Evaluation of Imatinib and Its Combination With Albendazole Against Echinococcus granulosus Protoscoleces and Microcysts In Vitro.

Abstract

Background: Currently, benzimidazoles are the main drugs used for the treatment of hydatidosis. However, the available medications do not demonstrate the expected therapeutic efficacy. As a tyrosine kinase inhibitor, imatinib may interfere with parasite signaling pathways and exert antiparasitic effects. The present study is among the first to evaluate imatinib in Echinococcus granulosus, especially on microcysts and in combination with albendazole. The aim of this study was to investigate the in vitro antiparasitic effects of imatinib and its combination with albendazole on the protoscoleces and microcysts of E. granulosus.

Materials and methods: The effects of imatinib alone and in combination with albendazole were assessed on protoscoleces and microcysts over 33 and 15 days, respectively, and compared with albendazole monotherapy. The viability percentage of protoscoleces was determined using the eosin exclusion assay. Ultrastructural and morphological changes were evaluated using scanning electron microscopy and inverted microscopy.

Results: Maximum protoscolicidal activity was observed at a concentration of 40 μg/mL imatinib and the combination of 20 μg/mL albendazole + 20 μg/mL imatinib, both of which resulted in complete mortality of protoscoleces within 6 days. In contrast, 6 days after exposure to 10 μg/mL albendazole, 84.33% ± 4.5% of protoscoleces remained viable. Exposure of microcysts to 15 μg/mL imatinib and the combination of 10 μg/mL albendazole + 1 μg/mL imatinib led to their complete destruction by Day 6.

Conclusion: The findings of this study demonstrated that imatinib has a significant effect on the protoscoleces and larval cyst forms of E. granulosus, showing higher protoscolicidal activity compared with albendazole. Moreover, the combination of imatinib and albendazole exhibited stronger and faster effects than monotherapy. These effects may be related to inhibition of tyrosine kinase-dependent pathways. Further in vivo studies are required to confirm these results and evaluate their potential clinical implications.