Activity of tribendimidine and praziquantel combination therapy against the liver fluke Opisthorchis viverrini in vitro and in vivo

Opisthorchiasis, caused by the liver fluke Opisthorchis viverrini, a food-borne trematode, is an important public health problem; however, only a single drug, praziquantel is available. We investigated tribendimidine-praziquantel combinations against O. viverrini in vitro and in vivo. The IC50 values of 0.16μg/ml and 0.05μg/ml were determined for praziquantel and tribendimidine, respectively, against adult O. viverrini in vitro. When O. viverrini was exposed to both drugs simultaneously (using a drug ratio based on the IC50 (1:3.2)) a synergistic effect was calculated (combination index (CI) at the IC50=0.7). A similar result was observed when drug addition in vitro was spaced by the respective half-lives of the drugs (a CI of 0.78 at the IC50 for tribendimidine followed by praziquantel and a CI of 0.47 at the IC50 for praziquantel followed by tribendimidine). In vivo median-effect dose (ED50) values of 191mg/kg and 147mg/kg were calculated for praziquantel and tribendimidine, respectively. Low to moderate worm burden reductions (38-62%) were observed in O. viverrini infected hamsters when both drugs were administered simultaneously or on subsequent days, pointing to antagonistic effects in vivo. Further studies are necessary to understand the striking differences between the in vitro and in vivo observations using combinations of praziquantel and tribendimidine on O. viverrin

Prevalence of the Intestinal Flukes Haplorchis taichui and H. yokogawai in a Mountainous Area of Phongsaly Province, Lao PDR

Phongsaly Province, located in the northernmost area of Lao PDR, was previously suggested to be endemic for the liver fluke Opisthorchis viverrini infection. To confirm, or rule out, this suggestion, the Phonxay village in the Khoua District, Phongsaly Province, was selected for a survey. Ten volunteers (8 men and 2 women aged 31-57 years) who consumed raw freshwater fish and had gastrointestinal troubles were treated with a single dose of praziquantel (40 mg/kg) and pyrantel pamoate (10 mg/kg) and purged with magnesium sulfate to recover any worm parasites. Eight of the 10 volunteers expelled 1 or more species of trematodes, nematodes, or cestodes (worm positive rate; 80%). The worms were morphologically identified as H. taichui (861 worms from 8 people), H. yokogawai (59 from 6 people), Phaneropsolus bonnei (1 from 1 person), Trichostrongylus sp. (2 from 2 people), Ascaris lumbricoides (2 from 1 person), Enterobius vermicularis (11 from 3 people), and Taenia saginata (1 strobila with scolex from 1 person). The results indicate that the mountainous area of Phongsaly Province, Lao PDR, is not endemic for the liver fluke but endemic for intestinal flukes, in particular, Haplorchis taichui and H. yokogawai

Low Efficacy of Single-Dose Albendazole and Mebendazole against Hookworm and Effect on Concomitant Helminth Infection in Lao PDR

Parasitic worms remain a public health problem in developing countries. Regular deworming with the drugs albendazole and mebendazole is the current global control strategy. We assessed the efficacies of a single tablet of albendazole (400 mg) and mebendazole (500 mg) against hookworm in children of southern Lao PDR. From each child, two stool samples were examined for the presence and number of hookworm eggs. Two hundred children were found to be infected. They were randomly assigned to albendazole (n = 100) or mebendazole (n = 100) treatment. Three weeks later, another two stool samples were analyzed for hookworm eggs. Thirty-two children who were given albendazole had no hookworm eggs anymore in their stool, while only 15 children who received mebendazole were found egg-negative. The total number of hookworm eggs was reduced by 85.3% in the albendazole and 74.5% in the mebendazole group. About one third of the children who were co-infected with the Asian liver fluke Opisthorchis viverrini were cleared from this infection following albendazole treatment and about one forth in the mebendazole group. Concluding, both albendazole and mebendazole showed disappointingly low cure rates against hookworm, with albendazole performing somewhat better. The effect of these two drugs against O. viverrini should be studied in greater detail

Helminth and Intestinal Protozoa Infections, Multiparasitism and Risk Factors in Champasack Province, Lao People's Democratic Republic

Multiparsitism is a general public health concern in tropical countries, and is of particular importance in the Mekong River basin of Southeast Asia. Here, we report results obtained from an in-depth study of hepato-biliary and intestinal multiparasitism and associated risk factors in three settings of the most southern province of Lao People's Democratic Republic. Multiple species intestinal parasite infections were very common: more than 80% of the study participants harbored at least two and up to seven different intestinal parasites concurrently. Of particular concerns are the high prevalence of the liver fluke Opisthorchis viverrini (64.1%) and the moderate prevalence of the blood fluke Schistosoma mekongi (24.2%), as these fluke infections are responsible for severe hepato-biliary morbidity, including the bile duct cancer cholangiocarcinoma. Hookworm was the most common nematode infection (76.8%). We conclude that given the very high prevalence rates of parasite infections and the extent of multiparasitism, regular deworming is warranted and that this intervention should be coupled with health education and improved assess to clean water and adequate sanitation to consolidate morbidity control and ensure long-term sustainability

Metal encapsulation in zeolite particles: a rational design of zeolite-supported catalyst with maximum site activity

Zeolite-supported metal catalysts have been proven effective in many important catalytic reactions, such as hydrogenation, Fisher-Tropsch synthesis, automobile exhaust catalysis, selective catalytic reduction and many others. Despite the successful preparation of the catalyst through widely adopted methods, including ion exchange and impregnation, the metal dispersion over the zeolite is lack of control with high randomness. This renders the so-called “catalytic performance” an overall contribution from the metal sites located inside the zeolite micropores and those located on the external surface. This is exceptionally true for small to medium pore zeolites with typical free apertures of 0.3 – 0.6 nm (such as LTA and MFI). A more rational design of zeolite-supported metal catalysts is by encapsulating the metal nanoparticles or clusters within zeolite pores prior to the zeolite formation. Encapsulation of metals in zeolite prevents them from sintering and sulphur poisoning by cage confinement and molecular exclusion (via well-defined pore size and shape), respectively. This paper gives a new perspective on using metal clusters and nanoparticles as catalysts and the design of an effective zeolite-supported catalytic system

Dose-response relationships and tegumental surface alterations in Opisthorchis viverrini following treatment with mefloquine in vivo and in vitro

The treatment and control of opisthorchiasis relies on a single drug, praziquantel; hence, there is a need to develop novel opisthorchicidal drugs. We investigated the in vitro and in vivo activity of the antimalarial mefloquine against Opisthorchis viverrini. Hamsters infected with O. viverrini for 2 weeks (juvenile infections) and 4 weeks (adult infections) were treated orally with single 200-400-mg/kg oral mefloquine. Worm burden reductions were assessed against untreated control hamsters. Worms were incubated in the presence of 10 and 100 microg/ml mefloquine. Scanning electron microscopy was used to examine adult O. viverrini after recovery from hamsters and following in vitro incubation. A single oral dose of 300-mg/kg mefloquine resulted in worm burden reductions of 88.5% (juvenile infection) and 96.0% (adult infections), respectively. Incubation with 10 and 100 microg/ml mefloquine resulted in rapid death of O. viverrini. Extensive tegumental disruption such as blebbing, sloughing, and furrowing was seen on worms incubated in vitro and on flukes recovered 48 h posttreatment. In conclusion, we have documented promising opisthorchicidal activities in hamsters and in vitro with the tegument being an important drug target. Proof-of-concept studies with mefloquine could be considered in opisthorchiasis patient

Opisthorchis viverrini : efficacy and tegumental alterations following administration of tribendimidine in vivo and in vitro

The tegumental changes in adult Opisthorchis viverrini induced by tribendimidine were analyzed by scanning electron microscopy (SEM). We exposed O. viverrini to tribendimidine at a concentration of 10 mug/ml for 4 h. In addition, hamsters were treated with a single 400 mg/kg oral dose of tribendimidine and flukes were recovered from the bile ducts 24, 48, 72, and 96 h post-treatment. SEM analysis of the flukes incubated in vitro showed only mild damage of the tegument. Twenty-four hours post-treatment of hamsters, extensive disruption such as sloughing, furrowing, or blebbing of the tegument was evident, which did not increase in severity 48-72 h post-treatment. Ninety-six hours after tribendimidine administration, the majority of flukes had been expelled. A single 400 mg/kg oral dose of tribendimidine administered to O. viverrini-infected hamsters yielded a worm burden reduction of 63.0%. In conclusion, our experiments confirm that tribendimidine possesses interesting trematocidal properties, which warrant additional investigations and provide further data for subsequent clinical trials

Opisthorchis viverrini: Analysis of the sperm-specific rhophilin associated tail protein 1-like

Concurrent deficiency of rhophilin associated tail protein (ROPN1) and ROPN1-like (ROPN1L) in mice causes structural abnormalities and immotility of sperm and thereby infertility. In the present research, ROPN1L of the human liver fluke Opisthorchis viverrini was molecularly characterized and showed unexpected potential as a diagnostic tool. ROPN1L transcripts were detected in 2-week-old juveniles by RT-PCR. Immunohistochemical analysis of the adult worm localized the protein in testis lobes, seminal vesicle and receptacle and immunoelectron microscopic analysis revealed its location on the tail of spermatozoa. Interestingly, sera of experimentally infected hamsters and sera of individuals suffering from opisthorchiasis showed reactivity to recombinant OvROPN1L (rOvROPN1L). The protein shows modest conservation to the human homolog at 47.2% sequence identity and a mouse anti-rOvROPN1L antiserum was not reactive with sperm protein extracts from hamsters, mice and rats. Unsurprisingly, conservation is higher in trematodes, e.g. 78.4% and 71.2% identity to Fasciola gigantica and Schistosoma haematobium, respectively and evaluation of diagnostic specificity is required using sera of individuals suffering from different trematodiases in Thailand

Activity of tribendimidine and praziquantel combination therapy against the liver fluke Opisthorchis viverrini in vitro and in vivo

Opisthorchiasis, caused by the liver fluke Opisthorchis viverrini, a food-borne trematode, is an important public health problem; however, only a single drug, praziquantel is available. We investigated tribendimidine-praziquantel combinations against O. viverrini in vitro and in vivo. The IC50 values of 0.16 μg/ml and 0.05 μg/ml were determined for praziquantel and tribendimidine, respectively, against adult O. viverrini in vitro. When O. viverrini was exposed to both drugs simultaneously (using a drug ratio based on the IC50 (1:3.2)) a synergistic effect was calculated (combination index (CI) at the IC50= 0.7). A similar result was observed when drug addition in vitro was spaced by the respective half-lives of the drugs (a CI of 0.78 at the IC50 for tribendimidine followed by praziquantel and a CI of 0.47 at the IC50 for praziquantel followed by tribendimidine). In vivo median-effect dose (ED50) values of 191 mg/kg and 147 mg/kg were calculated for praziquantel and tribendimidine, respectively. Low to moderate worm burden reductions (38-62%) were observed in O. viverrini infected hamsters when both drugs were administered simultaneously or on subsequent days, pointing to antagonistic effects in vivo. Further studies are necessary to understand the striking differences between the in vitro and in vivo observations using combinations of praziquantel and tribendimidine on O. viverrini