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洛匹那韦/利托那韦及载有洛匹那韦/利托那韦的聚乳酸-羟基乙酸共聚物纳米粒对实验性弓形虫病的影响

The effect of lopinavir/ritonavir and lopinavir/ritonavir loaded PLGA nanoparticles on experimental toxoplasmosis.

作者信息

Abou-El-Naga Iman Fathy, El Kerdany Eman Dorry, Mady Rasha Fadly, Shalaby Thanaa Ibrahim, Zaytoun Enas Mohammed

机构信息

Medical Parasitology Department, Alexandria Faculty of Medicine, Egypt.

Medical Parasitology Department, Alexandria Faculty of Medicine, Egypt.

出版信息

Parasitol Int. 2017 Dec;66(6):735-747. doi: 10.1016/j.parint.2017.08.007. Epub 2017 Aug 21.

Abstract

A marked reduction has been achieved in the incidence and clinical course of toxoplasmic encephalitis after the introduction of protease inhibitors within the treatment regimen of HIV (HIV-PIs). This work was undertaken to study for the first time, the efficacy of HIV-PIs, lopinavir/ritonavir (L/R), as a therapeutic agent in acute experimental toxoplasmosis. Lopinavir/ritonavir (L/R) were used in the same ratio present in aluvia, a known HIV-PIs drug used in the developing countries in the treatment regimens of AID's patient. Poly lactic-co-glycolic acid (PLGA) nanoparticles were used as a delivery system to L/R therapy. L/R alone or after its encapsulation on PLGA were given to Swiss strain albino mice that were infected with RH virulent toxoplasma strain. Both forms caused parasitological improvement in both mortality rate and parasite count. The higher efficacy was achieved by using L/R PLGA together with minimizing the effective dose. There was significant reduction in the parasite count in the peritoneal fluid and the liver. Parasite viability and infectivity were also significantly reduced. The anti-toxoplasma effect of the drug was attributed to the morphological distortion of the tachyzoites as evident by the ultrastructure examination and suppressed the egress of tachyzoites. L/R also induced changes that suggest apoptosis and autophagy of tachyzoites. The parasitophorous vacuole membrane was disrupted and vesiculated. The nanotubular networks inside the parasitophorous vacuole were disrupted. Therefore, the present work opens a new possible way for the approved HIV-PIs as an alternative treatment against acute toxoplasmosis. Furthermore, it increases the list of the opportunistic parasites that can be treated by this drug. The successful in vivo effect of HIV-PIs against Toxoplasma gondii suggests that this parasite may be a target in HIV treated patients, thus decrease the possibility of toxoplasmic encephalitis development.

摘要

在抗逆转录病毒治疗方案(HIV-PIs)中引入蛋白酶抑制剂后,弓形虫性脑炎的发病率和临床病程已显著降低。本研究首次探讨了HIV-PIs洛匹那韦/利托那韦(L/R)作为急性实验性弓形虫病治疗药物的疗效。洛匹那韦/利托那韦(L/R)的使用比例与阿卢维亚相同,阿卢维亚是一种在发展中国家用于艾滋病患者治疗方案的已知HIV-PIs药物。聚乳酸-乙醇酸共聚物(PLGA)纳米颗粒被用作L/R治疗的递送系统。将L/R单独使用或包裹在PLGA上后,给予感染了RH强毒株弓形虫的瑞士白化小鼠。两种形式均在死亡率和寄生虫计数方面带来了寄生虫学改善。将L/R与PLGA一起使用并减少有效剂量可实现更高的疗效。腹膜液和肝脏中的寄生虫计数显著减少。寄生虫的活力和传染性也显著降低。药物的抗弓形虫作用归因于速殖子的形态畸变,超微结构检查可明显看出,并且抑制了速殖子的逸出。L/R还诱导了一些变化,提示速殖子发生凋亡和自噬。寄生泡膜破裂并形成囊泡。寄生泡内的纳米管网络被破坏。因此,本研究为已获批的HIV-PIs作为急性弓形虫病的替代治疗开辟了一条新的可能途径。此外,它增加了可用该药物治疗的机会性寄生虫种类。HIV-PIs对刚地弓形虫的体内治疗成功表明,这种寄生虫可能是HIV治疗患者的一个靶点,从而降低了弓形虫性脑炎发生的可能性。

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