Abstract
Schistosomiasis is a major neglected tropical disease. Control of schistosomiasis currently relies on a single drug, praziquantel, and despite its efficacy against the all schistosome species that parasitize humans, it displays some problematic drawbacks and alone is ineffective in counteracting adverse pathologies associated with infection. Moreover, due to the development of the potential emergence of PZQ-resistant strains, the search for additional or alternative antischistosomal drugs have become a public health priority. The current drug discovery for schistosomiasis has been slow and uninspiring. By contrast, repurposing of existing approved drugs may offer a safe, rapid and cost-effective alternative. Combined treatment with PZQ and other drugs with different mode of action, i.e., antimalarials, shows promise results. In addition, a combination of anthelminthic drugs with antioxidant might be advantageous for modulating oxidative processes associated with schistosomiasis. Herein, we review studies dealing with combination therapies that involve PZQ and other anthelminthic drugs and/or antioxidant agents in treatment of schistosomiasis. Whereas PZQ combined with antioxidant agents might or might not interfere with anthelminthic efficacy, combinations may nonetheless ameliorate tissue damage and infection-associated complications. In fact, alone or combine with other drugs, antioxidants might be a valuable adjuvant to reduce morbidity and mortality of schistosomiasis. Therefore, attempting new combinations of anthelmintic drugs with other biomolecules such as antioxidants provides new avenues for discovery of alternatives to PZQ.
Highlights
The Tropical Diseases Research arm of the World Health Organization classifies schistosomiasis as one of the major neglected tropical diseases
Infection with S. haematobium is classified as a group I carcinogen; urogenital schistosomiasis (UGS) often leads to squamous cell carcinoma of the bladder [12]
Botros et al [107] investigate the possible use of adamantylamide dipeptide (AdDP) (Figure 4) as adjuvant therapy to PZQ in mice infected with PZQ-insusceptible and susceptible S. mansoni isolate in a trial to increase the susceptibility of this isolate to the drug
Summary
The Tropical Diseases Research arm of the World Health Organization classifies schistosomiasis as one of the major neglected tropical diseases It is considered the most important of the helminthoses of humanity in terms of mortality and morbidity [1,2]. Control strategies employ approaches to block transmission and reduce the disease burden including mass and targeted chemotherapy, and absence of safe water and sanitation facilities, modification of the environment, and use of molluscides [3]. The goal of these approaches includes mitigating the burden of disease, by reducing morbidity [16] at both the individual and community levels [17]. Combination treatments with PZQ and other anthelminthic drugs as well as administration of antioxidant agents alone or as adjuvant in treatment of schistosomiasis are addressed and reviewed
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