Abstract
Pneumocystis carinii pneumonia is often the terminal event for patients with the acquired immunodeficiency syndrome. Eflornithine (DL-alpha-difluoromethylornithine [DFMO]; Ornidyl; Merrell Dow Research Institute, Cincinnati, Ohio) has been used successfully against this protozoan disease in limited clinical trials, although not all patients respond to therapy. In contrast, results of the only reported experiments with DFMO in an animal model were negative. We retested DFMO against P. carinii in an immunosuppressed rat model by inclusion of 3% DFMO in the drinking water, a dose rate about twice that used previously. A combination of trimethoprim and sulfamethoxazole, a proven anti-P. carinii agent, was used as a positive control. After 3 weeks of anti-P. carinii pneumonia therapy, the surviving rats were sacrificed and the degree of parasitosis was judged by examination of lung sections stained with silver methenamine to reveal cysts. In three separate experiments, DFMO showed definite anti-P. carinii pneumonia activity; the parasitosis of DFMO-treated animals was significantly less than that of control animals (P less than 0.001 for all experiments). DFMO was not as active as trimethoprim-sulfamethoxazole, however. Several other experimental therapies were tested, including dapsone and two additional antiprotozoal agents: suramin and diminazene aceturate (Berenil; Farbwerke Hoechst, Frankfurt, Federal Republic of Germany). Diminazene aceturate, a veterinary drug related to the standard anti-P. carinii pneumonia agent pentamidine, was very active (P less than 10(-10]. Suramin and dapsone were weakly active. The combinations suramin-diminazene aceturate and suramin-DFMO were tested, but they were antagonistic rather than synergistic.
Full text
PDF





Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Clarkson A. B., Jr, Bienen E. J., Bacchi C. J., McCann P. P., Nathan H. C., Hutner S. H., Sjoerdsma A. New drug combination for experimental late-stage African trypanosomiasis: DL-alpha-difluoromethylornithine (DFMO) with suramin. Am J Trop Med Hyg. 1984 Nov;33(6):1073–1077. doi: 10.4269/ajtmh.1984.33.1073. [DOI] [PubMed] [Google Scholar]
- Cushion M. T., Ruffolo J. J., Linke M. J., Walzer P. D. Pneumocystis carinii: growth variables and estimates in the A549 and WI-38 VA13 human cell lines. Exp Parasitol. 1985 Aug;60(1):43–54. doi: 10.1016/s0014-4894(85)80021-7. [DOI] [PubMed] [Google Scholar]
- Cushion M. T., Stanforth D., Linke M. J., Walzer P. D. Method of testing the susceptibility of Pneumocystis carinii to antimicrobial agents in vitro. Antimicrob Agents Chemother. 1985 Dec;28(6):796–801. doi: 10.1128/aac.28.6.796. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Engelberg L. A., Lerner C. W., Tapper M. L. Clinical features of Pneumocystis pneumonia in the acquired immune deficiency syndrome. Am Rev Respir Dis. 1984 Oct;130(4):689–694. doi: 10.1164/arrd.1984.130.4.689. [DOI] [PubMed] [Google Scholar]
- Golden J. A., Sjoerdsma A., Santi D. V. Pneumocystis carinii pneumonia treated with alpha-difluoromethylornithine. A prospective study among patients with the acquired immunodeficiency syndrome. West J Med. 1984 Nov;141(5):613–623. [PMC free article] [PubMed] [Google Scholar]
- Grove J., Fozard J. R., Mamont P. S. Assay of alpha-difluoromethylornithine in body fluids and tissues by automatic amino-acid analysis. J Chromatogr. 1981 May 8;223(2):409–416. doi: 10.1016/s0378-4347(00)80114-0. [DOI] [PubMed] [Google Scholar]
- Hanson W. L., Bradford M. M., Chapman W. L., Jr, Waits V. B., McCann P. P., Sjoerdsma A. alpha-Difluoromethylornithine: a promising lead for preventive chemotherapy for coccidiosis. Am J Vet Res. 1982 Sep;43(9):1651–1653. [PubMed] [Google Scholar]
- Haverkos H. W. Assessment of therapy for pneumocystis carinii pneumonia. PCP Therapy Project Group. Am J Med. 1984 Mar;76(3):501–508. doi: 10.1016/0002-9343(84)90670-3. [DOI] [PubMed] [Google Scholar]
- Hopewell P. C., Luce J. M. Pulmonary involvement in the acquired immunodeficiency syndrome. Chest. 1985 Jan;87(1):104–112. doi: 10.1378/chest.87.1.104. [DOI] [PubMed] [Google Scholar]
- Hughes W. T., Smith B. L. Efficacy of diaminodiphenylsulfone and other drugs in murine Pneumocystis carinii pneumonitis. Antimicrob Agents Chemother. 1984 Oct;26(4):436–440. doi: 10.1128/aac.26.4.436. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kim H. K., Hughes W. T. Comparison of methods for identification of Pneumocystis carinii in pulmonary aspirates. Am J Clin Pathol. 1973 Oct;60(4):462–466. doi: 10.1093/ajcp/60.4.462. [DOI] [PubMed] [Google Scholar]
- Leggiadro R. J., Winkelstein J. A., Hughes W. T. Prevalence of Pneumocystis carinii pneumonitis in severe combined immunodeficiency. J Pediatr. 1981 Jul;99(1):96–98. doi: 10.1016/s0022-3476(81)80967-5. [DOI] [PubMed] [Google Scholar]
- Mitsuyasu R., Groopman J., Volberding P. Cutaneous reaction to trimethoprim-sulfamethoxazole in patients with AIDS and Kaposi's sarcoma. N Engl J Med. 1983 Jun 23;308(25):1535–1536. doi: 10.1056/NEJM198306233082512. [DOI] [PubMed] [Google Scholar]
- Pegg A. E., McCann P. P. Polyamine metabolism and function. Am J Physiol. 1982 Nov;243(5):C212–C221. doi: 10.1152/ajpcell.1982.243.5.C212. [DOI] [PubMed] [Google Scholar]
- Siegel S. E., Wolff L. J., Baehner R. L., Hammond D. Treatment of Pneumocystis carinii pneumonitis. A comparative trial of sulfamethoxazole-trimethoprim v pentamidine in pediatric patients with cancer: report from the Children's Cancer Study Group. Am J Dis Child. 1984 Nov;138(11):1051–1054. [PubMed] [Google Scholar]
- Sjoerdsma A., Schechter P. J. Chemotherapeutic implications of polyamine biosynthesis inhibition. Clin Pharmacol Ther. 1984 Mar;35(3):287–300. doi: 10.1038/clpt.1984.33. [DOI] [PubMed] [Google Scholar]
- Sjoerdsma A. Suicide enzyme inhibitors as potential drugs. Clin Pharmacol Ther. 1981 Jul;30(1):3–22. doi: 10.1038/clpt.1981.121. [DOI] [PubMed] [Google Scholar]
- Walzer P. D., Kim C. K., Foy J., Linke M. J., Cushion M. T. Cationic antitrypanosomal and other antimicrobial agents in the therapy of experimental Pneumocystis carinii pneumonia. Antimicrob Agents Chemother. 1988 Jun;32(6):896–905. doi: 10.1128/aac.32.6.896. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Winston D. J., Lau W. K., Gale R. P., Young L. S. Trimethoprim-sulfamethoxazole for the treatment of Pneumocystis carinii pneumonia. Ann Intern Med. 1980 Jun;92(6):762–769. doi: 10.7326/0003-4819-92-6-762. [DOI] [PubMed] [Google Scholar]