Infectious and Tropical Diseases Group (e-INTRO), IBSAL-CIETUS (Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain.
Clinica Universidad de Navarra, Pamplona, Spain.
Sci Rep. 2021 Feb 24;11(1):4476. doi: 10.1038/s41598-021-84009-y.
Schistosoma mansoni is less susceptible to the antiparasitic drug ivermectin than other helminths. By inhibiting the P-glycoprotein or cytochrome P450 3A in mice host or parasites in a murine model, we aimed at increasing the sensitivity of S. mansoni to the drug and thus preventing infection. We assigned 124 BALB/c mice to no treatment, treatment with ivermectin only or a combination of ivermectin with either cobicistat or elacridar once daily for three days before infecting them with 150 S. mansoni cercariae each. The assignment was done by batches without an explicit randomization code. Toxicity was monitored. At eight weeks post-infection, mice were euthanized. We determined number of eggs in intestine and liver, adult worms in portal and mesenteric veins. Disease was assessed by counting granulomas/cm of liver and studying organ weight indices and total weight. IgG levels in serum were also considered. No difference between groups treated with ivermectin only or in combination with cobicistat or elacridar compared with untreated, infected controls. Most mice treated with ivermectin and elacridar suffered severe neurological toxicity. In conclusion, systemic treatment with ivermectin, even in the presence of pharmacological inhibition of P-glycoprotein or cytochrome P450 3A, did not result in effective prophylaxis for S. mansoni infection in an experimental murine model.
曼氏血吸虫比其他蠕虫对驱虫药伊维菌素的敏感性较低。通过抑制小鼠宿主中的 P 糖蛋白或细胞色素 P450 3A 或在小鼠模型中的寄生虫,我们旨在提高曼氏血吸虫对该药物的敏感性,从而预防感染。我们将 124 只 BALB/c 小鼠分配到未治疗、仅用伊维菌素治疗或伊维菌素联合考比司他或埃拉曲库林每日一次治疗三天,然后用 150 个曼氏血吸虫尾蚴感染每组。分配是分批进行的,没有明确的随机代码。监测了毒性。感染后 8 周,处死小鼠。我们确定了肠道和肝脏中的虫卵数量、门静脉和肠系膜静脉中的成虫数量。通过计数肝脏每厘米的肉芽肿、研究器官重量指数和总重量来评估疾病。还考虑了血清中的 IgG 水平。与未治疗、感染对照相比,仅用伊维菌素或与考比司他或埃拉曲库林联合治疗的组之间没有差异。大多数用伊维菌素和埃拉曲库林治疗的小鼠遭受严重的神经毒性。总之,即使在存在 P 糖蛋白或细胞色素 P450 3A 的药理抑制的情况下,全身用伊维菌素治疗也不能在实验性小鼠模型中有效预防曼氏血吸虫感染。