Department of Clinical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
Naunyn Schmiedebergs Arch Pharmacol. 2021 Sep;394(9):1869-1878. doi: 10.1007/s00210-021-02124-z. Epub 2021 Jul 29.
Giardia duodenalis is a common cause of infection in children and travelers. The most frequent symptom is diarrhea in these patients. G. duodenalis trophozoites use a highly specialized adhesive disc to attach the host intestinal epithelium to induce intestinal damages. Pathological features of the small intestine following giardiasis include villous atrophy; infiltration of granulocytes, lymphocytes, and plasma cells into the lamina propria; and nodular lymphoid hyperplasia. The disturbed intestinal microbiota has been observed in patients with giardiasis. Therefore, a growing body of evidence has emphasized restoring the gut microbiome by probiotics in giardiasis. This study aimed to review the literature to find the pathologic features of giardiasis and its relationship with imbalanced microbiota. Then, benefits of probiotics in giardiasis and their potential molecular mechanisms were discussed. It has been illustrated that using probiotics (e.g., Lactobacillus and Saccharomyces) can reduce the time of gastrointestinal symptoms and repair the damages, particularly in giardiasis. Probiotics' capability in restoring the composition of commensal microbiota may lead to therapeutic outcomes. According to preclinical and clinical studies, probiotics can protect against parasite-induced mucosal damages via increasing the antioxidant capacity, suppressing oxidative products, and regulating the systemic and mucosal immune responses. In addition, they can reduce the proportion of G. duodenalis load by directly targeting the parasite. They can destroy the cellular architecture of parasites and suppress the proliferation and growth of trophozoites via the production of some factors with anti-giardial features. Further researches are required to find suitable probiotics for the prevention and treatment of giardiasis.
十二指肠贾第鞭毛虫是儿童和旅行者感染的常见原因。这些患者最常见的症状是腹泻。贾第鞭毛虫滋养体使用高度专业化的粘性盘附着在宿主肠上皮上，诱导肠道损伤。贾第虫病后的小肠病理学特征包括绒毛萎缩；粒细胞、淋巴细胞和浆细胞浸润固有层；和结节性淋巴组织增生。在贾第虫病患者中观察到肠道微生物群失调。因此，越来越多的证据强调通过益生菌恢复贾第虫病中的肠道微生物组。本研究旨在回顾文献，寻找贾第虫病的病理特征及其与失衡微生物群的关系。然后，讨论了益生菌在贾第虫病中的益处及其潜在的分子机制。已经表明，使用益生菌（例如，乳酸杆菌和酿酒酵母）可以减少胃肠道症状的时间并修复损伤，特别是在贾第虫病中。益生菌恢复共生微生物群组成的能力可能导致治疗效果。根据临床前和临床研究，益生菌可以通过增加抗氧化能力、抑制氧化产物和调节全身和粘膜免疫反应来保护免受寄生虫引起的粘膜损伤。此外，它们可以通过直接针对寄生虫来减少十二指肠贾第鞭毛虫负荷的比例。它们可以通过产生具有抗贾第虫特征的一些因子来破坏寄生虫的细胞结构并抑制滋养体的增殖和生长。需要进一步研究以找到适合预防和治疗贾第虫病的益生菌。
