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  • Plenary
  • N2.08 - Arachidonic acid: Potential new treatment for schistosomiasis in school-age Egyptian children

    Monday, June 30, 2014 4:05 PM - Monday, June 30, 2014 4:05 PM

    • Kevin Hadley, DSM North America, USA ;
    • Rashida Barakat, Alexandria University, Egypt ;
    • Maaike Bruins, DSM Biotechnology Center, R&D, Netherlands ;
    • Azza El Amir, Cairo University, Egypt ;
    • Rashika El Ridi, Cairo University, Egypt ;
    • Ola El Sagheer, Cairo University, Egypt ;
    • Sahar Selim, National Liver Institute, Menoufia University, Egypt
    Kevin Hadley, DSM North America, USA; Rashida Barakat, Alexandria University, Egypt; Maaike Bruins, DSM Biotechnology Center, R&D, Netherlands; Azza El Amir, Cairo University, Egypt; Rashika El Ridi, Cairo University, Egypt; Ola El Sagheer, Cairo University, Egypt; Sahar Selim, National Liver Institute, Menoufia University, Egypt;
    Schistosomiasis, a trematode infection, affects >250 million individuals, especially children. Arachidonic acid (ARA, 20:4n-6) rich oil from Mortierella alpina is generally recognized as safe for human consumption. Preclinical studies have shown ARA has cidal activity against schistosomes in vitro and in laboratory rodents. This investigation assessed the safety and potential efficacy of ARA in treatment of children infected with Schistosoma mansoni. Children (6-15 yrs.) from Menoufiya (N=66) and Kafr El Sheikh (N=269) governorates, with confirmed infection were randomly assigned to one of three study arms for treatment with: 1) a single dose on day 1 of 40 mg/kg praziquantel (PZQ), the standard of care schistosomicide; 2) 10 mg/kg /d of ARA for 15 days, or; 3) the combination of PZQ+ARA as described, respectively. Assessments included biochemical and hematological parameters, in vitro cytokine responses to schistosome antigen, and plasma lipids, assessed 3 days post-ARA treatment, corresponding to 18 days post-treatment with PZQ . Cure rate was based on eggs per gram stool (epg) counts six weeks post-treatment. Infection intensities were graded low (<100 epg), moderate (100- 400 epg), and high (>400 epg). ARA was well tolerated and its content in total plasma lipids was not influenced by infection, and was increased (P<0.001) nearly 60%, relative to uninfected children (N=20) , as a result of ARA or ARA+PZQ administration. Supplementation with ARA maintained normal liver, kidney, and immunological functions. PZQ and ARA cure rates were comparable in low intensity infections. Yet, PZQ efficacy in moderate and heavy infections was approximately two-fold greater compared to ARA. Highest cure rate was achieved at all levels of infection from the combination of ARA+PZQ. Biochemical, immunological, and parasitological indices demonstrate that microbial ARA is safe, bioavailable, effective, and, may act in concert with PZQ. Future studies are suggested to confirm these findings.