The therapeutic effects of vonoprazan against giardiasis in rats: parasitological, pathological, and immunological aspects.

Giardiasis is a serious public health issue caused by Giardia lamblia. The medications used in its treatment induce unfavorable adverse effects. Furthermore, treatment failure and drug resistance are other challenges in its management. Vonoprazan is a safe, recently approved potassium-competitive acid blocker. The current study aimed to assess the potential therapeutic effects of vonoprazan, alone or in combination with metronidazole, on giardiasis. The efficiency of the treatment was evaluated by parasitological, histopathological, immunohistochemical, scanning electron microscopic, and biochemical studies. According to the results, the combination treatment significantly reduced the number of cysts in the stool and trophozoites in the small intestinal wash and ameliorated the intestinal pathological alterations. The expression of TNF-α and caspase-3 in the intestinal tissues was reduced. Also, there were reductions in the levels of IL-6, iNO, and MAD and an elevation in TAC levels in the serum. The combination therapy exhibited better efficacy than metronidazole alone. To sum up, this study underlines the suitability of using vonoprazan as an adjuvant to metronidazole in treating giardiasis.