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Innovative chemotherapeutical treatment options for alveolar and cystic echinococcosis

Published online by Cambridge University Press:  16 July 2007

A. HEMPHILL ,
M. SPICHER ,
B. STADELMANN ,
J. MUELLER ,
A. NAGULESWARAN ,
B. GOTTSTEIN  and
M. WALKER
A. HEMPHILL*
Affiliation:
Institute of Parasitology, University of Berne, Länggass-Strasse 122, CH-3012 Berne, Switzerland
M. SPICHER
Affiliation:
Institute of Parasitology, University of Berne, Länggass-Strasse 122, CH-3012 Berne, Switzerland
B. STADELMANN
Affiliation:
Institute of Parasitology, University of Berne, Länggass-Strasse 122, CH-3012 Berne, Switzerland
J. MUELLER
Affiliation:
Institute of Parasitology, University of Berne, Länggass-Strasse 122, CH-3012 Berne, Switzerland
A. NAGULESWARAN
Affiliation:
Department of Pharmacology and Toxicology, Indiana University School of Medicine, 635 Barnhill Drive, MS A-515, Indianapolis, IN 46202, USA
B. GOTTSTEIN
Affiliation:
Institute of Parasitology, University of Berne, Länggass-Strasse 122, CH-3012 Berne, Switzerland
M. WALKER
Affiliation:
Department of Medicine, Harvard School of Public Health, Boston, MA 02115, USA
*
*Corresponding author: Institute of Parasitology, Vetsuisse Faculty, University of Berne, Länggass-Strasse 122, CH-3012 Berne, Switzerland. Tel: +41 31 6312384. Fax: +41 31 6312477. E-mail: hemphill@ipa.unibe.ch
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Summary

Echinococcus granulosus and Echinococcus multilocularis are cestode parasites, of which the metacestode (larval) stages cause the diseases cystic echinococcosis (CE) and alveolar echinococcosis (AE), respectively. Albendazole and mebendazole are presently used for chemotherapeutical treatment. However, these benzimidazoles do not appear to be parasiticidal in vivo against AE. In addition, failures in drug treatments as well as the occurrence of side-effects have been reported. New drugs are needed to cure AE and CE, which are considered to be neglected diseases. Strategies currently being implemented to identify novel chemotherapeutical treatment options include (i) conventional primary in vitro testing of broad-spectrum anti-infective drugs, either in parallel with, or followed by, animal experimentation; (ii) studies of drugs which interfere with the proliferation of cancer cells and of Echinococcus metacestodes; (iii) exploitation of the similarities between the parasite and mammalian signalling machineries, with a special focus on targeting specific signalling receptors; (iv) in silico approaches, employing the current Echinococcus genomic database information to search for suitable targets for compounds with known modes of action. In the present article, we review the efforts toward obtaining better anti-parasitic compounds which have been undertaken to improve chemotherapeutical treatment of echinococcosis, and summarize the achievements in the field of host-parasite interactions which may also lead to new immuno-therapeutical options.

Keywords

cystic echinococcosis (CE)alveolar echinococcosis (AE)chemotherapyimmunotherapysignallingdrugshost-parasite interactions
Type
Review Article
Information
Parasitology , Volume 134 , Issue 12 , November 2007 , pp. 1657 - 1670
Copyright
Copyright © Cambridge University Press 2007

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