title: Pharmacodynamics of mefloquine and praziquantel combination therapy in mice harbouring juvenile and adult Schistosoma mansoni.
abstract: Praziquantel (PZQ) is currently the only drug widely used for the treatment of schistosomiasis, but the antimalarial drug mefloquine (Mef) possesses interesting antischistosomal properties. Combination therapy with these two drugs has been suggested as a strategy for transmission control, as PZQ is active against adult worms and Mef is active against schistosomula. To examine the efficacy of combination therapy, Schistosoma mansoni-reinfected mice were separated into seven groups: untreated (I), treated with PZQ in doses of 200 mg/kg (II) or 1,000 mg/kg (III), treated with Mef in doses of 200 mg/kg (IV) or 400 mg/kg (V); each dose was divided equally and given on two consecutive days. Group VI was treated with doses of PZQ + Mef as in groups II and IV, respectively, while group VII was treated with PZQ + Mef as in groups III and V, respectively. PZQ + Mef at the reduced doses of 200 mg/kg each enhanced the therapeutic efficacy over the reduced PZQ dose alone as shown by a very high reduction in the total numbers of mature worms (95% vs. 49%), immature worms (96% vs. 29%) and the complete eradication of immature females, mature females and immature eggs. The reduction in worm burden was associated with the healing of hepatic granulomatous lesions and the normalisation of all liver enzymes. Therefore, the use of Mef with PZQ is more effective than PZQ alone and should be considered for clinical trials in humans as a potential treatment regimen to prevent treatment failures in areas with high rates of schistosomiasis.
authors: Department of Pharmacology, Theodor Bilharz Research Institute, Warak El-Hadar, Imbaba PO Box 30, Giza 12411, Egypt. naglaaellakkany@yahoo.com
authors: Naglaa Mohamed
authors: NM
authors: el-Lakkany
authors: Sayed Hassan Seif
authors: SH
authors: el-Din
authors: Abdel-Nasser Abdel-Aal
authors: AN
authors: Sabra
authors: Olfat Ali
authors: OA
authors: Hammam
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006099:Granuloma / Q000469:parasitology / Q000473:pathology; D008099:Liver / Q000469:parasitology / Q000473:pathology; D008297:Male; D015767:Mefloquine / Q000008:administration & dosage* / Q000493:pharmacokinetics; D051379:Mice; D010270:Parasite Egg Count; D011223:Praziquantel / Q000008:administration & dosage* / Q000493:pharmacokinetics; D012550:Schistosoma mansoni / Q000187:drug effects*; D012555:Schistosomiasis mansoni / Q000188:drug therapy* / Q000469:parasitology / Q000473:pathology; D012556:Schistosomicides / Q000008:administration & dosage* / Q000493:pharmacokinetics
chemical_list: D012556:Schistosomicides; D011223:Praziquantel; D015767:Mefloquine