Efficacy of nitazoxanide, ivermectin and albendazole in treatment of cryptosporidiosis in immunosuppressed mice

Abstract

Cryptosporidiosis is one of the main causes of fatal watery diarrhea, especially in immunocompromised patients worldwide. Although nitazoxanide (NTZ) is the only effective FDA approved drug for cryptosporidiosis, it is partially effective in immunocompromised patients. So, there is an urgent need for new alternatives for treating cryptosporidiosis in those patients. The present study aims to assess the efficacy of ivermectin (IVM) and albendazole (ALB) as compared to NTZ and their combinations in treatment of cryptosporidiosis in immunosuppressed infected mice. Mice were divided into 7 groups (G) with 10 mice each; GI: treated with NTZ. GII: treated with IVM. GIII: treated with ALB. GIV: treated with combined NTZ and IVM. GV: treated with combined NTZ and ALB. GVI: non-infected non-treated (negative control). GVII: infected non-treated (positive control). Parasitological, histopathological, and immunological studies were done for all studied groups. The combined therapy of NTZ and IVM showed the best results in reducing the oocysts shedding (reduction rate of 91.9%), healing the histopathological inflammatory changes of ileum, in addition to enhancing the cellular immune response by marked elevation of serum INF-γ levels as compared to the other treatment regimens. Therefore, we concluded that this synergistic combination is promising in controlling cryptosporidiosis in immunocompromised patients.

Keywords: Albendazole; Cryptosporidiosis; Cryptosporidium; Ivermectin; Nitazoxanide.