Fumagillin treatment of intestinal microsporidiosis
Fumagillin treatment of intestinal microsporidiosis
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DOI：
10.1056/nejmoa012924
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发表时间：
2002-06-20
影响因子：
158.5
通讯作者：
Derouin, F
中科院分区：
文献类型：
--
作者：
Molina, JM;Tourneur, M;Derouin, F
背景：由肠道细胞寄生虫引起的肠道微孢子虫病是免疫功能低下患者慢性腹泻、吸收不良和消瘦的原因。目前，还没有有效的治疗方法。方法：我们进行了一项随机、双盲、安慰剂对照试验，使用伏马西林(每天60毫克，连续两周)治疗慢性比内乌斯艾美耳球虫感染患者。主要通过清除微孢子虫来评估疗效，通过对粪便样本的分析证实了这一点。微孢子虫未被清除的患者接受了两周的开放式标签烟美西林治疗。结果：12例患者入选本研究，其中10例合并获得性免疫缺陷综合征，2例接受过器官移植。与安慰剂组的6例患者相比，雾化青霉素组的6例患者微孢子虫全部清除(P=0.002)。雾化青霉素治疗后，D-木糖的吸收率增加(P=0.003)，卡诺夫斯基评分增加(P
Background: Intestinal microsporidiosis due to Enterocytozoon bieneusi is a cause of chronic diarrhea, malabsorption, and wasting in immunocompromised patients. Currently, there is no effective treatment.Methods: We conducted a randomized, double-blind, placebo-controlled trial of fumagillin (60 mg per day orally for two weeks) in patients with chronic E. bieneusi infection. Efficacy was assessed primarily by the clearance of microsporidia, as evidenced by analysis of stool specimens. Patients in whom microsporidia were not cleared received treatment for two weeks with open-label fumagillin. After clearance of the parasite, follow-up stool examinations were performed monthly to detect relapses.Results: Twelve patients were enrolled in this study, 10 with the acquired immunodeficiency syndrome and 2 who had received organ transplants. Clearance of microsporidia occurred in all six of the patients in the fumagillin group, as compared with none of the six in the placebo group (P=0.002). Treatment with fumagillin was also associated with increases in absorption of d-xylose (P=0.003) and in Karnofsky performance scores (P