[New indications of ivermectin]

Anti-inflammatory effects of ivermectin in mouse model of allergic asthma

BACKGROUND AND OBJECTIVE

Asthma is an inflammatory disease of the lungs that is characterised by increased inflammatory cell infiltration into the airways and poor respiratory function. Ivermectin is a semi-synthetic derivative of a family of macrocyclic lactones that shows broad-spectrum anti-parasitic activity. This drug has been shown to possess anti-inflammatory activity, but whether it can be used in asthma treatment has not yet been investigated. In this study, we aimed to investigate the inhibitory effects of ivermectin on allergic asthma symptoms in mice.

METHODS AND RESULTS

We used a mouse asthma model, in which allergic airway inflammation and airway remodelling were induced by ovalbumin (OVA) sensitisation and challenge. Ivermectin or PBS treatment was administered 1 h before OVA challenge. Ivermectin at 2 mg/kg significantly diminished recruitment of immune cells, production of cytokines in the bronchoalveolar lavage fluids and secretion of OVA-specific IgE and IgG1 in the serum. Histological studies indicated that ivermectin suppressed mucus hypersecretion by goblet cells in the airway.

CONCLUSIONS

This is the first study to demonstrate that ivermectin is an effective suppressor of inflammation and may be efficacious in the treatment of non-infectious airway inflammatory diseases such as allergic asthma.

Comparative pharmacokinetics of some injectable preparations containing ivermectin in dogs

Little is known about the kinetics of ivermectin formulations following subcutaneous administration in dogs. The vehicle components used in production may change the pharmacokinetics of the drug. The present study was aimed at the comparison of the pharmacokinetics of seven injectable ivermectin formulation of different brand names (A-G). The animals were allocated to seven groups, each comprising seven dogs. The dogs were administered ivermectin at a dose of 200 microg/kg bw by subcutaneous route and blood samples were collected from all groups up to 288h post-injection. Plasma ivermectin analyses were performed using a HPLC with a fluorescence detector. Compared to Group 1(A), it was determined that statistically significant differences existed in Groups 2(B), 3(C), 4(D), 5(E), and 7(G) for C(max) values; and in Groups 3(C), 4(D), 6(F), 7(G) for AUC(0-->288) and AUC(0-->infinity) values. These values were highest in Group 1(A) and lowest in Group 7(F). The results obtained in the present study demonstrated that, in cases which require subacute administration, optimal exposure is achieved with the preparation A. However, it must be noted that this evaluation was based on pharmacokinetic parameters and not antiparasitic efficacy.

Inhibitory effects of ivermectin on nitric oxide and prostaglandin E2 production in LPS-stimulated RAW 264.7 macrophages

We have previously shown that ivermectin inhibits LPS-induced production of inflammatory cytokines. In the present study, we investigated the effect of ivermectin on lipopolysaccharide (LPS)-induced nitric oxide (NO) and prostaglandin E(2) (PGE(2)) production in RAW 264.7 macrophages. Ivermectin inhibited LPS-induced NO and PGE(2) production. Consistent with these observations, the protein and mRNA expression levels of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) enzymes were inhibited by ivermectin in a concentration-dependent manner. Furthermore, the phosphorylation of p38, ERK1/2, and JNK in LPS-stimulated RAW 264.7 cells was suppressed by ivermectin in a dose-dependent manner. These results suggest that ivermectin suppresses NO and PGE(2) production, as well as iNOS and COX-2 expression, by inhibiting phosphorylation of mitogen-activated protein kinases (MAPK) (p38, ERK1/2, and JNK) in LPS-stimulated RAW 264.7 cells.

Myiasis owing to Dermatobia hominis in a HIV-infected subject: Treatment by topical ivermectin

We report the occurrence of myiasis owing to Dermatobia hominis (Dh) in a HIV-infected subject. HIV infection did not modify the pathogenicity of myiasis. However, the clinical presentation seemed unusual with voluminous inflammatory nodules. Use of topical ivermectin killed the larvae and facilitated their extraction.

Control of head lice: past, present and future

Pediculosis capitis is common among children. Rapid and accurate detection is an underlying principle of effective control and the use of a fine-tooth comb in wet, conditioned hair is most sensitive. However, none of the available treatments are fully effective. Of the current pediculicides available over the counter in the UK, those based on malathion are more effective than pyrethroids. Carbaryl is likely to be the most effective insecticide but is only available on prescription. Wet combing with conditioner has proven to be as effective as some over-the-counter lotions for unsupervised use in the home. There are several promising candidates for new insecticidal actives that are likely to be highly effective for a new generation of pediculicides, as well as a variety of unconventional novel treatments.

Ivermectin treatment of three cases of demodecidosis during human immunodeficiency virus infection

Demodecidosis is an ectoparasitosis that is infrequently observed in subjects with human immunodeficiency virus (HIV) infection. It has a rosacea-like presentation. We present three cases in patients with acquired immunodeficiency syndrome (AIDS). Two of these patients had a profuse eruption, and all three cases were cured by ivermectin. The single-dose treatment could be repeated in cases of subsequent recurrence. Ivermectin thus seems to be a good alternative in the treatment of demodecidosis in patients with HIV infection.

Démodécie chez un malade infecté par le VIH : guérison par ivermectine

INTRODUCTION

Demodex is a saprophyte parasite in mammals. In Man, it is associated with differing clinical profiles (rosacea-like dermatitis, folliculitis and blepharitis). We report a case of demodecidosis in an HIV-infected patient that was successfully treated with ivermectin.

CASE REPORT

A man from Laos, infected by HIV and treated for glandular tuberculosis, presented with a prurigenous eruption on the face and the pre-sternal and interscapular areas. Direct examination of scraped product and histopathological examinations confirmed the diagnosis of demodecidosis. Clinical cure was obtained after 2 single cures of ivermectin a one month's distance.

DISCUSSION

The features of demodecidosis are often similar to those of rosacea. In immunodeficient patients, the semiology remains the same but the eruption is more abundant. During HIV-infection, demodecidosis occurs at the AIDS stage or with a CD4 count lower than 200/mm3. Many anti-dust mite molecules are used to treat the disease but frequently lead to irritation. Administration of a single cure of ivermectin, repeated if necessary, appears to be an interesting alternative to contact anti-dust mite agents.