Advances in therapeutic and vaccine targets for Cryptosporidium: Challenges and possible mitigation strategies

•Cryptosporidium causing potentially fatal diarrhea, long-term growth stunting and cognitive deficits.•No drug has shown potentially effective results in susceptible hosts.•Limitation includes lack of good animal models, molecular genetic tools and culture system of the cryptosporidium parasite.•Special attention needs to the interface between host immunity and cryptosporidium parasite.•Drug development through genetic modification of cryptosporidium needs extraordinary attention. Cryptosporidium is known to be the second most common diarrheal pathogen in children, causing potentially fatal diarrhea and associated with long-term growth stunting and cognitive deficits. The only Food and Drug Administration-approved treatment for cryptosporidiosis is nitazoxanide, but this drug has not shown potentially effective results in susceptible hosts. Therefore, a safe and effective drug for cryptosporidiosis is urgently needed. Cryptosporidium genome sequencing analysis may help develop an effective drug, but both in vitro and in vivo approaches to drug evaluation are not fully standardized. On the other hand, the development of partial immunity after exposure suggests the possibility of a successful and effective vaccine, but protective surrogates are not precise. In this review, we present our current perspectives on novel cryptosporidiosis therapies, vaccine targets and efficacies, as well as potential mitigation plans, recommendations and perceived challenges. [Display omitted]