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The present study aimed to evaluate the effect of nanoemulsions using combined synthetic anthelmintics, thiabendazole (TBZ), levamisole (LEV), and ivermectin (IVM), with carvacryl acetate (CA) against Haemonchus contortus, and also tested the presence and absence of alginate (ALG). The anthelmintic effect of the CA/TBZ nanoemulsion was evaluated in the egg hatch test (EHT). The effects of CA/IVM and CA/LEV nanoemulsions were evaluated in the larval development test (LDT). The emulsions CA/TBZ/ALG and CA/TBZ showed a multimodal profile, with most particles on the nanometric scale. The encapsulation efficiency in CA/TBZ/ALG was 80.25%, and that in CA/LEV/ALG was 89.73%. In the EHT, CA/TBZ and CA/TBZ/ALG showed mean combination indices (CIs) of 0.55 and 0.36, respectively, demonstrating synergism in both. In LDT, CA/IVM had an average CI of 0.75, and CA/LEV and CA/LEV/ALG showed CI values of 0.4 and 0.93, respectively. It was concluded that CA/TBZ showed a synergistic interaction, and CA/TBZ/ALG showed an enhanced effect. In addition, the matrix brought stability to the product, encouraging its improvement to obtain higher efficacy.
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Anthelmintic efficacy was evaluated among sheep that had become naturally infected with gastrointestinal nematodes in 17 flocks located in the semiarid region of Minas Gerais, Brazil. Feces were collected individually from 1021 hairy sheep to determine the number of eggs per gram of feces (EPG) and for coprocultures to identify nematode genera the nematodes. Only the animals that presented EPG counts greater than or equal to 200 were included in the study (totaling 381 sheep). The animals were divided into three treatment groups: albendazole, ivermectin and levamisole. Fourteen days after the administration of anthelmintics, fecal samples were taken from all animals. In each flock, the pre-treatment and post-treatment arithmetic mean EPG were used to calculate the efficacy (FECR) for each of the treatment groups and the lower 95% confidence limit. Data were analyzed with the "eggCounts 2.3" package in RStudio, using a Bayesian model for paired design. The anthelmintics were classified as being efficacious (when the FECR was both equal to or above 95% and the lower 95% confidence limit was equal to or above 90%) or as encountering anthelmintic resistance (when the FECR was below 95% and the lower 95% confidence limit was below 90%) or inconclusive (when none of the other criteria were fulfilled). Albendazole and ivermectin were not effective in any of the flocks. Levamisole was effective against gastrointestinal nematodes in 25% of the flocks studied. Haemonchus, Trichostrongylus and Oesophagostomum genera were identified in this study in a semiarid region of Minas Gerais, Brazil. The genus Haemonchus was the most prevalent, followed by Trichostrongylus and Oesophagostomum. After anthelmintic treatment, the most prevalent genus was Haemonchus, followed by Trichostrongylus; the genus Oesophagostomum was not detected. The highest percentage of Haemonchus larvae was observed after treatment with ivermectin, followed by albendazole and levamisole. This study revealed the existence of gastrointestinal nematodes in sheep that present multiple resistance to all three main classes of anthelmintic drugs.
Assuntos
Anti-Helmínticos , Haemonchus , Nematoides , Animais , Ovinos , Levamisol/farmacologia , Levamisol/uso terapêutico , Albendazol/farmacologia , Albendazol/uso terapêutico , Ivermectina/farmacologia , Ivermectina/uso terapêutico , Brasil/epidemiologia , Teorema de Bayes , Anti-Helmínticos/farmacologia , Anti-Helmínticos/uso terapêutico , TrichostrongylusRESUMO
This study aimed to determine the efficacy and parasite resistance of levamisole (LV) and ivermectin (IVM) in beef cattle naturally infected with gastrointestinal nematodes, as well as the effect on the liveweight gain in a tropical wet region of Oaxaca, Mexico. From November 2019 to January 2020, sixty-six grazing calves were randomly allocated into three groups of twenty-two animals each, treated with LV or IVM or an untreated control group (day 0). Feces were collected 1 day before treatment and 15 days after treatment. The liveweight gain from each animal was recorded at days 0, 15, 30 and 45 post treatment. The LV group presented the highest reduction of eggs per gram (EPG) of feces, followed by the IVM group. Resistance to IVM was detected, although LV resistance was also suspected. The IVM group had significantly higher effective treatment at 93.5%, resulting in an increase (P<0.05) of liveweight gain of 16.1kg, followed by the LV group (92.4%) with 17.1kg, compared to the untreated control group. A signiï¬cant (P < 0.05) negative correlation was observed between EPG and weight gain for the LV (r = -0.46) and IVM groups (r = -0.32). LV and IVM showed a lack of efficacy against gastrointestinal nematodes, as well as an adequate capacity for EPG reduction but with IVM resistance and detrimental effects on growth performance in grazing beef cattle.
Os nematódeos gastrointestinais do gado de pastoreio causam perdas econômicas substanciais em todo o mundo. Este estudo teve como objetivo determinar a eficácia e a resistência parasitária do levamisol (LV) e da ivermectina (IVM) em bovinos de corte naturalmente infectados com nematódeos gastrointestinais, bem como o efeito no ganho de peso vivo, em uma região tropical úmida de Oaxaca, México. De novembro de 2019 a janeiro de 2020, 66 bezerros de pasto foram distribuídos aleatoriamente em três grupos de 22 animais cada um, tratados com LV ou IVM, ou em um grupo controle sem tratamento (dia 0). As fezes foram coletadas 1 dia antes do tratamento e 15 dias após o tratamento. O ganho de peso vivo de cada animal foi registrado nos dias 0, 15, 30 e 45 pós-tratamento. O grupo do LV apresentou a maior redução de ovos por grama de fezes (EPG), seguido pelo grupo IVM. A resistência à IVM foi detectada, embora também se suspeitasse de resistência ao LV. O grupo IVM teve um tratamento eficaz significativamente maior, com 93,5%, resultando em um aumento (P < 0,05) do ganho de peso vivo de 16,1kg, seguido pelo grupo LV (92,4%), com 17,1kg, em comparação com o grupo controle sem tratamento. Foi observada uma correlação negativa (P < 0,05) entre o EPG e o ganho de peso para os grupos LV (r = -0,46) e IVM (r = -0,32). LV e IVM mostraram falta de eficácia contra nematódeos gastrointestinais, assim como uma capacidade adequada de redução de EPG, mas com resistência IVM e efeitos prejudiciais no desempenho de crescimento em gado de corte em pastagem.
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Animais , Bovinos , Resistência a Medicamentos , Aumento de Peso , Doenças dos Bovinos/parasitologia , Anti-Helmínticos , Nematoides/patogenicidade , MéxicoRESUMO
Resumen El levamisol es un antiparasitario de uso veterinario que actualmente es empleado para aumentar el volumen y la potencia de la cocaína. La mezcla de estas dos sustancias puede causar un cuadro caracterizado por lesiones propias de la cocaína, como la afección del cartílago septal con perforación del tabique nasal, y vasculitis cutánea de pequeños vasos con afectación de los pabellones auriculares y del cartílago nasal, afección conocida como vasculitis inducida por cocaína-levamisol (VICOL) que puede avanzar a necrosis e incluso ulceraciones cutáneas, asociadas a agranulocitosis, artralgias y glomerulonefritis . En el presente artículo se describe el caso de un paciente con historia de consumo de sustancias en quien se encontraron lesiones purpúricas palpables en miembros superiores, tronco, pabellones auriculares y miembros inferiores. Se consideró una clínica sugestiva de VICOL dado el antecedente de consumo de sustancias. En el proceso diagnóstico se descartaron entidades como la vasculitis por anticuerpos contra el citoplasma de los neutrófilos (ANCAs) y crioglobulinemia, entre otras posibles afecciones. Se llevó a cabo un tratamiento con esteroides y con ello presentó una respuesta adecuada, pero luego recurrieron los síntomas, particularmente abdominales, los cuales se consideraron asociados con vasculitis. Se le brindó manejo adicional con ciclofosfamida y nuevos pulsos de esteroides, con que se logró el control total de los síntomas. A través este caso se resaltan entonces los ejercicios diagnósticos y clínicos en la vasculitis cocaína- levamisol, y se sugiere la consideración de los síntomas abdominales como posible componente del cuadro vasculítico.
Abstract Levamisole is an antiparasitic agent for veterinary use. Currently it is used to increase the volume and potency of cocaine. Levamisole and cocaine combined result in the septum nasal perforation and small-vessel vasculitis in the ears and nasal cartilage. These findings are known as cocaine levamisole-induced vasculitis and can progress to necrosis and even skin ulceration, which is associated with agranulocytosis, arthralgia, and glomerulonephritis. This article describes the case of a patient with a history of substance abuse in whom palpable purpuric lesions were found in the upper and lower limbs, trunk, and ears. A clinical condition suggestive of vasculitis induced by cocaine-levamisole was considered, given the history of substance consumption. In the diagnostic process, entities such as Anti-neutrophil Cytoplasmic Antibodiy (ANCA) vasculitis and cryoglobulinemia, among other possible conditions, were ruled out. Steroid treatment was carried out, to which the patient had an adequate response, but then symptoms recurred, particularly abdominal, which were associated with vasculitis. Additional management with cyclophosphamide and new steroid pulses were provided, and with those symptom control was achieved. In this case report highlights the diagnostic and clinical exercises in cocaine levamisole vasculitis and is suggested the consideration of abdominal symptoms as a possible component of the vasculitis flare.
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Levamisole is a veterinary anthelmintic drug and a common adulterant of misused drugs. This study analyses the lethal, antinociceptive and haematological effects produced by acute or repeated levamisole administration by itself or combined with morphine. Independent groups of male Swiss Webster mice were i.p. injected with 100 mg/kg morphine, 31.6 mg/kg levamisole (lethal doses at 10%, LD10 ) or the same doses combined. Naloxone pretreatment (10 mg/kg, i.p.) prevented morphine-induced death, as did 2.5 mg/kg, i.p. mecamylamine with levamisole. Co-administration of levamisole and morphine (Lvm + Mor) increased lethality from 10% to 80%. This augmented effect was prevented by 30 mg/kg, i.p. naloxone and reduced with 10 mg/kg naloxone plus 2.5 mg/kg, i.p. mecamylamine. In independent groups of mice, 17.7 mg/kg, i.p. levamisole antagonized the acute morphine's antinociceptive effect evaluated in the tail-flick test. Repeated 17.7 mg/kg levamisole administration (2×/day/3 weeks) did not affect tolerance development to morphine (10 mg/kg, 3×/day/1 week). Blood samples obtained from mice repeatedly treated with levamisole showed leukopenia and neutropenia. Morphine also produced neutropenia, increased erythrocyte count and other related parameters (e.g. haemoglobin). Lvm + Mor had similar effects on leukocyte and neutrophil counts to those seen with levamisole only, but no erythrocyte-related alterations were evident. Blood chemistry analysis did not indicate liver damage but suggested some degree of electrolyte balance impairment. In conclusion, Lvm + Mor increased death risk, altered morphine-induced antinociceptive effects and produced haematologic abnormalities. The importance of studying combinations of drugs of abuse lies in the fact that drug users frequently combine drugs, which are commonly adulterated.
Assuntos
Morfina , Neutropenia , Analgésicos , Animais , Levamisol/farmacologia , Masculino , Mecamilamina , Camundongos , Morfina/farmacologia , Naloxona/farmacologia , Neutropenia/induzido quimicamenteRESUMO
Resumen Introducción: El levamisol es un fármaco antihelmíntico, también conocido por su uso como inmunomodulador el cual, como consecuencia de sus efectos tóxicos, fue retirado a finales del siglo XX. En el 2005, producto de un incremento en el diagnóstico de vasculitis pauci-inmune entre la población usuaria de sustancias psicoactivas, se documentó la adulteración con fines comerciales de la cocaína combinándola con levamisol, a partir de un aumento de manifestaciones reumáticas asociadas al consumo de dicha droga. Reporte de caso: Se presenta el caso de un adulto joven con antecedentes de síndrome de Alport y consumo reciente de sustancias psicoactivas. Se realiza biopsia renal demostrándose la presencia de glomerulonefritis crescéntica pauci-inmune. Por lo anterior, se relacionó este tipo de vasculitis de pequeño vaso con afectación renal y depósito de complejos inmunes al consumo de cocaína adulterada con levamisol. Discusión: El levamisol, medicamento aprobado por la FDA en 1991, actúa como inmunomodulador, antiparasitario y coadyuvante en quimioterapia. El levamisol produce un síndrome reumático caracterizado por la presencia de glomerulonefritis, hemorragia alveolar, púrpura retiforme, neutropenia y agranulocitosis en relación con la presencia de anticuerpos anticitoplasma de neutrófilo. Conclusión: El levamisol es conocido por sus propiedades antihelmínticas e inmunomoduladoras, adicionalmente puede producir efectos tóxicos ostensibles. Dado el alto consumo de cocaína entre la población indigente, la presencia de este adulterante constituye un problema de salud pública creciente.
Abstract Introduction: Levamisole is an anthelmintic drug, also known for its use as an immunomodulator which, because of its toxic effects, was withdrawn at the end of the 20th century. In 2005, because of an increase in the diagnosis of pauci-immune vasculitis among the population that uses psychoactive substances, the adulteration of cocaine for commercial purposes by combining it with levamisole was documented. Case Report: The case of a young adult with a history of Alport Syndrome and recent consumption of psychoactive substances is presented. A renal biopsy is performed, demonstrating the presence of pauci-immune crescentic glomerulonephritis. Therefore, this type of small vessel vasculitis with kidney involvement and immune complex deposition was associated with the use of cocaine adulterated with levamisole. Discussion: Levamisole, a drug approved by the FDA in 1991, acts as an immunomodulator, antiparasitic and adjuvant in chemotherapy. Levamisole produces a rheumatic syndrome characterized by the presence of glomerulonephritis, alveolar hemorrhage, retinal purpura, neutropenia, and agranulocytosis in association with the presence of anti-neutrophil cytoplasmic antibodies. Conclusion: levamisole is known for its anthelmintic and immunomodulatory properties, additionally it can produce ostensible toxic effects. Given the high consumption of cocaine among the indigent population, the presence of this adulterant constitutes a growing public health problem.
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Abstract Pyoderma gangrenosum associated to the use of cocaine/levamisole is a rare condition associated to their consumption. Cocaine use is frequent in Colombia, and the substance is contaminated with levamisole, an anthelmintic that increases the psychotropic effects and enhances its side effects. We present three clinical cases of patients with ulcerated lesions, in which the diagnosis was pyoderma gangrenosum secondary to the use of cocaine contaminated with levamisole. This called the attention of the health staff to investigate the abuse of substances in gangrenous pyoderma and also evidence that the interruption of consumption was the basis of management.
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Humanos , Pioderma Gangrenoso/induzido quimicamente , Pioderma Gangrenoso/tratamento farmacológico , Cocaína/efeitos adversos , Transtornos Relacionados ao Uso de Cocaína/complicações , Levamisol , ColômbiaRESUMO
Nematicide combinations may be a valid strategy to achieve effective nematode control in the presence of drug resistance. The goal of the current trial was to evaluate the pharmaco-parasitological performance of the moxidectin (MOX) and levamisole (LEV) combination after four years of continuous use in lambs naturally parasitized with multi-resistant gastrointestinal nematodes. At the beginning of the trial, 40 lambs were divided into four groups (n = 10), which were untreated (control) or subcutaneously treated with MOX (0.2 mg/kg), LEV (8 mg/kg) or with the combination MOX + LEV (administered separately at 0.2 and 8 mg/kg, respectively). Blood samples were collected at different times post-treatment and LEV and MOX plasma concentrations were measured by HPLC. The clinical efficacy of the continuous use of MOX + LEV combination was assessed with the controlled efficacy test (CET), performed at the beginning and end of the study, and with the faecal egg count reduction (FECR) test, performed over the four-year study period. No significant adverse pharmacokinetic changes were observed either for MOX or LEV after their co-administration to infected lambs. The CET (first year) showed efficacies of 84.3 % (Haemonchus contortus), 100 % (Teladorsagia circumcincta and Trichostrongylus axei), and 97.4 % (T. colubriformis). After the repetitive use of the combined treatment for four years, those efficacies remained high (100 %) and only decreased to 58 % against T. colubriformis. The evaluation of the FECR over the study period showed fluctuations in the performance of the combined administration. The initial FECR (2014) was 99 % (MOX), 85 % (LEV) and 100 % (MOX + LEV). The co-administration of MOX + LEV during the four-year experimental period resulted in a significantly higher anthelmintic effect (87 %) than that of MOX (42 %) or LEV (69 %) given alone. The combined use of MOX + LEV to control resistant gastrointestinal nematodes appears to be a valid strategy under specific management conditions. A high initial therapeutic response to the combination would be a relevant feature for the success of this tool.
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Levamisol/uso terapêutico , Macrolídeos/uso terapêutico , Nematoides/efeitos dos fármacos , Infecções por Nematoides/veterinária , Doenças dos Ovinos/tratamento farmacológico , Animais , Anti-Helmínticos/administração & dosagem , Anti-Helmínticos/uso terapêutico , Área Sob a Curva , Esquema de Medicação , Combinação de Medicamentos , Resistência a Múltiplos Medicamentos , Feminino , Meia-Vida , Levamisol/administração & dosagem , Levamisol/farmacocinética , Macrolídeos/administração & dosagem , Macrolídeos/farmacocinética , Masculino , Infecções por Nematoides/tratamento farmacológico , Infecções por Nematoides/parasitologia , Ovinos , Doenças dos Ovinos/parasitologiaRESUMO
Pyoderma gangrenosum associated to the use of cocaine/levamisole is a rare condition associated to their consumption. Cocaine use is frequent in Colombia, and the substance is contaminated with levamisole, an anthelmintic that increases the psychotropic effects and enhances its side effects. We present three clinical cases of patients with ulcerated lesions, in which the diagnosis was pyoderma gangrenosum secondary to the use of cocaine contaminated with levamisole. This called the attention of the health staff to investigate the abuse of substances in gangrenous pyoderma and also evidence that the interruption of consumption was the basis of management.
Assuntos
Transtornos Relacionados ao Uso de Cocaína , Cocaína , Pioderma Gangrenoso , Cocaína/efeitos adversos , Transtornos Relacionados ao Uso de Cocaína/complicações , Colômbia , Humanos , Levamisol , Pioderma Gangrenoso/induzido quimicamente , Pioderma Gangrenoso/tratamento farmacológicoRESUMO
The resistance of Haemonchus contortus to synthetic anthelmintics is of increasing concern; and different strategies are being evaluated to improve parasite control. The present study investigated the in vitro effects of combinations of synthetic compounds and monoterpenes. Additionally, the chemical association of the best combinations and their impact on the ultrastructural and biophysical properties of H. contortus eggs was evaluated. We assessed the efficacy of the monoterpenes, carvacrol, thymol, r-carvone, s-carvone, citral, and p-cymene and the anthelmintics, albendazole and levamisole using the egg hatch test (EHT) and the larval migration inhibition test (LMIT), respectively. The minimum effective concentrations of the monoterpenes, according to the EHT (efficacy ranging from 4.4%-11.8%) and LMIT (efficacy ranging from 5.6%-7.4%), were used in combination with different concentrations of synthetic compounds, and the IC50 and synergism rate (SR) were calculated. Fourier-transform infrared spectroscopy (FTIR) was used to analyze the chemical association between the best combinations as revealed by the in vitro tests (albendazole and levamisole with r-carvone or s-carvone). Atomic force microscopy (AFM) was used to assess the ultrastructural and biophysical properties of H. contortus eggs treated with the albendazole and r-carvone combination. Among the monoterpenes, the highest efficacies were exhibited by carvacrol (IC50 = 185.9 µg/mL) and thymol (IC50 = 187.0 µg/mL), according to the EHT, and s-carvone and carvacrol (IC50 = 1526.0 and 1785.3 µg/mL, respectively), according to the LMIT. According to the EHT, albendazole showed a slight statistically significant synergism in combination with r-carvone (SR = 3.8) and s-carvone (SR = 3.0). According to the LMIT, among the monoterpenes, r-carvone (SR = 1.7) and s-carvone (SR = 1.7) showed an increase in efficacy with levamisole; however, this was not statistically significant. The FTIR spectra of albendazole and levamisole, in association with r-carvone and s-carvone, indicated the presence of chemical interactions between the synthetic and natural molecules, contributing to the possible synergistic effects of these associations. Eggs treated with albendazole and r-carvone showed an increase in roughness and a decrease in height, suggesting that the treatment induced damage to the egg surface and an overflow of its internal contents. Overall, the combination of albendazole with r-carvone and s-carvone was efficacious against H. contortus, demonstrating a chemical association between the compounds; the significant changes in the egg ultrastructure justify this efficacy.