我国血吸虫对吡喹酮抗药性研究之概要
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摘要
血吸虫病是一种严重危害人类健康、影响社会经济发展的重大传染病,为全球公共卫生负担和危害最严重的被忽视的热带病之一。吡喹酮是20世纪70年代研制出的一种高效、低毒、价廉的广谱抗蠕虫口服药,为世界卫生组织(WHO)推荐的抗血吸虫的首选药物。吡喹酮在血吸虫病流行区现场大规模反复使用已超过40年,血吸虫是否会对吡喹酮产生抗药性引起国际社会极大担忧,为学术界关注的热点科学问题。针对血吸虫病防治中这一重大需求,自1996年起,在国家科技支撑计划、国家自然科学基金、江苏省自然科学基金等项目基金资助下,我们在血吸虫病流行区现场和实验室,对血吸虫在吡喹酮药物的压力是否会产生抗药性、抗性虫株的生物学特性、抗性的检测、吡喹酮抗性的交叉抗药性及抗药性的预防和控制等科学问题进行较为系统的研究,本文就其研究及其意义作一概述。
Schistosomiasis, caused by blood fluked(trematodes) of the genus Schitosma, is a neglected parasitic disease affecting human health, social and economic development in tropical and subtropical areas of the world. Since praziquantel was developed in 1970 s, it has replaced other antischistosomal drugs to become the only drug of choice for treatment of human schistosomiasis, due to high efficacy, excellent tolerability, few and transient side effects, simple administration, and competitive cost. It has been widely used as tool for morbidity control through population-based treatment for more than 40 years. Under the pressure of the drug selection, the possibility of development of resistance to praziquantel in Schistosoma has been paid great attention as scientific issues of international concern. Since 1996 a series of studies on resistance of Schistosoma to praziquantel has been done in lab and field in China. In the paper, the main achievements in the resistance to praziquantel induced in Schistosoma japonicum, in vitro responses and biological characteristics of praziquantel-resistant isolates of Schitosoma, detection of praziquantel resistance in Schitosoma, susceptibility of Schistosoma japonicum to praziquantel in China, cross drug resistance and control of resistance of Schistosoma to praziquantel were summarized briefly.
Schistosomiasis, caused by blood fluked(trematodes) of the genus Schitosma, is a neglected parasitic disease affecting human health, social and economic development in tropical and subtropical areas of the world. Since praziquantel was developed in 1970 s, it has replaced other antischistosomal drugs to become the only drug of choice for treatment of human schistosomiasis, due to high efficacy, excellent tolerability, few and transient side effects, simple administration, and competitive cost. It has been widely used as tool for morbidity control through population-based treatment for more than 40 years. Under the pressure of the drug selection, the possibility of development of resistance to praziquantel in Schistosoma has been paid great attention as scientific issues of international concern. Since 1996 a series of studies on resistance of Schistosoma to praziquantel has been done in lab and field in China. In the paper, the main achievements in the resistance to praziquantel induced in Schistosoma japonicum, in vitro responses and biological characteristics of praziquantel-resistant isolates of Schitosoma, detection of praziquantel resistance in Schitosoma, susceptibility of Schistosoma japonicum to praziquantel in China, cross drug resistance and control of resistance of Schistosoma to praziquantel were summarized briefly.
引文
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[2]MCMANUSD P,DUNNED W,SACKO M,et al.Schistosomiasis[J].Nat Rev Dis Primers,2018,4(1):13.
[3]ASSARéR K,KNOPP S,N’GUESSANN A,et al.Sustaining control of schistosomiasis mansoni in moderate endemicity areas in western C?te d’Ivoire:A SCORE study protocol[J].BMC Public Health,2014,14:1290.
[4]DE LAVAL F,SAVINI H,BIANCE-VALERO E,et al.Human schistosomiasis:an emerging threat for Europe[J].Lancet,2014,384(9948):1094-1095.
[5]BOISSIER J,GRECH-ANGELINI S,WEBSTERB L,et al.Outbreak of urogenital schistosomiasis in Corsica(France):An epidemiological case study[J].Lancet Infect Dis,2016,16(8):971-979.
[6]WHO.The control of schistosomiasis,second report of the WHO expert committee[R].WHO Techn Rep Ser,1993:830.
[7]陈名刚.世界血吸虫病流行情况及防治进展[J].中国血吸虫病防治杂志,2002,14(2):81-83.
[8]KATZ N,DIASE P,ARAúJO N,et al.Estudo de uma cepa humana de Schistosoma mansoni resistente a agentes esquistossomicidas[J].Rev Soc Bras Med Trop,1973,7(6):381-387.
[9]CAMPOS R,MOREIRA A,SETTE H Jr,et al.Hycanthone resistance in a human strain of Schistosoma mansoni[J].Trans R Soc Trop Med Hyg,1976,70(3):261-262.
[10]BRINDLEY P.Drug resistance to schistosomicides and other anthelminties of medical significance[J].Acta Trop,1994,56(2/3):213-231.
[11]JANSMA W B,ROGERS S H,LIU C L,et al.Experimentally produced resistance of Schistosoma mansoni to hycanthone[J].Am JTrop Med Hyg,1977,26(5 Pt 1):926-936.
[12]CIOLI D.Praziquantel:is there real resistance and are there alternatives?[J].Curr Opin Infect Dis,2000,13(6):659-663.
[13]DOENHOFF M J,CIOLI D,UTZINGER J.Praziquantel:mechanisms of action,resistance and new derivatives for schistosomiasis[J].Curr Opin Infect Dis,2008,21(6):659-667.
[14]FALLON P G,DOENHOFF M J.Drug-resistant schistosomiasis:Resistance to praziquantel and oxamniquine induced in schistosoma mansoni in mice is drug specific[J].TheAmericanJournalof Tropical Medicine and Hygiene,1994,51(1):83-88.
[15]FALLON P G,STURROCK R F,NIANG A C,et al.Short report:diminished susceptibility to praziquantel in a Senegal isolate of Schistosoma mansoni[J].Am J Trop Med Hyg,1995,53(1):61-62.
[16]ISMAIL M,METWALLY A,FARGHALY A,et al.Characterization of isolates of Schistosoma mansoni from Egyptian villagers that tolerate high doses of praziquantel[J].Am J Trop Med Hyg,1996,55(2):214-218.
[17]STELMA F F,GRYSEELSB,DEELDERA M,et al.Efficacy and side effects of praziquantel in an epidemic focus of schistosoma mansoni[J].The American Journal of Tropical Medicine and Hygiene,1995,53(2):167-170.
[18]STELMA F F,SALL S,DAFF B,et al.Oxamniquine cures Schistosoma mansoni infection in a focus in which cure rates with praziquantel are unusually low[J].J Infect Dis,1997,176(1):304-307.
[19]CIOLI D.Praziquantel:is there real resistance and are there alternatives?[J].Curr Opin Infect Dis,2000,13(6):659-663.
[20]DOENHOFF M J,CIOLI D,UTZINGER J.Praziquantel:mechanisms of action,resistance and new derivatives for schistosomiasis[J].Curr Opin Infect Dis,2008,21(6):659-667.
[21]CHEN X Y,WANG L Y,CAI J M,et al.Schistosomiasis control in China:The impact of a 10-year World Bank Loan Project(1992-2001)[J].World Health Organ,2005,83(1):43-48.
[22]CHEN M G.Use of praziquantel for clinical treatment and morbidity control of schistosomiasis japonica in China:A review of 30 years'experience[J].Acta Trop,2005,96(2/3):168-176.
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