الفهرس 
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Abstract
Hymenolepiasis is the most prevalent tapeworm infection worldwide, it infects mainly children owing to the lack of faecal hygiene together with bad feeding habits and poverty. H.nana is being considered an opportunistic parasite with a life-threatening effect among immunosuppressed patients thus hymenolepiasis should be eliminated before initiating immunosuppressive therapy for fear of cysticercoids dissemination and persistence of infection.
Praziquantel is the drug of choice for the treatment of H.nana but because of the tapeworm’s relative resistance to chemotherapy and the potential tendency for autoinfection; the patient’s stool should be checked for eggs one and three months after treatment. Although praziquantel has a wide margin of safety it was found hepatotoxic, genotoxic and carcinogenic in albino rats.
There is an increased demand for using plants in therapy ”back to nature instead of using synthetic drugs, which may have adverse effects that may be more dangerous than the disease itself. N.sativa oil is one of the most common folk medicine remedies which is known to have immunemodulator action, antioxidant, anti- inflammatory and anti-parasitic actions.
The aim of the present work was to evaluate the parasitological histopathological, apoptotic changes and the immune response in the small intestines of H.nana experimentally infected mice before and after treatment with N.sativa in comparision with praziquantel, the drug of choice for treatment of H.nana infection.
In this study, 48 laboratory bread Swiss albino female mice were inoculated with 250 eggs/mice and divided into four groups; infected non treated group A, infected praziquantel treated group B, infected N.sativa treated group C and non infected control group D. The treatment started in all infected groups at the 12th day post infection. The praziquantel treatment was given as a single oral dose of 25 mg/kg body weight. While N.sativa was given at a dose of 5 mg/ kg /day for five successive days.
The mice were sacrificed at the same times for all groups at the 17th, 28th and 35th days post infection.
The small intestine was taken from each mouse, and was opened to recover the worms. The recovered worms were counted, weighed then fixed and stained with carmine to evaluate the effect of the used drugs.
The small intestine was divided and one part was prepared for haematoxyline and eosine, Giemsa stain and immunohistochemical stain to detect caspase-3 expression as an early marker for apoptosis. The
second part was deep frozen at -80°C until RT-PCR was done to evaluate cytokine gene expression of IL-13, IFN-γ and TNF-α in the small intestine of infected mice before and after treatment with praziquantel and N.sativa.
In the present study N.sativa was found to change the morphology and decrease adult worm biomass and the number of eggs produced.
Both PZQ (group B) and N.sativa (group C) showed a highly significant reduction (P<0.0001) in the mean of worm number, worm biomass, egg number per gram of faecal matter and goblet cell number in comparing with infected non treated group A and also in the corresponding subgroups.
The current study showed a significant correlation (P<0.05 and P<0.01)between goblet cell number and worm number, biomass and egg number/g faecal matter in the infected non treated group A and N.sativa treated group C while no significant correlation was found in PZQ treated group B.
The adult worms recovered from N. sativa treated mice group C showed many pathological changes when compared with the recovered worms from the infected non treated group A such as attenuation of the segments, constrictions of the worms, degeneration and loss of the internal organs, decreased egg development in gravid segments formation of cuticle blebings, swellings, shrinkage and deformity of the lateral margin of the worms. In the current study no adult worms were recovered from the small intestines of PZQ treated group B.
In the current study, PZQ showed higher cure rates than N.sativa, 100% and 25% at 17th d.p.i, 100%, 50% at 28th d.p.i and it was 100% and 75% at 35th d.p.i, respectively, but the difference between PZQ compared with N.sativa was statistically not significant (P3>0.05) However, when comparing PZQ and N.sativa cure rates throughout the study the difference of both drugs was significant (P3 < 0.05).
Concerning the drug efficacy, both praziquantel and N.sativa showed a significant difference when compared to infected non treated group A P1<0.05 and P2<0.05) respectively. It was 100% and 93.2% at 17th d.p.i 100% and 97.1% at 28th d.p.i and 100% and 96.2% at 35th d.p.i respectively. However, there was no significant difference (P>0.05) in the efficacy percentage between PZQ treated group (100%) and N.sativa treated group (94.8%).
In the current study, both PZQ and N.sativa produced an improvement of the pathological changes in the small intestine of infected treated mice groups. They showed restoration of the normal architecture of the intestinal villi regarding its length and width, intact brush border decrease the lymphocytic infiltration and restoration of the normal thickness of the musculosa.
In this study, PZQ treated group showed improvement of apoptosis in intestinal epithelial cells which was represented by weak expression of caspase-3. However, N.sativa treated group showed less improvement of apoptosis in the intestinal epithelial cells represented by moderate to marked expression of caspase-3.
In the current study, cytokine gene expression by RT-PCR, showed elevation of Th2 cytokines measured throughout the study in infected non treated group A when compared with non infected non treated group D.
There was increase in IL-13 and TNF-α gene expression while IFN-γ gene expression was found to be increased in the subgroup A3 with the tendency of infection to be chronic. In the current study, both praziquantel and N. sativa were very highly significant (P1 & P2<0.0001 in reducing IL-13 and TNF-α gene expressions. N. sativa was found to increase gene expression of IFN-γ and the difference between N. sativa and PZQ was significant (P<0.05).