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甲氟喹,一种在实验研究中针对血吸虫和其他蠕虫的新型化合物。

Mefloquine, a new type of compound against schistosomes and other helminthes in experimental studies.

机构信息

National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, MOH, WHO Collaborating Centre for Malaria, Schistosomiasis, and Filariasis, Shanghai, 200025, People's Republic of China,

出版信息

Parasitol Res. 2013 Nov;112(11):3723-40. doi: 10.1007/s00436-013-3559-0. Epub 2013 Aug 27.

Abstract

Up to date, schistosomiasis is still prevalent worldwide. It is estimated that more than 200 million individuals are infected, and 120 million suffer from clinical morbidity. Facing such huge cases of schistosomiasis, only heavy reliance on a single praziquantel for schistosomiasis control does not adapt and may promote the selection and spread of drug-resistant parasites. Therefore, it is an urgent need to develop the new antischistosomal drug. In 2008-2009, the antimalarial drug mefloquine, an arylaminoalcohol compound, has been found to be effective against schistosomes. According to the experimental studies, the deepest impression on the antischistosomal properties of mefloquine can be summarized as following points: (1) single dose of mefloquine possesses potential effect against three major species of schistosomes (Schistosoma mansoni, Schistosoma haematobium, and Schistosoma japonicum) infecting humans; (2) the drug displays similar effects against developing stages of juvenile and adult schistosomes, which are superior to that of artemisinins and praziquantel; (3) in vitro mefloquine exerts direct killing effect on juvenile and adult schistosomes, while in vivo, the efficacy of the drug is independent to host immune response, (4) mefloquine causes extensive and severe morphological, histopathological, and ultrastructural damage to adult and juvenile schistosomes, particularly, the worm tegument, musculature, gut, and vitelline glands of female worms are the key sites attacked by the drug; (5) combined treatment with mefloquine and praziquantel, or artemisinins shows synergistic effect against schistosome in experimental therapy,while in initially clinical trial, mefloquine in combination with artesunate also exhibits higher cure rates against schistosomiasis hematobia and schistosomiasis mansoni, and (6) several mefloquine-related arylmethanols exhibit potential effect against schistosomes in vivo, which is a useful clue helpful for development of new antischistosomal compound. In the present review, we have summarized the major results published in recent years, and the significance as well as the prospect for the future study of mefloquine have been discussed briefly.

摘要

截至目前,血吸虫病仍在全球广泛流行。据估计,全球有超过 2 亿人感染血吸虫病,1.2 亿人患有临床疾病。面对如此庞大的血吸虫病病例,仅依赖于单一的吡喹酮进行血吸虫病控制是不适应的,并且可能会促进耐药寄生虫的选择和传播。因此,迫切需要开发新的抗血吸虫病药物。2008-2009 年,抗疟药物甲氟喹,一种芳基氨基醇化合物,被发现对血吸虫具有疗效。根据实验研究,甲氟喹的抗血吸虫特性给人留下的最深印象可以概括为以下几点:(1)单次剂量的甲氟喹对感染人类的三种主要血吸虫(曼氏血吸虫、埃及血吸虫和日本血吸虫)具有潜在的疗效;(2)该药物对发育中的幼体和成虫阶段的血吸虫具有相似的作用,优于青蒿素和吡喹酮;(3)在体外,甲氟喹对幼体和成虫血吸虫直接发挥杀伤作用,而在体内,药物的疗效独立于宿主免疫反应;(4)甲氟喹对成虫和幼体血吸虫造成广泛而严重的形态、组织病理学和超微结构损伤,特别是虫体的表皮、肌肉、肠道和雌性虫的卵黄腺是药物攻击的关键部位;(5)在实验治疗中,甲氟喹与吡喹酮或青蒿素联合治疗显示出协同作用,而在最初的临床试验中,甲氟喹与青蒿琥酯联合治疗埃及血吸虫病和曼氏血吸虫病也显示出更高的治愈率;(6)几种与甲氟喹相关的芳基甲醇在体内对血吸虫具有潜在疗效,这为开发新的抗血吸虫化合物提供了有用的线索。在本综述中,我们总结了近年来发表的主要结果,并简要讨论了甲氟喹的意义和未来研究前景。

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