PubMed · 15733711
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Masamine Jimba, Jitra Waikugul, Somei Kojima, Tsutomu Takeuchi, Pratap Singhasivanon. Beyond deworming.. https://doi.org/10.1016/s0140-6736(05)17976-8
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Praziquantel (PZQ) is a broadly effective anthelminthic drug available for human and veterinary use, being the drug of choice for the treatment of all forms of schistosomiasis. Nevertheless, large doses are required in order to achieve adequate concentrations at the target site due to the poor solubility of PZQ and its significant first pass metabolism. To improve it, avoiding efficiency loss, we have designed a controlled-release system, in which PZQ was encapsulated in beta-cyclodextrin (beta-CD). The inclusion complexes between PZQ/beta-CD were studied at two different stoichiometries 1:1 and 1:2, through experimental and theoretical analysis. Molecular modeling calculations were used to foresee the better stoichiometry of the complex formed as well as the possible orientations of PZQ inside the beta-CD cavity. The complexes prepared were analyzed through H1 two-dimensional nuclear magnetic resonance (H1 2D-NMR) experiments, which provide (evidences) for the 1:1 complexation of PZQ/beta-CD. H1 2D-NMR also revealed details of PZQ/beta-CD molecular interaction, in which the isoquinoline ring of praziquantel is located inside the beta-CD cavity. Finally, phase-solubility diagrams revealed a five-fold increase in praziquantel water solubility upon addition of increasing beta-CD concentrations up to 16 mM, corresponding to the solubility of beta-CD itself. The solubilization profile is consistent with 1:1 stoichiometry of the PZQ/beta-CD complex while the solubilization effect will certainly increase the pharmacological activity of praziquantel.
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Parasitic infections, although common in tropical and subtropical regions, are prevalent worldwide because of changing immigration patterns and in international travel. The burden of worm infection is enormous and the intensity of infection is usually high among the poor and in immunocompromised individuals. Pulmonary eosinophilia occurs in almost all metazoan infections. In the Western world, the most common infections are caused by Strongyloides, Ascaris, Toxocara, and Ancylostoma species. Most of the nematodes multiply within the human host and cause pulmonary eosinophilia during larval migration through the lungs. Despite larval migration through the lungs, there is usually no permanent lung damage. The result is an increased number of eosinophils in the airways or lung parenchyma with or without peripheral eosinophilia. Löffler's syndrome, visceral larva migrans, and tropical pulmonary eosinophilia are the most common infections that cause pulmonary eosinophilia. The most serious parasitic eosinophilic lung disease is tropical pulmonary eosinophilia, a disorder caused by the filarial worms Wuchereria bancrofti and Brugia malayi, in which cases have typically been reported to masquerade acute or refractory bronchial asthma. Increasing awareness, newer diagnostic techniques, preventative measures, and antiparasitic drugs are important in reducing the worldwide morbidity and mortality from parasitic helminths and protozoa. This review focuses on common and some uncommon causes of pulmonary parasitic eosinophilia and their manifestations, diagnosis, and management.