Saccharomyces boulardii inhibits the expression of pro-inflammatory cytokines and inducible nitric oxide synthase genes in the colonic mucosa of rats experimentally-infected with Blastocystis subtype-3 cysts.

Blastocystis spp. is the most frequent infectious unicellular, luminal parasite in all species of animals and humans. It has been linked to diarrhoea and irritable bowel syndrome. Saccharomyces boulardii (Sb) is a widely used probiotic that previously showed efficacy against several intestinal pathogens. The aim of this study was to investigate the therapeutic role of Sb on Blastocystis spp. Methods: Five groups of Blastocystis subtype-3 infected rats were treated with either live Sb alone, metronidazole (MTZ) alone, Sb extract, both Sb and MTZ, or placebo-treated besides the noninfected control group. Assessment of treatment effectiveness was done by study of parasitological cure rate, histopathological effect and analysis of the colonic mucosal level of mRNAs expressions for the proinflammatory cytokines interleukin-6 (IL-6), IL-8, tumour necrosis factor alpha (TNF-α) and Inducible nitric oxide synthase (iNOS) by real-time reverse transcription-polymerase chain reaction (real-time RT-PCR). Results showed that live Sb significantly improved the histological characteristics and decreased the cytokines and iNOS in the colonic mucosa. Co-administration of live Sb together with MTZ gave a better effect than other treatments and had early efficacy and revealed a 100% reduction of the parasite stages from both the stool and intestinal wash fluid.

Chemical analysis of aqueous extracts of Origanum majorana and Foeniculum vulgare and their efficacy on Blastocystis spp. cysts.

BACKGROUND: Origanum majorana (O. majorana) and Foeniculum vulgare (F. vulgare) are traditionally used herbs in Egypt for treatment of several diseases including parasitic diseases. The Purpose was to determine the efficacy of O. majorana and F. vulgare aqueous extracts (AEs) on Blastocystis spp. in vitro, and to reveal their phenolic, flavonoids components and antioxidant activities through chemical analysis. METHODS: The Efficacy of both plant AEs on human Peripheral Blood Mononuclear Cells (PBMCs) viability was assessed using MTT assay. Isolated Blastocystis spp. cysts from patients' diarrhea samples were incubated with different concentrations of O. majorana and F. vulgare AEs for different incubation periods (24, 48 and 72 h) in comparison with nitazoxanide (NTZ) as a drug control. The total contents of phenolic and flavonoid compounds in the AEs and their ability to reduce DPPH were assessed. High performance liquid chromatography (HPLC) analysis for quantitative and qualitative determination of the phenolic and flavonoid contents was performed. RESULTS: O. majorana AE at a dose of 400 µg /ml showed efficacy rates of 96% and 100% against Blastocystis parasite after 48 and 72 h, respectively, which nearly equivalent to NTZ at a dose of 500 µg/ml. F. vulgare at a dose of 250 µg/ml showed less efficacy rate of 56.4% after 48 h and increased to 70.7% after 72 h. Both extracts contain high phenolic and flavonoid compounds that possess antioxidant and free radical scavenging activities. CONCLUSION: O. majorana and F. vulgare AEs showed dose and time dependent anti-Blastocystis activity.

Chemical analysis and giardicidal effectiveness of the aqueous extract of Cymbopogon citratus Stapf.

Searching for new effective and safe treatment of Giardia lamblia (G. lamblia) parasite is mandatory. The aim was to evaluate the in vitro and in vivo effectiveness of an aqueous extract prepared from the leaves of Cymbagogon citratus (CcAE) against G. lamblia and to reveal the phenolic and antioxidant properties of CcAE. METHODS: CcAE (25, 50, 100, 200, 400, and 500 µg/ml) was in vitro incubated with G. lamblia trophozoites in comparison with metronidazole (MTZ 10 and 25 µg/ml). Growth inhibition was evaluated after 3, 24, and 48 h of drug exposure. Infected groups of mice were orally treated for 7 days with CcAE at 125, 250, and 500 mg/kg/day/mouse, in comparison with a group treated with 15 mg/kg/day/mouse MTZ for the same period. The total phenolic components (TPC), the total flavonoid components (TFC), the 2,2,diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging activity, and the high-performance liquid chromatography (HPLC) for quantitative and qualitative phenolic content were chemically estimated. After 24 and 48 h of in vitro incubation, the estimated minimal inhibitory concentrations (MIC) were 500 and 400 µg/ml, respectively, and the concentrations that induced 50% growth inhibition (IC50) were 93.8 and 60.4 µg/ml, respectively (P < 0.001). Mice given 500 mg/kg CcAE showed 100% stool clearance of G. lamblia stages, similar to MTZ-treated control group (P < 0.001). The TPC was 10.7 ± 0.2 mg GAE/g and the TFC was 23.9 ± 0.3 mg quercetin/g, and the estimated IC50 for DPPH free radical scavenging was 16.4 ± 0.1 mg/ml. HPLC revealed the major phenolic components of CcAE to be carnosic acid, p-coumaric acid, cinnamiac acid, quercetin, rutin, and chlorogenic acid. In conclusion, CcAE is significantly effective against G. lamblia in vitro and in vivo, and has considerable phenolic and antioxidant properties.

Acanthamoeba keratitis in noncompliant soft contact lenses users: Genotyping and risk factors, a study from Cairo, Egypt.

Acanthamoeba keratitis (AK) is a severe corneal infection that may occur as a serious outcome of improper use of contact lenses (CL). OBJECTIVES: The study aimed to diagnose AK in soft CL users presenting with infectious keratitis, and to identify the prevalent genotypes isolated from different cases. Another aim was to determine the CL hygiene-related risk behaviors, and to explore the risk of water exposure for developing AK. METHODS: A cross sectional study was performed. A questionnaire was carried out including 260 clinically diagnosed cases as infectious keratitis (170 females and 90 males); all of them were soft CL users for the suspected risk factors. Corneal scrapes from the affected eyes were cultured to diagnose bacterial and AK. PCR was performed and the amplified products were sequenced and compared with GenBank data. RESULTS: The parasite was positively amplified from 32 samples (12.3%). Acanthamoeba T4 genotype was identified in 27/32 (84.4%) of isolates. Other detected genotypes belonged to T5 and T3 genotypes at rates of 9.4%, and 6.25%, respectively. The most important risk factors associated with development of AK were female sex, sleeping while wearing CL, and exposure to water resources through different practices. These practices included rinsing the CL case in tap water, swimming and/or showering while wearing CL, using multipurpose solution for cleaning the lenses, using water from over-building tanks. Rubbing the eyes due to discomfort when applying CL was an additional important risk factor associated with AK. The protective factor was regular hand washing before using CL. CONCLUSION: CL users were more exposed to AK and should gain enough health education regarding proper lens hygiene and dangers of tap water exposure.

Modified dot-ELISA for diagnosis of human trichinellosis.

This study aimed to modify Dot-Enzyme-linked immunosorbent assay (dot-ELISA) for the diagnosis of human trichinellosis and to compare its performance with indirect ELISA and Western-blot assay (EITB). A total of 175 human serum samples were enrolled in the study. Indirect ELISA was used for the primary diagnosis. EITB versus fractionated 1st larval stage excretory-secretory antigens (TL-1 ESA) revealed three specific protein fractions at MW of 45, 50, and 55 kDa (kDa). Dot-ELISA was performed in two ways. In the first one, sera were dotted on the separated three specific protein fractions, while in the second one the three fractions were eluted, concentrated at one pooled antigen that used in classic dot-ELISA. Both types of dot-ELISA proved absolute (100%) sensitivity and specificity in comparison with the gold standard EITB reaction. While sensitivity of ELISA was 100% and its specificity was 79.5%. The fraction at 45 kDa was the most sensitive one. The use of the pooled antigen improved the test results. The described dot-ELISA is an easy applicable diagnostic tool gathering the benefits of both ELISA and EITB.

Efficacy, acceptability and cost effectiveness of four therapeutic agents for treatment of scabies.

The aim of this study is to evaluate four drug regimens for treatment of scabies as regard their efficacy, acceptability and cost effectiveness. Two hundred cases with ordinary scabies were randomized into four groups. First group received ivermectin 200 µg/kg body weight single oral dose, repeated after one week. The second received benzyl benzoate 20% cream. The third received permethrin 2.5%-5% lotion, whereas the fourth group received 5-10% sulfur ointment. Topical treatments were applied for five consecutive nights. Patients were followed up for two weeks for cure rate and adverse effects. At the end of the study, permethrin provided a significant efficacy of 88% and acceptability in 100% of cases, but had higher cost to treat one case (20.25 LE). Ivermectin provided efficacy and acceptability rates of 84% and 96%, respectively, and had a cheaper cost (9.5 LE). Benzyl benzoate provided 80% for both rates and was the cheapest drug. Sulfur ointment provided the least rates, and it was the most expensive. Treatment choice will depend on the age, the general condition of cases, patient compliance to topical treatment and his ability to stick to its roles, and the economic condition of the patient.

Invasion biology meets parasitology: a case study of parasite spill-back with Egyptian Fasciola gigantica in the invasive snail Pseudosuccinea columella.

The liver fluke Fasciola gigantica is a trematode parasite of ruminants and humans that occurs naturally in Africa and Asia. Cases of human fascioliasis, attributable at least in part to F. gigantica, are significantly increasing in the last decades. The introduced snail species Galba truncatula was already identified to be an important intermediate host for this parasite and the efficient invader Pseudosuccinea columella is another suspect in this case. Therefore, we investigated snails collected in irrigation canals in Fayoum governorate in Egypt for prevalence of trematodes with focus on P. columella and its role for the transmission of F. gigantica. Species were identified morphologically and by partial sequencing of the cytochrome oxidase subunit I gene (COI). Among all 689 snails found at the 21 sampling sites, P. columella was the most abundant snail with 296 individuals (42.96%) and it was also the most dominant species at 10 sites. It was not found at 8 sites. Molecular detection by PCR and sequencing of the ITS1-5.8S-ITS2 region of the ribosomal DNA (rDNA) revealed infections with F. gigantica (3.38%), Echinostoma caproni (2.36%) and another echinostome (7.09%) that could not be identified further according to its sequence. No dependency of snail size and trematode infection was found. Both high abundance of P. columella in the Fayoum irrigation system and common infection with F. gigantica might be a case of parasite spill-back (increased prevalence in local final hosts due to highly susceptible introduced intermediate host species) from the introduced P. columella to the human population, explaining at least partly the observed increase of reported fascioliasis-cases in Egypt. Eichhornia crassipes, the invasive water hyacinth, which covers huge areas of the irrigation canals, offers safe refuges for the amphibious P. columella during molluscicide application. As a consequence, this snail dominates snail communities and efficiently transmits F. gigantica.