Evaluation of the role of combined prebiotic and probiotic supplements as prophylactic and therapeutic agents against experimental giardiasis

Abstract

Background: Giardiasis is considered as one of the most prevalent gastrointestinal parasitic infectionsworldwide. Most of the used anti-Giardia drugs may cause side effects and are often associated withclinical failure and drug resistance. Prebiotic and probiotic therapy has been posited as potential naturaltherapeutic agent for many parasitic diseases.Objective: To evaluate the effect of combined prebiotic and probiotic therapy as a natural supplement andafter addition to nitazoxanide (NTZ) in treatment of giardiasis in murine model.Material and Methods: Ninety-six laboratory bred Swiss albino male mice were used. Mice were dividedinto three main groups that included 16 subgroups (6 mice each). Control group (A1-7) included controlnegative (non-infected non-treated), control positive (infected non-treated), and another five controlsubgroups (SGs) that received natural prebiotic and probiotic supplements and NTZ. Prophylactic group (B)included three SGs in which infected mice received prebiotic and probiotic separately and in combinationfor one week before infection and continued till the end of experiment. Infected treated group (C1-6)composed of six infected SGs that received treatment by prebiotic and probiotic separately, and combinedprebiotic/probiotic, NTZ alone (full dose), and after addition of combined supplement to NTZ (half orfull dose). Evaluation was achieved using parasitological, histopathological, immunohistochemical, andimmunological parameters.Results: There was significant reduction of Giardia cyst shedding in all prophylactic and infected treatedSGs. The highest mean cyst reduction was observed in group C after addition of combined supplementto NTZ post infection (PI) and in group B receiving prophylactic combined supplement. Remarkableimprovement of histopathological findings was observed especially in group C after receiving combinedsupplement in addition to NTZ, followed by other prophylactic and infected treated SGs. The resultsof immunohistochemical caspase 3 expression revealed that combined supplement was effective inpreventing apoptotic cell death of intestinal cells that is induced by giardiasis especially after addition ofcombined supplement to NTZ in group C. Immunological assessment of interleukin-6 (IL-6) level showedsignificant increase in all treated SGs with boosted elevation in combined supplement after addition toNTZ in group C.Conclusion: Combined prebiotic and probiotic products can be considered as good prophylactic andtherapeutic agents when added to NTZ against giardiasis.