In vitro evaluation of the scolicidal activity of cyclosporin A against the protoscolices of human echinococcus granulosus

ABSTRACT

Hydatid disease, also known as echinococcosis or hydatidosis, is caused by infection with larva of Echinococcus granulosus, which causes cystic hydatid disease. Surgery is the recommended treatment for hydatid cysts; however, drug therapy and percutaneous drainage have recently been introduced as alternative treatments. The scolicidal agents, including 3% hydrogen peroxide, 10% chlorhexidine, 20% hypertonic saline have been used mainly during surgical manipulation of the cysts. Recently cyclosporin A has been found to be lethal for E. granulosus protoscolices in vitro using cultured sheep hydatid cyst. The present work was designed to evaluate the effectiveness of different concentrations of cyclosporin A as a scolicidal agent on protoscolices of Echinococcus granulosus in vitro. Hydatid cysts were collected from 42 patients [10 males and 32 females with age range from 12-61 years] that have hydatosis during the surgical operation for the removal of these cysts. Eeosin exclusion test was utilized to examine the scolicidal activity of different concentrations of cyclosporin A compared to different concentrations of hydrogen peroxide, in addition to the effects on the integrity of the germinal layer compared to that produced by sodium hypochlorite. The results indicated that cyclosporin A, when used in a concentration of 25 micro g/ml, is more effective and safer than 3% solution of hydrogen peroxide; it can be used with sodium hypochlorite for complete scolicidal effect and melting of the germinal layer. In conclusion, cyclosporin A can be a good candidate as a scolicidal agent during surgical removal of hydatid cysts. The present work indicated that cyclosporin A has a good scolicidal effect when used in a concentration of 25 micro g/ml, and it is more effective and safer than 3% solution of hydrogen peroxide, it can be used in combination with sodium hypochlorite for complete scolicidal effect and melting of the germinal layer of the hydatid cyst. This may give an opportunity for using this compound in percutaneous drainage