Over one billion people worldwide are predicted to harbor Toxoplasma infection frequently with unknown life long health consequences. Toxoplasmosis is an important cause of food borne, inflammatory illnesses, as well as congenital abnormalities. Toxoplasma has a unique tropism for central nervous system and is transmitted sexually through semen (Oz, 2014).
In Egypt a study by Kamal et al., (2015) showed that the sero prevalence of T. gondii infection among the high risk pregnancy group was 50.8% versus 8.3% among the normal pregnancy. The relationship between maternal infection with T. gondii and the post-delivery adverse pregnancy outcomes was observd in 80.3% and abortion was the highest risk among the adverse pregnancy outcomes.
Toxoplasmosis is fatal in the immunocompromised individuals such as cancer patients with chemotherapy. Clinical toxoplasmosis in cancer patients is a great public health concern in China (Jiang et al., 2015).Ocular toxoplasmosis is a vision-threatening disease and Toxoplasmic retinochoroiditis is the most common cause of posterior uveitis (intraocular inflammatory syndrome) in immunocompetent patients (Dukaczewska et al., 2015).
Currently available therapies are ineffective for persistent chronic disease and congenital toxoplasmosis or have severe side effects which may result in life-threatening complications. There is an urgent need for safe and effective therapies to treat this cosmopolitan infectious and inflammatory disease (Oz, 2014).
Spiramycin is a macrolide antibiotic that has been used effectively in the treatment of pregnant women and congenital infection .( Antczak et al.,2016)
However, spiramycin demonstrates poor penetration across the blood brain barrier and does not reach effective concentrations in the brain due to prescence of the efflux transporters multi drug resistant protein 2(Mrp2) and p-glycoprotein,for which spiramycin is a substrate ( Tian et al.,2007,Grover and Benrt,2009 and Antczak et al.,2016)
Several treatment failure of toxoplasmic encephalitis, chorioretinitis and congential toxoplasmosis have been reported (Doliwa et al.,2013)
The combination of pyrimethamine and sulphadiazine remains the mainstay for treatment and prophylaxis of most clinical presentations of toxoplasmosis. However, this therapeutic regimen is not always suitable for prolonged treatment because of appearance of adverse side effects and the potential to contribute to clinical failure by selecting drug-resistant parasite variants. Consequently, new therapies are critically needed (Reich& Mackensen, 2015).
Nitrofurantoin,(Z)-1-[(5-nitrofuran-2-yl)methyleneamino]-imidazolidine-2,4-dion), a newly synthesized derivative of imidazolidine-2,4-dione is bacteriostatic or bactericidal agent depending on the concentration and susceptibility of the infecting organism. Nitrofurantoin is active against some gram positive and gram negative organism It may be used as an alternative to trimethoprim/sulfamethoxazole for treating urinary tract infections . Nitrofurantoin is highly stable to the development of bacterial resistance, a property thought to be due to its multiplicity of mechanisms of action ( Tara and Kerry,2005)
Nitrofurantoin showed good anti-toxoplasmosis effects in T. gondi-infected mice. (RH Strain). Nitrofurantoin is a potentially useful anti-T. gondii candidate drug that could have a therapeutic value for the treatment of toxoplasmosis. (Yeo etal.,2016)
AIM OF THE WORK
The aim of this work is to evaluate the efficacy of Nitrofurantoin on treatment of murine toxoplasmosis as an attempt to overcome shortcomings of other traditional drugs.
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