1
|
Zhu HTL, Luo J, Peng Y, Cheng XF, Wu SZ, Zhao YD, Chang L, Sun ZJ, Dong DL. Nitazoxanide protects against experimental ulcerative colitis through improving intestinal barrier and inhibiting inflammation. Chem Biol Interact 2024; 395:111013. [PMID: 38663798 DOI: 10.1016/j.cbi.2024.111013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/14/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024]
Abstract
Ulcerative colitis is a chronic disease with colonic mucosa injury. Nitazoxanide is an antiprotozoal drug in clinic. Nitazoxanide and its metabolite tizoxanide have been demonstrated to activate AMPK and inhibit inflammation, therefore, the aim of the present study is to investigate the effect of nitazoxanide on dextran sulfate sodium (DSS)-induced colitis and the underlying mechanism. Oral administration of nitazoxanide ameliorated the symptoms of mice with DSS-induced colitis, as evidenced by improving the increased disease activity index (DAI), the decreased body weight, and the shortened colon length. Oral administration of nitazoxanide ameliorated DSS-induced intestinal barrier dysfunction and reduced IL-6 and IL-17 expression in colon tissues. Mechanistically, nitazoxanide and its metabolite tizoxanide treatment activated AMPK and inhibited JAK2/STAT3 signals. Nitazoxanide and tizoxanide treatment increased caudal type homeobox 2 (CDX2) expression, increased alkaline phosphatase (ALP) activity and promoted tight junctions in Caco-2 cells. Nitazoxanide and tizoxanide treatment restored the decreased zonula occludens-1(ZO-1) and occludin protein levels induced by LPS or IL-6 in Caco-2 cells. On the other hand, nitazoxanide and tizoxanide regulated macrophage bias toward M2 polarization, as evidenced by the increased arginase-1expression in bone marrow-derived macrophages (BMDM). Nitazoxanide and tizoxanide reduced the increased IL-6, iNOS and CCL2 pro-inflammatory gene expressions and inhibited JAK2/STAT3 activation in BMDM induced by LPS. In conclusion, nitazoxanide protects against DSS-induced ulcerative colitis in mice through improving intestinal barrier and inhibiting inflammation and the underlying mechanism involves AMPK activation and JAK2/STAT3 inhibition.
Collapse
Affiliation(s)
- Hu-Tai-Long Zhu
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Jing Luo
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Yi Peng
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Xiao-Fan Cheng
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Shang-Ze Wu
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Yin-Di Zhao
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Le Chang
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Zhi-Jie Sun
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China.
| | - De-Li Dong
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China.
| |
Collapse
|
2
|
Liu KX, Wang ZY, Ying YT, Wei RM, Dong DL, Sun ZJ. The antiprotozoal drug nitazoxanide improves experimental liver fibrosis in mice. Biochem Pharmacol 2024; 224:116205. [PMID: 38615918 DOI: 10.1016/j.bcp.2024.116205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 03/18/2024] [Accepted: 04/11/2024] [Indexed: 04/16/2024]
Abstract
Nitazoxanide is an FDA-approved antiprotozoal drug. Our previous studies find that nitazoxanide and its metabolite tizoxanide affect AMPK, STAT3, and Smad2/3 signals which are involved in the pathogenesis of liver fibrosis, therefore, in the present study, we examined the effect of nitazoxanide on experimental liver fibrosis and elucidated the potential mechanisms. The in vivo experiment results showed that oral nitazoxanide (75, 100 mg·kg-1) significantly improved CCl4- and bile duct ligation-induced liver fibrosis in mice. Oral nitazoxanide activated the inhibited AMPK and inhibited the activated STAT3 in liver tissues from liver fibrosis mice. The in vitro experiment results showed that nitazoxanide and its metabolite tizoxanide activated AMPK and inhibited STAT3 signals in LX-2 cells (human hepatic stellate cells). Nitazoxanide and tizoxanide inhibited cell proliferation and collagen I expression and secretion of LX-2 cells. Nitazoxanide and tizoxanide inhibited transforming growth factor-β1 (TGF-β1)- and IL-6-induced increases of cell proliferation, collagen I expression and secretion, inhibited TGF-β1- and IL-6-induced STAT3 and Smad2/3 activation in LX-2 cells. In mouse primary hepatic stellate cells, nitazoxanide and tizoxanide also activated AMPK, inhibited STAT3 and Smad2/3 activation, inhibited cell proliferation, collagen I expression and secretion. In conclusion, nitazoxanide inhibits liver fibrosis and the underlying mechanisms involve AMPK activation, and STAT3 and Smad2/3 inhibition.
Collapse
Affiliation(s)
- Kai-Xin Liu
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Zeng-Yang Wang
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Ya-Ting Ying
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Rui-Miao Wei
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China
| | - De-Li Dong
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China.
| | - Zhi-Jie Sun
- Department of Pharmacology, China Pharmaceutical University, Nanjing, People's Republic of China.
| |
Collapse
|
3
|
Li C, Wang F, Han Y, Zhai J, Jin Y, Liu R, Niu Y, Yao Z, Zhao J. Nitazoxanide reduces inflammation and bone erosion in mice with collagen-induced arthritis via inhibiting the JAK2/STAT3 and NF-κB pathways in fibroblast-like synoviocytes. Biomed Pharmacother 2024; 171:116195. [PMID: 38262149 DOI: 10.1016/j.biopha.2024.116195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/25/2024] Open
Abstract
Our recent study showed that Nitazoxanide (NTZ), an FDA-approved anti-parasitic drug, prevents ovariectomy-induced bone loss by inhibiting osteoclast activity. However, there have been no investigations to determine whether NTZ has preventive potential in other bone resorbing diseases, especially rheumatoid arthritis (RA). In this study, the primary RA fibroblast-like synoviocytes (RA-FLS) and collagen-induced arthritis (CIA) murine model were used to evaluate the effect of NTZ. The results showed that NTZ potently inhibited proliferation, migration and invasion capacity of RA-FLS in a dose dependent manner by restraining cell entry into S phases, without induction of cell apoptosis. NTZ obviously reduced spontaneous mRNA expression of IL-1β, IL-6 and RANKL, as well as TNF-α-induced transcription of the IL-1β, IL-6, and MMP9 genes. In terms of molecular mechanism, NTZ significantly inhibited the basal or TNF-α-induced activation of JAK2/STAT3 (T705) and NF-κB pathway, but not MAPK and STAT3 (S727) phosphorylation. Moreover, NTZ ameliorated synovial inflammation and bone erosion in CIA mice through reducing the production of inflammatory mediators and osteoclast formation, respectively. Collectively, our findings indicate that NTZ exhibits anti-inflammatory and anti-erosive effects both ex vivo and in vivo, which provides promising evidence for the therapeutic application of NTZ as a novel therapeutic agent for RA.
Collapse
Affiliation(s)
- Changhong Li
- Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, PR China; Osteoporosis and Bone Metabolic Diseases Center, Peking University Third Hospital, Beijing 100191, PR China.
| | - Fengliang Wang
- Department of Internal Medicine, Qingdao Fuwai Cardiovascular Hospital, Qingdao 266000, PR China
| | - Yijun Han
- Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, PR China
| | - Jiayu Zhai
- Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, PR China
| | - Yinji Jin
- Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, PR China
| | - Rui Liu
- Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, PR China
| | - Yan Niu
- Department of Medicinal Chemistry, School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing 100191, PR China
| | - Zhongqiang Yao
- Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, PR China.
| | - Jinxia Zhao
- Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, PR China; Osteoporosis and Bone Metabolic Diseases Center, Peking University Third Hospital, Beijing 100191, PR China.
| |
Collapse
|
4
|
Rubio-Mora E, Carrascoso GR, Rodríguez JG. Sapovirus infection as another cause of persistent viral diarrhea: case series and review of the literature. Eur J Clin Microbiol Infect Dis 2024; 43:55-59. [PMID: 37924444 DOI: 10.1007/s10096-023-04695-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/24/2023] [Indexed: 11/06/2023]
Abstract
Human sapovirus (HuSaV) is a common cause of gastroenteritis worldwide and is responsible for approximately 4% of acute gastroenteritis episodes in Europe. As reported with norovirus, patients with immunocompromised states are at increased risk of developing HuSaV infection, which can lead to persistent diarrhea and chronic viral shedding in some individuals. Chronic infections are incompletely investigated in these patients, and, due to the lack of specific treatment for HuSaV infection, different clinical approaches were carried out in order to provide further evidence on clinical evolution of these patients with different treatments. In this retrospective study, we report five immunocompromised pediatric patients with recurrent diarrhea caused by HuSaV and long-term viral shedding. Stool samples were analyzed by real-time PCR and tested for enteropathogenic viruses and bacteria and protozoa. Among transplant recipients, reduction of immunosuppressant therapy led to clinical improvement and relief of symptoms, maintaining a balance between managing the infection and preventing graft rejection. Nitazoxanide for 14 days was only used in one of these patients, showing to be an effective therapy to achieve reduction in time to resolution of symptoms. Neither nitazoxanide nor modification of immunosuppressant therapy could avoid recurrences. Further investigations are needed to develop new approaches that can both clear the infection and avoid persistent diarrhea in these patients.
Collapse
Affiliation(s)
- Eduardo Rubio-Mora
- Servicio de Microbiología y Parasitología, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046, Madrid, Spain.
| | - Guillermo Ruiz Carrascoso
- Servicio de Microbiología y Parasitología, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046, Madrid, Spain
| | - Julio García Rodríguez
- Servicio de Microbiología y Parasitología, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046, Madrid, Spain
| |
Collapse
|
5
|
Taha NM, Zalat RS, Khaled E, Elmansory BM. Evaluation of the therapeutic efficacy of some essential oils in experimentally immunosuppressed mice infected with Cryptosporidium parvum. J Parasit Dis 2023; 47:733-743. [PMID: 38009149 PMCID: PMC10667177 DOI: 10.1007/s12639-023-01621-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 07/21/2023] [Indexed: 11/28/2023] Open
Abstract
Cryptosporidiosis is a serious intestinal disease affecting mal-nourished children and immunocompromised individuals with severe fatal diarrhea. Our present work was done to evaluate the possible curative effects of different essential oils (Mint, Thyme, Chamomile and Basil) on Cryptosporidium parvum (C. parvum) in vivo compared with nitazoxanide (NTZ). Seventy immunosuppressed white Albino male mice were allocated in 7 groups as follows: group I infected and not treated (Positive control), group II (GII) treated with NTZ, group III (GIII) treated with Mint essential oil, group IV (GIV) treated with Thyme essential oil, group V (GV) treated with Chamomile essential oil, group VI (GVI) treated with Basil essential oil and group VII (GVII) naïve not infected mice (Negative control). Evaluation was done using parasitological, histopatholgical, serological as well as biochemical methods. All study groups revealed significant reduction (P value < 0.01) in the mean number of C. parvum oocysts in stool. Results of GII were the best with 87.7% reduction in the oocysts count followed by GIII (77.9%), GIV (74.7%), GVI (68.2%) and lastly GV (67.2%). Improvement of the histopathological damage in the small intestine was shown in treated groups. All treated mice showed significant upregulation in the interferon gamma (IFN-γ) levels, significant reduction in the malondialdehyde (MDA) levels and increase in superoxide dismutase (SOD) levels (P value < 0.0001). It is concluded that Mint, Thyme, Chamomile and Basil oils showed promising anti-cryptosporidial, anti-inflammatory and antioxidant functions.
Collapse
Affiliation(s)
- Noha Madbouly Taha
- Department of Medical Parasitology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rabab Sayed Zalat
- Department of Parasitology, Theodor Bilharz Research Institute, Imbaba, Giza, Egypt
| | - Eman Khaled
- Department of Surgical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Basma M. Elmansory
- Department of Medical Parasitology, Faculty of Medicine, Tanta University, Tanta, Egypt
| |
Collapse
|
6
|
Kelleni MT. The African Kelleni's roadmap using nitazoxanide and broad-spectrum antimicrobials to abort returning to COVID-19 square one. Inflammopharmacology 2023; 31:3335-3338. [PMID: 37326756 PMCID: PMC10691980 DOI: 10.1007/s10787-023-01263-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 05/29/2023] [Indexed: 06/17/2023]
Abstract
For over 3.5 years, SARS CoV-2 is continuing to evolve threatening to return all and any improvement the world has made into square one. In this clinically oriented systematic review and perspective, the author explains how the best current medical evidence is strongly supporting the use of the low cost, widely available and very safe nitazoxanide in early management of COVID-19, debates the relevant theoretical studies that negated or doubted this benefit, and suggests an African roadmap to preempt the worst-case scenario if or when a new SARS CoV-2 (sub) variant or even a new respiratory virus causes a new global surge of morbidity and mortality. Kelleni's protocol, including nitazoxanide as an integral component, is continuing to perfectly save lives of patients infected with many viruses, including SARS CoV-2 and the author stresses that respiratory RNA viruses are best managed with early pharmacological treatment. Broad-spectrum antimicrobials as nitazoxanide and azithromycin together with other therapeutics as non-steroidal anti-inflammatory drugs and the antihistaminic loratadine should be considered first to personalize the clinical management of COVID-19 and selected other alarming viral infections.
Collapse
Affiliation(s)
- Mina T Kelleni
- Pharmacology Department, College of Medicine, Minia University, El Minya, 61111, Egypt.
| |
Collapse
|
7
|
Stelitano D, La Frazia S, Ambrosino A, Zannella C, Tay D, Iovane V, Montagnaro S, De Filippis A, Santoro MG, Porotto M, Galdiero M. Antiviral activity of nitazoxanide against Morbillivirus infections. J Virus Erad 2023; 9:100353. [PMID: 38028567 PMCID: PMC10679774 DOI: 10.1016/j.jve.2023.100353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/04/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
The measles virus (MeV) and canine distemper virus (CDV) belong to the genus Morbillivirus of the Paramyxoviridae family. They are enveloped viruses harboring a non-segmented negative-sense RNA. Morbilliviruses are extremely contagious and transmitted through infectious aerosol droplets. Both MeV and CDV may cause respiratory infections and fatal encephalitis, although a high incidence of brain infections is unique to CDV. Despite the availability of a safe and effective vaccine against these viruses, in recent years we are witnessing a strong resurgence of Morbillivirus infection. Measles still kills more than 100,000 people each year, and CDV causes widespread outbreaks, especially among wild animals, including non-human primates. No drugs are currently approved for MeV and CDV. Therefore, the identification of effective antiviral agents represents an unmet medical need. Here, we have investigated the potential antiviral properties of nitazoxanide (NTZ) against MeV and CDV. Antiviral activity was explored with live virus and cell-based assays. NTZ is a thiazolide that is approved by the FDA as an antiprotozoal agent for the treatment of Giardia intestinalis and Cryptosporidium parvum. Further, nitazoxanide and its metabolite tizoxanide have recently emerged as broad-spectrum antiviral agents. We found that NTZ blocks the MeV and CDV replication, acting at the post-entry level. Moreover, we showed that NTZ affects the function of the viral fusion protein (F), impairing viral spread. Our results indicate that NTZ should be further explored as a therapeutic option in measles and canine distemper virus treatment.
Collapse
Affiliation(s)
- Debora Stelitano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, via Santa Maria di Costantinopoli 16, 80138, Naples, Italy
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, 701 West 168th st, 10032, New York, NY, USA
- Center for Host–Pathogen Interaction, Columbia University Vagelos College of Physicians and Surgeons, 701 West 168th st, 10032, New York, NY, USA
| | - Simone La Frazia
- Department of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica 1, 00133, Rome, Italy
| | - Annalisa Ambrosino
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, via Santa Maria di Costantinopoli 16, 80138, Naples, Italy
| | - Carla Zannella
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, via Santa Maria di Costantinopoli 16, 80138, Naples, Italy
| | - Daniel Tay
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, 701 West 168th st, 10032, New York, NY, USA
- Center for Host–Pathogen Interaction, Columbia University Vagelos College of Physicians and Surgeons, 701 West 168th st, 10032, New York, NY, USA
| | - Valentina Iovane
- Department of Agriculture Sciences, University of Naples “Federico II”, Via Università, 100-Portici, 80055, Naples, Italy
| | - Serena Montagnaro
- Department of Veterinary Medicine and Animal Production, University of Naples “Federico II”, via Federico Delpino 1, 80137, Naples, Italy
| | - Anna De Filippis
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, via Santa Maria di Costantinopoli 16, 80138, Naples, Italy
| | - Maria Gabriella Santoro
- Department of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica 1, 00133, Rome, Italy
- Institute of Translational Pharmacology, CNR, Via Fosso del Cavaliere 100, 00133, Rome, Italy
| | - Matteo Porotto
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, via Santa Maria di Costantinopoli 16, 80138, Naples, Italy
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, 701 West 168th st, 10032, New York, NY, USA
- Center for Host–Pathogen Interaction, Columbia University Vagelos College of Physicians and Surgeons, 701 West 168th st, 10032, New York, NY, USA
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, via Santa Maria di Costantinopoli 16, 80138, Naples, Italy
- Virology and Microbiology Unit, University Hospital “Luigi Vanvitelli”, via Santa Maria di Costantinopoli 16, 80138, Naples, Italy
| |
Collapse
|
8
|
Haneczok J, Delijewski M, Moldzio R. AI molecular property prediction for Parkinson's Disease reveals potential repurposing drug candidates based on the increase of the expression of PINK1. Comput Methods Programs Biomed 2023; 241:107731. [PMID: 37544165 DOI: 10.1016/j.cmpb.2023.107731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 05/20/2023] [Accepted: 07/23/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Parkinson's Disease (PD), a common neurodegenerative disorder and one of the major current challenges in neuroscience and pharmacology, may potentially be tackled by the modern AI techniques employed in drug discovery based on molecular property prediction. The aim of our study was to explore the application of a machine learning setup for the identification of the best potential drug candidates among FDA approved drugs, based on their predicted PINK1 expression-enhancing activity. METHODS Our study relies on supervised machine learning paradigm exploiting in vitro data and utilizing the scaffold splits methodology in order to assess model's capability to extract molecular patterns and generalize from them to new, unseen molecular representations. Models' predictions are combined in a meta-ensemble setup for finding new pharmacotherapies based on the predicted expression of PINK1. RESULTS The proposed machine learning setup can be used for discovering new drugs for PD based on the predicted increase of expression of PINK1. Our study identified nitazoxanide as well as representatives of imidazolidines, trifluoromethylbenzenes, anilides, nitriles, stilbenes and steroid esters as the best potential drug candidates for PD with PINK1 expression-enhancing activity on or inside the cell's mitochondria. CONCLUSIONS The applied methodology allows to reveal new potential drug candidates against PD. Next to novel indications, it allows also to confirm the utility of already known antiparkinson drugs, in the new context of PINK1 expression, and indicates the potential for simultaneous utilization of different mechanisms of action.
Collapse
Affiliation(s)
| | - Marcin Delijewski
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Rudolf Moldzio
- Institute of Medical Biochemistry, Department of Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
| |
Collapse
|
9
|
Stewart DD. Can Nitazoxanide and/or other anti-viral medications be a solution to long COVID? Case report with a brief literature review. Clin Case Rep 2023; 11:e8162. [PMID: 38028066 PMCID: PMC10654558 DOI: 10.1002/ccr3.8162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/20/2023] [Accepted: 10/21/2023] [Indexed: 12/01/2023] Open
Abstract
Key Clinical Message Findings here imply lingering of virus, SARS-CoV-2, in the body for months. Thus, Nitazoxanide and/or other anti-viral medications might be potential options to combat long COVID. This could transform treatment for long COVID patients globally. Abstract Long COVID or post-acute sequelae of COVID-19 (PASC) continues to affect many people even after a relatively mild acute illness. Underlying causes of PASC are poorly understood. There is no particular treatment or management program developed yet. Thus, the possibility of well-known, safe anti-viral medications use against PASC is proposed here.
Collapse
|
10
|
Bashir S, Shabbir K, Din FU, Khan SU, Ali Z, Khan BA, Kim DW, Khan GM. Nitazoxanide and quercetin co-loaded nanotransfersomal gel for topical treatment of cutaneous leishmaniasis with macrophage targeting and enhanced anti-leishmanial effect. Heliyon 2023; 9:e21939. [PMID: 38027656 PMCID: PMC10661431 DOI: 10.1016/j.heliyon.2023.e21939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose Anti-leishmanial medications administered by oral and parenteral routes are less effective for treatment of cutaneous leishmaniasis (CL) and cause toxicity, hence targeted drug delivery is an efficient way to improve drug availability for CL with reduced toxicity. This study aimed to develop, characterize and evaluate nitazoxanide and quercetin co-loaded nanotransfersomal gel (NTZ-QUR-NTG) for the treatment of CL. Methods NTZ-QUR-NT were prepared by thin film hydration method and were statistically optimized using Box-Behnken design. To ease the topical delivery and enhance the retention time, the NTZ-QUR-NT were dispersed in 2 % chitosan gel. Moreover, in-vitro drug release, ex-vivo permeation, macrophage uptake, cytotoxicity and anti-leishmanial assays were performed. Results The optimized formulation indicated mean particle size 210 nm, poly dispersity index (PDI) 0.16, zeta potential (ZP) -15.1 mV and entrapment efficiency (EE) of NTZ and QUR was 88 % and 85 %, respectively. NTZ-QUR-NT and NTZ-QUR-NTG showed sustained release of the incorporated drugs as compared to the drug dispersions. Skin permeation of NTZ and QUR in NTZ-QUR-NTG was 4 times higher in comparison to the plain gels. The NTZ-QUR-NT cell internalization was almost 10-folds higher than NTZ-QUR dispersion. The cytotoxicity potential (CC50) of NTZ-QUR-NT (71.95 ± 3.32 μg/mL) was reduced as compared to NTZ-QUR dispersion (49.77 ± 2.15 μg/mL. A synergistic interaction was found between NTZ and QUR. Moreover, in-vitro anti-leishmanial assay presented a lower IC50 value of NTZ-QUR-NT as compared to NTZ-QUR dispersion. Additionally, a significantly reduced lesion size was observed in NTZ-QUR-NTG treated BALB/c mice, indicating its antileishmanial potential. Conclusion It can be concluded that nanotransfersomal gel has the capability to retain and permeate the incorporated drugs through stratum corneum and induce synergetic anti-leishmanial effect of NTZ and QUR against cutaneous leishmaniasis.
Collapse
Affiliation(s)
- Sidra Bashir
- Nanomedicine Research Group, Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University Islamabad, Pakistan
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University Islamabad, Pakistan
| | - Kanwal Shabbir
- Nanomedicine Research Group, Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University Islamabad, Pakistan
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University Islamabad, Pakistan
| | - Fakhar ud Din
- Nanomedicine Research Group, Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University Islamabad, Pakistan
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University Islamabad, Pakistan
| | - Saif Ullah Khan
- Institute of Biotechnology and Microbiology, Bacha Khan University, Charsada, KPK, Pakistan
| | - Zakir Ali
- Nanomedicine Research Group, Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University Islamabad, Pakistan
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University Islamabad, Pakistan
| | - Barkat Ali Khan
- Drugs Design and Cosmetics Lab (DDCL), Faculty of Pharmacy Gomal University, Dera Ismail Khan, Pakistan
| | - Dong Wuk Kim
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, 41566, South Korea
| | - Gul Majid Khan
- Nanomedicine Research Group, Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University Islamabad, Pakistan
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University Islamabad, Pakistan
- Islamia College University, Peshawar, Khyber Pakhtunkhwa, Pakistan
| |
Collapse
|
11
|
Pfarr KM, Krome AK, Al-Obaidi I, Batchelor H, Vaillant M, Hoerauf A, Opoku NO, Kuesel AC. The pipeline for drugs for control and elimination of neglected tropical diseases: 2. Oral anti-infective drugs and drug combinations for off-label use. Parasit Vectors 2023; 16:394. [PMID: 37907954 PMCID: PMC10619278 DOI: 10.1186/s13071-023-05909-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/31/2023] [Indexed: 11/02/2023] Open
Abstract
In its 'Road map for neglected tropical diseases 2021-2030', the World Health Organization outlined its targets for control and elimination of neglected tropical diseases (NTDs) and research needed to achieve them. For many NTDs, this includes research for new treatment options for case management and/or preventive chemotherapy. Our review of small-molecule anti-infective drugs recently approved by a stringent regulatory authority (SRA) or in at least Phase 2 clinical development for regulatory approval showed that this pipeline cannot deliver all new treatments needed. WHO guidelines and country policies show that drugs may be recommended for control and elimination for NTDs for which they are not SRA approved (i.e. for 'off-label' use) if efficacy and safety data for the relevant NTD are considered sufficient by WHO and country authorities. Here, we are providing an overview of clinical research in the past 10 years evaluating the anti-infective efficacy of oral small-molecule drugs for NTD(s) for which they are neither SRA approved, nor included in current WHO strategies nor, considering the research sponsors, likely to be registered with a SRA for that NTD, if found to be effective and safe. No such research has been done for yaws, guinea worm, Trypanosoma brucei gambiense human African trypanosomiasis (HAT), rabies, trachoma, visceral leishmaniasis, mycetoma, T. b. rhodesiense HAT, echinococcosis, taeniasis/cysticercosis or scabies. Oral drugs evaluated include sparfloxacin and acedapsone for leprosy; rifampicin, rifapentin and moxifloxacin for onchocerciasis; imatinib and levamisole for loiasis; itraconazole, fluconazole, ketoconazole, posaconazole, ravuconazole and disulfiram for Chagas disease, doxycycline and rifampicin for lymphatic filariasis; arterolane, piperaquine, artesunate, artemether, lumefantrine and mefloquine for schistosomiasis; ivermectin, tribendimidine, pyrantel, oxantel and nitazoxanide for soil-transmitted helminths including strongyloidiasis; chloroquine, ivermectin, balapiravir, ribavirin, celgosivir, UV-4B, ivermectin and doxycycline for dengue; streptomycin, amoxicillin, clavulanate for Buruli ulcer; fluconazole and isavuconazonium for mycoses; clarithromycin and dapsone for cutaneous leishmaniasis; and tribendimidine, albendazole, mebendazole and nitazoxanide for foodborne trematodiasis. Additional paths to identification of new treatment options are needed. One promising path is exploitation of the worldwide experience with 'off-label' treatment of diseases with insufficient treatment options as pursued by the 'CURE ID' initiative.
Collapse
Affiliation(s)
- Kenneth M Pfarr
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany
| | - Anna K Krome
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany
- Department of Pharmaceutical Technology and Biopharmaceutics, University of Bonn, Bonn, Germany
| | - Issraa Al-Obaidi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Hannah Batchelor
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Michel Vaillant
- Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Grand Duchy of Luxembourg
| | - Achim Hoerauf
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany
| | - Nicholas O Opoku
- Department of Epidemiology and Biostatistics School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Annette C Kuesel
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (WHO/TDR), World Health Organization, Geneva, Switzerland.
| |
Collapse
|
12
|
Lu W, Yang F, Meng Y, An J, Hu B, Jian S, Yang G, Lu H, Wen C. Immunotoxicity and transcriptome analysis of zebrafish embryos exposure to Nitazoxanide. Fish Shellfish Immunol 2023; 141:108977. [PMID: 37579811 DOI: 10.1016/j.fsi.2023.108977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/23/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023]
Abstract
Nitazoxanide (NTZ) is a broad-spectrum immunomodulatory drug, and little information is about the immunotoxicity of aquatic organisms induced by NTZ. In the present study, reduced body length and decreased yolk sac absorption in the NTZ-treated group were observed. Meanwhile, the number of innate immune cells and adaptive immune cells was substantially reduced upon NTZ exposure, and the migration and retention of macrophages and neutrophils in the injured area were inhibited. Following NTZ stimulation, oxidative stress levels in the zebrafish increased obviously. Mechanistically, RNA-seq, a high-throughput method, was performed to analyze the global expression of differentially expressed genes (DEGs) in zebrafish embryos treated with NTZ. 531 DEGs were identified by comparative transcriptome analysis, including 121 up-regulated and 420 down-regulated genes in zebrafish embryos after NTZ exposure. The transcriptome sequences were further subjected to the Kyoto Encyclopedia of Genes and Genomes (KEGG) and gene ontology (GO) and analysis, showing phototransduction and metabolic pathway, respectively, and were most enriched. In addition, some immune-related genes were inhibited after NTZ exposure. RNA-seq results confirmed by qRT-PCR were used to verify the expression of the 6 selected genes. The other immune-related genes such as two pro-inflammatory cytokines (IL-1β, tnfα) and two chemokines (CXCL8b.3, CXCL-c1c) were further confirmed and were differentially regulated after NTZ exposure. In summary, NTZ exposure could lead to immunotoxicity and increased ROS in zebrafish embryos, this study provides valuable information for future elucidating the molecular mechanism of exogenous stimuli-induced immunotoxicity in aquatic ecosystems.
Collapse
Affiliation(s)
- Wuting Lu
- Department of Aquatic Science, College of Life Science, Nanchang University, Xuefu Avenue, Nanchang, Jiangxi Province, 330031, China
| | - Fanhua Yang
- College of Food Science and Technology, Nanchang University, Nanchang, 330031, China
| | - Yunlong Meng
- Department of Medical Genetics, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Jinhua An
- Department of Aquatic Science, College of Life Science, Nanchang University, Xuefu Avenue, Nanchang, Jiangxi Province, 330031, China
| | - Baoqing Hu
- Department of Aquatic Science, College of Life Science, Nanchang University, Xuefu Avenue, Nanchang, Jiangxi Province, 330031, China
| | - Shaoqing Jian
- Department of Aquatic Science, College of Life Science, Nanchang University, Xuefu Avenue, Nanchang, Jiangxi Province, 330031, China
| | - Gang Yang
- Department of Aquatic Science, College of Life Science, Nanchang University, Xuefu Avenue, Nanchang, Jiangxi Province, 330031, China
| | - Huiqiang Lu
- Ganzhou Key Laboratory for Drug Screening and Discovery, Gannan Normal University, Ganzhou, 341000, Jiangxi, China; Jiangxi Engineering Laboratory of Zebrafish Modeling and Drug Screening for Human Diseases, Jiangxi Key Laboratory of Developmental Biology of Organs, Affiliated Hospital of Jinggangshan University, Ji'an, 343009, China.
| | - Chungen Wen
- Department of Aquatic Science, College of Life Science, Nanchang University, Xuefu Avenue, Nanchang, Jiangxi Province, 330031, China.
| |
Collapse
|
13
|
Andrade DL, Jalalizadeh M, Salustiano ACC, Reis LO. Bladder cancer immunomodulatory effects of intravesical Nitazoxanide, Rapamycin, Thalidomide and Bacillus Calmette-Guérin (BCG). World J Urol 2023; 41:2375-2380. [PMID: 37470811 DOI: 10.1007/s00345-023-04526-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/10/2023] [Indexed: 07/21/2023] Open
Abstract
PURPOSE To understand the effect of Nitazoxanide (NTZ), Rapamycin, Thalidomide, alone and in combination with BCG on bladder cancer (BC) histopathology and programmed death-ligand 1 (PD-L1) and anti-cytotoxic T lymphocyte antigen 4 (CTLA4) expression. METHODS Female Fisher-344 rats underwent intravesical N-methyl-N-nitrosourea (MNU) followed by weekly intravesical treatment with saline (controls, n = 10), BCG (n = 10), NTZ (n = 8), BCG plus NTZ (n = 8), Rapamycin (n = 10) BCG plus Rapamycin (n = 10), Thalidomide (n = 10), and BCG plus Thalidomide (n = 10), and euthanized after 8 weeks and their bladders were investigated for BC and PD-L1 and CTLA4 expression. RESULTS Rapamicyn alone and in combination with BCG had the lowest number of bladder neoplasias in the histopathology exam (1/10). Neoplastic lesions were found in 4/10 BCG recipients, 5/10 Thalidomide recipients, 4/10 Thalidomide plus BCG recipients, 5/8 NTZ and 3/8 NTZ plus BCG recipients. Adding NTZ to BCG increased the expression of PD-L1 and adding Rapamycin or Thalidomide decreased PD-L1 and CTLA4 expression compared to BCG alone. Rapamycin alone significantly increased CTLA4 and slightly increased PD-L1 expression but its combination with BCG significantly decreased both markers. Thalidomide had a similar effect; however, it was only slightly different from the control and BCG alone groups. CONCLUSION Intravesical BCG combination treatment seems to effectively prevent BC development in an immunecompetent clinically relevant animal model, introducing Thalidomide, Nitazoxanide, and specially Rapamycin as candidates in the intravesical immunotherapy advancement. Our study contributes in understanding the mechanism of cancer immunotherapy.
Collapse
Affiliation(s)
- Danilo L Andrade
- UroScience and Department of Urology, Faculty of Medical Sciences, State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Mehrsa Jalalizadeh
- UroScience and Department of Urology, Faculty of Medical Sciences, State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Ana Clara C Salustiano
- UroScience and Department of Urology, Faculty of Medical Sciences, State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Leonardo O Reis
- UroScience and Department of Urology, Faculty of Medical Sciences, State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil.
- Urologic Oncology Department, School of Life Sciences, Pontifical Catholic University of Campinas, PUC-Campinas, Av. John Boyd Dunlop-Jardim Ipaussurama, Campinas, São Paulo, 13034-685, Brazil.
| |
Collapse
|
14
|
Beshay EVN, Nassef NE, El Shafei OK, Saleh MM, Kora MA, Shalaan FH. Therapeutic efficacy of proton pump inhibitor (omeprazole) on cryptosporidiosis parvum in immunosuppressed experimental mice. J Parasit Dis 2023; 47:535-549. [PMID: 37520212 PMCID: PMC10382457 DOI: 10.1007/s12639-023-01592-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/04/2023] [Indexed: 08/01/2023] Open
Abstract
Cryptosporidiosis is one of the most frequent food and water-borne diseases. The disease might be life-threatening in immunosuppressed patients. Unfortunately, the only approved drug, nitazoxanide, is with variable efficacies, particularly in malnourished children and immunocompromised patients. Therefore, there is a need to discover an alternative treatment that could be achieved by targeting the metabolic pathways. One of the important enzymes in the glycolysis pathway of C. parvum is triosephosphate isomerase, which could be hindered by the proton pump inhibitor (PPI) omeprazole. In this study, omeprazole was repurposed against C. parvum infection in experimentally immunosuppressed mice. This study was conducted on five mice groups (n = 10). Group I (Normal Control), group II (Infected Control): Mice were infected orally with 1 × 105 C. parvum oocysts on the 15th day of DEX induced immunosuppression. Group III (NTZ-treated): infected and treated by NTZ. Group IV (Omeprazole-treated), and lastly, Group V (NTZ + Omeprazole-treated). The result obtained with omeprazole alone was better than nitazoxanide regarding oocyst shedding reduction percentages (84.9% & 56.1%, respectively). Also, it was better regarding restoration of histopathological and ultrastructural architectures, improvement of liver enzymes (alanine aminotransferase and aspartate aminotransferase) and renal functions (urea and creatinine), and the reduction of C. parvum triosephosphate isomerase (TIM) gene expression by RT-PCR. However, the best results were obtained with the combined treatment. Hence, omeprazole could be considered a novel drug option to treat this life-threatening parasitic infection either alone or combined with NTZ, especially in immunosuppressed patients.
Collapse
Affiliation(s)
- Engy V. N. Beshay
- Medical Parasitology Department, Faculty of Medicine, Menoufia University, Yassin Abdel Gaffar St. from Gamal Abdel Nasser St., Shebin El-Kom, Menoufia Egypt
| | - Nashaat E. Nassef
- Medical Parasitology Department, Faculty of Medicine, Menoufia University, Yassin Abdel Gaffar St. from Gamal Abdel Nasser St., Shebin El-Kom, Menoufia Egypt
| | - Omaima K. El Shafei
- Medical Parasitology Department, Faculty of Medicine, Menoufia University, Yassin Abdel Gaffar St. from Gamal Abdel Nasser St., Shebin El-Kom, Menoufia Egypt
| | - Mona M. Saleh
- Medical Parasitology Department, Faculty of Medicine, Menoufia University, Yassin Abdel Gaffar St. from Gamal Abdel Nasser St., Shebin El-Kom, Menoufia Egypt
| | - Mona A. Kora
- Pathology Department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia Egypt
| | - Fatma H. Shalaan
- Medical Parasitology Department, Faculty of Medicine, Menoufia University, Yassin Abdel Gaffar St. from Gamal Abdel Nasser St., Shebin El-Kom, Menoufia Egypt
| |
Collapse
|
15
|
Azami M, Amini Rarani S, Kiani F. Treatment of Urticaria caused by severe cryptosporidiosis in a 17-month-old child - a case report. BMC Infect Dis 2023; 23:461. [PMID: 37430189 DOI: 10.1186/s12879-023-08446-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 07/06/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Cryptosporidium is an intracellular protozoan that causes gastrointestinal symptoms in humans and animals. In immunocompromised patients and children under 5 years of age, the infection is severe and can be life-threatening due to severe diarrhea. CASE PRESENTATION We report a case of urticaria associated with Cryptosporidium in a 17-month-old female Iranian child. The patient had moderate diarrhea (> 3 loose, watery stools but not more than 10 diarrhea stools in a day), weight loss, and acute urticarial (rash clears completely within 6 weeks). Since the child's father worked in livestock farming, the parasite may have been transferred from the cow or calve to the house and the child. Several Cryptosporidium oocysts were detected in the modified acid-fast staining of the child's stool sample. The patient was successfully treated with nitazoxanide (100 mg twice daily) and became negative for parasites three days after treatment and one week after discharge from the hospital. The child was observed to produce < 3 loose stools in the previous 24 h after 1-week post-treatment and after 6 months of follow-up. CONCLUSION A number of parasites are associated with urticaria, but to our knowledge, there is no information on Cryptosporidium-induced urticaria. Therefore, our result may be evidence for the role of this parasite in the development of urticaria if other causes such as food allergies, autoimmune diseases and etc. don't role in urticaria.
Collapse
Affiliation(s)
- Mehdi Azami
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical sciences, Isfahan, Iran.
- Basir Laboratory Research and Development Center, Basir Medical Diagnostic Laboratory, Isfahan, Iran.
- Department of Medical Parasitology and Microbiology, Hojjatieh Medical Diagnostic Laboratory, Hojjatieh Hospital, Isfahan, Iran.
| | - Saeid Amini Rarani
- Nursing and Midwifery Care Research Center, Department of Operating Room, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Kiani
- Department of Medical Parasitology and Microbiology, Hojjatieh Medical Diagnostic Laboratory, Hojjatieh Hospital, Isfahan, Iran
| |
Collapse
|
16
|
Amireddy N, Dulam V, Kaul S, Pakkiri R, Kalivendi SV. The mitochondrial uncoupling effects of nitazoxanide enhances cellular autophagy and promotes the clearance of α-synuclein: Potential role of AMPK-JNK pathway. Cell Signal 2023:110769. [PMID: 37315747 DOI: 10.1016/j.cellsig.2023.110769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/26/2023] [Accepted: 06/11/2023] [Indexed: 06/16/2023]
Abstract
Upregulation and aggregation of the pre-synaptic protein, α-synuclein plays a key role in Parkinson's disease (PD) and mitochondrial dysfunction was surmised to be an upstream event in the disease pathogenesis. Emerging reports identified the role of nitazoxanide (NTZ), an anti-helminth drug, in enhancing mitochondrial oxygen consumption rate (OCR) and autophagy. In the present study, we have examined the mitochondrial effects of NTZ in mediating cellular autophagy and subsequent clearance of both endogenous and pre-formed aggregates of α-synuclein in cellular model of PD. Our results demonstrate that the mitochondrial uncoupling effects of NTZ results in the activation of AMPK and JNK, which in-turn leads to the enhancement of cellular autophagy. Also,1-methyl-4-phenylpyridinium (MPP+) mediated decrease in autophagic flux with a concomitant increase in the α-synuclein levels were ameliorated in cells treated with NTZ. However, in cells lacking functional mitochondria (ρ0 cells), NTZ did not mitigate MPP+ mediated alterations in the autophagic clearance of α-synuclein, indicating that the mitochondrial effects of NTZ play a crucial role in the clearance of α-synuclein by autophagy. Also, the ability of AMPK inhibitor, compound C, in abrogating NTZ mediated enhancement in the autophagic flux and α-synuclein clearance highlight the pivotal role of AMPK in NTZ mediated autophagy. Further, NTZ per se enhanced the clearance of preformed α-synuclein aggregates that were exogenously added to the cells. Overall, the results of our present study suggest that NTZ activates macroautophagy in cells due to its uncoupling effects on mitochondrial respiration via activation of AMPK-JNK pathway resulting in the clearance of both endogenous and pre-formed α-synuclein aggregates. As NTZ happens to possess good bioavailability and safety profile, considering this drug for PD based on its mitochondrial uncoupling and autophagy enhancing properties for mitigating mitochondrial reactive oxygen species (ROS) and α-synuclein toxicity appears to be a promising therapeutic option.
Collapse
Affiliation(s)
- Niharika Amireddy
- Department of Applied Biology, CSIR-Indian Institute of Chemical Technology, Uppal Road, Hyderabad 500007, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Vandana Dulam
- Department of Applied Biology, CSIR-Indian Institute of Chemical Technology, Uppal Road, Hyderabad 500007, India
| | - Shweta Kaul
- Department of Applied Biology, CSIR-Indian Institute of Chemical Technology, Uppal Road, Hyderabad 500007, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Rajeswari Pakkiri
- Department of Applied Biology, CSIR-Indian Institute of Chemical Technology, Uppal Road, Hyderabad 500007, India
| | - Shasi V Kalivendi
- Department of Applied Biology, CSIR-Indian Institute of Chemical Technology, Uppal Road, Hyderabad 500007, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India.
| |
Collapse
|
17
|
Yahia SH, El gamal RL, Fathy GM, Al-Ghandour AMF, El-Akabawy N, Abdel-Hameed BH, Elbahaie ES. The potential therapeutic effect of Nigella sativa and Zingiber officinale extracts versus Nitazoxanide drug against experimentally induced cryptosporidiosis in laboratory mice. J Parasit Dis 2023; 47:329-339. [PMID: 37193490 PMCID: PMC10182196 DOI: 10.1007/s12639-023-01572-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/26/2023] [Indexed: 05/18/2023] Open
Abstract
In this study, the potential anti-cryptosporidial effect of Nigella sativa (black seeds) and Zingiber officinale (ginger) alcoholic extracts versus Nitazoxanide (NTZ) medication was investigated in immunosuppressed (IS) laboratory mice. Parasitological, histopathological studies were used to assess their therapeutic efficacy. Serum level and tissue expression percentage of IFN-γ was also used. Nigella extract succeeded to reduce the mean oocyst counts in the feces of immunosuppressed mice followed by NTZ. Ginger-treated ones showed the lowest reduction percentage. Nigella sativa showed the best results in terms of restoring the normal architecture of ileal epithelium in histopathological sections stained with H&E. NTZ treatment sub-groups showed mild improvement, followed by ginger-treated mice, which showed a slight improvement in small intestine microenvironment. A significant substantial rise in serum and intestinal tissue IFN-γ cytokine levels were recorded in Nigella subgroups compared to those of NTZ and ginger respectively. According to our findings Nigella sativa outperformed Nitazoxanide in terms of anti-cryptosporidial effectiveness and regeneration characteristics revealing a promising medication. When compared to the commonly used Nitazoxanide medication or Nigella extracts, the outcomes of ginger extract were suboptimal.
Collapse
Affiliation(s)
- Samah Hassan Yahia
- Department of Medical Parasitology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Reda Lamei El gamal
- Department of Medical Parasitology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ghada Mahmoud Fathy
- Department of Medical Parasitology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Nadia El-Akabawy
- Department of Medical Histology and Cell Biology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Enas Saed Elbahaie
- Department of Medical Parasitology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| |
Collapse
|
18
|
Romano F, Lallo MA. Efficacy of a single dose of nitazoxanide in dogs naturally infected with Giardia duodenalis. Res Vet Sci 2023; 159:252-256. [PMID: 37182304 DOI: 10.1016/j.rvsc.2023.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/16/2023]
Abstract
Giardia duodenalis is a protozoan parasite that infects many mammals, including dogs and cats. This waterborne and foodborne zoonosis is a major problem in one health. Treatment can be challenging because of long regimens and drug resistance. The objective of this study was to evaluate the efficacy of single-dose nitazoxanide (NTZ) for dogs naturally infected by Giardia duodenalis. Although widely used in humans, pharmacological safety is incipient, since the approval of the safe use of nitaxozanide for dogs is not a consensus in the world. Fifty dogs diagnosed with G. duodenalis by zinc sulfate flotation technique (Faust method) and cysts detection by light microscopy. Half of the animals received a dose of 50 mg/kg of NTZ and the other half received 3 doses of 50 mg/kg of fenbendazole (FBZ), both orally. One week after treatment, new fecal exams were done to prove the effectiveness. Of the animals treated with NTZ, 84% were negative for the protozoan, while 76% of the animals treated with FBZ were negative, no significant difference was identified. Side effects such as vomiting and hyporexia were manageable in NTZ treatment and no changes in laboratory tests showed hepatic or renal impairment. We conclude that the use of NTZ in a single dose of 50 mg/kg is effective for canine giardiasis, constituting an option to be considered for dogs with relapses, poor response to conventional drugs and to facilitate administration regimens.
Collapse
Affiliation(s)
- Felipe Romano
- Programa de Pós-Graduação em Patologia Ambiental e Experimental, Universidade Paulista - UNIP, Rua Dr. Bacelar 902, CEP 04057-000 São Paulo, SP, Brazil
| | - Maria Anete Lallo
- Programa de Pós-Graduação em Patologia Ambiental e Experimental, Universidade Paulista - UNIP, Rua Dr. Bacelar 902, CEP 04057-000 São Paulo, SP, Brazil.
| |
Collapse
|
19
|
Imbaby S, Elkholy SE, Faisal S, Abdelmaogood AKK, Mehana AE, Mansour BSA, Abd El-Moneam SM, Elaidy SM. The GSTP1/MAPKs/BIM/SMAC modulatory actions of nitazoxanide: Bioinformatics and experimental evidence in subcutaneous solid Ehrlich carcinoma-inoculated mice. Life Sci 2023; 319:121496. [PMID: 36822315 DOI: 10.1016/j.lfs.2023.121496] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 02/25/2023]
Abstract
AIMS Ehrlich ascites carcinoma and its subcutaneous inoculated solid tumour form (SEC) are reliable models for chemotherapeutic molecular targets exploration. Novel chemotherapeutic approaches are identified as molecular targets for intrinsic apoptosis, like the modulation of the second mitochondria-derived activator of caspases (SMAC). SMAC is a physiological substrate of mitogen-activated protein kinases (MAPKs). Glutathione-S-transferase P1 (GSTP1) and its close association with MAPKs play an important role in malignant cell proliferation, metastasis, and resistance to chemotherapeutics. Nitazoxanide (NTZ) is an emerging cancer therapy and its targeted GSTP1 evidence remains a knowledge need. MAIN METHODS In the present mice-established SEC, the chemotherapeutic roles of oral NTZ (200 mg/kg/day) and 5-fluorouracil (5-FU; 20 mg/kg/day, intraperitoneally) regimens were evaluated by measuring changes in tumour mass, the tumour MAPKs, cytochrome c, Bcl-2 interacting mediator of cell death (BIM), and SMAC signalling pathway in addition to its molecular downstream; caspases 3 and 9. KEY FINDINGS Computational analysis for these target protein interactions showed direct-ordered interactions. After individual therapy with NTZ and 5-FU regimens, the histological architecture of the extracted tumour discs revealed decreases in viable tumour regions with significant necrosis surrounds. These findings were consistent with gross tumour sizes. Each separate regimen lowered the remarkable GSTP1 and elevated the low MAPKs expressions, cytochrome c, BIM, SMAC, and caspases 3, and 9 in EST tissues. SIGNIFICANCE The chemotherapeutic activity of NTZ in SEC was proven. Additionally, NTZ possesses a SMAC modulatory activity that, following thorough research, should be taken into consideration as a chemotherapeutic approach in solid tumours.
Collapse
Affiliation(s)
- Samar Imbaby
- Department of Clinical Pharmacology, Faculty of Medicine, Suez Canal University, 41522 Ismailia, Egypt.
| | - Shereen E Elkholy
- Department of Clinical Pharmacology, Faculty of Medicine, Port Said University, Port Said, Egypt
| | - Salwa Faisal
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Suez Canal University, 41522 Ismailia, Egypt
| | - Asmaa K K Abdelmaogood
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Suez Canal University, 41522 Ismailia, Egypt
| | - Amir E Mehana
- Department of Zoology, Faculty of Science, Suez Canal University, 41522 Ismailia, Egypt
| | - Basma S A Mansour
- Department of Human Anatomy and Embryology, Faculty of Medicine, Suez Canal University, 41522 Ismailia, Egypt
| | - Samar M Abd El-Moneam
- Department of Human Anatomy and Embryology, Faculty of Medicine, Suez Canal University, 41522 Ismailia, Egypt
| | - Samah M Elaidy
- Department of Clinical Pharmacology, Faculty of Medicine, Suez Canal University, 41522 Ismailia, Egypt.
| |
Collapse
|
20
|
Sharma K, Srivastava S, Tak V. Cryptosporidiosis in India and the World: A review. Infect Disord Drug Targets 2023; 23:IDDT-EPUB-130656. [PMID: 37016532 DOI: 10.2174/1871526523666230403103344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 02/16/2023] [Accepted: 02/27/2023] [Indexed: 06/19/2023]
Abstract
Cryptosporidiosis is caused by infection with a coccidian parasite belonging to the genus Cryptosporidium. Initially, human cryptosporidiosis was believed to be caused only by one species, but since the advent of molecular studies, 15 more species have been discovered to cause this infection. Among them, Cryptosporidium hominis and Cryptosporidium parvum are the most common species involved. This mainly affects children and causes diarrhea in most cases. It is mainly diagnosed by microscopy, especially in low-middle-income countries. This review covers the epidemiology, life cycle, risk factors, clinical manifestations, different diagnostic methods and treatment of this disease.
Collapse
Affiliation(s)
- Kirtika Sharma
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Saumya Srivastava
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Vibhor Tak
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India
| |
Collapse
|
21
|
Romero-Cabello R, Romero-Feregrino R, Romero-Feregrino R, Muñoz-Cordero B, Sevilla-Fuentes S. Outpatient treatment of COVID-19: an experience with 552 cases in Mexico. J Infect Dev Ctries 2023; 17:311-318. [PMID: 37023433 DOI: 10.3855/jidc.16982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 01/16/2023] [Indexed: 04/08/2023] Open
Abstract
INTRODUCTION The impact of the coronavirus disease 2019 (COVID-19) pandemic has globally challenged health services, especially because when the pandemic first reached Mexico, in February 2020, there was no known effective and safe treatment. A treatment scheme was offered by the Institute for the Integral Development of Health (IDISA) in Mexico City from March 2020 to August 2021 when there were many patients with COVID-19. This report summarizes the experience managing COVID-19 with this scheme. MATERIALS AND METHODS This is a descriptive, retrolective study. The data was obtained from the case files of the patients who attended the IDISA from March 2020 to August 2021 with COVID-19. All the cases were treated with the scheme consisting of nitazoxanide, azithromycin, and prednisone. Various laboratory blood tests and chest computerized tomography scan were done. When indicated, supplementary oxygen, and another specific treatment were used. A standardized clinical recording was conducted for 20 days based on symptoms and systemic symptoms. RESULTS Based on the World Health Organization criteria, the patients were classified according to the disease severity: 170 mild, 70 moderate, and 312 severe cases. The outcome was the discharge of 533 patients after their recovery, 16 were excluded from the study, and 6 died. CONCLUSIONS The use of nitazoxanide, azithromycin, and prednisone proved to be effective as it resulted in improvement of symptoms and in successful outcomes for the management of COVID-19 outpatients.
Collapse
|
22
|
Kelleni MT. Real-world practice of the Egyptian Kelleni's protocol amid changing tropism of SARS-CoV-2 omicron BA.5.2.1.7, XBB 1.5 and CH.1.1 subvariants: a multi-purpose protocol. Inflammopharmacology 2023;:1-2. [PMID: 36928633 DOI: 10.1007/s10787-023-01180-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 02/25/2023] [Indexed: 03/18/2023]
Abstract
The Egyptian immune-modulatory Kelleni's protocol, including nitazoxanide as an integral component, is being safely and effectively practiced to manage SARS-CoV-2, RSV, influenza infections in pediatric, adult and pregnant patients with negligible requirements for the relatively expensive diagnostic molecular tests. Most recently, Kelleni's protocol is being likewise used to manage potential norovirus infection which is currently confused with SARS-CoV-2 Omicron new enterotropic subvariants and the antihistaminic loratadine has been co-administered in selected patients. Notably, Africa has the least mandates, restrictions and SARS-CoV-2 vaccination rates and yet the least COVID-19 mortality.
Collapse
|
23
|
Panny L, Akrhymuk I, Bracci N, Woodson C, Flor R, Elliott I, Zhou W, Narayanan A, Campbell C, Kehn-Hall K. Venezuelan equine encephalitis virus E1 protein interacts with PDIA6 and PDI inhibition reduces alphavirus production. Antiviral Res 2023; 212:105560. [PMID: 36822370 DOI: 10.1016/j.antiviral.2023.105560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/13/2023] [Accepted: 02/19/2023] [Indexed: 02/25/2023]
Abstract
Venezuelan equine encephalitis virus (VEEV) is an alphavirus transmitted by mosquitos that can cause a febrile illness and induce severe neurological complications in humans and equine populations. Currently there are no FDA approved vaccines or antiviral treatments to combat VEEV. Proteomic techniques were utilized to create an interactome of the E1 fusion glycoprotein of VEEV. VEEV E1 interacted with a number of cellular chaperone proteins including protein disulfide isomerase family A member 6 (PDIA6). PDI inhibition through LOC14 and/or nitazoxanide treatment effectively decreased production of VEEV and other alphaviruses in vitro, including eastern equine encephalitis virus, Sindbis virus, and chikungunya virus. Decreased oxidoreductive capabilities of PDIs through LOC14 or nitazoxanide treatment impacted both early and late events in viral replication, including the production of non-infectious virions and decreased VEEV E1 disulfide bond formation. Results from this study identified PDIs as critical regulators of alphavirus replication and potential therapeutic targets.
Collapse
Affiliation(s)
- Lauren Panny
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA; Center for Emerging, Zoonotic, and Arthropod-borne Pathogens, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA
| | - Ivan Akrhymuk
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA
| | - Nicole Bracci
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA
| | - Caitlin Woodson
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA
| | - Rafaela Flor
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA; Center for Emerging, Zoonotic, and Arthropod-borne Pathogens, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA
| | - Isaac Elliott
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA
| | - Weidong Zhou
- Center for Applied Proteomics and Molecular Medicine, School of Systems Biology, George Mason University, Manassas, VA, 20110, USA
| | - Aarthi Narayanan
- Department of Biology, George Mason University, Fairfax, VA, 22030, USA
| | | | - Kylene Kehn-Hall
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA; Center for Emerging, Zoonotic, and Arthropod-borne Pathogens, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA.
| |
Collapse
|
24
|
Huang Q, Liu M, Zhang D, Lin BB, Fu X, Zhang Z, Zhang B, Dong JT. Nitazoxanide inhibits acetylated KLF5-induced bone metastasis by modulating KLF5 function in prostate cancer. BMC Med 2023; 21:68. [PMID: 36810084 PMCID: PMC9945734 DOI: 10.1186/s12916-023-02763-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/30/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Castration-resistant prostate cancer often metastasizes to the bone, and such bone metastases eventually become resistant to available therapies, leading to the death of patients. Enriched in the bone, TGF-β plays a pivotal role in bone metastasis development. However, directly targeting TGF-β or its receptors has been challenging for the treatment of bone metastasis. We previously found that TGF-β induces and then depends on the acetylation of transcription factor KLF5 at K369 to regulate multiple biological processes, including the induction of EMT, cellular invasiveness, and bone metastasis. Acetylated KLF5 (Ac-KLF5) and its downstream effectors are thus potential therapeutic targets for treating TGF-β-induced bone metastasis in prostate cancer. METHODS A spheroid invasion assay was applied to prostate cancer cells expressing KLF5K369Q, which mimics Ac-KLF5, to screen 1987 FDA-approved drugs for invasion suppression. Luciferase- and KLF5K369Q-expressing cells were injected into nude mice via the tail artery to model bone metastasis. Bioluminescence imaging, micro-CT), and histological analyses were applied to monitor and evaluate bone metastases. RNA-sequencing, bioinformatic, and biochemical analyses were used to understand nitazoxanide (NTZ)-regulated genes, signaling pathways, and the underlying mechanisms. The binding of NTZ to KLF5 proteins was evaluated using fluorescence titration, high-performance liquid chromatography (HPLC), and circular dichroism (CD) analysis. RESULTS NTZ, an anthelmintic agent, was identified as a potent invasion inhibitor in the screening and validation assays. In KLF5K369Q-induced bone metastasis, NTZ exerted a potent inhibitory effect in preventive and therapeutic modes. NTZ also inhibited osteoclast differentiation, a cellular process responsible for bone metastasis induced by KLF5K369Q. NTZ attenuated the function of KLF5K369Q in 127 genes' upregulation and 114 genes' downregulation. Some genes' expression changes were significantly associated with worse overall survival in patients with prostate cancer. One such change was the upregulation of MYBL2, which functionally promotes bone metastasis in prostate cancer. Additional analyses demonstrated that NTZ bound to the KLF5 protein, KLF5K369Q bound to the promoter of MYBL2 to activate its transcription, and NTZ attenuated the binding of KLF5K369Q to the MYBL2 promoter. CONCLUSIONS NTZ is a potential therapeutic agent for bone metastasis induced by the TGF-β/Ac-KLF5 signaling axis in prostate cancer and likely other cancers.
Collapse
Affiliation(s)
- Qingqing Huang
- Department of Human Cell Biology and Genetics, School of Medicine, Southern University of Science and Technology, 1088 Xueyuan Blvd, Shenzhen, 518055, China
| | - Mingcheng Liu
- Department of Human Cell Biology and Genetics, School of Medicine, Southern University of Science and Technology, 1088 Xueyuan Blvd, Shenzhen, 518055, China
| | - Duo Zhang
- Department of Human Cell Biology and Genetics, School of Medicine, Southern University of Science and Technology, 1088 Xueyuan Blvd, Shenzhen, 518055, China
| | - Bing-Biao Lin
- Department of Human Cell Biology and Genetics, School of Medicine, Southern University of Science and Technology, 1088 Xueyuan Blvd, Shenzhen, 518055, China.,Department of Urology, Kidney and Urology Center, Pelvic Floor Disorders Center, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518000, China
| | - Xing Fu
- Department of Human Cell Biology and Genetics, School of Medicine, Southern University of Science and Technology, 1088 Xueyuan Blvd, Shenzhen, 518055, China
| | - Zhiqian Zhang
- Department of Human Cell Biology and Genetics, School of Medicine, Southern University of Science and Technology, 1088 Xueyuan Blvd, Shenzhen, 518055, China
| | - Baotong Zhang
- Department of Human Cell Biology and Genetics, School of Medicine, Southern University of Science and Technology, 1088 Xueyuan Blvd, Shenzhen, 518055, China
| | - Jin-Tang Dong
- Department of Human Cell Biology and Genetics, School of Medicine, Southern University of Science and Technology, 1088 Xueyuan Blvd, Shenzhen, 518055, China.
| |
Collapse
|
25
|
Sukanya R, Mohandoss S, Lee YR. Synthesis of active-site rich molybdenum-doped manganese tungstate nanocubes for effective electrochemical sensing of the antiviral drug (COVID-19) nitazoxanide. Chemosphere 2023; 311:137005. [PMID: 36347350 PMCID: PMC9636157 DOI: 10.1016/j.chemosphere.2022.137005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/18/2022] [Accepted: 10/23/2022] [Indexed: 06/16/2023]
Abstract
Nitazoxanide (NTZ), a promising antiviral agent, is currently being tested in clinical trials as a potential treatment for novel coronavirus disease 2019 (COVID -19). This paper describes a one-pot hydrothermal synthesis to prepare molybdenum (Mo)-doped manganese tungstate nanocubes (Mo-MnWO4 NCs) for the electrochemical sensing of NTZ. The as-prepared Mo-MnWO4 NCs were characterized using various techniques such as XRD, Raman, FE-SEM, FE-TEM, and XPS to confirm the crystal structure, morphology, and elemental composition. The obtained results demonstrate that Mo doping on MnWO4 generates many vacancy sites, exhibiting remarkable electrochemical activity. The kinetic parameters of the electrode modified with Mo-MnWO4 NCs were calculated to be (Ks) 1.1 × 10-2 cm2 s-1 and (α) 0.97, respectively. Moreover, a novel electrochemical sensor using Mo-MnWO4 NCs was fabricated to detect NTZ, which is used as a primary antibiotic to control COVID-19. Under optimal conditions, the electrochemical reduction of NTZ was determined with a low detection limit of 3.7 nM for a linear range of 0.014-170.2 μM with a high sensitivity of 0.78 μA μM-1 cm-2 and negligible interference with other nitro group-containing drugs, cations, and anions. The electrochemical sensor was successfully used to detect NTZ in the blood serum and urine samples and achieved high recoveries in the range of 94-99.2% and 95.3-99.6%, respectively. This work opens a way to develop high-performance sensing materials by exploring the introduction of defect engineering on metal tungstates to detect drug molecules for practical applications.
Collapse
Affiliation(s)
- Ramaraj Sukanya
- School of Chemical Engineering, Yeungnam University, Gyeongsan, Gyeongbuk, 38541, Republic of Korea
| | - Sonaimuthu Mohandoss
- School of Chemical Engineering, Yeungnam University, Gyeongsan, Gyeongbuk, 38541, Republic of Korea
| | - Yong Rok Lee
- School of Chemical Engineering, Yeungnam University, Gyeongsan, Gyeongbuk, 38541, Republic of Korea.
| |
Collapse
|
26
|
Abdo SM, Ghallab MMI, Zaghloul MS, Elhadad H. Efficacy of Nitazoxanide, Nitazoxanide-Garlic Combination and Tinidazole in Treatment of Giardia duodenalis and Blastocystis hominis: Coproscopic Assessment. Iran J Parasitol 2023; 18:48-55. [PMID: 37197063 PMCID: PMC10183438 DOI: 10.18502/ijpa.v18i1.12379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Indexed: 05/19/2023]
Abstract
Background Giardia duodenalis and Blastocystis hominis are among the most common intestinal protozoa worldwide. Treatment of infection by metronidazole (MTZ) has some limitations. The objective of this study was to detect the prevalence of Blastocystis and giardiasis among school-age children from December 2021 till March 2022 from Motoubes, Kafrelsheikh, Egypt, and determine the efficacy of nitazoxanide (NTZ), NTZ plus garlic and tinidazole (TIN) on Blastocystis and giardiasis infection. Methods Stool samples were collected from 390 children and microscopically examined using formalin-ethyl acetate concentration and culturing on Jones' medium for B. hominis. Those who tested positive for giardiasis (120 children, 30.7%) (Group I) or Blastocystis (180 children, 46.1%) (Group II) were equally divided into four subgroups. The first subgroup received NTZ orally, every 12 hours for three successive days. The second subgroup received NTZ in the same dose as the first subgroup plus dry garlic powder every 12 hours for three successive days. The third subgroup received TIN as a single oral dose, and a fourth control subgroup. Successful cure was considered if no Blastocystis or giardiasis stages were found in post-treatment faecal specimens. Results Cure rate was significantly higher in TIN treated groups (75.5% and 96.6%) than NTZ (57.7% and 40%) or NTZ plus garlic treated groups (55.5% and 43%) in both Blastocystis and giardiasis, respectively (P<0.05). Conclusion TIN, once, is more efficacious than NTZ or NTZ plus garlic in the treatment of Blastocystis and giardiasis in children.
Collapse
Affiliation(s)
- Sarah M. Abdo
- Department of Medical Parasitology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, 35516, Egypt
| | | | - Mariam S. Zaghloul
- Department of Hepatology, Gastroenterology and Infectious Diseases, Kafrelshiekh University, 33516, Kafrelsheikh, Egypt
| | - Heba Elhadad
- Parasitology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| |
Collapse
|
27
|
Sharfalddin AA, Inas Muta'eb Alyounis E, Emwas AH, Jaremko M. Biological efficacy of novel metal complexes of Nitazoxanide: Synthesis, characterization, anti-COVID-19, antioxidant, antibacterial and anticancer activity studies. J Mol Liq 2022; 368:120808. [PMID: 36411838 PMCID: PMC9670593 DOI: 10.1016/j.molliq.2022.120808] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/24/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022]
Abstract
It has been repeatedly reported that nitazoxanide (NTZ) exhibits a wide range of antiviral activities against various viral infections and has shown antimicrobial properties against anaerobic bacteria, helminths and protozoa. To improve these properties, three novel metal complexes were synthesized. The bidentate characteristic of the NTZ ligand was characterized by different spectroscopic techniques, including Fourier transform infrared (FT-IR), thermogravimetric, nuclear magnetic resonance (NMR) and UV - visible spectroscopy. The geometries of the formed compounds were evaluated by density functional theory, and the results revealed that NTZ-Ru(III) has an octahedral geometry, while NTZ-Au(III) and NTZ-Ag(I) complexes have distorted square planar structures. Binding between the metal complexes and calf thymus DNA (Ct-DNA) has been studied via absorption spectra. Moreover, human albumen serum (HAS) titration has been carried out to test their susceptibility to interact with a major target molecule via absorption and fluorescence spectroscopic techniques. Several in vitro bioassays were performed to evaluate the biological activity, antibacterial potency against E. coli, antioxidant activity and cytotoxicity of the ligand and the obtained complexes. The results showed that complexes Ru(III) and Au(III) have the highest radical scavenging percentage while the Ag(I) demonstrated the greatest antibacterial activity. Moreover, the metal complexes presented potentially effective against E. coli. Furthermore, compared with NTZ-Ag and the free ligand, the in vitro cytotoxicity assay showed that both NTZ-Ru(III) and NTZ-Au(III) exhibited significant anticancer activity against HeLa cells. The efficiency of the novel compounds as antivirals was tested by molecular docking with two COVID-19 receptors to obtain all interaction details.
Collapse
Affiliation(s)
- Abeer A Sharfalddin
- Department of Chemistry, Faculty of Science, King Abdulaziz University, P.O. Box 80203, Jeddah 21589, Saudi Arabia
| | | | - Abdul-Hamid Emwas
- King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - Mariusz Jaremko
- Smart-Health Initiative (SHI) and Red Sea Research Center (RSRC), Division of Biological and Environmental Sciences and Engineering (BESE), King Abdullah University of Science and Technology (KAUST), Thuwal, Jeddah, Saudi Arabia
| |
Collapse
|
28
|
Hassan ZR, Salama DEA, Ibrahim HF. Apoptotic changes in the intestinal epithelium of Cryptosporidium-infected mice after silver nanoparticles treatment versus nitazoxanide. J Parasit Dis 2022; 46:1011-1020. [PMID: 36457780 PMCID: PMC9606195 DOI: 10.1007/s12639-022-01520-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 06/29/2022] [Indexed: 10/16/2022] Open
Abstract
Cryptosporidium has been identified as one of the prevalent opportunistic parasites that cause diarrhea, which may be persistent and fatal. Current chemotherapeutic agents, including nitazoxanide (NTZ), are frequently associated with therapeutic failure, and their roles in the induction of apoptosis in cryptosporidiosis remain to be a topic of debate. Thus, this study aimed to assess the apoptotic changes in cryptosporidiosis in immunocompetent (IC) and immunosuppressed (IS) mice after treatment with silver nanoparticles (AgNPs) and NTZ either alone or after loading. In total, 120 laboratory-bred Swiss albino mice were divided into two groups. Group A included IC mice, while Group B included IS mice. Both groups were divided into six subgroups: noninfected nontreated, infected nontreated, infected AgNP-treated, infected NTZ-treated, infected AgNP-loaded NTZ (full-dose)-treated, and infected AgNP-loaded NTZ (half-dose)-treated. The assessment was achieved through parasitological, histopathological, and apoptotic marker expression evaluation. AgNP-loaded NTZ (different doses) treatment showed the highest oocyst shedding reduction and remarkable improvement in histopathological changes, followed by individual treatment with NTZ and then AgNPs in IC and IS mice. Results of apoptotic marker expression revealed that AgNP-loaded NTZ treatment exhibited a promising role in regulating apoptotic changes in cryptosporidiosis through the expression of the lowest levels of cytochrome C and caspase-3 in IC and IS mice at the end of the experiment. Therefore, AgNP-loaded NTZ can be a potential therapeutic agent against cryptosporidiosis for IC and IS mice.
Collapse
Affiliation(s)
- Zeinab R. Hassan
- Department of Parasitology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Doaa E. A. Salama
- Department of Pathology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Hanan F. Ibrahim
- Department of Microbiology and Immunology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| |
Collapse
|
29
|
Martins-Filho PR, do Nascimento-Júnior EM, Barreto-Alves JA, Fakhouri R, Ferreira LC. Efficacy and safety of nitazoxanide in treating SARS-CoV-2 infection: a systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials. Eur J Clin Pharmacol 2022. [PMID: 36066651 DOI: 10.1007/s00228-022-03380-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/30/2022] [Indexed: 12/15/2022]
Abstract
Purpose Nitazoxanide is a broad-spectrum antiparasitic that has been tested for COVID-19 due to its anti-inflammatory effects and in vitro antiviral activity. This study synthesized the best evidence on the efficacy and safety of nitazoxanide in COVID-19. Methods Searches for studies were performed in peer-reviewed and grey-literature from January 1, 2020 to May 23, 2022. The following elements were used to define eligibility criteria: (1) Population: individuals with COVID-19; (2) Intervention: nitazoxanide; (3) Comparison: placebo; (4) Outcomes: primary outcome was death, and secondary outcomes were viral load, positive RT-PCR status, serum biomarkers of inflammation, composite measure of disease progression (ICU admission or invasive mechanical ventilation), and any adverse events; (5) Study type: blinded, placebo-controlled, randomized clinical trials (RCTs). Treatment effects were reported as relative risk (RR) for dichotomous variables and standardized mean difference (SMD) for continuous variables with 95% confidence intervals (CI). Results Five blinded, placebo-controlled RCTs were included and enrolled individuals with mild or moderate SARS-CoV-2 infection. We found no difference between nitazoxanide and placebo in reducing viral load (SMD = − 0.16; 95% CI − 0.38 to 0.05) and the frequency of positive RTP-PCR results (RR = 0.92; 95% CI 0.81 to 1.06). In addition, there was no decreased risk for disease progression (RR = 0.63; 95% CI 0.38 to 1.04) and death (RR = 0.81; 95% CI 0.36 to 1.78) among patients receiving nitazoxanide. Patients with COVID-19 treated with nitazoxanide had decreased levels of white blood cells (SMD = − 0.15; 95% − 0.29 to − 0.02), lactate dehydrogenase (LDH) (SMD − 0.32; 95% − 0.52 to − 0.13), and D-dimer (SMD − 0.49; 95% CI − 0.68 to − 0.31) compared to placebo, but the magnitude of effect was considered small to moderate. Conclusion This systematic review showed no evidence of clinical benefits of the use of nitazoxanide to treat patients with mild or moderate COVID-19. In addition, we found a reduction in WBC, LDH, and D-dimer levels among nitazoxanide-treated patients, but the effect size was considered small to moderate. Supplementary Information The online version contains supplementary material available at 10.1007/s00228-022-03380-5.
Collapse
|
30
|
Hemmati-Dinarvand M, Kheirandish S, Khodadadian A, Mostafazadeh M, Seghatoleslam A. Blockage of Wnt/β-catenin Signaling Pathway in Colorectal Cancer Resistant Cells by Nitazoxanide Effects on Peptidylarginine Deiminases Expression. Asian Pac J Cancer Prev 2022; 23:3215-3222. [PMID: 36172687 PMCID: PMC9810304 DOI: 10.31557/apjcp.2022.23.9.3215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Multidrug resistance (MDR) is a major cause of unsuccessful cancer treatment in which drugs are not effective. Therefore, it is necessary to identify the critical mechanisms of the development of MDR and target those with novel compounds. Accordingly, the current study is the first to investigate the combination effect and molecular mechanism of nitazoxanide (NTZ) and oxaliplatin (OXP) on LS174T/OXP-resistant cells. METHODS The effect of NTZ on OXP cytotoxicity in LS174T and LS174T/OXP cell lines was evaluated by MTT assay. Changes in expression levels of MDR1, MRP1, CTNNB1, peptidylarginine deiminase (PAD)2, and PAD4 genes and proteins were evaluated by RT-qPCR and western blotting methods, respectively. Lastly, the apoptosis assay was performed by flow cytometer. RESULTS OXP resistant and sensitive cells were identified based on the IC50 values (11567 nM vs. 1745 nM, p<0.05 for 24 h treatment; and 5161 nM vs. 882 nM, p<0.05 for 48 h incubation). The combination of NTZ and OXP for 48 h led to a reduction in IC50 values in resistant cells (2154 nM, p<0.05). The effect of NTZ plus OXP significantly decreased the expression of MDR1 (p<0.001), MRP1 (p<0.05), and CTNNB1 (p<0.001), while PAD2 and PAD4 expression was significantly increased (p<0.001). This combination therapy enhanced the percentage of the sub-G1 population (apoptosed) compared to other groups. CONCLUSION The results showed that NTZ leads to notable upregulation of PAD2 and PAD4, which can disrupt the Wnt/β-catenin signaling pathway and reverse the MDR by reducing MDR1 and MRP1 expression.
Collapse
Affiliation(s)
- Mohsen Hemmati-Dinarvand
- Department of Clinical Biochemistry, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
| | - Shahnaz Kheirandish
- Department of Medical Genetics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Ali Khodadadian
- Department of Medical Genetics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Mostafa Mostafazadeh
- Department of Clinical Biochemistry, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Atefeh Seghatoleslam
- Department of Clinical Biochemistry, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
31
|
Abdelmaksoud HF, Aboushousha TS, El-Ashkar AM. Deep glance on the antiparasitic anticancer activities of wheat germ oil in chronically infected immunosuppressed mice with cryptosporidiosis. J Parasit Dis 2022; 46:785-794. [PMID: 36091275 PMCID: PMC9458820 DOI: 10.1007/s12639-022-01497-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/07/2022] [Indexed: 11/25/2022] Open
Abstract
Cryptosporidium species are the major cause of water-borne epidemics of diarrhea in both developing and developed countries that vary from self-limited in immunocompetent patients to severe life-threatening in the immunocompromised hosts. There was a proven correlation between cryptosporidiosis and colorectal cancers, although, studies in this field are still limited. Wheat germ oil (WGO) is a natural product with a known antiparasitic effect and potential antiproliferative activities. This study aimed to evaluate the antiparasitic and anticancer activities of WGO in chronically infected immunosuppressed mice compared to Nitazoxanide (NTZ). This experimental case-control study was performed in the period from January till September 2021. Eighty immunosuppressed bred laboratory mice were divided into 4 groups, 20 mice each; GI non-infected; negative control (NC), GII infected non treated; positive control (PC), GII infected, and treated with NTZ, GIV infected, and treated with WGO. Parasitological, histopathological, and immunohistochemical examinations were performed with estimating the rate of maximal survival for the study groups. Parasitological examination revealed a marked reduction in the mean Cryptosporidium spp. oocyst counts in the stool of GIV compared to PC, and GIII (P-value < 0.001). Histopathological and immunohistochemical examinations showed the best results with GIV which revealed restoration of normal villous pattern, with no dysplasia or malignancy could be detected. GIV showed the best survival rate compared to PC and GIII. WGO is an extremely promising agent that has an excellent therapeutic effect against cryptosporidiosis with the ability to control the tumorigenesis process in the chronically infected immunosuppressed hosts.
Collapse
Affiliation(s)
| | | | - Ayman M. El-Ashkar
- Department of Medical Parasitology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Department of Basic Medical Science, College of Medicine, University of Bisha, Bisha, Kingdom of Saudi Arabia
| |
Collapse
|
32
|
Abdelmaksoud HF, Osman EEA, Abdel-Hameed SS, Aboushousha T, Naggar HME. In vivo evaluation of anticryptosporidial effects of wheat germ extracts in immunocompromised mice. J Parasit Dis 2022; 46:833-844. [PMID: 36091283 PMCID: PMC9458818 DOI: 10.1007/s12639-022-01502-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 05/20/2022] [Indexed: 10/18/2022] Open
Abstract
Cryptosporidium species is a prime cause of diarrheal disease in individuals with competent immunity. In patients with compromised immunity, infections are more severe particularly in developing countries. Wheat germ oil was described to have antiparasitic effect. This study was done to evaluate the possible role of wheat germ extracts in Cryptosporidium parvum (C. parvum) infected immunocompromised mice. Thirty white albino mice were classified into six groups as follow: four study groups, all immunosuppressed and infected with C. parvum oocysts. These four groups received treatments as follow: Group (I): treated with nitazoxanide. Group (II): treated with wheat germ oil. Group (III): treated with wheat germ extracted by hexane. Group (IV): treated with wheat germ extracted by ethanol. The remaining two groups were immunosuppressed control groups as follow: Group (V): only infected with C. parvum oocysts (Positive control). Group (VI): non-infected (Negative control). Stool samples were collected and examined to detect oocyst and the ileocecal region was subjected to histopathological and immunohistochemical examination. Wheat germ extracts showed a statistically significant effect against C. parvum specially wheat germ oil with P value: < 0.001, this effect was also confirmed by pathological and immunohistochemical examinations. C. parvum has an influence on human health by its effect in diarrheal disease. Wheat germ oil and its extracts has proved to be a reliable herb for C. parvum. treatment confirmed by different methodologies.
Collapse
Affiliation(s)
| | - Ezzat E. A. Osman
- Department of Medicinal Chemistry, Theodor Bilharz Institute, Giza, Egypt
| | | | - Tarek Aboushousha
- Department of Pathology, Theodor Bilharz Research Institute, Giza, Egypt
| | - Heba M. El Naggar
- Department of Parasitology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
33
|
Driouich JS, Cochin M, Touret F, Petit PR, Gilles M, Moureau G, Barthélémy K, Laprie C, Wattanakul T, Chotsiri P, Hoglund RM, Tarning J, Fraisse L, Sjö P, Mowbray CE, Escudié F, Scandale I, Chatelain E, de Lamballerie X, Solas C, Nougairède A. Pre-clinical evaluation of antiviral activity of nitazoxanide against SARS-CoV-2. EBioMedicine 2022; 82:104148. [PMID: 35834886 PMCID: PMC9271885 DOI: 10.1016/j.ebiom.2022.104148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/16/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background To address the emergence of SARS-CoV-2, multiple clinical trials in humans were rapidly started, including those involving an oral treatment by nitazoxanide, despite no or limited pre-clinical evidence of antiviral efficacy. Methods In this work, we present a complete pre-clinical evaluation of the antiviral activity of nitazoxanide against SARS-CoV-2. Findings First, we confirmed the in vitro efficacy of nitazoxanide and tizoxanide (its active metabolite) against SARS-CoV-2. Then, we demonstrated nitazoxanide activity in a reconstructed bronchial human airway epithelium model. In a SARS-CoV-2 virus challenge model in hamsters, oral and intranasal treatment with nitazoxanide failed to impair viral replication in commonly affected organs. We hypothesized that this could be due to insufficient diffusion of the drug into organs of interest. Indeed, our pharmacokinetic study confirmed that concentrations of tizoxanide in organs of interest were always below the in vitro EC50. Interpretation These preclinical results suggest, if directly applicable to humans, that the standard formulation and dosage of nitazoxanide is not effective in providing antiviral therapy for Covid-19. Funding This work was supported by the Fondation de France “call FLASH COVID-19”, project TAMAC, by “Institut national de la santé et de la recherche médicale” through the REACTing (REsearch and ACTion targeting emerging infectious diseases), by REACTING/ANRS MIE under the agreement No. 21180 (‘Activité des molécules antivirales dans le modèle hamster’), by European Virus Archive Global (EVA 213 GLOBAL) funded by the European Union's Horizon 2020 research and innovation program under grant agreement No. 871029 and DNDi under support by the Wellcome Trust Grant ref: 222489/Z/21/Z through the COVID-19 Therapeutics Accelerator”.
Collapse
Affiliation(s)
- Jean-Sélim Driouich
- Unité des Virus Émergents (UVE: Aix-Marseille University -IRD 190-Inserm 1207), Marseille, France.
| | - Maxime Cochin
- Unité des Virus Émergents (UVE: Aix-Marseille University -IRD 190-Inserm 1207), Marseille, France
| | - Franck Touret
- Unité des Virus Émergents (UVE: Aix-Marseille University -IRD 190-Inserm 1207), Marseille, France
| | - Paul-Rémi Petit
- Unité des Virus Émergents (UVE: Aix-Marseille University -IRD 190-Inserm 1207), Marseille, France
| | - Magali Gilles
- Unité des Virus Émergents (UVE: Aix-Marseille University -IRD 190-Inserm 1207), Marseille, France
| | - Grégory Moureau
- Unité des Virus Émergents (UVE: Aix-Marseille University -IRD 190-Inserm 1207), Marseille, France
| | - Karine Barthélémy
- Unité des Virus Émergents (UVE: Aix-Marseille University -IRD 190-Inserm 1207), Marseille, France
| | | | - Thanaporn Wattanakul
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Palang Chotsiri
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Richard M Hoglund
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Joel Tarning
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Laurent Fraisse
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - Peter Sjö
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | | | - Fanny Escudié
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - Ivan Scandale
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - Eric Chatelain
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - Xavier de Lamballerie
- Unité des Virus Émergents (UVE: Aix-Marseille University -IRD 190-Inserm 1207), Marseille, France
| | - Caroline Solas
- Unité des Virus Émergents (UVE: Aix-Marseille University -IRD 190-Inserm 1207), Marseille, France; APHM, Laboratoire de Pharmacocinétique et Toxicologie, Hôpital La Timone, Marseille, France
| | - Antoine Nougairède
- Unité des Virus Émergents (UVE: Aix-Marseille University -IRD 190-Inserm 1207), Marseille, France
| |
Collapse
|
34
|
Smith T, Hoyo-Vadillo C, Adom AA, Favari-Perozzi L, Gastine S, Dehbi HM, Villegas-Lara B, Mateos E, González YSP, Navarro-Gualito MD, Cruz-Carbajal AS, Cortes-Vazquez MA, Bekker-Méndez C, Aguirre-Alvarado C, Aguirre-Gil G, Delgado-Pastelin L, Owen A, Lowe D, Standing J, Escobedo J. Favipiravir and/or nitazoxanide: a randomized, double-blind, 2×2 design, placebo-controlled trial of early therapy in COVID-19 in health workers, their household members, and patients treated at IMSS (FANTAZE). Trials 2022; 23:583. [PMID: 35869526 PMCID: PMC9306230 DOI: 10.1186/s13063-022-06533-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/08/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The 2020 pandemic of SARS-CoV-2 causing COVID-19 disease is an unprecedented global emergency. COVID-19 appears to be a disease with an early phase where the virus replicates, coinciding with the first presentation of symptoms, followed by a later 'inflammatory' phase which results in severe disease in some individuals. It is known from other rapidly progressive infections such as sepsis and influenza that early treatment with antimicrobials is associated with a better outcome. The hypothesis is that this holds for COVID-19 and that early antiviral treatment may prevent progression to the later phase of the disease. METHODS Trial design: Phase IIA randomised, double-blind, 2 × 2 design, placebo-controlled, interventional trial. RANDOMISATION Participants will be randomised 1:1 by stratification, with the following factors: gender, obesity, symptomatic or asymptomatic, current smoking status presence or absence of comorbidity, and if the participant has or has not been vaccinated. BLINDING Participants and investigators will both be blinded to treatment allocation (double-blind). DISCUSSION We propose to conduct a proof-of-principle placebo-controlled clinical trial of favipiravir plus or minus nitazoxanide in health workers, their household members and patients treated at the Mexican Social Security Institute (IMSS) facilities. Participants with or without symptomatic COVID-19 or who tested positive will be assigned to receive favipiravir plus nitazoxanide or favipiravir plus nitazoxanide placebo. The primary outcome will be the difference in the amount of virus ('viral load') in the upper respiratory tract after 5 days of therapy. Secondary outcomes will include hospitalization, major morbidity and mortality, pharmacokinetics, and impact of antiviral therapy on viral genetic mutation rate. If favipiravir with nitazoxanide demonstrates important antiviral effects without significant toxicity, there will be a strong case for a larger trial in people at high risk of hospitalization or intensive care admission, for example older patients and/or those with comorbidities and with early disease. TRIAL REGISTRATION ClinicalTrials.gov NCT04918927 . Registered on June 9, 2021.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - David Lowe
- Division of Infection and Immunity, UCL, London, UK
| | | | | |
Collapse
|
35
|
Abdel-Lateef MA, Alzahrani E, Pashameah RA, Almahri A, Abu-Hassan AA, El Hamd MA, Mohammad BS. A specific turn-on fluorescence probe for determination of nitazoxanide based on feasible oxidation reaction with hypochlorite: Applying cobalt ferrite nanoparticles for pre-concentration and extraction of its metabolite from real urine samples. J Pharm Biomed Anal 2022; 219:114941. [PMID: 35905532 DOI: 10.1016/j.jpba.2022.114941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 01/14/2023]
Abstract
Nitazoxanide is an antimicrobial compound that was originally developed as an antiprotozoal drug. Recently nitazoxanide has been identified as broad-spectrum antiviral agent and redirected for the remediation of some respiratory tract viral infections. In this study, the spectrofluorimetric technique has been applied to determine Nitazoxanide (NTX) in tablets or its metabolite, tizoxanide (TZD), in human urine samples. The developed methodology is based on oxidizing NTX (non-fluorescence) into a highly fluorescent product by sodium hypochlorite. The fluorescence emission intensity was measured at 436.5 nm after fluorescence excitation at 362.5 nm. After optimizing all conditions, the analytical procedures and bio-analytical steps were evaluated and validated using ICH and FDA criteria, respectively. The method linearity, LOQ, and LOD values of NTX were 1.0-5.0 µg/mL, 0.434, and 0.143 µg/mL, respectively. The other novelty side of the presented work is the application of cobalt ferrite (CoFe2O4) nanoparticles (NPs) as a magnetic solid-phase for the pre-concentration and extraction process. The synthesized magnetic nanoparticles were characterized by scanning electron microscope and zeta sizer techniques. Finally, the utilized magnetic nanoparticles exhibited good recovery results for pre-concentration and extraction of NTX or its metabolite from spiked and real human urine samples, respectively.
Collapse
Affiliation(s)
- Mohamed A Abdel-Lateef
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut 71524, Egypt.
| | - Eman Alzahrani
- Department of Chemistry, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Rami Adel Pashameah
- Department of Chemistry, Faculty of Applied Science, Umm Al-Qura University, Makkah 24230, Saudi Arabia
| | - Albandary Almahri
- Department of Chemistry, College of Science and Humanities in Al-Khar j, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Ahmed A Abu-Hassan
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut 71524, Egypt
| | - Mohamed A El Hamd
- Department of Pharmaceutical Sciences, College of Pharmacy, Shaqra University, Al Dwadmi 11961, Saudi Arabia; Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, South Valley University 83523 Qena, Egypt.
| | - Bassam Shaaban Mohammad
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Menoufia University, Shebin El-Kom, Menoufia, Egypt
| |
Collapse
|
36
|
Ferreira de Lima N, de Andrade Picanço G, Costa TL, Vinaud MC. In vitro metabolic stress induced by nitazoxanide and flubendazole combination in Taenia crassiceps cysticerci. Exp Parasitol 2022; 238:108265. [PMID: 35525309 DOI: 10.1016/j.exppara.2022.108265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 04/18/2022] [Accepted: 04/25/2022] [Indexed: 11/17/2022]
Abstract
Taenia crassiceps is often used as experimental model for T. solium cysticercosis studies. Currently cysticercosis antiparasitic treatment is based on albendazole and praziquantel which may present side effects and parasitic resistance. The search for other antiparasitic drugs is necessary. Nitazoxanide (NTZ) and flubendazole (FLB) are broad spectrum antiparasitic drugs that present anti-cysticercosis effect. Metabolic analyses help to determine the impact of these drugs on parasites. The aim of this study was to determine the impact on the production and excretion of organic metabolites in T. crassiceps cysticerci after in vitro exposure to NTZ and FLB, isolated or in combination. T. crassiceps cysticerci were culture in RPMI medium and exposed to 10μg/mL of NTZ, 10μg/mL of FLB or 10μg/mL of NTZ +10μg/mL of FLB. 24h after exposure, the parasites were chromatographic analyzed to determine the impact of these drugs on glycolysis, homolactic fermentation, tricarboxylic acid cycle, fatty acids oxidation and proteins catabolism. It was possible to determine that the drugs combination induced greater metabolic impact on cysticerci in comparison to the isolated drugs exposure. The drugs combination induced gluconeogenesis, metabolic acidosis, increase in tricarboxylic acid cycle and in proteins catabolism. While the NTZ isolated exposure induced metabolic acidosis and protein catabolism and the FLB isolate exposure induced gluconeogenesis and protein catabolism. These results show that the combination of drugs with different modes of action increase the antiparasitic effect and may be indicated as alternative cysticercosis treatments.
Collapse
Affiliation(s)
- Nayana Ferreira de Lima
- Laboratory of Studies of the Host-parasite Relationship, Tropical Pathology and Public Health Institute, Federal University of Goias, Brazil
| | - Guaraciara de Andrade Picanço
- Laboratory of Studies of the Host-parasite Relationship, Tropical Pathology and Public Health Institute, Federal University of Goias, Brazil
| | - Tatiane Luiza Costa
- Laboratory of Studies of the Host-parasite Relationship, Tropical Pathology and Public Health Institute, Federal University of Goias, Brazil
| | - Marina Clare Vinaud
- Laboratory of Studies of the Host-parasite Relationship, Tropical Pathology and Public Health Institute, Federal University of Goias, Brazil.
| |
Collapse
|
37
|
Riccio A, Santopolo S, Rossi A, Piacentini S, Rossignol JF, Santoro MG. Impairment of SARS-CoV-2 spike glycoprotein maturation and fusion activity by nitazoxanide: an effect independent of spike variants emergence. Cell Mol Life Sci 2022; 79:227. [PMID: 35391601 PMCID: PMC8989121 DOI: 10.1007/s00018-022-04246-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/03/2022] [Accepted: 03/11/2022] [Indexed: 12/12/2022]
Abstract
SARS-CoV-2, the causative agent of COVID-19, has caused an unprecedented global health crisis. The SARS-CoV-2 spike, a surface-anchored trimeric class-I fusion glycoprotein essential for viral entry, represents a key target for developing vaccines and therapeutics capable of blocking virus invasion. The emergence of SARS-CoV-2 spike variants that facilitate virus spread and may affect vaccine efficacy highlights the need to identify novel antiviral strategies for COVID-19 therapy. Here, we demonstrate that nitazoxanide, an antiprotozoal agent with recognized broad-spectrum antiviral activity, interferes with SARS-CoV-2 spike maturation, hampering its terminal glycosylation at an endoglycosidase H-sensitive stage. Engineering multiple SARS-CoV-2 variant-pseudoviruses and utilizing quantitative cell–cell fusion assays, we show that nitazoxanide-induced spike modifications hinder progeny virion infectivity as well as spike-driven pulmonary cell–cell fusion, a critical feature of COVID-19 pathology. Nitazoxanide, being equally effective against the ancestral SARS-CoV-2 Wuhan-spike and different emerging variants, including the Delta variant of concern, may represent a useful tool in the fight against COVID-19 infections.
Collapse
Affiliation(s)
- Anna Riccio
- Department of Biology, University of Rome Tor Vergata, Rome, Italy
| | - Silvia Santopolo
- Department of Biology, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Rossi
- Institute of Translational Pharmacology, CNR, Rome, Italy
| | - Sara Piacentini
- Department of Biology, University of Rome Tor Vergata, Rome, Italy
| | | | - M Gabriella Santoro
- Department of Biology, University of Rome Tor Vergata, Rome, Italy. .,Institute of Translational Pharmacology, CNR, Rome, Italy.
| |
Collapse
|
38
|
Li F, Jiang M, Ma M, Chen X, Zhang Y, Zhang Y, Yu Y, Cui Y, Chen J, Zhao H, Sun Z, Dong D. Anthelmintics nitazoxanide protects against experimental hyperlipidemia and hepatic steatosis in hamsters and mice. Acta Pharm Sin B 2022; 12:1322-1338. [PMID: 35530137 PMCID: PMC9069401 DOI: 10.1016/j.apsb.2021.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/16/2021] [Accepted: 08/27/2021] [Indexed: 01/16/2023] Open
Abstract
Lipid metabolism disorders contribute to hyperlipidemia and hepatic steatosis. It is ideal to develop drugs simultaneous improving both hyperlipidemia and hepatic steatosis. Nitazoxanide is an FDA-approved oral antiprotozoal drug with excellent pharmacokinetic and safety profile. We found that nitazoxanide and its metabolite tizoxanide induced mild mitochondrial uncoupling and subsequently activated AMPK in HepG2 cells. Gavage administration of nitazoxanide inhibited high-fat diet (HFD)-induced increases of liver weight, blood and liver lipids, and ameliorated HFD-induced renal lipid accumulation in hamsters. Nitazoxanide significantly improved HFD-induced histopathologic changes of hamster livers. In the hamsters with pre-existing hyperlipidemia and hepatic steatosis, nitazoxanide also showed therapeutic effect. Gavage administration of nitazoxanide improved HFD-induced hepatic steatosis in C57BL/6J mice and western diet (WD)-induced hepatic steatosis in Apoe -/- mice. The present study suggests that repurposing nitazoxanide as a drug for hyperlipidemia and hepatic steatosis treatment is promising.
Collapse
Affiliation(s)
- Fengfeng Li
- Department of Pharmacology (the State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin 150086, China
- Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Harbin Medical University, Harbin 150086, China
| | - Man Jiang
- Department of Pharmacology (the State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin 150086, China
- Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Harbin Medical University, Harbin 150086, China
| | - Minghui Ma
- Department of Pharmacology (the State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin 150086, China
- Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Harbin Medical University, Harbin 150086, China
| | - Xuyang Chen
- Department of Pharmacology (the State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin 150086, China
- Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Harbin Medical University, Harbin 150086, China
| | - Yidan Zhang
- Department of Pharmacology (the State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin 150086, China
- Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Harbin Medical University, Harbin 150086, China
| | - Yixin Zhang
- Department of Pharmacology (the State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin 150086, China
- Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Harbin Medical University, Harbin 150086, China
| | - Yuanyuan Yu
- Department of Pharmacology (the State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin 150086, China
- Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Harbin Medical University, Harbin 150086, China
| | - Yunfeng Cui
- Department of Pharmacology (the State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin 150086, China
- Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Harbin Medical University, Harbin 150086, China
| | - Jiahui Chen
- Department of Pharmacology (the State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin 150086, China
- Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Harbin Medical University, Harbin 150086, China
| | - Hui Zhao
- Department of Pharmacology (the State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin 150086, China
- Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Harbin Medical University, Harbin 150086, China
| | - Zhijie Sun
- Department of Pharmacology, China Pharmaceutical University, Nanjing 211198, China
- Corresponding authors.
| | - Deli Dong
- Department of Pharmacology (the State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin 150086, China
- Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Harbin Medical University, Harbin 150086, China
- Department of Pharmacology, China Pharmaceutical University, Nanjing 211198, China
- Corresponding authors.
| |
Collapse
|
39
|
Kelleni MT. NSAIDs and Kelleni's protocol as potential early COVID-19 treatment game changer: could it be the final countdown? Inflammopharmacology 2022; 30:343-348. [PMID: 34822026 PMCID: PMC8613510 DOI: 10.1007/s10787-021-00896-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 11/14/2021] [Indexed: 12/12/2022]
Abstract
We have previously published several papers illustrating numerous immunomodulatory and anti-inflammatory potential benefits when we repurposed safe, generic non-steroidal anti-inflammatory drugs (NSAIDs)/nitazoxanide/azithromycin (Kelleni's protocol), to early manage our COVID-19 pediatric, adult, and pregnant patients. In this manuscript, we discuss some recently published meta-analysis and clinical studies supporting our practice and discuss a molecular study that might be interpreted as an academic proof that our protocol might also prevent SARS-CoV-2 replication. Moreover, after aspirin has been suggested to be independently associated with reduced risk of mechanical ventilation, ICU admission and in-hospital mortality of COVID-19, we claim that the molecular interpretation of the results that led to this suggestion was not scientifically accurate, and we provide our academic interpretation confirming that low-dose aspirin is least likely to improve COVID-19 mortality through anticoagulation as was suggested. Furthermore, we describe other potential benefits related to aspirin-triggered lipoxins and resolvins while illustrating how NSAIDs interfere with COX-1, COX-2, SARS-CoV-2/ SARS-CoV-2 ORF protein-dependent activation of caspases and their subsequent mitochondrial dysfunction, endoplasmic reticulum stress, apoptosis and necroptosis which were associated with COVID-19 complications. Similarly, NSAIDs are known caspase inhibitors and thus they might independently inhibit other caspase-related COVID-19-associated downstream pathological signaling mechanisms. Finally, we postulated that CARD-14, a caspase recruitment domain-containing protein, polymorphisms might play a role in the development of severe and critical COVID-19 and confirmed our old call to early adopt NSAIDs, as an integral part of Kelleni's protocol, as of choice in its management aiming to end this pandemic.
Collapse
Affiliation(s)
- Mina T Kelleni
- Pharmacology Department, College of Medicine, Minia University, Minya, Egypt.
| |
Collapse
|
40
|
de Andrade Picanço G, Ferreira de Lima N, Cristina Gomes T, de Sousa Mendes Moreira Alves D, Luísa da Costa T, Vinaud MC. Intraperitoneal and intracranial experimental cysticercosis present different metabolic preferences after treatment with isolated or combined albendazole and nitazoxanide. Acta Trop 2022; 226:106264. [PMID: 34919953 DOI: 10.1016/j.actatropica.2021.106264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 11/15/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022]
Abstract
Cysticercosis is a zoonotic public health issue especially severe when the parasite is in the central nervous system although it may be found all over the human organism. Taenia crassiceps cysticerci inoculated in mice is the experimental model used to study cysticercosis. The most used cysticercosis treatment is with albendazole (ABZ). Nitazoxanide (NTZ) has been experimentally tested against this parasite. Metabolic analysis has been used to determine drugs impact on the parasite. The aim of this study was to determine the in vivo metabolic impact of the ABZ-NTZ combination in T. crassiceps cysticerci inoculated in mice peritoneal and intracranial cavities. Mice were experimentally inoculated with T. crassiceps cysticerci in the intraperitoneal cavity or in the intracranial one. Thirty days after the infection they were treated with NaCl 0.9% (control group), 50 mg/kg of ABZ, 50 mg/kg of NTZ or 50 mg/kg of NTZ and ABZ (ABZ/NTZ combination). 24 h after treatment the animals were euthanized and the cysticerci analyzed through high performance chromatography and spectrophotometry in order to detect the glycolytic, mitochondrial and protein catabolism pathways. The intracranial parasites used more intensely the homolactic fermentation while the intraperitoneal ones presented a greater use of the mitochondrial pathways and protein catabolism. Regarding the glycolytic pathways, it was possible to observe a significant impact induced by the drugs used, both isolated or in combination. It was possible to detect an increase in the fumarate reductase pathway after the drugs exposure and no impact in the protein's catabolism. Therefore, the cysticerci showed different uses of metabolic pathways regarding the site of inoculation due to the availability of nutrients inherent of each environment. This study showed the parasite metabolic resilience and capability of use of different biochemical pathways in order to ensure survival in spite of a hostile environment.
Collapse
Affiliation(s)
- Guaraciara de Andrade Picanço
- Laboratory of studies of the host-parasite relationship, Tropical Pathology and Public Health Institute, Federal University of Goias, Rua 235, s/n, Setor Universitário, Goiania, Goias CEP 74605-050 Brazil
| | - Nayana Ferreira de Lima
- Laboratory of studies of the host-parasite relationship, Tropical Pathology and Public Health Institute, Federal University of Goias, Rua 235, s/n, Setor Universitário, Goiania, Goias CEP 74605-050 Brazil
| | - Taynara Cristina Gomes
- Laboratory of studies of the host-parasite relationship, Tropical Pathology and Public Health Institute, Federal University of Goias, Rua 235, s/n, Setor Universitário, Goiania, Goias CEP 74605-050 Brazil
| | - Daniella de Sousa Mendes Moreira Alves
- Laboratory of studies of the host-parasite relationship, Tropical Pathology and Public Health Institute, Federal University of Goias, Rua 235, s/n, Setor Universitário, Goiania, Goias CEP 74605-050 Brazil
| | - Tatiane Luísa da Costa
- Laboratory of studies of the host-parasite relationship, Tropical Pathology and Public Health Institute, Federal University of Goias, Rua 235, s/n, Setor Universitário, Goiania, Goias CEP 74605-050 Brazil
| | - Marina Clare Vinaud
- Laboratory of studies of the host-parasite relationship, Tropical Pathology and Public Health Institute, Federal University of Goias, Rua 235, s/n, Setor Universitário, Goiania, Goias CEP 74605-050 Brazil.
| |
Collapse
|
41
|
Rahman SU, Mi R, Zhou S, Gong H, Ullah M, Huang Y, Han X, Chen Z. Advances in therapeutic and vaccine targets for Cryptosporidium: Challenges and possible mitigation strategies. Acta Trop 2022; 226:106273. [PMID: 34906550 DOI: 10.1016/j.actatropica.2021.106273] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 12/14/2022]
Abstract
Cryptosporidium is known to be the second most common diarrheal pathogen in children, causing potentially fatal diarrhea and associated with long-term growth stunting and cognitive deficits. The only Food and Drug Administration-approved treatment for cryptosporidiosis is nitazoxanide, but this drug has not shown potentially effective results in susceptible hosts. Therefore, a safe and effective drug for cryptosporidiosis is urgently needed. Cryptosporidium genome sequencing analysis may help develop an effective drug, but both in vitro and in vivo approaches to drug evaluation are not fully standardized. On the other hand, the development of partial immunity after exposure suggests the possibility of a successful and effective vaccine, but protective surrogates are not precise. In this review, we present our current perspectives on novel cryptosporidiosis therapies, vaccine targets and efficacies, as well as potential mitigation plans, recommendations and perceived challenges.
Collapse
|
42
|
Sekiba K, Otsuka M, Funato K, Miyakawa Y, Tanaka E, Seimiya T, Yamagami M, Tsutsumi T, Okushin K, Miyakawa K, Ryo A, Koike K. HBx-induced degradation of Smc5/6 complex impairs homologous recombination-mediated repair of damaged DNA. J Hepatol 2022; 76:53-62. [PMID: 34478763 DOI: 10.1016/j.jhep.2021.08.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/25/2021] [Accepted: 08/11/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND & AIMS HBV causes hepatocellular carcinoma (HCC). While it was recently shown that the ability of HBV X protein (HBx) to impair the Smc5/6 (structural maintenance of chromosome 5/6) complex is important for viral transcription, HBx is also a potent driver of HCC. However, the mechanism by which HBx expression induces hepatocarcinogenesis is unclear. METHODS Degradation of the Smc5/6 complex and accumulation of DNA damage were observed in both in vivo and in vitro HBV infection models. Rescue experiments were performed using nitazoxanide (NTZ), which inhibits degradation of the Smc5/6 complex by HBx. RESULTS HBx-triggered degradation of the Smc5/6 complex causes impaired homologous recombination (HR) repair of DNA double-strand breaks (DSBs), leading to cellular transformation. We found that DNA damage accumulated in the liver tissue of HBV-infected humanized chimeric mice, HBx-transgenic mice, and human tissues. HBx suppressed the HR repair of DSBs, including that induced by the CRISPR-Cas9 system, in an Smc5/6-dependent manner, which was rescued by restoring the Smc5/6 complex. NTZ restored HR repair in, and colony formation by, HBx-expressing cells. CONCLUSIONS Degradation of the Smc5/6 complex by HBx increases viral transcription and promotes cellular transformation by impairing HR repair of DSBs. LAY SUMMARY The hepatitis B virus expresses a regulatory protein called HBV X protein (or HBx). This protein degrades the Smc5/6 complex in human hepatocytes, which is essential for viral replication. We found that this process also plays a key role in the accumulation of DNA damage, which contributes to HBx-mediated tumorigenesis.
Collapse
Affiliation(s)
- Kazuma Sekiba
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Motoyuki Otsuka
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
| | - Kazuyoshi Funato
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Yu Miyakawa
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Eri Tanaka
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Takahiro Seimiya
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Mari Yamagami
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Takeya Tsutsumi
- Division of Infectious Diseases, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan
| | - Kazuya Okushin
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; Department of Infection Control and Prevention, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Kei Miyakawa
- Department of Microbiology, Yokohama City University School of Medicine, Kanagawa 236-0004, Japan
| | - Akihide Ryo
- Department of Microbiology, Yokohama City University School of Medicine, Kanagawa 236-0004, Japan
| | - Kazuhiko Koike
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| |
Collapse
|
43
|
Jha SK, Kumar R, Kumar A, Purkayastha S, Keshri R, Kumar S, Singh AV. Addition of Nitazoxanide to Standard Clarithromycin Based Triple Therapy for 2 Weeks Effectively Eradicates Treatment-Naive Helicobacter Pylori Infection. A Single Centre prospective, open-label study. Middle East J Dig Dis 2022; 14:77-84. [PMID: 36619726 PMCID: PMC9489334 DOI: 10.34172/mejdd.2022.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 06/18/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND: The increasing prevalence of antibiotic-resistant strains of Helicobacter pylori (H. pylori) led to reduced success with traditional H. pylori treatments. This warrants further evaluation of other treatment options. One such treatment regimen of interest is nitazoxanide containing regimen. In this study, we evaluated the efficacy of the addition of nitazoxanide to clarithromycin-based triple therapy in patients with H. pylori infection. METHODS: In this single-center prospective observational trial, patients with H. pylori infection were treated with a regimen comprising of nitazoxanide 1000 mg, amoxicillin 2000 mg, clarithromycin 1000 mg, and esomeprazole 80 mg per day (NACE regimen) for14 days. Eradication of H. pylori infection was assessed 4 weeks after completion of therapy by using stool antigen assay. Treatment compliance and adverse effects were also evaluated. RESULTS: Out of 111 patients who entered into the study for final analysis, H. pylori eradication was achieved in 93.7% (104 out of 111) patients in per-protocol analysis and 90.4% (104 out of 115) patients in intention to treat analysis. The treatment regimen was well tolerated. CONCLUSION: The addition of nitazoxanide to standard clarithromycin-based triple therapy effectively eradicates H. pylori infection. This regimen is safe and well tolerated.
Collapse
Affiliation(s)
- Sanjeev K. Jha
- Additional Professor, Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India,Corresponding Author: Sanjeev Kumar Jha, MD, DM ORCID-ID: 0000-0002-6851-7722 Room no. 186, Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India Tel.:+91 612 2297631 Fax:+91 612 2297225 E mail:
| | - Ravikant Kumar
- Assistant Professor, Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India
| | - Amitesh Kumar
- Senior Resident, Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India
| | - Shubham Purkayastha
- Senior Resident, Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India
| | - Ravi Keshri
- Senior Resident, Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India
| | - Saurabh Kumar
- Senior Resident, Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India
| | - Aditya Vardhan Singh
- Senior Resident, Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India
| |
Collapse
|
44
|
Gong F, Shen T, Zhang J, Wang X, Fan G, Che X, Xu Z, Jia K, Huang Y, Li X, Lu H. Nitazoxanide induced myocardial injury in zebrafish embryos by activating oxidative stress response. J Cell Mol Med 2021; 25:9740-9752. [PMID: 34533278 PMCID: PMC8505840 DOI: 10.1111/jcmm.16922] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/24/2021] [Accepted: 09/01/2021] [Indexed: 12/20/2022] Open
Abstract
Nitazoxanide (NTZ) is a broad-spectrum antiparasitic and antiviral drug (thiazole). However, although NTZ has been extensively used, there are no reports concerning its toxicology in vertebrates. This study used the zebrafish as a vertebrate model to evaluate the safety of NTZ and to analyse the related molecular mechanisms. The experimental results showed that zebrafish embryos exposed to NTZ had cardiac malformation and dysfunction. NTZ also significantly inhibited proliferation and promoted apoptosis in cardiomyocytes. Transcriptomic analysis used compared gene expression levels between zebrafish embryos in the NTZ treatment and the control groups identified 200 upregulated genes and 232 downregulated genes. Analysis by Kyoto encyclopaedia of genes and genomes (KEGG) and gene ontology (GO) showed that signal pathways on cardiomyocyte development were inhibited while the oxidative stress pathways were activated. Further experiments showed that NTZ increased the content of reactive oxygen species (ROS) in the hearts of zebrafish. Antioxidant gadofullerene nanoparticles (GFNPs) significantly alleviated the developmental toxicity to the heart, indicating that NTZ activated the oxidative stress response to cause embryonic cardiomyocyte injury in zebrafish. This study provides evidence that NTZ causes developmental abnormalities in the cardiovascular system of zebrafish.
Collapse
Affiliation(s)
- Fanghua Gong
- School of Pharmacy, Wenzhou Medical University, Wenzhou, China
| | - Tianzhu Shen
- School of Pharmacy, Wenzhou Medical University, Wenzhou, China
| | - Jiangnan Zhang
- School of Pharmacy, Wenzhou Medical University, Wenzhou, China
| | - Xuye Wang
- School of Pharmacy, Wenzhou Medical University, Wenzhou, China
| | - Guoqiang Fan
- School of Pharmacy, Wenzhou Medical University, Wenzhou, China
| | - Xiaofang Che
- Center for drug screening and research, School of Geography and Environmental Engineering, Gannan Normal University, Ganzhou, Jiangxi, China
| | - Zhaopeng Xu
- Center for drug screening and research, School of Geography and Environmental Engineering, Gannan Normal University, Ganzhou, Jiangxi, China
| | - Kun Jia
- Center for drug screening and research, School of Geography and Environmental Engineering, Gannan Normal University, Ganzhou, Jiangxi, China
| | - Yong Huang
- Center for drug screening and research, School of Geography and Environmental Engineering, Gannan Normal University, Ganzhou, Jiangxi, China
| | - Xiaokun Li
- School of Pharmacy, Wenzhou Medical University, Wenzhou, China
| | - Huiqiang Lu
- Center for drug screening and research, School of Geography and Environmental Engineering, Gannan Normal University, Ganzhou, Jiangxi, China.,Jiangxi Engineering laboratory of Zebrafish Modeling and Drug Screening for Human Diseases; Jiangxi Key Laboratory of Developmental Biology of Organs, Ji'an, Jiangxi, China
| |
Collapse
|
45
|
Moawad HSF, Hegab MHAE, Badawey MSR, Ashoush SE, Ibrahim SM, Ali AAES. Assessment of chitosan nanoparticles in improving the efficacy of nitazoxanide on cryptosporidiosis in immunosuppressed and immunocompetent murine models. J Parasit Dis 2021; 45:606-19. [PMID: 34475640 DOI: 10.1007/s12639-020-01337-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022] Open
Abstract
Cryptosporidiosis is one of the major causes of diarrhea in immunocompetent and immunocompromised patients. It is self-limited in immunocompetent individuals. However, in the immunocompromised it can cause life-threatening diarrhea and results in chronic malabsorption of fluids, vitamins and electrolytes resulting in wasting. Our study is concerned with assessing and comparing the efficacy of nitazoxanide (NTZ) alone and NTZ loaded chitosan nanoparticles (NTZ loaded CS NPs) in the treatment of experimental cryptosporidiosis using parasitological and histopathological parameters. One hundred mice were divided into 5 groups (20 mice each). Each group was divided into 2 subgroups according to the immune status [a-immunocompetent, b-immunosuppressed]. group 1: control (healthy), group 2: control infected by Cryptosporidium oocysts, group 3: infected treated by NTZ, group 4: infected then treated by NTZ loaded CS NPs and group 5: infected then treated by chitosan nanoparticles (CS NPs) alone. Treatment of Cryptosporidium infected mice with NTZ loaded on CS NPs resulted in the highest significant reduction in oocysts shedding in both immunocompetent and immunosuppressed groups followed by treatment with NTZ form then by treatment with CS NPs alone. The treatment with NTZ loaded CS NPs displayed a remarkable improvement of the histopathological changes of the intestine, liver and lung while NTZ treated group showed some improvement. Treatment with NTZ loaded CS NPs in murine cryptosporidiosis gave the best results as it caused marked reduction in fecal oocysts counts and improvement of histopathological changes in immunocompetent and immunosuppressed groups.
Collapse
|
46
|
Sun H, Ou T, Hu J, Yang Z, Lei Q, Li Y, Wang G, Li Y, Wu K, Wang S, Wu S. Nitazoxanide impairs mitophagy flux through ROS-mediated mitophagy initiation and lysosomal dysfunction in bladder cancer. Biochem Pharmacol 2021; 190:114588. [PMID: 33957094 DOI: 10.1016/j.bcp.2021.114588] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/04/2021] [Accepted: 04/26/2021] [Indexed: 02/05/2023]
Abstract
Bladder cancer is one of the most common malignancy in the urinary tract with high recurrence and drug resistance in clinics. Alternative treatments from existing drugs might be a promising strategy. Nitazoxanide (NTZ), an FDA-approved antiprotozoal drug, has got increasingly noticed because of its favorable safety profile and antitumor potential, yet the effects in bladder cancer and underlying mechanisms remain poorly understood. Herein, we find that NTZ induces mitochondrial damage and mitophagy initiation through PINK1-generated phospho-ubiquitin(pS65-Ub) and autophagy receptor-mediated pathway even in the absence of Atg5/Beclin1. Meanwhile, NTZ inhibits lysosomal degradation activity, leading to mitophagy flux impairment at late stage. Mitochondrial reactive oxygen species (ROS) production is critical in this process, as eliminating ROS with N-acetylcysteine (NAC) efficiently inhibits PINK1 signaling-mediated mitophagy initiation and alleviates lysosomal dysfunction. Co-treatment with NTZ and autophagy inhibitor Chloroquine (CQ) to aggravate mitophagy flux impairment promotes NTZ-induced apoptosis, while alleviation of mitophagy flux impairment with ROS scavenger reduces cell death. Moreover, we also discover a similar signaling response in the 3D bladder tumor spheroid after NTZ exposure. In vivo study reveals a significant inhibition of orthotopic bladder tumors with no obvious systemic toxicity. Together, our results uncover the anti-tumor activities of NTZ with the involvement of ROS-mediated mitophagy modulation at different stages and demonstrate it as a potential drug candidate for fighting against bladder tumors.
Collapse
Affiliation(s)
- Haiyan Sun
- Institute of Urology, The Third Affiliated Hospital of Shenzhen University (Luohu Hospital Group), Shenzhen 518000, China; Shenzhen Following Precision Medical Research Institute, Luohu Hospital Group, Shenzhen 518000, China
| | - Tong Ou
- Institute of Urology, The Third Affiliated Hospital of Shenzhen University (Luohu Hospital Group), Shenzhen 518000, China; Shenzhen Following Precision Medical Research Institute, Luohu Hospital Group, Shenzhen 518000, China; Medical Laboratory, The Third Affiliated Hospital of Shenzhen University (Luohu Hospital Group), Shenzhen 518000, China
| | - Jianyang Hu
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong 999077, China
| | - Ziyi Yang
- Institute of Urology, The Third Affiliated Hospital of Shenzhen University (Luohu Hospital Group), Shenzhen 518000, China; Shenzhen Following Precision Medical Research Institute, Luohu Hospital Group, Shenzhen 518000, China
| | - Qifang Lei
- Institute of Urology, The Third Affiliated Hospital of Shenzhen University (Luohu Hospital Group), Shenzhen 518000, China; Shenzhen Following Precision Medical Research Institute, Luohu Hospital Group, Shenzhen 518000, China
| | - Yuqing Li
- Institute of Urology, The Third Affiliated Hospital of Shenzhen University (Luohu Hospital Group), Shenzhen 518000, China; Shenzhen Following Precision Medical Research Institute, Luohu Hospital Group, Shenzhen 518000, China
| | - Gang Wang
- Institute of Urology, The Third Affiliated Hospital of Shenzhen University (Luohu Hospital Group), Shenzhen 518000, China; Shenzhen Following Precision Medical Research Institute, Luohu Hospital Group, Shenzhen 518000, China
| | - Yongpeng Li
- Institute of Urology, The Third Affiliated Hospital of Shenzhen University (Luohu Hospital Group), Shenzhen 518000, China; Shenzhen Following Precision Medical Research Institute, Luohu Hospital Group, Shenzhen 518000, China
| | - Kai Wu
- Institute of Urology, The Third Affiliated Hospital of Shenzhen University (Luohu Hospital Group), Shenzhen 518000, China; Shenzhen Following Precision Medical Research Institute, Luohu Hospital Group, Shenzhen 518000, China
| | - Shupeng Wang
- Institute of Urology, The Third Affiliated Hospital of Shenzhen University (Luohu Hospital Group), Shenzhen 518000, China; Shenzhen Following Precision Medical Research Institute, Luohu Hospital Group, Shenzhen 518000, China
| | - Song Wu
- Institute of Urology, The Third Affiliated Hospital of Shenzhen University (Luohu Hospital Group), Shenzhen 518000, China; Shenzhen Following Precision Medical Research Institute, Luohu Hospital Group, Shenzhen 518000, China; Teaching Center of Shenzhen Luohu Hospital, Shantou University Medical College, Shenzhen 518000, China; Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510000, China.
| |
Collapse
|
47
|
Bharti C, Sharma S, Goswami N, Sharma H, Rabbani SA, Kumar S. Role of nitazoxanide as a repurposed drug in the treatment and management of various diseases. Drugs Today (Barc) 2021; 57:455-473. [PMID: 34268533 DOI: 10.1358/dot.2021.57.7.3235211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Nitazoxanide (NTZ) is an orally active drug with significant postmarketing experience including more than 75 million adults and children. Presently, this drug is widely used for a number of infectious conditions and diseases. It has a wide range of applications such as antiprotozoal, anthelmintic and antiviral against various types of Gram-positive and Gram-negative bacteria, parasites and certain viruses. Chemically, NTZ nitrothiazole is a [2-[(5-nitro-1,3- thiazol-2-yl) carbamoyl]phenyl] acetate compound. A number of clinical trials have suggested that it can be used in cryptosporidiosis, hepatitis B, hepatitis C, ovarian cancer, viral infections and helicobacter infection. Recent research has proposed its beneficial effect in treating the symptoms of coronavirus infection. It is proposed that the activity of NTZ is due to interference with pyruvate-ferredoxin oxidoreductase (PFOR), which is an enzyme that catalyzes the ferredoxin-dependent electron transfer reaction completed in anaerobiotic energy metabolism. The available literature suggested the importance of NTZ and its efficiency against various bacterial infections as well as in viral infectious diseases. The aim of this review is to examine and discuss the most important aspects of NTZ in different types of microbial infections.
Collapse
Affiliation(s)
- Charu Bharti
- Department of Pharmaceutical Sciences, School of Medical and Allied Sciences, K.R. Mangalam University, Gurugram, Haryana, India
| | - Shrestha Sharma
- Department of Pharmaceutical Sciences, School of Medical and Allied Sciences, K.R. Mangalam University, Gurugram, Haryana, India.
| | - Nitin Goswami
- Dr. KN Modi Institute of Pharmaceutical Sciences and Research, Modinagar, Uttar Pradesh, India
| | - Himanchal Sharma
- IIMT College of Medical Sciences, IIMT University, Meerut, Uttar Pradesh, India
| | - Syed Arman Rabbani
- Department of Clinical Pharmacy and Pharmacology, RAK College of Pharmaceutical Sciences, RAK Medical and Health Sciences University, United Arab Emirates
| | - Shobhit Kumar
- Department of Pharmaceutical Technology, Meerut Institute of Engineering and Technology, Meerut, Uttar Pradesh, India
| |
Collapse
|
48
|
Blum VF, Cimerman S, Hunter JR, Tierno P, Lacerda A, Soeiro A, Cardoso F, Bellei NC, Maricato J, Mantovani N, Vassao M, Dias D, Galinskas J, Janini LMR, Santos-Oliveira JR, Da-Cruz AM, Diaz RS. Nitazoxanide superiority to placebo to treat moderate COVID-19 - A Pilot prove of concept randomized double-blind clinical trial. EClinicalMedicine 2021; 37:100981. [PMID: 34222847 PMCID: PMC8235996 DOI: 10.1016/j.eclinm.2021.100981] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/14/2021] [Accepted: 06/03/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The absence of specific antivirals to treat COVID-19 leads to the repositioning of candidates' drugs. Nitazoxanide (NTZ) has a broad antiviral effect. METHODS This was a randomized, double-blind pilot clinical trial comparing NTZ 600 mg BID versus Placebo for seven days among 50 individuals (25 each arm) with SARS-COV-2 RT-PCR+ (PCR) that were hospitalized with mild respiratory insufficiency from May 20th, 2020, to September 21st, 2020 (ClinicalTrials.gov NCT04348409). Clinical and virologic endpoints and inflammatory biomarkers were evaluated. A five-point scale for disease severity (SSD) was used. FINDINGS Two patients died in the NTZ arm compared to 6 in the placebo arm (p = 0.564). NTZ was superior to placebo when considering SSD (p < 0001), the mean time for hospital discharge (6.6 vs. 14 days, p = 0.021), and negative PCR at day 21 (p = 0.035), whereas the placebo group presented more adverse events (p = 0.04). Among adverse events likely related to the study drug, 14 were detected in the NTZ group and 22 in placebo (p = 0.24). Among the 30 adverse events unlikely related, 21 occurred in the placebo group (p = 0.04). A decrease from baseline was higher in the NTZ group for d-Dimer (p = 0.001), US-RCP (p < 0.002), TNF (p < 0.038), IL-6 (p < 0.001), IL-8 (p = 0.014), HLA DR. on CD4+ T lymphocytes (p < 0.05), CD38 in CD4+ and CD8+ T (both p < 0.05), and CD38 and HLA-DR. on CD4+ (p < 0.01). INTERPRETATION Compared to placebo in clinical and virologic outcomes and improvement of inflammatory outcomes, the superiority of NTZ warrants further investigation of this drug for moderate COVID-19 in larger clinical trials. A higher incidence of adverse events in the placebo arm might be attributed to COVID-19 related symptoms.
Collapse
Affiliation(s)
| | | | | | - Paulo Tierno
- Hospital Municipal Dr. Francisco Moran (Barueri), Rua Ângela Mirella, Brazil
| | | | | | | | | | | | | | | | - Danilo Dias
- Federal University of São Paulo, São Paulo, Brazil
| | | | | | | | - Alda Maria Da-Cruz
- Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, Brazil (Laboratório Interdisciplinar de Pesquisa Médicas, Instituto Oswaldo Cruz (FIOCRUZ), Brazil
| | | |
Collapse
|
49
|
Fathy El Sayed A, Magd Eldin Mohammad Sadek A, Ahmed Ragab Abdelhamid W. Comparison between Hybrid, Reverse Hybrid, and Non-Bismuth Levofloxacin Quadruple Regimens for Helicobacter Pylori Infection in Egypt: A Randomized Trial. Middle East J Dig Dis 2021; 13:223-229. [PMID: 36606218 PMCID: PMC9489458 DOI: 10.34172/mejdd.2021.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 04/15/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The prevalence of Helicobacter pylori (H. pylori) in developing countries is 50.8%, with the highest occurrence presented in Africa (79.1%). It increases the risk of chronic gastritis, peptic ulcer, cancer of the stomach, and lymphoma. The effect of standard treatment for H. pylori eradication is below 80%, and evaluation of alternative lines of treatment is needed. We aimed to compare the hybrid, reverse hybrid, and levofloxacin quadruple therapies as first-line therapy in Egypt. METHODS This was a randomized interventional trial done in the clinics affiliated with the Internal Medicine Department. 330 individuals were selected according to the inclusion criteria. They were divided into three groups: group 1 (110 subjects who received a reverse hybrid regimen), group 2 (110 subjects who received a hybrid regimen), and group 3 (110 subjects who received a non-bismuth levofloxacin quadruple regimen). RESULTS Group 3 had a significantly lower eradication rate of 82.7% versus 92.7% and 91.8% in groups 1 and 2, respectively. There were non-significant differences in the incidence rates of adverse events among the three groups. CONCLUSION Both the reverse hybrid and hybrid groups had good eradication rates in the Egyptian population, but non-bismuth levofloxacin quadruple therapy did not obtain a sufficient eradication rate.
Collapse
Affiliation(s)
- Ayman Fathy El Sayed
- Lecturer of Internal Medicine, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | | | - Walid Ahmed Ragab Abdelhamid
- Lecturer of Internal Medicine, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
,Corresponding Author: Walid Ahmed Ragab Abdelhamid, MD Lecturer of Internal Medicine, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt Tel: + 20 1062904443 Fax: + 20 552345452
| |
Collapse
|
50
|
Goel V, Jain A, Sharma G, Jhajharia A, Agarwal VK, Ashdhir P, Pokharna R, Chauhan V. Evaluating the efficacy of nitazoxanide in uncomplicated amebic liver abscess. Indian J Gastroenterol 2021; 40:272-280. [PMID: 33991310 DOI: 10.1007/s12664-020-01132-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 11/24/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Amebic liver abscess is treated successfully with metronidazole or another nitroimidazole drug followed by a luminal amebicide. Metronidazole has long been preferred, but has been associated with several adverse effects including intolerance in certain clinical situations. Mechanisms of metronidazole resistance and mutagenic potential have been described. Effects of the use of drug in pregnant women and infants of lactating women are unknown. Nitazoxanide was proven to be efficacious in treating invasive intestinal amebiasis. Therefore, the present study was undertaken to assess the efficacy and safety of nitazoxanide as compared to metronidazole in patients with uncomplicated amebic liver abscess. METHODS Patients with clinical and ultrasonography features suggestive of liver abscess, positive amebic serology, and/or anchovy sauce appearance on aspiration of the pus were included in the study and randomized into two parallel treatment groups. Group M received metronidazole, 2-2.5 g/day intravenous (IV), for inpatients, or 2-2.4 g/day oral, for outpatients in three divided doses for 14 days. Group N received nitazoxanide 500 mg BD per oral for 10 days. RESULTS A total of sixty subjects fulfilling the inclusion criteria were randomized equally into two groups, group M and group N. Number of patients achieving symptomatic clinical response (SCR) was similar in the two groups (80% vs. 76.7%, p = 1.00), though time to achieve symptomatic clinical response was significantly lower in metronidazole group as compared to that in nitazoxanide group. Greater proportion of patients achieved early clinical response (ECR) in metronidazole group as compared to nitazoxanide group. Complete resolution of abscess, at 6 months, was noted in 18 (60%) patients in the M group and 22 (73.3%) patients in the N group (p = 0.273). Metronidazole was associated with significantly greater frequency of adverse effects than nitazoxanide. CONCLUSIONS This study shows equivalent efficacy of nitazoxanide in uncomplicated amebic liver abscess as compared to metronidazole, with better tolerability and advantage of simultaneous luminal clearance, thus reducing chances of recurrence. TRIAL REGISTRATION CTRI/2019/01/017249.
Collapse
Affiliation(s)
- Vasudha Goel
- Department of Gastroenterology, SMS Medical College and Hospital, Jaipur 302 004, India
| | - Anubhav Jain
- Department of Gastroenterology, SMS Medical College and Hospital, Jaipur 302 004, India
| | - Garima Sharma
- Department of Pathology, SMS Medical College and Hospital, Jaipur, 302 004, India
| | - Ashok Jhajharia
- Department of Gastroenterology, SMS Medical College and Hospital, Jaipur 302 004, India
| | - Vishnu Kumar Agarwal
- Department of Gastroenterology, SMS Medical College and Hospital, Jaipur 302 004, India
| | - Prachis Ashdhir
- Department of Gastroenterology, SMS Medical College and Hospital, Jaipur 302 004, India.
| | - Rupesh Pokharna
- Department of Gastroenterology, SMS Medical College and Hospital, Jaipur 302 004, India
| | - Virender Chauhan
- Department of Gastroenterology, SMS Medical College and Hospital, Jaipur 302 004, India
| |
Collapse
|