Antimicrosporidial activity of (fluoro)quinolones in vitro and in vivo.

Microsporidia are a cause of emerging and opportunistic infections in humans and animals. Although two drugs are currently being used to treat microsporidiosis, concerns exist that albendazole is only selective for inhibiting some species of microsporidia that infect mammals, and fumagillin appears to have been found to be toxic. During a limited sequence survey of the Vittaforma corneae genome, a partial gene encoding for the ParC topoisomerase IV subunit was identified. The purpose of this set of studies was to determine if fluoroquinolones, which target topoisomerase IV, exert activity against Encephalitozoon intestinalis and V. corneae in vitro, and whether these compounds could prolong survival of V. corneae-infected athymic mice. Fifteen fluoroquinolones were tested. Of these, norfloxacin and ofloxacin inhibited E. intestinalis replication by more than 70% compared with non-treated control cultures, while gatifloxacin, lomefloxacin, moxifloxacin, and nalidixic acid (sodium salt) inhibited both E. intestinalis and V. corneae by at least 60% at concentrations not toxic to the host cells. These drugs were tested in vivo also, where gatifloxacin, lomefloxacin, norfloxacin, and ofloxacin prolonged survival of V. corneae-infected athymic mice (P < 0.05), whereas moxifloxacin and nalidixic acid failed to prolong survival. Therefore, these results support continued studies for evaluating the efficacy of the fluoroquinolones for treating microsporidiosis and for characterizing the target(s) of these fluoroquinolones in the microsporidia.

Antimicrosporidial activities of fumagillin, TNP-470, ovalicin, and ovalicin derivatives in vitro and in vivo.

Therapies for microsporidiosis in humans are limited, and fumagillin, which appears to be the most broadly effective antimicrosporidial drug, is considered to be moderately toxic. The purpose of this study was to apply an in vitro drug screening assay for Encephalitozoon intestinalis and Vittaforma corneae and an in vivo athymic mouse model of V. corneae infection to assess the efficacy of TNP-470 (a semisynthetic analogue of fumagillin), ovalicin, and eight ovalicin derivatives. TNP-470, ovalicin, and three of the ovalicin derivatives inhibited both E. intestinalis and V. corneae replication by more than 70% in vitro. Another three of the ovalicin derivatives inhibited one of the two microsporidian species by more than 70%. None of the treated athymic mice survived the V. corneae infection, but they did survive statistically significantly longer than the untreated controls after daily treatment with fumagillin administered at 5, 10, and 20 mg/kg of body weight subcutaneously (s.c.), TNP-470 administered at 20 mg/kg intraperitoneally (i.p.), or ovalicin administered at 5 mg/kg s.c. Of two ovalicin derivatives that were assessed in vivo, NSC 9665 given at 10 mg/kg i.p. daily also statistically significantly prolonged survival of the mice. No lesions associated with drug toxicity were observed in the kidneys or livers of uninfected mice treated with these drugs at the highest dose of 20 mg/kg daily. These results thus support continued studies to identify more effective fumagillin-related drugs for treating microsporidiosis.

Therapeutic strategies for human microsporidia infections.

Over the past 20 years, microsporidia have emerged as a cause of infectious diseases in AIDS patients, organ transplant recipients, children, travelers, contact lens wearers and the elderly. Enterocytozoon bieneusi and the Encephalitozoon spp., Encephalitozoon cuniculi, Encephalitozoon hellem and Encephalitozoon intestinalis, are the most frequently identified microsporidia in humans, and are associated with diarrhea and systemic disease. The microsporidia are small, single-celled, obligately intracellular parasites that have been identified in water sources, as well as in wild, domestic and food-producing farm animals, thereby raising concerns for waterborne, foodborne and zoonotic transmission. Current therapies for microsporidiosis include albendazole, a benzimidazole that inhibits microtubule assembly and is effective against several microsporidia, including the Encephalitozoon spp., although it is less effective against Encephalitozoon bieneusi. Fumagillin, an antibiotic and antiangiogenic compound produced by Aspergillus fumigatus, is more broadly effective against Encephalitozoon spp. and E. bieneusi; however, is toxic when administered systemically to mammals. Recent studies are also focusing on compounds that target the microsporidia polyamines (e.g., polyamine analogs), methionine aminopeptidase 2 (e.g., fumagillin-related compounds), chitin inhibitors (e.g., nikkomycins), topoisomerases (e.g., fluoroquinolones) and tubulin (e.g., benzimidazole-related compounds).

Microsporidia intestinales en pacientes viviendo con SIDA en Honduras / Intestinal microsporidiosis in patients with AIDS in Honduras

ANTECEDENTES: Organismos pertenecientes al grupo Microspora son conocidos mundialmente como agentes de enfermedad oportunista en pacientes viviendo con SIDA. OBJETIVOS: Investigar la presencia de especies de microsporidia y la coinfección con parásitos intestinales en pacientes viviendo con SIDA en Honduras. METODOLOGÍA: Se examinó una muestra de heces de cada uno de 56 pacientes viviendo con SIDA del Hospital Mario Catarino Rivas, San PedroSula, Honduras, de mayo a agosto 1999, por la técnica de reacción en cadena de la polimerasa (PCR) y por coloraciones histoquímicas con Calcofluor Blanco 2MR y tricromo modificado y por cuatro métodos adicionales de rutina investigando la coinfección con parásitos intestinales. RESULTADOS: Se identificó esporas de microsporidia en 25 (14/56) de pacientes, por coloraciones histoquímicas de heces. La técnica de PCR, más sensitiva, identificó 41.5 (22/53) de pacientes con infección por microsporidia. Diez resultaron Enterocytozoon bieneusi o especies de Encephalitozoon; uno resultó E. bieneusi, 6 fueron positivos para Encephalitozoon spp, y 7 pertenecían a especies no determinadas. Diez y nueve de 22 individuos (86.3) identificados con esporas de microsporidia tenían también parásitos intestinales: Isospora belli (30.4), Strongyloides stercoralis (21.4), Ascaris lumbricoides(17.1), Cryptosporidium spp. (16.1), Trichuris trichiura (14.3) y uncinaria (10.7). Quistes de Giardia lamblia, Entamoeba histolytica/E. dispar,ooquistes de Cyclospora cayetanensis y huevos de Hymenolepis nana se encontraron en menor porcentaje.CONCLUSIÓN: Este estudio permitió identificar por primera vez infecciones por microsporidia intestinales en personas viviendo con SIDA en Honduras, solas o en asociación con otras infecciones por nemátodos,céstodos y protozoos comunes y/u oportunistas...