Effect of probiotics on giardiasis. Where are we?

Abstract

Giardiasis, an intestinal infection caused by Giardia lamblia, was recently included in the 'Neglected Diseases Initiative' by the World Health Organization. Symptomatic patients can develop mild diarrhea up to a severe malabsorption syndrome, and children may show significantly impaired cognitive and physical development. Currently, nitroimidazoles are the main class of antibiotic used to treat giardiasis. Despite the efficacy of these drugs, adverse effects and reported resistance have increased, encouraging studies to identify and develop therapeutic alternatives. In this context, probiotics may represent an attractive option. Probiotics are defined as live microorganisms that, when administered in suitable amounts, confer a health benefit to the host. The use of probiotics in the treatment of parasitosis has been suggested because of its beneficial effects, such as a reduced time of gastrointestinal symptoms and parasite load in animal models and humans. Probiotics have been studied as an alternative treatment for giardiasis. In this review, we evaluated probiotic effectiveness in the treatment and prevention of this disease. Based on the studies examined herein, we conclude that probiotics have a beneficial effect on the modulation of giardiasis.

Evaluation of the role of combined prebiotic and probiotic supplements as prophylactic and therapeutic agents against experimental giardiasis

“…In a metanalysis study, Ventura et al [34] recorded the anti-giardial effect of different probiotic strains. Besides, Perrucci et al [16] stated that commercial multistrain probiotic Slab51(containing 200 billion lactic acid bacteria) showed higher antagonistic effects on G. duodenalis both in vitro and ex vivo intestinal tissue cultures.…”

“…The results of the present study concur with those of research that revealed modulation of both non-specific and specific immune responses. This modulation was manifested by increased nitric oxide, secretory anti-Giardia IgA and IgG antibody and antiinflammatory cytokines (ILs 6, and 10) levels, after separate supplementation of either prebiotic inulin [19] or probiotic L. casei [34,48,49] , and also with combined supplements [21] either prior to or simultaneously with Giardia infection to nourished or malnourished mice.…”

Assessment of the Therapeutic Effect of Probiotic Lactobacilli Alone and in Combination with Metronidazole in Murine Giardiasis

“…These findings may be attributed to the fact that, the pathophysiology of acute diarrhea in giardiasis implicates increased rates of enterocytes apoptosis and disruption of the intestinal barrier function. Activation of host lymphocytes (CD8 lymphocyte) mediated shortening of brush border microvilli with or without coinciding villous atrophy and crypt hyperplasia [31]. Histopathological examination of the infected treated MTZ (S.G.2B) subgroup, showed partial improvement in the histopathological changes following Giardia infection.…”

Giardia and Cryptosporidium in Neo-Tropical Rodents and Marsupials: Is There Any Zoonotic Potential?

“…Probiotic use for the treatment of Giardiasis has also been found in clinical animal model studies to have some success, with infected animals showing great promise [ 87 ]. Experimental studies by Goyal and Shukla [ 88 ] have found that oral administration of probiotics to Giardia -infected mice results in an anti- Giardia effect and an improved immune response, while Shukla and Shukla [ 88 ] studies found that a combination treatment of probiotics and antiprotozoal drugs resulted in enhanced recovery in mice models.…”