Synergistic Effect of Focused Ultrasound and Albendazole Sulfoxide on Hydatid Cyst Protoscolices in Vitro

Background and Aim: Hydatid cyst is caused by the larval stage of Echinococcus granulosus. This zoonotic disease causes fatalities and economic losses worldwide. Surgical and chemical treatments may be harmful or ineffective. This study evaluated ultrasonic waves and albendazole sulfoxide’s synergistic effect on hydatid cyst protoscolices. Materials and Methods: Echinococcus protoscolices from the livers of naturally infected sheep were separated into four groups. One group was exposed to 12.5 and 25 µg/mL albendazole sulfoxide for 24 hours. Another group was exposed to ultrasonic waves for 5, 9, 12, and 18 seconds at the intensities of 5, 15, and 25 w/cm2, respectively. Another group was affected by ultrasound after 24 hours of Albendazole sulfoxide exposure. A control group was considered in each case. Mortality was assessed for each group and subgroup by observing protoscolices under a light microscope after adding 0.1% eosin. The data were analyzed in SPSS 23. Results and Conclusion: Ultrasound had a greater effect on the protoscolices’ mortality than albendazole sulfoxide and the lethality was associated with intensity (F = 64.467, P=0.001) and exposure duration (F=179.932, P=0.001). Ultrasound and albendazole sulfoxide together were more effective than either alone (P=0.037), resulting in 100% death in all subgroups impacted by the combination. Ultrasound alone can quickly destroy hydatid cyst protoscolices. Also, the synergistic effects of ultrasonic waves and albendazole sulfoxide make it possible to accomplish total protoscolices death with lower dosages of albendazole sulfoxide and shorter duration and lower intensity of ultrasonic irradiation.