Pathogenesis and post-infectious complications in giardiasis.

Area of Science:

• Gastroenterology
• Infectious Diseases
• Microbiology

Background:

• Giardia is a prevalent enteropathogen in early childhood.
• It is associated with diarrhea and post-infectious complications.
• Giardia infection is a risk factor for stunting in children.

Purpose of the Study:

• To review the mechanisms by which Giardia causes intestinal abnormalities.
• To understand the role of Giardia in stunting and extra-intestinal complications.
• To highlight the impact of Giardia on gut barrier function and microbiota.

Main Methods:

• Review of prospective longitudinal cohort studies.
• Analysis of pathophysiological mechanisms induced by Giardia.
• Focus on assemblage-dependent effects and parasite proteases.

Main Results:

• Giardia causes epithelial malabsorption, increased transit, mucus depletion, and microbiota disruption.
• It increases intestinal permeability, facilitating bacterial invasion.
• Loss of intestinal barrier function underlies acute and post-infectious complications.
• Cysteine proteases are key effectors of Giardia's pathophysiology.

Conclusions:

• Giardia induces significant intestinal abnormalities contributing to stunting, independent of diarrhea.
• Disruption of intestinal barrier function is central to Giardia's pathology.
• Parasite proteases play a crucial role in mediating Giardia's adverse effects.