Fahmy Mennat-Elrahman Ahmed, Abdelaal Amany Ahmed, Hassan Soad Ismail, Shalaby Maisa Ahmed, Ismail Mousa Abdelgawad Mousa, Khairy Rasha Ahmed, Badawi Manal Abdelmaged, Afife Adam Ashraf, Fadl Hanaa Omar
Medical Parasitology Department, Theodor Bilharz Research Institute - TBRI, Giza, Egypt.
Medical Parasitology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Rev Bras Parasitol Vet. 2021 Nov 24;30(4):e012121. doi: 10.1590/S1984-29612021087. eCollection 2021.
The present work aims to investigate the antiparasitic and the immunomodulating effects of nitazoxanide (NTZ) and ivermectin (IVC) alone or combined together or combined with selenium (Se), on Cryptosporidium infection in diabetic mice. The results revealed that the combined NTZ and IVC therapy achieved the highest reduction of fecal oocysts (92%), whereas single NTZ showed the lowest reduction (63%). Also, adding Se to either NTZ or IVC resulted in elevation of oocyst reduction from 63% to 71% and from 82% to 84% respectively. All treatment regimens, with the exception of NTZ monotherapy, showed a significant improvement in the intestinal histopathology, the highest score was in combined NTZ and IVC therapy. The unique results of immunohistochemistry in this study showed reversal of the normal CD4/CD8 T cell ratio in the infected untreated mice, however, following therapy it reverts back to a normal balanced ratio. The combined (NTZ+ IVC) treatment demonstrated the highest level of CD4 T cell expression. Taken together, NTZ and IVC combined therapy showed remarkable anti-parasitic and immunostimulatory effects, specifically towards the CD4 population that seem to be promising in controlling cryptosporidiosis in diabetic individuals. Further research is required to explore other effective treatment strategies for those comorbid patients.
本研究旨在探讨硝唑尼特（NTZ）和伊维菌素（IVC）单独使用、联合使用或与硒（Se）联合使用对糖尿病小鼠隐孢子虫感染的抗寄生虫和免疫调节作用。结果显示，NTZ和IVC联合治疗使粪便卵囊减少率最高（92%），而单独使用NTZ时减少率最低（63%）。此外，在NTZ或IVC中添加Se分别使卵囊减少率从63%提高到71%，从82%提高到84%。除NTZ单一疗法外，所有治疗方案均使肠道组织病理学有显著改善，NTZ和IVC联合治疗的得分最高。本研究免疫组化的独特结果显示，未治疗的感染小鼠的正常CD4/CD8 T细胞比值发生了逆转，但治疗后又恢复到正常的平衡比值。联合（NTZ + IVC）治疗显示CD4 T细胞表达水平最高。综上所述，NTZ和IVC联合治疗显示出显著的抗寄生虫和免疫刺激作用，特别是对CD4群体，这似乎有望控制糖尿病个体的隐孢子虫病。对于那些合并症患者，还需要进一步研究以探索其他有效的治疗策略。
