The in vitro effect of mefloquine and praziquantel against juvenile and adult Schistosoma japonicum

Mefloquine, an antimalarial drug, has been found to be effective against various stages of schistosomes in vivo. The purpose of the study is to explore the in vitro effect of mefloquine against adult and juvenile Schistosoma japonicum and to compare its efficacy with praziquantel. Three-hour-old schistosomula were prepared by penetrating the mouse skin with schistosome cercariae, while schistosomes 7-, 14-, and 35-day-old were collected from mice infected with S. japonicum cercariae for 7, 14, and 35 days by perfusion. Schistosomes were placed to each of 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 mefloquine and praziquantel, adult worms exposed to mefloquine and praziquantel for 1 and 4 h were transferred to the medium without the drugs and incubated continuously for another 72 h. The reversible effect of mefloquine and praziquantel was assessed by the recovery of the worm motor activity and parasite survival. The minimal effective concentration of mefloquine against adult schistosomes in vitro was 10 μg/mL, which revealed that the worm motor activity was first stimulated, then decreased significantly, followed by bleb formation, focal swelling and elongation of the worm body, cessation of gut peristalsis, and death of 56.3% (18/32) worms within 24-72 h. Similar appearance was seen in the adult worms exposed to higher mefloquine concentration of 20 and 30 μg/mL, but all worms died within 4-24 h. The adult schistosomes exposed to praziquantel 1-30 μg/mL showed fast spasmodic contraction of the worm body, followed by bleb formation along the tegument, feeble movement of oral sucker, and death of a part of males and females 72 h after incubation. When male and female schistosomes exposed to mefloquine 10 and 20 μg/mL for 1 and 4 h were transferred to the medium without the drug, no apparent recovery of worm motor activity and survival was seen. In case of worms exposed to praziquantel at the same concentration for 1 and 4 h before replacement of drug-free medium, a well recovery of worm motor activity, looseness of worm body, and reduction or disappearance of blebs along the tegument were observed. Mefloquine also exhibited in vitro effect against 3-h-old and 7- and 14-day-old schistosomula which was similar to that seen in adult worms, but all or parts of worms showed decrease in motor activity or even death (3-h-old and 7-day-old schistosomula) at a lower mefloquine concentration of 5 μg/mL. In 14 day-old schistosomula exposed to praziquantel 1-30 μg/mL, spasmodic contraction and significant decrease in motor activity of the worm body with movement of oral and ventral suckers were observed, but no death of worm was seen during a 3-day incubation period. The results indicate that in vitro mefloquine exhibits a direct killing effect against adult and juvenile S. japonicum which is different from that of praziquantel. Meanwhile, the juvenile schistosomes are more susceptible to mefloquine than the adult ones. Furthermore, the in vitro effect of mefloquine against adult schistosomes is irreversible, while that of praziquantel is reversible.