Additionally, peristalsis and the renewal of enterocytes provide further protection against parasites. Nitric oxide production
Nitric oxide does not kill the parasite, but it inhibits the growth of trophozoites as well as excystation and encystation. Innate immune system
Lectin pathway of complement
The lectin pathway of complement is activated by mannose-binding lectin (MBL) which binds to N-acetylglucosamine. N-acetylglucosamine is a ligand for MBL and is present on the surface of Giardia. The classical pathway of complement
The classical pathway of complement is activated by antibodies specific against Giardia. Adaptive immune system
Antibodies
Antibodies inhibit parasite replication and also induce parasite death via the classical pathway of complement.Infection with Giardia typically results in a strong antibody response against the parasite. While IgG is made in significant amounts, IgA is believed to be more important in parasite control. IgA is the most abundant isotype in intestinal secretions, and it is also the dominant isotype in mothers milk. Antibodies in mothers milk protect children against giardiasis (passive immunization). T cells
The major aspect of adaptive immune responses is the T cell response. Giardia is an extracellular pathogen. Therefore CD4+ helper T cells are primarily responsible for this protective effect.One role of helper T cells is to promote antibody production and isotype switching. Other roles include cytokine production (Il-4,IL-9) to help recruit other effector cells of the immune response. Diagnosis
According to the CDC, detection of antigens on the surface of organisms in stool specimens is the current test of choice for diagnosis of giardiasis and provides increased sensitivity over more common microscopy techniques.
Lymphocytic colitis is a subtype of microscopic colitis, a condition characterized by chronic non-bloody watery diarrhea. Presentation
Causes
No definite cause has been determined. The peak incidence of lymphocytic colitis is in persons over age 50; the disease affects women and men equally. Some reports have implicated long-term usage of NSAIDs, proton pump inhibitors, and selective serotonin reuptake inhibitors, and other drugs. Associations with other autoimmune disorders suggests that overactive immune responses occur. Diagnosis
The colonoscopy is normal but histology of the mucosal biopsy reveals an accumulation of lymphocytes in the colonic epithelium and connective tissue (lamina propria). Collagenous colitis shares this feature but additionally shows a distinctive thickening of the subepithelial collagen table. Treatment
Budesonide, in colonic release preparations, has been shown in randomized controlled trials to be effective in treating this disorder. It helps control the diarrheal symptoms and treatment is usually given for several weeks. Sometimes it is used to prevent frequent relapses.Over-the-counter antidiarrheal drugs may be effective for some people with lymphocytic colitis. Anti-inflammatory drugs, such as salicylates, mesalazine, and systemic corticosteroids may be prescribed for people who do not respond to other drug treatment. The long-term prognosis for this disease is good with a proportion of people suffering relapses which respond to treatment. History
Lymphocytic colitis was first described in 1989. See also
Colitis

References
External links

NIH 
eMedicine.com