1 Department of Medical Parasitology

2 Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo 11566

3 Department of Pathology, Ahmed Maher Teaching Hospital, MOH & P, Cairo, Egypt


Giardia lamblia is the most common worldwide intestinal protozoan infection. TNF-α has an important
role in early giardiasis control. TNF-α antagonists had been used in the past few years to treat
many inflammatory diseases as RA, ankylosing spondylitis, and Crohn’s disease. This study aimed to
investigate the effect of TNF-α antagonist (Adalimumab®) on the pathology and the outcome of giardiasis
in mice. A total of 45 laboratory-bred Swiss albino mice were divided into 2 groups: tested
group and control group. Tested group was G. lamblia infected, then treated with Adalimumab and
subdivided into 3 subgroups (GIa, GIb, & GIc) according to given doses (1.5, 3, & 6mg/kg/BW respectively).
Control group was subdivided into 2 subgroups, Giardia infected control and normal control
(not infected or treated). Infection was assessed by successive stool analysis for cyst count and trophozoite
count in intestinal wash, and histo-pathological changes in small intestinal sections. Serum TNF-
α level was evaluated by ELISA.
The results showed that highest mean serum TNF-α in infected control on 16th dpi compared to normal
control and GIb & GIc. Mean serum TNF-α didn't not show significant differences in tested group
compared to control on 28 dpi. Peak of cyst count was on 15th dpi in tested group and infected control.
The highest cyst count was in GIb (3mg/kg/BW). Cyst count was significantly higher in tested group
compared to infected control to the experimental end. Number of trophozoites in intestinal wash in tested
group was significantly higher than in infected control on 28th dpi. The intestinal sections of tested
group showed moderate to severe inflammatory reaction with more inflammatory cellular infiltration
in the lamina propria causing villous shortening and blunting more than in the infected control. The
lymphoid follicles and sloughing of the epithelium were only in test subgroups on 16th dpi.