Comparative inflammatory, oxidative stress, and tissue injury signatures in amoebiasis and giardiasis

A case-control study was conducted in Basrah, Iraq, between September 2023 and December 2024. Stool samples from 110 symptomatic individuals were examined microscopically using direct wet mounts, concentration methods, and permanent staining techniques. Confirmed cases included 43 patients infected with Entamoeba spp. and 30 patients infected with Giardia duodenalis, while 50 apparently healthy individuals served as controls. Hemoglobin and leukocyte differential counts, serum total protein, albumin, interleukin-1 beta (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), C-X-C motif chemokine ligand 10 (CXCL10), malondialdehyde (MDA), glutathione (GSH), and lactate dehydrogenase (LDH) were evaluated. The results demonstrated significant hematological, biochemical, inflammatory, and oxidative stress alterations among infected individuals. Hemoglobin, serum total protein, and albumin levels were significantly reduced in both amoebiasis and giardiasis patients compared with healthy controls, with more pronounced alterations observed in amoebiasis. IL-1β, IL-6, IL-8, CXCL10, MDA, and LDH levels were significantly elevated, whereas increased GSH levels may reflect a compensatory antioxidant response rather than antioxidant depletion, particularly among amoebiasis patients. Giardiasis patients exhibited inflammatory and oxidative stress changes, although these alterations were less pronounced than those observed in amoebiasis. Comparative analysis indicated that amoebiasis induced stronger inflammatory, oxidative, and tissue injury responses than giardiasis, due to the invasive nature of amoebic infection. Overall, Entamoeba spp. infection elicited stronger inflammatory, oxidative stress, and tissue injury responses than giardiasis, providing further insight into the distinct host-parasite interactions associated with these intestinal protozoan infections.