The effect of iron on metronidazole activity against Trichomonas vaginalis in vitro

Elwakil, Hala Salah; Tawfik, Rania Ayman; Alam-Eldin, Yosra Hussein; Nassar, Doaa Ashraf

doi:10.1016/j.exppara.2017.09.021

Cited by 9 publications

(3 citation statements)

References 12 publications

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“…In Egypt, trichomoniasis was reported by many authors (El-Sherbini et al, 2009;Kamal et al, 2015;Abdel-Magied et al, 2017;Elwakil et al, 2017). T. vaginalis infected females were presented with clinical symptoms ranged between asymptomatic to acute or chronic infections (Sherrard et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Potential Role of Trichomonas Vaginalis in Women With Primary and Secondary Infertility in Beni-Suef, Egypt

Ibrahim¹,

Ismail²,

Elaskary³

et al. 2021

Journal of the Egyptian Society of Parasitology

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Section: Introductionmentioning

confidence: 99%

Potential Role of Trichomonas Vaginalis in Women With Primary and Secondary Infertility in Beni-Suef, Egypt

Ibrahim¹,

Ismail²,

Elaskary³

et al. 2021

Journal of the Egyptian Society of Parasitology

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“…Iron is a key structural and metabolic component of PFOR and Fdx; decreasing iron stores available to T. vaginalis isolates decrease their ability to synthesize these critically important enzymes. Supplemental addition of iron with MTZ treatment decreases MLCs under both aerobic and anaerobic conditions in MTZ-sensitive strains (Elwakil et al ., 2017).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of the literature on mechanisms of 5-nitroimidazole resistance inTrichomonas vaginalis

et al. 2020

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Background Trichomonas vaginalis is the most common non-viral sexually transmitted infection. 5-Nitroimidazoles [metronidazole (MTZ) and tinidazole (TDZ)] are FDA-approved treatments. To better understand treatment failure, we conducted a systematic review on mechanisms of 5-nitroimidazole resistance. Methods PubMed, ScienceDirect and EMBASE databases were searched using keywords Trichomonas vaginalis, trichomoniasis, 5-nitroimidazole, metronidazole, tinidazole and drug resistance. Non-English language articles and articles on other treatments were excluded. Results The search yielded 606 articles, of which 550 were excluded, leaving 58 articles. Trichomonas vaginalis resistance varies and is higher with MTZ (2.2–9.6%) than TDZ (0–2%). Resistance can be aerobic or anaerobic and is relative rather than absolute. Differential expression of enzymes involved in trichomonad energy production and antioxidant defenses affects 5-nitroimidazole drug activation; reduced expression of pyruvate:ferredoxin oxidoreductase, ferredoxin, nitroreductase, hydrogenase, thioredoxin reductase and flavin reductase are implicated in drug resistance. Trichomonas vaginalis infection with Mycoplasma hominis or T. vaginalis virus has also been associated with resistance. Trichomonas vaginalis has two genotypes, with greater resistance seen in type 2 (vs type 1) populations. Discussion 5-Nitroimidazole resistance results from differential expression of enzymes involved in energy production or antioxidant defenses, along with genetic mutations in the T. vaginalis genome. Alternative treatments outside of the 5-nitroimidazole class are needed.

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“…В связи с этим необходим поиск совершенно но вых подходов к терапии трихомониаза или возможных способов потенцирования действия 5нитроимидазо лов. Учитывая, что ранее однократно было показано, что ионы железа двухвалентного способны потенциро вать действие метронидазола в отношении трихомонад в условиях in vitro, мы решили изучить, будет ли наблю даться эта закономерность в условиях in vivo [15].…”

Section: Introductionunclassified

Effect of topical use of solution containing ferrous ions on treatment efficacy in women with recurrent urogenital trichomoniasis

Cherkasova,

Kremleva,

Shchetinina

et al. 2022

CMAC

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Objective. To assess effect of topical use of solution containing ferrous ions on efficacy of metronidazole therapy in women with recurrent urogenital trichomoniasis. Materials and Methods. The study enrolled 55 women aged of 20–30 years with recurrent trichomoniasis after failures of multiple standard of care regimens. All patients received oral (tablets) and intravaginal (1% gel) metronidazole therapy. Participants in the experimental group (29 women) received intravaginal therapy with a solution of ferrous ions at concentration which was determined as effective for potentiating metronidazole in a previous study. In the control group, saline solution was used. Biological samples for laboratory tests were collected prior to treatment and on treatment days 4, 8 and 22. Treatment efficacy was assessed by laboratory results (detection of T. vaginalis, leukocyte-epithelial index). Results. Concomitant use of solutions containing ferrous ions at concentration 8.96 mmol/L can increase frequency of successful treatment outcomes in recurrent trichomoniasis. T. vaginalis was detected at the end of therapy in 10.3% of patients from the experimental group and 69.2% of patients from the control group. Conclusions. The concomitant use of metronidazole and solution containing ferrous ions makes it possible to increase the efficacy of therapy for Trichomonas infection. The results of the study allow us to consider topical use of iron-containing drugs to increase metronidazole treatment efficacy in recurrent trichomoniasis.

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The effect of iron on metronidazole activity against Trichomonas vaginalis in vitro

Cited by 9 publications

References 12 publications

Potential Role of Trichomonas Vaginalis in Women With Primary and Secondary Infertility in Beni-Suef, Egypt

Potential Role of Trichomonas Vaginalis in Women With Primary and Secondary Infertility in Beni-Suef, Egypt

A systematic review of the literature on mechanisms of 5-nitroimidazole resistance inTrichomonas vaginalis

Effect of topical use of solution containing ferrous ions on treatment efficacy in women with recurrent urogenital trichomoniasis

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