Giardia duodenalis: Biology and Pathogenesis

Gastroenterology in Rodents

Gastrointestinal (GI) diseases are frequently diagnosed in rodents. Clinical signs are usually nonspecific and include anorexia, weight loss, chronic wasting, abdominal discomfort, gas accumulation in the intestine and stomach, and diarrhea. Malabsorption associated with GI dysfunction or gastroenteritis quickly leads to negative energy balance and metabolic acidosis. Therefore, all disorders of the GI tract should be treated as soon as possible. The article describes selected disorders of the GI tract in guinea pigs (Cavia porcellus), chinchillas (Chinchilla lanigera), degus (Octodon degus), and rats (Rattus norvegicus).

Trichomoniasis and Other Sexually Transmitted Parasitic Diseases in Women

Parasitic sexually transmitted infections are spread through sexual contact (vaginal, oral, and/or anal sex). The majority of parasitic STIs involve protozoan pathogens (ie, Trichomonas vaginalis, Entamoeba histolytica, and Giardia duodenalis); however, ectoparasitic infections (Pthirus pubis and Sarcoptes scabiei) are also included in this group. The purpose of this review is to provide a comprehensive summary of the epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of parasitic sexually transmitted infections, with a particular focus on their impact on women.

Licochalcone a: A promising antiparasitic drug against giardiasis

Giardiasis, caused by Giardia duodenalis, is a prevalent and significant zoonotic disease. While nitroimidazole drugs are primarily used to treat giardiasis, the urgent need for the development and formulation of new drugs has arisen due to increasing drug resistance. Several plant derived medicine have been employed as antiparasitic drugs. This study has evaluated the anti-Giardia effect of Licochalcone A (Lic A) through both in vitro and in vivo experiments. We determined the 50% inhibitory concentration (IC50) of Lic A, analyzed the adhesive ability of G. duodenalis, and assessed intestinal morphology and various indicators in the gerbil model. The in vitro assays demonstrated that the IC50 value of Lic A against G. duodenalis was 27.42 μM. Additionally, Lic A significantly inhibited the adhesiveability of G. duodenalis trophozoites, impairing their cell structure and cytoskeleton. In vivo experiments showed that Lic A significantly mitigated weight loss due to G. duodenalis infection, and lowered the intestinal parasite load. Histopathological examinations in gerbils indicated that Lic A could reduce intestinal damage, increase the height of intestinal villi, decrease crypt depth, and maintain the integrity of intestinal structure. Furthermore, Lic A altered cytokine levels and enhanced the body's antioxidant capacity. In conclusion, Lic A exbibits significant anti-Giardia effects both in vitro and in vivo, suggesting its potential as a promising antiparasitic drug candidate against giardiasis.

Prevalence, genetic diversity, and zoonotic potential of Giardia duodenalis in New and Old World Camelids: A comparative systematic review and meta-analysis

This study aimed to review and analyze the prevalence, genetic diversity, and zoonotic potential of Giardia duodenalis in New World Camelids (NWCs) and Old World Camelids (OWCs), highlighting geographic and host-related variations. The statistical analyses were conducted using CMA software to estimate pooled prevalence rates. Heterogeneity was evaluated with the I² statistic, and sensitivity analysis tested pooled prevalence after removing certain studies. Meta-regression examined the association between G. duodenalis prevalence in camelids and factors like publication year and sample size. Subgroup analyses investigated prevalence variations based on countries, continents, WHO regions, publication years, diagnostic methods, and sample sizes. A total of 22 studies/23 datasets were included, with eight on NWCs and 15 on OWCs, covering 5008 camelids across nine countries. The weighted G. duodenalis prevalence in camelids was 8.7 % (95 % CI: 5.6-13.3), with NWCs at 10.3 % (95 % CI: 3-29.7) and OWCs at 9.1 % (95 % CI: 6.7-12.2). Geographical analyses revealed the highest prevalence of G. duodenalis in South America (40.4 %) and the AMR WHO region (10.8 %), with notable rates in Peru (40.4 %) and Iraq (11.9 %). Sensitivity analysis showed that prevalence rates remain robust, unaffected by study exclusions. Neither the year of study nor sample size influenced infection rates in camelids. The identification of zoonotic assemblages A and E, and zoonotic sub-assemblage AI in camelids, is of public health significance. These insights enhance our understanding of G. duodenalis epidemiology in camelids, underscoring the need for ongoing surveillance and research regarding their effects on human and animal health.

Culturing of Giardia lamblia under microaerobic conditions can impact metronidazole susceptibility by inducing increased expression of antioxidant enzymes

The microaerophilic/anaerobic protist Giardia lamblia is a world-wide occurring parasite of the human small intestine. It causes giardiasis which manifests as diarrhoea accompanied by other sequelae. Giardiasis is most commonly treated with either the 5-nitroimidazole metronidazole or the benzimidazole albendazole. Unfortunately, the number of refractory cases is increasing, which is probably caused, at least in part, by drug resistance. However, most attempts to isolate metronidazole-resistant G. lamblia strains from patients have failed so far because the parasites were not resistant when tested in vitro. We hypothesized that this failure might be caused by drug assay conditions which are standardly anaerobic, and performed metronidazole susceptibility testing with two well studied strains, i.e. WB C6 and BRIS/87/HEPU/713 (strain 713) under microaerophilic conditions. Indeed, 713 proved to be less susceptible to metronidazole under microaerophilic conditions as compared to anaerobic conditions, and residual growth was even noted at concentrations of metronidazole similar to those in the serum of treated patients (i.e. about 100 μM). Further experiments showed that 713 also grows much faster under microaerobic conditions than WB C6. Reduced susceptibility to metronidazole under microaerobic conditions was also observed in a clinical isolate from a refractory giardiasis case. Two-dimensional gel electrophoresis showed that microaerobic growth was accompanied by the upregulation of superoxide reductase, a pyridoxamine 5'-phosphate oxidase putative domain-containing protein, and a TlpA-like protein in 713 but not in WB C6. All three proteins are known, or can be predicted to have antioxidant functions. Indeed, overexpression of pyridoxamine 5'-phosphate oxidase in WB C6 from a plasmid carrying the respective gene behind the arginine deiminase promoter significantly improved growth of the transfected cell line under microaerobic conditions. Moreover, similarly overexpressed superoxide reductase conferred significant protection against metronidazole. Our results suggest that oxygen concentrations can affect the outcomes of metronidazole treatment against G. lamblia.

Assessment of Human Taeniasis and Other Intestinal Parasites in Narok County, Kenya

Data are sparse on the epidemiological picture of Taenia saginata taeniasis in Kenya. Infections are underreported, and their persistence nonetheless negatively impacts the beef industry. Populations vulnerable to taeniasis in the developing world are commonly burdened with other intestinal parasites, ubiquitous in unsanitary environments. This study aimed to estimate the occurrence of human taeniasis in Narok County, Kenya, and screen for the presence of other intestinal parasitic infections. A community-based survey was conducted in five pastoral wards, and stool samples, mainly from adults, subjected to multiple diagnostic tests. One sample tested positive for Taenia spp. by coproantigen enzyme-linked immunosorbent assay (0.3%, 95% CI, 0-1.6, n = 360), and all samples tested negative on multiplex copro-polymerase chain reaction targeting the cytochrome c oxidase subunit 1 gene and copromicroscopy. Microscopy (n = 361) additionally identified Entamoeba histolytica/dispar/moshkovskii at a prevalence of 15.5% (95% CI, 12.1-19.6), Giardia spp. at 5.3% (95% CI, 3.4-8.1), Hymenolepis spp. at 1.1% (95% CI, 0.4-2.8), and hookworm at 0.3% (95% CI, 0-1.6). Grazing livestock near the homestead (< 2 km) and a formal education background were associated with a reduced likelihood of Giardia spp. infection (AOR 0.07, 95% CI 0-0.36, p=0.011, and AOR 0.06, 95% CI 0.01-0.50, p=0.014, respectively). Our findings suggest a very low prevalence of human taeniasis in the population. The occurrence of other pathogenic zoonotic intestinal parasites highlights a public health concern and calls for a One Health approach in the enhancement of hygiene initiatives.

Giardia duodenalis triggered neutrophil extracellular traps in goats

Giardia duodenalis is a globally distributed zoonotic parasite primarily transmitted through the fecal-oral route, infecting various vertebrates, and the infection of which is prevalent in goats. Immune cells play a crucial role in pathogens invasion, and neutrophil extracellular traps (NETs) released by neutrophils serve as a non-specific defense mechanism against pathogens including parasites. In this study, we investigated the characteristics, components, and molecular mechanisms of goat NETs upon stimulation with G. duodenalis trophozoites. This study demonstrates that G. duodenalis trigger dose-dependent NETs formation in goat neutrophils, composed of DNA, citrullinated histone H3 (CitH3), and neutrophil elastase (NE). Reactive oxygen species (ROS) accumulation synchronizes with NETosis during G. duodenalis infection. Inhibitor experiments confirmed that G. duodenalis-induced NETs and ROS production depend on TLR2/4 signaling and require NADPH oxidase (NOX), ERK1/2, and p38 MAPK activation. This work identifies TLR2/4, NOX, ERK1/2, and p38 MAPK pathways as key regulators of NETs/ROS coordination during G. duodenalis infection, providing the first evidence of G. duodenalis-triggered NETs in goats. The findings highlight NETs as critical components of anti-G. duodenalis immunity and suggest potential for NETs-targeted therapeutic strategies.

The Spiky Side of Urban Wildlife, First Detection of a Zoonotic Assemblage of Giardia duodenalis in European Hedgehogs (Erinaceus europaeus) from Italy

PURPOSE OF REVIEW

Giardia duodenalis is a flagellate protozoan parasite of several mammals, that is transmitted via the fecal-oral route and causes gastrointestinal diarrheal illness. Molecular analyses of several genetic markers have classified G. duodenalis into eight assemblages (A to H) exhibiting different host specificities. Assemblages A and B have zoonotic potential and infect a broad range of hosts. The European hedgehog (Erinaceus europaeus) is one of the wild species well-adapted to live in close proximity to humans. Therefore, surveying potential zoonotic parasites harbored by hedgehogs can also be of public health concern, particularly in urban settings with high animal densities.

RECENT FINDINGS

Coproparasitological examinations are routinely conducted on hedgehogs admitted to WildUmbria Wildlife Rescue Center. Giardia duodenalis cysts were found in the fecal flotation of a hedgehog and were further tested using a direct immunofluorescent assay and PCR-RFLP molecular analysis of the β-giardin gene for assemblage and sub-assemblage characterization. The RFLP protocol attributed the samples to the AI-like zoonotic assemblage. Additionally, trophozoites attached to the intestinal mucosa of the small intestine were detected via histological techniques. Although G. duodenalis has been detected in hedgehogs from several countries, it was never before reported in Italian hedgehogs. The identification of a zoonotic assemblage in hedgehogs suggests the potential for the parasite to be shared between wild and domestic environments, with pets possibly serving as bringing hosts.

Binary protein interactome mapping of the Giardia lamblia proteasome lid reveals extra proteasomal functions of GlRpn11

The assembly of the 26S proteasome, a multi-subunit complex for regulated protein turnover, proceeds via the formation of intermediates. Giardia lamblia does not encode proteasome regulatory subunit Rpn12 or proteasome complex subunit Sem1, two proteins crucial for assembling the proteasome lid. To understand how the interactions between the giardial proteasome lid subunits may have changed to compensate for their absence, we used yeast two-hybrid to generate a binary interactome map of Giardia's lid subunits. Most interactions within the Giardia lid are stronger than Saccharomyces cerevisiae lid, which may compensate for Rpn12 and Sem1 absence. A notable exception was the weaker interaction between the two non-ATPase lid subunits, GlRpn11 and GlRpn8, compared to the strong interaction between yeast orthologs Rpn11 and Rpn8. The Rpn11-Rpn8 dimer provides a platform for lid assembly. Their interaction involves the insertion of a methionine residue of Rpn11 into a hydrophobic pocket of Rpn8. Molecular modeling indicates that GlRpn8's pocket is wider, reconciling the experimental observation of its weak interaction with GlRpn11. This weaker interaction may have evolved to support proteasome-independent functions of GlRpn11, which localizes to multiple subcellular regions, including the mitosomes, where other proteasome subunits cannot be detected. Functional complementation in yeast shows that GlRpn11 can influence mitochondrial function and distribution. Together these observations show that GlRpn11 functions at the mitosome. Thus, this parasite's proteasome lid has a simpler subunit architecture than that of yeast with structural attributes to support dual functionalities for GlRpn11. Such parasite-specific proteasome features provide opportunities for controlling parasite transmission.

Molecular Survey of Protist Enteroparasites in Bats (Order Chiroptera) from Portugal

PURPOSE

Bats constitute 20% of all mammal species, playing a vital role in ecosystem health as pollinators, seed dispersers, and regulators of insect populations. However, these animals can also be reservoirs for infectious agents, including viruses, bacteria, and enteroparasites such as Cryptosporidium spp., Giardia duodenalis, and Balantioides coli, raising questions about their role in the epidemiology of these agents. Our study analyses bat faecal samples from Portugal with the aim of assessing the prevalence, distribution and diversity of enteroparasitic protozoa.

METHODS

We conducted a retrospective study that included 380 bat faecal samples collected between 2014 and 2018 in northern and central Portugal.

RESULTS

In our study, a Cryptosporidium spp. prevalence of 3.2% was identified, with genetic diversity observed and strains grouped with known bat genotypes. Giardia duodenalis was detected in 0.5% of the samples, exhibiting distinct genetic characteristics that may suggest a potential new assembly group encompassing bats and rodents. Finally, B. coli was detected in 0.26% of samples, representing the first observation of this ciliate in bats, with the identified genetic variant belonging to genotype B.

CONCLUSION

Our results provide valuable molecular epidemiological insights that underscore the importance of bats in the epidemiology of these enteroparasites. Furthermore, this is the first report of Cryptosporidium spp. and G. duodenalis in bat faeces samples from Portugal, and the first study worldwide to show that bats can shed B. coli in their faeces.

Prevalence and Molecular Characterization of Cryptosporidium spp., Giardia duodenalis and Enterocytozoon bieneusi in Donkeys of Inner Mongolia, Northern China

BACKGROUND

Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi are important zoonotic pathogens. In Inner Mongolia, a single pathogen molecular epidemiological survey of these three protozoa was previously conducted on only 176 fecal samples donkeys. In this study, the purpose is to simultaneously evaluate the zoonotic potential of three protozoa.

METHODS

Small subunit ribosomal RNA (SSU rRNA) and gp60 from Cryptosporidium; SSU rRNA, gdh, tpi, and bg from G. duodenalis; and ITS of E. bieneusi were analyzed in 300 fecal samples collected from donkeys from two intensive farms in Inner Mongolia in 2022. Sample processing, nucleic acid extraction, polymerase chain reaction, sequencing, and sequence analysis were performed to determine the prevalence and genetic characteristics of the protozoans.

RESULTS

Our results revealed that 75.33% (226/300) of the samples were infected with at least one protozoan, whereas 2.33% (7/300) were simultaneously infected with all three genera. Mixed infection was observed in 20.67% (62/300; Cryptosporidium + G. duodenalis), 5.33% (16/300; Cryptosporidium + E. bieneusis), and 5.67% (17/300; G. duodenalis + E. bieneusis) of the samples. Overall prevalence of Cryptosporidium, G. duodenalis, and E. bieneusi was 56.33% (169/300), 36.33% (109/300), and 13.33% (40/300), respectively. Five Cryptosporidium species were identified, with C. andersoni being the predominant species. The C. parvum subtypes identified were IIdA20G1 (66.67%) and IIdA19G1 (33.33%). Three G. duodenalis assemblages were identified, with assemblage B being predominant. Seven isolates formed two different assemblage B MLGs, two different assemblage A MLGs, and two different assemblage B + E MLGs. Three known and eight novel sequences of E. bieneusis were identified in group 1 (including horse1 and NMG6-NMG8) and group 2 (including J, BEB6, and NMG1-NMG5), with horse1 being the predominant genotype.

CONCLUSIONS

To our knowledge, this is the first study to demonstrate that donkeys can be infected with a combination of two or three protozoa, with C. andersoni being the most detected Cryptosporidium species. Meanwhile, assemblage B was predominant among G. duodenalis, whereas horse1 was the dominant genotype for E. bieneusi. Moreover, the prevalence of C. bovis, C. ryanae, C. suis, C. parvum subtype IIdA20G1 and eight novel sequences of E. bieneusis and new features of G. duodenalis assemblages were identified in donkeys for the first time. These findings reconfirmed that donkeys in Inner Mongolia are infected with these three protozoa, emphasizing the risk of disease transmission by these protozoans to humans.

Analysis of the role of acetylation in Giardia lamblia and the giardicidal potential of garcinol

Introduction

Post-translational modifications of proteins provide cellular physiology with a broad range of adaptability to the external environment flexibly and rapidly. In the case of the protozoan parasite Giardia lamblia, the study of these modifications has gained relevance in recent years, mainly focusing on methylation and deacetylation of proteins. This study investigates the significance of acetylation in this protozoan parasite.

Methods

This study explores the role of acetylation in G. lamblia through a combination of immunofluorescence assays, manipulation of acetyltransferase enzymes, and the use of garcinol, an acetylation inhibitor, during the growth phase.

Results

The acetylation of histone marks H3K9 and H3K27 occurs during growth and is followed by deacetylation during encystation. Transfections modifying acetyltransferase activity induced a latent cellular state, underscoring the importance of protein acetylation for parasite survival. Garcinol treatment during growth caused significant morphological changes, including plasma membrane blebbing and apoptotic-like bodies. Immunofluorescence revealed these bodies contained α-tubulin/acetylated α-tubulin and reactive oxygen species. Flow cytometry and Annexin V staining indicated early apoptosis within 24 hours of treatment. Additionally, garcinol led to the deacetylation of H3K9 and H3K27, with redistribution of tubulin and acetylated tubulin from microtubules to the cytosol. Significantly, garcinol prevented parasite recrudescence after treatment withdrawal.

Discussion

These results demonstrate that acetylation is essential for trophozoite survival and highlight the natural histone acetyltransferase inhibitor garcinol as a potential candidate for drug development against giardiasis, considering its giardicidal activity.

Molecular prevalence of Giardia duodenalis in domestic pig (Sus domesticus) and captive wild boar (Sus scrofa) in China: A systematic review and meta-analysis

Giardia duodenalis is a typical enteric protozoan pathogen that causes diarrhea in humans and various animals, including domestic pigs (Sus domesticus) and wild boars (Sus scrofa). A healthy livestock would help maintain a hygienic environment, which is crucial for human health. This review has summarized the molecular prevalence of G. duodenalis among various types of pigs (domestic pigs and captive wild boars) in China on the basis of relevant data. A random-effects model of meta-analysis was used to estimate the overall and subgroup-based pooled prevalence of G. duodenalis, and the I2 index was used for the evaluation of the heterogeneity. Altogether, 23 datasets from 20 studies reporting G. duodenalis in 8282 pigs and captive wild boars across 12 regions in China revealed a 6.5 % (95 % CI, 6.0-7.0) pooled molecular prevalence of the parasite. Sensitivity analysis demonstrated that the data included in this study were stable. Meta-regression analysis showed that regions, type of pigs, age, and gender were not notably associated with the prevalence of G. duodenalis in the swine population in China. It was found that five G. duodenalis assemblages (A-E) are capable of infecting pigs in China, and assemblage E was found to be significantly dominant genotype (i.e., 73.2 % for the positive samples). G. duodenalis assemblages A and B were of major zoonotic concern with regard to humans; however, some reports have also documented assemblages C, D, and E from humans. Until now, information on the occurrence and distribution of G. duodenalis assemblages in Chinese pigs is limited, and therefore requires a rigorous and in-depth research.

A Global Systematic Review and Meta-Analysis of Giardia duodenalis in Rabbits: Epidemiology, Genetic Diversity and Possible Zoonotic Concerns

BACKGROUND

Giardia duodenalis is a pathogenic protozoan responsible for gastrointestinal infections in various hosts, including rabbits. Understanding its epidemiology, genetic diversity and zoonotic implications is vital for public health and veterinary medicine. This systematic review and meta-analysis aimed to synthesize global data on the prevalence of G. duodenalis in rabbit populations, assess the genetic diversity of the isolates and evaluate the associated zoonotic potential.

METHODS

We conducted a thorough literature search across multiple databases (PubMed, Scopus, Web of Science and Google Scholar) for studies published until 18 October 2024. Only peer-reviewed articles reporting original research on G. duodenalis in rabbits were included. We extracted data on prevalence rates, testing times, publication years, countries, continents, WHO regions, diagnostic methods, genes used, assemblages and sub-assemblages. A meta-analysis using random-effects models was performed to calculate pooled prevalence rates, with the I2 index used to assess heterogeneity.

RESULTS

A total of 26 studies/datasets were analysed, covering data from 5543 rabbits across 15 countries. The estimated pooled prevalence of G. duodenalis in rabbits was 12.1% (95% CI: 7%-20%), with substantial heterogeneity (I2 = 96.5%). Geographic analysis showed higher prevalence rates in Africa and the AFR WHO region (72.3%, 95% CI: 61.7%-80.8%). Genetic analysis revealed three zoonotic assemblages (A, B and E) and two zoonotic sub-assemblages (AI and BIV) of G. duodenalis in rabbits, highlighting concerns over zoonotic transmission.

CONCLUSIONS

The findings highlight the global presence and genetic diversity of G. duodenalis in rabbits, indicating potential zoonotic risks. Ongoing monitoring and research are essential to clarify the transmission dynamics and public health implications of G. duodenalis in these animals. Raising awareness among pet owners, veterinarians and public health officials is vital to mitigate potential zoonosis.

Molecular characterization and risk analysis of Giardia duodenalis assemblages in corticosteroid-treated and non-treated patients in Ismailia, Arab Republic of Egypt

BACKGROUND

Giardia duodenalis (G. duodenalis) is an intestinal protozoan parasite of human and animal hosts. The present study investigated and compared the assemblages of G. duodenalis-infected faecal samples in patients on corticosteroid therapy (POCT) and control patients-not on corticosteroid therapy (CONT) and differentiated its assemblages and/or sub-assemblages' relationship with associated risk factors.

METHODS

Utilizing multi-locus sequence typing (MLST) with three loci targeted-triosephosphate isomerase (tpi), ꞵ-giardin (bg), and glutamate dehydrogenase (gdh)-G. duodenalis isolated from POCT and CONT were analyzed. Risk factors linked with Giardia infection and its assemblages were investigated.

RESULTS

In total, 52 G. duodenalis-infected patients were enrolled: 21 POCT and 31 CONT. The mean age was 12.3 years, the majority were male (59.6%), and 73.1% lived in rural areas. The POCT group was 36 times more likely than the CONT group to have a concurrent parasitic infection. About 73% (38/52) of Giardia samples were genotyped and/or sub-genotyped in at least one of the three loci. MLST identified sixteen isolates (42.0%) as assemblage B, ten isolates (26.3%) as assemblage A, and twelve isolates (31.6%) as a mixed infection of A + B and B + E. Most individuals of the POCT group were infected with G. duodenalis assemblage A while most of the CONT group were infected with assemblage B. Sub-assemblage AII was identified by phylogenetic analysis in the isolates of both groups under investigation.

CONCLUSION

This research advances giardiasis epidemiology in Arab Republic of Egypt (ARE) and reflects how corticosteroid-treated patients differ from those non-treated in Giardia assemblage pattern and their susceptibility to concomitant infection. Overall, Giardia assemblage patterns in this research populations reflect anthroponotic and zoonotic transmission, emphasizing the importance of public health policy and giardiasis prevention of illness transmission, particularly among those on corticosteroid therapy in ARE.

Prevalence and genetic diversity of Giardia duodenalis in sheep from large-scale farms in Southern Xinjiang, China

Giardia duodenalis is a significant zoonotic parasite. In this study, 767 fresh fecal samples were collected randomly from six large-scale sheep farms in Southern Xinjiang, China. Initially, G. duodenalis was screened using PCR at the SSU rRNA gene. Positive samples then underwent PCR amplification at the bg, gdh, and tpi genes. The prevalence of G. duodenalis in sheep was 17.5% (134/767), with the highest prevalence observed in the 3-6 months age group at 26.8% (56/209) and the lowest in the over 12 months age group at 6.8% (14/205). Among the 134 positive samples, only Assemblage E was identified. A total of 106, 92, and 98 sequences of G. duodenalis were obtained at the gdh, tpi, and bg genes, respectively. Fourteen isolates of G. duodenalis were successfully amplified at all three genes, resulting in nine G. duodenalis multilocus genotypes (MLG) named MLG E1-MLG E14, indicating high genetic diversity. In conclusion, G. duodenalis infection in sheep from large-scale farms is common in Southern Xinjiang, China, showing geographical regional distributions and genetic diversity.

Occurrence and assemblage distribution of Giardia Duodenalis in symptomatic and asymptomatic patients in southeastern Iran (2019-2022)

BACKGROUND

The ubiquitous protozoan parasite Giardia duodenalis is a major contributor to the global burden of diarrhoea, particularly in young children living in poor-resource regions. Although rarely mortal, giardiasis is associated with growth retardation and cognitive impairment in early childhood. Here we investigate the epidemiology of human giardiasis in Iranshahr (south-eastern Iran), a region where this information was previously lacking.

METHODS

Stool samples were collected from 17,455 outpatients and inpatients attended at three major hospital settings during April 2020 and March 2022. Microscopy was used as a screening method for the presence of Giardia cysts, and the identification of G. duodenalis assemblages was carried out using PCR and Sanger sequencing.

RESULTS

The overall prevalence of giardiasis was 1.87 (326/17,455; 95% CI: 1.7-2.1). Being female was positively associated with higher odds of giardiasis (p = 0.014). Individuals without diarrhoea were less likely to have giardiasis (p = 0.022). Individuals attending the Iran Hospital were more likely to harbour G. duodenalis infections compared to those attending at the Khatam Hospital and the Clinical Reference Laboratory (p = 0.001). Our sequence analyses revealed the presence of assemblages A (56.5%, 13/23), B (39.1%, 9/23), and A + B (4.4%, 1/23). No association was observed between the occurrence of a given assemblage and the occurrence of diarhroea.

CONCLUSIONS

Giardia infections were found at relatively low prevalence rates in both symptomatic and asymptomatic individuals seeking medical attention. Being female, having diarrhoea, and being sampled during 2020-21 were predictors of giardiasis. Although limited, our molecular data indicate that some Giardia infections may be zoonotic in nature. These data should be corroborated and expanded in future epidemiological studies targeting simultaneously human, animal, and environmental (water) samples to improve our understanding of the epidemiology of giardiasis in Iran.

Wastewater-based intestinal protozoa monitoring in Shanghai, China

Intestinal protozoa Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi have been implicated in serious waterborne outbreaks worldwide. Wastewater-based epidemiology (WBE) is a promising approach for evaluating the disease prevalence in a catchment population in that it monitors the contamination level of the intestinal pathogens in wastewater. We collected 48 urban wastewater samples (24 from influents and 24 from effluents) from the Yangpu Wastewater Treatment Plant (YPWTP) in Shanghai, China. We identified Cryptosporidium spp., G. duodenalis, and E. bieneusi by nested polymerase chain reaction (PCR) amplification. Cryptosporidium hominis and subtype IdA14 were identified in two samples by analyzing the sequences of small subunit ribosomal RNA (SSU rRNA) and 60-kDa glycoprotein (gp60) genes, respectively. The G. duodenalis sub-assemblage AII (n = 8) and assemblage C (n = 4) in 12 samples were determined by analyzing triosephosphate isomerase (tpi) gene sequences. The E. bieneusi genotype A was identified in one sample by analyzing the sequence of the internal transcribed spacer (ITS) region of the rRNA gene. These findings suggest that improving wastewater treatment and monitoring the virility of pathogens in effluents is critical. We observed similar prevalence and genotypes/subtypes of the three intestinal protozoa in our wastewater samples as those reported in previous studies, providing evidence that WBE can be used as an effective epidemic management tool.IMPORTANCECryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi are common intestinal protozoa causing diarrhea. The infective oocysts, cysts, and spores released in feces can survive in different environments, including multiple types of water bodies. Humans can acquire these intestinal protozoan infections via the fecal-oral route as in waterborne transmission. Wastewater-based epidemiology can rapidly and reliably detect and monitor the emergence and spread of waterborne diseases. We detected Cryptosporidium spp., G. duodenalis, and E. bieneusi in a wastewater treatment plant in Shanghai, China, reflecting the occurrence and genetic characterizations of the three intestinal pathogens from community members served by the wastewater treatment plant.

Imaging Giardia intestinalis cellular organisation using expansion microscopy reveals atypical centrin localisation

Advanced imaging of microorganisms, including protists, is challenging due to their small size. Specimen expansion prior to imaging is thus beneficial to increase resolution and cellular details. Here, we present a sample preparation workflow for improved observations of the single-celled eukaryotic pathogen Giardia intestinalis (Excavata, Metamonada). The binucleated trophozoites colonize the small intestine of humans and animals and cause a diarrhoeal disease. Their remarkable morphology includes two nuclei and a pronounced microtubular cytoskeleton enabling cell motility, attachment and proliferation. By use of expansion and confocal microscopy, we resolved in a great detail subcellular structures and organelles of the parasite cell. The acquired spatial resolution enabled novel observations of centrin localization at Giardia basal bodies. Interestingly, non-luminal centrin localization between the Giardia basal bodies was observed, which is an atypical eukaryotic arrangement. Our protocol includes antibody staining and can be used for the localization of epitope-tagged proteins, as well as for differential organelle labelling by amino reactive esters. This fast and simple technique is suitable for routine use without a superresolution microscopy equipment.

Cytotoxic effects of ivermectin on Giardia lamblia: induction of apoptosis and cell cycle arrest

Introduction

Giardia lamblia is a flagellated protozoan parasite causing giardiasis, a common intestinal infection characterized by diarrhea, abdominal cramps, and nausea. Treatments employed to combat this parasitic infection have remained unchanged for the past 40 years, leading to the emergence of resistant strains and prompting the search for new therapeutic agents.

Methods

This study investigated the cytotoxic effects of ivermectin (IVM) on G. lamblia trophozoites. We conducted dose-response experiments to assess IVM-induced cytotoxicity. We utilized various biochemical and ultrastructural analyses to explore the underlying mechanisms of cell death, including reactive oxygen species (ROS) production, DNA fragmentation, cell cycle arrest, and apoptosis markers.

Results

Our findings demonstrate that IVM induces dose-dependent cytotoxicity and triggers cell death pathways. We found that IVM treatment generates elevated levels of reactive oxygen species (ROS), DNA fragmentation, and arrests of trophozoites in the cell cycle's S phase. Additionally, ultrastructural analysis reveals morphological alterations consistent with apoptosis, such as cytoplasmic vacuolization, chromatin condensation, and tubulin distribution.

Discussion

The insights gained from this study may contribute to developing new therapeutic strategies against giardiasis, addressing the challenge posed by drug-resistant strains.

Molecular characterization of Giardia duodenalis, Cryptosporidium spp., and Entamoeba spp. infecting domestic and feral/stray cats in Jordan

This study aimed to carry out a molecular screening for the presence of Giardia, Cryptosporidium, and/or Entamoeba in the feces of pet and stray/feral cats in Jordan. G. duodenalis was found in 27.9% (95% CI, 23.2-32.9) of the 348 sampled cats overall; E. histolytica was found in only 0.6% (95% CI, 0.1-2.1) of the cats, while none of the sampled cats had Cryptosporidium infections. The infection rate of G. duodenalis among indoor cats (32.3%) did not differ significantly from that among outdoor cats (24.1%). There were significantly more infections (p = 0.0004) geographically in the cold semiarid areas (67%) than in the cold desert areas (24%). Multilocus sequence typing analysis of amplicons based on the bg, tpi, and gdh genes revealed that the majority of G. duodenalis infections were zoonotic assemblage B (65.9%; 64 of 97 positive samples); followed by feline-specific assemblage F (18.5%, 18/97); cattle-specific assemblage E (5.2%, 5/97); and then assemblage C that was shared with canids (1.0%; 1/97). Within Giardia isolates, a substitution mutation (A/G) was found at position 297 of the complete protein coding sequence (cds) of tpi-assemblage B, which may represent a new spreading mutation within this gene among the cat population in Jordan. The results of the present study suggest that close human-cat interactions could play a role in zoonotic transmission of Giardia, but further research is needed to determine the possible contribution of cats to the transmission of other protozoa to humans.

Genetic Mechanisms Involved in Microbial Stress Responses

The ability of living beings to deal with abrupt environmental changes is paramount for survival, and organisms have evolved a large variety of molecular mechanisms (known globally as stress responses) to buffer the harmful effects of stressors on cellular homeostasis [...].

Report of Giardia duodenalis in a non-captive chital Axis axis (Erxleben 1777) in Santa Catarina, South of Brazil

Giardiasis is an infection of the small intestine by protozoa of the genus Giardia, which has a wide range of susceptible hosts, including domestic and wild animals and humans. Giardia is a zoonotic agent and represents one of the main human parasites, with high prevalence and great importance in public health. This report aims to describe the parasitism of a non-captive Chital deer (Axis axis) by Giardia duodenalis. The animal, after being rescued by soldiers from the 2nd Platoon of the 2nd Company of the 2nd Battalion of the Environmental Military Police of the State of Santa Catarina, was sent to the Wildlife Studies Center (NEVS) of the University of Western Santa Catarina (UNOESC). During clinical care, an exposed fracture in the left pelvic limb and signs of acute respiratory failure were found. Fecal samples were collected for later parasitological diagnosis. Two techniques were applied: centrifugal flotation with zinc sulfate, to diagnose parasites of the gastrointestinal system, and Baermann, to search for parasitism in the respiratory tract. The investigation revealed the presence of Giardia duodenalis. The animal died on the same day of its arrival due to a cardiorespiratory arrest. The presence of this parasite in an invasive exotic deer species highlights its epidemiological importance, as it can act as a source of infection and spread the disease to humans and other animals.

Lysine methyltransferase 2 plays a key role in the encystation process in the parasite Giardia lamblia

Histone post-translational modifications are extensively studied for their role in regulating gene transcription and cellular environmental adaptation. Research into these modifications has recently begun in the protozoan parasite Giardia lamblia, focusing on histone-modifying enzymes and specific post-translational changes. In the transformation from the trophozoite to the cyst form in the life cycle of this parasite, significant morphological and genetic alterations occur, culminating in the synthesis of cyst wall proteins responsible for forming the protective cyst wall. It has been previously demonstrated that histone deacetylation is required during encystation and that the enzyme lysine methyltransferase 1 is involved in the upregulation of encystation. Our study aims to extend the analysis to lysine methyltransferase 2 (GlKMT2) function. For this, two constructs were generated: one that downregulate the expression of GLKMT2 via antisense (glkmt2-as transgenic cells) and the other overexpressing GlKMT2 (glkmt2-ha transgenic cells). We found that the glktm2-as transgenic cells showed an arrest in progress at the late encystation stage. Consequently, the number of cysts produced was lower than that of the control cells. On the other hand, we found that the overexpression of GlKMT2 acts as a negative mutant of the enzyme. In this way, these glktm2-ha transgenic cells showed the same behavior during growth and encystation as glkmt2-as transgenic cells. This interplay between different enzymes acting during encystation reveals the complex process behind the differentiation of the parasite. Understanding how these enzymes play their role during the encystation of the parasite would allow the design of inhibitors to control the parasite.

Diffusely Infiltrative Small Bowel Disease

Multiple infiltrative disorders can affect the small bowel, often resulting in diffuse small bowel wall thickening. These infiltrative disorders can manifest owing to various factors such as an influx of immunologic or neoplastic cells or the accumulation of substances within one or more layers of the intestinal wall. Although there can be considerable overlap in the appearances of infiltrative diseases on cross-sectional images, a comprehensive understanding of more specific ancillary imaging features and clinicopathologic correlation can substantially narrow the differential diagnosis. The radiologist can be instrumental in synthesizing the clinical and imaging information and guiding subsequent workup. The authors present a comprehensive review of the infiltrative disorders that commonly involve the small bowel. These disorders are organized on the basis of their pathophysiologic features, with multiple illustrative case examples to enhance understanding of these entities. CT and MRI are currently the most commonly used imaging modalities for evaluating small bowel disorders, and this review is focused on these two modalities. Detailed information regarding the pathologic features, clinical presentation, and imaging findings of these infiltrative disorders is provided to aid radiologists in recognizing and differentiating these conditions. ©RSNA, 2024.

Extracellular vesicles release from protozoa parasite and animal model

Diseases caused by protozoan parasites, such as leishmaniasis, trypanosomiasis, and malaria, are highly complex and together continue to cause high annual morbidity and mortality. The search for new compounds in environmental biodiversity, repositioning known drugs, and developing vaccines using old and innovative technologies have been employed to discover vaccines and new and alternative treatments. Extracellular vesicles (EVs) can carry parasite antigens, creating a new possibility to develop an effective and affordable platform for treatment, vaccines, and drug delivery. Thus, the evaluation of EVs in animal models can and should be explored among the countless biomedical applications. Herein, we will address the concept of EVs, their acquisition and characterization in protozoan parasite models, and the primary studies using these vesicles in therapeutic applications.

Insights into Peptidyl-Prolyl cis-trans Isomerases from Clinically Important Protozoans: From Structure to Potential Biotechnological Applications

Peptidyl-prolyl cis/trans isomerases (PPIases) are present in a wide variety of microorganisms, including protozoan parasites such as Trypanosoma cruzi, Trypanosoma brucei, Trichomonas vaginalis, Leishmania major, Leishmania donovani, Plasmodium falciparum, Plasmodium vivax, Entamoeba histolytica, Giardia intestinalis, Cryptosporidium parvum, and Cryptosporidium hominis, all of which cause important neglected diseases. PPIases are classified as cyclophilins, FKBPs, or parvulins and play crucial roles in catalyzing the cis-trans isomerization of the peptide bond preceding a proline residue. This activity assists in correct protein folding. However, experimentally, the biological structure-function characterization of PPIases from these protozoan parasites has been poorly addressed. The recombinant production of these enzymes is highly relevant for this ongoing research. Thus, this review explores the structural diversity, functions, recombinant production, activity, and inhibition of protozoan PPIases. We also highlight their potential as biotechnological tools for the in vitro refolding of other recombinant proteins from these parasites. These applications are invaluable for the development of diagnostic and therapeutic tools.

Unveiling the presence and genotypic diversity of Giardia duodenalis on large-scale sheep farms: insights from the Henan and Ningxia Regions, China

BACKGROUND

The parasitic protozoan Giardia duodenalis is an important cause of diarrheal disease in humans and animals that can be spread by fecal-oral transmission through water and the environment, posing a challenge to public health and animal husbandry. Little is known about its impact on large-scale sheep farms in China. In this study we investigated G. duodenalis infection of sheep and contamination of the environment in large-scale sheep farms in two regions of China, Henan and Ningxia.

METHODS

A total of 528 fecal samples, 402 environmental samples and 30 water samples were collected from seven large-scale sheep farms, and 88 fecal samples and 13 environmental samples were collected from 12 backyard farms. The presence of G. duodenalis was detected by targeting the β-giardin (bg) gene, and the assemblage and multilocus genotype of G. duodenalis were investigated by analyzing three genes: bg, glutamate dehydrogenase (gdh) and triphosphate isomerase (tpi).

RESULTS

The overall G. duodenalis detection rate was 7.8%, 1.4% and 23.3% in fecal, environmental and water samples, respectively. On the large-scale sheep farms tested, the infection rate of sheep in Henan (13.8%) was found to be significantly higher than that of sheep in Ningxia (4.2%) (P < 0.05). However, the difference between the rates of environmental pollution in Henan (1.9%) and Ningxia (1.0%) was not significant (P > 0.05). Investigations of sheep at different physiological stages revealed that late pregnancy ewes showed the lowest infection rate (1.7%) and that young lambs exhibited the highest (18.8%). Genetic analysis identified G. duodenalis belonging to two assemblages, A and E, with assemblage E being dominant. A total of 27 multilocus genotypes were identified for members of assemblage E.

CONCLUSIONS

The results suggest that G. duodenalis is prevalent on large-scale sheep farms in Henan and Ningxia, China, and that there is a risk of environmental contamination. This study is the first comprehensive examination of the presence of G. duodenalis on large-scale sheep farms in China. Challenges posed by G. duodenalis to sheep farms need to be addressed proactively to ensure public health safety.

Impact of COVID-19 Restrictions on Incidence of Enteropathogenic Bacteria, Virus, and Parasites in Denmark: A National, Register-Based Study

Diarrheal diseases caused by enteric pathogens are a significant public health concern. It is widely considered that close contact between persons, poor hygiene, and consumption of contaminated food are the primary causes of gastroenteritis. Clinical microbiology laboratory observations indicate that the incidence of enteropathogenic microorganisms may have been reduced in Denmark during the COVID-19 pandemic. All Departments of Clinical Microbiology in Denmark provided data on the monthly incidence of Salmonella spp., Escherichia coli, Campylobacter spp., Clostridioides difficile, Norovirus GI+GII, Giardia duodenalis, and Cryptosporidium from March 2018 to February 2021. The data were divided into three periods as follows: Control Period 1 (March 2018 to February 2019); Control Period 2 (March 2019 to February 2020); and the Restriction (pandemic) Period (March 2020 to February 2021). The incidences of pathogenic Salmonella spp.-, Escherichia coli-, and Campylobacter spp.-positive samples decreased by 57.3%, 48.1%, and 32.9%, respectively, during the restriction period. No decrease in C. difficile was observed. Norovirus GI+GII-positive samples decreased by 85.6%. Giardia duodenalis-positive samples decreased by 66.2%. Cryptosporidium species decreased by 59.6%. This study demonstrates a clear decrease in the incidence of enteropathogenic bacteria (except for C. difficile), viruses, and parasites during the SARS-CoV-2 restriction period in Denmark.

Prevalence and Genetic Characterization of Giardia duodenalis and Blastocystis spp. in Black Goats in Shanxi Province, North China: From a Public Health Perspective

Blastocystis spp. and Giardia duodenalis are two prevalent zoonotic intestinal parasites that can cause severe diarrhea and intestinal diseases in humans and many animals. Black goat (Capra hircus) farming is increasingly important in China due to the remarkable adaptability, high reproductive performance, rapid growth rate, and significant economic value of black goats. A number of studies have indicated that black goats are the potential reservoir of multiple zoonotic protozoans in China; however, the prevalence and zoonotic status of G. duodenalis and Blastocystis spp. in black goats in Shanxi Province is still unknown. Thus, a total of 1200 fecal samples of black goats were collected from several representative regions at different altitudes in Shanxi Province and were examined for the presence and genotypes of G. duodenallis and Blastocystis spp. by amplifying the beta-giardin (bg), glutamate dehydrogenase (gdh), and triosephosphate isomerase (tpi) loci of G. duodenalis and SSU rRNA of Blastocystis spp. using PCR and sequence analysis methods, respectively. The overall prevalence of G. duodenalis and Blastocystis spp. in black goats in Shanxi Province were 7.5% and 3.5%, respectively. Two assemblages (B and E) of G. duodenalis and four subtypes (ST5, ST10, ST14, and ST30) of Blastocystis spp. were identified, with assemblage E and ST10 as the prevalent genotype and subtype in black goats, respectively. One novel multilocus genotype (MLG) was identified in MLG-E and was designated as MLG-E12. For both G. duodenalis and Blastocystis spp., the prevalence was significantly related to the region and age groups (p < 0.05). This is the first report on the prevalence of G. duodenalis and Blastocystis spp. in black goats in Shanxi Province. These results not only provide baseline data for the prevention and control of both parasites in black goats in Shanxi Province, but also enhance our understanding of the genetic composition and zoonotic potential of these two parasites.

Comparative genomics of Giardia duodenalis sub-assemblage AI beaver (Be-2) and human (WB-C6) strains show remarkable homozygosity, sequence similarity, and conservation of VSP genes

Giardia duodenalis, a major cause of waterborne infection, infects a wide range of mammalian hosts and is subdivided into eight genetically well-defined assemblages named A through H. However, fragmented genomes and a lack of comparative analysis within and between the assemblages render unclear the molecular mechanisms controlling host specificity and differential disease outcomes. To address this, we generated a near-complete de novo genome of AI assemblage using the Oxford Nanopore platform by sequencing the Be-2 genome. We generated 148,144 long-reads with quality scores of > 7. The final genome assembly consists of only nine contigs with an N50 of 3,045,186 bp. This assembly agrees closely with the assembly of another strain in the AI assemblage (WB-C6). However, a critical difference is that a region previously placed in the five-prime region of Chr5 belongs to Chr4 of Be-2. We find a high degree of conservation in the ploidy, homozygosity, and the presence of cysteine-rich variant-specific surface proteins (VSPs) within the AI assemblage. Our assembly provides a nearly complete genome of a member of the AI assemblage of G. duodenalis, aiding population genomic studies capable of elucidating Giardia transmission, host range, and pathogenicity.

TATA-Binding Protein-Based Virtual Screening of FDA Drugs Identified New Anti-Giardiasis Agents

Parasitic diseases, predominantly prevalent in developing countries, are increasingly spreading to high-income nations due to shifting migration patterns. The World Health Organization (WHO) estimates approximately 300 million annual cases of giardiasis. The emergence of drug resistance and associated side effects necessitates urgent research to address this growing health concern. In this study, we evaluated over eleven thousand pharmacological compounds sourced from the FDA database to assess their impact on the TATA-binding protein (TBP) of the early diverging protist Giardia lamblia, which holds medical significance. We identified a selection of potential pharmacological compounds for combating this parasitic disease through in silico analysis, employing molecular modeling techniques such as homology modeling, molecular docking, and molecular dynamics simulations. Notably, our findings highlight compounds DB07352 and DB08399 as promising candidates for inhibiting the TBP of Giardia lamblia. Also, these compounds and DB15584 demonstrated high efficacy against trophozoites in vitro. In summary, this study identifies compounds with the potential to combat giardiasis, offering the prospect of specific therapies and providing a robust foundation for future research.

Non-Host Factors Influencing Onset and Severity of Celiac Disease

Celiac disease (CeD) is a chronic autoimmune condition driven by gluten ingestion in genetically predisposed individuals, resulting in inflammatory lesions in the proximal small intestine. Although the presence of specific HLA-linked haplotypes and gluten consumption are necessary for disease development, they alone do not account for the variable onset of CeD in susceptible individuals. This review explores the multifaceted role of non-host factors in CeD development, including dietary and microbial influences. We discuss clinical associations and observations highlighting the impact of these factors on disease onset and severity. Furthermore, we discuss studies in CeD-relevant animal models that offer mechanistic insights into how diet, the microbiome, and enteric infections modulate CeD pathogenesis. Finally, we address the clinical implications and therapeutic potential of understanding these cofactors offering a promising avenue for preventive and therapeutic interventions in CeD management.

Molecular characterization of Cryptosporidium spp. and Giardia duodenalis in pet cats in Henan Province, central China

Cryptosporidium spp. and G. duodenalis often infect humans, cats, and other mammals, causing diarrhea and being responsible for numerous outbreaks of waterborne and foodborne infections worldwide. The rapid increase in the number of pet cats poses a substantial public health risk. However, there were few reports about the infection of Cryptosporidium spp. and G. duodenalis infections in pet cats in Henan Province, central China. Thus, to understand the prevalence and genetic distribution of Cryptosporidium spp. and G. duodenalis in pet cats, and to evaluate the zoonotic potential, possible transmission routes and public health implications of isolates, fecal samples (n = 898) were randomly collected from pet cats in 11 cities in Henan Province, central China. Nested PCR based on the SSU rRNA gene and bg gene was used to the prevalence of Cryptosporidium spp. and G. duodenalis, respectively. The prevalence was 0.8 % (7/898) and 2.0 % (18/898) for Cryptosporidium spp. and G. duodenalis respectively. Additionally, the Cryptosporidium spp. positive isolates were identified as C. parvum subtype IIdA19G1 by gp60 gene. In the present study, the IIdA19G1 subtype was discovered in pet cats for the first time in China, enriching the information on the host type and geographical distribution of Cryptosporidium spp. in China. For G. duodenalis, a total of 18 G. duodenalis positive samples were identified, belonging to four assemblages: a zoonotic assemblage A1 (4/898), three host-specific assemblages C (8/898), D (5/898), and F (1/898). Interestingly, we found that pet cats infected with Cryptosporidium spp. and G. duodenalis are more likely to experience emaciation symptoms compared to the negative group. More importantly, the prevalence of Cryptosporidium spp. and G. duodenalis detected in the present study were low, but the subtype IIdA19G1 of Cryptosporidium spp. and the assemblages A1, C, D, and F of G. duodenalis have the potential for zoonotic transmission. Thus, we should focus on preventing and controlling the risk of cross-species transmission that may occur in pet cats in Henan Province.

Prevalence and Molecular Characterization of Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi in Cattle in Heilongjiang Province, Northeast China

Crytosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi are important diarrheal pathogens with a global distribution that threatens the health of humans and animals. Despite cattle being potential transmission hosts of these protozoans, the associated risks to public health have been neglected. In the present study, a total of 1155 cattle fecal samples were collected from 13 administrative regions of Heilongjiang Province. The prevalence of Cryptosporidium spp., G. duodenalis, and E. bieneusi were 5.5% (64/1155; 95% CI: 4.2-6.9), 3.8% (44/1155; 95% CI: 2.7-4.9), and 6.5% (75/1155; 95% CI: 5.1-7.9), respectively. Among these positive fecal samples, five Cryptosporidium species (C. andersoni, C. bovis, C. ryanae, C. parvum, and C. occultus), two G. duodenalis assemblages (E and A), and eight E. bieneusi genotypes (BEB4, BEB6, BEB8, J, I, CHS7, CHS8, and COS-I) were identified. Phylogenetic analysis showed that all eight genotypes of E. bieneusi identified in the present study belonged to group 2. It is worth noting that some species/genotypes of these intestinal protozoans are zoonotic, suggesting a risk of zoonotic disease transmission in endemic areas. The findings expanded our understanding of the genetic composition and zoonotic potential of Cryptosporidium spp., G. duodenalis, and E. bieneusi in cattle in Heilongjiang Province.

Assessment of Drug Activities against Giardia Using Hyperspectral Raman Microscopy

This study demonstrates the capability of Raman microscopy for detecting structural differences in Giardia cells exposed to different drugs and incubation times. While metronidazole (MTZ) visibly affects the cells by inducing extracellular vesicle releases of toxic iron intermediates and modified triple-bond moieties, oseltamivir (OSM) alters the phenylalanine and lipid structures. Modifications in the heme protein environment and the transformation of iron from ferric to ferrous observed for both drug treatments are more notable for MTZ. Different contents and amounts of vesicle excretion are detected for 24 h or 48 h with MTZ incubation. At a shorter drug exposure, releases of altered proteins, glycogen, and phospholipids dominate. Agglomerates of transformed iron complexes from heme proteins and multiple-bond moieties prevail at 48 h of treatment. No such vesicle releases are present in the case of OSM usage. Drug incorporations into the cells and their impact on the plasma membrane and the dynamics of lipid raft confirmed by confocal fluorescence microscopy reveal a more destructive extent by OSM, corroborating the Raman results. Raman microscopy provides a broader understanding of the multifaceted factors and mechanisms responsible for giardiasis treatment or drug resistance by enabling a label-free, simultaneous monitoring of structural changes at the cellular and molecular levels.

Microscopy detection and molecular characterisation of Giardia duodenalis infection in outpatients seeking medical care in Egypt

Introduction

Giardiosis remains one of the most prevalent enteric parasitic infections globally. Earlier molecular-based studies conducted in Egypt have primarily focused on paediatric clinical populations and most were based on single genotyping markers. As a result, there is limited information on the frequency and genetic diversity of G. duodenalis infections in individuals of all age groups.

Methods

Individual stool samples (n = 460) from outpatients seeking medical care were collected during January-December 2021 in Kafr El-Sheikh governorate, northern Egypt. Initial screening for the presence of G. duodenalis was conducted by coprological examination. Microscopy-positive samples were further confirmed by real-time PCR. A multilocus sequence typing approach targeted amplification of the glutamate dehydrogenase (gdh), beta-giardin (bg), and triose phosphate isomerase (tpi) genes was used for genotyping purposes. A standardised epidemiological questionnaire was used to gather basic sociodemographic and clinical features of the recruited patients.

Results

Giardia duodenalis cysts were observed in 5.4% (25/460, 95% CI: 3.6-7.9) of the stool samples examined by conventional microscopy. The infection was more frequent in children under the age of 10 years and in individuals presenting with diarrhoea but without reaching statistical significance. Stool samples collected during the winter period were more likely to harbour G. duodenalis. All 25 microscopy-positive samples were confirmed by real-time PCR, but genotyping data was only available for 56.0% (14/25) of the isolates. Sequence analyses revealed the presence of assemblages A (78.6%, 11/14) and B (21.4%, 3/14). All assemblage A isolates were identified as sub-assemblage AII, whereas the three assemblage B sequences belonged to the sub-assemblage BIII. Patients with giardiosis presenting with diarrhoea were more frequently infected by the assemblage A of the parasite.

Conclusion

This is one of the largest epidemiological studies evaluating G. duodenalis infection in individuals of all age groups in Egypt. Our molecular data suggest that G. duodenalis infections in the surveyed population are primarily of anthropic origin. However, because assemblages A and B are zoonotic, some of the infections identified can have an animal origin. Additional investigations targeting animal (domestic and free-living) and environmental (water) samples are warranted to better understand the epidemiology of giardiosis in Egypt.

High-resolution comparative atomic structures of two Giardiavirus prototypes infecting G. duodenalis parasite

The Giardia lamblia virus (GLV) is a non-enveloped icosahedral dsRNA and endosymbiont virus that infects the zoonotic protozoan parasite Giardia duodenalis (syn. G. lamblia, G. intestinalis), which is a pathogen of mammals, including humans. Elucidating the transmission mechanism of GLV is crucial for gaining an in-depth understanding of the virulence of the virus in G. duodenalis. GLV belongs to the family Totiviridae, which infects yeast and protozoa intracellularly; however, it also transmits extracellularly, similar to the phylogenetically, distantly related toti-like viruses that infect multicellular hosts. The GLV capsid structure is extensively involved in the longstanding discussion concerning extracellular transmission in Totiviridae and toti-like viruses. Hence, this study constructed the first high-resolution comparative atomic models of two GLV strains, namely GLV-HP and GLV-CAT, which showed different intracellular localization and virulence phenotypes, using cryogenic electron microscopy single-particle analysis. The atomic models of the GLV capsids presented swapped C-terminal extensions, extra surface loops, and a lack of cap-snatching pockets, similar to those of toti-like viruses. However, their open pores and absence of the extra crown protein resemble those of other yeast and protozoan Totiviridae viruses, demonstrating the essential structures for extracellular cell-to-cell transmission. The structural comparison between GLV-HP and GLV-CAT indicates the first evidence of critical structural motifs for the transmission and virulence of GLV in G. duodenalis.

Prevalence of Giardia duodenalis among Asian children: a systematic review and meta-analysis

Giardia duodenalis is one of the major causes of diarrhea among children. We performed a systematic review and meta-analysis to assess the prevalence of G. duodenalis and associated risk factors among Asian children. We searched online databases (PubMed, Scopus and Web of Science) and Google Scholar search engine for studies published from 1 January 2000 to 15 March 2022 that measured the prevalence of G. duodenalis among Asian children. Accordingly, the pooled prevalence and 95% CIs were estimated using a random-effects meta-analysis model for the included studies. A total of 182 articles from 22 Asian countries met the inclusion criteria. The pooled prevalence of G. duodenalis infection among Asian children was estimated as 15.1% (95% CI 14.1 to 16%). The highest and lowest pooled prevalence values of G. duodenalis infection were estimated for Tajikistan and China as 26.4% (95% CI 22.9 to 30%) and 0.6% (95% CI 0.001 to 1.02%), respectively. The infection had a higher prevalence in males than in females (OR=1.24; 95% CI 1.16 to 1.31; p<0.001), which was statistically significant. Giardiasis is common among Asian children, hence, a prevention and control scheme of this protozoan in children should be considered by health officials and health policymakers, especially in Asian countries where the prevalence is highest.

Current Understanding of Giardia lamblia and Pathogenesis of Stunting and Cognitive Deficits in Children from Low- and Middle-Income Countries

Purpose of Review

Giardia lamblia is a common intestinal parasite worldwide, mainly in children from low- and middle-income countries (LMIC). Also, it has been associated with increased intestinal permeability, stunting, and cognitive impairment. Nonetheless, the pathogenesis of long-term consequences is difficult to elucidate.

Recent Findings

Recent studies try to understand the long-term consequences of Giardia infections. First, well-characterized studies associate Giardia with intestinal damage and child growth. Second, infections appear not to be associated with inflammation, but "lack of inflammation" may not, however, entirely exclude a pro-inflammatory pathway. Finally, some important amino acids are lower and could contribute to prolongate stunting and cognitive deficit.

Summary

Giardia infections in LMIC used to be associated with child growth shortfalls, gut permeability, and cognitive deficits. Multifactorial effects could be associated with Giardia, including nutritional, altered microbiota, and generation of potentially toxic microbial metabolic byproducts, all together increasing risk of long-term outcomes.

A Thorny Tale of Parasites: Screening for Enteric Protozoan Parasites in Hedgehogs from Portugal

Enteric protozoan parasites, such as Blastocystis sp., Balantioides coli, Cryptosporidium spp., and Giardia duodenalis, may have implications for both animal and human health.Transmitted through the fecal-oral route, these parasites cause symptoms such as diarrhea, abdominal pain, and weight loss. This study investigated the presence of these enteric protozoan parasites and genetically characterized them in hedgehogs from Portugal. A total of 110 hedgehog stool samples were collected. Molecular detection methods showed an overall occurrence of protozoa in 1.82% (2/110 95% CI: 0.22-6.41) of hedgehogs, with Blastocystis being found in one hedgehog and Cryptosporidium being found in another. No evidence for the presence of B. coli or G. duodenalis was found. This study suggests that there is a need to stay aware of hedgehogs as potential hosts of enteric protozoa. Ongoing research and surveillance efforts are recommended to explore practical prevention and control strategies. The results contribute to the limited knowledge of these parasites in Portuguese hedgehog populations and underscore their potential relevance to both veterinary and public health.

Fused Enzyme Glucose-6-Phosphate Dehydrogenase::6-Phosphogluconolactonase (G6PD::6PGL) as a Potential Drug Target in Giardia lamblia, Trichomonas vaginalis, and Plasmodium falciparum

Several microaerophilic parasites such as Giardia lamblia, Trichomonas vaginalis, and Plasmodium falciparum are major disease-causing organisms and are responsible for spreading infections worldwide. Despite significant progress made in understanding the metabolism and molecular biology of microaerophilic parasites, chemotherapeutic treatment to control it has seen limited progress. A current proposed strategy for drug discovery against parasitic diseases is the identification of essential key enzymes of metabolic pathways associated with the parasite's survival. In these organisms, glucose-6-phosphate dehydrogenase::6-phosphogluconolactonase (G6PD:: 6PGL), the first enzyme of the pentose phosphate pathway (PPP), is essential for its metabolism. Since G6PD:: 6PGL provides substrates for nucleotides synthesis and NADPH as a source of reducing equivalents, it could be considered an anti-parasite drug target. This review analyzes the anaerobic energy metabolism of G. lamblia, T. vaginalis, and P. falciparum, with a focus on glucose metabolism through the pentose phosphate pathway and the significance of the fused G6PD:: 6PGL enzyme as a therapeutic target in the search for new drugs.

Differential gene expression (DGE) analysis in persons with a history of giardiasis

Giardiasis, which is caused by Giardia duodenalis, has clinical symptoms such as steatorrhea and can be very dangerous in children. In addition, some documents reported that this parasite is present inside the tissue of patients with cancer. In this study, we analyzed the gene expression profiles of some main genes important to apoptosis and anti-apoptosis in humans.Expression profile arrays of Genomic Spatial Event (GSE) 113666, GSE113667, and GSE113679 obtained from Gene Expression Omnibus were used for meta-analysis using R commands. Cytoscape and STRING databases used the protein-protein Interaction network. Then, the Kyoto Encyclopedia of Genes and Genomes and Gene Ontology analysis was performed. Similar genes in Homo sapiens were identified using Basic Local Alignment Search Tool analysis. The validation was performed on eight people using real-time Polymerase chain reaction. In addition to the candidate genes, the gene expression of some other genes, including Serine/Threonine Kinase 1 (AKT1), Cyclin Dependent Kinase Inhibitor 2A (CDKN2A), Kirsten Rat Sarcoma (KRAS), and Phosphatidylinositol-4,5-Bisphosphate 3-Kinase Catalytic Subunit Alpha (PIK3CA) were also examined. Analysis of the expression of serum amyloid A1 (SAA1), Regenerating Islet-Derived 3 Gamma (REG3G), and REG3A genes did not show any difference between the two groups of healthy and diseased people. Examining the mean expression of the four genes AKT1, CDKN2A, KRAS, and PIK3CA showed that three genes of AKT1, CDKN2A, and KRAS had increased expression in people with a history of giardiasis compared to healthy people. We showed that the gene expression pattern differs in apoptosis and anti-apoptosis signaling in people with a history of giardiasis. Giardia duodenalis seems to induce post-non-infectious symptoms with stimulation of human gene expression.

Real-time loop-mediated isothermal amplification for the detection of Giardia duodenalis in fecal specimens

INTRODUCTION

Giardiasis is a leading cause of subacute or chronic diarrhoea and is frequently associated with impaired physical, cognitive and psychosocial development, especially in children. The diagnosis relies mainly on the microscopic evaluation of stool specimens that have a low sensitivity. In contrast, molecular advancements like the polymerase chain reaction and Real-time loop-mediated isothermal amplification (Real-time LAMP) are promising techniques and reportedly have better diagnostic characteristics.

METHODS

We have evaluated the performance of Real-time LAMP for detecting Giardia in ninety stool specimens compared to microscopy and nested PCR.

RESULTS

A total of 35 fecal samples were detected positive by microscopy, 41 by nested PCR and 43 by real-time LAMP. Microscopy and nested PCR detected 33, microscopy and real-time LAMP detected 35, and nested PCR and real-time LAMP detected 41 positive samples.

CONCLUSION

The real-time LAMP assay was found suitable for the rapid and accurate detection of G. duodenalis with a better sensitivity in comparison to nested PCR and microscopy. Furthermore, besides being sensitive and rapid, LAMP had the advantage of an adequate rapid turn-around time of eleven to 15 ​min as compared to 5 ​h of nested PCR.

Prevalence and assemblage of Giardia duodenalis in a case-control study of children under 5 years from Jimma, Southwest Ethiopia

Giardia duodenalis is a common pathogenic intestinal protozoan parasite with high prevalence in developing countries, especially among children. The distribution of giardia assemblages among humans and their clinical relevance remains controversial. This study aimed to determine the prevalence and assemblage of Giardia among children under 5 years of age in Jimma, Southwest Ethiopia. Employing a case-control design, 606 children presenting with diarrhea at Jimma university medical center and Serbo Health Center were enrolled from December 2016 to July 2018 along with 617 matched controls without diarrhea. Giardia was detected and typed using real-time PCR. Univariate and multivariate regression analysis was performed. The total prevalence of Giardia was 41% (501/1223) and did not differ significantly between cases and controls (40% vs 42%). Prevalence increased by age, with the highest prevalence seen in children aged ≥ 25 months. Children without diarrhea with a history of diarrhea during the last month were more likely to be Giardia positive compared to children with no history diarrhea (OR 1.8 and 95%CI; 1.1-2.9). Regardless of current diarrhea symptoms, assemblage B predominated with 89%, followed by assemblage A (8%) and mixed infection assemblage A and B (3%). We report a high prevalence of Giardia by PCR detection in Jimma, Ethiopia, with assemblage B being predominant. There was a similar distribution of Giardia assemblages between children with and without diarrhea. Increasing age was a risk factor for Giardia infection. Community-based prevention and control strategies need to be employed to decrease the risk of giardia infection.

Prevalence and Multilocus Genotyping of Giardia duodenalis in Donkeys in Shanxi Province, North China

Giardia duodenalis is a ubiquitous flagellated protozoan, causing significant economic losses to animal husbandry and posing threats to public health. China ranks the world's sixth largest major producer of donkeys, rearing approximately 2.6 million donkeys in 2019, but limited investigation of G. duodenalis prevalence has been conducted in the past, and it is yet to be known whether donkeys in Shanxi Province are infected with G. duodenalis. In the present study, a total of 815 fecal samples collected from donkeys in representative regions of Shanxi Province, North China, were examined for G. duodenalis using nested PCR. Then, the assemblages and multilocus genotypes (MLGs) were examined based on three established loci: namely, β-giardin (bg), triosephosphate isomerase (tpi), and glutamate dehydrogenase (gdh). The overall prevalence of G. duodenalis in donkeys in Shanxi Province was 16.81% (137/815). The region was identified as the main risk factor for the observed difference in G. duodenalis prevalence in donkeys among the three study areas (χ2 = 21.611, p < 0.001). Assemblages A, E, and B were identified, with the latter as the predominant assemblage. Three MLGs (MLG-novel-1 to 3) were formed based on sequence variation among the three loci. The present study reveals the presence of G. duodenalis in donkeys in Shanxi Province, North China, for the first time, which not only enriches the data on the distribution of G. duodenalis in donkeys in China but also provides useful baseline data for planning control strategies against G. duodenalis infection in the sampled areas.

[Feline and canine giardiosis: An Update]

Giardia duodenalis is a facultative pathogenic intestinal parasite. Giardiosis in dogs and cats may appear with or without clinical signs. Typical signs include diarrhea with or without vomiting. The prevalence in young animals is high and may amount to up to 50%. There are 8 different genotypes (A - H), which are called assemblages. Assemblages C and D are most common in dogs and assemblage F most frequent in cats. However, animals may also be infected with the zoonotically effective assemblages A and B or exhibit mixed infections. The immunofluorescence test (IFA), the enzyme-linked immunosorbent assay (ELISA) and fecal centrifugation using zinc sulphate solution are currently recommended as diagnostic methods. Polymerase chain reaction (PCR) may be used to determine the corresponding assemblage. Approved treatments for giardiosis include fenbendazole and metronidazole. In addition, undertaking specific hygiene measures is warranted. Only animals showing clinical signs or those living in the same household with high-risk patients (e. g. immunosuppressed humans) are recommended to receive medication. The aim of treatment is clinical improvement of the diseased dogs and cats. Frequently, complete elimination of Giardia is not attained.

Assessment of potential zoonotic transmission of Giardia duodenalis from dogs and cats

Giardia duodenalis is one of the major causes of diarrhea among humans, especially in young children. Statistical analysis revealed that the pooled prevalence of G. duodenalis in humans, dogs, and cats was 9.72% (10,921/112383), 15.60% (7510/48140), and 14.53% (1125/7740), respectively. Unquestionably, the canine-specific assemblages C and D and the feline-specific assemblage F were the dominant genotypes in dogs and cats, respectively. Additionally, the prevalence of zoonotic G. duodenalis assemblages (A and B) in dogs and cats was 23.07% (875/3792) and 41.42% (169/408), respectively, implying that the potential transmission of G. duodenalis from dogs and cats to human infection cannot be ignored. The highest frequency of potentially zoonotic assemblages was found among working dogs (3.55%, 25/705) and the 1-5 age group (22.92%, 11/48). In summary, dogs and cats have a significant role in the zoonotic transmission of G. duodenalis due to their close contact with humans and the higher frequency presence of zoonotic assemblages. Further studies are necessary to explore the presence of G. duodenalis among humans and animals and in environmental samples. Researchers should adopt a one-health approach to gain a deeper understanding of G. duodenalis in dogs and cats and potential transmission routes to humans.

The opportunistic protist, Giardia intestinalis, occurs in gut-healthy humans in a high-income country

Giardia intestinalis, a cosmopolitan gastrointestinal protist, is detected mainly in patients with clinical giardiasis in high-income countries. In contrast, there is very little information on the presence of Giardia in asymptomatic individuals. Therefore, the aim of this study was to determine the presence and prevalence of Giardia in gut-healthy volunteers in the Czech Republic and to perform a comparative evaluation of different diagnostic methods, since Giardia diagnostics is complicated. Our results confirmed that the qPCR method is the most sensitive method for detecting Giardia and revealed a prevalence of 7% (22/296) in asymptomatic individuals. In most cases, the colonization intensity ranged from 10-1-101. A conventional PCR protocol targeting the TPI gene was used to identify the assemblages. However, this protocol had limited sensitivity for Giardia amplification, effectively detecting colonization above an intensity of 104. In addition, Giardia was detected in 19% of the animals, which were closely associated with the study participants. However, due to methodological limitations, zoonotic transmission could not be clearly confirmed. Notably, contact with animals proved to be the only factor that had a significant impact on the incidence of Giardia in gut-healthy humans.

Occurrence and Phylogenetic Analysis of Zoonotic Enteropathogenic Protist Parasites in Asymptomatic Domestic Ruminants from Portugal

Enteropathogenic parasites are of significant concern for public health due to their zoonotic potential and their impact on human and animal health. In this study, we investigated their occurrence and characterized these enteropathogens in asymptomatic domestic ruminants from Portugal. A total of 302 stool samples were collected from cattle (n = 166), sheep (n = 73), and goats (n = 63) in various regions of Portugal and tested for Cryptosporidium spp., Giardia duodenalis, Enterocytozoon bieneusi, Blastocystis sp., and Balantioides coli by PCR. The occurrence of Cryptosporidium spp. was found to be 12.7% (8/63, 95% confidence interval [CI]: 5.65-23.5) in goats; however, no sample was found to be positive for Cryptosporidium spp. in cattle and sheep. For E. bieneusi, 6.35% (4/63; 95%CI: 1.76-15.47) of goats were found to be positive; however, no cattle or sheep were found to be positive. Blastocystis sp. was found in sheep (9.59%; 7/73; 95% [CI]: 0.394-18.76) and goats (12.70%; 8/63; 95% [CI]: 5.65-23.50) but none was found in cattle. No positive results for G. duodenalis or B. coli were detected in this study. This study provides essential baseline information for understanding the silent shedding and epidemiology of these enteropathogens in Portugal, contributing to overall livestock health and related occupational safety. Raising awareness among consumers, veterinarians, and farm owners is crucial to minimize the risk of transmission and promote effective disease control strategies.