Treatment of echinococcosis: albendazole and mebendazole – what else?

Abstract

The search for novel therapeutic options to cure alveolar echinococcosis (AE), due to the metacestode of Echinococcus multilocularis, is ongoing, and these developments could also have a profound impact on the treatment of cystic echinococcosis (CE), caused by the closely related Echinococcus granulosus s.l. Several options are being explored. A viable strategy for the identification of novel chemotherapeutically valuable compounds includes whole-organism drug screening, employing large-scale in vitro metacestode cultures and, upon identification of promising compounds, verification of drug efficacy in small laboratory animals. Clearly, the current focus is targeted towards broad-spectrum anti-parasitic or anti-cancer drugs and compound classes that are already marketed, or that are in development for other applications. The availability of comprehensive Echinococcus genome information and gene expression data, as well as significant progress on the molecular level, has now opened the door for a more targeted drug discovery approach, which allows exploitation of defined pathways and enzymes that are essential for the parasite. In addition, current in vitro and in vivo models that are used to assess drug efficacy should be optimized and complemented by methods that give more detailed information on the host-parasite interactions that occur during drug treatments. The key to success is to identify, target and exploit those parasite molecules that orchestrate activities essential to parasite survival.

Cystic echinococcosis therapy: Albendazole-loaded lipid nanocapsules enhance the oral bioavailability and efficacy in experimentally infected mice

“…In the current experimental work, we characterized the plasma and cyst exposure of ABZ, ABZ-SO and ABZ-SO2, and the clinical efficacy of ABZ against CE developed in mice, after the administration of 5 mg/kg ABZ as a LNCbased formulation or a conventional suspension. Other authors have compared the effect of different new drugs or formulations versus ABZ at doses up to 200 mg/kg (Hemphill et al, 2014). As we mentioned above, ABZ is barely absorbed from the gastrointestinal tract since it is a poorly watersoluble drug.…”

Immunotherapy of alveolar echinococcosis via PD‐1/PD‐L1 immune checkpoint blockade in mice

“…Therefore, recurrence rates after interruption of therapy are high. Beside the inconvenience of a daily and long‐term drug administration, some patients experience side effects such as hepatotoxicity and drug interactions, thus alternative treatment options are required, especially when this could offer a curative prognosis.…”

Presentation of secondary parasitic infection 37 years after primary infection

“…Benzimidazoles, such as Albendazole remain the most clinically used chemotherapy [1] which is continued for weeks to months [10]. Praziquantel can be used in conjunction with Benzimidazoles [10].…”