Folia Parasitologica 52[1/2] 173-181 (2005) | DOI: 10.14411/fp.2005.022

Antimicrosporidial activity of (fluoro)quinolones in vitro and in vivo

Elizabeth S. Didier1, Lisa Bowers1, Mary E. Stovall1, Dorothy Kuebler2, Derek Mittleider3, Paul J. Brindley3, Peter J. Didier2
1 Division of Microbiology and Immunology, Tulane National Primate Research Center, Covington, Louisiana 70433, USA
2 Division of Comparative Pathology, Tulane National Primate Research Center, Covington, Louisiana 70433, USA
3 Department of Tropical Medicine, Tulane University Health Sciences Center, Tulane University, New Orleans, Louisiana 70112, USA

Microsporidia are a cause of emerging and opportunistic infections in humans and animals. Although two drugs are currently being used to treat microsporidiosis, concerns exist that albendazole is only selective for inhibiting some species of microsporidia that infect mammals, and fumagillin appears to have been found to be toxic. During a limited sequence survey of the Vittaforma corneae (syn. Nosema corneum Shadduck, Meccoli, Davis et Font, 1990) genome, a partial gene encoding for the ParC topoisomerase IV subunit was identified. The purpose of this set of studies was to determine if fluoroquinolones, which target topoisomerase IV, exert activity against Encephalitozoon intestinalis (syn. Septata intestinalis Cali, Kotler et Orenstein, 1993) and V. corneae in vitro, and whether these compounds could prolong survival of V. corneae-infected athymic mice. Fifteen fluoroquinolones were tested. Of these, norfloxacin and ofloxacin inhibited E. intestinalis replication by more than 70% compared with non-treated control cultures, while gatifloxacin, lomefloxacin, moxifloxacin, and nalidixic acid (sodium salt) inhibited both E. intestinalis and V. corneae by at least 60% at concentrations not toxic to the host cells. These drugs were tested in vivo also, where gatifloxacin, lomefloxacin, norfloxacin, and ofloxacin prolonged survival of V. corneae-infected athymic mice (P < 0.05), whereas moxifloxacin and nalidixic acid failed to prolong survival. Therefore, these results support continued studies for evaluating the efficacy of the fluoroquinolones for treating microsporidiosis and for characterizing the target(s) of these fluoroquinolones in the microsporidia.

Keywords: fluoroquinolone, microsporidia, opportunistic infection, emerging infection, Encephalitozoon intestinalis, Vittaforma corneae

Received: October 5, 2004; Accepted: January 5, 2005; Published: May 1, 2005  Show citation

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Didier, E.S., Bowers, L., Stovall, M.E., Kuebler, D., Mittleider, D., Brindley, P.J., & Didier, P.J. (2005). Antimicrosporidial activity of (fluoro)quinolones in vitro and in vivo. Folia Parasitologica52(1-2), 173-181. doi: 10.14411/fp.2005.022
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References

  1. ANDERSSON M.I., MacGOWAN A.P. 2003: Development of the quinolones. J. Antimicrob. Chemother. 51 (Suppl. 1): 1-11 Go to original source... Go to PubMed...
  2. BAKER M.D., VOSSBRINCK C.R., DIDIER E.S., MADDOX J.V., SHADDUCK J.A. 1995: Small subunit ribosomal DNA phylogeny of various microsporidia with emphasis on AIDS related forms. J. Eukaryot. Microbiol. 42: 564-570 Go to original source... Go to PubMed...
  3. BALL P. 2000: Quinolone generations: natural history or natural selection? J. Antimicrob. Chemother. 46 (Suppl. T1): 17-24 Go to original source... Go to PubMed...
  4. BIANCIARDI P., FASANELL A., FOGLIA A., MANZILLO V., TROTTA T., PAGANO A., SORINO S., GRADONI L., OLIVA G. 2004: The efficacy of enrofloxacin, alone or combined with metronidazole, in the therapy of canine leishmaniasis. Parasitol. Res. 93: 486-492 Go to original source... Go to PubMed...
  5. BLANSHARD C., ELLIS D.S., TOVEY D.G., DOWELL S., GAZZARD B.G. 1992: Treatment of intestinal microsporidiosis with albendazole in patients with AIDS. AIDS 6: 311-313 Go to original source... Go to PubMed...
  6. BRYAN R.T., SCHWARTZ D.A. 1999: Epidemiology of microsporidiosis. In: M. Wittner and L.M. Weiss (Eds.), The Microsporidia and Microsporidiosis. ASM Press, Washington, D.C., pp. 502-516 Go to original source...
  7. CALI A., KOTLER D.P., ORENSTEIN J.M. 1993: Septata intestinalis n. g., n. sp., an intestinal microsporidian associated with chronic diarrhea and dissemination in AIDS patients. J. Eukaryot. Microbiol. 40: 101-112 Go to original source... Go to PubMed...
  8. CAVALIER-SMITH T. 1998: A revised six-kingdom system of life. Biol. Rev. Camb. Philos. Soc. 73: 203-266 Go to original source... Go to PubMed...
  9. CHAMPOUX J.J. 2001: DNA topoisomerases: structure, function, and mechanism. Ann. Rev. Biochem. 70: 369- 413 Go to original source... Go to PubMed...
  10. CHAN C.M., THENG J.T., LI L., TAN D.T. 2003: Microsporidial keratoconjunctivitis in healthy individuals: a case series. Ophthalmology 110: 1420-1425 Go to original source... Go to PubMed...
  11. CHAVALITSHEWINKOON-PETMITR P., WORASING R., WILAIRAT P. 2001: Partial purification of mitochondrial DNA topoisomerase II from Plasmodium falciparum and its sensitivity to inhibitors. S.E. Asian J. Trop. Med. Public Health 32: 733-738.
  12. CONTEAS C.N., BERLIN O.G., ASH L.R., PRUTHI J.S. 2000: Therapy for human gastrointestinal microsporidiosis. Am. J. Trop. Med. Hyg. 63: 121-127 Go to original source... Go to PubMed...
  13. DESPORTES-LIVAGE I. 2000: Biology of microsporidia. Contrib. Microbiol. 6: 140-165 Go to original source... Go to PubMed...
  14. DIDIER E.S. 1997: Effects of albendazole, fumagillin, and TNP-470 on microsporidia replication in vitro. Antimicrob. Agents Chemother. 41: 1541-1546 Go to original source... Go to PubMed...
  15. DIDIER E.S. 2005: Microsporidiosis: an emerging and opportunistic infection in humans and animals. Acta Trop. 94: 61-76 Go to original source... Go to PubMed...
  16. DIDIER E.S., ROGERS L.B., ORENSTEIN J.M., BAKER M.D., VOSSBRINCK C.R., VAN GOOL T., HARTSKEERL R., SOAVE R., BEAUDET L.M. 1996: Characterization of Encephalitozoon (Septata) intestinalis isolates cultured from nasal mucosa and bronchoalveolar lavage fluids of two AIDS patients. J. Eukaryot. Microbiol. 43: 34-43 Go to original source... Go to PubMed...
  17. DIDIER E.S., VARNER P.W., DIDIER P.J., ALDRAS A.M., MILLICHAMP N.J., MURPHEY-CORB M., BOHM R.P., SHADDUCK J.A. 1994: Experimental microsporidiosis in immunocompetent and immunodeficient mice and monkeys. Folia Parasitol. 41: 1-11 Go to PubMed...
  18. DIVO A.A., SARTORELLI A.C., PATTON C.L., BIA F.J. 1988: Activity of fluoroquinolone antibiotics against Plasmodium falciparum in vitro. Antimicrob. Agents Chemother. 32: 1182-1186 Go to original source... Go to PubMed...
  19. DRLICA K., ZHAO X. 1997: DNA gyrase, topoisomerase IV, and the 4-quinolones. Microbiol. Mol. Biol. Rev. 61: 377-392 Go to original source... Go to PubMed...
  20. EMMERSON A.M., JONES A.M. 2003: The quinolones: decades of development and use. J. Antimicrob. Chemother. 51 (Suppl. 1): 13-20 Go to original source... Go to PubMed...
  21. FICHERA M.E., ROOS D.S. 1997: A plastid organelle as a drug target in apicomplexan parasites. Nature 390: 407- 409 Go to original source... Go to PubMed...
  22. FRIEDBERG D.N., RITTERBAND D.C. 1999: Ocular microsporidiosis. In: M. Wittner and L.M. Weiss (Eds.), The Microsporidia and Microsporidiosis. ASM Press, Washington, D.C., pp. 293-314 Go to original source...
  23. GOZALBES R., BRUN-PASCAUD M., GARCIA-DOMENECH R., GALVEZ J., GIRARD P.M., DOUCET J.P., DEROUIN F. 2000: Anti-toxoplasma activities of 24 quinolones and fluoroquinolones in vitro: prediction of activity by molecular topology and virtual computational techniques. Antimicrob. Agents Chemother. 44: 2771-2776 Go to original source... Go to PubMed...
  24. HAMZAH J., SKINNER-ADAMS T., DAVIS T.M. 2000: In vitro antimalarial activity of trovafloxacin, a fourth-generation fluoroquinolone. Acta Trop. 74: 39-42 Go to original source... Go to PubMed...
  25. HAWKEY P.M. 2003: Mechanisms of quinolone action and microbial response. J. Antimicrob. Chemother. 51 (Suppl. 1): 29-35 Go to original source... Go to PubMed...
  26. HINKLE G., MORRISON H.G., SOGIN M.L. 1997: Genes coding for reverse transcriptase, DNA-directed RNA polymerase, and chitin synthase from the microsporidian Spraguea lophii. Biol. Bull. 193: 250-251. (http://jbpc.mbl. edu/Spraguea-html/) Go to original source... Go to PubMed...
  27. HOOPER D.C. 2000: Mechanisms of action and resistance of older and newer fluoroquinolones. Clin. Infect. Dis. 31 (Suppl. 2): S24-S28 Go to original source... Go to PubMed...
  28. HOOPER D.C. 2001: Mechanisms of action of antimicrobials: focus on fluoroquinolones. Clin. Infect. Dis. 32 (Suppl. 1): 9-15 Go to original source... Go to PubMed...
  29. INCE D., HOOPER D.C. 2003: Quinolone resistance due to reduced target enzyme expression. J. Bacteriol. 185: 6883-6892 Go to original source... Go to PubMed...
  30. KATINKA M.D., DUPRAT S., CORNILLOT E., METENIER G., THOARAT F., PRENSIER G., BARE V., PEYRETAILLADE E., BROTTIER P., WINCKER P., DELBAC F., El ALAOUI H., PEYRET P., SAURIN W., GOUY M., WEISSENBACH J., VIVARES C.P. 2001: Genome sequence and gene compaction of the eukaryote parasite Encephalitozoon cuniculi. Nature 414: 450-453 Go to original source... Go to PubMed...
  31. KATZNELSON H., JAMIESON C.A. 1952: Control of nosema disease of honeybees with fumagillin. Science 115: 70-71 Go to original source... Go to PubMed...
  32. KEELING P.J., FAST N.M. 2002: Microsporidia: biology and evolution of highly reduced intracellular parasites. Ann. Rev. Microbiol. 56: 93-116 Go to original source... Go to PubMed...
  33. KHAN A.A., SLIFER T., ARAUJO F.G., POLZER R.J., REMINGTON J.S. 1997: Activity of trovafloxacin in combination with other drugs for treatment of acute murine toxoplasmosis. Antimicrob. Agents Chemother. 41: 893-897 Go to original source... Go to PubMed...
  34. KHAN A.A., SLIFER T., ARAUJO F.G., REMINGTON J.S. 1996: Trovafloxacin is active against Toxoplasma gondii. Antimicrob. Agents Chemother. 40: 1855-1859 Go to original source... Go to PubMed...
  35. KOTLER D.P., ORENSTEIN J.M. 1998: Clinical syndromes associated with microsporidiosis. Adv. Parasitol. 40: 321- 349 Go to original source... Go to PubMed...
  36. KOTLER D.P., ORENSTEIN J.M. 1999: Clinical syndromes associated with microsporidiosis. In: M. Wittner and L.M. Weiss (Eds.), The Microsporidia and Microsporidiosis. ASM Press, Washington, D.C., pp. 258-292 Go to original source...
  37. MITTLEIDER D., GREEN L.C., MANN V.H., MICHAEL S.F., DIDIER E.S., BRINDLEY P.J. 2002: Survey of genome sequences from the opportunistic microsporidian pathogen, Vittaforma corneae. J. Eukaryot. Microbiol. 49: 393-401 Go to original source... Go to PubMed...
  38. MOLINA J.M., TOURNEUR M., SARFATI C., CHEVRET S., DE GOUVELLO A., GOBERT J.G., BALKAN S., DEROUIN F. and Agence Nationale de Recherches sur le SIDA 090 Study Group. 2002: Fumagillin treatment of intestinal microsporidiosis. N. Engl. J. Med. 346: 1963- 1969 Go to original source... Go to PubMed...
  39. NENORTAS E.C., BODLEY A.L., SHAPIRO T.A. 1998: DNA topoisomerases: a new twist for antiparasitic chemotherapy? Biochim. Biophys. Acta 1400: 349-354 Go to original source... Go to PubMed...
  40. NENORTAS E., BURRI C., SHAPIRO T.A. 1999: Antitrypanosomal activity of fluoroquinolones. Antimicrob. Agents Chemother. 43: 2066-2068 Go to original source... Go to PubMed...
  41. NENORTAS E., KULIKOWICZ T., BURRI C., SHAPIRO T.A. 2003: Antitrypanosomal activities of fluoroquinolones with pyrrolidinyl substitutions. Antimicrob. Agents Chemother. 47: 3015-3017 Go to original source... Go to PubMed...
  42. RUIZ J. 2003: Mechanisms of resistance to quinolones: target alterations, decreased accumulation and DNA gyrase protection. J. Antimicrob. Chemother. 51: 1109-1117 Go to original source... Go to PubMed...
  43. SARMA P.S. 1989: Norfloxacin: a new drug in the treatment of falciparum malaria. Ann. Intern. Med. 111: 336-337. Go to original source... Go to PubMed...
  44. SHADDUCK J.A. 1980: Effect of fumagillin on in vitro multiplication of Encephalitozoon cuniculi. J. Protozool. 27: 202-208 Go to original source... Go to PubMed...
  45. SHADDUCK J.A., MECCOLI R.A., DAVIS R., FONT R.L. 1990: Isolation of a microsporidian from a human patient. J. Infect. Dis. 162: 773-776 Go to original source... Go to PubMed...
  46. SOUSA M.C., POIARES-da-SILVA J. 2001: The cytotoxic effects of ciprofloxacin in Giardia lamblia trophozoites. Toxicol. In Vitro 15: 297-301 Go to original source... Go to PubMed...
  47. TRIPATHI K.D., SHARMA A.K., VALECHA N., BISWAS S. 1993: In vitro activity of fluoroquinolones against chloroquine-sensitive and chloroquine-resistant Plasmodium falciparum. Indian J. Malariol. 30: 67-73 Go to PubMed...
  48. VIVARES C.P., GOUY M., THOARAT F., METENIER G. 2002: Functional and evolutionary analysis of a eukaryotic parasitic genome. Curr. Opin. Microbiol. 5: 499- 505 Go to original source... Go to PubMed...
  49. VOSSBRINCK C.R., ANDREADIS T.G., WEISS L.M. 2004: Phylogenetics: taxonomy and the microsporidia as derived fungi. In: D.S. Lindsay and L.M. Weiss (Eds.), Opportunistic Infections: Toxoplasma, Sarcocystis, and Microsporidia. Kluwer Academic Publishers, Boston, pp. 189- 213 Go to original source...
  50. VOSSBRINCK C.R., MADDOX J.V., FRIEDMAN S.S., DEBRUNNER-VOSSBRINCK B.A., WOESE C.R. 1987: Ribosomal RNA sequence suggests microsporidia are extremely ancient eukaryotes. Nature 326: 411-414 Go to original source... Go to PubMed...
  51. WATT G., SHANKS G.D., EDSTEIN M.D., PAVANAND K., WEBSTER H.K., WECHGRITAYA S. 1991: Ciprofloxacin treatment of drug-resistant falciparum malaria. J. Infect. Dis. 164: 602-604 Go to original source... Go to PubMed...
  52. WEBER R., DEPLAZES P., SCHWARTZ D. 2000: Diagnosis and clinical aspects of human microsporidiosis. Contrib. Microbiol. 6: 166-192 Go to original source... Go to PubMed...
  53. WEISS L.M., EDLIND T.D., VOSSBRINCK C.R., HASHIMOTO T. 1999: Microsporidian molecular phylogeny: the fungal connection. J. Eukaryot. Microbiol. 46: 17S-18S Go to PubMed...