atovaquone / Generic mfg. - LARVOL DELTA

Self-Delivery Nanotherapeutics for Tumor Low-Temperature Photothermal Immunotherapy through Cascade Heat Shock Protein and Inflammation Inhibition. (PubMed, ACS Appl Mater Interfaces) - "To address these challenges, we developed a multifunctional immunophotothermal nanoplatform (IAC NPs) through rational engineering of human serum albumin for combinatorial delivery of indocyanine green as a photothermal converter, atovaquone for HSP70-mediated thermoresistance blockade, and celecoxib for COX-2/PGE2 pathway inhibition. In vivo, the IAC NPs mediated profound suppression of both primary tumors and metastatic dissemination while exhibiting optimal biocompatibility for clinical translation. Our work validates a nanoenabled self-delivery system that augments the efficacy of LTPTT immunotherapy against TNBC by orchestrating coordinated inhibition of HSPs and inflammatory responses."

IO biomarker • Journal • Breast Cancer • Oncology • Solid Tumor • Triple Negative Breast Cancer • CD4 • CD8

MSN/STAT3 drives cancer stemness and chemoresistance via IL-6/LPAR1 ligand receptor complex in triple-negative breast cancer. (PubMed, Breast Cancer Res) - "Our findings uncover the critical role of MSN in regulating STAT3-mediated cancer stemness via the IL-6/NF-κB signaling axis. These results provide a strong rationale for repositioning STAT3 inhibitors such as Atovaquone as a therapeutic strategy in Adriamycin-resistant TNBC patients exhibiting pSTAT3-MSN complex upregulation."

Journal • Breast Cancer • Oncology • Solid Tumor • Triple Negative Breast Cancer • CDC42 • IGF1 • IL6 • MSN • STAT3

Panhypopituitarism and Arginine-vasopressin Deficiency in a Case of Toxoplasma Encephalitis Secondary to AIDS (ENDO 2025) - "The patient was started on a 6-week regimen of Atovaquone, Leucovorin, and Pyrimethamine...At 8 weeks post-presentation, he continued to require substitution with desmopressin, at a decreased dose compared to initially, corticosteroids, and levothyroxine... The incidence of toxoplasmic encephalitis (TE) has significantly declined with the advancement of antiretroviral therapy. However, untreated or undiagnosed HIV-positive patients remain at high risk, with up to 30% developing TE. A high clinical suspicion of endocrine deficiencies in such cases is essential for timely diagnosis and treatment."

Clinical • CNS Disorders • Endocrine Disorders • Human Immunodeficiency Virus • Hypotension • Infectious Disease • Ophthalmology • Pneumonia • Respiratory Diseases • CD4 • IGF1

Management of human babesiosis - approaches and perspectives. (PubMed, Expert Rev Anti Infect Ther) - "Most cases of human babesiosis are successfully treated with atovaquone plus azithromycin or clindamycin plus quinine. Two immediate goals are, (i) to develop new antimicrobial agents that target Babesia spp. through novel mechanisms and can overcome resistance to currently recommended antimicrobial agents and, (ii) to gain a better understanding of the efficacy of red blood cell exchange transfusion and indications for its use."

Journal • Review

Oxygen-Enhanced Multispectral Optoacoustic Tomography for Assessment of Atovaquone-Mediated Hypoxia Alleviation in Pediatric Tumors (SNMMI 2025) - "The EC50 of AVO was 18.2 ± 3.8 µM and 28.6 ± 8.3 µM in D425 and A-204 respectively (Figure 1A). OCR measurements in A-204 cells showed that AVO effectively inhibited oxidative phosphorylation (OXPHOS) near the EC50 (Figure 1B). OE-MSOT effectively traced spatiotemporal changes in tumor oxygen saturation (ΔsO2)."

Clinical • Brain Cancer • Medulloblastoma • Oncology • Pediatrics • Solid Tumor

Oxygen-Enhanced Multispectral Optoacoustic Tomography for Assessment of Atovaquone-Mediated Hypoxia Alleviation in Pediatric Tumors (SNMMI 2025) - "The EC50 of AVO was 18.2 ± 3.8 µM and 28.6 ± 8.3 µM in D425 and A-204 respectively (Figure 1A). OCR measurements in A-204 cells showed that AVO effectively inhibited oxidative phosphorylation (OXPHOS) near the EC50 (Figure 1B). OE-MSOT effectively traced spatiotemporal changes in tumor oxygen saturation (ΔsO2)."

Clinical • Brain Cancer • Medulloblastoma • Oncology • Pediatrics • Solid Tumor

Pneumocystis pneumonia in a patient receiving nab-paclitaxel plus gemcitabine for unresectable pancreatic cancer: A case report. (PubMed, Intern Med) - "We herein report the first case of pneumocystis pneumonia (PCP) in a 78-year-old man with unresectable pancreatic head cancer who was treated with nab-paclitaxel plus gemcitabine. After treatment with corticosteroids and trimethoprim/sulfamethoxazole, the patient's general condition improved, followed by atovaquone. The administration of corticosteroids to prevent chemotherapy-induced nausea and vomiting (CINV) and lymphocytopenia due to chemotherapy may be therefore involved in the development of PCP."

Journal • Chemotherapy-Induced Nausea and Vomiting • Hematological Disorders • Infectious Disease • Oncology • Pancreatic Cancer • Pneumonia • Respiratory Diseases • Solid Tumor

Efficacy and mechanism of action of cipargamin as an antibabesial drug candidate. (PubMed, Elife) - "Resistant strains showed no significant cross-resistance to atovaquone or tafenoquine succinate (TQ), with less than a onefold change in IC50 values. Combining CIP with TQ effectively eliminated B. microti infection in SCID mice with no relapse, and parasite DNA was not detected by qPCR within 90 days post-infection. Our findings reveal the efficacy of CIP as an antibabesial agent, its limitations as a monotherapy due to resistance development, and the potential of combination therapy with TQ to overcome said resistance and achieve complete parasite clearance."

Journal • Infectious Disease

From Tick Bite to Broken Heart: A Case of Stress Cardiomyopathy Induced by Severe Babesiosis. (PubMed, Cureus) - "Despite treatment with atovaquone and azithromycin, her clinical status deteriorated, necessitating exchange transfusion, mechanical ventilation for respiratory failure, and hemodynamic support with inotropes and vasopressors for refractory cardiogenic shock. Echocardiography confirmed Takotsubo cardiomyopathy, which resolved with appropriate treatment. This case underscores the diagnostic complexity and potential severity of babesiosis, highlighting the importance of maintaining a high index of suspicion and initiating prompt therapy to prevent serious complications."

Journal • Cardiomyopathy • Cardiovascular • Fatigue • Hematological Disorders • Infectious Disease • Lyme Disease • Respiratory Diseases

Anti-Parasitic Activity of Azaindole Compounds on Babesia duncani, a Causative Agent of Human Babesiosis (ASM Microbe 2025) - "Building upon these results,synergistic testing of compound 18 with atovaquone, azithromycin, clindamycin, and quininerevealed enhanced anti-parasitic effects in certain combinations. These findings provide a basisfor further exploration of azaindole-based therapies in combating babesiosis.Keywords: Babesiaduncani, babesiosis, azaindole, anti-parasitic compounds, novel therapies"

Infectious Disease • Malaria

Clinically applicable parasite viability assay for rapid assessment of antimalarial pharmacodynamic endpoints. (PubMed, Antimicrob Agents Chemother) - "In this study, the accuracy of direct viability assessment (DVA) of the parasite using MT staining was compared with the previously established PRR assay to evaluate the efficacy of four reference antimalarial drugs (dihydroartemisinin, chloroquine, atovaquone, and pyrimethamine) using P. falciparum 3D7 strain. In conclusion, the DVA relies on specialized equipment and technical expertise. However, it can emerge as an alternative to the PRR, offering a faster and more clinically suited approach for studies."

Journal • PK/PD data • Infectious Disease • Malaria

A propidium iodide-based in vitro screen of the "Bug Box" against Babesia duncani reveals potent inhibitors. (PubMed, Antimicrob Agents Chemother) - "A screen of the 41-compound library Structural Genomics Consortium Bug Box was conducted, yielding five hits: trimethoprim, atovaquone, SDDC M7, diphenyleneiodonium chloride, and panobinostat. Dose-response testing of structurally related compounds revealed multiple potential leads, including nanatinostat and quisinostat, both of which were potent at the nanomolar level and showed favorable selectivity index in cytotoxicity studies. High-throughput screening using PI and 384-well plates is an advance in drug discovery for babesiosis, and HDAC inhibitors show promise as lead compounds worthy of further investigation."

Journal • Preclinical • Infectious Disease

Risk Factors for Pneumocystis jirovecii Pneumonia in Rheumatoid Arthritis: The Protective Potential of Salazosulfapyridine. (PubMed, Int J Rheum Dis) - "Patients with RA complicated by interstitial pneumonia are at a higher risk of developing PCP. Although methotrexate and b/tsDMARDs do not increase the risk of developing PCP, SASP may potentially reduce the risk. A prospective study is warranted to investigate the efficacy and safety of SASP in patients with RA at high risk for PCP."

Journal • Retrospective data • Immunology • Infectious Disease • Inflammatory Arthritis • Interstitial Lung Disease • Pneumonia • Respiratory Diseases • Rheumatoid Arthritis • Rheumatology

Enhancing Adherence to Prophylaxis and Pre-Administration Screening Protocols for Rituximab Infusions in the Renal Assessment Unit ( RAU) (UKKW 2025) - "We prescribe antibiotic prophylaxis with co-trimoxazole or atovaquone to prevent the risk of pneumocystis Jirovecii pneumonia infection. Targeted simple interventions, which included implementing the pre-infusion checklist and educating the multidisciplinary team, including prescribers, nursing staff, and pharmacists, initially resulted in significant improvement. However, this was not sustained. This has highlighted the need for ongoing regular education and training, which have now been implemented."

Adherence • Clinical • Glomerulonephritis • Hepatology • Human Immunodeficiency Virus • Infectious Disease • Inflammation • Lupus Nephritis • Nephrology • Pneumonia • Respiratory Diseases • Tuberculosis

The Thienopyrimidinone Gamhépathiopine Targets the QO Site of Plasmodium falciparum Cytochrome b. (PubMed, ACS Infect Dis) - "Cross-resistance profiling and docking studies indicate that gamhépathiopine occupies a similar, but not identical, binding pose to the established QO-targeting antimalarial atovaquone. The implications of these findings for the future development of gamhépathiopine are discussed."

Journal • Infectious Disease • Malaria

Babesiosis-Induced Hemophagocytic Lymphohistiocytosis Following Spontaneous Splenic Rupture in a Florida Resident: A Case Report. (PubMed, Cureus) - "The patient responded well to atovaquone and azithromycin, with complete resolution of HLH symptoms and laboratory abnormalities. This case highlights the necessity for clinical vigilance, the integration of travel history into diagnostic evaluations, and the potential for fatal outcomes if babesiosis-induced HLH is not promptly diagnosed and treated. Increased awareness and training for clinicians in non-endemic regions, as well as public health measures, are essential to improving outcomes."

Journal • Hematological Disorders • Hemophagocytic lymphohistiocytosis • Immunology • Infectious Disease • Rare Diseases • Septic Shock • Thrombocytopenia

Identifying antimalarials that disrupt malaria parasite transmission when fed to the mosquito. (PubMed, Int J Parasitol) - "Azithromycin, an antibiotic targeting apicoplast protein synthesis, significantly lowered sporozoite infectivity in mice. T111, a next generation compound targeting the parasite electron transport chain, reduced sporozoite numbers in P. berghei at equivalent concentrations to the gold standard electron transport chain inhibitor, atovaquone...Our findings suggest that several antimalarials can be used to target mosquito-stage parasites via sugar baits and limit malaria transmission. Importantly, mosquito feeding of antimalarials could vastly increase the range of potentially useful parasiticidal compounds to include those failing to meet the exacting standards required for human antimalarial drugs, potentially improving malaria control for minimal cost."

Journal • Infectious Disease • Malaria

Developing Novel Therapies Against Endometriosis Through Inhibition of Oxidative Phosphorylation (WCE 2025) - "Atovaquone is extensively used to treat malaria in humans and is therefore an excellent agent to consider for the treatment of endometriosis. The metabolic adaptations by the OXPHOS inhibitor-treated endometriotic cells may provide additional targets for drug development."

Endometriosis • Gynecology • Infectious Disease • Malaria • Women's Health

Inner-mitochondrial membrane protein PfMPV17 is linked to P. falciparum in vitro resistance to the indoloquinolizidine alkaloid alstonine. (PubMed, J Antimicrob Chemother) - "These data demonstrate that PfMPV17 is linked to alstonine resistance and suggest that alstonine action is linked to the mitochondria and/or pyrimidine biosynthesis pathways."

Journal • Preclinical • Infectious Disease • Malaria

Cohabitating in the City: A Case of Hemolytic Anemia in a Patient Coinfected With Babesiosis, Lyme Disease, and Mononucleosis. (PubMed, Cureus) - "Treatment with doxycycline and valganciclovir was started, as IgM antibodies were positive for Lyme disease and cytomegalovirus (CMV). Due to worsening symptoms and clinical deterioration, the treatment was broadened with azithromycin and atovaquone, after which the patient experienced significant clinical and paraclinical improvement. Further studies revealed active babesiosis and EBV infection, besides a negative CMV viral load, indicating a false-positive initial result. After finishing treatment for babesiosis and Lyme disease, the patient recovered completely and remains asymptomatic to this day. Diagnosing active babesiosis, Lyme, and EBV coinfection was challenging because of the absence of erythema migrans, lack of apparent tick exposure history, and concerns for cross-reactivity. To the best of our knowledge, this is one of the first cases of coinfection among these three pathogens reported in medical literature."

Journal • Anemia • Autoimmune Hemolytic Anemia • Cytomegalovirus Infection • Dermatology • Epstein-Barr Virus Infections • Fatigue • Hematological Disorders • Immunology • Infectious Disease • Inflammatory Arthritis • Lyme Disease • Musculoskeletal Pain • Pain • Rheumatology

Ex Vivo Drug Susceptibility of Plasmodium malariae Isolates to Antimalarial Drugs in Gabon. (PubMed, Pathogens) - "The mean concentrations required to inhibit 50% of growth (IC50) with chloroquine (n = 21), artesunate (n = 20), atovaquone (n = 21), and lumefantrine (n = 14) were 7.2 nM, 2.7 nM, 3.1 nM, and 7.4 nM, respectively. Our study provides novel data on the ex vivo susceptibility of P. malariae to several key antimalarials, including the first dataset for atovaquone."

Journal • Preclinical • Infectious Disease • Malaria

Leptospira(ls) to Pulmonary Hemorrhage (ATS 2025) - "The patient was started on doxycycline, atovaquone, and azithromycin for concern of tickborne illness...Given the severity of his disease and initial lack of improvement, the patient was administered ceftriaxone, while continuing doxycycline...Initially, bronchoscopy was considered, however, given that the patient improved clinically with antibiotic therapy, it was deferred. Our patient was fortunate to have complete recovery with appropriate therapies, as leptospirosis presenting with DAH carries a mortality rate of >70%.2 This case demonstrates the importance of considering leptospirosis amongst the differential diagnoses for pulmonary hemorrhage, regardless of exposure endorsement."

Acute Kidney Injury • Back Pain • Barrett Esophagus • Gastrointestinal Disorder • Hematological Disorders • Hepatology • Infectious Disease • Musculoskeletal Pain • Pain • Renal Disease • Thrombocytopenia

Splenic Infarction in Babesiosis: What Happens in the Caribbean Should Stay in the Caribbean (ATS 2025) - "Babesia species infection was confirmed with PCR, prompting initiation of azithromycin and atovaquone...At this time, doxycycline was empirically added, although he eventually tested negative for all other tick-borne illnesses...Interestingly, 42% of the 34 cases of splenic complications did not report abdominal pain, which is consistent with the painless presentation of our patient. The low incidence of splenic complications, a lack of correlation between parasitemia level and splenic injury, and the inconsistent manifestation of abdominal pain in these patients should highlight the need to maintain a high level of suspicion and the need to obtain abdominal imaging in a patient with Babesiosis who becomes clinically unstable."

Acute Kidney Injury • Cardiomyopathy • Cardiovascular • Diabetes • Fatigue • Genito-urinary Cancer • Hepatology • Infectious Disease • Metabolic Disorders • Nephrology • Pain • Prostate Cancer • Renal Disease • Septic Shock • Solid Tumor

A Case of Acute Liver Failure Secondary to Profound Babesia in a Patient With No Known Liver Disease (ATS 2025) - "He was started on atovaquone, azithromycin, and doxycycline, and transferred to a tertiary care center for consideration of exchange transfusion given his significant parasite burden and clinical deterioration. Infections in immunocompetent hosts are rare and only a handful of case reports with kidney and liver failure exist. As these infections increase, further familiarity and understanding of those with severe disease is necessary."

Clinical • Anemia • Fibrosis • Heart Failure • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Liver Failure • Pain

Hemophagocytic Lymphohistiocytosis (HLH) Triggered by a Tick Bite in a Patient With Undiagnosed T-cell Lymphoma (ATS 2025) - "She was started on atovaquone and azithromycin for possible babesiosis and doxycycline for ehrlichiosis. A few days after her death, a Karius test returned positive for Ehrlichia chaffeensis, confirming the final diagnosis of HLH secondary to Ehrlichiosis in the setting of previously undiagnosed T-cell lymphoma.DiscussionCompared to other triggers, HLH associated with lymphoma have worse prognosis than those associated with infection or malignancy.2 This case illustrates the complexity of HLH when triggered by both an infectious agent, Ehrlichiosis, and undiagnosed malignancy. Nonetheless, this highlights the importance of having a high clinical suspicion for HLH and consideration of co-infection with tick-borne illness in patient from endemic areas to guide appropriate and timely treatment."

Clinical • Atypical Hemolytic Uremic Syndrome • Cardiovascular • CNS Disorders • Dyslipidemia • Hematological Disorders • Hematological Malignancies • Hemophagocytic lymphohistiocytosis • Hypertension • Hypertriglyceridemia • Immunology • Infectious Disease • Lymphoma • Musculoskeletal Pain • Nephrology • Oncology • Pain • Rare Diseases • Renal Disease • Sjogren's Syndrome • T Cell Non-Hodgkin Lymphoma • Thrombocytopenia • Thrombocytopenic Purpura • TNFRSF8