Evaluation of myrrh (Mirazid) therapy in fascioliasis and intestinal schistosomiasis in children: immunological and parasitological study

Soliman, O.E.; El-Arman, M.; Abdul-Samie, E.R.; El-Nemr, H.I.; Massoud, A.

Journal of the Egyptian Society of Parasitology 34(3): 941-966

2004


ISSN/ISBN: 1110-0583
PMID: 15587320
Document Number: 314
A total of 21 children with fascioliasis (8 males & 13 females) with mean age of 10.4 years, 8 children with schistosomiasis mansoni (6 males & 2 females) with mean age of 11.37 years were treated with Myrrh (Mirazid®) which is an oleo-gum resin from the stem of Commiphora molmol tree (Family Burseraceae). Also, ten healthly cross matched children were utilized as controls. Diagnosis was based on the detection of Fasciola hepatica or Schistosoma mansoni eggs in stool by Kato-Katz technique. Mirazid° was given as 10 mg/kg/d an hour before breakfast for 3 consecutive days in schistosomiasis and for 6 days in fascioliasis. Clinical evaluation and stool analysis were done initially and at 2, 4 & 12 weeks post treatment to evaluate cure. Rectal snip was done for responding schistosomiasis cases to confirm recovery. Automated complete blood count with manual assessment of eosinophils, serum total IgE (enzyme immunoassay) and in vitro cytokines assay (1L-1 (3, IL4, 11,-5) by ELISA were performed for all subjects before treatment and repeated 12 weeks only for patients after therapy. Parasitologic cure was 90.9% in fascioliasis and 100% in schistosomiasis at 4 weeks post treatment. After a second dose Fasciola patients who remained positive were cured. Total IgE was significantly higher in Fasciola and Schistosoma patients before treatment compared to control (p<0.001;0.005 respectively) and decreased significantly with therapy (p=0.001; 0.036). IL-1 was higher in both patient groups than control (p<0.001; 0.003) and decreased significantly 12 weeks after therapy to control level (p<0.001; 0.017). IL-5 was high before treatment in both groups (p=0.041; 0.027) and decreased significantly after 12 weeks after therapy (p=0.005; 0.012). IL-4 did not differ from control before therapy (p=0.58; 0.79) but increased significantly after treatment in both patient groups (p=0.04; 0.02). It is concluded that Mirazie is an effective fasciolicidal and schistosomicidal drug. IL-1[3 and IL5 were high in fascioliasis and schistosomiasis, but decreased with therapy denoting immunopathogenesis. The depressed IL-4 production may be a parasite immune evasion or host regulatory mechanism and cytokines levels may be criteria of cure.

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Evaluation of myrrh (Mirazid) therapy in fascioliasis and intestinal schistosomiasis in children: immunological and parasitological study