Treatment Of Amebiasis Research Articles

Real-time analysis of gut flora in Entamoeba histolytica infected patients of Northern India

BackgroundAmebic dysentery is caused by the protozoan parasite Entamoeba histolytica and the ingestion of quadrinucleate cyst of E. histolytica from fecally contaminated food or water initiates infection. Excystation occurs in the lumen of small intestine, where motile and potentially invasive trophozoites germinate from cysts. The ability of trophozoites to interact and digest gut bacteria is apparently important for multiplication of the parasite and its pathogenicity; however the contribution of resident bacterial flora is not well understood. We quantified the population of Bacteroides, Bifidobacterium, Ruminococcus, Lactobacillus, Clostridium leptum subgroup, Clostridium coccoides subgroup, Eubacterium, Campylobacter, Methanobrevibacter smithii and Sulphur reducing bacteria using genus specific primers in healthy (N = 22) vs amebic patients (E. histolytica positive, N = 17) stool samples by Real-time PCR.ResultsAbsolute quantification of Bacteroides (p = .001), Closrtridium coccoides subgroup (p = 0.002), Clostridium leptum subgroup (p = 0.0001), Lactobacillus (p = 0.037), Campylobacter (p = 0.0014) and Eubacterium (p = 0.038) show significant drop in their population however, significant increase in Bifdobacterium (p = 0.009) was observed where as the population of Ruminococcus (p = 0.33) remained unaltered in healthy vs amebic patients (E. histolytica positive). We also report high prevalence of nimE gene in stool samples of both healthy volunteers and amebic patients. No significant decrease in nimE gene copy number was observed before and after the treatment with antiamebic drug.ConclusionsOur results show significant alteration in predominant gut bacteria in E. histolytica infected individuals. The frequent episodes of intestinal amoebic dysentery thus result in depletion of few predominant genera in gut that may lead to poor digestion and absorption of food in intestine. It further disturbs the homeostasis between gut epithelium and bacterial flora. The decrease in beneficial bacterial population gives way to dysbiosis of gut bacteria which may contribute to final outcome of the disease. Increase in the copy number of nimE gene harboring bacteria in our population reflects possible decrease in the availability of metronidazole drug during treatment of amoebiasis.

ANTIDIABETIC EFFICACY OF ETHANOLIC EXTRACT OF HOLARRHENA ANTIDYSENTERICA SEEDS IN STREPTOZOTOCIN – INDUCED DIABETIC RATS AND IT’S INFLUENCE ON CERTAIN BIOCHEMICAL PARAMETERS

ABSTRACT Holarrhena antidysenterica commonly known as kurci, kurchi or kutaj is being used from ancient time in the treatment of amoebiasis, chronic bronchitis, diabetes and locally for boils and ulcers. Present study was designed to evaluate the hypoglycemic effect of ethanolic extract of its seeds in streptozotocin – induced diabetic rats and its effect on serum cholesterol, triglyceride, aspartate transaminase (AST), alanine transaminase (ALT), alkaline transferase (ALP), total protein, urea, creatinine and uric acid. Hyperglycemia was induced in overnight fasted albino rats by single intraperitoneal injection of streptozotocin (STZ) in 40 mg/kg body weight dose. The extract was administered orally at a dose of 300 and 600 mg/kg body weight for 28 days. Oral glucose tolerance test done in normal rat. Glibenclamide was the reference drug used in the treatment. Significant antihyperglycemic effect was observed in ethanolic extract treated diabetic rats. There was gain in body weight and above mentioned biochemical parameter were reversed to near normal in ethanolic extract treated rats as compared to diabetic control rats. This is an indication of its potent antidiabetic effect. Key words : Hypoglycemic, streptozotocin, Holarrhena antidysenterica, diabetic

Arsthinol nanosuspensions: pharmacokinetics and anti-leukaemic activity on NB4 promyelocytic leukaemia cells

Abstract Objectives The organoarsenical arsthinol was used in the 1950s in the treatment of amoebiasis and yaws and was considered as ‘highly tolerated’. The aim of this work was to study its anti-leukaemic activity and to develop nanosuspensions of the drug, thereby limiting brain concentrations and the risk of encephalopathy. Methods Arsthinol nanosuspensions were produced by high-pressure homogenization. The anti-leukaemic activity was assessed on NB4 acute promyelocytic leukaemia cells (vs solutions of arsthinol, As2O3 and melarsoprol). In addition, a pharmacokinetics study was performed to compare the nanosuspensions and the solution of arsthinol. Key findings Arsthinol induced growth inhibition of NB4 cells at lower concentration (IC50 (concentration inhibiting growth by 50%) = 0.78 ± 0.08 μmol/l after 24 h) than As2O3 (IC50 = 1.60 ± 0.23 μmol/l after 24 h) or melarsoprol (IC50 = 1.44 ± 0.08 μmol/l after 24 h). When formulated as nanosuspension, arsthinol remained cytotoxic (IC50 = 1.33 ± 0.30 μmol/l after 24 h). This formulation also reduced the drug's access to the brain (Cmax = 0.03 μmol/g) whereas bone marrow concentrations remained very high (Cmax = 2 μmol/g). Conclusions Nanosuspensions of arsthinol could be proposed for further studies in the treatment of acute promyelocytic leukaemia.

Bioavailability of two oral formulas of secnidazole in healthy volunteers

Secnidazole is an antimicrobial agent used primarily in the treatment of amoebiasis. For this bioequivalence study of secnidazole, twenty-eight healthy female volunteers were enrolled in a randomized crossover study. Each volunteer was given a single oral dose of secnidazole test preparation and then the reference preparation, or vice versa, with a wash out interval of two weeks. The plasma concentrations of secnidazole were determined by HPLC, and the samples were extracted with tert-butyl-methyl-ether: dicloromethane (60:40, v/v). Secnidazole and its parent compound metronidazole were separated on a C18 column with water:acetonitrile (85:15, v/v) as the mobile phase, and monitored at 310 nm. The ratio of mean Cmax, AUC0-t and AUC0-∞ values for the test and reference products were within the predetermined range established by ANVISA, demonstrating that the two formulations are bioequivalent in rate and extent of absorption.

Arsthinol nanosuspensions: pharmacokinetics and anti-leukaemic activity on NB4 promyelocytic leukaemia cells

The organoarsenical arsthinol was used in the 1950s in the treatment of amoebiasis and yaws and was considered as 'highly tolerated'. The aim of this work was to study its anti-leukaemic activity and to develop nanosuspensions of the drug, thereby limiting brain concentrations and the risk of encephalopathy. Arsthinol nanosuspensions were produced by high-pressure homogenization. The anti-leukaemic activity was assessed on NB4 acute promyelocytic leukaemia cells (vs solutions of arsthinol, As(2)O(3) and melarsoprol). In addition, a pharmacokinetics study was performed to compare the nanosuspensions and the solution of arsthinol. Arsthinol induced growth inhibition of NB4 cells at lower concentration (IC50 (concentration inhibiting growth by 50%) = 0.78 +/- 0.08 micromol/l after 24 h) than As(2)O(3) (IC50 = 1.60 +/- 0.23 micromol/l after 24 h) or melarsoprol (IC50 = 1.44 +/- 0.08 micromol/l after 24 h). When formulated as nanosuspension, arsthinol remained cytotoxic (IC50 = 1.33 +/- 0.30 micromol/l after 24 h). This formulation also reduced the drug's access to the brain (C(max) = 0.03 micromol/g) whereas bone marrow concentrations remained very high (C(max) = 2 micromol/g). Nanosuspensions of arsthinol could be proposed for further studies in the treatment of acute promyelocytic leukaemia.

Molecular Structure and Vibrational Spectroscopic Investigation of Secnidazole Using Density Functional Theory

Secnidazole (alpha,2-dimethyl-5-nitro-1H-imidazole-1-ethanol) is an antimicrobical drug, and it is particularly effective in the treatment of amebiasis, giardiasis, trichomoniasis, and bacterial vaginosis. Secnidazole crystallizes as a hemihydrate, which belongs to a monoclinic system having space group P2(1)/c, with a = 12.424 A, b = 12.187 A, c = 6.662 A, and beta = 100.9 degrees. The optimized geometries and total energies of different conformers of the secnidazole molecule have been determined by the method of density functional theory (DFT). For both geometry and total energy, it has been combined with B3LYP functionals having extended basis sets 4-31G, 6-31G, and 6-311++G(d,p) for each of the three stable conformers of secnidazole. Using this optimized structure, we have calculated the infrared and Raman wavenumbers and compared them with the experimental data. The calculated wavenumbers are in an excellent agreement with the experimental values. Based on these results, we have discussed the correlation between the vibrational modes and the crystalline structure of the most stable conformer of secnidazole. A complete assignment is provided for the observed Raman and IR spectra.

Nitazoxanide in the treatment of amoebiasis

Amoebiasis is a significant cause of morbidity worldwide and is the third leading cause of death from parasitic diseases. This study evaluated nitazoxanide, a thiazolide anti-infective, in the treatment of intestinal and hepatic amoebiasis. Prospective, randomised, double-blind, placebo-controlled studies were conducted in outpatients with intestinal amoebiasis from the Nile Delta of Egypt. Nitazoxanide was administered twice daily for 3 days at doses of 500mg (age > or =12 years), 200mg (age 4-11 years) or 100mg (age 1-3 years). Seventeen adults hospitalised with hepatic amoebiasis were treated with 500mg nitazoxanide twice daily for 10 days. Four days after completion of therapy, 32 (94%) of 34 nitazoxanide-treated patients with intestinal amoebiasis resolved symptoms compared with 15 (50%) of 30 patients who received placebo (P<0.001). Thirty-two (94%) of 34 nitazoxanide-treated patients were free of Entamoeba histolytica in two post-treatment stool specimens compared with only 13 (43%) of 30 patients receiving placebo (P<0.0001). All patients with hepatic amoebiasis responded to nitazoxanide therapy. Nitazoxanide is effective in treating invasive intestinal amoebiasis and in eliminating E. histolytica colonisation of the intestinal tract. Further studies are warranted in patients with hepatic amoebiasis.

Le secnidazole, un nouveau 5-nitro-imidazolé

Secnidazole is a new 5-nitro-imidazole demonstrating good antimicrobial activity against parasites and some bacteria. Secnidazole is widely used in the treatment of amoebiasis, giardiasis and genital infections due to Trichomonas vaginalis. Secnidazole demonstrates excellent activity against anaerobic bacteria similar to that of metronidazole. The antibacterial activity includes some curved bacteria such as Helicobacter pylori. The long half-life of secnidazole allows the treatment of vaginal trichomoniasis and giardiasis by a 2 g single dose. The same 2 g treatment applies to bacterial vaginosis. Tolerance is good in relation with single dose treatment.

Studies on the Development of Colon Targeted Oral Drug Delivery Systems for Ornidazole in the Treatment of Amoebiasis

The aim of the present study is to develop colon-targeted drug delivery sytems for ornidazole using guar gum as a carrier. The core formulation containing ornidazole was directly compressed. Compression-coated tablets of ornidazole containing various proportions of guar gum in the coat were prepared. All the formulations were evaluated for hardness and drug content uniformity and were subjected to in vitro drug release studies. The amount of ornidazole released from tablets at different time intervals was estimated by the HPLC method. The compression-coated formulations released less than 8% of ornidazole in the physiological environment of stomach and small intestine. The compression-coated tablets with 85%, 75%, and 65% of guar gum coat released about 21%, 38%, and 73% of ornidazole, respectively, in simulated colonic fluids indicating the susceptibility of the guar gum formulations to the rat caecal contents. The results of the study show that compression-coated ornidazole tablets with either 65% (OLV-65) or 75% (OLV-75) of guar gum coat are most likely to provide targeting of ornidazole for local action in the colon owing to its minimal release of the drug in the first 5 hr. The ornidazole compression-coated tablets showed no change in physical appearance, drug content, or in dissolution pattern after storage at 40°C/75% relative humidity for 6 months.

Studies on the development of oral colon targeted drug delivery systems for metronidazole in the treatment of amoebiasis

The aim of the present study is to develop colon targeted drug delivery sytems for metronidazole using guar gum as a carrier. Matrix, multilayer and compression coated tablets of metronidazole containing various proportions of guar gum were prepared. All the formulations were evaluated for the hardness, drug content uniformity, and were subjected to in vitro drug release studies. The amount of metronidazole released from tablets at different time intervals was estimated by high performance liquid chromatography method. Matrix tablets and multilayer tablets of metronidazole released 43–52% and 25–44% of the metronidazole, respectively, in the physiological environment of stomach and small intestine depending on the proportion of guar gum used in the formulation. Both the formulations failed to control the drug release within 5 h of the disolution study in the physiological environment of stomach and small intestine. The compression coated formulations released less than 1% of metronidazole in the physiological environment of stomach and small intestine. When the dissolution study was continued in simulated colonic fluids, the compression coated tablet with 275 mg of guar gum coat released another 61% of metronidazole after degradation by colonic bacteria at the end of 24 h of the dissolution study. The compression coated tablets with 350 and 435 mg of guar gum coat released about 45 and 20% of metronidazole, respectively, in simulated colonic fluids indicating the susceptibility of the guar gum formulations to the rat caecal contents. The results of the study show that compression coated metronidazole tablets with either 275 or 350 mg of guar gum coat is most likely to provide targeting of metronidazole for local action in the colon owing to its minimal release of the drug in the first 5 h. The metronidazole compression coated tablets showed no change either in physical appearance, drug content or in dissolution pattern after storage at 40 °C/75% RH for 6 months.

Design and in vitro evaluation of oral colon targeted drug delivery systems for tinidazole.

The aim of the present investigation is to develop colon targeted drag delivery sytems for tinidazole using guar gum as a carrier in the treatment of amoebiasis. Fast-disintegrating tinidazole core tablets were compression-coated with 55, 65 and 75% of guar gum. All the formulations were evaluated for the hardness, drug content uniformity, and subjected to in vitro drug release studies. The amount of tinidazole released from tablets at different time intervals was estimated by HPLC method. The compression-coated formulations released < 0.5% of tinidazole in the physiological environment of stomach and small intestine. When the dissolution study was continued in simulated colonic fluids, the compression coated tablet with 55% of guar gum coat released 99% of tinidazole after degradation by colonic bacteria at the end of 24 h of the dissolution study. The compression coated tablets with 65 and 75% of guar gum coat released about 67 and 20% of tinidazole, respectively in simulated colonic fluids indicating the susceptibility of the guar gum formulations to the rat caecal contents. The results of the study show that compression coated tinidazole tablets with either 55 or 65% of guar gum coat is most likely to provide targeting of tinidazole for local action in the colon owing to its minimal release of the drug in the first 5 h of physiological environment of stomach and small intestine. The tinidazole compression coated tablets showed no change either in physical appearance, drug content or in dissolution pattern after storage at 40 degrees C/75% RH for 6 months.

Mixture of closely related isomeric triterpenoid derivatives: Separation and purification by reversed-phase high-performance liquid chromatography

Twelve triterpenes were isolated from the alcoholic extract ofMentha villosa as their acetyl methyl ester derivatives. This vegetal specimen, which was collected in the Horto de Plantas Medicinais da Universidade Federal do Ceara, Fortaleza, Brazil, is used as popular remedy in the treatment of amebiasis, giardiasis and shistosomiasis. The separation and purification of the triterpenoid derivatives from complex mixtures of closely related isomeric triterpenoid acids has been performed successfully by reversed-phase HPLC.

Varioliform mucosal polypoid lesions in intestinal tract in a patient with adult T-cell leukemia

We describe a case of adult T-cell leukemia (ATL) with intestinal infiltration. In the early clinical stage, the endoscopic findings for the intestine were similar to those of amebic enterocolitis, i.e., varioliform mucosal polypoid lesions, and amebic cyst was detected with stool examination. Although no specific pathological factor could be identified on biopsy, the patient was treated for amebiasis as a diagnostic therapy. The findings of varioliform mucosal polypoid lesions were detected in the duodenum on endoscopic examination, but the lesions eventually disappeared during the treatment for amebiasis. We then suspected lymphoma partially masked by the amebiasis. Immunological staining of a specimen of the colonic mucosa revealed T cell invasion and Southern blotting demonstrated adult T-cell leukemia provirus invasion. Thus, ATL cell infiltration of the intestinal tract was confirmed. It is suggested that systemic disease should also be considered when varioliform mucosal polypoid lesions are found on colonoscopic examination.

Treatment of symptomatic amebic colitis in human immunodeficiency virus-infected persons

While most Entamoeba histolytica appearing in male homosexuals infected with human immunodeficiency virus (HIV) is considered non-invasive in Western countries, and treatment of amebiasis in these persons has received very little attention, in Japan some male homosexual amebiasis patients infected with HIV complain of symptoms attributable to E. histolytica infection. We investigated whether symptomatic E histolytica amebic colitis in HIV-infected persons requires higher doses or longer duration of antiamebic drug therapy than in non HIV-infected patients. Four symptomatic amebic colitis patients infected with HIV-1, three of them severely immunocompromised, with CD4 cell counts <200/mm 3, were treated with oral metronidazole: 1500 mg a day for 10 days in 2 patients, 1000 mg a day for 10 days in 1 patient, and 1000 mg a day for 6 days and then 750 mg for 4 days in 1 patient, and good therapeutic results with no side effects were obtained. This indicates that symptomatic amebic colitis in HIV-infected persons can be successfully treated with metronidazole at the same dose and duration of treatment used in non-HIV-infected persons.

PROTOZOA: Amebiasis

The intestinal protozoan parasite Entamoeba histolytica causes amebic dysentery and amebic liver abscess, and ranks third worldwide among parasitic causes of death. The application of molecular techniques to the study of this organism have led to major advances in understanding the pathophysiology of amebic infection. This article reviews what is currently known about the pathogenesis, clinical manifestations, diagnosis, and treatment of amebiasis.

Secnidazole. A review of its antimicrobial activity, pharmacokinetic properties and therapeutic use in the management of protozoal infections and bacterial vaginosis.

Secnidazole is structurally related to the commonly used 5-nitroimidazoles metronidazole and tinidazole. These drugs share a common spectrum of activity against anaerobic micro-organisms and they appear particularly effective in the treatment of amoebiasis, giardiasis, trichomoniasis and bacterial vaginosis. Secnidazole is rapidly and completely absorbed after oral administration and has a longer terminal elimination half-life (approximately 17 to 29 hours) than commonly used drugs in this class. in patients with intestinal amoebiasis or giardiasis, clinical or parasistological cure rates of 80 to 100% are achieved after treatment with a single dose of secnidazole 2g (30 mg/kg in children), similar to the response rates achieved with multiple dosage regimens of metronidazole or tinidazole. Patients with hepatic amoebiasis appears to respond well to 5- to 7-day therapy with secnidazole, but the efficacy of this drug regimen requires further evaluation in larger numbers of patients. After administration of a single dose of secnidazole, parasitological eradication was achieved in approximately 92 to 100% of patients with urogenital trichomoniasis. Patients with bacteria vaginosis respond at least as well to a single dose of secnidazole as to single-dose tinidazole, or single- or 7-day treatment with metronidazole; clinical improvement and/or microbiological evidence of cure was attained in approximately 59 to 96% of patients. In the clinical trials reviewed, secnidazole was well tolerated; most adverse events were gastrointestinal in nature and did not require treatment intervention or withdrawal from therapy. In summary, available evidence suggests that secnidazole is as efficacious as other 5-nitroimidazole drugs in the treatment of protozoal infections and bacterial vaginosis. The convenience and ease of administration associated with single-dose therapy, combined with a good tolerability profile, make secnidazole a suitable option to other single-dose treatments and an attractive alternative to multiple dosage regimens with other drugs in this class.

AMEBIASIS AND “NONPATHOGENIC” INTESTINAL PROTOZOA

Infection with single or multiple species of intestinal protozoa is common in humans and can result in either asymptomatic colonization or symptoms of intestinal disease. Entamoeba histolytica serves as a paradigm for invasive colonic protozoal infection. The key to diagnosis and treatment of amebiasis is knowledge of the epidemiologic risk factors and clinical manifestations, a rational approach to diagnosis, and an understanding of the sites of action and uses of anti-amebic drugs. This knowledge of treatment provides a context for consideration of intestinal infection with less common protozoan pathogens such as Dientamoeba fragilis and Balantidium coli and 'nonpathogenic' protozoa such as Blastocystis hominis and Entamoeba coli.

Treatment of Asymptomatic Amebiasis in Homosexual Men Clinical Trials with Metronidazole, Tinidazole, and Diloxanide Furoate

In a randomized trial, the authors treated 42 asymptomatic homosexual men who had Entamoeba histolytica in fecal specimens with either metronidazole or tinidazole (study 1). They treated both groups initially with 2,000 mg in a single dose, and in case of failure with 2,000 mg daily for 5 days. In cases of repeated failure, the authors prescribed a dosage of 500 mg of diloxanide furoate three times per day (TID) for 10 days. In a subsequent study (study 2) the authors treated 49 asymptomatic homosexual men who had E. histolytica in fecal specimens with 500 mg of diloxanide furoate TID for 10 days. In study 1, the parasitological cure rates (PCR) for metronidazole and tinidazole were 29%-56%. Among the men treated with diloxanide furoate, the PCR was 93%. In study 2 the PCR with diloxanide furoate was 88%, which was significantly better (P less than .05) than metronidazole/tinidazole treatment in study 1. The present studies show that diloxanide furoate is an effective treatment of amebiasis in asymptomatic patients.

Treatment of amoebiasis in turtles

International Zoo YearbookVolume 28, Issue 1 p. 60-61 Treatment of amoebiasis in turtles HARALD JES, HARALD JES Curator of Aquarium, Kölner Aquarium am Zoo, AG Zoologischer Garten Köln, Riehler Strasse 173, 5000 Köln 60, West GermanySearch for more papers by this author HARALD JES, HARALD JES Curator of Aquarium, Kölner Aquarium am Zoo, AG Zoologischer Garten Köln, Riehler Strasse 173, 5000 Köln 60, West GermanySearch for more papers by this author First published: January 1989 https://doi.org/10.1111/j.1748-1090.1989.tb03254.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume28, Issue1January 1989Pages 60-61 RelatedInformation

Treatment of amoebiasis in turtles

Treatment of amoebiasis in turtles