Evaluation of metformin’s effect on the adult and juvenile stages of Schistosoma mansoni: an in-vitro study

Metformin (Met), a well-known anti-diabetic drug with a potent autophagy induction property, has been proven to be effective against several parasitic diseases. In the present in vitro study, the effect of Met on the viability and ultrastructure of Schistosoma mansoni adults and juveniles in comparison with the standard anti-schistosomal drug, praziquantel (PZQ), was investigated. Adults and juveniles were treated in vitro with 5 µM PZQ and/or 10 mM Met. The viability of the treated worms was screened over a three-day period by light microscopy and recorded as mortality rates (MR). The alterations in the ultrastructure were verified using scanning and transmission electron microscopy. Met showed significant anti-schistosomal activity against both adults and juveniles and resulted in severe tegumental damage in the form of loss of integrity and architecture, with evident vacuolation suggestive of increased autophagy. Met might be a potential drug either alone or as an adjuvant to PZQ for the treatment of schistosomiasis mansoni and warrant its further assessment in animal models of disease.