Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-25T06:49:17.478Z Has data issue: false hasContentIssue false
  • English
  • Français

Monitoring the efficacy of different doses of praziquantel by quantification of circulating antigens in serum and urine of schistosomiasis patients

Published online by Cambridge University Press:  06 April 2009

L. van Lieshout ,
N. de Jonge ,
N. El-Masry ,
M. M. Mansour ,
S. Bassily ,
F. W. Krijger  and
A. M. Deelder
L. van Lieshout
Affiliation:
U.S. Naval Medical Research Unit No. 3, (Cairo, Egypt), FPO AE 09835-0007, USA Laboratory of Parasitology, Medical Faculty, University of Leiden, P.O. Box 9605, 2300 RC Leiden, The Netherlands
N. de Jonge
Affiliation:
Laboratory of Parasitology, Medical Faculty, University of Leiden, P.O. Box 9605, 2300 RC Leiden, The Netherlands Department of Clinical Chemistry, Diagnostic Centre SSDZ, P.O. Box 5010, 2600 GA Delft, The Netherlands
N. El-Masry
Affiliation:
U.S. Naval Medical Research Unit No. 3, (Cairo, Egypt), FPO AE 09835-0007, USA
M. M. Mansour
Affiliation:
U.S. Naval Medical Research Unit No. 3, (Cairo, Egypt), FPO AE 09835-0007, USA
S. Bassily
Affiliation:
U.S. Naval Medical Research Unit No. 3, (Cairo, Egypt), FPO AE 09835-0007, USA
F. W. Krijger
Affiliation:
Laboratory of Parasitology, Medical Faculty, University of Leiden, P.O. Box 9605, 2300 RC Leiden, The Netherlands
A. M. Deelder
Affiliation:
Laboratory of Parasitology, Medical Faculty, University of Leiden, P.O. Box 9605, 2300 RC Leiden, The Netherlands
Get access Rights & Permissions [Opens in a new window]

Summary

We evaluated the quantitation of two schistosome circulating antigens in serum and urine as a tool for the assessment of the efficacy of praziquantel dosage regimens (40 versus 60 mg/kgbw). In addition we compared the efficacy of two different brands of praziquantel (Biltricide® and Distocide®), given at the same dosage (40 mg/kgbw). Thirty five Egyptian hospitalized schistosomiasis mansoni patients participated in this study. Thirteen patients (Group 1) received 60 mg/kgbw Biltricide®, administered in 3 oral doses of 20 mg in one day; 22 individuals (Group 2) were treated with 40 mg/kgbw (12 Biltricide®, 10 Distocide®), given in one oral dose. Circulating anodic antigen (CAA) and circulating cathodic antigen (CCA) were quantitated by monoclonal antibody-based ELISA's before, and 1, 3 and 6 weeks after chemotherapy. Before treatment, all patients were positive for at least one of the circulating antigen assays. Three to six weeks after treatment significantly more patients were found to be negative in Group 1 compared to Group 2 (X2 = 7·13, P = 0·008, n = 35). Also the levels of CCA and CAA in serum and of CCA in urine were found to be significantly higher in Group 2 (Mann- Whitney U < 85, P < 0·05, n = 35). These results were confirmed by parasitological data. No differences were found between treatment with Biltricide® or Distocide®. Our results indicate that praziquantel treatment of schistosomiasis with 60 mg/kgbw divided in 3 doses results in a higher cure rate compared to 40 mg/kgbw as a single dose, and provide further evidence for the use of the CAA and CCA assays as a sensitive method to monitor the efficacy of chemotherapy, particularly when circulating antigen assays are combined by parallel testing.

Keywords

schistosomiasispraziquantelBiltricideDistocidedrug efficacycirculating anodic antigen (CAA)circulating cathodic antigen (CCA)
Type
Research Article
Information
Parasitology , Volume 108 , Issue 5 , June 1994 , pp. 519 - 526
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Barsoum, I. S., Kamal, K. A., Bassily, S., Deelder, A. M. & Colley, D. G. (1991). Diagnosis of human schistosomiasis by detection of circulating cathodic antigen with a monoclonal antibody. Journal of Infectious Diseases 164, 1010–13.CrossRefGoogle ScholarPubMed
Bell, D. (1967). Membrane filters and microfilariae: a new diagnostic technique. Annals of Tropical Medicine and Parasitology 61, 220–3.CrossRefGoogle ScholarPubMed
Deelder, A. M., De Jonge, N., Boerman, O. C., Fillié, Y. E., Hilberath, G. W., Rotmans, J. P., Gerritse, M. J. & Schut, D. W. O. A. (1989). Sensitive determination of circulating anodic antigen in Schistosoma mansoni infected individuals by an enzyme-linked immunosorbent assay using monoclonal antibodies. American Journal of Tropical Medicine and Hygiene 40, 268–72.CrossRefGoogle ScholarPubMed
De Jonge, N., De Caluwé, P., Hilberath, G. W., Krijger, F. W., Polderman, A. M. & Deelder, A. M. (1989 a). Circulating anodic antigen levels in serum before and after chemotherapy with praziquantel in schistosomiasis mansoni. Transactions of the Royal Society of Tropical Medicine and Hygiene 83, 368–72.CrossRefGoogle ScholarPubMed
De Jonge, N., Fillié, Y. E. & Deelder, A. M. (1987). A simple and rapid treatment (trichloro-acetic acid precipitation) of serum samples to prevent nonspecific reactions in the immunoassay of a proteoglycan. Journal of Immunological Methods 99, 195–7.CrossRefGoogle Scholar
De Jonge, N., Fillié, Y. E., Hilberath, G. W., Krijger, F. W., Lengeler, C., De Savigny, D. H., Van Vliet, N. G. & Deelder, A. M. (1989 b). Presence of schistosome circulating anodic antigen (CAA) in urine of patients with Schistosoma mansoni or S. haematobium infections. American Journal of Tropical Medicine and Hygiene 41, 563–9.CrossRefGoogle ScholarPubMed
De Jonge, N., Gryseels, B., Hilberath, G. W., Polderman, A. M. & Deelder, A. M. (1988). Detection of circulating anodic antigen by ELISA for seroepidemiology of schistosomiasis mansoni. Transactions of the Royal Society of Tropical Medicine and Hygiene 82, 591–4.CrossRefGoogle ScholarPubMed
De Jonge, N., Kremsner, P. G., Krijger, F. W., Schommer, G., Fillié, Y. E., Kornelis, D., Van Zeyl, R. J. M., Van Dam, G. J., Feldmeier, H. & Deelder, A. M. (1990 a). Detection of the schistosome circulating cathodic antigen by enzyme immunoassay using biotinylated monoclonal antibodies. Transactions of the Royal Society of Tropical Medicine and Hygiene 84, 815–18.CrossRefGoogle ScholarPubMed
De Jonge, N., Schommer, G., Feldmeier, H., Krijger, F. W., Dafalla, A. A., Bienzle, U. & Deelder, A. M. (1990 b). Mixed Schistosoma haematobium and S. mansoni infection: effect of different treatments on the serum level of circulating anodic antigen (CAA). Acta Tropica 48, 25–35.CrossRefGoogle ScholarPubMed
De Vlas, S. J. & Gryseels, B. (1992). Underestimation of Schistosoma mansoni prevalences. Parasitology Today 8, 274–7.CrossRefGoogle ScholarPubMed
El-Masry, N. A., Bassily, S. & Fared, Z. (1988). A comparison of the efficacy and side effects of various regimens of praziquantel for the treatment of schistosomiasis. Transactions of the Royal Society of Tropical Medicine and Hygiene 82, 719–20.CrossRefGoogle ScholarPubMed
Gryseels, B. & Polderman, A. M. (1991). Morbidity, due to schistosomiasis mansoni, and its control in subsaharan Africa. Parasitology Today 7, 244–8.CrossRefGoogle ScholarPubMed
Hassan, M. M., Badawi, M. A. & Strand, M. (1992). Circulating schistosomal antigen in diagnosis and assessment of cure in individuals infected with Schistosoma mansoni. American Journal of Tropical Medicine and Hygiene 46, 737–44.CrossRefGoogle ScholarPubMed
Homeida, M. M. A., Eltom, I. A., Sulaiman, S. M., Ali, H. M. & Bennet, J. L. (1989). Tolerance of two brands of praziquantel. The Lancet Aug 12, 391.CrossRefGoogle Scholar
Katz, N., Chaves, A. & Pellegrino, J. (1972). A simple device for quantitative stool thick smear technique in schistosomiasis mansoni. Revista do Instituto de Medicina tropical de Sao Paulo 14, 397–400.Google ScholarPubMed
Katz, N., Rocha, R. S. & Chaves, A. (1981). Clinical trials with praziquantel in schistosomiasis mansoni. Revista do Instituto de Medicina tropical de Sao Paulo 23, 72–8.Google ScholarPubMed
King, C. H. & Mahmoud, A. A. F. (1989). Drugs five years later: praziquantel. Annals of Internal Medicine 110, 290–6.CrossRefGoogle ScholarPubMed
Kremsner, P. G., De Jonge, N., Simarro, P. P., Mühlschlegel, F., Mir, M., Sima, F. O., Feldmeier, H., Bienzle, U. & Deelder, A. M. (1993). Quantitative determination of circulating anodic and cathodic antigens in serum and urine of individuals infected with Schistosoma intercalatum. Transactions of the Royal Society of Tropical Medicine and Hygiene 87, 167–9.CrossRefGoogle ScholarPubMed
Madwar, M. A., Hassan, M. M. & Strickland, G. T. (1988). Circulating antigens for assessing cure in schistosomiasis mansoni. Transactions of the Royal Society of Tropical Medicine and Hygiene 82, 881–4.CrossRefGoogle ScholarPubMed
Mandour, M. E. M., El Turabi, H., Homeida, M. M. A., El Sadig, T., Ali, H. M., Bennett, J. L., Leahey, W. J. & Harron, D. W. G. (1990). Pharmacokinetics of praziquantel in healthy volunteers and patients with schistosomiasis. Transactions of the Royal Society of Tropical Medicine and Hygiene 84, 389–93.CrossRefGoogle ScholarPubMed
Massoud, A. A. E., El Kholy, A. M. & Anwar, W. A. (1984). Assessment of efficacy of praziquantel against Schistosoma mansoni infection. Journal of Tropical Medicine and Hygiene 87, 119–21.Google ScholarPubMed
Polderman, A. M., Gryseels, B. & De Caluwé, P. (1988). Cure rates and egg reduction in treatment of intestinal schistosomiasis with oxamniquine and praziquantel in Maniema, Zaire. Transactions of the Royal Society of Tropical Medicine and Hygiene 82, 115–16.CrossRefGoogle ScholarPubMed
Ripert, C., Appriou, M., Tribouley-Duret, J., Tribouley, J., Ambassa, P. & Samé-Ekobo, A. (1989). Effect of a mass treatment with praziquantel on the excretion in urine of a polysaccharide antigen used for diagnosis of schistosomiasis due to S. mansoni in Cameroon. Tropical Medicine and Parasitology 40, 169–71.Google Scholar
Shekhar, K. C. (1991). Schistosomiasis drug therapy and treatment considerations. Drugs 42, 379–405.CrossRefGoogle ScholarPubMed
Stelma, F. F., Talla, I., Niang, M., Sturrock, R. F. & Gryseels, B. (1992). Schistosoma mansoni infection in a non-immune community in Northern Senegal. In XIIIth International Congress for Tropical Medicine and Malaria, Abstracts, Vol. 2, MoP3–16.Google Scholar
Van Dam, G. J., Seind, J., Rotmans, J. P., Daha, M. R. & Deelder, A. M. (1993). Schistosoma mansoni circulating anodic antigen but not circulating cathodic antigen interacts with complement component C1q. European Journal of Immunology 23, 2807–12.CrossRefGoogle Scholar
Van Lieshout, L., De Jonge, N., Bassily, S., Mansour, M. M. & Deelder, A. M. (1991). Assessment of cure in schistosomiasis patients after chemotherapy with praziquantel by quantitation of circulating anodic antigen (CAA) in urine. American Journal of Tropical Medicine and Hygiene 44, 323–8.CrossRefGoogle ScholarPubMed
Van Lieshout, L., De Jonge, N., El Masry, N. A., Mansour, M. M., Krijger, F. W. & Deelder, A. M. (1992). Improved diagnostic performance of the circulating antigen assay in human schistosomiasis by parallel testing for circulating anodic and cathodic antigens in serum and urine. American Journal of Tropical Medicine and Hygiene 47, 463–9.CrossRefGoogle ScholarPubMed
Van Lieshout, L., De Jonge, N., Mansour, M. M., Bassily, S., Krijger, F. W. & Deelder, A. M. (1993). Circulating cathodic antigen levels in serum and urine of schistosomiasis patients before and after chemotherapy with praziquantel. Transactions of the Royal Society of Tropical Medicine and Hygiene 87, 311–12.CrossRefGoogle ScholarPubMed
Van 'T Wout, A. B., De Jonge, N., Tiu, W. U., Garcia, E. E., Mitchell, G. F. & Deelder, A. M. (1992). Schistosome circulating anodic antigen in serum of individuals infected with Schistosoma japonicum from the Philippines before and after chemotherapy with praziquantel. Transactions of the Royal Society of Tropical Medicine and Hygiene 86, 410–13.CrossRefGoogle ScholarPubMed
Webbe, G. (1987). Treatment of schistosomiasis. European Journal of Clinical Pharmacology 32, 433–6.CrossRefGoogle ScholarPubMed
Wilkins, H. A. (1989). Reinfection after treatment of schistosome infections. Parasitology Today 5, 83–8.CrossRefGoogle ScholarPubMed