Department of Medical Parasitology and Infection Biology, Basel, Switzerland.
Curr Opin Infect Dis. 2010 Oct;23(5):513-20. doi: 10.1097/QCO.0b013e32833de06a.
More than 40 million people are affected by food-borne trematode infections. Diagnosis is unsatisfactory and there are only two drugs available for treatment and control: praziquantel and triclabendazole. This review provides an update on recent developments in the diagnosis and treatment of food-borne trematodiases.
The trematocidal properties of tribendimidine and peroxidic drugs (e.g. artemisinins and synthetic trioxolanes) have been characterized, including in-vitro and in-vivo studies, elucidating structure-activity relationships and pharmacokinetics and their efficacies have been evaluated in large animal models. Tribendimidine achieved high worm burden reductions against Opisthorchis viverrini and Clonorchis sinensis harboured in rodents and the antimalarial drug mefloquine showed promising opisthorchicidal activity in vivo. Advances have been made with immunological and molecular diagnostics. Metabolic profiling investigations in rodents experimentally infected with Fasciola hepatica and Echinostoma caproni yielded parasite-specific candidate biomarkers, which might give rise to novel diagnostic targets. The FLOTAC technique showed a higher sensitivity and efficiency for detecting F. hepatica eggs in rat faecal samples than the sedimentation method.
Progress has been registered with trematocidal drug candidates that need to be studied in greater detail preclinically, with the most promising ones progressing into proof-of-concept trials. Drug development research should go hand-in-hand with innovation and application into new and improved diagnostic tools.
超过 4000 万人受到食源性吸虫感染。诊断效果并不理想，目前仅有两种药物可用于治疗和控制：吡喹酮和三氯苯达唑。本综述介绍了食源性吸虫病诊断和治疗的最新进展。
曲贝替定和过氧代药物（例如青蒿素和合成三噁烷）的杀吸虫特性已被描述，包括体外和体内研究，阐明了结构-活性关系和药代动力学，并且在大型动物模型中评估了它们的疗效。曲贝替定对啮齿动物体内携带的华支睾吸虫和麝猫后睾吸虫的虫负荷有很高的降低作用，抗疟药甲氟喹在体内显示出有前途的麝猫杀吸虫活性。免疫和分子诊断方面也取得了进展。对感染有肝片吸虫和棘口吸虫的啮齿动物进行代谢组学研究，产生了寄生虫特异性候选生物标志物，这些标志物可能为新的诊断靶点提供依据。FLOTAC 技术在检测大鼠粪便样本中的肝片形吸虫卵的敏感性和效率方面优于沉淀法。
在杀吸虫候选药物方面取得了进展，这些药物需要在临床前进行更详细的研究，最有前途的药物将进入概念验证试验。药物开发研究应与创新和应用新的和改进的诊断工具齐头并进。
