A total of 21 children with
fascioliasis (8 males and 13 females) with mean age of 10.4 years, 8 children with
schistosomiasis mansoni (6 males and 2 females) with mean age of 11.37 years were treated with
Myrrh (
Mirazid) which is an oleo-gum resin from the stem of Commiphora molmol tree (Family Burseraceae). Also, ten healthly cross matched children were utilized as controls. Diagnosis was based on the detection of Fasciola hepatica or Schistosoma mansoni eggs in stool by Kato-Katz technique.
Mirazid was given as 10 mg/kg/d an hour before breakfast for 3 consecutive days in
schistosomiasis and for 6 days in
fascioliasis. Clinical evaluation and stool analysis were done initially and at 2, 4 and 12 weeks post treatment to evaluate cure. Rectal snip was done for responding
schistosomiasis cases to confirm recovery. Automated complete blood count with manual assessment of eosinophils, serum total
IgE (
enzyme immunoassay) and in vitro
cytokines assay (IL-1 beta, IL-4, IL-5) by ELISA were performed for all subjects before treatment and repeated 12 weeks only for patients after
therapy. Parasitologic cure was 90.9% in
fascioliasis and 100% in
schistosomiasis at 4 weeks post treatment. After a second dose Fasciola patients who remained positive were cured. Total
IgE was significantly higher in Fasciola and Schistosoma patients before treatment compared to control (p < 0.001; 0.005 respectively) and decreased significantly with
therapy (p = 0.001; 0.036). IL-1beta was higher in both patient groups than control (p < 0.001; 0.003) and decreased significantly 12 weeks after
therapy to control level (p < 0.001; 0.017).
IL-5 was high before treatment in both groups (p = 0.041; 0.027) and decreased significantly after 12 weeks after
therapy (p = 0.005; 0.012).
IL-4 did not differ from control before
therapy (p = 0.58; 0.79) but increased significantly
after treatment in both patient groups (p = 0.04; 0.02). It is concluded that
Mirazid is an effective fasciolicidal and schistosomicidal
drug. IL-1beta and
IL5 were high in
fascioliasis and
schistosomiasis, but decreased with
therapy denoting immunopathogenesis. The depressed
IL-4 production may be a parasite immune evasion or host regulatory mechanism and
cytokines levels may be criteria of cure.