丙硫咪唑治疗儿童华支睾吸虫及蛲虫感染的疗效观察

62例感染华支睾吸虫儿童应用丙硫咪唑治疗,每日400mg连服3或5日,停药1个月、3个月后复查,20例连服3日和42例连服5日的受染儿童,大便华支睾吸虫卵阴转率分别为55.O%和90.5%。140例感染蛲虫的幼儿园儿童用两种单剂丙硫咪唑进行驱虫,经3次肛拭复查,25例服200mg和115例服100mg的蛲虫卵阴转率依次为96.0%和92.2%。药物反应轻微。     

从文献回顾分析抗蠕虫药物的现状与发展趋势

目的 运用文献计量学方法对已发表的抗蠕虫药物文献进行分析,探讨抗蠕虫药物的现状和发展趋势。方法　 收集在PubMed数据库上收录的1997-2007年医学专业学术期刊抗蠕虫药物的相关文献,通过一定数据准入标准筛选符合要求的文献并构建Access数据库。对数据库中相关文献进行如“研究类型”、 “发表年代”、 “涉及药物”等分类项归类。用SPSS17.0软件对数据进行相应的线性回归和二次回归等统计学分析。 结果 抗蠕虫药物相关论文年度发表数量呈逐年增长趋势,年相关论文发表量增加约6篇;应用性研究为主要研究主题;主要研究病种依次为血吸虫病、丝虫病、蛔虫病、棘球蚴病和钩虫病,其中血吸虫病相关文献数量最多,与其他4种主要蠕虫病的相关文献数量差异均有统计学意义（P<0.05）;主要研究药物为阿苯达唑、吡喹酮、甲苯咪唑、伊维菌素和乙胺嗪;抗蠕虫药物相关文献在多种医学杂志上发表,发表抗蠕虫药物文献数量第1位和第10位的期刊分别占文献总数的5.52%和 1.63%。 结论 近10年来抗蠕虫药物愈来愈受到重视,但其种类不多,亟需发展新药。     

Progress in control of hydatidosis using vaccination--a review of formulation and delivery of the vaccine and recommendations for practical use in control programmes

A vaccine to protect sheep, goats, and bovines against hydatid disease caused by the cysts of Echinococcus granulosus is prepared as a recombinant fusion protein expressed in Escherichia coli. Solubilised inclusion bodies are injected, together with Quil A, subcutaneously on two occasions 1 month or more apart, and induce protection against infection which lasts for at least 12 months. A third injection given 6-12 months after the second injection induces a high and long-lasting protection against artificial or natural challenge infections. This review describes work carried out on the formulation, safety and efficacy of the vaccine under laboratory and field conditions, using artificial or natural challenges with E. granulosus eggs, followed by necropsy. Hydatid control programmes based on regular treatment of all dogs with the correct dose of a highly-efficient anthelmintic have sometimes not been successful in Continental environments. Access to dogs is difficult in summer because of the distances to summer pastures, and is often impossible in winter because of snow. A control program using strategic twice-yearly anthelmintic treatment of dogs is likely to be successful provided grazing animals are vaccinated as well. Vaccination as a control tool only requires the veterinarians to visit two times a year, and while the veterinarian is present, the dogs can be treated with anthelmintic for little additional cost. One visit should take place after the autumn kill of animals for winter consumption, and this is a good time to vaccinate animals born in the summer, and also all other animals while they are healthy and immunologically responsive. The other visit should take place in the spring, at which time animals born during winter can be vaccinated. Although a single immunization has been shown to induce a useful degree of protection, where possible it is best to give two initial injections, 1 month apart. If it is possible for veterinarians to stay in the field for 2 months in November/December and March/April, in order to give the two injections, a more rapid onset of full protective immunity will initially be achieved than if the injections are given 6 months apart. A large-scale safety and efficacy trial involving 50,000 and 100,000 lambs in Qinghai and Xinjiang Provinces of China has taken place. Results have confirmed safety and efficacy. In most countries, prevalence of infection increases with age. The vaccine has no effect on established cysts, and therefore, in order to prevent the biomass of Echinococcus spp. from increasing, it might be an effective strategy to begin a control programme by vaccinating all animals. Because many of the older stock will already be infected, they will remain a source of infection for dogs for the average lifetime of the stock. Dogs will still be able to be infected from the older stock, and will continue to infect humans. We advocate that a vaccination programme be accompanied by education about hydatid disease, and anthelmintic treatment of dogs in late autumn and early spring.     

Anthelmintic Prescribing Patterns of a Sample of General Practitioners from Selected Areas in the Colombo District of Sri Lanka

General Practitioners (GPs) provide first contact care of children and pregnant mothers in the community. This study ascertained the prescribing pattern of anthelmintics to children and pregnant women by a sample of GPs from the district of Colombo. Two hundred medical practitioners engaged in full-time General Practice (100 urban and 100 rural), were selected randomly. A pre-tested interviewer-administered questionnaire was used to collect data. A total of 183 GPs aged between 26 and 72 years (median 38) participated with 94 coming from urban areas. Seventy percent of the GPs were male. Almost 13% of GPs from urban areas had a Postgraduate degree in comparison to 4.5% from the rural areas (P < 0.05). Over 50% of GPs had 6-20 years of service and over 30% treated 16-30 patients daily. Seventy-three percent of GPs from rural areas accessed health-related reading material either daily or weekly in contrast to only 40% from urban areas (P < 0.001). All GPs prescribed anthelmintics to children. Pyrantel pamoate was the preferred anthelmintic used for children by both groups. Approximately 55% and 64% of GPs from urban and rural areas, respectively, prescribed anthelmintics during pregnancy. A majority of GPs prescribed drugs after the first trimester. However, 25% from urban areas gave drugs during any trimester (P < 0.001). Regression analysis revealed that GPs with postgraduate qualifications, those having frequent access to health-related material and those seeing more than 30 patients daily, prescribed anthelmintics to pregnant women more often. Although routine de-worming of pregnant women and children should occur through government antenatal and well-baby clinics, and through the schools de-worming programme, it may not happen due to various reasons. Thus, GPs play a vital role in achieving good coverage of anthelmintics among children and pregnant women. Making available clear national guidelines on prescribing anthelmintics in Sri Lanka would improve the prescribing patterns of anthelmintics among GPs.     

A new primary screening test for anthelmintics utilizing the parasitic stages ofNippostrongylus brasiliensis,in vitro

A new in vitro test suitable for the large scale screening of chemical compounds for anthelmintic activity is described. The test which utilizes the fourth larval and adult stages ofNippostrongylus brasiliensis in a medium capable of supporting the growth and development of the parasite, detects selectively those compounds which possess either broad spectrum anthelmintic or specific anti-trichostrongyle activity. The screen is easy to operate requiring only minute quantities of experimental compound. It renders fully reproducible results which furthermore can be interpreted objectively. This is the first reported in vitro test directed against the parasitic stages of a nematode that is capable of detecting reliably the activity of a wide range of anthelmintics including thiophanate and all the benzimidazoles.     

Anthelmintics for drug repurposing: Opportunities and challenges

Drug repositioning is defined as a process to identify a new application for drugs. This approach is critical as it takes advantage of well-known pharmacokinetics, pharmacodynamics, and toxicity profiles of the drugs; thus, the chance of their future failure decreases, and the cost of their development and the required time for their approval are reduced. Anthelmintics, which are antiparasitic drugs, have recently demonstrated promising anticancer effects in vitro and in vivo. This literature review focuses on the potential of anthelmintics for repositioning in the treatment of cancers. It also discusses their pharmacokinetics and pharmacodynamics as antiparasitic drugs, proposed anticancer mechanisms, present development conditions, challenges in cancer therapy, and strategies to overcome these challenges.     

Increase of gluthatione S-transferase,carboxyl esterase and carbonyl reductase in Fasciola hepatica recovered from triclabendazole treated sheep

Fasciolasis is a zoonotic parasitic disease caused by Fasciola hepatica and its control is mainly based on the use of triclabendazole (TCBZ). Parasite resistance to different anthelmintics is growing worldwide, including the resistance of F. hepatica to TCBZ. In the present work we evaluate “in vivo” the activity of xenobiotic metabolizing enzymes of phase I (carboxyl esterases) and phase II (glutathione S-transferases and carbonyl reductases) recovered of flukes from sheep treated with TCBZ. All three enzymes showed increased activity in TCBZ flukes returning 60 h post-treatment at similar to baseline unexposed flukes. TCBZ action may induce secondary oxidative stress, which may explain the observed increment in activities of the analyzed enzymes as a defensive mechanism. The enzymes analyzed are candidates to participate actively in the development of resistance at TCBZ in F. hepatica.     

我国抗蠕虫药物研究的进展及面临的问题

本文综述新中国成立以来我国抗蠕虫药物,包括抗线虫、吸虫和绦虫药物的研究进展及其在寄生虫病防治工作中所起的作用,并就在抗蠕虫药物研究中所面临的问题提出一些看法。     

6种抗蠕虫药物治疗小鼠尖吻蝮蛇舌状虫感染的疗效观察

目的观察吡喹酮、甲苯达唑、三苯双脒、伊维菌素、蒿甲醚和双氢青蒿素对感染舌状虫小鼠的疗效。方法 35只小鼠每鼠口服感染40个尖吻蝮蛇舌状虫虫卵25～37周后,分为10组,每组2～8只,其中9组分别用吡喹酮500mg/(kg·d)×5d、500mg/(kg·d)×14d,甲苯达唑300mg/(kg·d)×5d,三苯双脒300mg/(kg·d)×5d,伊维菌素8mg/(kg·d)×3d、10mg/(kg·d)×3d和15mg/(kg·d)×14d、蒿甲醚400mg/(kg·d)×5d和双氢青蒿素200mg/(kg·d)×5d治疗,余1组不治疗为对照组。治毕后1～3周剖检小鼠,自腹壁和内脏剥离含有若虫的囊包,观察其在生理盐水中的活动情况并计数。结果感染尖吻蝮蛇舌状虫的小鼠用吡喹酮、甲苯达唑、三苯双脒、伊维菌素、蒿甲醚和双氢青蒿素治疗,各组的平均若虫数与对照组的差异均无统计学意义(P0.05),减虫率为8.3%～35.0%。在剖检受治鼠过程中未查见异常的若虫囊包,若虫的形态、色泽、大小和在生理盐水中的活动均与对照组相仿。结论吡喹酮、甲苯达唑、三苯双脒、伊维菌素、蒿甲醚和双氢青蒿素在所用的实验条件下对小鼠的尖吻蝮蛇舌状虫若虫感染疗效不佳。