title: Combination therapy using Pentostam and Praziquantel improves lesion healing and parasite resolution in BALB/c mice co-infected with Leishmania major and Schistosoma mansoni.
abstract: BACKGROUND
  Most natural host populations are exposed to a diversity of parasite communities and co-infection of hosts by multiple parasites is commonplace across a diverse range of systems. Co-infection with Leishmania major and Schistosoma mansoni may have important consequences for disease development, severity and transmission dynamics. Pentavalent antimonials and Praziquantel (PZQ) have been relied upon as a first line of treatment for Leishmania and Schistosoma infections respectively. However, it is not clear how combined therapy with the standard drugs will affect the host and parasite burden in concomitance. The aim of the current study was to determine the efficacy of combined chemotherapy using Pentostam and PZQ in BALB/c mice co-infected with L. major and S. mansoni.
  
  
  METHODS
  The study used BALB/c mice infected with L. major and S. mansoni. A 3 × 4 factorial design with three parasite infection groups (Lm, Sm, Lm + Sm designated as groups infected with L. major, S. mansoni and L. major + S. mansoni, respectively) and four treatment regimens [P, PZQ, P + PZQ and PBS designating Pentostam®(GlaxoSmithKline UK), Praziquantel (Biltricide®, Bayer Ag. Leverkusen, Germany), Pentostam + Praziquantel and Phosphate buffered saline] as factors was applied. In each treatment group, there were 10 mice. Lesion development was monitored for 10 weeks. The parasite load, body weight, weight of the spleen and liver were determined between week 8 and week 10.
  
  
  RESULTS
  Chemotherapy using the first line of treatment for L. major and S. mansoni reduced the lesion size and parasite loads but did not affect the growth response, spleen and liver. In the co-infected BALB/c mice, the use of Pentostam or PZQ did not result in any appreciable disease management. However, treatment with P + PZQ resulted in significantly (p < 0.05) larger reduction of lesions, net increase in the body weight, no changes in the spleen and liver weight and reduced Leishman-Donovan Units (LDU) and worm counts than BALB/c mice treated with Pentostam or PZQ alone.
  
  
  CONCLUSIONS
  The present study demonstrated that the combined first line of treatment is a more effective strategy in managing co-infection of L. major and S. mansoni in BALB/c mice.
authors: Christopher
authors: C
authors: Khayeka-Wandabwa
authors: Helen
authors: H
authors: Kutima
authors: Venny C S
authors: VC
authors: Nyambati
authors: Johnstone
authors: J
authors: Ingonga
authors: Elijah
authors: E
authors: Oyoo-Okoth
authors: Lucy
authors: L
authors: Karani
authors: Bernard
authors: B
authors: Jumba
authors: Kiige
authors: K
authors: Githuku
authors: Christopher O
authors: CO
authors: Anjili
mesh_terms: D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage*; D000967:Antimony Sodium Gluconate / Q000008:administration & dosage; D060085:Coinfection; D004359:Drug Therapy, Combination; D018320:Leishmania major / Q000187:drug effects*; D016773:Leishmaniasis, Cutaneous / Q000150:complications / Q000188:drug therapy*; D008099:Liver / Q000469:parasitology; D051379:Mice; D008807:Mice, Inbred BALB C; D011223:Praziquantel / Q000008:administration & dosage; D012550:Schistosoma mansoni / Q000187:drug effects*; D012555:Schistosomiasis mansoni / Q000150:complications / Q000188:drug therapy*; D013154:Spleen / Q000469:parasitology
chemical_list: D000871:Anthelmintics; D011223:Praziquantel; D000967:Antimony Sodium Gluconate
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