Rasha F. Mady, Radwa G. Diab and Doaa A. Abdel Monsef
Department of Medical Parasitology and Medical Biochemistry, Faculty of Medicine, Alexandria University, Egypt
Microsporidia, of the genus Enterocytozoon, are an important cause of life-threatening diarrhea especially in immunocompromised hosts. There are controversies on the use of albendazole in treatment, whereas, fumagillin was to be more effective but with undesirable side effects. Ginger has been used as an antimicrobial agent since ancient times. However its potential therapeutic effect against Enterocytozoon bieneusi has not been tested. This study was done to investigate the effect of ginger as a prospective therapy for microsporidia versus fumagillin in immunocompetent and immunosuppressed mice. Also, to report the synergistic effect of the two compounds together in a drug-combination regimen. Enterocytozoon bieneusi was the species identified in the stool samples collected from immunocompromised patients and was used to initiate the in vivo infection in albino mice. Animals were divided into three major groups. Group I: Normal, non-infected nontreated, control group; group II: infected, immunocompetent group; and group III: infected, immunosuppressed group. Each infected group was subdivided into four equal subgroups a, b, c and d which comprise non-treated, fumagillintreated, ginger-treated, and combined ginger/fumagillin treated mice respectively. Evaluation of the ginger efficacy in infected mice was achieved by assessment of fecal spore shedding, intestinal spore load, and biochemical assay which aimed at estimation of the malondialdehyde level and total antioxidant capacity. Spore count in both stool and intestinal sections and malondialdehyde level decreased significantly with ginger treatment. Best results were obtained when ginger is combined with fumagillin in all measured parameters. Ginger could be a good enhancer for fumagillin efficacy to eradicate infection. However, further studies on their its principles, mechanisms of action, toxicity evaluation are still needed.