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Comparative efficacies of albendazole and the Chinese herbal medicine long-dan-xie-gan-tan, used alone or in combination, in the treatment of experimental eosinophilic meningitis induced by Angiostrongylus cantonensis.
Ann Trop Med Parasitol. 2008 Mar; 102(2):143-50.AT

Abstract

Angiostrongylus cantonensis, the rat lungworm, is the principal cause of human eosinophilic meningitis or meningoencephalitis world-wide. In the present study, the efficacies of early-stage treatment with the Chinese herbal medicine long-dan-xie-gan-tan (LDXGT) and albendazole, used alone or in combination, were evaluated in BALB/c mice with A. cantonensis-induced dysfunction of the blood-central-nervous-system barrier and eosinophilic meningo-encephalitis. Indicators of the therapeutic effect included worm recovery, histopathological scores for the meningitis, assays of tissue-type plasminogen activator (PA), urokinase-type PA and matrix metalloproteinase-9 (MMP-9) in the brain, the ratio between albumin concentrations in the cerebrospinal fluid (CSF) and serum, and counts of eosinophils in the CSF. Combined treatment with albendazole and LDXGT gave better results than monotherapy based on either drug, apparently inhibiting eosinophilic meningitis via antagonists of the PA/MMP-9 system. LDXGT may have a therapeutic role in reducing inflammatory reaction in the subarachnoid space. Monotherapy with such an anti-inflammatory drug may relieve the symptoms of mild infection and the host's immune responses to A. cantonensis larvae. In severe infection, however, co-therapy with an anthelmintic (to kill the larvae) and an anti-inflammatory agent (to provide symptomatic relief) is probably a better approach. The therapeutic strategy should be tailored to the severity of the illness and the numbers of eosinophils in the CSF.

Authors+Show Affiliations

Department of Parasitology, Chung Shan Medical University, Taichung 402, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18318936

Citation

Lai, S C., et al. "Comparative Efficacies of Albendazole and the Chinese Herbal Medicine Long-dan-xie-gan-tan, Used Alone or in Combination, in the Treatment of Experimental Eosinophilic Meningitis Induced By Angiostrongylus Cantonensis." Annals of Tropical Medicine and Parasitology, vol. 102, no. 2, 2008, pp. 143-50.
Lai SC, Chen KM, Chang YH, et al. Comparative efficacies of albendazole and the Chinese herbal medicine long-dan-xie-gan-tan, used alone or in combination, in the treatment of experimental eosinophilic meningitis induced by Angiostrongylus cantonensis. Ann Trop Med Parasitol. 2008;102(2):143-50.
Lai, S. C., Chen, K. M., Chang, Y. H., & Lee, H. H. (2008). Comparative efficacies of albendazole and the Chinese herbal medicine long-dan-xie-gan-tan, used alone or in combination, in the treatment of experimental eosinophilic meningitis induced by Angiostrongylus cantonensis. Annals of Tropical Medicine and Parasitology, 102(2), 143-50. https://doi.org/10.1179/136485908X252304
Lai SC, et al. Comparative Efficacies of Albendazole and the Chinese Herbal Medicine Long-dan-xie-gan-tan, Used Alone or in Combination, in the Treatment of Experimental Eosinophilic Meningitis Induced By Angiostrongylus Cantonensis. Ann Trop Med Parasitol. 2008;102(2):143-50. PubMed PMID: 18318936.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative efficacies of albendazole and the Chinese herbal medicine long-dan-xie-gan-tan, used alone or in combination, in the treatment of experimental eosinophilic meningitis induced by Angiostrongylus cantonensis. AU - Lai,S C, AU - Chen,K M, AU - Chang,Y H, AU - Lee,H H, PY - 2008/3/6/pubmed PY - 2008/8/5/medline PY - 2008/3/6/entrez SP - 143 EP - 50 JF - Annals of tropical medicine and parasitology JO - Ann Trop Med Parasitol VL - 102 IS - 2 N2 - Angiostrongylus cantonensis, the rat lungworm, is the principal cause of human eosinophilic meningitis or meningoencephalitis world-wide. In the present study, the efficacies of early-stage treatment with the Chinese herbal medicine long-dan-xie-gan-tan (LDXGT) and albendazole, used alone or in combination, were evaluated in BALB/c mice with A. cantonensis-induced dysfunction of the blood-central-nervous-system barrier and eosinophilic meningo-encephalitis. Indicators of the therapeutic effect included worm recovery, histopathological scores for the meningitis, assays of tissue-type plasminogen activator (PA), urokinase-type PA and matrix metalloproteinase-9 (MMP-9) in the brain, the ratio between albumin concentrations in the cerebrospinal fluid (CSF) and serum, and counts of eosinophils in the CSF. Combined treatment with albendazole and LDXGT gave better results than monotherapy based on either drug, apparently inhibiting eosinophilic meningitis via antagonists of the PA/MMP-9 system. LDXGT may have a therapeutic role in reducing inflammatory reaction in the subarachnoid space. Monotherapy with such an anti-inflammatory drug may relieve the symptoms of mild infection and the host's immune responses to A. cantonensis larvae. In severe infection, however, co-therapy with an anthelmintic (to kill the larvae) and an anti-inflammatory agent (to provide symptomatic relief) is probably a better approach. The therapeutic strategy should be tailored to the severity of the illness and the numbers of eosinophils in the CSF. SN - 0003-4983 UR - https://www.unboundmedicine.com/medline/citation/18318936/Comparative_efficacies_of_albendazole_and_the_Chinese_herbal_medicine_long_dan_xie_gan_tan_used_alone_or_in_combination_in_the_treatment_of_experimental_eosinophilic_meningitis_induced_by_Angiostrongylus_cantonensis_ L2 - https://medlineplus.gov/eosinophilicdisorders.html DB - PRIME DP - Unbound Medicine ER -