Jing QD, A JD, Liu LX, Fan HN. Current status of drug therapy for alveolar echinococcosis. World J Hepatol 2024; 16(11): 1243-1254 [DOI: 10.4254/wjh.v16.i11.1243]
Corresponding Author of This Article
Hai-Ning Fan, DPhil, Chief Physician, Professor, Department of Hepatobiliary and Pancreatic Surgery, Qinghai Province Research Key Laboratory for Echinococcosis, Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining 810001, Qinghai Province, China. fanhaining@medmail.com.cn
Research Domain of This Article
Parasitology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Nov 27, 2024; 16(11): 1243-1254 Published online Nov 27, 2024. doi: 10.4254/wjh.v16.i11.1243
Current status of drug therapy for alveolar echinococcosis
Qin-Dong Jing, Ji-De A, Lin-Xun Liu, Hai-Ning Fan
Qin-Dong Jing, Lin-Xun Liu, Department of General Surgery, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
Qin-Dong Jing, School of Clinical Medicine, Qinghai University, Xining 810000, Qinghai Province, China
Ji-De A, Department of Hepatic Hydatidosis, Qinghai Provincial People’s Hospital, Xining 810007, Qinghai Province, China
Hai-Ning Fan, Department of Hepatobiliary and Pancreatic Surgery, Qinghai Province Research Key Laboratory for Echinococcosis, Affiliated Hospital of Qinghai University, Xining 810001, Qinghai Province, China
Co-first authors: Qin-Dong Jing and Ji-De A.
Co-corresponding authors: Lin-Xun Liu and Hai-Ning Fan.
Author contributions: Jing QD and A JD conceptualized and designed this research and obtained, analyzed, interpreted data, and prepared the initial draft of the manuscript, both authors have made crucial and indispensable contributions to the completion of the project, and therefore qualify as co first authors of the paper; Liu LX and Fan HN conducted a critical review of the important knowledge content in the manuscript, as co corresponding authors, they played an indispensable role in data interpretation and manuscript preparation; Fan HN conceptualized, designed, and supervised the entire process of the project; All the authors have read and approved the final manuscript.
Supported bythe Guiding Program Project of Qinghai Provincial Health Commission, No. 2020-wjzdx-27.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Ning Fan, DPhil, Chief Physician, Professor, Department of Hepatobiliary and Pancreatic Surgery, Qinghai Province Research Key Laboratory for Echinococcosis, Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining 810001, Qinghai Province, China. fanhaining@medmail.com.cn
Received: July 18, 2024 Revised: September 13, 2024 Accepted: October 15, 2024 Published online: November 27, 2024 Processing time: 110 Days and 18.3 Hours
Abstract
Alveolar echinococcosis (AE) is a chronic zoonotic parasitic disease caused by infection with Echinococcus multilocularis. AE is associated with a high mortality rate and poses a significant threat to human health. The primary treatment for AE is surgical resection of the lesions; however, owing to its long incubation period and insidious disease progression, many patients are diagnosed only after the onset of complications such as liver cirrhosis, jaundice, and portal hypertension, which preclude curative surgical intervention. For patients who are unwilling or unable to undergo surgery, lifelong administration of anti-AE medications is necessary. Benzimidazole compounds, such as albendazole and mebendazole, are the current mainstays of treatment, offering good efficacy. Nevertheless, these medications primarily inhibit parasite proliferation rather than eradicate the infection, and their long-term use can lead to significant drug-related toxic effects. Consequently, there is an urgent need to develop new therapeutic strategies that convey better efficacy and reduce the adverse effects associated with current treatments. Recent advancements in AE therapy include novel synthetic compounds such as antiviral agents, antibiotics, antineoplastic agents, immunosuppressants, and antiangiogenic agents, as well as natural compounds derived from traditional Chinese and Tibetan medicine. These new drugs show promising clinical potential because they interfere with parasitic metabolic pathways and cellular structures. This review aims to discuss recent research on AE drug therapy, including mechanisms of action, dosing regimens, signalling pathways, and therapeutic outcomes, with a goal of providing new insights and directions for the development of anti-AE drugs and summarizing current advancements in AE pharmacotherapy.
Core Tip: Our manuscript reviews the research on albendazole and other drugs in the treatment of alveolar echinococcosis (AE), with a particular focus on anti-angiogenic drugs, immunosuppressants, and the role of the immune microenvironment in AE. These areas represent significant parts of our manuscript and are currently in the exploratory phase, so extensive basic validation experiments are still needed.
