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伊维菌素:为委内瑞拉的人道主义危机重新利用一种多用途药物。

Ivermectin: repurposing a multipurpose drug for Venezuela's humanitarian crisis.

机构信息

Infectious Diseases Division, Venezuelan Science Incubator and the Zoonosis and Emerging Pathogens Regional Collaborative Network, Instituto de Investigaciones Biomédicas IDB. Barquisimeto, Lara, Venezuela.

Global WASH, Houston, TX, USA.

出版信息

Int J Antimicrob Agents. 2020 Aug;56(2):106037. doi: 10.1016/j.ijantimicag.2020.106037. Epub 2020 May 29.

Abstract

Ivermectin (IVM) is a robust antiparasitic drug with an excellent tolerance and safety profile. Historically it has been the drug of choice for onchocerciasis and lymphatic filariasis global elimination programs. IVM is an oral insecticide and is a standard treatment against intestinal helminths and ectoparasites. The current humanitarian crisis in Venezuela is a regional public health threat that requires immediate action. The public health system in Venezuela has crumbled because of a 70% shortage of medicines in public hospitals, low vaccination campaigns, and the mass exodus of medical personnel. Herein we discuss the repurposing of IVM to attenuate the burden imposed by the most prevalent neglected tropical diseases (NTDs) in Venezuela, including soil-transmitted helminths, ectoparasites and, possibly, vector-borne diseases, such as malaria. In addition, novel experimental evidence has shown that IVM is active and efficacious in vitro against Chagas disease, Leishmaniases, arboviruses, and SARS-CoV-2. In crisis-hit Venezuela, all these infectious diseases are public health emergencies that have long been ignored and require immediate attention. The versatility of IVM could serve as a powerful tool to tackle the multiple overlapping endemic and emergent diseases that currently affect Venezuela. The repurposing of this multipurpose drug would be a timely therapeutic approach to help mitigate the tremendous burden of NTDs nationwide.

摘要

伊维菌素(IVM)是一种强大的抗寄生虫药物,具有极佳的耐受性和安全性。从历史上看,它一直是盘尾丝虫病和淋巴丝虫病全球消除规划的首选药物。IVM 是一种口服杀虫剂,是治疗肠道蠕虫和外寄生虫的标准药物。委内瑞拉目前的人道主义危机是对该地区公共卫生的威胁,需要立即采取行动。由于公立医院药品短缺 70%、疫苗接种率低以及医务人员大量外流,委内瑞拉的公共卫生系统已经崩溃。在此,我们讨论重新利用 IVM 来减轻委内瑞拉最常见的被忽视热带病(NTDs)的负担,包括土壤传播的蠕虫、外寄生虫,以及可能的蚊媒疾病,如疟疾。此外,新的实验证据表明,IVM 对恰加斯病、利什曼病、虫媒病毒和 SARS-CoV-2 在体外具有活性和疗效。在深受危机影响的委内瑞拉,所有这些传染病都是长期被忽视的公共卫生紧急事件,需要立即关注。IVM 的多功能性可以作为一种强大的工具,用于解决目前影响委内瑞拉的多种重叠的地方性和新发疾病。重新利用这种多用途药物将是一种及时的治疗方法,可以帮助减轻全国范围内 NTDs 的巨大负担。

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