Background: Environmental enteric dysfunction (EED) is a serious medical condition associated with malnutrition. It is an important cause of pediatric morbidity and mortality worldwide. Meanwhile, cryptosporidiosis is a major cause of malabsorption leading to enteropathy and stunted growth.
Objectives: To investigate whether cryptosporidiosis causes EED. A secondary objective is to explore the validity of biomarkers recommended for the diagnosis of EED on a histopathological basis.
Material and Methods: Forty male Swiss albino mice were divided into four groups (10 mice each): GI (IC): immunocompetent uninfected); GII (ICI): immunocompetent infected], GIII (IS): immunosuppressed uninfected), and GIV (ISI): immunosuppressed infected]. Mice of each group were euthanized at two-time intervals, 7- and 14 days post infection (dpi). Stool samples were microscopically examined for oocyst counts and assessment of fecal EED markers including fecal myeloperoxidase (fMPO) and fecal alpha-1-antitrypsin (fA1AT). Serum samples were analyzed for intestinal fatty acid binding protein (I-FABP). Histopathological correlation was performed using microscopic examination of stained ileal sections.
Results: Cryptosporidiosis significantly increased fMPO, fA1AT and serum levels of I-FABP in the infected groups compared to the uninfected groups (P≤0.05). These parameters were significantly higher in ISI mice in comparison to ICI mice. The histopathological changes were like those previously reported in EED cases. In addition, histopathological scoring showed a significant positive correlation with various markers examined for EED at both 7- and 14 dpi (P≤0.001).
Conclusion: Cryptosporidiosis is a potential leading cause of EED. Further studies are recommended to confirm usefulness of these noninvasive markers as efficient predictors of EED rather than intestinal biopsy.