TREATMENT OF CONGENITAL TOXOPLASMOSIS

先天性弓形虫病的治疗

• 批准号: 3141800
• 负责人: Rima L McLeod
• 金额: $ 2.13万
• 依托单位: MICHAEL REESE HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1989
• 资助国家: 美国
• 起止时间: 1989-09-01 至 1992-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3141800
• 关键词: Toxoplasma gondii; adolescence (12-20); antiprotozoal agents; blood disorder; blood tests; child (0-11); child physical development; congenital infection; enzyme linked immunosorbent assay; eye disorder diagnosis; female; folate; hearing disorders; hearing tests; high performance liquid chromatography; human subject; human therapy evaluation; immunoglobulin M; immunologic assay /test; infant human (0-1 year); laboratory mouse; laboratory rabbit; longitudinal human study; macrolide antibiotics; mass screening; mathematical model; nervous system disorder; nervous system disorder diagnosis; nervous system infection; ocular toxoplasmosis; parasitic disease chemotherapy; parasitic disease diagnosis; patient care management; performance; placental transfer; pregnancy infection; prenatal diagnosis; prognosis; pyrimethamine; radioimmunoassay; serology /serodiagnosis; toxoplasmosis

Long term objectives are to reduce morbidity and mortality due to congenital Toxoplasma gondii infection through improved use of antimicrobial agents. Specific aims are to develop optimal methods to treta congenital toxoplasmosis. To develop optimal strategies to manage human congenital Toxoplasma infection, a serologic screening program to diagnose Toxoplasma infection acquired during pregnancy will be evaluated. Congenitally infected infants identified in this program (and through collaborative arrangements) will be studied prospectively to determine feasibility, safety, adn efficacy of treatment. Treatment for clinically normal infants or those with mild involvement will be either one year of pyrimethamine and trisulfapyrimidines or this regimen for six months followed by these medications in alternating months with spiramycin. Infants with severe neurologic or ocular involvement at birth will receive treatment for one year iwth pyrimethamine and trisulfapyrimidines. Their pyrimethamine treatment will be administered in one of two dosage regimens: either one milligram per kilogram daily for two or for six months followed by the same dosage administered three times per week for a total of one year of therapy. Growth and development, general clinical, neurologic, ophthalmologic, audiologic and hematologic status at near birth and one, three, five, ten, fifteen and twenty years of age will be evaluated in a uniform manner. Outcome for treated children will also be compared with outcome of historical, untreated controls. Early evaluations will provide information concerning response to therapy of acute signs and symptoms du to Toxoplasma infection, immediate information about toxicity of medications, and preliminary indications of potential general, neurologic, audiologic, intellectual adn ophthalmologic function. The later evaluations will assess incidence of recrudescent chorioretinitis and ultimate general, ophthalmologic, audiologic status and intellectual performance. Pharmacokinetics of pyrimethamine and folinic acid will be studied, as currently there are no such data to guide therapy. This information is greatly needed, as at present therapy is totally empiric and potentially toxic. Immunologic functions of children in the study, which are of potential importance in containing Toxoplasma infection, also will be evaluated. These studies will attempt to determine how to best provide medical care to children afflicted with congenital toxoplasmosis.

长期目标是降低发病率和死亡率 通过改进使用来预防先天性弓形虫感染 抗菌剂。 具体目标是开发最佳方法 Treta 先天性弓形体病。 制定最佳管理策略 人类先天性弓形虫感染，血清学筛查计划 诊断怀孕期间获得的弓形虫感染 评价。 本计划中发现的先天性感染婴儿 （并通过合作安排）将进行前瞻性研究 确定治疗的可行性、安全性和疗效。 治疗 对于临床正常的婴儿或轻度受累的婴儿 一年乙胺嘧啶和三磺胺嘧啶或此方案 六个月后，交替使用这些药物 螺旋霉素。 患有严重神经系统或眼部受累的婴儿 出生时将接受为期一年的乙胺嘧啶治疗，并且 三磺胺嘧啶类。 他们将接受乙胺嘧啶治疗 两种剂量方案之一：每天每公斤一毫克 持续两个月或六个月，然后给予相同剂量的三个月 每周一次，总共一年的治疗。 成长和 发育、一般临床、神经病学、眼科、听力学 以及临近出生时的血液学状况以及一、三、五、十、十五 二十岁以下统一评定。 结果 对于接受治疗的儿童，还将与历史结果进行比较， 未经处理的对照。 早期评估将提供信息 关于对急性体征和症状治​​疗的反应 弓形虫感染，有关毒性的即时信息 药物治疗，以及潜在一般情况的初步迹象， 神经、听力、智力和眼科功能。 这 稍后的评估将评估复发性脉络膜视网膜炎的发生率 以及最终的一般、眼科、听力状况和智力状况 表现。 乙胺嘧啶和亚叶酸的药代动力学 研究，目前没有此类数据来指导治疗。 这 非常需要信息，因为目前的治疗完全是经验性的 并且有潜在的毒性。 研究中儿童的免疫功能， 这对于遏制弓形虫感染具有潜在的重要性， 也会被评价。 这些研究将试图确定如何 最好为患有先天性疾病的儿童提供医疗护理 弓形体病。