Efecto in vitro del antirretroviral tipranavir sobre taquizoitos de Toxoplasma gondii

La introducción de la terapia antirretroviral de alta eficiencia ha conllevado a una disminución en la frecuencia de neurotoxoplasmosis en personas con VIH. Experimentalmente se demostró que los antirretrovirales inhibidores de proteasas pueden tener además una acción directa sobre el parásito, en este caso Toxoplasma gondii. El objetivo es evaluar la actividad antitoxoplasma in vitro del tipranavir, un antirretroviral inhibidor de proteasa de tercera generación. Para ello se determinó la inhibición del crecimiento causada por el tipranavir sobre taquizoitos intracelulares de Toxoplasma gondii, así como su citotoxicidad frente a macrófagos residentes en el peritoneo de ratones OF-1. En paralelo, se evaluaron el atazanavir, la sulfadiazina y pirimetamina como fármacos de referencia. El tipranavir mostró actividad inhibitoria frente a taquizoitos de T. gonddi, con una CI50 de 21,2 ± 3,0 µM, la cual fue similar (p> 0,05) a la obtenida con la sulfadiazina (CI50= 23,3 ± 3,6 µM) y mayor (p< 0,05) que el atazanavir (CI50= 2,8 ± 0,7 µM) y la pirimetamina (CI50= 1,2 ± 0,2 µM). Sin embargo, mostró un valor de CC50 (105,9 ± 10,0 µM) superior (p< 0,05) con respecto a los fármacos de referencia (atazanavir (CC50= 25,0 ± 0,5 µM), sulfadiazina (CC50= 25,2 ± 3,2 µM) y pirimetamina (CC50= 4,4 ± 1,2 µM). En conclusión, este trabajo describe por primera vez la actividad in vitro del tipranavir sobre taquizoitos de T. gondii.

The introduction of highly efficient antiretroviral therapy has brought about a decrease in the frequency of neurotoxoplasmosis among people with HIV. It was demonstrated experimentally that protease inhibitor antiretrovirals may also have a direct action against the parasite, in this case Toxoplasma gondii. The purpose of the study was to evaluate the antitoxoplasma activity in vitro of tipranavir, a third-generation protease inhibitor antiretroviral. To achieve this aim, determination was made of the growth inhibition caused by tipranavir in Toxoplasma gondii intracellular tachyzoites, as well as its cytotoxicity against macrophages living in the peritoneum of OF-1 mice. Additionally, evaluation was conducted of atazanavir, sulfadiazine and pyrimethamine as reference drugs. Tipranavir displayed inhibitory activity against T. gondii tachyzoites, with a IC50 of 21.2 ± 3,0 µM, similar (p> 0.05) to the one obtained with sulfadiazine (IC50= 23.3 ± 3.6 µM) and higher (p< 0.05) than atazanavir (IC50= 2.8 ± 0.7 µM) and pyrimethamine (IC50= 1.2 ± 0.2 µM). However, its CC50 value (105.9 ± 10.0 µM) was higher (p< 0.05) than that of the reference drugs atazanavir (CC50= 25.0 ± 0.5 µM), sulfadiazine (CC50= 25.2 ± 3.2 µM) and pyrimethamine (CC50= 4.4 ± 1.2 µM). This is the first time a description is provided of the in vitro activity of tipranavir against T. gondii tachyzoites.

Antiretroviral activity of protease inhibitors against Toxoplasma gondii / Terapia antiretroviral de inibidores da protease contra Toxoplasma gondii

The introduction of highly active antiretroviral therapy (HAART) has caused a marked reduction in the occurrence and severity of parasitic infections, including the toxoplasmic encephalitis (TE). These changes have been attributed to the restoration of cell-mediated immunity. This study was developed to examine the activity of six antiretroviral protease inhibitors (API) on Toxoplasma gondii tachyzoites. The six API showed anti-Toxoplasma activity, with IC50 value between 1.4 and 6.6 µg/mL. Further studies at the molecular level should be performed to clarify if the use of API could be beneficial or not for AIDS patients with TE.

La introducción de la terapia antirretroviral de alta efectividad ha causada una marcada reducción en la ocurrencia y curso clínico de las infecciones parasitarias, incluyendo la toxoplasmosis encefálica (TE). Estos cambios han sido atribuidos a la restauración celular. Este estudio fue desarrollado para examinar la actividad de seis inhibidores de proteasas antirretrovirales (IPA) sobre taquizoitos de Toxoplasma gondii. Los seis IPA mostraron actividad anti-Toxoplasma, con valores de CI50 entre 1.4 y 6.6 µg/mL. Futuros estudios a nivel molecular deben ser realizados, los cuales podrán delucidar si el uso de IPA pudiera beneficiar o no a los pacientes que sufren de TE.

Primoinfección por Toxoplasma gondii durante el embarazo / Frist infection with Toxoplasma gondii during pregnancy

Congenital toxoplasmosis is a consequence of a first infection during pregnancy. A descriptive study was carried out in a sample of 181 pregnant women. This sample was representative of a universe integrated by pregnant women from 3 policlinics of La Lisa municipality, Havana City, booked from March to September 2004, with the aim of identifying those with acute or recent toxoplasmosis infection. As well, the follow-up and control of seronegative pregnant women was also conducted. The sample size was determined through a simple, randomized sampling. The serological method of Indirect Immunofluorescence (IFI) was used to detect the IgG and IgM anti-Toxoplasma antibodies, and the molecular method of the Polymerase Chain Reaction (PCR) to confirm infection in blood or amniotic fluid. One of the patients of this study, who was at her 18th week of gestation with acute infection and probable congenital transmission, showed seroconversion with IgG antibody titters of 1/256 and 1/2048 in her first and second sera, respectively. The result of the IgM detection was of 1/32. These findings demonstrate a 44,2% of seroprevalence of T. gondii infection in a pregnant women population

Toxoplasma gondii antigenuria in patients with acquired immune deficiency syndrome

A longitudinal study was performed with sera and urine of patients with acquired immune deficiency syndrome (AIDS), taken before, during and after clinically Toxoplasma infection. The tested patients were followed for an average of two years. The titres of the specific IgG and IgM antibodies were measured by an indirect fluorescent antibody test (IFAT), and the appearance of circulating antigens of T. gondii was determined in 36 urine samples of 13 patients with neurotoxoplasmosis by means of the coagglutination test. The presence of T. gondii antigens in the urine of AIDS patients by this test was correlated with the immunoblot technique, with clinical symptoms and also with pathological findings. Our results indicate that the detection of T. gondii antigens in the urine of AIDS patients can be regarded as a rapid and efficient method for the diagnosis of acute toxoplasmosis.