Bevacizumab: A new take on therapy of muscle phase of Trichinella spiralis infection.

Trichinellosis is a zoonosis that causes health and economic problems worldwide. The available therapy is far from perfect as the conventional drugs used against Trichinella spiralis (T. spiralis) are active against the intestinal adult parasites but much less active against encapsulated larvae in muscles. Therefore, this work aimed to evaluate the effect of the anti-angiogenic agent, bevacizumab, on the muscle larvae of T. spiralis. For this aim, T. spiralis-infected mice were treated by two different doses of bevacizumab, thereafter larval counts as well as biochemical and pathological changes were evaluated in the muscles. The larval burden was reduced in the muscles of treated mice, denoting a detrimental effect of bevacizumab against encapsulated Trichinella larvae. Moreover, there was marked improvement of muscle inflammation with the treatment, evidenced by reduction of the proinflammatory cytokines (IL-6 and TNF-α) and regression of the inflammatory infiltrates in histological sections. Amelioration of oxidative stress in the muscle was also observed in treated animals with reduction of malondialdehyde and carbonic anhydrase III and increase in superoxide dismutase levels. Finally, the treatment induced downregulation of the expression of VEGF and CD31, denoting suppressed angiogenesis. All these beneficial effects were found to be dose dependent. In conclusion, bevacizumab exhibited anthelmintic, anti-inflammatory, antioxidant, and anti-angiogenic activities against Trichinella during the muscular phase of infection. Therefore, bevacizumab could be considered as a useful adjuvant treatment in the late stages of trichinellosis.

The scabicide effect of moxidectin in vitro and in experimental animals: Parasitological, histopathological and immunological evaluation.

Scabies is considered one of the commonest dermatological diseases that has a global health burden. Current treatment with ivermectin (IVM) is insufficient and potential drug resistance was noticed. Moxidectin (MOX), with a better pharmacological profile may be a promising alternative. The efficacy of moxidectin against Sarcoptes scabiei was assessed both in vitro and in vivo in comparison with ivermectin. For the in vitro assay, both drugs were used in two concentrations (50 µg/ml and 100 µg/ml). For the in vivo assay, twenty rabbits infected with Sarcoptes scabiei were divided into three groups: untreated, moxidectin-treated and ivermectin-treated with the same dose of 0.3 mg/kg once. Another four rabbits were used as a normal control non-infected group. Treatment efficacy was evaluated by clinical assessment, parasitological evaluation and histopathological examination of skin samples using Hematoxylin and eosin and toluidine blue for mast cell staining. Immune response was also assessed by immunohistochemical staining of CD3 T cells in skin samples. Our results showed that moxidectin had a high efficacy (100%) in killing mites when used in both concentrations (50 µg/ml, 100 µg/ml) in the in vitro assay. Concerning the in vivo assay, on day 14 post-treatment, all MOX-treated rabbits were mite-free with full clinical cure by the end of the study (D21) showing (100%) reduction of mites count. Also, marked improvement in the epidermis with absence of mites in skin samples were shown. Poor clinical and parasitological improvements were noted in the ivermectin-treated rabbits, when given as a single dose with a percentage reduction (60.67%) in the 2nd week and progressive increase in lesions and mites count in the 3rd week post-treatment. Regarding the immune response, MOX-treated group showed mild infiltration with both mast cells and CD3 T cells in comparison to severe infiltration with both types of cells in the untreated and IVM-treated group. On conclusion, our results demonstrated that a single dose of MOX was more effective than IVM, supporting MOX as a valuable therapeutic approach for scabies therapy.