Mitigation of benznidazole toxicity and oxidative stress following ascorbic acid supplementation in an adult traveler with chronic indeterminate Chagas disease

Background: Benznidazole is an effective drug in the trypanocidal treatment of acute and chronic indeterminate Chagas disease. However, adverse drug reactions (ADR) are common and frequently cause patients to discontinue treatment. Objectives: We hypothesized that antioxidant supplementation could mitigate benznidazole-induced toxicity. Methods: We co-supplemented an adult traveler with chronic indeterminate Chagas disease who experienced benznidazole ADR with ascorbic acid (AA), 1000 mg/day. We measured selected serum biomarkers of oxidative stress (TAS, TOS, Nrf2, MDA, GPx3, CAT, T-SOD) at timepoints before and throughout benznidazole treatment, and after AA co-supplementation. Results: AA co-supplementation effectively mitigated benznidazole-induced ADR during the etiologic treatment of chronic indeterminate CD. The kinetics of serum biomarkers of oxidative stress suggested significantly decreased oxidative insult in our patient. Conclusions: We hypothesize that the key pathophysiological mechanism to benznidazole-associated toxicity is oxidative stress, rather than hypersensitivity. AA co-supplementation may improve adherence to benznidazole treatment of chronic indeterminate (or acute) Chagas disease. Oxidative stress biomarkers have potential to guide the clinical management of Chagas disease. Prospective studies are needed to establish the benefit of antioxidant co-supplementation to benznidazole treatment of Chagas disease in reducing benznidazole toxicity, parasite clearance and the prevention of end-organ damage.

Jaar van publicatie:2022

Trefwoorden:A1 Journal article

Toegankelijkheid:Open