Abstract
Giardiasis is an intestinal infection caused by ingestion of water or food contaminated with cysts of Giardia lamblia. Susceptibility is higher in children and overall prevalence can reach up to 90% in low-income areas, although outbreaks are also reported in developed countries. Both parasite and immune-mediated epithelial damage has been observed in vitro and in animal models. However, whether enterocytes are directly damaged during infection is not entirely known. Our goal was to identify whether plasma levels of intestinal fatty acid binding protein (I-FABP), a marker of enterocyte damage, are related to the immune response in giardiasis. Blood plasma was collected from 31 children (19 Giardia-positive) from a public day care in Rio de Janeiro, Brazil. The levels of I-FABP were increased in Giardia-infected children compared to children without detectable infection. There was no difference in I-FABP levels in giardiasis caused by different genetic assemblages of Giardia. Levels of IL-8 were decreased, while there was a trend to elevated IL-17 in the Giardia-positive children. A positive correlation was observed between I-FABP and IL-17 levels as well as TNF, suggesting that epithelial damage can be related to cytokine production during giardiasis. These results help elucidate the relationship between the disruption of the intestinal mucosal barrier and immune responses to G. lamblia in children.
Highlights
Giardiasis is a worldwide intestinal infectious disease caused by transmission of water or food contaminated with cysts of Giardia lamblia, and exhibits both anthroponotic and zoonotic transmission.The real incidence of giardiasis is likely underestimated, since asymptomatic and even symptomaticPathogens 2020, 9, 7; doi:10.3390/pathogens9010007 www.mdpi.com/journal/pathogensPathogens 2020, 9, 7 patients frequently do not seek care
In an observational study performed in a government-run day care in Rio de Janeiro city, we identified 19 children infected with G. lamblia and 12 without laboratory evidence of intestinal parasites
Considering that enterocyte damage has been implicated in increased intestinal permeability and microbial translocation into the circulation [13] we evaluated whether G. lamblia infection could increase intestinal fatty acid binding protein (I-FABP) levels, a known biomarker for damaged intestinal epithelial cells
Summary
Giardiasis is a worldwide intestinal infectious disease caused by transmission of water or food contaminated with cysts of Giardia lamblia, and exhibits both anthroponotic and zoonotic transmission.The real incidence of giardiasis is likely underestimated, since asymptomatic and even symptomaticPathogens 2020, 9, 7; doi:10.3390/pathogens9010007 www.mdpi.com/journal/pathogensPathogens 2020, 9, 7 patients frequently do not seek care. Giardiasis is a worldwide intestinal infectious disease caused by transmission of water or food contaminated with cysts of Giardia lamblia, and exhibits both anthroponotic and zoonotic transmission. The real incidence of giardiasis is likely underestimated, since asymptomatic and even symptomatic. Pathogens 2020, 9, 7 patients frequently do not seek care. The low sensitivity of microscopic detection methods, commonly utilized in middle and low-income areas, further contributes to underreporting. Global initiatives examining the etiology of diarrhea identified Giardia as the second most common pathogen detected among children 12–24 months old [1] and one of the top four contributors to stunting, globally [2]. In Brazil, we showed that the prevalence of Giardia can reach 78% [3]. Eight assemblages of G. lamblia (A to H) have been described based on genetic differences
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