The most common medications for the treatment of zoonotic toxoplasmosis are pyrimethamine and sulfadiazine, which may cause serious undesirable side effects. Thus, there is an urgent need to develop novel therapeutics. Baicalein (BAI, C₁₅H₁₀O₅) has been shown to perform well against protozoan parasites including Leishmania and Cryptosporidium. In this study, the inhibition efficacy of BAI on Toxoplasma gondii was evaluated using plaque, invasion, and intracellular proliferation assays. BAI effectively inhibited T. gondii (half-maximum inhibitory concentration (IC₅₀)=6.457×10^-5 mol/L), with a reduced invasion rate (33.56%) and intracellular proliferation, and exhibited low cytotoxicity (half-maximum toxicity concentration (TC₅₀)=5.929×10^-4 mol/L). Further investigation using a mouse model shed light on the inhibitory efficacy of BAI against T. gondii, as well as the potential mechanisms underlying its anti-parasitic effects. The survival time of T. gondii-infected ICR mice treated with BAI was remarkably extended, and their parasite burdens in the liver and spleen were greatly reduced compared with those of the negative control group. Histopathological examination of live sections revealed effective therapeutic outcomes in the treatment groups, with no notable pathological alterations observed. Furthermore, alterations in cytokine levels indicated that BAI not only effectively suppressed the growth of T. gondii but also prevented excessive inflammation in mice. Collectively, these findings underscore the significant inhibitory efficacy of BAI against T. gondii, positioning it as a promising alternative therapeutic agent for toxoplasmosis.
Animals ; Toxoplasma/drug effects* ; Flavanones/therapeutic use* ; Mice ; Antiparasitic Agents/therapeutic use* ; Mice, Inbred ICR ; Toxoplasmosis/drug therapy* ; Female

Toxoplasmosis is an opportunistic infection caused by the protozoan parasite Toxoplasma gondii. T. gondii is widespread globally and causes severe diseases in individuals with impaired immune defences as well as congenitally infected infants. The high prevalence rate in some parts of the world such as South America and Africa, coupled with the current drug treatments that trigger hypersensitivity reactions, makes the development of immunotherapeutics intervention a highly important research priority. Immunotherapeutics strategies could either be a vaccine which would confer a pre-emptive immunity to infection, or passive immunization in cases of disease recrudescence or recurrent clinical diseases. As the severity of clinical manifestations is often greater in developing nations, the development of well-tolerated and safe immunotherapeutics becomes not only a scientific pursuit, but a humanitarian enterprise. In the last few years, much progress has been made in vaccine research with new antigens, novel adjuvants, and innovative vaccine delivery such as nanoparticles and antigen encapsulations. A literature search over the past 5 years showed that most experimental studies were focused on DNA vaccination at 52%, followed by protein vaccination which formed 36% of the studies, live attenuated vaccinations at 9%, and heterologous vaccination at 3%; while there were few on passive immunization. Recent progress in studies on vaccination, passive immunization, as well as insights gained from these immunotherapeutics is highlighted in this review.
Drug Discovery/trends ; Global Health ; Humans ; Immunization/*methods ; Immunotherapy/*methods/trends ; Protozoan Vaccines/immunology/isolation & purification ; Toxoplasma/*immunology ; Toxoplasmosis/*therapy

Ocular toxoplasmosis is a disease caused by the infection with Toxoplasma gondii through congenital or acquired routes. Once the parasite reaches the retina, it proliferates within host cells followed by rupture of the host cells and invasion into neighboring cells to make primary lesions. Sometimes the restricted parasite by the host immunity in the first scar is activated to infect another lesion nearby the scar. Blurred vision is the main complaint of ocular toxoplasmic patients and can be diagnosed by detection of antibodies or parasite DNA. Ocular toxoplasmosis needs therapy with several combinations of drugs to eliminate the parasite and accompanying inflammation; if not treated it sometimes leads to loss of vision. We describe here clinical features and currently available chemotherapy of ocular toxoplasmosis.
Animals ; Antiprotozoal Agents/therapeutic use ; Humans ; Toxoplasma/*isolation & purification ; Toxoplasmosis, Ocular/*drug therapy/parasitology

A 54-year-old man presented with blurred central vision in the right eye of two weeks' duration. On presentation, visual acuity was 40 / 50 in the right eye and fundus examination showed a whitish-yellow inflammatory lesion near an atrophic, pigmented retinochoroidal scar located in the superotemporal quadrant. Serologic assessment was negative for IgM, but serum IgG to toxoplasma was elevated. Spectral domain optical coherence tomography (SD-OCT) revealed increased reflectivity from the inner retinal layer, retinal thickening, and choroidal shadowing while focal posterior hyaloid thickening and detachment were observed in the new lesion. He was treated with trimethoprim/sulfamethoxazole, clindamycin, and prednisone. SD-OCT is helpful for definitively differentiating ocular toxoplasmosis from other retinal diseases.
Diagnosis, Differential ; Humans ; Male ; Middle Aged ; Tomography, Optical Coherence/*methods ; Toxoplasmosis, Ocular/*diagnosis/drug therapy ; Visual Acuity

No abstract available.
Adult ; Anemia, Aplastic/*surgery ; Antiprotozoal Agents/therapeutic use ; Drug Therapy, Combination ; Encephalitis/diagnosis/drug therapy/*parasitology ; Female ; Hematopoietic Stem Cell Transplantation/*adverse effects ; Humans ; Immunosuppressive Agents/adverse effects ; Magnetic Resonance Imaging ; Parasitology/methods ; Polymerase Chain Reaction ; Republic of Korea ; Toxoplasma/genetics/*isolation & purification ; Toxoplasmosis, Cerebral/diagnosis/drug therapy/*parasitology ; Transplantation, Homologous ; Treatment Outcome

OBJECTIVETo identify more effective and less toxic drugs to treat animal toxoplasmosis.

METHODSEfficacy of seven kinds of sulfonamides against Toxoplasma gondii (T. gondii) in an acute murine model was evaluated. The mice used throughout the study were randomly assigned to many groups (10 mice each), which either remained uninfected or were infected intraperitoneally with tachyzoites of T. gondii (strains RH and CN). All groups were then treated with different sulfonamides and the optimal treatment protocol was determined candidates. Sulfadiazine-sodium (SD) was used for comparison.

RESULTSThe optimal therapy involved gavaging mice twice per day with 250 mg/kg bw of sulfachloropyrazine-sodium (SPZ) for five days. Using this protocol, the average survival time and the time-point of 50% fatalities were prolonged significantly compared with SD treatment. Treatment with SPZ protected 40% of mice from death, and the heart and kidney tissue of these animals was parasite-free, as determined by nested-PCR. SPZ showed excellent therapeutic effects in the treatment of T. gondii in an acute murine model and is therefore a promising drug candidate for the treatment and prevention of T. gondii in animals.

CONCLUSIONSIt can be concluded that the effective drug sulfachloropyrazine may be the new therapeutic options against animal toxoplasmosis.

Administration, Oral ; Animals ; Antiprotozoal Agents ; administration & dosage ; DNA, Protozoan ; analysis ; isolation & purification ; Disease Models, Animal ; Female ; Heart ; parasitology ; Kidney ; parasitology ; Mice ; Polymerase Chain Reaction ; Sulfanilamides ; administration & dosage ; Survival Analysis ; Toxoplasma ; drug effects ; genetics ; isolation & purification ; Toxoplasmosis ; drug therapy ; Treatment Outcome

We report here the records of 10 consecutive Korean patients (10 eyes) with ocular toxoplasmosis which showed the typical clinical manifestations with seropositivity for Toxoplasma gondii specific IgG antibodies by micro-ELISA between 2006 and 2010. Nine patients were males and 1 was female; their age was 50.5+/-13.8 years. The most common accompanying signs were vitritis (100%), anterior uveitis (70%), and scattered white deposit (80%). Pre-existing retinochoroidal scar was found in 1 (10%) patient. All patients received antiparasitic chemotherapy and systemic corticosteroid treatment, which resolved the presenting attack and recovered the visual acuity better than initial one in 9 patients and worse in 1. Optic atrophy, cataract, and retinal neovascularization were observed during the follow-up period and recurrence was detected in 3 eyes (30%) 6 to 20 months after the initial attack. In Korea, although rarely detected and reported, ocular toxoplasmosis needs more attention in clinical field of retinal diseases.
Adrenal Cortex Hormones/administration & dosage ; Adult ; Age Distribution ; Aged ; Anti-Inflammatory Agents/administration & dosage ; Antibodies, Protozoan/*blood ; Antiprotozoal Agents/administration & dosage ; Cataract/pathology ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin G/blood ; Korea ; Male ; Middle Aged ; Optic Atrophy/pathology ; Retinal Neovascularization/pathology ; Sex Distribution ; Toxoplasma/immunology/*isolation & purification ; Toxoplasmosis, Ocular/complications/*diagnosis/drug therapy/*pathology ; Uveitis, Anterior/complications/drug therapy/parasitology/pathology

A 36-year old female with acute myelogenous leukemia presented with a sudden decrease in vision one month following bone marrow transplantation (BMT). She had been taking multiple immunosuppressants to treat her recently-developed graft-versus-host-disease (GVHD). Visual acuity was 20/60 in her right eye and 20/25 in her left. Ophthalmic examination revealed mild inflammatory reaction in both the anterior chamber and the vitreous of both eyes, as well as densely opaque yellow-white infiltrates with well-demarcated borders in the posterior retina of both eyes. She was originally diagnosed as CMV retinitis, but treatment with ganciclovir failed to improve her ocular condition. Subsequent work-up, including serology and brain MRI, led to a diagnosis of combined ocular and cerebral toxoplasmosis. After 6 weeks of antiparasitic therapy, her retinal lesions became inactive and her cerebral lesions improved. Immunosuppressed patients with necrotizing retinochoroiditis should be suspected of having toxoplasmosis. Accurate differentiation between this condition and CMV, and early intervention with the appropriate treatment may be critical to preserve the best vision.
Adult ; Anti-Bacterial Agents/therapeutic use ; *Bone Marrow Transplantation ; Chorioretinitis/*diagnosis/drug therapy/parasitology ; Clindamycin/therapeutic use ; Cytomegalovirus Retinitis/*diagnosis ; Drug Therapy, Combination ; Female ; Functional Laterality ; Humans ; Leukemia, Myeloid, Acute/*surgery ; Magnetic Resonance Imaging ; Tomography, Optical Coherence ; Toxoplasmosis, Cerebral/*diagnosis/drug therapy ; Toxoplasmosis, Ocular/*diagnosis/drug therapy ; Transplantation, Homologous ; Trimethoprim-Sulfamethoxazole Combination/therapeutic use

Some parasitic diseases are more prevalent in children than in adults. Such agespecific diseases usually result from the mode of infection. Enterobiasis and head lice infestations are contact-borne. Congenital toxoplasmosis is a transplacental infection. Hepatic capillariasis results from contact with an environment contaminated with cat stools. Enterobiasis is the most common helminthic disease in children. The diagnosis and treatment is difficult because of its characteristic life cycle: eggs are present at the end of the life of the female adult worm. Vigorous screening and repeated chemotherapy for the entire family and contact group are required. Recently, there have been reports of congenital toxoplasmosis. There may be an increase in the number of cases of toxoplasmosis owing to the increase in the number of stray cats. Cryptosporidiosis does not evoke serious illness in immunocompetent children, while severe diarrhea can occur in immunocompromised children. One case of hepatic capillariasis has been reported in Korea. Owing to its high morbidity and mortality, prompt diagnosis and treatment are required. Head lice infestation is easy to diagnose and is still an indication of public health status. Mass screening and prevention are required. In local clinics, parasitic diseases are rarely suspected, since their incidence is very low and the symptoms are usually non-specific, except in a few parasitic diseases. Therefore, a thorough evaluation of the symptoms and past history and appropriate laboratory tests are necessary.
Adult ; Animals ; Cats ; Child* ; Cryptosporidiosis ; Diagnosis ; Diarrhea ; Drug Therapy ; Eggs ; Enterobiasis ; Female ; Helminths ; Humans ; Incidence ; Korea ; Lice Infestations ; Life Cycle Stages ; Mass Screening ; Mortality ; Ovum ; Parasitic Diseases* ; Pediculus ; Public Health ; Toxoplasmosis ; Toxoplasmosis, Congenital

OBJECTIVETo study the therapeutic effects of azithromycin in treatment of congenital toxoplasmosis in children.

METHODSDefinite diagnosis of congenital toxoplasmosis was made on the basis of clinical manifestation combined with one or more positive results of the following laboratory tests and excluded other congenital infectious diseases: toxoplasma DNA (TOX-DNA), circulating toxoplasma antigen (TOX-CAG), and toxoplasma IgM antibody (TOX-IgM). All the patients were given oral azithromycin 10 mg/(kg.d) for 6 days followed by 8 days without medication (one course of treatment), and the regimen was persisted for 2 months and then another 2-month treatment was given at a 1-month interval. The authors continued to provide further treatment according to the state of the illness at one month interval. The patients received 2 to 8 (average 5) courses of treatment. The patients were followed-up for 2.5 to 5 (average 4) years.

RESULTSThe treatment was effective in all the patients and the patient's condition was improved. The authors repeated in 12 cases the four tests for toxoplasma (TOX-DNA, TOX-CAG, TOX-IgM, and TOX-IgG) 9 months to one and a half years after treatment. In 10 cases all these tests showed negative results, in 2 cases TOX-IgG was positive and in the other 4 cases symptoms disappeared.

CONCLUSIONThe results of the study showed that oral azithromycin had significant therapeutic effects with little side effect and was well tolerated. Azithromycin may become an alternative therapy in treatment of congenital Toxoplasma gondii infection in children.

Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Azithromycin ; administration & dosage ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Male ; Prognosis ; Toxoplasmosis, Congenital ; diagnosis ; drug therapy ; Treatment Outcome