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

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