title: Azithromycin is able to control Toxoplasma gondii infection in human villous explants.
abstract: BACKGROUND
  Although Toxoplasma gondii infection is normally asymptomatic, severe cases of toxoplasmosis may occur in immunosuppressed patients or congenitally infected newborns. When a fetal infection is established, the recommended treatment is a combination of pyrimethamine, sulfadiazine and folinic acid (PSA). The aim of the present study was to evaluate the efficacy of azithromycin to control T. gondii infection in human villous explants.
  
  
  METHODS
  Cultures of third trimester human villous explants were infected with T. gondii and simultaneously treated with either PSA or azithromycin. Proliferation of T. gondii, as well as production of cytokines and hormones by chorionic villous explants, was analyzed.
  
  
  RESULTS
  Treatment with either azithromycin or PSA was able to control T. gondii infection in villous explants. After azithromycin or PSA treatment, TNF-α, IL-17A or TGF-β1 levels secreted by infected villous explants did not present significant differences. However, PSA-treated villous explants had decreased levels of IL-10 and increased IL-12 levels, while treatment with azithromycin increased production of IL-6. Additionally, T. gondii-infected villous explants increased secretion of estradiol, progesterone and HCG+β, while treatments with azithromycin or PSA reduced secretion of these hormones concurrently with decrease of parasite load.
  
  
  CONCLUSIONS
  In conclusion, these results suggest that azithromycin may be defined as an effective alternative drug to control T. gondii infection at the fetal-maternal interface.
authors.forename: Letícia S
authors.initials: LS
authors.lastname: Castro-Filice
authors.forename: Bellisa F
authors.initials: BF
authors.lastname: Barbosa
authors.forename: Mariana B
authors.initials: MB
authors.lastname: Angeloni
authors.forename: Neide M
authors.initials: NM
authors.lastname: Silva
authors.forename: Angelica O
authors.initials: AO
authors.lastname: Gomes
authors.forename: Celene M O S
authors.initials: CM
authors.lastname: Alves
authors.forename: Deise A O
authors.initials: DA
authors.lastname: Silva
authors.forename: Olindo A
authors.initials: OA
authors.lastname: Martins-Filho
authors.forename: Maria C
authors.initials: MC
authors.lastname: Santos
authors.forename: José R
authors.initials: JR
authors.lastname: Mineo
authors.affiliation: Laboratory of Immunophysiology of Reproduction, Institute of Biomedical Sciences, Universidade Federal de Uberlândia, Av, Pará 1720, Uberlândia, MG 38400-902, Brazil. eloisa@umuarama.ufu.br.
authors.forename: Eloisa A V
authors.initials: EA
authors.lastname: Ferro
mesh_terms: D017963:Azithromycin / Q000494:pharmacology / Q000627:therapeutic use*; D002824:Chorionic Villi / Q000469:parasitology*; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D002955:Leucovorin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D011247:Pregnancy; D011739:Pyrimethamine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D013411:Sulfadiazine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D014122:Toxoplasma / Q000187:drug effects; D014123:Toxoplasmosis / Q000188:drug therapy*
chemical_list: D013411:Sulfadiazine; D017963:Azithromycin; D002955:Leucovorin; D011739:Pyrimethamine