Activities of anti-Toxoplasma drugs and compounds against tissue cysts in the last 3 decades (1987 to 2017), a systematic review

Background and Objective: Currently, there is no approved therapy that can eradicate Toxoplasma gondii tissue cysts, which are responsible for the chronic infection. This systematic review was performed to assess drugs or compounds that can be used as anti-T. gondii tissue cysts. Search Method: English electronic databases (i.e., PubMed, Science Direct, Scopus, Google Scholar, and Web of Science) were systematically searched for articles published up to 2017. Findings: A total of 55 papers published from 1987 to 2017, were eligible for inclusion in this systematic review. Among the drugs, atovaquone and azithromycin were found effective after long-term inoculation into mice; however, clinical cases of resistance to these drugs have been reported. Also, FR235222, QUI-11, tanshinone IIA, and hydroxyzine were shown to be effective against Toxoplasma cysts, but their effectiveness in vivo remains unknown. Additionally, compound 32, endochin-like quinolones, miltefosine, and guanabenz can be used as effective anti-parasitic with the unique ability to reduce brain tissue cysts in chronically infected mice. Conclusion: Future studies should focus on the mechanisms of action of drugs or compounds that have sterilizing activity against the T. gondii cyst form in chronic toxoplasmosis in patients with cysts who are at risk for reactivating acute toxoplasmosis.

Keywords:

Toxoplasma gondii , Toxoplasmosis , Drugs , Compounds , Tissue cysts