziquantel (PZQ) has become virtually the sole basis of schistosomiasis control in sub-Saharan Africa and elsewhere, and the drug is reviewed here in the context of the increasing rate that it is being used for this purpose. Attention is drawn to our relative lack of knowledge about the mechanisms of action of PZQ at the molecular level, the need for more work to be done on schistosome isolates that have been collected recently from endemic areas rather than those maintained in laboratory conditions for long periods, and our reliance for experimental work mainly on Schistosoma mansoni, little work having been done on S. haematobium. There is no evidence that resistance to PZQ has been induced in African schistosomes as a result of its large-scale use on that continent to date, but there is also no assurance that PZQ and/or schistosomes are in any way unique and that resistant organisms will not be selected as a result of widespread drug usage. The failure of PZQ to produce complete cures in populations given a routine treatment should therefore solicit considerable concern. With few alternatives to PZQ currently available and/or on the horizon, methods to monitor drug-susceptibility in African schistosomes need to be devised and used to help ensure that this drug remains effective for as long a time as possibl

Ca2+ signalling, voltage-gated Ca2+ channels and praziquantel in flatworm neuromusculature

Author Posting. © The Author, 2005. This is the author's version of the work. It is posted here by permission of Cambridge University Press for personal use, not for redistribution. The definitive version was published in Parasitology 131 (2005): S97-S108, doi:10.1017/S0031182005008346.Transient changes in calcium (Ca2+) levels regulate a wide variety of cellular processes, and cells employ both intracellular and extracellular sources of Ca2+ for signaling. Praziquantel, the drug of choice against schistosomiasis, disrupts Ca2+ homeostasis in adult worms. This review will focus on voltage-gated Ca2+ channels, which regulate levels of intracellular Ca2+ by coupling membrane depolarization to entry of extracellular Ca2+. Ca2+ channels are members of the ion channel superfamily and represent essential components of neurons, muscles, and other excitable cells. Ca2+ channels are membrane protein complexes in which the pore-forming α1 subunit is modulated by auxiliary subunits such as β and α2δ. Schistosomes express two Ca2+ channel β subunit subtypes: a conventional subtype similar to β subunits found in other vertebrates and invertebrates; and a novel variant subtype with unusual structural and functional properties. The variant schistosome β subunit confers praziquantel sensitivity to an otherwise praziquantel-insensitive mammalian Ca2+ channel, implicating it as a mediator of praziquantel action.RMG is supported by NIH grant #AI 40522, by the Woods Hole Center for Oceans and Human Health, and by the Neal Cornell Research Fund at the Marine Biological Laboratory

Praziquantel: its use in control of schistosomiasis in sub-Saharan Africa and current research needs

Treatment with praziquantel (PZQ) has become virtually the sole basis of schistosomiasis control in sub-Saharan Africa and elsewhere, and the drug is reviewed here in the context of the increasing rate that it is being used for this purpose. Attention is drawn to our relative lack of knowledge about the mechanisms of action of PZQ at the molecular level, the need for more work to be done on schistosome isolates that have been collected recently from endemic areas rather than those maintained in laboratory conditions for long periods, and our reliance for experimental work mainly on Schistosoma mansoni, little work having been done on S. haematobium. There is no evidence that resistance to PZQ has been induced in African schistosomes as a result of its large-scale use on that continent to date, but there is also no assurance that PZQ and/or schistosomes are in any way unique and that resistant organisms will not be selected as a result of widespread drug usage. The failure of PZQ to produce complete cures in populations given a routine treatment should therefore solicit considerable concern. With few alternatives to PZQ currently available and/or on the horizon, methods to monitor drug-susceptibility in African schistosomes need to be devised and used to help ensure that this drug remains effective for as long a time as possibl

Comparison of Microscopy and Alamar Blue Reduction in a Larval Based Assay for Schistosome Drug Screening

Only one drug, praziquantel, is widely available for treating schistosomiasis, a disease affecting an estimated 200 million people. Because of increasing usage there is concern about development of praziquantel drug resistance and a perceived need to develop new schistosomicides. Possible sources of these are large collections of compounds held by pharmaceutical companies and academic institutions. Anti-schistosome activity can be detected in vitro by visually assessing damage to cultured adult schistosome worms, but these are large and are recovered from mice which somewhat limits screening throughput. By contrast, schistosomula can be produced in vitro and used for screening in microwell plates, thus allowing medium throughput screening. High throughput screening (HTS) would require automated readout of schistosomulicidal action rather than manual microscopy. Here we report on the use of Alamar blue (AB), a fluorescent indicator of cell viability which can be measured rapidly and automatically. The AB assay was readily able to detect compounds causing death or severe damage to the larvae but was less reliable than microscopy for more subtle morphological changes including those induced by some known schistosome drugs. It is concluded that an automated HTS would benefit from integrated use of both AB and automatic image-based morphology assays

Neoadjuvant plus adjuvant combined or sequenced vemurafenib, cobimetinib and atezolizumab in patients with high-risk, resectable BRAF-mutated and wild-type melanoma: NEO-TIM, a phase II randomized non-comparative study

Background: Following the increased survival of patients with metastatic melanoma thanks to immunotherapy and targeted therapy, neoadjuvant approaches are being investigated to address the unmet needs of unresponsive and intolerant patients. We aim to investigate the efficacy of neoadjuvant plus adjuvant combined or sequenced vemurafenib, cobimetinib and atezolizumab in patients with high-risk, resectable BRAF-mutated and wild-type melanoma. Methods: The study is a phase II, open-label, randomized non-comparative trial in patients with stage IIIB/C/D surgically resectable, BRAF-mutated and wild-type melanoma, with three possible treatments: (1) vemurafenib 960 mg twice daily from day 1 to 42; (2) vemurafenib 720 mg twice daily from day 1 to 42; (3) cobimetinib 60 mg once daily from day 1 to 21 and from day 29 to 42; and (4) atezolizumab 840 mg for two cycles (day 22 and day 43). Patients will be randomized to three different arms: A) BRAF-mutated patients will receive over 6 weeks (1) + (3); B) BRAF-mutated patients will receive over 6 weeks (2) + (3) + (4); C) BRAF wild-type patients will receive over 6 weeks (3) + (4). All patients will also receive atezolizumab 1200 mg every 3 weeks for 17 cycles after surgery and after a second screening period (up to 6 weeks). Discussion: Neoadjuvant therapy for regional metastases may improve operability and outcomes and facilitate the identification of biomarkers that can guide further lines of treatment. Patients with clinical stage III melanoma may especially benefit from neoadjuvant treatment, as the outcomes of surgery alone are very poor. It is expected that the combination of neoadjuvant and adjuvant treatment may reduce the incidence of relapse and improve survival

Voltage-gated calcium channel subunits from platyhelminths : potential role in praziquantel action

Author Posting. © The Author(s), 2006. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in International Journal for Parasitology 36 (2006): 625-632, doi:10.1016/j.ijpara.2006.02.002.Voltage-gated calcium (Ca2+) channels provide the pathway for Ca2+ influxes that underlie Ca2+-dependent responses in muscles, nerves, and other excitable cells. They are also targets of a wide variety of drugs and toxins. Ca2+ channels are multisubunit protein complexes consisting of a pore-forming α1 subunit and other modulatory subunits, including the β subunit. Here, we review the structure and function of schistosome Ca2+ channel subunits, with particular emphasis on variant Ca2+ channel β subunits (Cavβvar) found in these parasites. In particular, we examine the role these β subunits may play in the action of praziquantel, the current drug of choice against schistosomiasis. We also present evidence that Cavβvar homologs are found in other praziquantel-sensitive platyhelminths such as the pork tapeworm, Taenia solium, and that these variant β subunits may thus represent a platyhelminth-specific gene family.This work was supported by PAPIIT grant IN-221702 to MCJ. RMG is supported by NIH grant AI 40522 and by the Neal Cornell Research Fund at the Marine Biological Laboratory

Equilibrium statistical mechanics on correlated random graphs

Biological and social networks have recently attracted enormous attention between physicists. Among several, two main aspects may be stressed: A non trivial topology of the graph describing the mutual interactions between agents exists and/or, typically, such interactions are essentially (weighted) imitative. Despite such aspects are widely accepted and empirically confirmed, the schemes currently exploited in order to generate the expected topology are based on a-priori assumptions and in most cases still implement constant intensities for links. Here we propose a simple shift in the definition of patterns in an Hopfield model to convert frustration into dilution: By varying the bias of the pattern distribution, the network topology -which is generated by the reciprocal affinities among agents - crosses various well known regimes (fully connected, linearly diverging connectivity, extreme dilution scenario, no network), coupled with small world properties, which, in this context, are emergent and no longer imposed a-priori. The model is investigated at first focusing on these topological properties of the emergent network, then its thermodynamics is analytically solved (at a replica symmetric level) by extending the double stochastic stability technique, and presented together with its fluctuation theory for a picture of criticality. At least at equilibrium, dilution simply decreases the strength of the coupling felt by the spins, but leaves the paramagnetic/ferromagnetic flavors unchanged. The main difference with respect to previous investigations and a naive picture is that within our approach replicas do not appear: instead of (multi)-overlaps as order parameters, we introduce a class of magnetizations on all the possible sub-graphs belonging to the main one investigated: As a consequence, for these objects a closure for a self-consistent relation is achieved.Comment: 30 pages, 4 figure

Electronic Commerce and Electronic Money - Co-operative efforts undertaken at the Bank for International Settlements (BIS)

The article describes the work undertaken by the BIS in 1998 and earlier on "electronic money". (Annotated text, based on a presentation made at the Conference "on "Trends in Electronic Commerce", Hamburg, Germany, 8th June 1998", published at the time at vsis-www.informatik.uni-hamburg.de; archive: http://archive.is/etri )