In Vitro Scolicidal Activity of the Sesquiterpenes Isofuranodiene, α-Bisabolol and Farnesol on Echinococcus granulosus Protoscoleces

Therapeutic Options in Hydatid Hepatic Cyst Surgery: A Retrospective Analysis of Three Surgical Approaches

Hydatid disease is endemic in certain geographical areas where animal breeding is common, frequently challenging the medical services in these regions. Hydatid cysts most often affect the liver, with damage to other organs accounting for around one-third of the total cases. The alternative to interventional or pharmacological approaches is surgical treatment, available in variants such as laparoscopy, laparoscopy with special instruments for hydatid disease, or open surgery. This article aims to analyze the outcomes of these three types of surgical approaches, considering preoperative indications, operative techniques and efficiency, and immediate and long-term postoperative results. A total of 149 patients from two different surgical units were analyzed over a period of seven years. It was observed that males were more affected by this pathology (53.02%), with the majority of patients coming from rural areas (62.42%). The distribution by surgical procedure type showed that 50.34% were operated on using open surgery, 33.56% by means of a laparoscopic approach with the usual instruments, and 16.11% by means of a laparoscopic approach with special instruments. The laparoscopic procedure with special instruments presented a lower rate of conversion to open surgery compared to the usual laparoscopic approach (p = 0.014). The analysis of the average operative duration revealed statistically significant differences between the three types of surgical techniques (p < 0.05), noting that interventions with specialized instruments had the shortest duration, while open surgery had the longest operative time (72.5 ± 27.23 min vs. 154 ± 52.04 min). In terms of intraoperative complications, they were documented in 8.34% of cases for the group operated on with special instruments, in 12.24% of cases for the standard laparoscopy group, and in 16% of cases for the open surgery group. Maximal cystectomy was the preferred method for resolving these cysts using minimally invasive surgery (p < 0.001), while Lagrot pericystectomy was preferred in the open approach (p < 0.001). The most frequent postoperative complication was biliary fistula (24.16%), encountered in varying percentages across each technique but without significant statistical difference (p > 0.05). Open surgery was associated with a longer length of hospitalization compared to minimally invasive procedures (p < 0.05), a higher number of late postoperative complications (p = 0.002), and a significantly higher number of recurrences (p < 0.001) compared to the other two techniques. The present study highlights the effectiveness of minimally invasive surgery for hydatid cysts as a safe alternative with fewer complications and superior results compared to open surgery. Additionally, it provides a comparative analysis of these surgical approaches (special instruments, standard laparoscopy, and open surgery) to hydatid disease for the first time. Under the circumstances where pharmacological treatment is recommended as a supportive measure before and after procedures, and using medication alone as the primary treatment option shows only modest efficacy, there is a necessity to consider invasive treatment methods. Percutaneous procedures represent the least invasive form of treatment, yielding results comparable to surgery in terms of efficacy. However, their effectiveness is influenced by factors such as the cyst's stage of development, its location, and the challenges in achieving complete intra-procedural isolation. Laparoscopy, particularly when using specialized instruments tailored to the tactical and technical demands of managing hydatid disease, serves to address the limitations of percutaneous methods. Open surgery's role is increasingly restricted, primarily serving as a fallback option in laparoscopic procedures or in cases complicated by hydatid disease. In conclusion, despite the rising popularity of percutaneous methods, surgery remains a viable therapeutic option for treating hydatid disease. Minimally invasive surgical interventions are increasingly versatile and yield comparable outcomes, further solidifying the role of surgery in its management.

Anti-Opisthorchis felineus effects of artemisinin derivatives: An in vitro study

BACKGROUND

The drug of choice for the treatment of opisthorchiasis caused by trematodes Opisthorchis viverrini and O. felineus is praziquantel (PZQ), but there is a constant search for new anthelmintics, including those of plant origin. Positive results on the use of artemisinin derivatives against O. viverrini opisthorchiasis have been shown previously, but the effect of these compounds on O. felineus has not been studied. Therefore, here, a comparative analysis of anthelmintic properties of artemisinin derivatives (artesunate [AS], artemether [AM], and dihydroartemisinin [DHA]) was carried out in vitro in relation to PZQ. Experiments were performed on newly excysted metacercariae (NEMs) and adult flukes of O. felineus.

RESULTS

Dose- and time-dependent effects of artemisinin derivatives and of PZQ were assessed in terms of motility and mortality of both NEMs and adult flukes. The most pronounced anthelmintic action was exerted by DHA, whose half-maximal inhibitory concentrations (IC50) of 1.9 (NEMs) and 2.02 µg/mL (adult flukes) were lower than those of PZQ (0.56 and 0.25 µg/mL, respectively). In contrast to PZQ, the effects of DHA and AS were similar when we compared the two developmental stages of O. felineus (NEMs and adult flukes). In addition, AM, AS, and especially DHA at doses of 100 µg/mL disrupted tegument integrity in adult flukes, which was not observed with PZQ.

CONCLUSIONS

Artemisinin derivatives (AS, AM, and DHA) have good anthelmintic efficacy against the trematode O. felineus, and the action of these substances is comparable to (and sometimes better than) the effects of PZQ.

Chemical compounds, antioxidant and scolicidal potencies of Thymus fontanesii essential oil

Medicinal plants have become a source of new drugs to treat various diseases due to their low cost, few side effects, and wide accessibility. Among these, essential oils are promising natural compounds for use in scolicidal activity. The targets of our current work were to assess the chemical composition, antioxidant and protoscolicidal activities of Thymus fontanesii essential oil. The essential oil was extracted by hydrodistillation, and chemical compounds were quantified by GC-MS/GC-FID. The in vitro antioxidant activity was determined by DPPH radical scavenging assay and ferric reducing power. Three concentrations of essential oil (4.625, 9.25, and 13.875 mg/ml) were tested for 5, 10, and 15 min against E. granulosus protoscoleces and their viability was assessed by eosin staining essay. The yield of the essential oil was 2.06 ± 0.41 % (w/w). Carvacrol (59.68 %) was the main compound of Thymus fontanesii essential oils. Moreover, Thymus fontanesii essential oil has an antioxidant activity IC50 of 346.08 μg/ml and EC50 of 869.82 μg/ml. Furthermore, 100 % mortality of protoscoleces was observed at the doses of 9.25 mg/ml and 13.875 mg/ml after 5 min of exposure. Our findings show a potency of antioxidant and protoscolicidal activities against protoscoleces of E. granulosus.

In vitro and in silico scolicidal effect of sanguinarine on the hydatid cyst protoscoleces

We aimed to investigate the scolicidal effects of sanguinarine on hydatid cyst protoscoleces (PSCs) in vitro and in silico. Different targets were docked into the active sites of sanguinarine. Molecular docking processes and visualization of interactions were performed using AutoDock Vina and Discovery Studio Visualizer. Binding energy was calculated and compared (kcal/mol). PSCs were aspirated from the hydatid cysts and washed. The sediments of PSCs were then exposed to various concentrations (50, 25, 12, 6, 3, and 1 μg/mL) of sanguinarine. The viability test was finally evaluated by the Trypan blue solution 4%. Levels of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH), glutathione peroxidase (GPX), and catalase were analyzed to assess the level of oxidative stress-treated PSCs. Caspase-3 activity rate was determined to evaluate cell apoptosis in treated PSCs. Among the receptors, acetylcholinesterase was identified as the excellent target, with Vina score of -11.8. Sanguinarine showed high scolicidal effects after 12, 24, and 48 h. Also, in the first hour of exposure to the drug, caspase-3 activity and MDA level significantly increased, but the levels of GSH and GPx had a significant reduction after 12, 24, and 48 h (P < 0.05). The findings of this study revealed that sanguinarine have potent scolicidal effects in vitro and in silico and could be considered an opportunity for the introduction of a novel and safe therapeutic agent for the treatment of cystic echinococcosis. However, supplementary studies will be desired to prove the current findings by examining sanguinarine in a clinical setting.

Expression profiling of exosomal miRNAs derived from different stages of infection in mice infected with Echinococcus granulosus protoscoleces using high-throughput sequencing

Echinococcosis is a worldwide zoonosis. The mechanism of the establishment, growth, and persistence of parasites in the host has not been fully understood. Exosomes are found to be a way of information exchange between parasites and hosts. They exist in various body fluids widely. There are few studies on host-derived exosomes and their miRNA expression profiles at different infection time points. In this study, BALB/c mice were intraperitoneally infected with protricercariae. Exosomes were extracted from plasma (0, 3, 9, and 20 weeks post infection), and the expression profiles of exosome miRNA in the peripheral blood of mice were determined using RNA-sequencing. Compared to the 0 week groups, 24, 35, and 22 differentially expressed miRNAs were detected in infected mouse at the three infection stages, respectively. The results showed that there were significant differences in the miRNAs of exosomes at different infection time points. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were used to annotate the different miRNAs. The results showed that the biological pathways of parasites changed significantly at different stages of infection, with many significant and abundant pathways involved in cell differentiation, inflammation, and immune response, such as MAPK signaling pathway, Th17 cell differentiation, Wnt signaling pathway, FoxO signaling pathway, Notch signaling pathway, etc. These results suggest that miRNA may be an important regulator of interactions between Echinococcus granulosus and host. The data provided here provide valuable information to increase understanding of the regulatory function of microRNAs in the host microenvironment and the mechanism of host-parasite interaction. This may help us to find targets for Echinococcus granulosus to escape host immune attack and control Echinococcus granulosus infection in the future.

The potential of Apiaceae species as sources of singular phytochemicals and plant-based pesticides

The Apiaceae Lindl. (=Umbelliferae Juss.), which includes several economical important vegetables, herbs, and spices, is one of the most numerous plant family. Umbelliferous crops (namely anise, fennel, carrot, coriander, parsley, etc.) are also valuable sources of botanical flavoring agents and fragrances. In addition, Apiaceae species yield a wide variety of distinctive specialized metabolites (i.e, volatile phenylpropanoids, furanocoumarins, sesquiterpene coumarins, polyacetylenes, and phthalides), some of them been described as uncommon natural phytochemicals exclusive of the family, which offers a great potential for bioprospection. Numerous studies have pointed out the outstanding biological activity of extracts and several classes of phytochemicals from Apiaceae species. Emphasis has been given to essential oils (EOs) and their constituents activities, most likely because this type of plant added value product benefits from a larger acceptance and application potential in integrated pest management (IPM) and integrated vector management (IVM) programs. Several species of the family offer a variety of unique compounds with great potential as biopesticidal and/or synergizing agents. Investigations covering their activity toward agricultural pests and phytopathogens have increased in the last years, nevertheless the interest remains strongly focus on arthropod species, predominantly those acting as vectors of human diseases. From our survey, it is patent the gap of knowledge concerning the potential molluscicidal properties of Apiaceae extracts/phytochemicals, as well as their herbicidal activities against invasive plant species. In this review, we propose to highlight the potential of Apiaceae species as suitable sources of bioactive phytochemicals with great relevance within the frame of plant-based pesticides R&D, and will discuss their applicability in real-world scenarios considering the recent developments regarding the design of stable formulations incorporating Apiaceae bioactive products. We expect that this review will encourage researchers to consider undervalued Apiaceae species as alternative sources of bioactive compounds and will give a contribute to the field by suggesting new research topics.