Different gut microbial communities correlate with efficacy of albendazole-ivermectin against soil-transmitted helminthiases

Pierre H. H. Schneeberger (), Morgan Gueuning, Sophie Welsche, Eveline Hürlimann, Julian Dommann, Cécile Häberli, Jürg E. Frey, Somphou Sayasone and Jennifer Keiser ()
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Pierre H. H. Schneeberger: Helminth Drug Development Unit
Morgan Gueuning: Agroscope, Research Group Molecular Diagnostics, Genomics and Bioinformatics
Sophie Welsche: Helminth Drug Development Unit
Eveline Hürlimann: Helminth Drug Development Unit
Julian Dommann: Helminth Drug Development Unit
Cécile Häberli: Helminth Drug Development Unit
Jürg E. Frey: Agroscope, Research Group Molecular Diagnostics, Genomics and Bioinformatics
Somphou Sayasone: University of Basel
Jennifer Keiser: Helminth Drug Development Unit

Nature Communications, 2022, vol. 13, issue 1, 1-12

Abstract: Abstract Soil-transmitted helminth infections represent a large burden with over a quarter of the world’s population at risk. Low cure rates are observed with standard of care (albendazole); therefore, a more effective combination therapy (albendazole and ivermectin) is being investigated but showed variable treatment efficacies without evidence of intrinsic parasite resistance. Here, we analyzed the microbiome of Trichuris trichiura and hookworm-infected patients and found an association of different enterotypes with treatment efficacy. 80 T. trichiura-infected patients with hookworm co-infections from Pak-Khan, Laos, received either albendazole (n = 41) or albendazole and ivermectin combination therapy (n = 39). Pre-/post-treatment stool samples were collected to monitor treatment efficacy and microbial communities were profiled using 16S rRNA gene sequencing, qPCR, and shotgun sequencing. We identified three bacterial enterotypes and show that pre-treatment enterotype is associated with efficacy of the combination treatment for both T. trichiura (CRET1 = 5.8%; CRET2 = 16.6%; CRET3 = 68.8%) and hookworm (CRET1 = 31.3%; CRET2 = 16.6%; CRET3 = 78.6%). This study shows that pre-treatment enterotype enables predicting treatment outcome of combination therapy for T. trichiura and hookworm infections. Trial registration: ClinicalTrials.gov, NCT03527732. Registered 17 May 2018, https://clinicaltrials.gov/ct2/show/NCT03527732 .

Date: 2022
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DOI: 10.1038/s41467-022-28658-1

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