Characterisation of the in vitro activity of a Nitazoxanide-N-methyl-1H-benzimidazole hybrid molecule against albendazole and nitazoxanide susceptible and resistant strains of Giardia intestinalis and its in vivo giardicidal activity

BACKGROUND It was previously demonstrated that CMC-20, a nitazoxanide and N-methyl-1H-benzimidazole hybrid molecule, had higher in vitro activity against Giardia intestinalis WB strain than metronidazole and albendazole and similar to nitazoxanide. OBJETIVES To evaluate the in vitro activity of CMC-20 against G. intestinalis strains with different susceptibility/resistance to albendazole and nitazoxanide and evaluate its effect on the distribution of parasite cytoskeletal proteins and its in vivo giardicidal activity. METHODS CMC-20 activity was tested against two isolates from patients with chronic and acute giardiasis, an experimentally induced albendazole resistant strain and a nitazoxanide resistant clinical isolate. CMC-20 effect on the distribution of parasite cytoskeletal proteins was analysed by indirect immunofluorescence and its activity was evaluated in a murine model of giardiasis. FINDINGS CMC-20 showed broad activity against susceptible and resistant strains to albendazole and nitaxozanide. It affected the parasite microtubule reservoir and triggered the parasite encystation. In this process, alpha-7.2 giardin co-localised with CWP-1 protein. CMC-20 reduced the infection time and cyst load in feces of G. muris infected mice similar to albendazole. MAIN CONCLUSIONS The in vitro and in vivo giardicidal activity of CMC-20 suggests its potential use in the treatment of giardiasis.

Characterisation of the in vitro activity of a Nitazoxanide-N-methyl-1H-benzimidazole hybrid molecule against albendazole and nitazoxanide susceptible and resistant strains of Giardia intestinalis and its in vivo giardicidal activity

BACKGROUND It was previously demonstrated that CMC-20, a nitazoxanide and N-methyl-1H-benzimidazole hybrid molecule, had higher in vitro activity against Giardia intestinalis WB strain than metronidazole and albendazole and similar to nitazoxanide. OBJETIVES To evaluate the in vitro activity of CMC-20 against G. intestinalis strains with different susceptibility/resistance to albendazole and nitazoxanide and evaluate its effect on the distribution of parasite cytoskeletal proteins and its in vivo giardicidal activity. METHODS CMC-20 activity was tested against two isolates from patients with chronic and acute giardiasis, an experimentally induced albendazole resistant strain and a nitazoxanide resistant clinical isolate. CMC-20 effect on the distribution of parasite cytoskeletal proteins was analysed by indirect immunofluorescence and its activity was evaluated in a murine model of giardiasis. FINDINGS CMC-20 showed broad activity against susceptible and resistant strains to albendazole and nitaxozanide. It affected the parasite microtubule reservoir and triggered the parasite encystation. In this process, alpha-7.2 giardin co-localised with CWP-1 protein. CMC-20 reduced the infection time and cyst load in feces of G. muris infected mice similar to albendazole. MAIN CONCLUSIONS The in vitro and in vivo giardicidal activity of CMC-20 suggests its potential use in the treatment of giardiasis.

Plant species used in giardiasis treatment: ethnopharmacology and in vitro evaluation of anti-Giardia activity

The aim of this study was to compile the traditional knowledge about plants used for the treatment of giardiasis, and also to carry out experimental research to evaluate the anti-Giardia activity of five species.To reach this objective, 398 interviews were performed using a previously prepared questionnaire, followed by an in vitro evaluation of giardicidal potential of hydroalcoholic leaf extracts of Anacardium occidentale L., Chenopodium ambrosioides L., Passiflora edulis Sims, Psidium guajava L., and Stachytarpheta cayennensis (Rich.) Vahl. Among the interviewed people, 55.53% reported the use of plants to treat diarrhea, the most severe symptom of giardiasis. The results indicated 36 species used by this population for these problems. The use of leaves (72.50%) of a single plant (64.25%) collected from backyards and gardens (44.34%) and prepared by decoction were predominant. The majority of the interviewees (85.52%) attributed their cure to the use of plants. In the experimental tests, all extracts inhibited the growth of Giardia lamblia trophozoites in different intensities: A. occidentale and P. guajava extracts elicited a moderate activity (250 ≤ IC50 ≤ 500 μg/ml), C. ambrosioides and S. cayennensis extracts evoked a high activity (100 ≤ IC50 ≤ 250 μg/ml), and P. edulis extract showed very high activity (IC50 ≤ 100 μg/ml). This study shows that an ethnopharmacological approach is useful in the selection of plant materials with potential giardicidal activity.

Plants and chemical constituents with giardicidal activity / Plantas e constituintes químicos com atividade giardicida

Intestinal infection caused by Giardia lamblia represents a serious public health problem, with increased rates of prevalence in numerous countries. Increased resistance of the parasite and the side-effects of the reference drugs employed in the treatment of giardiasis make necessary to seek new therapeutic agents. Natural products, especially of plant origin, represent excellent starting point for research. The objective of this study is to review the literature on plant extracts, fractions and chemical constituents whose giardicidal activity has been investigated in vitro. The review describes 153 (one hundred and fifty-three) plant species from 69 (sixty-nine) families that were evaluated for their giardicidal activity. The geographical distribution of the plant species, the part used, preparation, strain of Giardia lamblia tested and the results obtained by the authors are also given. One hundred and one compounds isolated from plant species, classified by chemical class, are presented. Recent aspects of research on natural products of plant origin employed in the treatment of giardiasis are also discussed.

Infecção intestinal causada por Giardia lamblia representa grave problema de saúde pública, com elevadas taxas de prevalência em diversos países. O aumento de resistência do parasita e os efeitos colaterais dos fármacos de referência empregados no tratamento da giardíase, tornam necessário a busca de novos agentes terapêuticos. Produtos naturais, especialmente de origem vegetal, representam excelentes fontes de pesquisas. Este trabalho tem como objetivo revisar a literatura de extratos de plantas, frações e compostos químicos com estudos in vitro de avaliação da atividade giardicida. A revisão refere 153 (cento e cinqüenta e três) espécies vegetais de 69 (sessenta e nove) famílias que foram submetidas à avaliação da atividade giardicida. Descreve a distribuição geográfica das espécies vegetais, parte usada, preparação, cepa de Giardia lamblia testada e resultados por autores. Apresenta 101 (cento e um) compostos isolados de espécies vegetais classificados por classes químicas. Discute aspectos recentes da pesquisa de produtos naturais de origem vegetal empregados no tratamento da giardíase.