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Combination therapy using Pentostam and Praziquantel improves lesion healing and parasite resolution in BALB/c mice co-infected with Leishmania major and Schistosoma mansoni

Christopher Khayeka–Wandabwa1*, Helen Lydiah Kutima2, Venny CS Nyambati2, Johnstone Ingonga3, Elijah Oyoo–Okoth45, Lucy Wanja Karani1, Bernard Jumba6, Kiige Samuel Githuku7 and Christopher O Anjili3

Author Affiliations

1 Institute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology (JKUAT), P.O. Box 62000-00200, Nairobi, Kenya

2 Biochemistry and Zoology departments, Jomo Kenyatta University of Agriculture and Technology (JKUAT), P O Box 62000 00200, Nairobi, Kenya

3 Centre for Biotechnology Research and Development (CBRD), Kenya Medical Research Institute (KEMRI), P O Box 54840 00200, Nairobi, Kenya

4 Division of Environmental Health, School of Environmental Studies, University of Eldoret, P O Box 1125 30100, Eldoret, Kenya

5 School Natural Resources and Environmental Studies, Karatina University, P O Box 1957 10101, Karatina, Kenya

6 Department of Biological Science (Parasitology), University of Eldoret, P O Box 1125 30100, Eldoret, Kenya

7 Department of Zoological Sciences, Kenyatta University, P O Box 43844 00100, Nairobi, Kenya

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Parasites & Vectors 2013, 6:244  doi:10.1186/1756-3305-6-244

Published: 22 August 2013

Abstract

Background

Most natural host populations are exposed to a diversity of parasite communities and co-infection of hosts by multiple parasites is commonplace across a diverse range of systems. Co-infection with Leishmania major and Schistosoma mansoni may have important consequences for disease development, severity and transmission dynamics. Pentavalent antimonials and Praziquantel (PZQ) have been relied upon as a first line of treatment for Leishmania and Schistosoma infections respectively. However, it is not clear how combined therapy with the standard drugs will affect the host and parasite burden in concomitance. The aim of the current study was to determine the efficacy of combined chemotherapy using Pentostam and PZQ in BALB/c mice co-infected with L. major and S. mansoni.

Methods

The study used BALB/c mice infected with L. major and S. mansoni. A 3 × 4 factorial design with three parasite infection groups (Lm, Sm, Lm + Sm designated as groups infected with L. major, S. mansoni and L. major + S. mansoni, respectively) and four treatment regimens [P, PZQ, P + PZQ and PBS designating Pentostam®(GlaxoSmithKline UK), Praziquantel (Biltricide®, Bayer Ag. Leverkusen, Germany), Pentostam + Praziquantel and Phosphate buffered saline] as factors was applied. In each treatment group, there were 10 mice. Lesion development was monitored for 10 weeks. The parasite load, body weight, weight of the spleen and liver were determined between week 8 and week 10.

Results

Chemotherapy using the first line of treatment for L. major and S. mansoni reduced the lesion size and parasite loads but did not affect the growth response, spleen and liver. In the co-infected BALB/c mice, the use of Pentostam or PZQ did not result in any appreciable disease management. However, treatment with P + PZQ resulted in significantly (p < 0.05) larger reduction of lesions, net increase in the body weight, no changes in the spleen and liver weight and reduced Leishman-Donovan Units (LDU) and worm counts than BALB/c mice treated with Pentostam or PZQ alone.

Conclusions

The present study demonstrated that the combined first line of treatment is a more effective strategy in managing co-infection of L. major and S. mansoni in BALB/c mice.

Keywords:
Schistosomiasis; Leishmaniasis; Leishmania major; Schistosoma mansoni; Praziquantel; Drug efficacy; Pentostam; Co-infection; Combination therapy