Abstract
Giardiasis is an intestinal protozoal disease caused by Giardia lamblia. The disease became a global health issue due to development of resistance to commonly used drugs. Since many plant-derived products have been used to treat many parasitic infestations, we aimed to assess the therapeutic utility of Artemisia annua (A. annua) for giardiasis. We showed that NO production was significantly reduced whereas serum levels of IL-6, IFN-γ, and TNF-α were elevated in infected hamsters compared to uninfected ones. Additionally, infection resulted in increased numbers of intraepithelial lymphocytes and reduced villi heights, goblet cell numbers, and muscularis externa thickness. We also showed that inducible NO synthase (iNOS) and caspase-3 were elevated in the intestine of infected animals. However, treatment with A. annua significantly reduced the intestinal trophozoite counts and IEL numbers, serum IL-6, IFN-γ, and TNF-α, while increasing NO and restoring villi heights, GC numbers, and ME thickness. Moreover, A. annua treatment resulted in lower levels of caspase-3, which indicates a protective effect from apoptotic cell death. Interestingly, A. annua therapeutic effects are comparable to metronidazole. In conclusion, our results show that A. annua extract is effective in alleviating infection-induced intestinal inflammation and pathological effects, which implies its potential therapeutic utility in controlling giardiasis.
Highlights
We found that infection with G. lamblia (IGL group) cantly reduced nitric oxide (NO) compared to uninfected animals (UI)
Maloney et al reported an increased production of arginases by small intestinal macrophages during giardiasis [28]. In line with these data, we have shown reduction in serum NO end products (NOx) levels in animals infected with G. lamblia
The increase in resistance of G. lamblia to commonly used anti-giardia agents necessitates the development of novel therapeutics
Summary
Giardiasis is one of the most common human intestinal protozoal infections [1]. It is caused by Giardia lamblia (G. lamblia; known as Giardia duodenalis), which is a flagellated protozoan infecting the small intestine of humans and animals [2]. 280 million people worldwide are infected with G. lamblia annually [3]. The prevalence rates were estimated at 20–30% and 2–5% in developing and developed countries, respectively [4]. In Egypt, the prevalence rate of giardiasis ranges from 10 to 35%, making Egypt an endemic region according to the World Health Organization (WHO) [5,6,7,8]
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