Pomegranate Peel Extract Is a Potential Alternative Therapeutic for Giardiasis.

Asmaa M El-Kady,Sheren F M Ahmed,Taghrid Istivan,Iman A M Abdel-Rahman,Heba A Osman,Samer S Fouad,Hatem A Elshabrawy,Al Shaimaa Hasan,Khaled S Allemailem

doi:10.3390/antibiotics10060705

Asmaa M El-Kady, Sheren F M Ahmed + Show 7 more

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https://doi.org/10.3390/antibiotics10060705

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Abstract

Giardiasis is a major diarrheal disease affecting approximately 2.5 million children annually in developing countries. Several studies have reported the resistance of Giardia lamblia (G. lamblia) to multiple drugs. Therefore, identifying an effective drug for giardiasis is a necessity. This study examined the antiparasitic effect of Punica granatum (pomegranate) and evaluated its therapeutic efficacy in rats infected with G. lamblia. In vitro study showed high efficacy of pomegranate peel ethanolic extract in killing G. lamblia cysts as demonstrated by eosin vital staining. We showed that treating infected rats with pomegranate extract resulted in a marked reduction in the mean number of G. lamblia cysts and trophozoites in feces and intestine respectively. Interestingly, the number of G. lamblia trophozoites and cysts were significantly lower in the pomegranate extract-treated group compared to the metronidazole-positive control group. Moreover, pomegranate extract treatment significantly induced nitric oxide (NO) and reduced serum IL-6 and TNF-α, compared to infected untreated rats. Histological and scanning electron microscopy (SEM) examination of the jejunum and duodenum of pomegranate extract-treated animals confirmed the antiparasitic effect of the extract, and demonstrated the restoration of villi structure with reduction of villi atrophy, decreased infiltration of lymphocytes, and protection of intestinal cells from apoptotic cell death. In conclusion, our data show that the pomegranate peel extract is effective in controlling G. lamblia infections, which suggests that it could be a viable treatment option for giardiasis.

Highlights

Giardiasis, caused by Giardia lamblia (G. lamblia), has been considered the second-most common cause of infectious diarrhea in humans after viral diarrhea [1]
We show that incubation of Giardia cysts with different concentrations of pomegranate extract resulted in a significant increase in the percentage of dead Giardia cysts, which was dose- and time-dependent (p < 0.001)
We showed that the pomegranate extract is effective in killing G. lamblia cysts, which is in agreement with previous studies [31–36]

Summary

Introduction

Giardiasis, caused by Giardia lamblia (G. lamblia), has been considered the second-most common cause of infectious diarrhea in humans after viral diarrhea [1]. According to the World Health Organization (WHO), G. lamblia is one of the most common intestinal parasites affecting Eastern Mediterranean and African children and is included in the WHO’s Neglected Disease Initiative [2]. It causes approximately 2.5 million cases of childhood diarrhea annually in developing countries [3,4]. G. lamblia is typically transmitted by exposure to contaminated water and food and could remain asymptomatic or become symptomatic with a wide range of clinical symptoms [7–9]. Other complications of giardiasis include weight loss, malabsorption, and growth retardation [10,11]. Giardiasis is a common cause of chronic diarrhea and growth retardation in children [12]

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