The efficacy of platelet rich plasma as adjuvant therapy in the treatment of cryptosporidiosis in experimentally infected immunosuppressed rats

Abstract

Background: Cryptosporidium species are zoonotic opportunistic coccidian parasites that could causedisseminated life-threatening infection in the immunocompromised host. Unfortunately, few availabledrugs effectively eradicate the infectious oocyst with limited availability in developing countries. AlthoughNitazoxanide (NTZ) is the drug of choice for the treatment of cryptosporidiosis, it has limited efficacyin malnourished and immunocompromised patients. Moreover, platelet-rich plasma (PRP) successfullyameliorated the hepatic granuloma size in patients with parasitic schistosomiasis mansoni.Objective: This study aims to test the potential therapeutic effect of PRP versus the currently used NTZ,and/or using PRP as adjuvant therapy.Material and Methods: Sixty-five immunosuppressed rats were divided into 5 groups: non-infected asnegative control (GI), infected non-treated as the positive control (GII), infected with Cryptosporidiumspp. and treated with either intraperitoneal PRP (GIII), or NTZ (GIV), or a combination of intraperitonealPRP and NTZ (GV). Parameters used for evaluation of the therapeutic efficacy included parasitologicalexamination, histopathological examination of ileocaecal and liver specimens, and quantitative analysisof reduced glutathione (GSH) and malondialdehyde (MDA) for evaluation of oxidative stress markers,glutamic-oxaloacetic transaminase (SGOT), and glutamic pyruvic transaminase (SGPT) for evaluation ofliver functions.Results: Parasitological and histopathological examinations revealed minimal improvement in GIII,marked improvement in GIV, and the best results were recorded in GV. The administration of PRP in GIIIproduced no significant changes in GSH, MDA, SGOT compared to positive control GII. Treatment withNTZ in GIV, and in addition to PRP in GV showed significant difference (P<0.05) compared to GII regardingserum results of GSH, MDA, and SGOT with the best results recorded in GV. GIV and GV showed reductionof serum levels of SGPT although there was statistically insignificant difference between the study groups.Conclusion: PRP could be used as a potential adjuvant therapy with NTZ to ameliorate the pathologic andinflammatory effects of cryptosporidiosis on the ileocaecal region. It also improves liver function in theimmunocompromised hosts.