High efficacy of a dimeticone-based pediculicide following a brief application: in vitro assays and randomized controlled investigator-blinded clinical trial.

BACKGROUND: Increasing resistance of head lice against neurotoxic agents and safety concerns have led to the search for treatment alternatives. Dimeticones with a physical mode of action are safe, and bear a reduced risk for the development of resistance. METHODS: We performed in vitro bioassays to assess pediculicidal and ovicidal activities of a new dimeticone-based product, and a randomized controlled clinical trial to assess efficacy, following 10 min application. Of 153 individuals screened, 100 participants with active head louse infestations were randomly assigned to treatment with either a dimeticone-based test product, or a 0.5% permethrin-based reference product (50 participants per group). Participants received two topical applications of either the test (10 min) or reference products (45 min) at days 0 and 7 or 8. Outcome measures included the efficacies of treatment and their safety, as well as global and local tolerability at baseline, and days 1, 7, and 10. RESULTS: After 10 min exposure, all lice treated with the dimeticone test product were classified as non-viable in the in vitro assay. Ovicidal activity after treatment of eggs with the dimeticone test product was 96.8%. In the clinical trial, 96 patients completed all study visits. In the full analysis set (FAS) population, on day 1 after one application, 98% of patients were cured in the test group, as compared to 84% cured in the reference group. All participants in both groups were free of head lice on day 10, following two applications (100% cure rate). In total, 42 adverse events (AEs) in 23 patients of both treatment groups were recorded, with the majority of AEs classified as mild. CONCLUSIONS: We have shown a high level of pediculicidal and ovicidal activity, and clinical efficacy and safety, of a brief application of a new dimeticone-based product. The short application time and reduced risk for the development of resistance are key drivers for improved patients' compliance. TRIAL REGISTRATION: EU Clinical Trials Register EudraCT  2016-004635-20 . Registered 14 November 2016.

Brine shrimp lethality test as a biological model for preliminary selection of pediculicidal components from natural source / Teste de toxicidade frente artemia como modelo preliminar de busca de substâncias pediculicidas a partir de fontes naturais

Brine shrimp lethality test as a biological model for the preliminary selection of pediculicidal components from a natural source. In order to achieve a good correlation between pediculicidal activity and brine shrimp lethality (BSL) test, several pediculicidal substances and active essential oils were tested in BSL test, with the purpose to use the latter as convenient preliminary protocol for pediculicidal activity. Benzyl benzoate, deltametrine and essential oil of Eucalyptus were purchased and clove essential oil obtained by hydrodistillation, besides essential oils, chloroform extracts from Duguetia furfuracea were also submitted to BSL test. All of them were carried out with same protocol described to pediculicidal assay found in the literature, i.e, flask tests were examined every five minutes in the first half hour and then every ten minutes until all the naupli were dead or no movements were observed (knockdown). During the BSL test, it was possible to observe the effect of a particular lethal dose or only a knockdown in the arthropod, as occurred in the test with lice. The results of the BSL test for essential oils and other active substances are essentially in agreement with those described in literature for pediculicidal activity. Extracts and essential oil obtained from aerial parts of D. furfuracea did not present activity, but the essential oil from underground stem bark was active. α-asarone has already been isolated from the underground stem and it has been previously described to possess insecticidal activity.

O teste de toxicidade frente a Artemia salina (TAS) foi utilizado como modelo biológico preliminar na busca de substâncias potencialmente pediculicidas a partir de fontes naturais. Foi encontrada uma boa correlação entre a atividade pediculicida e o TAS, várias substâncias e óleos essenciais descritos como pediculicidas foram testados sobre o microcrustáceo, com o objetivo de se obter um protocolo preliminar e apropriado para detectar aquela atividade. Benzoato de benzila, deltametrina, e óleos essenciais de eucalipto e cravo foram obtidos comercialmente e/ou por extração. Além desses, extratos e óleos essenciais de Duguetia furfuracea também foram testados frente a Artemia. Todas as amostras foram conduzidas utilizando o mesmo protocolo proposto para atividade pediculicida, ou seja, os frascos testes foram lidos a cada cinco minutos na primeira meia hora e depois a cada dez minutos até os nauplios estarem mortos ou sem movimento (knockdown). Durante o TAS foi possível observar a dose letal ou somente o knockdown na larva, como ocorrido no teste com piolho. Os resultados do TAS para os óleos essencial e os demais compostos ativos estão essencialmente de acordo com o descrito na literatura para a atividade pediculicida. Extratos das sementes e óleos essenciais das folhas e sementes D. furfuracea não apresentaram atividade, mas o óleo das cascas do caule subterrâneo foi ativo α-asarona foi isolado das cascas do caule e esta substância apresenta atividade inseticida.