Options for clinical trials of pre and post-natal treatments for congenital toxoplasmosis

Chêne, Geneviève; Thiébaut, Rodolphe

doi:10.1590/s0074-02762009000200025

Cited by 12 publications

(10 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous studies have shown that diagnosis of acute infection during pregnancy and its consequent treatment can reduce several forms of congenital infections [4-14,21,23,32,35,41-48,50-54,57-61],[80,81,86]. These studies emphasize the importance of preventive programs of congenital toxoplasmosis during pregnancy, including surveillance of seroconversion in seronegative pregnant women.…”

Section: Discussionmentioning

confidence: 98%

“…Therefore, these countries have not conducted any program for serological screening. There has been much discussion concerning the significance of these government programs to control toxoplasmosis in pregnancy [11,14,16,21,23,26,29,32-59]. Several facts hinder the enforcement of these protocols: identifying the acute phase of infection in pregnancy is difficult when seroconversion is not performed; proper interpretation of results of an IgG avidity test is difficult to achieve if it is carried out after 16 weeks of pregnancy [60-62]; treatment-compliance problems; inappropriate assistance to newborns (NB) according to the reference service; treatment provided for pregnant patients does not prevent vertical transmission of protozoan infection [11,14,16,27-40]; and the type of drug used to treat infected women causes international controversy [2,5-7,11,14,16,21,23,27-59].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Congenital toxoplasmosis and prenatal care state programs

et al. 2014

View full text Add to dashboard Cite

BackgroundControl programs have been executed in an attempt to reduce vertical transmission and the severity of congenital infection in regions with a high incidence of toxoplasmosis in pregnant women. We aimed to evaluate whether treatment of pregnant women with spiramycin associated with a lack of monitoring for toxoplasmosis seroconversion affects the prognosis of patients.MethodsWe performed a prospective cohort study with 246 newborns (NB) at risk for congenital toxoplasmosis in Goiânia (Brazil) between October 2003 and October 2011. We analyzed the efficacy of maternal treatment with spiramycin.ResultsA total of 40.7% (66/162) of the neonates were born seriously infected. Vertical transmission associated with reactivation during pregnancy occurred in 5.5% (9/162) of the NB, with one showing severe infection (systemic). The presence of specific immunoglobulins (fetal IgM and NB IgA) suggested the worst prognosis. Treatment of pregnant women by spiramycin resulted in reduced vertical transmission. When infected pregnant women did not undergo proper treatment, the risk of severe infection (neural-optical) in NB was significantly increased. Fetal IgM was associated with ocular impairment in 48.0% (12/25) of the fetuses and neonatal IgA-specific was related to the neuro-ophthalmologic and systemic forms of the disease. When acute toxoplasmosis was identified in the postpartum period, a lack of monitoring of seronegative pregnant women resulted in a higher risk of severe congenital infection.ConclusionTreatment of pregnant women with spiramycin reduces the possibility of transmission of infection to the fetus. However, a lack of proper treatment is associated with the onset of the neural-optical form of congenital infection. Primary preventive measures should be increased for all pregnant women during the prenatal period and secondary prophylaxis through surveillance of seroconversion in seronegative pregnant woman should be introduced to reduce the severity of congenital infection in the environment.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Congenital toxoplasmosis and prenatal care state programs

et al. 2014

View full text Add to dashboard Cite

show abstract

“…De la même manière, il faudrait comparer l'efficacité des approches thérapeutiques danoise et française dans la prise en charge des nouveau-nés contaminés pendant la grossesse. Ces deux grandes questions devraient pouvoir trouver des réponses grâce aux études randomisées contrôlées multicentriques qui vont débuter en France [64]. Il conviendrait aussi de renforcer et de prolonger la durée de la surveillance ophtalmologique des enfants contaminés.…”

Section: Resultsunclassified

Prise en charge de la toxoplasmose congénitale en France : données actuelles

et al. 2010

View full text Add to dashboard Cite

“…The association of sulfadiazine with pyrimethamine constitutes a protocol of treatment extensively used for toxoplasmosis, considering that it has been demonstrated to be highly effective against T. gondii tachyzoites, but it may cause severe hematological side effects, among other type of toxicities (Bosch-Driessen et al, 2002; Chêne and Thiébaut, 2009; Andrews et al, 2014). Previous in vitro and in vivo studies showed ScLL and ArtinM can be safely administered on murine models (Panunto-Castelo et al, 2001; Afonso-Cardoso et al, 2007; Cardoso et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Lectins from Synadenium carinatum (ScLL) and Artocarpus heterophyllus (ArtinM) Are Able to Induce Beneficial Immunomodulatory Effects in a Murine Model for Treatment of Toxoplasma gondii Infection

Souza

Ramos

Santana

et al. 2016

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

Infection by Toxoplasma gondii affects around one-third of world population and the treatment for patients presenting toxoplasmosis clinically manifested disease is mainly based by a combination of sulfadiazine, pyrimethamine, and folinic acid. However, this therapeutic protocol is significantly toxic, causing relevant dose-related bone marrow damage. Thus, it is necessary to improve new approaches to investigate the usefulness of more effective and non-toxic agents for treatment of patients with toxoplasmosis. It has been described that lectins from plants can control parasite infections, when used as immunological adjuvants in vaccination procedures. This type of lectins, such as ArtinM and ScLL is able to induce immunostimulatory activities, including efficient immune response against parasites. The present study aimed to evaluate the potential immunostimulatory effect of ScLL and ArtinM for treatment of T. gondii infection during acute phase, considering that there is no study in the literature accomplishing this issue. For this purpose, bone marrow-derived macrophages (BMDMs) were treated with different concentrations from each lectin to determine the maximum concentration without or with lowest cytotoxic effect. After, it was also measured the cytokine levels produced by these cells when stimulated by the selected concentrations of lectins. We found that ScLL showed high capacity to induce of pro-inflammatory cytokine production, while ArtinM was able to induce especially an anti-inflammatory cytokines production. Furthermore, both lectins were able to increase NO levels. Next, we evaluated the treatment effect of ScLL and ArtinM in C57BL/6 mice infected by ME49 strain from T. gondii. The animals were infected and treated with ScLL, ArtinM, ArtinM plus ScLL, or sulfadiazine, and the following parameters analyzed: Cytokines production, brain parasite burden and survival rates. Our results demonstrated that the ScLL or ScLL plus ArtinM treatment induced production of pro-inflammatory and anti-inflammatory cytokines, showing differential but complementary profiles. Moreover, when compared with non-treated mice, the parasite burden was significantly lower and survival rates higher in mice treated with ScLL or ScLL plus ArtinM, similarly with sulfadiazine treatment. In conclusion, the results demonstrated the suitable potential immunotherapeutic effect of ScLL and ArtinM lectins to control acute toxoplasmosis in this experimental murine model.

show abstract

Options for clinical trials of pre and post-natal treatments for congenital toxoplasmosis

Cited by 12 publications

References 35 publications

Congenital toxoplasmosis and prenatal care state programs

Congenital toxoplasmosis and prenatal care state programs

Prise en charge de la toxoplasmose congénitale en France : données actuelles

Lectins from Synadenium carinatum (ScLL) and Artocarpus heterophyllus (ArtinM) Are Able to Induce Beneficial Immunomodulatory Effects in a Murine Model for Treatment of Toxoplasma gondii Infection

Contact Info

Product

Resources

About