Iranian Hydatid Disease Registry: Establishment and Implementation of a Neglected Tropical Disease Registry.

BACKGROUND: Cystic echinococcosis (CE) or hydatid disease is a global public health concern which imposes considerable economic costs on the communities in endemic regions. CE surveillance data are not adequately reliable. The present study reports the development and outcomes of a CE registry in Iran. METHODS: Hydatid Registry (HydatidReg) was initially established as a single-center registry in 2014 after the ethical approval of KMU. Following a call from MoHME to promote registry of different diseases and health outcomes, a call for participation was announced and all the Iranian Universities of Medical Sciences were requested to contribute to the registry. Subsequently, a nation-wide registry of hydatid disease was established in 2016. With a global perspective, HydatidReg joined the European Register of Cystic Echinococcosis (ERCE). A data collection form based on minimum dataset was designed and standard operating procedures (SOPs) were prepared to ensure standardized patient enrolment in the registry. A biobank system with two-dimensional barcoding was established along with HydatidReg for management and organization of biological specimens. RESULTS: As of March 2021, a total of 690 patients were enrolled in the registry. HydatidReg registered 362 (17.3%) out of the total 2097 patients enrolled in ERCE. Quality control (QC) of the data demonstrated 91.2% completeness and 80% timeliness. In the biobank, 322 biological specimens from 184 CE patients have been deposited including 70 blood, 96 sera and 156 parasite materials. CONCLUSION: High-quality data in the HydatidReg registry provided opportunities for health professionals to improve quality of care and organize meaningful research.

In Vitro and In Vivo Antileishmanial Activities of Pistacia vera Essential Oil.

This study aims to evaluate the in vitro and in vivo antileishmanial activities of Pistacia vera essential oil and compare their efficacy with a reference drug, meglumine antimoniate (Glucantime®). This essential oil (0-100 µg/mL) was evaluated in vitro against the intracellular amastigote forms of Leishmania tropica (MHOM/IR/2002/Mash2) and then tested on cutaneous leishmaniasis of male BALB/c mice by Leishmania major (MRHO/IR/75/ER). In the in vitro assay, it could be observed that P. vera essential oil significantly (p < 0.05) inhibited the growth rate of amastigote forms (IC50 of 21.3 ± 2.1 µg/mL) in a dose-dependent response compared with the control drug. Meglumine antimoniate also demonstrated antileishmanial effects with an IC50 value of 44.6 ± 2.5 µg/mL for this clinical stage. In the in vivo assay, the results indicated that 30 mg/mL of the essential oil had potent suppression effects on cutaneous leishmaniasis in BALB/c mice (87.5% recovery), while 10 and 20 mg/mL of the essential oil represented the suppression effects as weak to intermediate. The mean diameter of the lesions decreased about 0.11 and 0.27 cm after the treatment of the subgroups with the essential oil concentrations of 10 and 20 mg/mL, respectively. In contrast, in the subgroup treated with the essential oil concentration of 30 mg/mL, the mean diameter of the lesions decreased about 0.56 cm. In the control subgroups, the mean diameter of the lesions increased to 1.01 cm. The main components of P. vera essential oil were limonene (26.21%), α-pinene (18.07%), and α-thujene (9.31%). It was also found that P. vera essential oil had no significant cytotoxic effect on J774 cells. The present study found that P. vera essential oil showed considerable in vitro and in vivo effectiveness against L. tropica and L. major compared to the reference drug. These findings also provided the scientific evidence that natural plants could be used in traditional medicine for the prevention and treatment of cutaneous leishmaniasis.

Chemical composition along with anti-leishmanial and cytotoxic activity of Zataria multiflora.

CONTEXT: Natural products and their compounds are some of the most interesting sources of new drugs. Reviews have reported various pharmacological properties such as antimicrobial effects of Zataria multiflora Boiss (Lamiaceae). OBJECTIVE: The present study investigates the chemical composition of Z. multiflora essential oil and evaluates its cytotoxic effects and anti-leishmanial activities against Leishmania tropica in an in vitro model. MATERIALS AND METHODS: The components of Z. multiflora oil were identified by gas chromatography/mass spectroscopy (GC/MS) analysis. Anti-leishmanial effects of the essential oil (0-100 µL/mL) and methanol extract of Z. multiflora (0-100 µg/mL) on promastigote forms as well as their cytotoxic activities against J774 cells were evaluated using MTT assay for 72 h. The leishmanicidal activity against amastigote forms of L. tropica was evaluated at the concentrations of 0-50 µg/mL in a macrophage model for 48 h. RESULTS: The chemical analyses demonstrated that the main components of essential oil were thymol (41.81%), carvacrol (28.85%), and p-cymene (8.36%). Regarding leishmanicidal activity, the IC50 values for the essential oil and methanol extract were 3.2 µL/mL and 9.8 µg/mL against promastigote forms and 8.3 µL/mL and 34.6 µg/mL against amastigote forms, respectively. Essential oil (CC50 89.3 µL/mL) indicated a higher cytotoxic effect than the methanol extract (CC50 591.6 µg/mL) of Z. multiflora. CONCLUSION: The present study revealed the chemical composition of Z. multiflora that might be a natural source of new anti-leishmanial agents in terms of use against cutaneous leishmaniasis.

Comparison of Scolicidal Effects of Amphotricin B, Silver Nanoparticles,_and Foeniculum vulgare Mill on Hydatid Cysts Protoscoleces.

BACKGROUND: Surgery is the preferred treatment for hydatid cyst (cystic echinococcosis, CE). At present, various scolicidal agents have been used for inactivation of protoscoleces during surgery, but they are associated with adverse side effects. The aim of the present study was to evaluate the scolicidal effects of amphotricin B, Silver nano particles, Foeniculum vulgare Mill, essential oil and hypertonic saline against protoscoleces of hydatid cyst on an in vitro model. METHODS: Protoscoleces were aseptically aspirated from the naturally infected livers of sheep and goats. Various concentrations of AmB (2.5-20 mg/ml), Ag-NPs (0.5-4 mg/ml), F. vulgare essential oil (0.125-1 mg/ml) and hypertonic saline (10-20%) were used for 5-60 min. Eosin exclusion test was used to determine the viability of protoscoleces. RESULTS: Maximum protoscolicidal effect of AmB and Ag-NPs was found at concentrations of 20 and 4 mg/mL, resulting in only 82.3% and 71.6% of the protoscoleces after 60 min of incubation, respectively. In contrast, F. vulgare essential oil at concentration of 1 mg/ml and hypertonic saline 20% killed 100% protoscoleces after 5 and 10 min of exposure, respectively. CONCLUSION: The results indicated weak scolicidal activity of AmB and Ag-NPs; whereas F. vulgare essential oil had potent scolicidal activity against protoscoleces of hydatid cyst that revealed the potential of F. vulgare as a natural source for the production of new scolicidal agent for use in hydatid cyst surgery. However, further studies will be needed to confirm these results by checking the essential oil and its active component in the in vivo model.

Protoscolecidal Effect of Berberis vulgaris Root Extract and Its Main Compound, Berberine in Cystic Echinococcosis.

BACKGROUND: Cystic echinococcosis (CE), a zoonotic parasitic infection caused by the metacestode (larvae) stage of dog tapeworm Echinococcus granulosus and recognized as a major economic and public health concern in the world. This study aimed to investigate the in vitro scolicidal effect of methanolic extract of Berberis vulgaris L. roots and its main compound, berberine against protoscoleces of hydatid cysts. METHODS: For this purpose, protoscoleces were aseptically aspirated from sheep livers having hydatid cysts. Various concentrations of the methanolic extract (0.25-2 mg/ml) and berberine (0.062- 0.5 mg/ml) were used for 5 to 30 min. Viability of protoscoleces was confirmed by eosin exclusive test. RESULTS: In the present study, all of the various concentrations of the B. vulgaris methanolic extract (0.25, 0.5, 1 and 2 mg/ml) and berberine (0.062, 0.125, 0.25 and 0.5 mg/ml) revealed significant (P<0.05) scolicidal effects against protoscoleces of E. granulosus in a dose-dependent manner. Both berberine and methanolic extract exhibited 100% inhibition against protoscoleces of E. granulosus at the concentration of 2.0 and 0.5 mg/ml after 10 min incubation, respectively. CONCLUSION: According to the results, both B. vulgaris methanolic extract and berberine alone demonstrated high scolicidal activities against protoscoleces of hydatid cysts in low concentration and short exposure time on in vitro model. However, in vivo efficacy of B. vulgaris and berberine also requires to be evaluated using an animal model with hydatid infection.