Albendazole solid dispersions against alveolar echinococcosis: a pharmacotechnical strategy to improve the efficacy of the drug

Ubenimex combined with Albendazole for the treatment of Echinococcus multilocularis-induced alveolar echinococcosis in mice

Introduction

Alveolar echinococcosis (AE) is a parasitic disease caused by E. multilocularis metacestodes and it is highly prevalent in the northern hemisphere. We have previously found that vaccination with E. multilocularis-Leucine aminopeptidase (EM-LAP) could inhibit the growth and invasion of E. multilocularis in host liver, and Ubenimex, a broad-spectrum inhibitor of LAP, could also inhibit E. multilocularis invasion but had a limited effect on the growth and development of E. multilocularis.

Methods

In this study, the therapeutic effect of Ubenimex combined with Albendazole on AE was evaluated. Mice were intraperitoneally injected with protoscoleces and imaging examination was performed at week 8 and week 16 to detect cyst change. During this period, mice were intraperitoneally injected with Ubenimex and intragastrically administered with Albendazole suspension. At last, the therapeutic effect was evaluated by morphological and pathological examination and liver function.

Results

The results revealed that the combined treatment could inhibit the growth and infiltration of cysts in BALB/c mice infected with E. multilocularis protoscoleces. The weight, number, invasion and fibrosis of cysts were reduced in mice treated with Ubenimex in combination with Albendazole. The same effect was achieved by the single Ubenimex treatment because of its inhibitory effect on LAP activity, but it was less effective in inhibiting the growth of cysts. The levels of ALT, AST, TBIL, DBIL, ALP, and γ-GT were reduced after the combined treatment, indicating that treatment with both Ubenimex and Albendazole could alleviate liver damage.

Discussion

This study suggests that the combined treatment with Ubenimex and Albendazole could be a potential therapeutic strategy for E. multilocularis infections.

Hepatic Alveolar Echinococcosis: Predictive Biological Activity Based on Radiomics of MRI

Background

To evaluate the role of radiomics based on magnetic resonance imaging (MRI) in the biological activity of hepatic alveolar echinococcosis (HAE).

Methods

In this study, 90 active and 46 inactive cases of HAE patients were analyzed retrospectively. All the subjects underwent MRI and positron emission tomography computed tomography (PET-CT) before surgery. A total of 1409 three-dimensional radiomics features were extracted from the T2-weighted MR images (T2WI). The inactive group in the training cohort was balanced via the synthetic minority oversampling technique (SMOTE) method. The least absolute shrinkage and selection operator (LASSO) regression method was used for feature selection. The machine learning (ML) classifiers were logistic regression (LR), multilayer perceptron (MLP), and support vector machine (SVM). We used a fivefold cross-validation strategy in the training cohorts. The classification performance of the radiomics signature was evaluated using receiver operating characteristic curve (ROC) analysis in the training and test cohorts.

Results

The radiomics features were significantly associated with the biological activity, and 10 features were selected to construct the radiomics model. The best performance of the radiomics model for the biological activity prediction was obtained by MLP (AUC = 0.830 ± 0.053; accuracy = 0.817; sensitivity = 0.822; specificity = 0.811).

Conclusions

We developed and validated a radiomics model as an adjunct tool to predict the HAE biological activity by combining T2WI images, which achieved results nearly equal to the PET-CT findings.