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- Title
The impact of vaccine-linked chemotherapy on liver health in a mouse model of chronic Trypanosoma cruzi infection.
- Authors
Nguyen, Duc Minh; Poveda, Cristina; Pollet, Jeroen; Gusovsky, Fabian; Bottazzi, Maria Elena; Hotez, Peter J.; Jones, Kathryn Marie
- Abstract
Background: Chagas disease, chronic infection with Trypanosoma cruzi, mainly manifests as cardiac disease. However, the liver is important for both controlling parasite burdens and metabolizing drugs. Notably, high doses of anti-parasitic drug benznidazole (BNZ) causes liver damage. We previously showed that combining low dose BNZ with a prototype therapeutic vaccine is a dose sparing strategy that effectively reduced T. cruzi induced cardiac damage. However, the impact of this treatment on liver health is unknown. Therefore, we evaluated several markers of liver health after treatment with low dose BNZ plus the vaccine therapy in comparison to a curative dose of BNZ. Methodology: Female BALB/c mice were infected with a bioluminescent T. cruzi H1 clone for approximately 70 days, then randomly divided into groups of 15 mice each. Mice were treated with a 25mg/kg BNZ, 25μg Tc24-C4 protein/ 5μg E6020-SE (Vaccine), 25mg/kg BNZ followed by vaccine, or 100mg/kg BNZ (curative dose). At study endpoints we evaluated hepatomegaly, parasite burden by quantitative PCR, cellular infiltration by histology, and expression of B-cell translocation gene 2(BTG2) and Peroxisome proliferator-activated receptor alpha (PPARα) by RT-PCR. Levels of alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were quantified from serum. Results: Curative BNZ treatment significantly reduced hepatomegaly, liver parasite burdens, and the quantity of cellular infiltrate, but significantly elevated serum levels of ALT, AST, and LDH. Low BNZ plus vaccine did not significantly affect hepatomegaly, parasite burdens or the quantity of cellular infiltrate, but only elevated ALT and AST. Low dose BNZ significantly decreased expression of both BTG2 and PPARα, and curative BNZ reduced expression of BTG2 while low BNZ plus vaccine had no impact. Conclusions: These data confirm toxicity associated with curative doses of BNZ and suggest that while dose sparing low BNZ plus vaccine treatment does not reduce parasite burdens, it better preserves liver health. Author summary: Chagas disease is a neglected tropical disease caused by the protozoal parasite Trypanosoma cruzi, which has long-term deleterious health effects. The current treatment for Chagas disease is administering the antiparasitic drug, benznidazole. While benznidazole effectively treats the disease during the acute phase, its efficacy is reduced during chronic infection. In addition, benznidazole therapy causes significant side effects, including liver toxicity. Texas Children's Hospital Center for Vaccine Development at Baylor College of Medicine has developed a treatment strategy that combines a prototype therapeutic vaccine with a lower dose of Benznidazole to promote a protective immune response, ameliorate the deleterious effects of the parasite, and limit the harmful side effect of the drug. We call this vaccine-linked chemotherapy, which has shown promising results regarding heart health by reducing parasite burden and pathology in the heart and improving cardiac function. This study evaluated the strategy's effectiveness in the liver since it is the prime metabolizer of the benznidazole drug, as well as the organ of parasite clearance. Results from this study demonstrated that vaccine-linked chemotherapy causes less damage to the liver compared to curative doses of benznidazole and may be a desirable treatment strategy to preserve overall health while retaining efficacy.
- Subjects
BAYLOR College of Medicine; TRYPANOSOMA cruzi; NEGLECTED diseases; LABORATORY mice; PEROXISOME proliferator-activated receptors; CHAGAS' disease
- Publication
PLoS Neglected Tropical Diseases, 2023, Vol 17, Issue 11, p1
- ISSN
1935-2727
- Publication type
Article
- DOI
10.1371/journal.pntd.0011519