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Novel Synergistic Protective Efficacy of Atovaquone and Diclazuril on Fetal-Maternal Toxoplasmosis.
[congenital toxoplasmosis]
Over
1
billion
people
globally
are
estimated
to
be
infected
with
Toxoplasma
gondii
with
severe
or
unknown
consequences
and
no
safe
and
effective
therapies
are
available
against
congenital
or
persistent
chronic
infection
.
We
propose
that
atovaquone
and
diclazuril
synergistically
protect
against
fetal
-
maternal
toxoplasmosis
.
Programmed
pregnant
mice
were
treated
with
atovaquone
and
diclazuril
monotherapy
,
or
combined
(
atovaquone
+
diclazuril
)
therapy
and
infected
with
tachyzoites
(
0
,
300
,
600
)
and
the
course
of
infection
was
studied
.
Infected
dams
with
low
dose
(
300
)
developed
moderate
toxoplasmosis
complications
and
treatments
were
similarly
effective
with
minor
differences
between
monotherapies
.
In
contrast
,
major
differences
were
observed
amongst
varied
treatments
during
high
-dose
(
600
)
infection
and
severe
related-
toxoplasmosis
complications
as
follows
.
Dams
developed
hydrothorax
,
ascities
and
excess
weight
gain
.
Combined
therapy
(
P
<
0
.
01
)
and
to
a
lesser
extent
diclazuril
monotherapy
(
P
<
0
.
05
)
protected
dams
from
excess
weight
,
hydrothorax
,
and
ascities
.
Infected
dams
exhibited
splenomegaly
,
hepatomegaly
and
severe
hepatitis
.
Combined
therapy
synergistically
normalized
pathology
(
P
<
0
.
001
)
and
to
a
lesser
degree
monotherapy
(
diclazuril
P
<
0
.
01
,
and
atovaquone
P
<
0
.
05
)
protected
dams
from
hepatitis
and
splemomegaly
.
Additionally
,
behavioral
response
to
pain
stimuli
and
fetal
weight
and
fetal
numbers
were
significantly
preserved
in
treated
dams
.
This
is
the
first
report
describing
combined
atovaquone
and
diclazuril
therapy
(
a
)
to
be
safe
in
pregnancy
,
(
b
)
to
exert
novel
synergistic
effects
,
and
(
c
)
to
protect
dams
and
their
nested
fetuses
against
adverse
effects
of
severe
toxoplasmosis
.
Diseases
Validation
Diseases presenting
"first report"
symptom
achondroplasia
alexander disease
aniridia
cadasil
canavan disease
child syndrome
cohen syndrome
congenital toxoplasmosis
cowden syndrome
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentinogenesis imperfecta
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
harlequin ichthyosis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
homocystinuria without methylmalonic aciduria
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
krabbe disease
lamellar ichthyosis
liposarcoma
lymphangioleiomyomatosis
monosomy 21
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
omenn syndrome
pendred syndrome
pleomorphic liposarcoma
primary hyperoxaluria type 1
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
werner syndrome
wiskott-aldrich syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
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