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Minocycline is better than Doxy?
 
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Published: 4 years ago
 

Minocycline is better than Doxy?


I found this article... I'm gathering up info as much as i can to set up my plan lately. So I think it's  kind of a must to take doxy with albendazole,Ivermec. But why Doxy is recommeded rather than Mino?

 

https://www.theatlantic.com/science/archive/2015/10/ivermectin-nobel-drugs-elephantiasis-filariasis-nematodes-wolbachia/409306/

 

How to Cure The Diseases That Nobel-Winning Drugs Cannot

Don’t go after the parasitic worms that cause the diseases; go after the bacteria that those worms depend on.

(...) 

So, why can’t we just kill the adult worms?

The answer involves a bacterium called Wolbachia, which colonizes the cells of up to 40 percent of insect species. Since its hosts are themselves the most numerous animals on the planet, Wolbachia can lay a strong claim to being one of Earth’s most successful bacteria. And beyond its normal insect hosts, it also lives in filarial nematodes.

No one is entirely sure what it does in the worms, but it is clearly essential. The nematodes cannot complete their life cycles without these microbes. They couldn’t trigger intense disease, either. When the worms die, they release their Wolbachia into their hosts. And while these bacteria can’t infect us, they can trigger inflammation. Mark Taylor from the University of Liverpool thinks that it’s the combination of immune responses against the worms and their bacteria that leads to the intense symptoms of filarial diseases.

And unfortunately, this means that killing the worms would make everything much worse, because they’d release all their Wolbachia in their death throes. “You get exploding nodules, and scrotal inflammation,” he told me. “You don’t want that. You want to kill the worms slowly, and it’s hard to think how you’d do that with an anti-nematode drug.”

So, Taylor has been aggressively pursuing another option: He’s ignoring the worms and going after the Wolbachia.

In lab tests, he and others showed that removing the bacteria with antibiotics has fatal results for the worms. The larvae fail to mature. The existing adults stop reproducing. And after some time, their cells start to self-destruct. The process is slow, taking up to 18 months, but a slow death is still a death. And since these worms have no Wolbachia to release, they can be slaughtered with impunity.

In the 1990s, Taylor and his colleagues showed that an antibiotic called doxycycline could eliminate Wolbachia from people with filariasis. In Ghana, Achim Hoerauf from the Bernhard Nocht Institute for Tropical Medicine found that doxycycline could sterilize female nematodes in villagers with river blindness. Meanwhile, in Tanzania, Taylor showed that it wiped out nematode larvae in people with elephantiasis. And at both sites, it killed the adult nematodes in around three-quarters of the volunteers, without triggering any catastrophic immune responses.

“For the first time, we were able to cure people of filariasis,” says Taylor. “We can’t do that with standard drugs.”

Doxycycline had other benefits too. In parts of central Africa, it is incredibly hard to treat people with river blindness, because they also carry a second filarial nematode called Loa loa—the so-called “eyeworm.” If you kill the species that causes river blindness, the eyeworms die too, and their larvae are so large that they can block blood vessels and cause brain damage. Go after one nematode, and the other could kill the patient in its death throes. But since the eyeworm doesn’t have Wolbachia, doxycycline won’t harm it. This drug can attack the parasites behind river blindness without inflicting heavy collateral damage.

But like ivermectin, doxycyline has its own weaknesses. Pregnant women can’t take it, nor can children. It also acts slowly, so people need to take several courses over many weeks. In rural, remote communities, it can be hard to get the drug to people over that whole period, much less persuade them to complete their course.

To find a better drug, Taylor set up an international team called A-WOL—the Anti-Wolbachia Consortium—in 2007. With $23 million of funding from the Bill and Melinda Gates Foundation, their mission is to find new drugs that kill filarial nematodes by targeting their Wolbachia symbionts. They have already screened thousands of potential chemicals and found one promising lead—minocycline. It proved to be 50 percent more potent than doxycycline, and the team immediately ushered it into trials in Ghana and Cameroon.

Minocycline is still inaccessible to kids and pregnant women, and is several times more expensive than doxycycline. But A-WOL has since screened another 60,000 compounds and identified dozens more promising candidates. “There’s always the valley of death in drug discovery,” says Taylor. “Things hit one problem or another, but we think we have enough candidates to overcome that.”

The idea is ambitious and the stakes are high. If A-WOL can break this partnership between worms and bacteria, which has been around for 100 million years, he could improve some 150 million lives.

 

 
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