Psidium guajava Linn leaf ethanolic extract: In vivo giardicidal potential with ultrastructural damage, anti-inflammatory and antioxidant effects

Safaa I Khedr; El Hassan M Mokhamer; Amal A A Hassan; Asmaa S El-Feki; Gihan M Elkhodary; Mohamed S A El-Gerbed

doi:10.1016/j.sjbs.2020.10.026

Psidium guajava Linn leaf ethanolic extract: In vivo giardicidal potential with ultrastructural damage, anti-inflammatory and antioxidant effects

Saudi J Biol Sci. 2021 Jan;28(1):427-439. doi: 10.1016/j.sjbs.2020.10.026. Epub 2020 Oct 27.

Authors

Safaa I Khedr¹, El Hassan M Mokhamer², Amal A A Hassan², Asmaa S El-Feki², Gihan M Elkhodary², Mohamed S A El-Gerbed²

Affiliations

¹ Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
² Department of Zoology, Faculty of Science, Damanhour University, Damanhour, Egypt.

Abstract

Introduction and aim: Considering the magnitude of giardiasis problem, the side-effects of the used anti-giardia drugs and the resistance posed against them, the current study aimed to evaluate the in-vivo giardicidal effect of Psidium guajava leaf extract (PGLE).

Methods: For fulfilling this aim, five Swiss-albino mice groups were included; GI: non-infected, GII: Giardia-infected and non-treated, GIII: Giardia-infected and metronidazole-treated, GIV: Giardia-infected and PGLE-treated, and GV: Giardia-infected and treated with both metronidazole and PGLE. Treatment efficacy was assessed via; Giardia cyst viability and trophozoite count, trophozoite electron microscopic ultrastructure, duodenal histopathological scoring, immunohistochemistry for TNF-α and duodenal scanning electron microscopy. Moreover, mice serum liver enzymes, total bilirubin, albumin, lipid profile including; total cholesterol, HDL, LDL and triglycerides were assessed. Additionally, hepatic oxidative stress markers including; malondialdehyde (MDA), nitric oxide (NO), reduced glutathione (GSH) and superoxide dismutase (SOD) were measured.

Results: Results showed that PGLE whether alone or combined with metronidazole has induced significant trophozoite count reduction and major architectural changes. Duodenal histological improvement, and local protective anti-inflammatory effect were confirmed. PGLE has also helped in healing of Giardia-induced gut atrophy. Thus, offered a comprehensive therapy for both the pathogen and the resultant pathological sequalae. Serum markers showed favorable hepatoprotective effect. Total cholesterol, LDL and triglycerides levels were less in PGLE-treated group than in metronidazole-treated group. Hepatic oxidative stress markers revealed the promising extract antioxidant effect. This study highlights, the promising in-vivo giardicidal PGLE activity, that was comparable to metronidazole, thus, the extract would be an ideal strongly recommended treatment for giardiasis. When combined with metronidazole, the extract potentiated its therapeutic effect. Besides, having hepatoprotective, anti-inflammatory, and antioxidant properties, the extract can combat the major side effects of metronidazole therapy.

Keywords: ALT, alanine aminotransferase; AST, aspartate aminotransferase; Duodenal ultrastructure; G. lamblia, Giardia lamblia; GSH, reduced glutathione; Giardia lamblia; H&E, hematoxylin and eosin; HDL, high-density lipoproteins; LDL, low-density lipoproteins; MDA, malondialdehyde; MNZ, metronidazole; NO, nitric oxide; Nitric oxide; PGLE, Psidium guajava Linn. leaf extract; Psidium guajava leaf extract; ROS, reactive oxygen species; SEM, scanning electron microscopy; SOD, superoxide dismutase enzyme; Superoxide dismutase; TEM, transmission electron microscopy; TNF-α, tumor necrosis factor-alpha; Tumor necrosis factor-α.