cNitazoxanide and three halogeno-thiazolides, RM-4850, RM-4865, and RM-5038, were tested against Cryptosporidium parvum in experimentally infected immunosuppressed Mongolian gerbils. Daily 400-mg/kg doses of the four test drugs for 5 to 8 consecutive days produced similar reductions of oocyst shedding. Using early-infected gerbils, a shorter 4-day treatment with RM-5038 reduced oocyst shedding by 95%, compared to 47% for nitazoxanide (P ؍ 0.02), suggesting that RM-5038 is more effective than nitazoxanide under the experimental conditions used.
We have previously reported the in vitro activities of several thiazolides against Cryptosporidium parvum and Sarcocystis neurona, two apicomplexan protozoa (1, 2). Recent tests of RM-5038 showed the same level of activity as its active circulating metabolite RM-4848, which, with RM-4850 and RM-4865, had exhibited the highest level of in vitro activity against C. parvum development. These compounds deserved to be tested in vivo to confirm their anticryptosporidial activity.The in vivo activities of nitazoxanide and three halogenothiazolides were studied in experimentally Cryptosporidium parvum-infected gerbils (Meriones unguiculatus). Animals weighing 30 to 40 g at the beginning of the study were individually housed in plastic cages equipped with a grill ceiling providing rodent food granules and water ad libitum. The cage was protected by another top wrapped with sterile paper in order to comply with level II contamination requirements. Animals were handled according to the technical and ethical regulations of the French Ministry of Agriculture. Gerbils were immunosuppressed by injection of dexamethasone (Qualimed, Puteaux, France) at 0.8 mg every 2 days and fed a low-protein diet (white bread) for at least 10 consecutive days before infection, and dexamethasone was administered until the end of the experiment. Prior to the start of treatment, each gerbil was inoculated by oral gavage with C. parvum oocysts. The test compounds were suspended in pure dimethyl sulfoxide (DMSO) and administered at a dose of 200 mg/kg of body weight twice daily by oral gavage in a constant volume. One to 3 days after the cessation of treatment, all of the animals were killed by deep sodium thiopental anesthesia. To assess C. parvum infection, the volume of the cecal and colonic contents collected from each sacrificed gerbil was suspended in a 10% (wt/vol) formalin solution and homogenized. The suspension was vortexed for 30 s and allowed to settle for an additional 30 s. Ten percent of the suspension was diluted in phosphate-buffered saline (PBS) and centrifuged at 1,800 ϫ g for 30 min. After washing, the pellet was resuspended in PBS and half of the oocyst-containing pellet was incubated with an oocyst-specific monoclonal antibody conjugated with fluorescein isothiocyanate (Crypt-aGlo; Waterborne, New Orleans, LA) in the dark at 37°C for 30 min. A CytoSpin was prepared for each specimen, and oocysts were counted by epifluorescence microscopy at a magnification of ϫ400. The number of oocyst...