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Original Article

Atorvastatin: In-Vivo Synergy with Metronidazole as Anti-Blastocystis Therapy

Maha M. A. Basyoni1, Shawky A. Fouad2, Marwa F. Amer3, Ahmed Fathy Amer4, Dalia Ibrahim Ismail5
The Korean Journal of Parasitology 2018;56(2):105-112.
Published online: April 30, 2018

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4Child Health Department, National Research Center, Cairo, Egypt

5Histology Department, Faculty of Medicine, Cairo University, Egypt

*Corresponding author (mmabulmagd@kasralainy.edu.eg; drmahaabu@gmail.com)
• Received: November 28, 2017   • Revised: April 4, 2018   • Accepted: April 8, 2018

Copyright © 2018 by The Korean Society for Parasitology and Tropical Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Atorvastatin: In-Vivo Synergy with Metronidazole as Anti-Blastocystis Therapy
Korean J Parasitol. 2018;56(2):105-112.   Published online April 30, 2018
DOI: https://doi.org/10.3347/kjp.2018.56.2.105
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Atorvastatin: In-Vivo Synergy with Metronidazole as Anti-Blastocystis Therapy
Korean J Parasitol. 2018;56(2):105-112.   Published online April 30, 2018
DOI: https://doi.org/10.3347/kjp.2018.56.2.105
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Atorvastatin: In-Vivo Synergy with Metronidazole as Anti-Blastocystis Therapy
Image Image Image
Fig. 1 Normal colon found in non-infected non-treated control group in the form of normal villous architecture and moderate number of goblet cells.
Fig. 2 (A) Active inflammatory changes in the form of increased inflammatory cells (red arrows) with shortened broad villi found in the colon of infected group treated with MTZ 10 mg/kg (21 days PI); black arrow indicates vacuolar form of Blastocystis with peripheral nuclei and central vacuole. (B) Boxed area of A was photographed using TEM to show Blastocystis vacuolar forms. M, mitochondrion; N, typical peripheral electron dense nuclei; CV, central vacuole (×10,000).
Fig. 3 TEM of Blastocystis from infected group treated with combined (AVA 40 mg/kg and MTZ 10 mg/kg) (21 days PI) shows apoptotic changes in the form of electron dense granulation (absent central vacuole), swollen mitochondrion with tabulation of cristea (red arrow), swollen nucleus (blue arrow), chromatin scattered in clumbs (yellow arrow) and cytoplasmic streaks extend inwards from the irregular outer membrane (×10,000).

Fig. 1

Fig. 2

Fig. 3

Atorvastatin: In-Vivo Synergy with Metronidazole as Anti-Blastocystis Therapy
Group 1: 10 infected non-treated mice, maintained as infection control group.
Group 2: 10 mice infected and treated with MTZ (10 mg/kg) as standard drug.
Group 3: 20 mice infected and treated with AVA. They were subdivided into group 3A (10 mice) given a dose of 20 mg/kg/day and group 3B (10 mice) given a dose of 40 mg/kg/day.
Group 4: 20 mice infected and treated with combinational therapy of AVA and MTZ. They were subdivided into group 4A (10 mice), given AVA at a dose of 20 mg/kg/day and MTZ (10 mg/kg) and group 4B (10 mice), given AVA at a dose of 40 mg/kg/day and MTZ (10 mg/kg).
Group 5: 50 mice non-infected and treated with MTZ and AVA to act as drug control group, divided in to: 5A: 10 mice received MTZ 10 mg/kg. 5B: 10 mice received AVA 20 mg/kg, 5C: 10 mice received AVA 40mg/kg. 5D: 10 mice received MTZ 10mg/kg and AVA 20 mg/kg, 5E: 10 mice received MTZ 10 mg/kg and AVA 40 mg/kg.
Group 6: 10 non-infected non-treated mice, maintained as control group.

Blastocystis shedding per gram of feces×103 in different groups

Group 5th day PI (mean±SD) 10th day PI (mean±SD) 15th day PI (mean±SD) 20th day PI (mean±SD)
Group 1: (Infected non-treated control) 42.6±8.3 55.6±15.8 85.4±12.6 176.2±45.3
Group 2: (Infected treated with MTZ 10 mg/kg) 34.3±2.5a 37.4±5.0a 36.2±4.3a 36.3±51.4a
Group 3A: (Infected treated with AVA 20 mg/kg) 29.2±3.8a,b 29.2±4.1a,b 20.2±14.5a,b 11.5±14.6a,b
Group 3B: (Infected treated with AVA 40 mg/kg) 20.9±6.7a,b 17.1±7.2a,b 16.1±4.3a,b 3.6±11.7a,b
Group 4A: (Infected treated with AVA 20 mg/kg & MTZ 10 mg/kg) 14.8±5.3a,b 11.5±2.4a,b 8.5±3.3a,b 3.33±3.27a,b
Group 4B: (Infected treated with AVA 40 mg/kg & MTZ 10 mg/kg) 8.1±3.3a,b 6.4±2.8a,b 1.21±3.11a,b 1±2.2a,b

Values are expressed as mean±SD.

aStatistically significant compared to infection control group=P-value<0.05.

bStatistically significant compared to MTZ treated group=P-value<0.05.

Susceptibility of different Blastocystis genotypes to different drug formulations and doses

Group No. (%) of mice harboring different genotypes
Genotype I Genotype II Genotype III Genotype IV
1 (Infected non-treated) 10 (100) 10 (100) 10 (100) 10 (100)
2 (MTZ 10 mg/kg) 7 (70) 9 (90) 10 (100) 8 (80)
3A (AVA 20 mg/kg) 7 (70) 10 (100) 9 (90) 8 (80)
3B (AVA 40 mg/kg) 3 (30) 6 (60) 7 (70) 4 (40)
4A (MTZ 10 mg/kg & AVA 20 mg/kg) 2 (20) 3 (30) 4 (40) 3 (30)
4B (MTZ 10 mg/kg & AVA 40 mg/kg) 0 (0) 0 (0) 1 (10) 2 (20)
Total (n=50) 29 (58) 38 (76) 41 (82) 35 (70)

Table 1 Blastocystis shedding per gram of feces×103 in different groups

Values are expressed as mean±SD.

Statistically significant compared to infection control group=P-value<0.05.

Statistically significant compared to MTZ treated group=P-value<0.05.

Table 2 Susceptibility of different Blastocystis genotypes to different drug formulations and doses

Table 1

Table 2

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