Acute Anisakiasis: Pharmacological Evaluation of Various Drugs in an Animal Model

Dig Dis Sci. 2021 Jan;66(1):105-113. doi: 10.1007/s10620-020-06144-2. Epub 2020 Feb 27.

Abstract

Background: The accidental ingestion of the third larval stage of Anisakis can cause acute clinical symptoms, which are relieved via extraction of the larvae. Although this is a highly effective technique, it can only be practiced when the larvae are found in accessible areas of the gastrointestinal tract, and therefore instead the condition has often been treated using various different drugs.

Aims: This study evaluates the effectiveness of gastric acid secretion inhibitors (omeprazole and ranitidine), gastric mucosal protectants (sucralfate) and anthelmintics (mebendazole and flubendazole) in treating anisakiasis in Wistar rats.

Methods: Rats were infected with Anisakis-type I larvae and administered the drugs via a gastric probe. Data were recorded regarding the number of live and dead larvae, their location both within the animal and in its feces, and the presence of gastrointestinal lesions. Additionally, gastric pH was measured and histology performed.

Results: While rats in all experimental groups exhibited lesions; those treated with ranitidine and mebendazole showed significantly fewer lesions (50% and 35% of rats exhibited lesions, respectively). Histological examination of the gastric lesions revealed infection-induced changes, but no significant differences were observed between the treated and untreated rats.

Conclusions: Mebendazole was found to be most efficacious in preventing gastrointestinal lesions, followed by ranitidine, which was the most effective antacid of those studied. Both these drugs could thus be considered as part of the conservative management of anisakiasis.

Keywords: Anisakiasis; Anthelmintics; Drug therapy; Gastric acidity; Stomach histological sections.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Animals
  • Anisakiasis / drug therapy*
  • Anisakiasis / pathology
  • Anthelmintics / pharmacology
  • Anthelmintics / therapeutic use*
  • Anti-Ulcer Agents / pharmacology
  • Anti-Ulcer Agents / therapeutic use*
  • Antinematodal Agents / pharmacology
  • Antinematodal Agents / therapeutic use*
  • Disease Models, Animal*
  • Drug Evaluation, Preclinical / methods
  • Female
  • Fishes / parasitology
  • Gastrointestinal Tract / drug effects
  • Gastrointestinal Tract / parasitology
  • Gastrointestinal Tract / pathology
  • Mebendazole / pharmacology
  • Mebendazole / therapeutic use
  • Omeprazole / pharmacology
  • Omeprazole / therapeutic use
  • Ranitidine / pharmacology
  • Ranitidine / therapeutic use
  • Rats
  • Rats, Wistar
  • Sucralfate / pharmacology
  • Sucralfate / therapeutic use*

Substances

  • Anthelmintics
  • Anti-Ulcer Agents
  • Antinematodal Agents
  • Sucralfate
  • Mebendazole
  • Ranitidine
  • Omeprazole