Artemisinins for schistosomiasis and beyond

Abstract

Schistosomiasis is a significant health issue caused by a blood fluke that affects more than 200 million individuals worldwide, over half of whom suffer from disease-associated symptoms. In areas of high burden, disease is mainly managed by controlling morbidity with the use of a single drug, praziquantel. However, the good safety and broad therapeutic profile of praziquantel, and the sharp reduction in price of the drug have stalled the improvement and advancement of other potential control options for schistosomiasis, such as vaccines, new drugs or diagnostics. One notable exception is the advances made with artemisinins. Preclinical studies demonstrating the antischistosomal activity of artemisinins, and clinical trials showing the safety and efficacy of these drugs, are summarized in this review. Furthermore, the effect of artemisinin-based combination therapy on young children co-infected with Plasmodium sp and Schistosoma haematobium is described, and the promising activity of artemisinins against intestinal and liver flukes in vivo, as well as against cancer cells is reviewed.