Sodium butyrate ameliorates Schistosoma japonicum-induced liver fibrosis by inhibiting HMGB1 expression.

Schistosomiasis is a prevalent zoonotic parasitic disease caused by schistosomes. Its main threat to human health is hepatic granuloma and fibrosis due to worm eggs. Praziquantel remains the first choice for the treatment of schistosomiasis but has limited benefit in treating liver fibrosis. Therefore, the need to develop effective drugs for treating schistosomiasis-induced hepatic fibrosis is urgent. High-mobility group box 1 protein (HMGB1) is a potential immune mediator that is highly associated with the development of some fibrotic diseases and may be involved in the liver pathology of schistosomiasis. We speculated that HMGB1 inhibitors could have an anti-fibrotic effect. Sodium butyrate (SB), a potent inhibitor of HMGB1, has shown anti-inflammatory activity in some animal disease models. In this study, we evaluated the effects of SB on a murine schistosomiasis model. Mice were percutaneously infected with 20 ± 2 cercariae of Schistosoma japonicum. SB (500 mg/kg/day) was administered every 3 days for the entire experiment period. The activity of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), liver histopathology, HMGB1 expression, and the levels of interferon gamma (IFN-γ), transforming growth factor-ß1 (TGF-ß1), and interleukin-6 (IL-6) in serum were analyzed. SB reduced hepatic granuloma and fibrosis of schistosomiasis, reflected by the decreased levels of ALT and AST in serum and the reduced expression of pro-inflammatory and fibrogenic cytokines (IFN-γ, TGF-ß1, and IL-6). The protective effect could be attributable to the inhibition of the expression of HMGB1 and release by SB.

Multiplex PCR for sexing Schistosoma japonicum cercariae and its utility.

Accurate discrimination of the Schistosoma japonicum cercariae gender is very important for establishing monosexual infection animal models and for standardizing the real intensity of infection. In this study, a multiplex PCR technique consisting of two pairs of primers, of which one amplifies a 185-bp band specific for the W chromosome and the other amplifies a 420-bp band for the Z chromosome, was established to sex the S. japonicum cercariae. For male cercariae (ZZ), a single 420-bp band is expected, and for female cercariea (ZW), two distinct 185-bp and 420-bp bands can be observed. There was no cross-reaction with S. mansoni, S. haematobium, Clonorchis sinensis, Paragonimus westermani, and Trichinella spiralis. After sexing the cercariae escaped from a single snail, mice in group A were infected with 60 male cercariae and mice of group B were infected with 40 female cercariae. Meanwhile, mice in group C were infected with 10 male and 10 female cercariae that were sexed by multiplex PCR. At 45 days postinfection, male and female adult worms were recovered to verify the accuracy of multiplex PCR for sexing S. japonicum cercariae and to calculate the male and female survival rate and paired worm ratio. Our results showed that the multiplex PCR technique could distinguish male cercariae with 100% accuracy. However, sometimes the discrimination results of multiplex PCR mis-scored mixed sexual cercariae as female cercariae. The mean male adult worm burden in mice of group C was 10.7 ± 2.4, and the mean female adult worm burden was 7.7 ± 2.5. There was a significant difference between the male worm burden and female worm burden in group C. The P value was 0.013. The real paired worm ratio of group C was 74.2% (95%CI 56.6~91.8%). These results demonstrated a male-biased sex ratio in the mice model with equilibrated sex ratio cercariae infection, as predicted by our multiplex PCR technique. In conclusion, our multiplex PCR technique is an effective tool for sexing S. japonicum cercariae, especially for distinguishing male cercariae, which is of great value for establishing monosexual cercariae infection mice models to harvest male adult worms for anti-schistosomal drug screening.

The ABL kinase inhibitor imatinib causes phenotypic changes and lethality in adult Schistosoma japonicum.

Schistosomiasis caused by different species of schistosome parasites is one of the most debilitating helminthic diseases of humans worldwide. For decades, chemotherapy is the main method of controlling schistosomiasis. However, the fear of drug resistance has motivated the search for alternatives. It has been demonstrated that the ABL kinase inhibitor imatinib affected the development and survival of Schistosoma mansoni in vitro; however, there is still lack of information on whether imatinib also affects other schistosome species such as Schistosoma japonicum. In the present study, the anti-schistosomal potency of imatinib on adult S. japonicum was investigated in vitro, and the results showed that imatinib had a significant impact on various physiological processes of S. japonicum adult worms. Besides its negative effects on worm motility, pairing stability, and gonad development, imatinib caused pathological changes in the gastrodermis as well as the death of the parasite. Our findings suggest that imatinib is an intriguing candidate for further development as an option to fight S. japonicum.

Praziquantel for the treatment of schistosomiasis during human pregnancy.

In 2014, an estimated 40 million women of reproductive age were infected with Schistosoma haematobium, S. japonicum and/or S. mansoni. In both 2003 and 2006, the World Health Organization (WHO) recommended that all schistosome-infected pregnant and breastfeeding women be offered treatment, with praziquantel, either individually or during treatment campaigns. In 2006, WHO also stated the need for randomized controlled trials to assess the safety and efficacy of such treatment. Some countries have yet to follow the recommendation on treatment and many programme managers and pregnant women in other countries remain reluctant to follow the recommended approach. Since 2006, two randomized controlled trials on the use of praziquantel during pregnancy have been conducted: one against S. mansoni in Uganda and the other against S. japonicum in the Philippines. In these trials, praziquantel treatment of pregnant women had no significant effect on birth weight, appeared safe and caused minimal side-effects that were similar to those seen in treated non-pregnant subjects. Having summarized the encouraging data, on efficacy, pharmacokinetics and safety, from these two trials and reviewed the safety data from non-interventional human studies, we recommend that all countries include pregnant women in praziquantel treatment campaigns. We identify the barriers to the treatment of pregnant women, in countries that already include such women in individual treatments and mass drug administration campaigns, and discuss ways to address these barriers.

En 2014, on estimait que 40 millions de femmes en âge de procréer étaient infectées par Schistosoma haematobium, S. japonicum et/ou S. mansoni. En 2003 et 2006, l'Organisation mondiale de la Santé (OMS) a recommandé qu'un traitement au praziquantel soit offert, individuellement ou dans le cadre de campagnes de traitement, à toutes les femmes enceintes et allaitantes infectées par le schistosome. En 2006, l'OMS a également affirmé la nécessité d'essais contrôlés randomisés pour évaluer l'innocuité et l'efficacité de ce traitement. Néanmoins, certains pays ne suivent toujours pas la recommandation relative au traitement et dans d'autres pays, bon nombre de gestionnaires de programme et de femmes enceintes demeurent réticents à suivre l'approche recommandée. Depuis 2006, deux essais contrôlés randomisés sur l'utilisation du praziquantel au cours de la grossesse ont été menés: l'un sur S. mansoni en Ouganda et l'autre sur S. japonicum aux Philippines. Dans le cadre de ces essais, le traitement au praziquantel des femmes enceintes n'a pas eu d'effet notable sur le poids à la naissance, s'est révélé sans danger et a provoqué des effets secondaires minimes, similaires à ceux constatés chez les femmes traitées qui n'étaient pas enceintes. Ayant résumé les données encourageantes sur l'efficacité, la pharmacocinétique et l'innocuité tirées de ces deux essais et examiné les données de sécurité provenant d'études non interventionnelles sur l'homme, nous recommandons que tous les pays incluent les femmes enceintes dans des campagnes de traitement au praziquantel. Nous mettons en évidence les obstacles qui empêchent le traitement des femmes enceintes ­ dans des pays les incluant déjà dans des traitements individuels et des campagnes d'administration massive de médicaments ­ et décrivons des moyens permettant de surmonter ces obstacles.

En 2014, se estima que 40 millones de mujeres en edad reproductiva estaban infectadas con Schistosoma haematobium, S. japonicum y/o S. mansoni. Tanto en 2003 como en 2006, la Organización Mundial de la Salud (OMS) recomendó que todas las mujeres embarazadas y lactantes infectadas con esquistosoma recibieran tratamiento, con praziquantel, ya fuera individualmente o durante las campañas de tratamiento. En 2006, la OMS también informó de la necesidad de ensayos aleatorizados controlados para evaluar la seguridad y la eficacia de dicho tratamiento. Algunos países todavía tienen que seguir la recomendación sobre el tratamiento y muchos gestores de programas y mujeres embarazadas en otros países siguen siendo reacios a seguir el enfoque recomendado. Desde 2006, se han llevado a cabo dos ensayos aleatorizados controlados sobre el uso de praziquantel durante el embarazo: uno contra el S. mansoni en Uganda y el otro contra el S. japonicum en Filipinas. En estos ensayos, el tratamiento con praziquantel en mujeres embarazadas no tuvo un efecto significativo sobre el peso en el momento del nacimiento, pareció seguro y causó efectos secundarios mínimos, similares a los observados en sujetos no embarazadas tratadas. Después de resumir los alentadores datos sobre la eficacia, la farmacocinética y la seguridad de estos dos ensayos y revisar los datos de seguridad de los estudios observacionales en humanos, recomendamos que todos los países incluyan a mujeres embarazadas en las campañas de tratamiento con praziquantel. Identificamos las barreras para el tratamiento de mujeres embarazadas, en países que ya incluyen a mujeres en los tratamientos individuales y en las campañas masivas de administración de medicamentos, y analizamos las formas de abordar estas barreras.

Sorafenib and praziquantel synergistically attenuate Schistosoma japonicum-induced liver fibrosis in mice.

Liver fibrosis is an important process that occurs in most types of chronic liver diseases and often results in the end stage of liver diseases, such as cirrhosis, portal hypertension, and hepatocellular carcinoma. Sorafenib, a multiple tyrosine kinase inhibitor, has been shown to inhibit liver fibrosis in multiple experimental fibrosis mouse and rat models. The aim of this study was to test the therapeutic effect of sorafenib on liver fibrosis induced by infection with a parasite, Schistosoma japonicum, in mice. Mice were percutaneously infected through the abdomen with Schistosoma cercariae to develop a schistosomula liver fibrosis model. Eight weeks after infection, infected mice were treated with the anti-parasitic agent praziquantel for 2 days and sorafenib for 2 weeks. Hepatic histopathological changes were assessed using hematoxylin and eosin (HE) and Masson's trichome staining. The hepatic expression levels of collagen I, collagen III, alpha-smooth muscle actin (α-SMA), platelet-derived growth factor (PDGF), and PDGF receptor-beta (PDGFR-ß) were analyzed by immunohistochemistry and western blot. Praziquantel administration alone but not sorafenib reduced liver fibrosis, and the combination of praziquantel and sorafenib significantly attenuated liver fibrosis in S. japonicum-infected mice. Moreover, sorafenib plus praziquantel markedly decreased the hepatic deposition of collagen and expression of fibrogenic genes in these mice. In conclusion, the use of sorafenib following praziquantel treatment may represent a potential therapeutic strategy for liver fibrosis induced by S. japonicum in patients.

Antischistosomal Properties of Hederacolchiside A1 Isolated from Pulsatilla chinensis.

Background: Schistosomiasis is a major neglected disease for which the current control strategy involves mass treatment with praziquantel, the only available drug. Hence, there is an urgent need to develop new antischistosomal compounds. Methods: The antischistosomal activity of hederacolchiside A1 (HSA) were determined by total or female worm burden reductions in mice harboring Schistosoma japonicum or S. mansoni. Pathology parameters were detected on HSA against 1-day-old S. japonicum-harboring mice. Moreover, we confirmed the antischistosomal effect of HSA on newly transformed schistosomula (NTS) of S. japonicum in vitro. Results: HSA, a natural product isolated from Pulsatilla chinensis (Bunge) Regel, was initially corroborated to possess promising antischistosomal properties. We demonstrated that HSA had high activity against S. japonicum and S. mansoni less in 11 days old parasites harbored in mice. The antischistosomal effect was even more than the currently used drugs, praziquantel, and artesunate. Furthermore, HSA could ameliorate the pathology parameters in mice harboring 1-day-old juvenile S. japonicum. We also confirmed that HSA-mediated antischistosomal activity is partly due to the morphological changes in the tegument system when NTS are exposed to HSA. Conclusions: HSA may have great potential to be an antischistosomal agent for further research.

Field evaluation of a novel molluscicide (niclosamidate) against Oncomelania hupensis, intermediate host of Schistosoma japonicum.

The molluscicidal activity of a novel molluscicide (niclosamidate) was evaluated in field trials against Oncomelania hupensis, the intermediate host of Schistosoma japonicum. The environmental safety of niclosamidate for local fishes was also studied under field conditions. The results showed that, at the dosages of 8.0 g/m2 and 4.0 g/m3, niclosamidate exhibits highly potent molluscicidal activity in the spraying and immersion trials, resulting in mortality rates of up to 81.8 and 72.7%, respectively. Its performance seems to be target-specific, with good molluscicidal ability observed for Oncomelania hupensis snails, but very low toxicity for local fishes and other aquatic organisms. The results suggest that niclosamidate can be used as an alternative molluscicide for snail control, which would be particularly applicable in semi-commercial or commercial aquaculture ponds.

Genistein improves schistosomiasis liver granuloma and fibrosis via dampening NF-kB signaling in mice.

In schistosomiasis, egg deposition in the liver contributes to the formation of hepatic granuloma and fibrosis, which are the most serious clinical pathological features. It has been proposed that activation of the nuclear factor kappa B (NF-κB) signaling pathways is closely associated with the development of hepatic granuloma and fibrosis. Genistein has been shown to inhibit the activity of NF-κB signaling pathways, which might be a potential agent to protect against Schistosoma japonicum egg-induced liver granuloma and fibrosis. In this study, liver granuloma and fibrosis were induced by infecting BALB/c mice with 18 ± 3 cercariae of S. japonicum. At the beginning of egg granuloma formation (early phase genistein treatment from 4 to 6 weeks after infection) or after the formation of liver fibrosis (late phase genistein treatment from 6 to 10 weeks after infection), the infected mice were injected with genistein (25, 50 mg/kg). The results revealed that genistein treatment significantly decreased the extent of hepatic granuloma and fibrosis in infected mice. The activity of NF-κB signaling declined sharply after the treatment with genistein, as evidenced by the inhibition of NF-κB-p65, phospho-NF-κB-p65, and phospo-IκB-α expressions, as well as the expression of IκB-α and the messenger RNA (mRNA) expression of inflammatory cytokines (MCP1, TNFα, IL1ß, IL4, IL10) mediated by NF-κB signaling pathways in the early phase of the infection. Moreover, western blot and immunohistochemistry assays demonstrated that the contents of α-smooth muscle actin (α-SMA) and transforming growth factor-ß were dramatically reduced in liver tissue under the treatment of genistein in the late phase of the infection. At the same time, the mRNA expression of MCP1, TNFα, and IL10 was inhibited markedly. These results provided evidence that genistein reduces S. japonicum egg-induced liver granuloma and fibrosis, at least partly due to decreased NF-κB signaling, and subsequently decreased MCP1, TNFα, and IL10 expressions. This implies that genistein can be a potential natural agent against schistosomiasis.

Antischistosomal activity of hederacochiside C against Schistosoma japonicum harbored in experimentally infected animals.

The present study was undertaken to investigate whether hederacochiside C (HSC) possesses antischistosomal effects and anti-inflammatory response activities in Schistosoma japonicum-infected mice. Different concentrations of HSC were administrated to the mice infected by schistosomula or adult worm by intravenous injection twice a day for five consecutive days. The total worm burden, female worm burden, and the egg burden in liver of mice treated with 400 mg/kg HSC were fewer than those in non-treated ones. Murine immune responses following HSC treatment were investigated using enzyme-linked immunosorbent assays (ELISA). Our results indicated that 200 mg/kg HSC could reduce the expression of IgG, tumor necrosis factor (TNF)-α, interleukin (IL)-4 and IL-17 in comparison to infected group, exhibiting best immunomodulatory effects. In addition, scanning electron microscopical examination revealed that male worms treated with HSC lost their normal surface architecture since its surface showed extensive swelling, erosion, and peeling in tegumental regions. Remarkable amelioration was noticed in histopathological investigations, and 200 mg/kg HSC treatment could reduce the size of granulomatous inflammatory infiltrations in the liver which was reflected in nearly normalization of liver architecture. These results suggested that HSC had potential antischistosomal activity and provided a basis for subsequent experimental.

Synthesis, Bioactivity Evaluation, and Toxicity Assessment of Novel Salicylanilide Ester Derivatives as Cercaricides against Schistosoma japonicum and Molluscicides against Oncomelania hupensis.

A series of novel salicylanilide ester derivatives were synthesized, characterized, and evaluated for cercaricidal potential against Schistosoma japonicum and molluscicidal potential against Oncomelania hupensis. Four derivatives exhibited remarkable cercaricidal activity superior to that of niclosamide. Among them, the most active compound, 4-chloro-2-((2-methoxy-4-nitrophenyl)carbamoyl)phenyl 4-methoxybenzoate (compound 4c), showed a marked minimum effective cercaricidal concentration as low as 0.43 µM and significant molluscicidal activity, with a 50% lethal concentration (LC50) of 0.206 g/m(2). Particularly, compound 4c displayed 88-fold decreased fish toxicity on Danio rerio and 44-fold reduced cytotoxicity on human kidney HEK293 cells in comparison with the toxicity of niclosamide. The results indicated that 4c could serve as a promising drug candidate, with environmental safety properties, against Schistosoma japonicum at transmission stages. The preliminary molecular mechanism of target compounds in Schistosoma japonicum cercariae was also investigated. Salicylanilide ester derivatives exhibited an inhibitory effect on nitric oxide synthase (NOS) but no effect on lactate dehydrogenase (LDH) and acetylcholinesterase (AChE), and a strong and significant correlation between NOS inhibitory efficacy and cercaricidal activity was observed. In addition, 4c could downregulate the expression of NOS in a dose-dependent manner. These results suggested that NOS was probably one of the drug targets of salicylanilide esters.

Antischistosomal activity of N,N'-arylurea analogs against Schistosoma japonicum.

Although the antischistosomal activities of N,N'-arylurea analogs were reported, systematic structure-activity relationships have not been conducted. In this Letter, we reported the design, synthesis and evaluation of 45 N,N'-arylurea analogs. Among these prepared compounds, 13 compounds were urea linker modified and 32 were N,N'-arylurea derivatives. The activity evaluation revealed 12 analogs exhibited IC50 values lower than 22.6µM, and 7 of them had IC50 less than 10µM against the juvenile Schistosoma japonicum in vitro. Their worm killing potency was even higher against adult worm. Unfortunately, low to moderate worm burden reduction of 0-33.4% was recorded after administration of a single oral dose of 200mg/kg or 400mg/kg to mice harboring S. japonicum.

Transcriptional responses of in vivo praziquantel exposure in schistosomes identifies a functional role for calcium signalling pathway member CamKII.

Treatment for clinical schistosomiasis has relied centrally on the broad spectrum anthelmintic praziquantel; however, there is limited information on its mode of action or the molecular response of the parasite. This paper presents a transcriptional and functional approach to defining the molecular responses of schistosomes to praziquantel. Differential gene expression in Schistosoma japonicum was investigated by transcriptome-wide microarray analysis of adult worms perfused from infected mice after 0.5 to 24 hours after oral administration of sub-lethal doses of praziquantel. Genes up-regulated initially in male parasites were associated with "Tegument/Muscle Repair" and "Lipid/Ion Regulation" functions and were followed by "Drug Resistance" and "Ion Regulation" associated genes. Prominent responses induced in female worms included up-regulation of "Ca(2+) Regulation" and "Drug Resistance" genes and later by transcripts of "Detoxification" and "Pathogen Defense" mechanisms. A subset of highly over-expressed genes, with putative drug resistance/detoxification roles or Ca(2+)-dependant/modulatory functions, were validated by qPCR. The leading candidate among these was CamKII, a putative calcium/calmodulin-dependent protein kinase type II delta chain. RNA interference was employed to knockdown CamKII in S. japonicum to determine the role of CamKII in the response to praziquantel. After partial-knockdown, schistosomes were analysed using IC50 concentrations (50% worm motility) and quantitative monitoring of parasite movement. When CamKII transcription was reduced by 50-69% in S. japonicum, the subsequent effect of an IC50 dosage of praziquantel was exacerbated, reducing motility from 47% to 27% in female worms and from 61% to 23% in males. These observations indicated that CamKII mitigates the effects of praziquantel, probably through stabilising Ca(2+) fluxes within parasite muscles and tegument. Together, these studies comprehensively charted transcriptional changes upon exposure to praziquantel and, notably, identified CamKII as potentially central to the, as yet undefined, mode of action of praziquantel.

Research and control of advanced schistosomiasis japonica in China.

Among the three main schistosomes (Schistosoma japonicum, Schistosoma mansoni, and Schistosoma haematobium) known to infect humans, S. japonicum causes the most serious pathological lesions. In China, only schistosomiasis japonica is transmitted. From the 1950s, massive epidemiological investigations and active control measures for schistosomiasis japonica have been carried out. At the early stage of schistosomiasis control program, there were about 12 million schistosomiasis patients, and about 5% of schistosomiasis patients belong to advanced patients, which was 600,000. After more than a half century of active schistosomiasis control work, the schistosomiasis situation has been reduced markedly. The nearest epidemiological investigation showed that, by the end of 2012, there were still 240,000 schistosomiasis patients with the descent rate of 98% and 30,000 advanced patients with the descent rate of 95%. This paper reviews the rich experiences of advanced schistosomiasis research and control in China, including that the epidemiology researches confirm there is a family aggregation of advanced schistosomiasis and advanced schistosomiasis patients have no significance to the schistosomiasis transmission in transmission-interrupted areas but still are an infection source in endemic areas; pathogenic mechanism researches verify that genetic factors and immunoregulation play important roles in the disease developing process; ultrasound image examinations are used not only in the diagnosis and differential diagnosis of advanced schistosomiasis but also in the guidance of treatment and evaluation of therapeutic effects and, furthermore, in the risk predictions of portal hypertension and upper gastrointestinal hemorrhage; clinical practices demonstrate that praziquantel can be used in most of advanced schistosomiasis patients, and the therapy not only can interrupt the schistosomiasis transmission somewhat but also is favorable for liver fibrosis improvement; the ascetic fluid concentration afflux is used in the therapy for obstinate ascites, and endoscopic varices ligation is used in the treatment of upper gastrointestinal bleeding, and both have good effects; hundreds and thousands of severe splenomegaly advanced schistosomiasis patients received splenectomy, and the long-term survival rate is more than 90%, most of them are basically cured from the disease and their labor force recovers, some dwarf patients begin growing and developing again, and some sterile women became fertile; the researches of traditional Chinese medicine in the treatment of liver fibrosis have made progress, such as Cordyceps sinensis showing some anti-fibrosis effect in the animal experiments and primary clinical trials; the animal experiments and epidemiological investigations indicate that schistosome infection is one of the carcinogenesis risk factors, especially for liver cancer. In conclusion, these experiences and lessons are plentiful and worth sharing with the peers of other endemic countries for reference.

Significance of higher drug concentration in erythrocytes of mice infected with Schistosoma japonicum and treated orally with mefloquine at single doses.

The purpose of the present study is to understand the pharmacokinetic feature of mefloquine measured by erythrocytes and plasma in Schistosoma japonicum (S. j.)-infected mice and non-infected mice after oral administration of the drug at single doses. A high-performance liquid chromatography (HPLC) method was used to measure the plasma and erythrocyte concentrations of mefloquine at varying intervals posttreatment. Our results demonstrated that in non-infected mice treated orally with mefloquine at an ineffective dose of 50 mg/kg or effective dose of 200 mg/kg for 2-72 h, the erythrocyte-to-plasma ratios of mefloquine were 5.8-11.2 or 2-14.2. On the other hand, in S. j.-infected mice treated with the same single doses of the drug, the erythrocyte and plasma drug concentration ratios were 3.1-4.6 or 2.9-8.5, manifesting that either in infected mice or in non-infected mice that received oral mefloquine resulted in higher concentration of mefloquine in erythrocytes than that in plasma. Unexpectedly, under oral administration of mefloquine at a higher single dose of 200 mg/kg, the pharmacokinetic parameter C max values for plasma from S. j.-infected and non-infected mice were 1.6 ± 0.3 and 2.0 ± 0.4 µg/mL, respectively, which were below the determined in vitro LC50 (50 % lethal concentration) value of 4.93 µg/mL. Therefore, the plasma concentration of mefloquine may display a little effect against schistosomes during the treatment. Although the values of T 1/2 and AUC0-∞ for erythrocytes were significantly longer and higher in infected mice than those of corresponding non-infect mice that received the same single mefloqine dose of 50 mg/kg, the C max value was only 2.6 ± 0.4 µg/mL lower than the determined in vitro LC50, which may explain why this low single dose is ineffective against schistosomes in vivo. After administration of higher mefloquine dose of 200 mg/kg, the C max value for erythrocytes in infected mice was 30 % (7.4 ± 0.7 versus 10.7 ± 2.7 µg/mL) lower than that in the corresponding non-infected mice, but its level was above the determined in vitro LC95 (95 % lethal concentration) value of 6.12 µg/mL. Meanwhile, longer T 1/2 value of 159.2 ± 129.3 h in infected mice led to significant increase in AUC0-∞ value (1969.3 ± 1057.7 vs 486.4 ± 53.0 µg/mL·h), relative to corresponding non-infected mice. In addition, the mean residence time (MRT0-∞) in infected mice was also significantly longer than that in non-infected mice. All these results may beneficial for the treatment. According to the results, we suggest that higher ratios of mefloquine concentration in erythrocytes to plasma may offer a way to transport mefloquine to the worm gut through ingestion of erythrocytes by the worms, where the gut is the site for displaying the effect by mefloquine.

Transdermal praziquantel administration attenuates hepatic granulomatosis in mice infected with Schistosoma japonicum.

Liver granuloma is a major pathogenic factor responsible for schistosomiasis, and no effective drugs or therapy methods to treat it have been found so far. Praziquantel (PZQ) has shown some anti-schistosomal effect, but little information is available about the effect of PZQ-prolonged administration on granuloma formation around schistosome eggs. Herein, we investigated the effect of PZQ on hepatic granuloma formation by treating the mice infected with Schistosoma japonicum using a long-term PZQ transdermal delivery. The results showed that the mean area of granulomas in the group treated with PZQ transdermal agent was (175.47 ± 116.73) × 10(3) µm(2) at the 49th day postinfection and (71.96 ± 45.99) × 10(3) µm(2) at the 56th day, while that in the control group was (304.51 ± 140.55) × 10(3) µm(2) and (526.44 ± 268.06) × 10(3) µm(2), respectively. The content of hydroxyproline in the livers of mice approached to the normal level on the 154th day in the treatment group, but it continued to increase from the 28th day to the 154th day after infection in the control group and nontreatment group. The ALT activity in serum of mice in the treatment group was also significantly lower than that in the control group (*P ≤ 0.05). Our results suggest that the long-term PZQ transdermal delivery is critical in the therapeutic approach to control the progress of hepatic schistosomiasis induced by egg granulomas.

Development of chiral praziquantel analogues as potential drug candidates with activity to juvenile Schistosoma japonicum.

A series of chiral praziquantel analogues were synthesized and evaluated against Schistosoma japonicum both in vitro and in vivo. All compounds exhibited low to considerable good activity in vivo. Remarkably, worm reduction rate of R-3 was 60.0% at a single oral dose of 200mg/kg against juvenile stage of Schistosoma japonicum. The target compounds displayed in vivo antischistosomal activity against both Schistosoma japonicum and Schistosoma mansoni. Furthermore, all R-isomers displayed stronger antischistosomal activity than S-isomers in vivo, indicating R-isomers were the active enantiomers, while S-isomers were less active ones. This structure activity relationship (SAR) could have important implications in further drug development for schistosomiasis.

Efficacy of artemether and artesunate in mice infected with praziquantel non-susceptible isolate of Schistosoma japonicum.

Praziquantel is currently the only drug of choice for the treatment of human Schistosoma japonicum infections, and praziquantel-based chemotherapy has been proved to be generally effective to control the morbidity and reduce the prevalence and intensity of S. japonicum infections. However, the potential emergence of praziquantel resistance in S. japonicum seriously threatens the elimination of this neglected tropical disease in China. The purpose of this study was designed, in mouse animals, to evaluate the in vivo efficacy of artemether and artesunate against praziquantel non-susceptible S. japonicum. Mice infected with a praziquantel non-susceptible isolate and a praziquantel-susceptible isolate of S. japonicum were treated with artemether and artesunate at a single oral dose of 300 mg/kg given once on each of days 7-8 and 35-36 post-infection to assess the efficacy against juvenile and adult worms. Administration with artemether and artesunate at a single oral dose of 300 mg/kg on each of days 7-8 post-infection resulted in total worm burden reductions of 72.8 and 73.5% in mice infected with praziquantel-susceptible S. japonicum, and 77.9 and 74.1% in mice infected with the non-susceptible isolate (both P values >0.05), while the same treatments given on days 35-36 post-infection reduced total worm burdens by 71.4 and 69.6% in mice infected with the susceptible isolate, and 75.3 and 69.6% in mice infected with the non-susceptible parasite (both P values >0.05). It is concluded that there is no evidence for reduced susceptibility of artemether and artesunate in praziquantel non-susceptible S. japonicum.

Is there a reduced sensitivity of dihydroartemisinin against praziquantel-resistant Schistosoma japonicum?

Praziquantel is currently the only drug of choice for the treatment of human schistosomiases. However, it has been proved that Schistosoma japonicum subjected to drug pressure may develop resistance to praziquantel. To evaluate the efficacy of dihydroartemisinin against praziquantel-resistant S. japonicum, mice infected with a praziquantel-resistant isolate and a praziquantel-susceptible isolate of S. japonicum were treated with dihydroartemisinin at a single oral dose of 300 mg/kg given once on each of 35-36 post-infection days, while infected but untreated mice served as controls. All mice were sacrificed 50 days post-infection, and the worm burden reductions were estimated. Administration of dihydroartemisinin at a single oral dose of 300 mg/kg on each of 35-36 post-infection days reduced total worm burdens of 69.8% and female worm burdens of 86% in mice infected with the praziquantel-susceptible isolate, and total worm burdens of 66.1% and female worm burdens of 85.1% in mice infected with the praziquantel-resistant isolate (both P values > 0.05). It is concluded that the sensitivity of artemisinin derivative dihydroartemisinin does not reduce in praziquantel-resistant S. japonicum.

Allograft inflammatory factor-1 alleviates liver disease of BALB/c mice infected with Schistosoma japonicum.

Allograft inflammatory factor-1 (AIF-1) plays an important role in various inflammatory conditions. Our previous study demonstrated that AIF-1 was over-expressed in the liver of BALB/c mice infected with Schistosoma japonicum and played significant role in the pathogenesis of schistosomiasis. The aim of this study was to focus on the effect of AIF-1 treatment on liver fibrosis and necrosis of BALB/c mice infected with S. japonicum. Seventy-two BALB/c mice were infected with cercariae of S. japonicum and then divided into three groups: AIF-1-treated group, saline-treated group, and control group. The vital signs, liver function, egg load, and hepatic pathological changes of the mice were assessed, and the levels of AIF-1 and TNF-α in the liver and spleen were measured at 5, 8, and 14 weeks postinfection. The treatment of AIF-1 on the mice infected with S. japonicum suppressed the expression of TNF-α and increased the effectiveness of AIF-1 in the liver and spleen at 14 weeks postinfection. Histopathological analysis and Masson trichrome staining for the liver tissues showed that the liver fibrosis and necrosis were alleviated previously compared with other infected mice at 14 weeks postinfection. The treatment of AIF-1 on the mice infected with S. japonicum can alleviate hepatic fibrosis and necrosis which indicate that AIF-1 use may prevent and cure the liver fibrosis.

[In vitro effect of photoactivated hypericin on anti-Schistosoma japonicum adult male worms].

OBJECTIVE: To investigate the in vitro effect of photoactivated hypericin on anti-Schistosoma japonicum adult male worms. METHODS: Kunming mice were infected with 60-80 Schistosoma japonicum single-sex cercariae. At 6 weeks post-infection, the mice were sacrificed and adult male worms of S. japonicum were collected. The worms were incubated in DMEM medium containing different concentrations of hypericin (0.1, 0.2, 0.5, 1.0, 1.5, 2.0, and 2.5 micromol/L) in the presence or absence of light. In photoactivated hypericin groups, after 6 h of dark incubation the worms were exposed to LED light irradiation (590 nm) for 30, 60, 90, and 120 min, respectively, and then cultured overnight in darkness (16h). In the next morning, the parasites were washed, resuspended in drug-free medium, and incubated in the dark for 48 h. These worms were observed with stereomicroscopy and scanning electron microscopy (SEM). RESULTS: Photoactivated hypericin showed the ability to kill Schistosoma japonicum in vitro. The death rate was 20% in 0.1 micromol/L photoactivated hypericin group under 30 min irradiation, and 100% in 2 micromol/L under 90 min irradiation and 2.5 micromol/L under 60 min irradiation, respectively. In blank control group, DMSO control group, and hypericin groups without light irradiation, worms were alive. After 60 min irradiation, the worms in 1.0, 2.5, 5.0 micromol/L photoactivated hypericin groups showed spastic paralysis characterized by reduced body length, pronounced tight curl, body stiffness, and complete cessation of movement. Surface tegumental damages of adult worms in 2.0 micromol/L photoactivated hypericin group for 60 min irradiation were observed under SEM, such as vacuole formation, erosion and peeling of the tegument, collapse of the sensory papillae, and even the normal structure disappeared completely. Both death rate and morphological damage of the worms treated by photoactivated hypericin were positively correlated with hypericin dose and light irradiation time. CONCLUSION: Photoactivated hypericin has anti-Schistosoma japonicum adult male worms effect in vitro.