IN-VIVO AND IN-VITRO EFFICACY OF OCTREOTIDE FOR TREATMENT OF ENTERIC CRYPTOSPORIDIOSIS

Previous evidence suggested a role of enterotoxin in the pathophysiolo gy of cryptosporidiosis, If so, antisecretory drugs should be effectiv e in reducing diarrhea, We evaluated the in vivo and in vitro efficacy of octreotide. which possesses antisecretory effects, for cryptospori dial diarrhea. Two children with severe cryptosporidial diarrhea were treated with octreotide, The volume modifications and chemical composi tion of stools were determined. Fecal supernatant was added to Caco-2 cell monolayers mounted in Ussing chambers with or without serosal oct reotide and electrical parameters were monitored, Octreotide was effec tive in reducing the stool volume and fecal Na+ concentration. Fecal s upernatant induced an enterotoxin-like increase in transepithelial pot ential difference, Octreotide induced a dose-dependent decrease in bas al potential difference, consistent with an absorptive effect. In cell s pretreated with octreotide, fecal supernatant induced an increase in the potential difference, whose magnitude and duration were significa ntly reduced compared to untreated cells, These results provide in viv o and in vitro evidence for the secretory nature of cryptosporidial di arrhea and for the efficacy of octreotide through a direct interaction with the enterocyte.