The in vitro and in vivo effect of tribendimidine and its metabolites against Clonorchis sinensis

The purpose of the study was to understand the in vitro and in vivo effect of tribendimidine (TBD) and its metabolites of p-(1-dimethylamino ethylimino)aniline (aminoamidine, deacylated amidantel, BAY d 9216, dADT), acetylated dADT (AdADT), terephthalaldehyde (TPAL), and terephthalic acid (TPAC) against adult Clonorchis sinensis. In in vitro test, the adults of C. sinensis were placed to each of the 24 wells of a Falcon plate and maintained in Hanks' balanced salt solution-20% calf serum. Besides observation on the direct in vitro effect of TBD and its metabolites, the worms exposed to TBD and its metabolites for 1-24 h were transferred to the medium without drug and incubated continually for another 72 h. The reversible effect of TBD and its metabolites was assessed by the recovery of worm motor activity and parasite survival. In in vivo test, 235 rats were divided into five batches for oral infection of each rat with 50 C. sinensis metacercariae. Five to 6 weeks post-infection, groups of rats were treated orally or intramuscularly with a single dose of TBD or its metabolites, while untreated but infected rats served as control. All treated rats were killed 2 weeks post-treatment for assessment of efficacy. When adult C. sinensis were exposed to TBD or dADT 0.5 μg/mL, they were paralyzed rapidly accompanied by dilatation of the gut. The in vitro effect of AdADT decreased significantly, which was at least lower than 20- to 40-fold compared with TBD and dADT. TPAL and TPAC at a high concentration of 100 μg/mL exhibited no effect against adult C. sinensis. In the worms exposed to TBD or dADT 1 μg/mL for 1 h, well recovery of the worm motor activity from paralysis was seen in the medium without drug. If exposure time extended to 4-24 h before transferred to the medium without drug, few worms were dead and most worms showed very poor recovery of their activity. When the worms exposed to TBD or dADT 10 μg/mL for 1, 4, and 24 h were transferred to the drug-free medium, recovery of poor motor activity of worms or worm death was seen. In the worms exposed to AdADT 20 and 40 μg/mL for 1-24 h, more worms recovered poor motor activity in the medium without drug. In rats infected with C. sinensis and treated orally with TBD or dADT, the ED₅₀ and ED₉₅ were 20.318 and 195.358 mg/kg or 18.969 and 268.882 mg/kg. Under the equal dosages used in the treatment of rats infected with C sinensis, the effects between TBD and dADT or TBD and AdADT were similar. Intramuscular TBD or dADT at a single dose of 12.5-75 mg/kg showed effect against adult C. sinensis harbored in rats. TPAL and TPAC exhibit no effect against C sinensis harbored in rats treated orally with a higher dose of 1 g/kg. The results indicate that TBD and dADT exhibit a strong in vitro effect to paralyze the adult C. sinensis, but less in vitro effect was seen in AdADT. TBD, dADT, and AdADT exhibit similar therapeutic effect in oral treatment of rats infected with C. sinensis, and intramuscular TBD and dADT also show promising effect against C. sinensis in rats. TPAL and TPAC are ineffective metabolites of TBD.