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ABSTRACT _Giardia lamblia_ is a human intestinal parasite and one of the most frequent enteric pathogen of companion animals. Clinical manifestations of giardiasis, such as diarrhoea,

anorexia, weight loss and lethargy, have been associated with _Giardia_ infections in both domestic and farm animals. A few anti-parasitic drugs are routinely used to treat giardiasis, but

re-infections are common and drug-resistant strains have already been reported. Unfortunately, efficient vaccines against _Giardia_ are not available. _Giardia_ undergoes antigenic

variation; through this mechanism, parasites can avoid the host’s immune defenses, causing chronic infections and/or re-infections. Antigenic variation is characterised by a continuous

switch in the expression of members of a homologous family of genes encoding surface antigens. In a previous report, we indicated that in _Giardia_, the mechanism responsible for the

exchange of variant-specific surface proteins (VSPs) involves the RNA interference (RNAi) pathway. From a repertoire of ~200 VSP genes, only one is expressed on the surface of single

trophozoites; however, RNAi machinery disruption generates trophozoites that express the complete VSP repertoire. We also demonstrated that gerbils orally immunised with VSPs isolated from

these altered parasites showed high levels of protection. Here we tested this vaccine in cats and dogs, and found that it is highly efficient in preventing new infections and reducing

chronic giardiasis in domestic animals both in experimental and natural infections. Remarkably, immunisation of dogs in a highly endemic area strongly decreased the percentage of infected

children in the community, suggesting that this vaccine would block the zoonotic transmission of the disease. SIMILAR CONTENT BEING VIEWED BY OTHERS EVALUATION OF A NOVEL VACCINE CANDIDATE

DERIVED FROM NEWLY EXCYSTED JUVENILES OF _FASCIOLA HEPATICA_ IN SHEEP Article Open access 03 May 2025 THE RVSV-EBOV VACCINE PROVIDES LIMITED CROSS-PROTECTION AGAINST SUDAN VIRUS IN GUINEA

PIGS Article Open access 10 June 2023 VACCINE-INDUCED TIME- AND AGE-DEPENDENT MUCOSAL IMMUNITY TO GASTROINTESTINAL PARASITE INFECTION Article Open access 07 July 2022 INTRODUCTION The

flagellated protozoan _Giardia lamblia_ (syn. _G. duodenalis_ or _G. intestinalis_) is one of the most common causes of intestinal disease in humans and waterborne outbreaks of diarrhoea, as

well as a frequent cause of diarrhoea in day-care settings, institutionalised populations and travellers.1,2 In regions characterised by deficient basic sanitation, _Giardia_ infections in

children are almost general.3 Although _G. lamblia_ is recognised worldwide as the most frequent protozoan parasite causing intestinal disease in humans, the relevance of _Giardia_

infections in other mammals is controversial.4 Domestic dogs and cats can be asymptomatic or suffer diarrhoea due to maldigestion, malabsorption and augmented gut motility. In companion

animals in particular, _Giardia_ is regarded as a potential cause of diarrhoea, weight loss and lethargy.5 The life cycle of _Giardia_ includes the infective cyst and the vegetative

trophozoite. Infection is spread to a number of different hosts that ingest cysts, which are eliminated with the faeces.6 Once flagellated trophozoites are excysted, they colonise the host’s

upper small intestine. Trophozoites are not invasive and proliferate attached to the surface of the intestinal epithelium via a ventral disk.2 Trophozoites are the agents responsible for

the clinical manifestations of the disease, which may range from asymptomatic infection to acute or chronic diarrhoea. Some individuals are chronically infected and could have no symptoms,

but may suffer malabsorption.7 The immune status of the host influences its susceptibility to infection as well as the severity of the clinical manifestations. In humans, children and the

elderly are especially vulnerable to _Giardia_.7 In companion animals, puppies and kittens are more susceptible than adult animals.8 In all species, symptoms usually appear 1–2 weeks after

infection and persist for several days.7,9 Much of veterinary research has studied _Giardia_ prevalence and performed molecular characterisation of isolates obtained from different hosts to

determine their zoonotic potential.10 Eight _G. lamblia_ assemblages (A–H) were identified via phylogenetic analyses.11,12 Assemblages A and B were found to be capable of infecting several

mammals that can become reservoirs of human infections.12 Humans can also be a possible _Giardia_ reservoir for domestic and production animals.13 _G. canis_ (assemblage C), _G. cati_

(assemblage F) and _G. bovis_ (assemblage E) would be limited to certain species or host types,12 whereas other _Giardia_ species have a broad host range, including the human assemblages A

and B.10–12 In addition to the livestock assemblage E, the zoonotic assemblage A and, on occasions, the human assemblage B have been found in production animals.14 _Giardia_ undergoes

surface antigenic variation, a mechanism by which parasitic microorganisms can evade the host’s immune response.9,15 Antigenic variation in _Giardia_ involves variant-specific surface

proteins (VSPs). Immune responses to _Giardia_ involve a strong humoral immune response to VSPs.9 A humoral immune response in experimentally as well as naturally _Giardia_-infected hosts

occurs along with the elimination of the original VSP; hence, a functional role of antibodies in selecting phenotypic variants during the course of infection has been suggested.15 In

addition, monoclonal antibodies (mAbs) of different immunoglobulin subtypes specific to different VSPs were found to be cytotoxic to trophozoites expressing a particular antigen.16,17 Of a

repertoire of over 200 homologue genes encoded in the parasite genome,18 only 1 VSP is expressed on the surface of every single trophozoite at any given moment;9,15 however, switching in

expression to an antigenically distinct VSP has been reported to occur even in the absence of any immune pressure.2,9 Although antigenic variation in _Giardia_ has been known for decades,

the molecular basis for its regulation remained elusive. In 2008, we reported that, in this parasite, a mechanism similar to RNA interference is involved in the control of the expression of

surface antigens.19 We found simultaneous transcription of several, or all, VSP genes (_vsp_s); however, a system containing a constitutively expressed RNA-dependent RNA-polymerase (RdRP)

produces antisense RNA, targeting all _vsp_ transcripts, except one. The duplexes generated between the sense and the antisense _vsp_ RNAs are further cleaved to 22–25 nt interfering RNAs by

a Dicer/Argonaute system, both _in vitro_ and _in vivo_. Notably, evidence obtained from knockdown experiments showed that RdRP and Dicer are involved in the change of expression from a

single to multiple VSPs in individual _Giardia_ trophozoites.19 We have recently hypothesised that trophozoites expressing the complete VSP repertoire on their surface would confer

protection against future infections. Therefore, we performed experiments using altered parasites of the _Giardia_ WB isolate (assemblage A) in the gerbil model of giardiasis. Our results

showed that the animals initially infected with cells expressing all of the VSPs encoded in their genome are largely protected from infection by _Giardia_ clones that express a unique VSP on

their surface or by cysts obtained from infected individuals.20 In addition, immunisation with the entire repertoire of VSPs purified from these transgenic cells, using a mAb directed to

the 5-amino-acid conserved cytoplasmic tail, also provided protection against secondary infections. In this work, we used wild-type and transgenic _Giardia_ parasites to determine the course

of experimental infections in young and adult dogs and cats. Subsequently, we used an oral vaccine formulation comprising VSPs immunopurified from trophozoites of the _Giardia_ WB isolate

expressing the full repertoire of their VSPs and tested the vaccine efficacy in experimental infections in dogs inhabiting a _Giardia_ endemic shanty town. Remarkably, vaccination of pets in

that disadvantaged community decreased the rate of infection in children, demonstrating the zoonotic potential of _Giardia_ parasites and the efficacy of this oral vaccine. RESULTS

Initially, experimental infections were induced in puppies and kittens to determine whether the results obtained in the gerbil model of giardiasis20 are similar to those in domestic animals.

We generated trophozoites of the WB isolate expressing the entire repertoire of VSPs by knocking down the expression of _Giardia_ Dicer (DAS) or _Giardia_ RdRP (RAS).19 As shown

previously,20 these transgenic trophozoites grow and encyst _in vitro_ and _in vivo_ as wild-type cells. These _Giardia_ populations and the wild-type WB clone expressing VSP9B10 were

initially used to infect _Giardia_-naive puppies and kittens (a total of 12 kittens and 12 puppies, 3 animals per experimental group). Infection was initiated by orogastric inoculation of

trophozoites or control phosphate-buffered saline (PBS). Cyst release, which clearly indicates animal infection and completion of the parasite life cycle, was evaluated by identifying

_Giardia_ cysts in stool samples via immunofluorescence assays using a mAb specific for _Giardia_ cyst wall protein2 (CWP2; mAb 7D6). Figure 1 shows that all populations were able to

establish infection in both puppies (left) and kittens (right). The beginning of cyst detection in stool samples and the number of cysts varied slightly among the different trophozoites and

animals used in this study. Infected animals presented some clinical manifestations of giardiasis between the second and fourth weeks of infection (Table 1). However, most of the animals

infected with trophozoites that express the entire repertoire of VSPs were able to self-cure by day 40 post infection, whereas the animals infected with a clonal population expressing a

unique VSP remained chronically infected, showing recurrent and intermittent clinical manifestations. The animals were treated before challenge experiments at day 60 post infection to avoid

possible chronic infection with a small number of trophozoites and to completely eradicate any possible infection. To determine whether animals previously infected with trophozoites

expressing a particular VSP (VSP9B10) or with cells expressing the entire repertoire of VSPs (DAS and RAS) were protected against subsequent infections, animals previously infected as in

Figure 1 were inoculated with clonal populations of trophozoites expressing a specific VSP (VSP9B10 or VSP1267) or with fresh cysts obtained from gerbils, 2 months after the cure of the

primary infection. The results of cyst elimination in puppies or kittens (Figure 2) clearly indicated that: (a) control animals (PBS) were readily infected with any _Giardia_ parasite; (b)

all animals infected with trophozoites expressing a unique VSP were refractory to a secondary infection with cells expressing the same VSP; (c) animals infected with cells expressing a

particular VSP were easily re-infected with trophozoites expressing a different VSP; and (d) most animals that were initially infected with trophozoite populations expressing the entire

repertoire of VSPs (DAS and RAS) were protected from future infections with clonal populations expressing a particular VSP on their surface or with cysts (Figure 2). The same challenge

experiments were performed 4, 12, 18 and 24 months after the original infection, showing the same results (data not shown). On the basis of our previous results in gerbils and those observed

in puppies and kittens, the entire repertoire of VSPs from the transgenic cells was immunopurified using a mAb that reacts with the 5-amino-acid cytoplasmic tail present in all known VSP

molecules.21 As a control, an internal, highly immunogenic antigen of _Giardia_, the molecular chaperone of the endoplasmic reticulum BiP,22 was immunopurified from _Giardia_ homogenates and

resuspended in the same buffer. Puppies and kittens were then immunised with these protein preparations without adjuvants by orogastric administration. After 2 months, animals were infected

with cysts or with a parasite population expressing particular VSPs (Figure 3). The infection was monitored by counting the cysts released in the stool and by performing an endoscopic study

at day 16 post infection to detect the presence of trophozoites in the small intestine. As in the results observed during primary infections with transgenic trophozoites, immunisation with

the complete repertoire of VSPs produced an immune response in which cyst shedding ceased very rapidly and the numbers of cysts released were also significantly reduced. By contrast, control

animals inoculated with BiP were easily infected by a clonal population of trophozoites (Figure 3). No signs of giardiasis or adverse reactions were observed in the vaccinated animals,

indicating that the clinical manifestations of the disease are produced by the entire trophozoites and not by the purified VSPs. Remarkably, unvaccinated dogs showed clinical signs of

giardiasis and intermittent shedding of cysts for a long time (Figure 3). In addition, serum and intestinal content were collected and confronted _in vitro_ with trophozoites expressing one

or various VSPs. Serum or intestinal content of BiP-immunised animals had no effect on parasite morphology, viability or motility (Figure 4). By contrast, when any clonal population was

confronted with serum or intestinal content of animals infected with cells in which Dicer had been silenced (DAS), agglutination of almost all the trophozoites occurred (Figure 4). These

results indicate that the infected puppies and kittens were able to develop an effective humoral response to the VSPs present on the trophozoites. We also tested intestinal fluids against

trophozoites of the isolate GS/assemblage B and of _G. muris_ (Figure 5). In these cases, intestinal content of animals immunised with VSPs purified from the WB isolate/assemblage A showed

partial cell agglutination (between 70 and 80%), indicating that _Giardia_ from different assemblages, or even species, may share common epitopes in their VSPs. By contrast, in the gerbil

model it was not possible to determine immunoglobulin subtypes.20 Here we found that all anti-VSPs Ig subtypes were found in the sera of the infected animals, whereas only sIgA could be

detected in the intestinal contents of immunised animals, indicating both local and systemic immune responses to _Giardia_ VSPs (Table 2). On the basis of the promising results of the

vaccine preparation in experimental studies in gerbils,20 and in puppies and kittens (this study), we decided to vaccinate a group of dogs and cats present in a poor, peri-urban community of

Córdoba, Argentina. The presence of giardiasis in children living in this shanty town as well as in dogs and cats roaming freely in this area was tested using a simple and rapid

immunodiagnostic dipstick device, which has been developed in our laboratory based on mAbs directed to _Giardia_ CWP1 and CWP2. In the initial screening attempted to determine the

sensitivity and specificity of the assays compared with immunofluorescence assays, 28 dogs and 16 cats of unknown age and pedigree were analysed. Stool samples showed that 100% of the

animals were positive for _Giardia_ cysts by both techniques (data not shown). Infection of children living in that community was almost universal (99% in samples from 134 children under 12

years of age tested at least twice). Additional genotyping of purified cysts showed that all samples belonged to assemblage A (data not shown). Infected animals were treated with a

combination of anti-helmints and anti-protozoan drugs for 3 days (albendazole and metronidazole, 25 mg/kg per day for both drugs). Subsequently, animals were marked, and 20 dogs and 10 cats

were vaccinated with two doses of the oral vaccine comprising the whole repertoire of VSPs of the WB isolate (assemblage A), and released back to the community. The remaining animals were

used as control. At random times for a period of 2 years, animals were recaptured, taken to the experimental kennel and tested for giardiasis, as described in Methods. Only 12 vaccinated

dogs, 5 vaccinated cats, 4 unvaccinated dogs and 2 unvaccinated cats could be followed for the 2-year period, whereas the others were tested occasionally when found. None of the vaccinated

dogs and cats was positive for giardiasis, whereas 70–100% of the unvaccinated animals tested positive at different times during this study (data not shown). Infection in children decreased

from almost 100–38% 24 months after animal vaccination. Three therapeutically vaccinated and two unvaccinated dogs were taken to the experimental facility and tested for _Giardia_ and signs

of the disease. Shedding of cysts into the environment and the sporadic signs of infection observed before vaccination was no longer recorded in the vaccinated dogs (Table 3). The cost of

producing our oral vaccine at a large scale includes immunoaffinity purification of the entire repertoire of VSPs from the transgenic parasites. Therefore, this efficient oral vaccine might

be considered expensive for veterinary use. For that reason, instead of purifying the entire repertoire of VSPs by immunoaffinity, we used an inexpensive cell fractionation procedure that

provides a plasma membrane preparation highly enriched in VSPs. When this fraction was used as an oral vaccine, the obtained results were identical to those observed with immunopurified

VSPs, including its high efficiency in preventing the establishment of new infections either by trophozoites expressing particular VSPs or by cysts, and the lack of clinical signs of the

disease (Figure 6). DISCUSSION _Giardia_ has been reported as a common parasite of dogs and cats worldwide.23 The reported prevalence of this parasite in dogs is ~10% in well-cared dogs,

35–50% in puppies and almost universal in breeding facilities and kennels.24–28 Prevalence in cats showing signs of gastrointestinal disease has been reported to vary between 6 and 20%,

being higher in young animals.24–28 To our knowledge, studies in disadvantaged areas lacking basic sanitary conditions have not been reported. To the best of our knowledge, experimental

infections of dogs and cats with human isolates of _Giardia_ have been rarely attempted.13,27 In this work, we show not only that wild-type parasites can successfully infect domestic animals

but also that _Giardia_, whose mechanism of antigenic variation has been disrupted, produces infection and signs of the disease in puppies and kittens, similar to those obtained in the

gerbil model of giardiasis.20 Animals initially infected with cells expressing the entire repertoire of potential surface antigens were refractory to subsequent infections with trophozoites

expressing a unique VSP on their surface or with cysts in which the VSP is unknown. Despite the limited number of animals used, taking together the results from puppies, kittens, dogs and

cats, as well as our previous report is gerbils, a reproducible trend is evident. The extracellular portion of _Giardia_ VSPs allows the parasite to overcome the hostile, hydrolytic

environment of the upper small intestine. VSPs are then very resistant to variable pH and digestion by intestinal proteases and therefore suitable for oral administration.20 In this work, we

not only confirmed the general findings obtained in the _Mongolian gerbil_ but also demonstrated that vaccine preparation is also effective in larger animals, such as cats and dogs, both

prophylactically and therapeutically. During infection with cells expressing the entire repertoire of VSPs cyst shedding was completely avoided when compared with the low number of cysts

released in the immunised animals, which may be due to the fact that trophozoites remain longer than the vaccine formulation in the upper portions of the small intestine. These results

validate our previous conclusion that antigenic variation is central for the parasite to escape the host’s immune response, and that induction of significant protection against _G. lamblia_

requires the entire repertoire of VSPs. Moreover, oral administration of the vaccine preparation to infected dogs, either symptomatic or not for giardiasis, reduced the number of cysts

released to the environment and, remarkably, ceased the symptoms of the disease, suggesting that vaccination provides protection from infection as well as parasite clearance post

establishment of an infection. Although _Giardia_ infections may be symptomatic or asymptomatic in domestic animals, blocking the release of cysts to the environment contributes to a

decrease in the rate of infected individuals in hyperendemic areas where basic sanitation practices are deficient. A commercial vaccine for giardiasis was previously developed for pets and

farm animals.29 This vaccine consisted of killed trophozoites isolated from a sheep (unknown assemblage) and has been reported to reduce shedding of cysts and prevent clinical disease

signs.30 The authors showed a decrease or elimination of intestinal trophozoites and faecal cyst excretion in puppies and kittens subcutaneously vaccinated with the trophozoite preparation.

Moreover, dogs with signs of chronic giardiasis and that had not responded to chemotherapy were treated with this vaccine preparation. In these cases, vaccination resulted in the cessation

of the clinical signs and faecal cyst shedding.31 However, results from studies of the efficacy of this vaccine are controversial. A complete study on the efficiency of this vaccine

preparation in dogs found no statistically significant differences between the vaccinated animals and the controls at any time regarding shedding of _Giardia_ antigens or cysts in stool

samples.32 This study also determined that this vaccine was not effective for the treatment of asymptomatic canine _Giardia_ infections, and that results differed from those previously

reported.32 These findings are consistent with similar experiments performed in cats33 and calves.34 Furthermore, studies performed on oral vaccine preparations consisting of recombinant

cyst wall proteins35 or bacteria expressing CWPs36 without the use of adjuvants demonstrated a reduction in the number of cysts released in the faeces of _G. muris_-challenged mice. Those

authors propose that these molecules are effective as potential transmission-blocking vaccines. Nevertheless, inhibition of cyst shedding was incomplete either with the recombinant protein

or the bacteria expressing CWP, indicating the need for further manipulation of the vaccine preparation. More importantly, our studies showed that cyst shedding was blocked when animals were

immunised with the complete repertoire of VSPs, clearly demonstrating that the immune response to these molecules is sufficient to kill the trophozoites before they arrive at the lower

parts of the small intestine to begin the process of encystation.6 Therefore, our preparations are more effective than the current vaccines not only in protecting the animals against

secondary infections but also in avoiding the release of cysts into the environment. Although we have used a low number of animals because of the long-term isolation needed during the

well-controlled challenge experiments, our vaccine preparation using VSPs of a human isolate showed similar results to those observed in the gerbil model of giardiasis, indicating that,

again, controlled oral immunisation with VSPs, even in the absence of any adjuvant, can generate a strong immune protection against _Giardia_ infections. The antibodies generated by our

vaccine comprising VSPs of the WB isolate (assemblage A) showed agglutination of parasites of the GS isolate (assemblage B), and even _G. muris_, clearly indicating that VSPs from different

_Giardia_ isolates may share common epitopes. Nevertheless, since the efficiency of an anti-_Giardia_ vaccine may depend on the VSPs present in different known and still unknown assemblages,

it could be necessary to purify VSPs from different isolates that can be cultured in the laboratory to improve the range of our vaccine formulation. Future genomics studies of _Giardia_

assemblages different from that used in our studies will allow us to silence the enzymes involved in the regulation of antigenic variation and the generation of transgenic trophozoites

expressing the entire repertoire of VSPs from other isolates that can be characterised in the future. In summary, oral immunisation with the complete repertoire of variable surface antigens

hindered establishment of infection by trophozoites or cysts, both in experimental and domestic animals; alleviated disease symptoms in already infected animals; and abolished the release of

cysts into the environment, reducing the transmission of the infection to susceptible hosts. These consistent results in three different species (gerbils, dogs and cats) pave the way for

the development of a _Giardia_ vaccine for humans. MATERIALS AND METHODS ETHICS All procedures performed on animals were conducted following the protocols specifically approved by the

Institutional Committee for Care and Use of Experimental Animals (protocol 2010-36-15p). These protocols adhere to the US PHS (Public Health Service of the United States) guidelines for

animal research. Field studies were performed on dogs and cats roving freely in a disadvantaged neighbourhood of Cordoba city, Argentina. Access to those animals was granted by an agreement

between the Municipality of Cordoba and the Catholic University of Cordoba (Res. 95/2010). No animals were harmed during the collection of blood, faecal samples or intestinal contents.

Faecal samples were taken from children after obtaining written consent of their parents, following the protocols specifically approved by the Bioethics Committee of the Catholic University

of Cordoba, which adhere to guidelines of the Ministry of Health of Argentina (Res. 1480/2011). PARASITES _Giardia lamblia_ WB (ATCC 50803) as well as GS/M (ATCC 50581), clones derived from

the WB and GS strains, and transgenic trophozoites were cultured at 37 °C in TYI-S-33 medium in 14-ml borosilicate screw-cap glass tubes.37 Trophozoites of _G. muris_ were isolated from the

small intestine of naturally infected Wistar rats.38 _Giardia_ clones expressing different surface antigens were obtained by limiting dilution using specific anti-VSP mAbs.16 Reactive clones

were expanded in culture medium overnight and controlled for homogeneity before use. WB clones 1267 (mAb 5C1), 9B10 (mAb 9B10) and GS/M-H7 (mAb G10/4) were employed in control experiments

and challenge infections. Wild-type parasites were genotyped as reported.39 GENERATION OF TRANSGENIC TROPHOZOITES EXPRESSING THE WHOLE REPERTOIRE OF VSPS Complementary sequences of the genes

encoding _Giardia_ enzymes RdRP and Dicer were cloned into plasmid pTubHA.pac. Antisense fragments were amplified by PCR from genomic DNA of clone WB/9B10, using oligonucleotide probes

containing the _Nco_I and _Eco_RV restriction sites and then cloned into the vector.19 _Giardia_ was transfected by electroporation and transgenic trophozoites were selected with puromycin.

Silencing of these enzymes was verified by quantitative reverse transcription PCR.19,20 IMMUNOFLUORESCENCE MICROSCOPY Trophozoites were detached from the tubes by chilling on ice for 20 min.

Cells were collected and resuspended in growth medium, and processed for immunofluorescence microscopy, as reported.19 A variety of anti-VSP mAbs were used to obtain clonal cell lines

expressing a particular VSP and to determine the simultaneous expression of many VSPs in individual trophozoites in a population in which antigenic variation has been deregulated.19,20 The

generation of mAbs against the CRGKA motif present in all VSPs was described previously.19 ANIMALS Experimental animals consisted of mixed breed, 6–8-week-old puppies (_n_=52) and

5–8-week-old kittens (_n_=42). The animals were free of _Giardia_ as determined by three independent immunofluorescence assays of their faeces using specific mAbs, as well as of any other

detectable infectious disease (all animals were completely vaccinated to common bacterial and viral infections before the start of the experimental period: nobivac DP and nobivac HHPPI from

MSD Animal Health, Bagovac Rabies from Biogenesis-Bago). Animals were maintained in isolation in individual roofed compartments with the access to an outside run of concrete floor, during

the initial infections and during the first 2 months of the challenge experiments. They were offered autoclaved food (commercial dog and cat feed) and sterile water supplemented with a

mixture of vitamins (Vigorex, Labyes, Buenos Aires, Argentina) _ad libitum_. All animals were housed under standard operating procedures of the International Animal Care Association. Adult

mixed breed dogs and cats from a peri-urban community were tested for the presence of the parasite and treated with anti-parasitic drugs before entering the trial. Each animal was identified

with a unique mark. Before infection, all animals were tested for serum antibodies against _Giardia_ antigens by enzyme-linked immunosorbent assay using a preparation of total proteins

extracted from trophozoites and cysts. The animals having anti-_Giardia_ antibodies were not included. Some animals were orally treated with 25 mg of metronidazole and 25 mg of albendazole

per kg for 3 days, 10 days before challenges, to rule out any possible presence of low level of _Giardia_ in their intestines. Three days before day 0, animals were weighed and randomly

allocated to experimental or control groups. The animals were clinically examined every week during the entire trial. Exams involved weight and temperature control, palpation of the abdomen,

and evaluation of the appearance, amount and consistency of the faeces.5 Following experimental infections, immunisation and challenges of puppies and kittens, faecal samples were collected

and analysed for the presence of _Giardia_ cysts as described below. Stool samples from adult animals captured from a field community were collected after isolating the dogs and cats under

the same conditions as the experimental animals, except that no anti-parasitic treatment were performed before challenges. INFECTIONS Infections were induced by orogastric inoculation of

2×105 trophozoites or 1×102 cysts resuspended in 0.5 ml of PBS containing 5 mM cysteine. Control animals were inoculated with 0.5 ml of PBS/cysteine by the same route. In this study, we also

used cysts freshly collected from experimentally infected gerbils to prevent samples from rapidly losing viability and infectivity, as previously reported to occur in samples collected from

infected individuals.40 Faeces from infected animals were collected daily between days 0 and 60 during the initial experiments. Cysts or trophozoites were identified visually via

immunofluorescence assays using anti-cyst mAbs41,42) or trophozoite-specific antigens (BiP22). Excreted _Giardia_ cysts were counted by collecting stool samples from individually housed

animals over a 24-h period as reported.20 The following criteria were used for considering animals uninfected; no cyst was found in the faeces, stool samples were unable to infect

experimental gerbils or no trophozoites were detected after 6 days in culture.43 For field studies, a _Giardia_ cyst-specific immunotest in a dipstick format was developed as described

below. PRODUCTION OF MABS TO RECOMBINANT _GIARDIA_ CWPS AND DEVELOPMENT OF A _GIARDIA_ IMMUNOTEST mAbs against recombinant CWP1,41 CWP242 or protein extracts of freshly isolated cysts

derived from the WB isolate were generated as reported.42 Hybridomas secreting antibodies were screened by enzyme-linked immunosorbent assay using the original immunogens and by indirect

immunofluorescence using encysting trophozoites and cysts. A mAbs anti-CWP1 (mAb 8F12, IgM) was spotted into a nitrocellulose membrane placed on top of a plastic support to capture _Giardia_

cysts from stool samples. _In vitro_ generated _Giardia_ cysts44 were used as positive control. The dipstick was then exposed to the anti-CWP2 mAb 7D6 (IgG2a) labelled with horseradish

peroxidase and subsequently to a color-developing reagent. The minimal amount of cysts that could be detected using this approach was 10 cysts per millilitre of stool samples diluted 50/50

in PBS. PURIFICATION OF VSPS FROM DICER-AS AND RDRP-AS TRANSGENIC TROPHOZOITES Axenic cultures of clones derived from the WB isolate (clones WB9B10 and WB1267), the GS/M isolate (GS/M-H7)

and transgenic WB trophozoites expressing the entire repertoire of surface antigens (Dicer-AS and/or RdRP-AS; referred to as DAS and RAS, respectively) were collected as previously

reported.20 The complete repertoire of VSPs expressed in the transgenic trophozoites were purified by immunoaffinity using the mAb 12F1 generated against the conserved 5-amino-acid tail of

VSPs.19 Purified VSPs were resuspended in PBS containing 0.01% Tween 20, quantified and used to immunise animals orally.20 Protein content in each fraction was quantified using the

Bradford’s method. VSP9B10 was purified from a clone expressing only this VSP using the same technique. PURIFICATION OF PLASMA MEMBRANE FROM TRANSGENIC TROPHOZOITES Cultures of the clones

expressing the entire repertoire of VSPs were maintained in 14-ml glass tubes fully filled with 5-mm borosilicate glass beads and TYI-S-33 medium containing puromycin. Thus, the total

surface where the trophozoites can attach and proliferate was increased approximately four times, whereas the necessary volume of culture medium was reduced by 60%, lowering the cost and

highly increasing the number of transgenic trophozoites. These cells were harvested by chilling the tubes for 30 min on ice and the culture medium was collected using Pasteur pipette from

the bottom of the tubes. Plasma membranes of sonicated trophozoites were obtained essentially as described.45 Fractions of purified membranes containing the full repertoire of VSPs were

selected by their reactivity with the mAb 5F12 by western blot, resuspended, quantified and used for oral immunisation. ORAL IMMUNISATIONS Animals were immunised with two successive oral

administrations of 400 μg of parasite proteins (immunopurified VSPs or isolated plasma membranes of transgenic trophozoites) resuspended in sterile PBS/0.01% Tween 20, 15 days apart. The day

of the last administration was considered day 0. Challenges were induced by orogastric inoculation of 2×105 trophozoites or 1×102 cysts resuspended in 0.5 ml of PBS/cysteine. Control

animals received 0.5 ml of either PBS/cysteine/Tween or 400 μg of purified _Giardia_ BiP in PBS/cysteine/Tween by the same route. Challenges were also performed using cysts freshly collected

from experimentally infected gerbils. Faecal samples from immunised animals were taken daily between days 0 and 60, and weekly up to day 600. Cysts or trophozoites were identified visually

by immunofluorescence assays. At some time points, selected dogs were subjected to a duodenal endoscopy to collect intestinal fluids, which were added to culture medium at 4 °C for 30 min.

The supernatants were collected and examined for _Giardia_ trophozoites using light and immunofluorescence microscopy or placed in culture medium for up to 6 days, as reported.20,43 BLOOD

SAMPLES Blood samples were taken after the first day of infection or immunisation to detect the presence of circulating anti-_Giardia_ antibodies. Blood was centrifuged at 800_g_ for 15 min

to obtain serum, which was stored at −70 °C until use. INTESTINAL CONTENTS At day 16 post infection, one animal per group was subjected to an endoscopy.5 Animals were previously fasted for 1

day and allowed free access to water. Small intestine fluids were aspirated and collected separately. In some cases, intestinal contents were centrifuged at 5,000_g_ at 4 °C to separate

cells, debris and bacteria. The supernatants were filter-sterilized and maintained at −70 °C until use in agglutination and immunofluorescence assays. AGGLUTINATION ASSAYS Assays were

performed in 96-well plates with flat-bottom wells. Approximately 5×105 trophozoites per well were incubated at 4 °C for 1 h with various dilutions of intestinal secretions, sera and ascitic

fluid containing VSP-specific mAbs (all heat-inactivated) in TYI-S-33 medium without adult bovine serum. The content of wells was mixed by repeated pipetting to assess agglutination of

trophozoites under microscope and reveal antibodies using anti-dog or anti-cat immunoglobulins (Abdserotec). REFERENCES * Thompson, R. C., Reynoldson, J. A. & Mendis, A. H. _Giardia_ and

giardiasis. _Adv. Parasitol._ 32, 71–160 (1993). Article  CAS  Google Scholar  * Adam, R. D. Biology of _Giardia lamblia_. _Clin. Microbiol. Rev._ 14, 447–475 (2001). Article  CAS  Google

Scholar  * Mata, L. [Criteria in evaluating the nutritional status of the child in Costa Rica]. _Rev. Biol. Trop._ 26, 415–430 (1978). CAS  PubMed  Google Scholar  * Thompson, R. C. The

zoonotic significance and molecular epidemiology of _Giardia_ and giardiasis. _Vet. Parasitol._ 126, 15–35 (2004). Article  Google Scholar  * Leib, M. S., Dalton, M. N., King, S. E. &

Zajac, A. M. Endoscopic aspiration of intestinal contents in dogs and cats: 394 cases. _J. Vet. Intern. Med._ 13, 191–193 (1999). Article  CAS  Google Scholar  * Lujan, H. D., Mowatt, M. R.

& Nash, T. E. Mechanisms of _Giardia lamblia_ differentiation into cysts. _Microbiol. Mol. Biol. Rev._ 61, 294–304 (1997). CAS  PubMed  PubMed Central  Google Scholar  * Buret, A. G.

Pathophysiology of enteric infections with _Giardia duodenalis_. _Parasite_ 15, 261–265 (2008). Article  CAS  Google Scholar  * Epe, C., Rehkter, G., Schnieder, T., Lorentzen, L. &

Kreienbrock, L. _Giardia_ in symptomatic dogs and cats in Europe-results of a European study. _Vet. Parasitol._ 173, 32–38 (2010). Article  CAS  Google Scholar  * Nash, T. E. Antigenic

variation in _Giardia lamblia_ and the host's immune response. _Philos. Trans. R. Soc. Lond. B Biol. Sci._ 352, 1369–1375 (1997). Article  CAS  Google Scholar  * Sprong, H., Caccio, S.

M. & van der Giessen, J. W. Identification of zoonotic genotypes of _Giardia duodenalis_. _PLoS Negl. Trop. Dis._ 3, e558 (2009). Article  Google Scholar  * Monis, P. T., Caccio, S. M.

& Thompson, R. C. Variation in _Giardia_: towards a taxonomic revision of the genus. _Trends Parasitol._ 25, 93–100 (2009). Article  Google Scholar  * Thompson, R. C., Hopkins, R. M.

& Homan, W. L. Nomenclature and genetic groupings of _Giardia_ infecting mammals. _Parasitol. Today_ 16, 210–213 (2000). Article  CAS  Google Scholar  * Rosa, L. A. et al. Infection of

dogs by experimental inoculation with human isolates of _Giardia duodenalis_: clinical and laboratory manifestations. _Vet. Parasitol._ 145, 37–44 (2007). Article  CAS  Google Scholar  *

Geurden, T., Vercruysse, J. & Claerebout, E. Is _Giardia_ a significant pathogen in production animals? _Exp. Parasitol._ 124, 98–106 (2009). Article  Google Scholar  * Nash, T. E.

Surface antigenic variation in _Giardia lamblia_. _Mol. Microbiol._ 45, 585–590 (2002). Article  CAS  Google Scholar  * Nash, T. E. & Aggarwal, A. Cytotoxicity of monoclonal antibodies

to a subset of _Giardia_ isolates. _J. Immunol._ 136, 2628–2632 (1986). CAS  PubMed  Google Scholar  * Hemphill, A., Stager, S., Gottstein, B. & Muller, N. Electron microscopical

investigation of surface alterations on _Giardia lamblia_ trophozoites after exposure to a cytotoxic monoclonal antibody. _Parasitol. Res._ 82, 206–210 (1996). Article  CAS  Google Scholar 

* Morrison, H. G. et al. Genomic minimalism in the early diverging intestinal parasite _Giardia lamblia_. _Science_ 317, 1921–1926 (2007). Article  CAS  Google Scholar  * Prucca, C. G. et

al. Antigenic variation in _Giardia lamblia_ is regulated by RNA interference. _Nature_ 456, 750–754 (2008). Article  CAS  Google Scholar  * Rivero, F. D. et al. Disruption of antigenic

variation is crucial for effective parasite vaccine. _Nat. Med._ 16, 551–557 (2010). Article  CAS  Google Scholar  * Mowatt, M. R., Aggarwal, A. & Nash, T. E. Carboxy-terminal sequence

conservation among variant-specific surface proteins of _Giardia lamblia_. _Mol. Biochem. Parasitol._ 49, 215–227 (1991). Article  CAS  Google Scholar  * Lujan, H. D., Mowatt, M. R., Conrad,

J. T. & Nash, T. E. Increased expression of the molecular chaperone BiP/GRP78 during the differentiation of a primitive eukaryote. _Biol. Cell_ 86, 11–18 (1996). CAS  PubMed  Google

Scholar  * Ballweber, L. R., Xiao, L., Bowman, D. D., Kahn, G. & Cama, V. A. Giardiasis in dogs and cats: update on epidemiology and public health significance. _Trends Parasitol._ 26,

180–189 (2010). Article  Google Scholar  * Hahn, N. E., Glaser, C. A., Hird, D. W. & Hirsh, D. C. Prevalence of _Giardia_ in the feces of pups. _J. Am. Vet. Med. Assoc._ 192, 1428–1429

(1988). CAS  PubMed  Google Scholar  * Kirkpatrick, C. E. Epizootiology of endoparasitic infections in pet dogs and cats presented to a veterinary teaching hospital. _Vet. Parasitol._ 30,

113–124 (1988). Article  CAS  Google Scholar  * Kirkpatrick, C. E. & Farrell, J. P. Feline giardiasis: observations on natural and induced infections. _Am. J. Vet. Res._ 45, 2182–2188

(1984). CAS  PubMed  Google Scholar  * Kirkpatrick, C. E. & Green, G. A. Susceptibility of domestic cats to infections with _Giardia lamblia_ cysts and trophozoites from human sources.

_J. Clin. Microbiol._ 21, 678–680 (1985). CAS  PubMed  PubMed Central  Google Scholar  * Carlin, E. P., Bowman, D. D., Scarlett, J. M., Garrett, J. & Lorentzen, L. Prevalence of

_Giardia_ in symptomatic dogs and cats throughout the United States as determined by the IDEXX SNAP _Giardia_ test. _Vet. Ther._ 7, 199–206 (2006). CAS  PubMed  Google Scholar  * Olson, M.

E., Ceri, H. & Morck, D. W. _Giardia_ vaccination. _Parasitol. Today_ 16, 213–217 (2000). Article  CAS  Google Scholar  * Olson, M. E., Morck, D. W. & Ceri, H. Preliminary data on

the efficacy of a _Giardia_ vaccine in puppies. _Can. Vet. J._ 38, 777–779 (1997). CAS  PubMed  PubMed Central  Google Scholar  * Olson, M. E., Hannigan, C. J., Gaviller, P. F. & Fulton,

L. A. The use of a _Giardia_ vaccine as an immunotherapeutic agent in dogs. _Can. Vet. J._ 42, 865–868 (2001). CAS  PubMed  PubMed Central  Google Scholar  * Anderson, K. A. et al. Impact

of _Giardia_ vaccination on asymptomatic _Giardia_ infections in dogs at a research facility. _Can. Vet. J._ 45, 924–930 (2004). PubMed  PubMed Central  Google Scholar  * Stein, J. E.,

Radecki, S. V. & Lappin, M. R. Efficacy of _Giardia_ vaccination in the treatment of giardiasis in cats. _J. Am. Vet. Med. Assoc._ 222, 1548–1551 (2003). Article  Google Scholar  *

Uehlinger, F. D. et al. Efficacy of vaccination in preventing giardiasis in calves. _Vet. Parasitol._ 146, 182–188 (2007). Article  Google Scholar  * Larocque, R., Nakagaki, K., Lee, P.,

Abdul-Wahid, A. & Faubert, G. M. Oral immunization of BALB/c mice with _Giardia duodenalis_ recombinant cyst wall protein inhibits shedding of cysts. _Infect. Immun._ 71, 5662–5669

(2003). Article  CAS  Google Scholar  * Lee, P. & Faubert, G. M. Oral immunization of BALB/c mice by intragastric delivery of _Streptococcus gordonii_-expressing _Giardia_ cyst wall

protein 2 decreases cyst shedding in challenged mice. _FEMS Microbiol. Lett._ 265, 225–236 (2006). Article  CAS  Google Scholar  * Keister, D. B. Axenic culture of _Giardia lamblia_ in

TYI-S-33 medium supplemented with bile. _Trans. R. Soc. Trop. Med. Hyg._ 77, 487–488 (1983). Article  CAS  Google Scholar  * Ropolo, A. S., Saura, A., Carranza, P. G. & Lujan, H. D.

Identification of variant-specific surface proteins in _Giardia muris_ trophozoites. _Infect. Immun._ 73, 5208–5211 (2005). Article  CAS  Google Scholar  * Lalle, M. et al. High genetic

polymorphism among _Giardia duodenalis_ isolates from Sahrawi children. _Trans. R. Soc. Trop. Med. Hyg._ 103, 834–838 (2009). Article  CAS  Google Scholar  * Deng, M. Y. & Cliver, D. O.

Degradation of _Giardia lamblia_ cysts in mixed human and swine wastes. _Appl. Environ. Microbiol._ 58, 2368–2374 (1992). CAS  PubMed  PubMed Central  Google Scholar  * Mowatt, M. R. et al.

Developmentally regulated expression of a _Giardia lamblia_ cyst wall protein gene. _Mol. Microbiol._ 15, 955–963 (1995). Article  CAS  Google Scholar  * Lujan, H. D., Mowatt, M. R., Conrad,

J. T., Bowers, B. & Nash, T. E. Identification of a novel _Giardia lamblia_ cyst wall protein with leucine-rich repeats. Implications for secretory granule formation and protein

assembly into the cyst wall. _J. Biol. Chem._ 270, 29307–29313 (1995). Article  CAS  Google Scholar  * Byrd, L. G., Conrad, J. T. & Nash, T. E. _Giardia lamblia_ infections in adult

mice. _Infect. Immun._ 62, 3583–3585 (1994). CAS  PubMed  PubMed Central  Google Scholar  * Boucher, S. M. & Gillin, F. D. Excystation of _in vitro_-derived _Giardia lamblia_ cysts.

_Infect. Immun._ 58, 3516–3522 (1990). CAS  PubMed  PubMed Central  Google Scholar  * Lujan, H. D. et al. Developmental induction of Golgi structure and function in the primitive eukaryote

_Giardia lamblia_. _J. Biol. Chem._ 270, 4612–4618 (1995). Article  CAS  Google Scholar  Download references ACKNOWLEDGEMENTS We thank Dr F.D. Rivero for initial studies in dogs. H.D.L.,

P.R.G., L.L.R. and M.C.S. are Members of the Scientific Investigator’s Career of the National Council for Scientific and Technical Research of Argentina. This work was supported by grants

from the National Council for Scientific and Technical Research of Argentina, the Catholic University of Cordoba and the Agency for Promotion of Science and Technology of Argentina. The

funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Centro de

Investigación y Desarrollo en Inmunología y Enfermedades Infecciosas. Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Cordoba, Argentina Marianela C Serradell, Alicia

Saura, Lucia L Rupil, Pablo R Gargantini & Hugo D Lujan * Facultad de Medicina, Universidad Católica de Córdoba, Cordoba, Argentina Alicia Saura, Lucia L Rupil, Pablo R Gargantini & 

Hugo D Lujan * Facultad de Veterinaria, Universidad Católica de Córdoba, Cordoba, Argentina Marcela I Faya & Paulina J Furlan Authors * Marianela C Serradell View author publications You

can also search for this author inPubMed Google Scholar * Alicia Saura View author publications You can also search for this author inPubMed Google Scholar * Lucia L Rupil View author

publications You can also search for this author inPubMed Google Scholar * Pablo R Gargantini View author publications You can also search for this author inPubMed Google Scholar * Marcela I

Faya View author publications You can also search for this author inPubMed Google Scholar * Paulina J Furlan View author publications You can also search for this author inPubMed Google

Scholar * Hugo D Lujan View author publications You can also search for this author inPubMed Google Scholar CONTRIBUTIONS M.C.S. and A.S. performed immunisations and vaccine efficiency

experiments; P.R.G. and L.L.R. generated vaccine preparations and assisted in the analysis on the results. M.I.F. and P.J.F. were the veterinarians in charge of animal controls, clinical

evaluation of infections, and vaccine effects and collection of the samples for analysis. M.C.S. and H.D.L. wrote the paper. H.D.L. supervised the entire work. CORRESPONDING AUTHOR

Correspondence to Hugo D Lujan. ETHICS DECLARATIONS COMPETING INTERESTS H.D.L. is a consultant of Zoetis since February 2015. The remaining authors declare no conflict of interest. RIGHTS

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Serradell, M., Saura, A., Rupil, L. _et al._ Vaccination of domestic animals with a novel oral vaccine prevents _Giardia_ infections, alleviates signs of giardiasis and reduces transmission

to humans. _npj Vaccines_ 1, 16018 (2016). https://doi.org/10.1038/npjvaccines.2016.18 Download citation * Received: 18 May 2016 * Revised: 06 July 2016 * Accepted: 28 July 2016 * Published:

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