Department Of Medical Parasitology, Faculty Of Medicine, Alexandria University, Alexandria, Egypt.
Department Of Pathology, Faculty Of Medicine, Alexandria University, Alexandria, Egypt.
Pathog Glob Health. 2022 Mar;116(2):107-118. doi: 10.1080/20477724.2021.1967628. Epub 2021 Aug 22.
Toxoplasmosis is a zoonotic disease of major significant perspectives in public health and veterinary medicine. So far, the available drugs control only the active infection, once the parasite encysts in the tissues, they lose their efficacy. Cytokines; IFN-γ and IL-10, play a critical role in the modulation of toxoplasmic encephalitis and neuro-inflammation in chronic toxoplasmosis. Antiretroviral protease inhibitors applied in the treatment of acquired immunodeficiency syndrome, revealed activity against multiple parasites. Aluvia (lopinavir/ritonavir) (L/R); an aspartyl protease inhibitor, had efficiently treated RH strain infection. We investigated the potential activity of L/R against experimental infection with a cystogenic Me49 strain in mice, considering the role of IFN-γ and IL-10 in the neuropathology versus pyrimethamine-sulfadiazine combination therapy. Three aluvia regimens were applied; starting on the day of infection (acute phase), 2-week PI (early chronic phase) and eight weeks PI (late chronic phase). L/R reduced the brain-tissue cyst burden significantly in all treatment regimens. It impaired the parasite infectivity markedly in the late chronic phase. Ultrastructural changes were detected in cyst membrane and wall, bradyzoite membrane and nuclear envelope. The signs of bradyzoite paraptosis and cytoplasmic lipid droplets were observed. L/R had significantly reduced the brain-homogenate levels of IFN-γ and IL-10 in its three regimens however, they could not reach the normal level in chronic phases. Cerebral hypercellularity, perivascular inflammatory response, lymphoplasmacytic infiltrates and glial cellular reaction were ameliorated by L/R treatment. Herein, L/R was proved to possess promising preventive and therapeutic perspectives in chronic cerebral toxoplasmosis.
弓形虫病是一种具有重要公共卫生和兽医意义的动物源性疾病。到目前为止,可用的药物只能控制活动性感染,一旦寄生虫在组织中形成囊包,它们就会失去疗效。细胞因子 IFN-γ 和 IL-10 在调节弓形虫脑炎和慢性弓形虫病的神经炎症中起着关键作用。抗逆转录病毒蛋白酶抑制剂应用于获得性免疫缺陷综合征的治疗,显示出对多种寄生虫的活性。阿卢维亚(洛匹那韦/利托那韦)(L/R);一种天冬氨酰蛋白酶抑制剂,已有效地治疗了 RH 株感染。我们研究了 L/R 对实验性感染致囊虫性 Me49 株的潜在活性,考虑到 IFN-γ 和 IL-10 在神经病理学方面与嘧啶甲噁唑-磺胺嘧啶联合治疗的作用。应用了三种 L/R 方案;感染当天(急性阶段)、感染后 2 周(早期慢性阶段)和 8 周(晚期慢性阶段)开始。L/R 显著降低了所有治疗方案中脑组织的囊包负荷。它显著损害了晚期慢性阶段的寄生虫感染力。在囊膜和壁、缓殖子膜和核膜中检测到超微结构变化。观察到缓殖子副凋亡和细胞质脂滴的迹象。L/R 在其三种方案中显著降低了脑匀浆中的 IFN-γ 和 IL-10 水平,但在慢性阶段仍无法达到正常水平。L/R 治疗改善了大脑高细胞性、血管周围炎症反应、淋巴浆细胞浸润和神经胶质细胞反应。在此,L/R 被证明在慢性脑弓形虫病中具有有前途的预防和治疗前景。