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Until recently, most have never heard of the drug ivermectin. However, the drug has been on the commercial market since , when it was originally approved for its multi-purpose use in animal health. The drug is primarily used to treat and prevent parasitic infections in animals such as cows and horses, but it is also used in smaller doses as the main compound in preventing heartworm infections in dogs and cats.
Discovered in the late-s, ivermectin is a dihydro derivative of avermectin&#;originating solely from a single microorganism isolated at the Kitasato Institute, in Tokyo, Japan. The isolated bacterium was discovered in Japanese soil by Satoshi Ōmura, a microbiologist, who was looking to find possible new antibacterial compounds. The newly discovered bacteria was labeled Streptomyces avermictilis. The active component, named avermectin, was chemically modified to increase its activity and its safety. The resulting compound, ivermectin, was shown to be effective against parasites and worms. Therefore, it soon became a top-selling veterinary drug in the world. Remarkably, despite decades of searching, Streptomyces avermictilis remains the only source of avermectin ever found.
In , after clinical studies, ivermectin was approved for human use. Similar to the same uses for animals, the drug is almost exclusively used to treat tropical diseases like intestinal strongyloidiasis and onchocerciasis, two conditions caused by parasitic worms. In addition, some topical forms of ivermectin are approved to treat external parasites like head lice and for skin conditions such as rosacea. While these may be rare conditions here in the United States, and other first-world countries, parasitic infections like the ones mentioned are common in places like Latin America and Africa. Since its approval for human use, the drug treatment has improved the lives of billions of people across the world &#; particularly in hot, wet climates where soil-based infections are a regular threat.
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In many ways, ivermectin has been applauded as a &#;wonder drug&#; as it has significantly improved the well-being of communities in rural poor areas within tropic environments. The excitement surrounding ivermectin has to do with both the direct and indirect beneficial impact on improving community health. Studies of long-term treatment with ivermectin to control specific parasitic diseases like, onchocerciasis has shown that use of the drug is associated with a significant reduction in the likelihood of infection with any soil-transmitted helminth parasites (including Ascaris, Trichuris, and hookworm), &#;most or all of which are deemed to be major causes of the morbidity arising from poor childhood nutrition and growth.&#;
While the FDA has a limited scope of what the avermectin derivative drug is currently approved for, studies continue to be funded and tested in an effort to explore other possible uses for ivermectin, including being a potential treatment for malaria. In its over 30 years since human approval, the drug has shown to have a positive safety profile which may be attributed to its high affinity to invertebrate neuronal ion channels and its inability to cross the blood-brain barrier in humans.
When given in highly specific doses, and overseen by a medical professional, ivermectin shows few adverse effects on human subjects. Due to these encouraging signs, the compound is being explored for possible off-label uses due to its anti-parasitic and anti-inflammatory properties.
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