Disposition of mefloquine and enpiroline is highly influenced by a chronic Schistosoma mansoni infection

Antimicrob Agents Chemother. 2013 Sep;57(9):4506-11. doi: 10.1128/AAC.01129-13. Epub 2013 Jul 8.

Abstract

Chronic Schistosoma mansoni infections lead to severe tissue destruction of the gut wall and liver and can influence drug disposition. This study aimed to investigate the impact of a chronic S. mansoni infection on the pharmacokinetic (PK) parameters of two promising antischistosomal lead candidates (mefloquine and enpiroline) in mice. Studies were conducted in two different mouse cohorts (S. mansoni-infected and uninfected mice) for both drugs. Plasma samples were collected at various time points after oral treatment (200 mg/kg of body weight) with study drugs. A high-performance liquid chromatography (HPLC) method was validated to analyze enpiroline and mefloquine in plasma. Livers and intestines were collected from infected animals to determine the onset of action, hepatic shift, and worm burden reduction. Following mefloquine administration, hepatic shifting and significant worm burden reductions (79.2%) were observed after 72 h. At 1 week posttreatment with enpiroline, the majority of worms had migrated to the liver and significant worm burden reductions were observed (93.1%). The HPLC method was selective, accurate (87.8 to 111.4%), and precise (<10%) for the analysis of both drugs in plasma samples. The PK profiles revealed increased values for half-life (t1/2) and area under the concentration-time curve (AUC) for both drugs in infected animals compared to the t1/2 and AUC values in uninfected animals. Considerable changes were observed for mefloquine, with a 5-fold increase of t1/2 (182.7 h versus 33.6 h) and 2-fold increase of AUC (1,116,517.8 ng · h/ml versus 522,409.1 ng · h/ml). S. mansoni infections in mice influence the PK profiles of enpiroline and mefloquine, leading to delayed clearance. Our data confirm that drug disposition should be carefully studied in schistosomiasis patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Animals
  • Anthelmintics / blood
  • Anthelmintics / pharmacokinetics*
  • Anthelmintics / pharmacology
  • Chronic Disease
  • Dose-Response Relationship, Drug
  • Female
  • Half-Life
  • Intestines / drug effects
  • Intestines / parasitology
  • Liver / drug effects
  • Liver / parasitology
  • Mefloquine / blood
  • Mefloquine / pharmacokinetics*
  • Mefloquine / pharmacology
  • Mice
  • Pyridines / blood
  • Pyridines / pharmacokinetics*
  • Pyridines / pharmacology
  • Rodent Diseases / blood
  • Rodent Diseases / drug therapy*
  • Rodent Diseases / parasitology
  • Schistosoma mansoni / drug effects*
  • Schistosoma mansoni / physiology
  • Schistosomiasis mansoni / blood
  • Schistosomiasis mansoni / drug therapy
  • Schistosomiasis mansoni / parasitology
  • Schistosomiasis mansoni / veterinary*

Substances

  • Anthelmintics
  • Pyridines
  • enpiroline
  • Mefloquine