Efficacy of alpha-cyclodextrin against experimental cryptosporidiosis in neonatal goats

Past, current, and potential treatments for cryptosporidiosis in humans and farm animals: A comprehensive review

The intracellular protozoan parasite of the genus Cryptosporidium is among the leading causes of waterborne diarrheal disease outbreaks throughout the world. The parasite is transmitted by ingestion of infective oocysts that are highly stable in the environment and resistant to almost all conventional disinfection methods and water treatments. Control of the parasite infection is exceedingly difficult due to the excretion of large numbers of oocysts in the feces of infected individuals that contaminate the environment and serve as a source of infection for susceptible hosts including humans and animals. Drug development against the parasite is challenging owing to its limited genetic tractability, absence of conventional drug targets, unique intracellular location within the host, and the paucity of robust cell culture platforms for continuous parasite propagation. Despite the high prevalence of the parasite, the only US Food and Drug Administration (FDA)-approved treatment of Cryptosporidium infections is nitazoxanide, which has shown moderate efficacy in immunocompetent patients. More importantly, no effective therapeutic drugs are available for treating severe, potentially life-threatening cryptosporidiosis in immunodeficient patients, young children, and neonatal livestock. Thus, safe, inexpensive, and efficacious drugs are urgently required to reduce the ever-increasing global cryptosporidiosis burden especially in low-resource countries. Several compounds have been tested for both in vitro and in vivo efficacy against the disease. However, to date, only a few experimental compounds have been subjected to clinical trials in natural hosts, and among those none have proven efficacious. This review provides an overview of the past and present anti-Cryptosporidium pharmacotherapy in humans and agricultural animals. Herein, we also highlight the progress made in the field over the last few years and discuss the different strategies employed for discovery and development of effective prospective treatments for cryptosporidiosis.

Diagnosis and control of cryptosporidiosis in farm animals

Cryptosporidium is a pathogenic protozoan parasite infecting the gastrointestinal epithelium of human and animal hosts. In farm animals, cryptosporidiosis causes significant economic losses including deaths in newborn animals, retarded growth, increased labor involved and high cost of drugs. The detection of Cryptosporidium oocysts in fecal samples is traditionally dependent on examination of stained slides by light microscope or by advanced microscopical tools such as: electron microscopy and phase contrast microscopy. Immunological diagnosis using either antibody or antigen detection could offer high sensitivity and specificity. Examples for these tests are Enzyme Linked Immunosorbent Assay (ELISA), Immunochromatographic tests, Immunochromatographic lateral flow (ICLF), Immunofluorescence assays (IFA) and Flow cytometry coupled with cell sorting. Molecular methods could differentiate species and genotypes of Cryptosporidium and help in studying the epidemiological features of this parasite with rapid, simple and sensitive procedures. Nanotechnology-based platforms could improve the sensitivity and specificity of other detection methods like: ELISA, ICLF, IFA and polymerase chain reaction. As the available prophylactic and therapeutic drugs or natural products treatments are insufficient and no approved vaccines are available, the best approach to control this parasite is by following firm hygienic measures. Many vaccine attempts were performed using hyperimmune colostrum, live or attenuated vaccines, recombinant and Deoxyribonucleic acid vaccines. Also, Clustered Regularly Interspaced Short Palindromic Repeats/Cas9 technology could help in Cryptosporidium genome editing to improve drug and vaccine discovery. Another approach that could be useful for assigning drug targets is metabolomics. Probiotics were also used successfully in the treatment of acute diarrhea and they proved a limiting effect on cryptosporidiosis in animal models. In addition, nanotherapy-based approaches could provide a good strategy for improving the potency of any type of drugs against Cryptosporidium and give good anti-cryptosporidial effects. In conclusion, accurate diagnosis using advanced techniques is the key to the control and prevention of cryptosporidiosis.

Rearing system with nurse cows and risk factors for Cryptosporidium infection in organic dairy calves

Rearing dairy calves with nurse cows has been increasingly adopted by French farmers especially in organic farming and is characterized by a fostering of two to four calves during the first month of life by an unmilked lactating cow. This type of rearing remains poorly documented regarding its impact on calf health, such as cryptosporidiosis. The objectives of our study were to describe practices related to rearing dairy calves with nurse cows and to evaluate the prevalence, intensity and risk factors for Cryptosporidium infection in calf neonates. Between January and September 2019, the rearing practices of calves were described in 20 organic French farms and faeces were sampled once from 611 animals aged between 5 and 21 days. Cryptosporidium oocyst shedding was identified by modified Ziehl-Neelsen technique and scored semi-quantitatively (score 0-4). The risk of excretion (score 0 versus 1-4) was analysed using multivariate logistic regression models. This cow-calf rearing system usually consisted of a first phase with the dam, followed by an optional phase of artificial milk feeding (calves being fed with whole milk of the farm) and a final phase of fostering by a nurse cow. Each nurse was suckled from one to five calves of close age with a fostering age of 8 days on average. The oocyst shedding prevalence was 40.2 % and similar to classically reared calves, but the intensity of shedding and the prevalence of diarrhoea appeared to be lower. The identified six risk factors for oocyst shedding were: born in the last two thirds of the birth order, born between January and July versus August and September, calf with its dam in the barn versus on pasture, having an artificial milk feeding phase versus being with the dam only, and contact between peer calves and notably the presence of an oocyst excretory calf fostered by the same nurse. These results emphasize the role of the environment for the direct and indirect contamination, particularly that related to the accumulation of oocysts from previous or peer calves facilitating the faecal-oral route of transmission. This highlights the crucial role of the premises used intensively during the winter and spring months with higher densities of calves in the barn compared to outdoor situations promoted by this rearing.

Cyclodextrins: Emerging Medicines of the New Millennium

Cyclodextrins, since their discovery in the late 19th century, were mainly regarded as excipients. Nevertheless, developments in cyclodextrin research have shown that some of these hosts can capture and include biomolecules, highlighting fatty acids and cholesterol, which implies that they are not inert and that their action may be used in specific medicinal purposes. The present review, centered on literature reports from the year 2000 until the present day, presents a comprehensive description of the known biological activities of cyclodextrins and their implications for medicinal applications. The paper is divided into two main sections, one devoted to the properties and applications of cyclodextrins as active pharmaceutical ingredients in a variety of pathologies, from infectious ailments to cardiovascular dysfunctions and metabolic diseases. The second section is dedicated to the use of cyclodextrins in a range of biomedical technologies.

Pomegranate (Punica granatum) peel is effective in a murine model of experimental Cryptosporidium parvum ultrastructural studies of the ileum

The current treatments for cryptosporidiosis are ineffective, and there is an urgent need to search for more effective and safer alternatives. One such alternative may be treatments derived from natural resources. The pomegranate peel has been used effectively in traditional medicine to cure diarrhea and dysentery. The purpose of this study was to examine the effectiveness of a Punica granatum (pomegranate) peel suspension as a treatment for Cryptosporidium parvum infection. In this study, the effects of this treatment on the ultrastructure of both the intestinal epithelial layer of infected nursling mice and the parasite were observed with a transmission electron microscope. The histological study focused on the examination of the microvilli, columnar epithelium, goblet cells, lamina propria, and crypts of Lieberkuhn. Examination of the ileums of infected mice that received the pomegranate peel suspension demonstrated that the general structure of the ileal tissue of these mice was similar to that of the control group. In the infected mice treated with the suspension, but not the infected/untreated mice, there was an improvement in all ultrastructure aspects at 28days post-inoculation. The study of the ultrastructure of the parasite (C. parvum) in mice treated with the suspension showed that there was decomposition in the parasite to the extent that in some cases we were unable to identify the stage of the parasite due to the severe degeneration. Significant decomposition of the nutrition organ was also observed. Additionally, microgamonte and macrogamonte were not observed in the suspension-treated group, explaining the disappearance of the sexual phases of the parasite in the lumens of this group. In all, this examination demonstrated the restoration of the normal structures of villi and the disappearance of acute symptoms in the suspension-treated mice and showed that the suspension directly affected the parasite at various stages of its development and led to its decomposition and death.

Cryptosporidiosis in small ruminants

Cryptosporidiosis is an infection caused by protozoan parasites belonging to the genus Cryptosporidium which is responsible for a potentially severe disease in new-born ruminants. This infection is highly prevalent in small ruminants throughout the world, especially in pre-weaned animals. The clinical expression is different between goat kids and lambs, the infection being generally more severe in the former. Molecular data demonstrate geographical variations in the species of Cryptosporidium infecting small ruminants. They also support the possibility of transmission of zoonotic species from these hosts to humans. Studies are still needed on molecular epidemiology, especially in goats, and on ways to control infection.

Activity of an anti-inflammatory drug against cryptosporidiosis in neonatal lambs

The efficacy of the anti-inflammatory drug Bobel-24 against experimental infection by Cryptosporidium parvum was evaluated in neonatal lambs. The animals were treated by oral administration of the drug at 50 or 500 mg/kg of body weight. The prophylactic/therapeutic treatment was started 4 h before inoculation of the lambs with oocysts and was continued for eight consecutive days. The therapeutic treatment was initiated at the onset of diarrhoea, after confirmation of infection, and was continued for six consecutive days. Infection was monitored by daily examination of faecal samples from the first day until 30 days post-inoculation. The criteria considered in evaluating development of the infection and the drug activity were: oocyst shedding, presence of diarrhoea and weight gain at 15 and 30 days post-inoculation. Bobel-24 was effective as a prophylactic/therapeutic treatment at the lowest dose (50 mg/kg of body weight); in the group treated with this dose of drug there was a longer prepatent period, a shorter patent period and a lower intensity of oocyst excretion than in the untreated control group, and the differences were all statistically significant (P < 0.05). Moreover, one animal did not excrete oocysts, and two lambs had diarrhoea, for only 1 and 2 days. In the group treated with the higher dose of the drug, the diarrhoea lasted for a significantly shorter period (P < 0.05) than in the untreated group.

Efficacy of nitazoxanide against experimental cryptosporidiosis in goat neonates

Preliminary results obtained in mice, rats and piglets experimentally infected with Cryptosporidium sp have indicated a partial prophylactic or curative efficacy of nitazoxanide when administered between 50 and 250 mg/kg BW. In this study, the efficacy of nitazoxanide was evaluated in goat neonates experimentally infected with Cryptosporidium sp oocysts. Forty-seven 2- to 4-day-old kids were experimentally infected once on day 0 with 10(6) Cryptosporidium oocysts isolated from a dead kid, and allocated to three groups. Group 1 acted as control untreated group, group 2 received nitazoxanide for 8 days from day -1 to day 6 at a daily dose rate of 200 mg/kg BW, group 3 received nitazoxanide for 7 days from day 2 to day 8 at 100 mg/kg BW. Individual oocyst shedding was monitored by daily examination of faecal smears stained by carbol fuchsin and scored semi-quantitatively (zero to four). The other criteria included for nitazoxanide evaluation were weight gain and mortality. In the control group, oocyst shedding that started 3 days post-inoculation (PI) was maximal 6-7 days PI (mean scores ranging from 1.69 to 1.94) and became undetectable from day 16 PI. In group 2, oocyst shedding started 1 day later, peaked 9-11 days PI (1.33 to 1.5) and vanished day 18 PI. In group 3, results were similar to those of group 1 except for the mean scores ranging from 1.0 to 1.58. No significant difference was seen for weight gains between groups. Five kids died in group 1 as well as in group 3, whereas seven kids died in group 2. An acute toxicity of nitazoxanide was suspected as soon as the first 2 days of treatment.

Giardiasis and cryptosporidiosis in ruminants

Although they differ considerably with respect to their biology, both Giardia duodenalis and Cryptosporidium parvum are common in ruminants, whereas Cryptosporidium andersoni is not. G. duodenalis infections are acquired during the first few months of life, tend to be chronic, and may be a production-limiting disease of ruminants. C. parvum infections remain an important cause of diarrhea in neonatal ruminants. Abomasal cryptosporidiosis, caused by C. andersoni, is an emerging disease of cattle that may affect both beef and dairy herds. This article reviews the life cycles, production impacts, treatments, controls, and zoonotic potentials of these important ruminant parasites.

Evaluation of two commercial disinfectants on the viability and infectivity of Cryptosporidium parvum oocysts

Cryptosporidiosis is mainly a problem in neonatal ruminants. Not only do Cryptosporidium spp. spread ubiquitously in our environment, but the protozoa are highly resistant to harsh environmental conditions and disinfectants, and a control measure is urgently required. This study investigated the potential biocidal activity on Cryptosporidium parvum oocysts of two commercial disinfectants developed originally to be used in farms and food-processing industries. The products, containing formaldehyde and hydrogen peroxide respectively, both had some anticryptosporidial effects. The viability and infectivity of purified C. parvum oocysts exposed to both disinfectants at different concentrations and exposure times were evaluated by inclusion or exclusion of vital dye (propidium iodide), use of an excystation technique and infection of suckling mice. Viability assays showed a decrease in oocyst viability associated with an increase in exposure time for each of the concentrations used. The intensity of infection in neonatal mice was significantly lower (P<0.05) than in the control litters.

ORAL ADMINISTRATION OF HYPERIMMUNE ANTI–CRYPTOSPORIDIUM PARVUM OVINE COLOSTRAL WHEY CONFERS A HIGH LEVEL OF PROTECTION AGAINST CRYPTOSPORIDIOSIS IN NEWBORN NMRI MICE

Hyperimmune anti-Cryptosporidium parvum ovine colostral whey (HOCW) was tested to determine whether it conferred passive immunity to newborn NMRI mice. Three HOCWs (groups IV-VI), 2 nonimmune colostral wheys (groups II and III), and PBS (group I) were administered once (experiment A) and 3 times (experiment B) daily from -1 to 15 days postinfection (PI). Mice in groups I-VI were inoculated with 5 x 10(5) oocysts (day 0 PI), and group VII mice acted as controls. The percentage and intensity of infection were measured at 6, 9, 12, and 16 days PI. In experiment A, HOCW did not reduce significantly the percentage and intensity of infection except for mice in group VI treated with HOCW with the highest titers of anti-C. parvum antibodies. In contrast, no infection was detected in between 18.7 and 62.5% of the mice in groups IV-VI in experiment B. Furthermore, in these groups, the intensity of the infection decreased significantly, ranging from 83.5 to 97.4%. Thus, HOCW did not completely avoid infection, but a high level of protection was observed, being proportional to the titer of specific antibodies and the amount of whey administered orally. Finally, group VII showed no presence of oocysts.