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The Korean Journal of Parasitology Jun 2021The use of albendazole and mebendazole, i.e., benzimidazole broad-spectrum anthelmintics, in treatment of parasitic infections, as well as cancers, is briefly reviewed.... (Review)
Review
The use of albendazole and mebendazole, i.e., benzimidazole broad-spectrum anthelmintics, in treatment of parasitic infections, as well as cancers, is briefly reviewed. These drugs are known to block the microtubule systems of parasites and mammalian cells leading to inhibition of glucose uptake and transport and finally cell death. Eventually they exhibit ovicidal, larvicidal, and vermicidal effects on parasites, and tumoricidal effects on hosts. Albendazole and mebendazole are most frequently prescribed for treatment of intestinal nematode infections (ascariasis, hookworm infections, trichuriasis, strongyloidiasis, and enterobiasis) and can also be used for intestinal tapeworm infections (taeniases and hymenolepiasis). However, these drugs also exhibit considerable therapeutic effects against tissue nematode/cestode infections (visceral, ocular, neural, and cutaneous larva migrans, anisakiasis, trichinosis, hepatic and intestinal capillariasis, angiostrongyliasis, gnathostomiasis, gongylonemiasis, thelaziasis, dracunculiasis, cerebral and subcutaneous cysticercosis, and echinococcosis). Albendazole is also used for treatment of filarial infections (lymphatic filariasis, onchocerciasis, loiasis, mansonellosis, and dirofilariasis) alone or in combination with other drugs, such as ivermectin or diethylcarbamazine. Albendazole was tried even for treatment of trematode (fascioliasis, clonorchiasis, opisthorchiasis, and intestinal fluke infections) and protozoan infections (giardiasis, vaginal trichomoniasis, cryptosporidiosis, and microsporidiosis). These drugs are generally safe with few side effects; however, when they are used for prolonged time (>14-28 days) or even only 1 time, liver toxicity and other side reactions may occur. In hookworms, Trichuris trichiura, possibly Ascaris lumbricoides, Wuchereria bancrofti, and Giardia sp., there are emerging issues of drug resistance. It is of particular note that albendazole and mebendazole have been repositioned as promising anti-cancer drugs. These drugs have been shown to be active in vitro and in vivo (animals) against liver, lung, ovary, prostate, colorectal, breast, head and neck cancers, and melanoma. Two clinical reports for albendazole and 2 case reports for mebendazole have revealed promising effects of these drugs in human patients having variable types of cancers. However, because of the toxicity of albendazole, for example, neutropenia due to myelosuppression, if high doses are used for a prolonged time, mebendazole is currently more popularly used than albendazole in anti-cancer clinical trials.
Topics: Albendazole; Animals; Anthelmintics; Antineoplastic Agents; Ascariasis; Female; Humans; Male; Mebendazole; Parasites; Trichuriasis
PubMed: 34218593
DOI: 10.3347/kjp.2021.59.3.189 -
Tropical Medicine and Infectious Disease Nov 2022Intestinal parasitic infections are common infectious diseases causing many health problems and impaired growth and physical development.. Children under five years old... (Review)
Review
Intestinal parasitic infections are common infectious diseases causing many health problems and impaired growth and physical development.. Children under five years old are the most vulnerable to infections, due to their immature immunity and feeding and exploratory behaviours. This systematic review aimed to assess the relationship between intestinal parasitic infections and undernutrition among children under 5 years old. Fifteen studies met the inclusion and exclusion criteria and were classified as high-quality studies. Twelve parasites were reported, including , spp., , , , hookworm, , , spp. and . Ascariasis is the most reported infection, with a prevalence ranging from 10.77% in Ethiopia to 57.14% in Malaysia, and is correlated with stunting (OR 2.17 (95% CI 1.14, 4.13), = 0.02). Giardiasis is the second most reported infection, with a prevalence ranging from 4.43% in Ethiopia to 66.33% in the Central African Republic, and is related to an increased risk of stunting (OR 2.34 (95% CI 1.07, 5.10), = 0.03)), wasting (OR 2.90 (95% CI 1.12, 7.49, = 0.03)), and being underweight (OR 1.53 (95% CI 1.02, 2.29, = 0.04)). The third and fourth most prevalent infections are and hookworm infections. Intestinal parasitic infections can occur very early in life and cause significant growth retardation. It is important to understand the prevalence and effects of infection based on the parasite species in order to implement therapeutic interventions and prevention controls.
PubMed: 36422922
DOI: 10.3390/tropicalmed7110371 -
The New England Journal of Medicine May 2023Current treatments for soil-transmitted helminth infections in humans have low efficacy against . Emodepside - a drug in veterinary use and under development for the... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
Current treatments for soil-transmitted helminth infections in humans have low efficacy against . Emodepside - a drug in veterinary use and under development for the treatment of onchocerciasis in humans - is a leading therapeutic candidate for soil-transmitted helminth infection.
METHODS
We conducted two phase 2a, dose-ranging, randomized, controlled trials to evaluate the efficacy and safety of emodepside against and hookworm infections. We randomly assigned, in equal numbers, adults 18 to 45 years of age in whom or hookworm eggs had been detected in stool samples to receive emodepside, at a single oral dose of 5, 10, 15, 20, 25, or 30 mg; albendazole, at a single oral dose of 400 mg; or placebo. The primary outcome was the percentage of participants who were cured of or hookworm infection (the cure rate) with emodepside 14 to 21 days after treatment, determined with the use of the Kato-Katz thick-smear technique. Safety was assessed 3, 24, and 48 hours after the receipt of treatment or placebo.
RESULTS
A total of 266 persons were enrolled in the trial and 176 in the hookworm trial. The predicted cure rate against in the 5-mg emodepside group (85% [95% confidence interval {CI}, 69 to 93]; 25 of 30 participants) was higher than the predicted cure rate in the placebo group (10% [95% CI, 3 to 26]; 3 of 31 participants) and the observed cure rate in the albendazole group (17% [95% CI, 6 to 35]; 5 of 30 participants). A dose-dependent relationship was shown in participants with hookworm: the observed cure rate was 32% (95% CI, 13 to 57; 6 of 19 participants) in the 5-mg emodepside group and 95% (95% CI, 74 to 99.9; 18 of 19 participants) in the 30-mg emodepside group; the observed cure rates were 14% (95% CI, 3 to 36; 3 of 21 participants) in the placebo group and 70% (95% CI, 46 to 88; 14 of 20 participants) in the albendazole group. In the emodepside groups, headache, blurred vision, and dizziness were the most commonly reported adverse events 3 and 24 hours after treatment; the incidence of events generally increased in a dose-dependent fashion. Most adverse events were mild in severity and were self-limited; there were few moderate and no serious adverse events.
CONCLUSIONS
Emodepside showed activity against and hookworm infections. (Funded by the European Research Council; ClinicalTrials.gov number, NCT05017194.).
Topics: Adult; Animals; Humans; Albendazole; Feces; Hookworm Infections; Soil; Trichuriasis; Trichuris; Depsipeptides; Antinematodal Agents; Young Adult; Middle Aged; Administration, Oral; Dose-Response Relationship, Drug
PubMed: 37195942
DOI: 10.1056/NEJMoa2212825 -
Clinical Laboratory Apr 2024Cutaneous larva migrans (CLM) is a helminthic infection found in tropical areas. It is commonly seen in patients in contact with soil contaminated by cat and dog...
BACKGROUND
Cutaneous larva migrans (CLM) is a helminthic infection found in tropical areas. It is commonly seen in patients in contact with soil contaminated by cat and dog hookworm larvae. CLM manifests as an erythematous, serpiginous, and pruritic cutaneous eruption. We present a case of a 27-year-old female with a serpiginous lesion on the plantar surface of the right foot.
METHODS AND RESULTS
The patient was prescribed Albendazole at 400 mg twice a day for three days. After treatment, the lesion and pruritus have decreased in severity.
CONCLUSIONS
Hookworm-related CLM is diagnosed clinically based on the typical clinical presentation. Clinicians need to be aware of the possibility of hookworm-related CLM with a history of travel to tropical areas, especially walking barefoot.
Topics: Female; Dogs; Humans; Animals; Cats; Adult; Larva Migrans; Albendazole; Travel; Catalase
PubMed: 38623662
DOI: 10.7754/Clin.Lab.2023.231008 -
The Journal of Allergy and Clinical... Dec 2021Hookworms are hematophagous nematode parasites that have infected a billion people worldwide. Anthelmintic drugs have limited efficacy and do not prevent reinfection.... (Review)
Review
Hookworms are hematophagous nematode parasites that have infected a billion people worldwide. Anthelmintic drugs have limited efficacy and do not prevent reinfection. Therefore, prophylactic vaccines are in high demand. Whole parasite vaccines are allergic and unsafe; thus, research into subunit vaccines has been warranted. A comprehensive overview of protein or peptide subunit vaccines' safety, protective efficacy, and associated immune responses is provided herein. The differences between the immune responses against hookworm infection by patients from epidemic versus nonepidemic areas are discussed in detail. Moreover, the different immunologic mechanisms of protection are discussed, including those that rely on allergic and nonallergic humoral and antibody-dependent cellular responses. The allergic and autoimmune potential of hookworm antigens is also explored, as are the immunoregulatory responses induced by the hookworm secretome. The potential of oral mucosal immunizations has been overlooked. Oral immunity against hookworms is a long-lived and safer immune response that is associated with elimination of infection and protective against reinfections. However, the harsh conditions of the gastrointestinal environment necessitates special oral delivery systems to unlock vaccines' protective potential. The potential for development of safer and more effective peptide- and protein-based anthelmintic vaccines is explored herein.
Topics: Ancylostomatoidea; Animals; Antigens, Helminth; Hookworm Infections; Humans; Immunity, Mucosal; Intestines; Necatoriasis; Vaccines; Vaccines, Subunit
PubMed: 34872650
DOI: 10.1016/j.jaci.2021.10.013 -
Parasitology International Apr 2020Helminth diseases are the ancient scourges of humans and their damages are 'silent and insidious'. Of the helminth infections, schistosomiasis and hookworm infection... (Review)
Review
Helminth diseases are the ancient scourges of humans and their damages are 'silent and insidious'. Of the helminth infections, schistosomiasis and hookworm infection have a great impact. This review covers information regarding vaccine candidates against schistosomiasis and hookworms that reached at least up to the phase-1 trial and literatures regarding other vaccine candidates have been excluded. For clinical manifestations, all available literatures were included, and for epidemiology and global burden of the diseases (GBD), literatures only within 2000-2019 were included. Literatures were searched surfing various databases including PubMED, Google Scholar, and Science Direct and overall over 150 literatures were identified. Globally ~250 million people are suffering from schistosomiasis, resulting 1430 thousand DALY (disability adjusted life year) per year. On the other hand, about 1.3 billion people are infected with hookworm (HW), and according to WHO, ~878 million school-age children (SAC) are at risk. HW is estimated to cause 65,000 deaths annually, accounts for 845 thousand DALYs as well as to cause 6-35.3% loss in productivity. Despite tremendous efforts, very few anthelmintic vaccine candidates such as Na-GST-1, Na-APR-1 and Na-ASP-2 against HW, and Sm28GST/Sh28GST, Sm-p80, Sm14 and Sm-TSP-1/SmTSP-2 against schistosomiasis reached up to the clinical trials. More efforts are needed to achieve the WHO targets taken against the maladies.
Topics: Cost of Illness; Hookworm Infections; Humans; Schistosomiasis; Vaccines
PubMed: 31911156
DOI: 10.1016/j.parint.2020.102051 -
Trends in Parasitology Sep 2021
Review
Topics: Ancylostoma; Ancylostomiasis; Animals; Humans; Life Cycle Stages
PubMed: 34049804
DOI: 10.1016/j.pt.2021.04.013