The molecular targets of ivermectin and lotilaner in the human louse Pediculus humanus humanus: New prospects for the treatment of pediculosis

Control of infestation by cosmopolitan lice (Pediculus humanus) is increasingly difficult due to the transmission of parasites resistant to pediculicides. However, since the targets for pediculicides have no been identified in human lice so far, their mechanisms of action remain largely unknown. The macrocyclic lactone ivermectin is active against a broad range of insects including human lice. Isoxazolines are a new chemical class exhibiting a strong insecticidal potential. They preferentially act on the γ-aminobutyric acid (GABA) receptor made of the resistant to dieldrin (RDL) subunit and, to a lesser extent on glutamate-gated chloride channels (GluCls) in some species. Here, we addressed the pediculicidal potential of isoxazolines and deciphered the molecular targets of ivermectin and the ectoparasiticide lotilaner in the human body louse species Pediculus humanus humanus. Using toxicity bioassays, we showed that fipronil, ivermectin and lotilaner are efficient pediculicides on adult lice. The RDL (Phh-RDL) and GluCl (Phh-GluCl) subunits were cloned and characterized by two-electrode voltage clamp electrophysiology in Xenopus laevis oocytes. Phh-RDL and Phh-GluCl formed functional homomeric receptors respectively gated by GABA and L-glutamate with EC50 values of 16.0 μM and 9.3 μM. Importantly, ivermectin displayed a super agonist action on Phh-GluCl, whereas Phh-RDL receptors were weakly affected. Reversally, lotilaner strongly inhibited the GABA-evoked currents in Phh-RDL with an IC50 value of 40.7 nM, whereas it had no effect on Phh-GluCl. We report here for the first time the insecticidal activity of isoxazolines on human ectoparasites and reveal the mode of action of ivermectin and lotilaner on GluCl and RDL channels from human lice. These results emphasize an expected extension of the use of the isoxazoline drug class as new pediculicidal agents to tackle resistant-louse infestations in humans.

Borrelia and Leptospira Species

Borrelia species (except Borrelia burgdorferi) cause relapsing fever, which is a zoonosis characterized by cyclic fevers alternating with periods of relative well-being. Endemic or tick-borne relapsing fever is caused by several Borrelia species associated with soft ticks of the genus Ornithodoros. Tick-spirochete specificity is useful for identifying Borrelia species. Epidemic or louse-borne relapsing fever is caused by Borrelia recurrentis. It is transmitted by the human body louse. Leptospirosis is a zoonosis of global distribution caused by infection with pathogenic spirochetes of the genus Leptospira. It is greatly underreported, particularly in tropical regions. Leptospirosis is maintained in nature by chronic renal infection of carrier animals that excrete the organism in their urine and contaminate the environment. Human infection occurs after direct contact with infected urine or tissues. Specific conditions related to these infections, their management, and treatment are reviewed.