The present work aims to investigate the antiparasitic and the immunomodulating effects of nitazoxanide (NTZ) and ivermectin (IVC) alone or combined together or combined with selenium (Se), on Cryptosporidium infection in diabetic mice. The results revealed that the combined NTZ and IVC therapy achieved the highest reduction of fecal oocysts (92%), whereas single NTZ showed the lowest reduction (63%). Also, adding Se to either NTZ or IVC resulted in elevation of oocyst reduction from 63% to 71% and from 82% to 84% respectively. All treatment regimens, with the exception of NTZ monotherapy, showed a significant improvement in the intestinal histopathology, the highest score was in combined NTZ and IVC therapy. The unique results of immunohistochemistry in this study showed reversal of the normal CD4/CD8 T cell ratio in the infected untreated mice, however, following therapy it reverts back to a normal balanced ratio. The combined (NTZ+ IVC) treatment demonstrated the highest level of CD4 T cell expression. Taken together, NTZ and IVC combined therapy showed remarkable anti-parasitic and immunostimulatory effects, specifically towards the CD4 population that seem to be promising in controlling cryptosporidiosis in diabetic individuals. Further research is required to explore other effective treatment strategies for those comorbid patients.

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Cyclospora cayetanensis (C. cayetanensis) can cause serious diarrheal illness in immunocompromised patients. The present work aimed to detect C. cayetanensis infection among patients with renal transplantation attending the nephrology unit of Kasr Al-Aini, Faculty of Medicine, Cairo University. A total of 50 stool samples were collected and subjected to direct microscopy to screen for parasitic stages. A modified acid fast staining technique (Kinyoun's method) was used to detect C. cayetanensis oocysts. Cyclospora oocysts were revealed in 5 (10%) of the stool samples examined. Other parasites detected among the patients included Cryptosporidium parvum 5 (10%) and Blastocystis 15 (30%). 30% of the patients were suffering from diarrhea and or colic. All C. cayetanensis positive cases were presenting with diarrhea.

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Blastocystis is the most common eukaryotic parasite of the human gastrointestinal tract. Its pathogenicity remains a matter of debate, however, many recent studies suggest that this organism is a pathogen. Some authors reported that cysteine protease plays important role in the pathogenicity of Blastocystis spp. The study investigated the protease activity of Blastocystis isolates obtained from stool samples of symptomatic and asymptomatic individuals using gelatin SDS-PAGE and azocasein assay. The present study was carried out on 62 subjects positive for Blastocystis whether presenting with gastrointestinal symptoms or not. The symptomatic group (cases, GI) included 42 cases while the asymptomatic (control, GII) group included 20 subjects.Using gelatin SDS-PAGE analysis, the protease profiles of Blastocystis isolates showed 14 protease bands of both high and low molecular weights with significant differences between symptomatic and asymptomatic groups at 35, 60 and 140 kDa MW bands. Statistical analysis of the protease profile of Blastocystis isolates showed a significant difference (P value < 0.05) between the two groups. Using Azocasein assay, Blastocystis isolates from symptomatic cases show quantitatively higher protease activity than asymptomatic cases but without significant difference between both groups.