Evaluation of myrrh (Mirazid) therapy in fascioliasis and intestinal schistosomiasis in children: immunological and parasitological study.
Evaluation of myrrh (Mirazid) therapy in fascioliasis and intestinal schistosomiasis in children: immunological and parasitological study.
复制标题
没药（Mirazid）治疗儿童片形吸虫病和肠血吸虫病的评估：免疫学和寄生虫学研究。
DOI：
--
复制
发表时间：
2004
期刊：
影响因子：
--
通讯作者：
A. Massoud
中科院分区：
文献类型：
--
作者：
O. Soliman;M. El;Elham R Abdul;H. El;A. Massoud
共有 21 名片形吸虫病儿童（8 名男性和 13 名女性），平均年龄为 10.4 岁，8 名曼氏血吸虫病儿童（6 名男性和 2 名女性），平均年龄为 11.37 岁，使用没药 (Mirazid) 进行治疗，没药是一种取自没药树（科）树干的油胶树脂。此外，十名健康交叉匹配的儿童被用作对照。诊断依据是采用 Kato-Katz 技术检测粪便中的肝片形吸虫或曼氏血吸虫卵。对于血吸虫病，米拉齐德按 10 mg/kg/d，早餐前一小时连续 3 天给药，对于片形吸虫病，连续 6 天。在治疗最初以及治疗后 2、4 和 12 周进行临床评估和粪便分析，以评估治愈情况。对血吸虫病病例进行直肠剪断以确认康复。在治疗前对所有受试者进行自动全血细胞计数，手动评估嗜酸性粒细胞、血清总 IgE（酶免疫测定）和通过 ELISA 进行的体外细胞因子测定（IL-1β、IL-4、IL-5），并仅对治疗后的患者重复 12 周。治疗后 4 周，片形吸虫病的寄生虫学治愈率为 90.9%，血吸虫病的寄生虫学治愈率为 100%。在第二次注射后，仍呈阳性的片形吸虫患者被治愈。与对照组相比，片吸虫和血吸虫患者在治疗前的总 IgE 显着升高（分别为 p < 0.001；0.005），并且在治疗后显着下降（p = 0.001；0.036）。两个患者组的 IL-1β 均高于对照组（p < 0.001；0.003），并且在治疗后 12 周显着下降至对照水平（p < 0.001；0.017）。两组患者治疗前 IL-5 均较高（p = 0.041；0.027），治疗后 12 周后显着下降（p = 0.005；0.012）。 IL-4 在治疗前与对照组没有差异 (p = 0.58; 0.79)，但在治疗后两组患者均显着增加 (p = 0.04; 0.02)。结论：Mirazid是一种有效的杀片割和杀血吸虫药物。 IL-1β 和 IL5 在片形吸虫病和血吸虫病中较高，但随着表明免疫发病机制的治疗而降低。 IL-4 产生减少可能是寄生虫免疫逃避或宿主调节机制，细胞因子水平可能是治愈的标准。
A total of 21 children with fascioliasis (8 males and 13 females) with mean age of 10.4 years, 8 children with schistosomiasis mansoni (6 males and 2 females) with mean age of 11.37 years were treated with Myrrh (Mirazid) which is an oleo-gum resin from the stem of Commiphora molmol tree (Family Burseraceae). Also, ten healthly cross matched children were utilized as controls. Diagnosis was based on the detection of Fasciola hepatica or Schistosoma mansoni eggs in stool by Kato-Katz technique. Mirazid was given as 10 mg/kg/d an hour before breakfast for 3 consecutive days in schistosomiasis and for 6 days in fascioliasis. Clinical evaluation and stool analysis were done initially and at 2, 4 and 12 weeks post treatment to evaluate cure. Rectal snip was done for responding schistosomiasis cases to confirm recovery. Automated complete blood count with manual assessment of eosinophils, serum total IgE (enzyme immunoassay) and in vitro cytokines assay (IL-1 beta, IL-4, IL-5) by ELISA were performed for all subjects before treatment and repeated 12 weeks only for patients after therapy. Parasitologic cure was 90.9% in fascioliasis and 100% in schistosomiasis at 4 weeks post treatment. After a second dose Fasciola patients who remained positive were cured. Total IgE was significantly higher in Fasciola and Schistosoma patients before treatment compared to control (p < 0.001; 0.005 respectively) and decreased significantly with therapy (p = 0.001; 0.036). IL-1beta was higher in both patient groups than control (p < 0.001; 0.003) and decreased significantly 12 weeks after therapy to control level (p < 0.001; 0.017). IL-5 was high before treatment in both groups (p = 0.041; 0.027) and decreased significantly after 12 weeks after therapy (p = 0.005; 0.012). IL-4 did not differ from control before therapy (p = 0.58; 0.79) but increased significantly after treatment in both patient groups (p = 0.04; 0.02). It is concluded that Mirazid is an effective fasciolicidal and schistosomicidal drug. IL-1beta and IL5 were high in fascioliasis and schistosomiasis, but decreased with therapy denoting immunopathogenesis. The depressed IL-4 production may be a parasite immune evasion or host regulatory mechanism and cytokines levels may be criteria of cure.