Current perspective of new anti-Wolbachial and direct-acting macrofilaricidal drugs as treatment strategies for human filariasis.
Current perspective of new anti-Wolbachial and direct-acting macrofilaricidal drugs as treatment strategies for human filariasis.
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DOI：
10.3205/id000079
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发表时间：
2022
影响因子：
--
通讯作者：
Hubner, Marc P
中科院分区：
文献类型：
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作者：
Ehrens, Alexandra;Hoerauf, Achim;Hubner, Marc P
淋巴丝虫病和盘尾丝虫病等丝虫病属于被忽视的热带病，在流行国家仍然是一个公共卫生问题。淋巴丝虫病和盘尾丝虫病可导致耻辱性病症，并给受影响人群及其流行国家带来社会经济负担。世界卫生组织目前的治疗建议包括使用伊维菌素进行大规模药物治疗盘尾丝虫病，以及在非盘尾丝虫病或罗伊虫病共同流行的地区使用伊维菌素、阿苯达唑和二乙基卡马嗪 (DEC) 联合治疗淋巴丝虫病。这些治疗策略的局限性是由于盘尾丝虫病和罗阿丝虫病患者分别在接受 DEC 或伊维菌素治疗后可能发生严重不良事件，这些药物缺乏杀丝虫功效以及产生耐药性的风险。因此，为了到 2030 年实现消除盘尾丝虫病传播和消除淋巴丝虫病这一公共卫生问题，世界卫生组织在其路线图中明确指出，需要采用杀大丝虫化合物的新替代治疗策略。在非营利组织被忽视疾病药物倡议 (DNDi)、比尔和梅琳达·盖茨基金会以及学术界和工业界合作伙伴的合作下，确定了几种新的有前景的大丝虫杀灭药物候选药物，本综述将对此进行讨论。
Filarial diseases like lymphatic filariasis and onchocerciasis belong to the Neglected Tropical Diseases and remain a public health problem in endemic countries. Lymphatic filariasis and onchocerciasis can lead to stigmatizing pathologies and present a socio-economic burden for affected people and their endemic countries. Current treatment recommendations by the WHO include mass drug administration with ivermectin for the treatment of onchocerciasis and a combination of ivermectin, albendazole and diethylcarbamazine (DEC) for the treatment of lymphatic filariasis in areas that are not co-endemic for onchocerciasis or loiasis. Limitations of these treatment strategies are due to potential severe adverse events in onchocerciasis and loiasis patients following DEC or ivermectin treatment, respectively, the lack of a macrofilaricidal efficacy of those drugs and the risk of drug resistance development. Thus, to achieve the elimination of transmission of onchocerciasis and the elimination of lymphatic filariasis as a public health problem by 2030, the WHO defined in its roadmap that new alternative treatment strategies with macrofilaricidal compounds are required. Within a collaboration of the non-profit organizations Drugs for Neglected Diseases initiative (DNDi), the Bill & Melinda Gates Foundation, and partners from academia and industry, several new promising macrofilaricidal drug candidates were identified, which will be discussed in this review.