Table 4. Characteristics of natural compounds for the treatment of human cystic and alveolar echinococcosis based on the published literature.
| Compound | Disease | Assay setting | Dosage | Treatment duration | Efficacy assessment | Toxicity | References | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| In vitro | In vivo | In patients (n) |
Initiation (p.i.) | Duration | Tested against | Successa (%) | |||||
| THYMOL, MENTHOL AND PLANT EXTRACTS RICH IN THYMOL | |||||||||||
| Thymol | CE | Yes | Yesb | — | 50–200 μg·mL-1 (PCS and cysts in vitro) | N/A (in vitro) | 1 min to 2 days (PSC and Cysts); 7 days (Cells) (in vitro) | PSC, Cysts, Cells | Yes (100 for PSC and Cysts; 63% for Cells, in vitro) | No | [142] [190] [191] [193] |
| 5 μg·mL-1 (cells in vitro) | |||||||||||
| 64 mg·kg-1·day-1 (in vivo)c | 3.5 months (in vivo) | 2 weeks (in vivo) | No (in vivo) | ||||||||
| AE | Yes | — | — | 10 μg·mL-1 | N/A | 10–36 days | PSC, Cysts | Yes (48 for PSC, NA for cysts) | N/A | [131] | |
| Menthol | CE | Yes | — | — | 50 μg·mL-1 | N/A | 5 days | PSC | Yes (100) | N/A | [190] |
| Trachyspermum ammi L. fruit essential oil | CE | Yes | — | — | 10 mg·mL-1 | N/A | 10 min | PSC | Yes (100) | N/A | [192] |
| Zataria multiflora water or methanol extracts | CE | — | Yesb | — | 20–40 mL·l-1,d | 0–8 months | 3–8 months | PSC, Cysts | Yes (100 in prophylaxis and 93 in therapy) | No | [88,89] |
| Thymus vulgaris and Origanum vulgare essential oils | CE | Yes | Yesb | — | 10 μg·mL-1 (in vitro) | 4 months | 5 days to 2 months (in vitro) | PSC, Cysts | Yes (60–70 for PSC, N/S for cysts in vitro) | N/A | [175] [194] |
| 40 mg kg-1·day-1 (in vivo)d | 20 days (in vivo) | Yes (72.3 in vivo) | |||||||||
| Salvia officinalis and Thymus vulgaris ethanol extracts | CE | Yes | — | — | 500 μg·mL-1 | N/A | 6–7 days | PSC | Yes (100) | N/A | [190] |
| Mentha spp. essential oil | CE | Yes | — | — | 10 μg·mL-1 | N/A | 1–18 days | PSC, Cysts, Cells | Yes (50–100 for PSC; NA for cysts; 77% for cells) | N/A | [195] [193] |
| Rosmarinus officinalis essential oil | CE | Yes | — | — | 10 μg·mL-1 | N/A | 7 days | Cells | Yes (82%) | N/A | [193] |
| PLANT AND FUNGUS EXTRACTS | |||||||||||
| Allium sativum methanol or chloroform extract | CE | Yes | — | — | 50–200 mg·mL-1 | N/A | 10–180 min | PSC | Yes (98–100) | N/A | [196–198] |
| Berberis vulgaris aequous extract | CE | Yes | — | — | 4 mg·mL-1 | N/A | 5 min | PSC | Yes (100) | N/A | [201] |
| Cnidium monnieri osthole | CE | Yes | — | — | 120 M | N/A | 3 days | PSC | Yes (100) | N/A | [210] |
| AE | — | Yesb | — | 100 mg·kg-1·day-1 | 3.5 months | 6 weeks | Cysts | Yes (50) | No | ||
| Corylus spp. and Curcurbia spp. hydroalcoholic extracts | CE | Yes | — | — | 50 mg·mL-1 | N/A | 2 h | PSC | Yes (10) | N/A | [197] |
| Curcuma longa ethanol extract | CE | Yes | — | — | 50 mg·mL-1 | N/A | 30 min | PSC | Yes (93) | N/A | [206] |
| Mallotus philippinensis fruit methanol extract | CE | Yes | — | — | 20 mg·mL-1 | N/A | 2 h | PSC | Yes (99) | N/A | [199] |
| Nigella sativa seed essential oil | CE | Yes | — | — | 10 mg·mL-1 | N/A | 10 min | PSC | Yes (100) | N/A | [208] |
| Olea europaea leaves aequous extract | CE | Yes | — | — | 0.1% | N/A | 2 h | PSC | Yes (90) | N/A | [203] |
| Penicillum extracted chitosan | CE | Yes | — | — | 200–400 μg·mL-1 | N/A | 3 h | PSC | Yes (100) | N/A | [212,213] |
| Penicillium aculeatum in silver particles | CE | Yes | — | — | 0.15 mg·mL-1 | N/A | 2 h | PSC | Yes (90) | N/A | [214] |
| Pestalotiopsis spp. ethyl acetate extract | CE | Yes | — | — | 20 mg·mL-1 | N/A | 30 min | PSC | Yes (100) | N/A | [202] |
| Pistacia atlantica fruit methanol extract | CE | Yes | — | — | 50 mg·mL-1 | N/A | 10 min | PSC | Yes (100) | No | [209] |
| Punica granatum peel aequous extract | CE | Yes | Yesb | — | 16 mg·mL-1 (in vitro) | 2 days | 48 h (in vitro) | PSC, Cysts | Yes (100, in vitro) | N/A | [211] |
| 650 mg·kg-1·day-1 (in vivo)d | 2 months (in vivo) | Yes (63, in vivo) | |||||||||
| Salvadora persica root ethanol extract | CE | Yes | — | — | 50 mg·mL-1 | N/A | 20 min | PSC | Yes (100) | No | [204] |
| Sambucus ebulus fruit methanol extract | CE | Yes | — | — | 100 mg·mL-1 | N/A | 2 h | PSC | Yes (99) | N/A | [200] |
| Satureja khuzestanica leaves hydroalcoholic extract | CE | Yes | — | — | 0.1% | N/A | 30 min | PSC | Yes (100) | N/A | [203] |
| Trametes robiniophila murr aequous extract | CE | Yes | Yesb | — | 2 mg·mL-1 (in vitro) | N/A (in vitro) | 12 days (in vitro) | PSC, Cysts | Yes (20, in vitro) | No | [101] |
| 15 g·kg-1·week-1 (in vivo)d | 1.5 months (in vivo) | 4 months (in vivo) | Yes (75, in vivo) | ||||||||
| Zingiber officinale ethanol extract | CE | Yes | — | — | 50–100 mg·mL-1 (PSC-Cysts) | N/A | 10 min (PSC, 72 h (Cysts) | PSC, Cysts | Yes (100) | N/A | [206] |
N/A: Not applicable; N/S: Not specified; PSC: Protoscoleces.
a Defined as a significant reduction of the parasite burden or the viability of the any form of the larval stage of the parasite, including protoscoleces or cysts.
b Experimental infection in mice.
c Intramuscular administration.
d Oral or intragastric administration.