Potential alternative treatment studies in congenital toxoplasmosis: a literature review.

Abstract

Toxoplasmosis is an infection caused by the protozoan Toxoplasma gondii and is a serious publichealth problem that can be fatal in immunocompromised individuals or congenital infections.Congenital toxoplasmosis disease results from transplacental parasite transfer to the fetus duringchildbirth or primary infection of the mother or acute relapse. The clinical manifestations aredifferent for neonates, with potentially fatal or debilitating consequences that primarily affect thecentral nervous system and/or generate ocular involvement. Depending on the gestational stage,the current treatment of congenital toxoplasmosis is limited to the use of spiramycin or, in fetalinfection, supported by the combination of pyrimethamine and sulfadiazine associated with folinicacid. However, these regimens may be toxic to the embryo/fetus. Therefore, research has examinedalternative therapies for this infection and thus the aim of this manuscript was to review the mainstudies involving different compounds as potential treatments for congenital toxoplasmosis. Amongthe compounds most frequently cited in the literature as an alternative therapy for congenitaltoxoplasmosis, were artemisinin, atovaquone, azithromycin and diclazuril. It was observed thatartemisinin and atovaquone may have teratogenic dose-dependent effects. Already azithromycinand diclazuril have shown promising results when used in murine models or cell culture, but theireffectiveness has not been fully confirmed in humans. The compounds mentioned here, despite stillbeing in experimental and clinical trials, add new data and perspectives for the treatment of infection.