Comparative Evaluation of Diosmectite Versus Nitazoxanide and Their Combination in the Treatment of Cryptosporidiosis in Immunosuppressed Mice

Background: Cryptosporidiosis is a parasitic infection that affects immunocompromised patients and can result in systemic involvement of different organs and death. Aim: To compare nitazoxanide (an antiprotozoal agent) and diosmectite (an antidiarrheal agent) and their combination in the treatment of cryptosporidiosis infection. Materials and methods: Mice were divided into five groups: negative control, the infected untreated (positive control), diosmectite-treated, nitazoxanide-treated, and the group treated with nitazoxanide and diosmectite simultaneously. The evaluation was through measuring body weight, oocyst shedding, intestinal, and hepatic histopathological examination, as well as estimation of some inflammatory and oxidative markers. Results: Body weight was improved significantly in all treatment groups. The highest oocyst reduction rate was observed in nitazoxanide-treated mice. Inflammatory scores of both intestine and liver were markedly improved in mice treated with diosmectite and nitazoxanide compared with each of them separately. Combined treatment with diosmectite and nitazoxanide significantly decreased interleukin-6, tumor necrosis factor alpha, and transforming growth factor-b levels while increasing interleukin-10 and catalase activity. Conclusion: Combined treatment with diosmectite and nitazoxanide demonstrated potent synergism by improving body weight, lessening oocyst shedding, and ameliorating the immunopathological changes in the intestine and liver.