Anti-Infective Agents   Send Orders for Reprints to reprints@benthamscience.net 130 Anti-Infective Agents, 2019, 17, 130-137 RESEARCH ARTICLE Prophylactic and Therapeutic Treatments' Effect of Moringa Oleifera Methanol Extract on Cryptosporidium Infection in Immunosuppressed Mice Nagwa M. El-Sayed 1,* and Ghada M. Fathy 2 1 Department of Medical Parasitology, Research Institute of Ophthalmology, Giza, Egypt; b Department of Parasitology, Faculty of Medicine, Zagazig University, Zagazig, Egypt Abstract: Background: As natural herbs and medicinal plants extracts are widely used as alterna- tive treatments for different parasitic diseases, some have been tested on Cryptosporidium either in vitro or in vivo. This study assessed the prophylactic and therapeutic treatments' effect of Moringa oleifera (M. oleifera) leaves methanol extract on immunosuppressed-Cryptosporidium infected mice. Methods: The evaluation was carried out by Cryptosporidium oocysts count in fecal samples, his- topathological changes in the intestinal tissues, determination of IFN-γ level in mice sera and measuring the antioxidant activity in the intestinal tissues. Results: Prophylactic treatment by M. oleifera extract lowered Cryptosporidium oocysts shedding from immunosuppressed-infected mice although there was no complete elimination of the parasite. However, therapeutic treatment induced a significant reduction in Cryptosporidium oocysts counts by 91.8% higher than that of the drug control (nitazoxanide) group (77.2%). Histopathologically, the intestinal tissues from immunosuppressed-Cryptosporidium infected mice showed loss of brush border with severe villous atrophy and extensive necrosis. M. oleifera prophylactic treatment in- duced a moderate improvement of the pathological changes. However, the villi in M. oleifera ther- apeutic treated mice retained their normal appearance with minimal inflammatory cells. It was ob- served that M. oleifera extract induced a significant upregulation of IFN-γ in both prophylactic and therapeutic treated groups compared to that of the infected untreated group. In addition, M. oleifera leaves extract exhibited a significant antioxidant activity by reducing the levels of Nitric Oxide (NO) and Malondialdehyde (MDA) and increasing Superoxide Dismutase (SOD) level in the intes- tinal tissues compared to those of the infected and drug controls. Conclusion: M. oleifera leaves extract has potent prophylactic and therapeutic activities against infection with Cryptosporidium. A R T I C L E H I S T O R Y Received: October 16, 2018 Revised: November 27, 2018 Accepted: December 14, 2018 DOI: 10.2174/2211352517666181221094420 Keywords: Moringa oleifera, antiparasitic, anti-Cryptosporidium, antioxidant, immunomodulatory effect, methanol extract. 1. INTRODUCTION Cryptosporidium is an enteric protozoan parasite that is able to infect and reproduce in the epithelial cell lining of the small intestine. Human infection occurs through ingestion of contaminated water or food with Cryptosporidium oocyst; the infective stage [1, 2]. In immunocompetent individuals, human cryptosporidiosis typically presents with self-limiting watery diarrhea for several days resulting from the increased intestinal permeability, chloride secretion, and malabsorption that caused by the host response to infection. However, life *Address correspondence to this author at the Department of Medical Para- sitology, Research Institute of Ophthalmology, 2 El-Ahram St, Intersection of El Bahr El Aazam St, Giza 12556, Egypt; Tel: +201095891150; Fax: (+2) 35752688; E-mails: nag.elsaka@yahoo.com; nagelsa- ka@hotmail.com threatening diarrhea can occur in immunosuppressed pa- tients, particularly those with HIV infection [1]. Cryptospor- idiosis is documented in about 10%-16.7% among Egyptian children presenting with diarrhea [2, 3]. Presently, nitazoxanide is the only proven anti- Cryptosporidium therapy. It acts by depriving the parasite of its anaerobic energy necessary for metabolism facilitating its clear- ance [4]. This drug has been shown to improve diarrhea and mortality rates among infected, malnourished children. Howev- er, its response rate in malnourished children was only 56% [5] and it is not effective in AIDS and transplant patients [6]. This limitation of treatment options represents a major public health challenge given the important burden of cryptosporidiosis. Moringa oleifera (M. oleifera) is a highly valuable plant, which cultivated in different regions in Egypt. Various parts of this plant; leaves, roots, seeds, fruit and flowers have been 2211-3533/19 $58.00+.00 ©2019 Bentham Science Publishers