Abstract
Cryptosporidiosis is a clinically significant opportunistic infection causing diarrhea especially among immunocompromised patients includes those with immunodeficiency syndrome and certain immunosuppressed patients undergoing chemotherapy, organ transplant recipients treated with drugs that suppress the immune system, and patients with autoimmune disorders. The aim of this study was to evaluate the potential antiparasitic effect of miltefosine, (a phospholipid drug used for the treatment of visceral and cutaneous leishmaniasis) in immunocompromised (Dexamethasone treated) mice infected with Cryptosporidium. Parasitological examination of feces for oocysts count was performed ten and twenty days after start of treatment. Histopathological examination of intestinal, liver and spleen sections was held. Results revealed no significant reduction in mean Cryptosporidium oocyst number detected in immunocompromised infected group ten days post treatment (1.44%). Twenty days post treatment showed statistical significant reduction (p<0.001) reaching (38.63 %) when compared to the mean oocysts counts of infected untreated immunosuppressed group of mice. Histopathological sections of small intestine, liver and spleen showed several degrees of inflammatory changes before treatment. In treated group with miltefosine no improvements of small intestinal photomicrographs were seen; in contrast, significant improvement was observed in liver and spleen histopathological sections. Ziehl–Neelsen acid-fast stain was originally undertaken for the detection of Cryptosporidium oocysts within intestinal mice tissue. In conclusion, oral administration of miltefosine in vivo showed moderate efficiency against cryptosporidiosis in immunocompromised infected mice.
Highlights
Cryptosporidium species are obligate. intracellular. protozoan parasites that infect the epithelial cells of the distal jejunum and ileum of vertebrates
(I) showing normal liver hexagons centered by central veins (Red arrow) miltefosine treated group (IIb) showing normal portal area with some interlobular inflammatory infiltrations (Red arrow) (400X). (200X), (B) immunocompromised group (IIa) showing sever inflammation (White arrows), sinusoidal dilatation and few liver cells damaged (Red arrow) (200X), (C) Masson Trichrome staining liver section of group (IIa) showing inflammatory cells (White arrow) and vacuolization no fibrosis found (Black arrow) (200X), (D) miltefosine treated group (IIb) showing normal portal area with some interlobular inflammatory infiltrations (Red arrow) (400X)
In another study the activity of miltefosine against C. parvum was demonstrated in vitro showing 78-98% inhibition of parasite at 45h post infection [24]. It seem that an intact immune system established a fair chemotherapeutic response, since treatment with miltefosine showed moderate effect in HIV –Ethiopian men with visceral leishmaniasis, initial treatment failure with miltefosine occurred in 18% of HIVinfected patients, compared with treatment failure in 5% of non– HIV-infected patients [25]
Summary
Cryptosporidium species are obligate. intracellular. protozoan parasites that infect the epithelial cells of the distal jejunum and ileum of vertebrates. Protozoan parasites that infect the epithelial cells of the distal jejunum and ileum of vertebrates. In immunocompetent individuals the disease is usually a self-limiting infection, but severe infection and diffusion to extra-intestinal sites or life-threatening can occur in high-risk individuals, such as the infant, children, and the old aged and in immunocompromised patients [1]. Cryptosporidium are spread by the ingestion of oocysts excreted by infected people or animals. Parasite development is relatively confined to the terminal jejunum and ileum yet, in immunosuppressed hosts the entire gastrointestinal tract as well as the biliary and pancreatic ducts may be infected and less frequently the respiratory tract [2]. The estimation of numerous chemotherapeutic agents as anti-cryptosporidial therapies to clear the host of these parasites is still limited [3]
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