Departamento de Ingenieria. Area Farmacia y Tecnologia Farmaceutica. Universidad Miguel Hernández de Elche, Elche, Spain.
Departamento de Farmacia y Tecnología Farmacéutica. Universidad de Valencia, Valencia, Spain.
Curr Top Med Chem. 2018;18(15):1287-1303. doi: 10.2174/1568026618666181002095314.
Giardia intestinalis infection causes enterocytes damage and loss of brush border of the epithelial cells of the intestine that leads to shortening of microvilli and altered epithelial barrier function. This pathology results in aqueous diarrhoea, steatorrhea, nausea, abdominal pain, vomiting and weight loss. However, most infections are asymptomatic. The main consequence of Giardia colonization is nutrients malabsorption. Several families of drugs with good efficacy are used for Giardia treatment, but sometime dosing regimens are suboptimal and emerging resistance begins to question their clinical value. Moreover, some of these drugs can cause side effects that result in patient discomfort and low adherence to the treatment. This paper reviews the drugs currently used for the treatment against Giardia: the mechanism of action, the efficacy, the normal dosing, side effects and in vitro and clinical studies. In addition, new therapies against Giardia such as those based on phytochemicals, Lactobacillus and nanotechnology are collected in this paper, trying to find the ideal treatment for this disease with maximum efficacy and minimum adverse effects.
肠道贾第鞭毛虫感染会导致肠上皮细胞的肠细胞损伤和刷状缘丢失，从而导致微绒毛缩短和上皮屏障功能改变。这种病理变化会导致水样腹泻、脂肪泻、恶心、腹痛、呕吐和体重减轻。然而，大多数感染是无症状的。贾第鞭毛虫定植的主要后果是营养物质吸收不良。有几类疗效较好的药物被用于贾第鞭毛虫的治疗，但有时剂量方案并不理想，而且新出现的耐药性开始质疑它们的临床价值。此外，这些药物中的一些会引起副作用，导致患者不适和治疗依从性低。本文综述了目前用于治疗贾第鞭毛虫的药物：作用机制、疗效、常规剂量、副作用以及体外和临床研究。此外，本文还收集了一些针对贾第鞭毛虫的新疗法，如基于植物化学物质、乳杆菌和纳米技术的疗法，试图找到一种疗效最佳、副作用最小的理想治疗方法。
