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Sarkar VK, De UK, Solanki P, Saxena H, Mehra S, Pateer DP, Prajapati SK. Fatal coinfection of blastocystosis and intestinal trichomoniasis in a rhesus macaque ( Macaca mulatta). J Parasit Dis 2024; 48:400-407. [PMID: 38840877 PMCID: PMC11147963 DOI: 10.1007/s12639-024-01659-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/25/2024] [Indexed: 06/07/2024] Open
Abstract
A 3-year-old male rhesus macaque was presented at Referral Veterinary Polyclinic-Teaching Veterinary Clinical Complex, with a chief complaint of chronic diarrhoea and swelling of dependent body parts. The patient's history indicates that the monkey had been experiencing diarrhoea for the past month, with 2-3 episodes of vomiting in the last 2 days. Additionally, oedema has developed within the last 2 weeks. The clinical examination findings revealed dullness and depression, the mucus membrane appeared pale, with a temperature-102.1 °F, a respiration rate-28/min, and a heart rate-92/min. The capillary refill time was 4 s. During the physical examination, the animal exhibited oedema on the dependent part of the body and faecal staining around the perineum along with loose yellow stool. Direct saline and iodine mount faecal smear examination revealed the presence of many motile pear-shaped flagellated protozoa and round vacuolated Blastocystis organisms. Giemsa-stained faecal smear cytology confirmed the presence of Pentatrichomonas sp. and Blastocystis sp. along with many microbes. The faecal culture was negative for all pathogenic microbes. The case was diagnosed as co-infection Blastocystosis and intestinal trichomoniasis. The treatment was initiated with a combination of sulfamethoxazole + trimethoprim @ 35 mg/kg body weight and metronidazole @25 mg/kg administered orally once daily for 7 days. Supportive therapy includes hematinic injection (iron sorbitol, folic acid and vitamin B12) @ 1 ml total dose, administered intramuscularly on alternate days for four occasions as well as intravenous infusion of crystalline amino acid @ 5 ml total dose on alternate days for four occasions. To manage vomition, injection ondansetron was administered@0.5 mg/kg intramuscularly, twice daily for 3 days and H2 blockers, including injection ranitidine@2 mg/kg intramuscularly twice daily for 3 days. Electrolyte and probiotic supplementation were administered orally. After 7 days of therapy, the oedema had significantly improved and episodes of vomition were stopped but there was no significant improvement in the episode of diarrhoea and consistency of faeces. Unfortunately, on the 10th day of therapy, the animal suddenly collapsed. Understanding the virulence pattern of opportunistic protozoa in primates is crucial, and identifying suitable therapeutic candidates to prevent fatal outcomes is the need of the hour, especially considering protozoal infections as an important differential diagnosis in gastrointestinal tract-related ailments. Our study successfully demonstrated the co-occurrence of blastocystosis and intestinal trichomoniasis, both uncommon infections with potential zoonotic implications.
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Affiliation(s)
- Varun Kumar Sarkar
- Division of Medicine, ICAR- Indian Veterinary Research Institute, Izatnagar, Bareilly, UP India
| | - Ujjwal Kumar De
- Division of Medicine, ICAR- Indian Veterinary Research Institute, Izatnagar, Bareilly, UP India
| | - Pooja Solanki
- Division of Medicine, ICAR- Indian Veterinary Research Institute, Izatnagar, Bareilly, UP India
| | - Harshit Saxena
- Division of Medicine, ICAR- Indian Veterinary Research Institute, Izatnagar, Bareilly, UP India
| | - Shivansh Mehra
- Division of Surgery, ICAR- Indian Veterinary Research Institute, Izatnagar, Bareilly, UP India
| | - Devendra Prasad Pateer
- Division of Parasitology, ICAR- Indian Veterinary Research Institute, Izatnagar, Bareilly, UP India
| | - Sudhir Kumar Prajapati
- Division of Microbiology, ICAR- Indian Veterinary Research Institute, Izatnagar, Bareilly, UP India
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Alexeree SMI, Abou-Seri HM, El-Din HES, Youssef D, Ramadan MA. Green synthesis of silver and iron oxide nanoparticles mediated photothermal effects on Blastocystis hominis. Lasers Med Sci 2024; 39:43. [PMID: 38246979 PMCID: PMC10800310 DOI: 10.1007/s10103-024-03984-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
The evolution of parasite resistance to antiparasitic agents has become a serious health issue indicating a critical and pressing need to develop new therapeutics that can conquer drug resistance. Nanoparticles are novel, promising emerging drug carriers that have demonstrated efficiency in treating many parasitic diseases. Lately, attention has been drawn to a broad-spectrum nanoparticle capable of converting absorbed light into heat via the photothermal effect phenomenon. The present study is the first to assess the effect of silver nanoparticles (Ag NPs) and iron oxide nanoparticles (Fe3O4 NPs) as sole agents and with the combined action of the light-emitting diode (LED) on Blastocystis hominins (B. hominis) in vitro. Initially, the aqueous synthesized nanoparticles were characterized by UV-Vis spectroscopy, zeta potential, and transmission electron microscopy (TEM). The anti-blastocyst efficiency of these NPs was tested separately in dark conditions. As these NPs have a wide absorption spectrum in the visible regions, they were also excited by a continuous wave LED of wavelength band (400-700 nm) to test the photothermal effect. The sensitivity of B. hominis cysts was evaluated using scanning laser confocal microscopy whereas the live and dead cells were accurately segmented based on superpixels and the k-mean clustering algorithm. Our findings showed that this excitation led to hyperthermia that induced a significant reduction in the number of cysts treated with photothermally active NPs. The results of this study elucidate the potential role of photothermally active NPs as an effective anti-blastocystis agent. By using this approach, new therapeutic antiparasitic agents can be developed.
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Affiliation(s)
- Shaimaa M I Alexeree
- Department of Laser Application in Metrology, Photochemistry, and Agricultural, National Institute of Laser Enhanced Science, Cairo University, Giza, Egypt.
| | - Hanan M Abou-Seri
- Department of Parasitology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hala E Shams El-Din
- Department of Parasitology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Doaa Youssef
- Department of Engineering Applications of Lasers, National Institute of Laser Enhanced Science, Cairo University, Giza, Egypt
| | - Marwa A Ramadan
- Department of Laser Application in Metrology, Photochemistry, and Agricultural, National Institute of Laser Enhanced Science, Cairo University, Giza, Egypt
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Abstract
Intestinal parasites include intestinal protozoa and intestinal helminths. Intestinal parasitic infections (IPIs) pose a global health problem affecting over one billion people worldwide. Although these infections are predominantly seen in the developing world, they are frequently seen in the developed countries, particularly in immunocompromised patients. Patients' clinical presentations generally include diarrhea, dysentery, abdominal pain, nausea, vomiting, nutritional deficiency, iron deficiency anemia, anal and perianal itching, and rarely intestinal obstruction. The intestinal parasites have similarities in their mode of transmission and life cycle. The stool test is the primary way of diagnosing IPIs. Treatment is given with various anti-parasitic agents. However, appropriate preventive measures are essential for successfully controlling the IPIs.
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Affiliation(s)
- Monjur Ahmed
- Division of Gastroenterology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA.
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Abdo SM, Ghallab MMI, Zaghloul MS, Elhadad H. Efficacy of Nitazoxanide, Nitazoxanide-Garlic Combination and Tinidazole in Treatment of Giardia duodenalis and Blastocystis hominis: Coproscopic Assessment. IRANIAN JOURNAL OF PARASITOLOGY 2023; 18:48-55. [PMID: 37197063 PMCID: PMC10183438 DOI: 10.18502/ijpa.v18i1.12379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Indexed: 05/19/2023]
Abstract
Background Giardia duodenalis and Blastocystis hominis are among the most common intestinal protozoa worldwide. Treatment of infection by metronidazole (MTZ) has some limitations. The objective of this study was to detect the prevalence of Blastocystis and giardiasis among school-age children from December 2021 till March 2022 from Motoubes, Kafrelsheikh, Egypt, and determine the efficacy of nitazoxanide (NTZ), NTZ plus garlic and tinidazole (TIN) on Blastocystis and giardiasis infection. Methods Stool samples were collected from 390 children and microscopically examined using formalin-ethyl acetate concentration and culturing on Jones' medium for B. hominis. Those who tested positive for giardiasis (120 children, 30.7%) (Group I) or Blastocystis (180 children, 46.1%) (Group II) were equally divided into four subgroups. The first subgroup received NTZ orally, every 12 hours for three successive days. The second subgroup received NTZ in the same dose as the first subgroup plus dry garlic powder every 12 hours for three successive days. The third subgroup received TIN as a single oral dose, and a fourth control subgroup. Successful cure was considered if no Blastocystis or giardiasis stages were found in post-treatment faecal specimens. Results Cure rate was significantly higher in TIN treated groups (75.5% and 96.6%) than NTZ (57.7% and 40%) or NTZ plus garlic treated groups (55.5% and 43%) in both Blastocystis and giardiasis, respectively (P<0.05). Conclusion TIN, once, is more efficacious than NTZ or NTZ plus garlic in the treatment of Blastocystis and giardiasis in children.
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Affiliation(s)
- Sarah M. Abdo
- Department of Medical Parasitology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, 35516, Egypt
| | | | - Mariam S. Zaghloul
- Department of Hepatology, Gastroenterology and Infectious Diseases, Kafrelshiekh University, 33516, Kafrelsheikh, Egypt
| | - Heba Elhadad
- Parasitology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
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Milner E, Stevens B, An M, Lam V, Ainsworth M, Dihle P, Stearns J, Dombrowski A, Rego D, Segars K. Utilizing Probiotics for the Prevention and Treatment of Gastrointestinal Diseases. Front Microbiol 2021; 12:689958. [PMID: 34434175 PMCID: PMC8381467 DOI: 10.3389/fmicb.2021.689958] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/05/2021] [Indexed: 12/12/2022] Open
Abstract
Probiotics are heavily advertised to promote a healthy gastrointestinal tract and boost the immune system. This review article summarizes the history and diversity of probiotics, outlines conventional in vitro assays and in vivo models, assesses the pharmacologic effects of probiotic and pharmaceutical co-administration, and the broad impact of clinical probiotic utilization for gastrointestinal disease indications.
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Affiliation(s)
- Erin Milner
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY, United States
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Benjamin Stevens
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY, United States
| | - Martino An
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY, United States
| | - Victoria Lam
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY, United States
| | - Michael Ainsworth
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY, United States
| | - Preston Dihle
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY, United States
| | - Jocelyn Stearns
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY, United States
| | - Andrew Dombrowski
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY, United States
| | - Daniel Rego
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY, United States
| | - Katharine Segars
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY, United States
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Silva JT, Fernández-Ruiz M, Grossi PA, Hernández-Jimenez P, López-Medrano F, Mularoni A, Prista-Leão B, Santos L, Aguado JM. Reactivation of latent infections in solid organ transplant recipients from sub-Saharan Africa: What should be remembered? Transplant Rev (Orlando) 2021; 35:100632. [PMID: 34130253 DOI: 10.1016/j.trre.2021.100632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 05/07/2021] [Accepted: 05/29/2021] [Indexed: 11/30/2022]
Abstract
International migration from Sub-Saharan African countries to the European Union and the United States has significantly increased over the past decades. Although the vast majority of these immigrants are young and healthy people, a minority can be affected by chronic conditions eventually leading to solid organ transplantation (SOT). Importantly, these candidates can bear geographically restricted fungal and parasitic latent infections that can reactivate after the procedure. An appropriate evaluation before transplantation followed by treatment, whenever necessary, is essential to minimize such risk, as covered in the present review. In short, infection due to helminths (Schistosoma spp. and Strongyloides stercoralis) and intestinal protozoa (Entamoeba histolytica, Giardia lamblia or Cyclospora cayetanensis) can be diagnosed by multiple direct stool examination, serological assays and stool antigen testing. Leishmaniasis can be assessed by means of serology, followed by nucleic acid amplification testing (NAAT) if the former test is positive. Submicroscopic malaria should be ruled out by NAAT. Screening for Histoplasma spp. or Cryptococcus spp. is not routinely indicated. Consultation with an Infectious Diseases specialist is recommended in order to adjust preemptive treatment among Sub-Saharan African SOT candidates and recipients.
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Affiliation(s)
- Jose Tiago Silva
- Unit of Infectious Diseases, University Hospital "12 de Octubre", Research Institute Hospital "12 de Octubre" (imas12), Madrid, Spain.
| | - Mario Fernández-Ruiz
- Unit of Infectious Diseases, University Hospital "12 de Octubre", Research Institute Hospital "12 de Octubre" (imas12), Madrid, Spain; Department of Medicine, Universidad Complutense, Madrid, Spain
| | - Paolo Antonio Grossi
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Pilar Hernández-Jimenez
- Unit of Infectious Diseases, University Hospital "12 de Octubre", Research Institute Hospital "12 de Octubre" (imas12), Madrid, Spain
| | - Francisco López-Medrano
- Unit of Infectious Diseases, University Hospital "12 de Octubre", Research Institute Hospital "12 de Octubre" (imas12), Madrid, Spain; Department of Medicine, Universidad Complutense, Madrid, Spain
| | - Alessandra Mularoni
- Department of Infectious Diseases, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy
| | - Beatriz Prista-Leão
- Department of Infectious Diseases, University Hospital Center "São João", School of Medicine, University of Porto, Porto, Portugal
| | - Lurdes Santos
- Department of Infectious Diseases, University Hospital Center "São João", School of Medicine, University of Porto, Porto, Portugal
| | - José María Aguado
- Unit of Infectious Diseases, University Hospital "12 de Octubre", Research Institute Hospital "12 de Octubre" (imas12), Madrid, Spain; Department of Medicine, Universidad Complutense, Madrid, Spain
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Mossallam SF, El- Mansoury SA, Tolba MM, Kohla AA, Khedr SI. In vitro susceptibility of human Blastocystis subtypes to simeprevir. Saudi J Biol Sci 2021; 28:2491-2501. [PMID: 33935570 PMCID: PMC8071969 DOI: 10.1016/j.sjbs.2021.01.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction and aim Blastocystis is a common enteric parasite, having a worldwide distribution. Many antimicrobial agents are effective against it, yet side effects and drug resistance have been reported. Thus, ongoing trials are being conducted for exploring anti-Blastocystis alternatives. Proteases are attractive anti-protozoal drug targets, having documented roles in Blastocystis. Serine proteases are present in both hepatitis C virus and Blastocystis. Since drug repositioning is quite trendy, the in vitro efficacy of simeprevir (SMV), an anti-hepatitis serine protease inhibitor, against Blastocystis was investigated in the current study. Methods Stool samples were collected from patients, Alexandria, Egypt. Concentrated stools were screened using direct smears, trichrome, and modified Ziehl-Neelsen stains to exclude parasitic co-infections. Positive stool isolates were cultivated, molecularly subtyped for assessing the efficacy of three SMV doses (100,150, and 200 μg/ml) along 72 hours (h), on the most common subtype, through monitoring parasite growth, viability, re-culture, and also via ultrastructure verification. The most efficient dose and duration were later tested on other subtypes. Results Results revealed that Blastocystis was detected in 54.17% of examined samples. Molecularly, ST3 predominated (62%), followed by ST1 (8.6%) and ST2 (3.4%). Ascending concentrations of SMV progressively inhibited growth, viability, and re-culture of treated Blastocystis, with a non-statistically significant difference when compared to the therapeutic control metronidazole (MTZ). The most efficient dose and duration against ST3 was 150 µg/ml for 72 h. This dose inhibited the growth of ST3, ST1, and ST2 with percentages of 95.19%, 94.83%, and 94.74%, successively and viability with percentages of 98.30%, 98.09%, and 97.96%, successively. This dose abolished Blastocystis upon re-culturing. Ultra-structurally, SMV induced rupture of Blastocystis cell membrane leading to necrotic death, versus the reported apoptotic death caused by MTZ. In conclusion, 150 µg/ml SMV for 72 h proved its efficacy against ST1, ST2, and ST3 Blastocystis, thus sparing the need for pre-treatment molecular subtyping in developing countries.
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Key Words
- Blastocystis subtypes
- CV, central vacuole
- DMSO, Dimethyl Sulfoxide
- IBS, irritable bowel syndrome
- In vitro
- MLO, Mitochondrion-like organelle
- MTZ, Metronidazole
- PCR, Polymerase chain reaction
- Re-culture
- SEM, Scanning electron microscopy
- SMV, Simeprevir
- ST, subtypes
- Simeprevir
- TEM, Transmission electron microscopy
- Ultrastructure
- Viability
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Affiliation(s)
- Shereen F. Mossallam
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Corresponding author at: Medical Parasitology Department, El Mowasah Medical and Educational Complex, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Salwa A.T. El- Mansoury
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mona M. Tolba
- Department of Parasitology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Asmaa A. Kohla
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Safaa I. Khedr
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Maleev VV, Tokmalaev AK, Kozhevnikova GM, Tsvetkova NA, Polovinkina NA, Golub VP, Maksimova MS, Barysheva IV, Konnov VV, Kharlamova TV. [Current view on Blastocystis species: clinical forms, diagnosis and treatment]. TERAPEVT ARKH 2020; 92:86-90. [PMID: 33720611 DOI: 10.26442/00403660.2020.11.000816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 12/26/2020] [Indexed: 11/22/2022]
Abstract
The symptomatic form of Blastocystis spp. infection not only with mild diarrhea or dysentery-like syndrome, but also with the development of severe ulcerative necrotic lesions of the intestine. Meanwhile, the pathogenicity of these microorganisms should not be exaggerated, due to majority asymptomatic cases or infection transmission with minor impaired bowel function.
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Affiliation(s)
- V V Maleev
- Central Research Institute of Epidemiology
| | | | | | | | | | - V P Golub
- People's Friendship University of Russia
| | - M S Maksimova
- Sechenov First Moscow State Medical University (Sechenov University)
| | | | - V V Konnov
- People's Friendship University of Russia
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Aykur M, Karakavuk E, Karakavuk M, Akıl M, Can H, Döşkaya M, Gürüz Y, Dağcı H. Inhibitory effect of Tunceli garlic (Allium tuncelianum) on blastocystis subtype 3 grown in vitro. Expert Opin Orphan Drugs 2020. [DOI: 10.1080/21678707.2020.1857725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Mehmet Aykur
- Department of Parasitology, Ege University Faculty of Medicine, İzmir, Turkey
- Department of Parasitology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Emrah Karakavuk
- Department of Nutrition and Dietetics, Munzur University Faculty of Health Sciences, Tunceli, Turkey
| | - Muhammet Karakavuk
- Department of Parasitology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Mesut Akıl
- Department of Parasitology, Medeniyet University Faculty of Medicine, İstanbul, Turkey
| | - Hüseyin Can
- Department of Biology, Molecular Biology Section, Ege University Faculty of Science, İzmir, Turkey
| | - Mert Döşkaya
- Department of Parasitology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Yüksel Gürüz
- Department of Parasitology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Hande Dağcı
- Department of Parasitology, Ege University Faculty of Medicine, İzmir, Turkey
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Younis MS, Abououf EAER, Ali AES, Abd elhady SM, Wassef RM. In vitro Effect of Silver Nanoparticles on Blastocystis hominis. Int J Nanomedicine 2020; 15:8167-8173. [PMID: 33116522 PMCID: PMC7588274 DOI: 10.2147/ijn.s272532] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/24/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION This study aims to assess the efficacy of silver nanoparticles (Ag Nps) alone and combined with metronidazole (Ag Nps + MTZ) as potential alternative therapeutic agents for Blastocystis hominis. METHODS The parasites were challenged with Ag Nps, Ag Nps + MTZ and MTZ. To assess the efficacy of drugs, counting of viable parasites was done after 1, 2, and 3 hours of adding the drugs. RESULTS Blastocystis hominis count was reduced by 20.72%, 28.23%, and 18.92% after one hour of adding Ag Nps, Ag Nps + MTZ, and MTZ, respectively. Cysts count was further reduced by 51.49%, 61.61%, and 40.78% after 2 hours and by 71.69%, 79.67%, and 62.65% after 3 hours of adding the drugs in the same order, respectively. CONCLUSION There was a statistically significant difference (P<0.05) in the in vitro growth inhibition of the parasite over the different time intervals when using the tested drugs against the control drug.
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Affiliation(s)
- Mohamed Saad Younis
- Medical Parasitology Department, Faculty of Medicine, Benha University, Benha, Egypt
| | | | - Ali El saeed Ali
- Medical Parasitology Department, Faculty of Medicine, Benha University, Benha, Egypt
| | | | - Rita Maher Wassef
- Medical Parasitology Department, Faculty of Medicine, Helwan University, Cairo, Egypt
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Hashan MR, Elhusseiny KM, Huu-Hoai L, Tieu TM, Low SK, Minh LHN, Nghia TLB, Loc LQ, Y MN, Eid PS, Abed M, Elkolaly SS, Tawfik GM, Huy NT. Effect of nitazoxanide on diarrhea: A systematic review and network meta-analysis of randomized controlled trials. Acta Trop 2020; 210:105603. [PMID: 32598920 DOI: 10.1016/j.actatropica.2020.105603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 06/20/2020] [Accepted: 06/25/2020] [Indexed: 01/30/2023]
Abstract
We aimed to systematically review evidence pertaining to the safety and efficacy of nitazoxanide in treating infectious diarrhea. On September 21, 2017, we identified relevant studies using 12 databases. The estimates of the included studies were pooled as a risk ratio (RR). We conducted a network and pairwise random-effects meta-analysis for both direct and indirect comparisons of different organisms that are known to cause diarrhea. The primary and secondary analysis outcomes were clinical response until cessation of illness, parasitological response and adverse events. We included 18 studies in our analysis. In cryptosporidiosis, the overall estimate favored nitazoxanide in its clinical response in comparison with placebo RR 1.46 [95% CI 1.22-1.74; P-value <0.0001]. Network meta-analysis among patients with Giardia intestinalis showed an increase in the probability of diarrheal cessation and parasitological responses in comparison with placebo, RR 1.69 [95% CI 1.08-2.64, P-score 0.27] and RR 2.91 [95% CI 1.72-4.91, P-score 0.55] respectively. In Clostridium difficile infection, the network meta-analysis revealed a non-significantly superior clinical response effect of nitazoxanide to metronidazole 31 days after treatment RR 1.21 [95% CI 0.87-1.69, P-score 0.26]. In Entamoeba histolytica, the overall estimate significantly favored nitazoxanide in parasitological response with placebo RR 1.80 [95% CI 1.35-2.40, P-value < 0.001]. We highlighted the effectiveness of nitazoxanide in the cessation of diarrhea caused by Cryptosporidium, Giardia intestinalis and Entamoeba histolytica infection. We also found significant superiority of NTZ to metronidazole in improving the clinical response to G. intestinalis, thus it may be a suitable candidate for treating infection-induced diarrhea. To prove the superiority of NTZ during a C. difficile infection may warrant a larger-scale clinical trial since its superiority was deemed insignificant. We recommend nitazoxanide as an appropriate option for treating infectious diarrhea.
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Hublin JSY, Maloney JG, Santin M. Blastocystis in domesticated and wild mammals and birds. Res Vet Sci 2020; 135:260-282. [PMID: 33046256 DOI: 10.1016/j.rvsc.2020.09.031] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/22/2020] [Accepted: 09/27/2020] [Indexed: 12/31/2022]
Abstract
Blastocystis is a ubiquitous parasite that infects a broad range of vertebrate hosts including humans and domestic and wild animals. While human infections have been occasionally associated with gastrointestinal illnesses and/or urticaria, animal infections are not usually associated with disease. However, from a public health perspective, most subtypes isolated in humans have also been isolated from animals raising the question of the importance of animal reservoirs in the epidemiology of this parasite. The identification of Blastocystis in water supplies suggests water can be a potential vehicle in the transmission of this parasite not only for humans but also for animals. In addition, Blastocystis has been detected in retail fresh produce. Knowledge of this parasite has greatly expanded in the last two decades from simple microscopic observations to the application of molecular tools to explore Blastocystis taxonomy and epidemiology. This review provides a comprehensive overview of Blastocystis in animals highlighting the subtype diversity of this widespread and genetically diverse parasite in different animal groups. This information will be useful in understanding the current status of taxonomy, epidemiology, zoonotic potential, and public health importance of Blastocystis.
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Affiliation(s)
- Josephine S Y Hublin
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, 10300 Baltimore Ave, Beltsville, MD 20705, United States
| | - Jenny G Maloney
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, 10300 Baltimore Ave, Beltsville, MD 20705, United States
| | - Monica Santin
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, 10300 Baltimore Ave, Beltsville, MD 20705, United States.
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Deng Y, Zhang S, Ning C, Zhou Y, Teng X, Wu X, Chu Y, Yu Y, Chen J, Tian L, Wang W. Molecular Epidemiology and Risk Factors of Blastocystis sp. Infections Among General Populations in Yunnan Province, Southwestern China. Risk Manag Healthc Policy 2020; 13:1791-1801. [PMID: 33061712 PMCID: PMC7532910 DOI: 10.2147/rmhp.s269664] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 09/03/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Blastocystis is a common enteric parasite of controversial pathogenic roles in human diseases. Although the prevalence of Blastocystis infections has been investigated in a diverse range of populations, there is little knowledge on the molecular epidemiology and risk factors of Blastocystis infections among general populations in southeastern China. MATERIALS AND METHODS A total of 507 individuals were randomly selected in Yunnan province, China from July 2016 to March 2017. Stool specimens were sampled for detection of Blastocystis sp. using PCR assay, and the risk factors of Blastocystis infections were identified. Blastocystis isolates were subtyped, and the associations of Blastocystis infections and subtypes with clinical manifestations were examined. RESULTS The overall detection rate of Blastocystis sp. was 9.47% (95% CI: 7.13-12.44%). Toilet type (OR = 3.248, 95% CI: 1.245-8.473), anemia (OR = 2.601, 95% CI: 1.245-8.473) and type of daily drinking water (OR = 3.11, 95% CI: 1.557-6.213) were identified as risk factors of Blastocystis infections; however, Blastocystis infections showed no associations with clinical symptoms. Four subtypes (ST1 to ST4) were characterized in Blastocystis isolates, in which ST3 was predominant (4.73%, 95% CI: 3.2-6.94%), followed by ST1 (3.16%, 95% CI: 1.95-5.07%), ST4 (1.38%, 95% CI: 0.07-2.82%) and ST2 (0.2%, 95% CI: 0-1.11%). In addition, ST1 subtype infection was found to correlate with anemia (OR = 4.66, 95% CI: 1.631-14.314). CONCLUSIONS There is a high prevalence of Blastocystis infections among general populations in Yunnan province, southwestern China, and toilet type, anemia and type of daily drinking water are risk factors of Blastocystis infections. ST3 is the dominant subtype of Blastocystis sp. characterized, and ST1 correlates with anemia. Improving hygiene conditions, developing healthy lifestyles and intensifying health education programs are strongly recommended to reduce the prevalence and transmission potential of Blastocystis infections.
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Affiliation(s)
- Yao Deng
- Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, Jiangsu Province, People's Republic of China
| | - Shunxian Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Chaoqun Ning
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Yongkang Zhou
- The First Clinical Medical College of Lanzhou University, Lanzhou 730000, Gansu Province, People's Republic of China
| | - Xuejiao Teng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Xiuping Wu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Yanhong Chu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Yingfang Yu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Jiaxu Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Liguang Tian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Wei Wang
- Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, Jiangsu Province, People's Republic of China
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Roshan N, Clancy A, Gunaratne AW, LeBusque A, Pilarinos D, Borody TJ. Two-day enema antibiotic therapy for parasite eradication and resolution of symptoms. World J Gastroenterol 2020; 26:3792-3799. [PMID: 32774058 PMCID: PMC7383847 DOI: 10.3748/wjg.v26.i26.3792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 05/14/2020] [Accepted: 06/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Blastocystis hominis (B. hominis) and Dientamoeba fragilis (D. fragilis) are two protozoan parasites of human bowel that are found throughout the world. There is still debate about the pathogenicity of these protozoans, despite them being commonly associated with gastrointestinal symptoms and can cause health issue in both children and adults. These parasites are usually transmitted through faecal-oral contact particularly under poor hygiene conditions or food/water contamination. Once a person is infected, the parasites live in the large intestine and are passed in the faeces.
AIM To investigate the effect of triple antibiotic therapy using enema infusion in the treatment of B. hominis and D. fragilis infections.
METHODS This retrospective longitudinal study was conducted in a single medical centre, which included fifty-four patients (≥ 18 years) who were positive for D. fragilis, B. hominis or both between 2017 and 2018. The treatment consisted of triple antibiotics that were infused over two consecutive days through rectal enema. Faecal samples were collected from participants pre- and post-treatment and were tested for parasites using microscopy and polymerase chain reaction. Patients’ symptoms were recorded prior and after the treatment as well as patient demographic data.
RESULTS Patients (n = 54), were either positive for B. hominis (37%), D. fragilis (35%) or both (28%). All patients completed the two-day treatment and no serious adverse effect was reported. The most common side effect experienced by the patients during the treatment was urine discolouration which was cleared by six weeks of follow-up. Common symptoms reported prior to treatment were diarrhoea, abdominal pain, constipation and fatigue. Other symptoms included abdominal discomfort, dizziness and blood in the stool. Eighty-nine percent of patients completed a final stool test post-treatment. At six weeks post-treatment, 79% of patients cleared the parasites from their faeces. Symptoms such as abdominal discomfort, dizziness and blood in the stool decreased significantly at both seven days and six weeks post-treatment (P < 0.040). The enema retention time, bowel preparation, previous antibiotic treatment or previous gastrointestinal problems had no significant effect on parasite eradication.
CONCLUSION Overall, eradication of parasites and improvement of clinical outcomes were observed in treated patients, showing the efficacy of this combination to eradicate the parasites and provide positive clinical outcome.
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Affiliation(s)
- Niloufar Roshan
- Centre for Digestive Diseases, New South Wales 2046, Australia
| | - Annabel Clancy
- Centre for Digestive Diseases, New South Wales 2046, Australia
| | | | | | | | - Thomas J Borody
- Centre for Digestive Diseases, New South Wales 2046, Australia
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15
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Blastocystis in Swiss children: a practical approach. Eur J Pediatr 2020; 179:979-984. [PMID: 32020333 DOI: 10.1007/s00431-020-03599-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 10/25/2022]
Abstract
Blastocystis is a parasite with a worldwide distribution and a varying prevalence in different countries. The pleomorphic nature of the protozoon and the lack of understanding a possible pathogenesis have led to confusion regarding its clinical significance. The aim of the study was to shed light on clinical characteristics of pediatric patients in Swiss children with a positive stool sample for Blastocystis, in order to provide recommendations for a practical approach for the clinician to know whom, when, and how to test. This is a retrospective study of pediatric patients, whose stool has been tested positive for Blastocystis in the last 10 years in northern Switzerland. A total of 4047 stool samples, belonging to 1887 different patients, were analyzed; 240 stool samples (of 160 patients) were tested positive for Blastocystis. On average, 2.2 (CI 1.98-2.35) stool samples per patient were analyzed, of which 1.48 (CI 1.36-1.61) were positive for Blastocystis. In 63% abdominal pain was the leading symptom, while in 17.5% it was an accidental finding without symptoms. There was a high significance in correlation of abdominal pain and chronicity (p < 0.0001) but none in diarrhea (p = 0.082) nor nausea/vomiting or other symptoms and chronicity. Followed by Entamoeba coli (8%), 26.3% of the patients with Blastocystis had a co-infection with another parasite, mostly Endolimax nana (13%).Conclusion: Carriage of Blastocystis is common; therefore, only children/teenagers at risk for a symptomatic Blastocystis infection should be tested. There is a good correlation between Blastocystis and chronic abdominal pain. Children with abdominal symptoms persisting over 4 weeks should have two different stool samples analyzed. No screening after travels/immigration is recommended.What is Known:• Blastocystis has a worldwide distribution.• The clinical significance is unclear.What is New:• Based on retrospective data, we recommend to only test children/teenagers with chronic abdominal pain for Blastocystis.• Two different stool samples should be examined by microscopy; serological investigations are not warranted.
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16
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Development and evaluation of high-resolution melting curve analysis for rapid detection and subtyping of Blastocystis and comparison the results with sequencing. Parasitol Res 2019; 118:3469-3478. [PMID: 31691003 DOI: 10.1007/s00436-019-06486-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
Blastocystis is a prevalent parasite that has a wide distribution. In order to design HRM real-time PCR, primers were selected from SSU rRNA gene to amplify specific fragment with different melting temperatures for each subtype of Blastocystis. Subsequently, HRM real-time PCR was performed and melting curve analysis was done by Rotor-Gene Q software. The results of HRM real-time PCR was then compared with sequence results of "barcoding region" of SSU rRNA gene of Blastocystis. To evaluate sensitivity of test, 10-fold serial dilutions of the parasite were prepared from ~ 106 to 1 parasite per mL of stool sample and were investigated by HRM real-time PCR. In order to determine specificity of method, HRM real-time PCR was done for some microorganisms and Blastocystis-negative stool samples. In silico analysis showed that all seventeen subtypes of Blastocystis were distinguish. In vitro analysis revealed that the test discriminated subtypes with specific melting temperatures.
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17
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Di Cristanziano V, D´Alfonso R, Berrilli F, Sarfo FS, Santoro M, Fabeni L, Knops E, Heger E, Kaiser R, Dompreh A, Phillips RO, Norman B, Feldt T, Eberhardt KA. Lower prevalence of Blastocystis sp. infections in HIV positive compared to HIV negative adults in Ghana. PLoS One 2019; 14:e0221968. [PMID: 31479472 PMCID: PMC6719849 DOI: 10.1371/journal.pone.0221968] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/18/2019] [Indexed: 12/20/2022] Open
Abstract
Background Sub-Saharan Africa is endemic for intestinal parasites and distinguished for the largest burden of HIV cases. Blastocystis sp. is one of the most common protists infecting humans but its role in human disease is still controversial. Aim of this study was to investigate the prevalence of Blastocystis sp. in HIV positive and negative adults in Ghana and its association with immune status and other risk factors. Methods 122 HIV positive outpatients and 70 HIV negative blood donors from the Komfo Anokye Teaching Hospital in Kumasi, Ghana, were included in the present study. Demographic, clinical and laboratory data were collected and HIV positive patients distinguished for CD4+ T cell count <200 cells/μl (n = 54) and >200 cells/μl (n = 68). A Blastocystis’s phylogenetic analysis was performed to determine sample subtype (ST). Results The prevalence of Blastocystis sp. in adult HIV positive individuals was lower than in HIV negative persons (6.6% vs. 20.0%, p = 0.008) and Blastocystis sp. ST1 was the most prevalent strain. Within HIV positive participants, the prevalence of Blastocystis sp. was lower in those individuals with CD4+ T cell count <200 cells/μl than in patients with higher CD4+ T cell count (1.9% vs. 10.3%, p = 0.076). Multiple regression analysis revealed that Blastocystis sp. was inversely associated with an obese Body Mass Index (BMI) in HIV negative persons (p = 0.040). Presence of Blastocystis sp. was correlated with higher CD4+ T cell count in HIV positive participants (p = 0.049). Conclusion It is largely reported that people living with HIV (PLHIV) in Africa are affected from parasite infections and that co-infections may adversely impact on their immune status, accelerating progress to AIDS and worsening gastrointestinal manifestations. Differently, in this study Blastocystis sp. was associated with a better immune status jointly with a healthy body weight while it seems to be reduced with the progression of HIV infection. This data agree with recent suggestions that Blastocystis sp. can represent a component of the healthy gut microbiota.
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Affiliation(s)
- Veronica Di Cristanziano
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Rossella D´Alfonso
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Federica Berrilli
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Fred Stephen Sarfo
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Maristella Santoro
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Lavinia Fabeni
- National Institute for Infectious Diseases L. Spallanzani—IRCCS, Rome, Italy
| | - Elena Knops
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Eva Heger
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Rolf Kaiser
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | | | - Richard Odame Phillips
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Kumasi Center for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Betty Norman
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Torsten Feldt
- Clinic of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Kirsten Alexandra Eberhardt
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
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18
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García-Flores L, Santillán-Benítez JG, Cuevas-Yáñez E, Caballero-Vásquez P, Zamudio-Chávez S, Morales-Ávila E. Evaluation of the effect of 1,3-bis-(4-phenyl-[1,2,3] triazole-1-il)2-propanol in comparison with metronidazole in an in vitro culture of Blastocystis in samples of patients with irritable bowel syndrome. J Parasit Dis 2019; 43:506-512. [PMID: 31406417 PMCID: PMC6667573 DOI: 10.1007/s12639-019-01118-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 04/23/2019] [Indexed: 12/17/2022] Open
Abstract
Metronidazole is the most-used pharmaceutical for the treatment of infection by Blastocystis. However, studies have reported resistance of the microorganism towards this pharmaceutical. In Mexico, studies concerning the prevalence of this parasite and its relationship to Irritable Bowel Syndrome have been carried out. To evaluate the in vitro effect of metronidazole and the compound 1,3-bis-(4-phenyl-[1,2,3] triazole-1-il)2-propanol over Blastocystis, as well as the prevalence of Blastocystis in patients with Irritable Bowel Syndrome. A prospective, transversal design study (April 2016-April 2017) of 51 samples of patients with Irritable Bowel Syndrome, obtained from the ISSEMyM Medical Center in Toluca, Mexico. For the identification of Blastocystis was done in three serial stool samples through direct microscopic examination and the Ritchie technique. The in vitro susceptibility test towards metronidazole and the triazolic compound was done through a microculture in concentrations of 1 to 1000 µg/mL, each one in triplicate. A 31.3% prevalence of Blastocystis was observed in the population, with greater prevalence in women (30.2%) than in men (25%). In the susceptibility test, a CL50 of 64 µg/mL was obtained for metronidazole, in comparison to the CL50 of 250 µg/mL for 1,3-bis-(4-phenyl-[1,2,3] triazole-1-il)2-propanol. This molecule in development has an effect for the treatment of infection by Blastocystis in vitro in patients with IBS and therefore, more studies should be performed.
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Affiliation(s)
- L. García-Flores
- Faculty of Chemistry, Autonomous University of the State of Mexico (UAEMex), Paseo Colón esq Paseo Tollocan, Col. Residencial Colón, Toluca, C.P. 50000 Mexico
| | - JG Santillán-Benítez
- Faculty of Chemistry, Autonomous University of the State of Mexico (UAEMex), Paseo Colón esq Paseo Tollocan, Col. Residencial Colón, Toluca, C.P. 50000 Mexico
- ISSEMyM Medical Center, Av. Baja Velocidad Km. 57.5 Carr. Méx./Tol. # 284 Col San Jerónimo Chicahualco. Municipio, Metepec, Mexico
| | - E. Cuevas-Yáñez
- Faculty of Chemistry, Autonomous University of the State of Mexico (UAEMex), Paseo Colón esq Paseo Tollocan, Col. Residencial Colón, Toluca, C.P. 50000 Mexico
| | - P. Caballero-Vásquez
- ISSEMyM Medical Center, Av. Baja Velocidad Km. 57.5 Carr. Méx./Tol. # 284 Col San Jerónimo Chicahualco. Municipio, Metepec, Mexico
| | | | - E. Morales-Ávila
- Faculty of Chemistry, Autonomous University of the State of Mexico (UAEMex), Paseo Colón esq Paseo Tollocan, Col. Residencial Colón, Toluca, C.P. 50000 Mexico
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Abstract
Human stool contains a myriad of microorganisms, of which the vast majority are nonpathogenic and represent an important component of the healthy microbiome. The increasing use of molecular techniques has allowed the rapid identification of bacteria, viruses and parasites in human stool. This review focuses on the 3 main classes of parasite responsible for human disease, helminths, protozoa and ectoparasites, and highlights the importance of differentiating between pathogenic and nonpathogenic parasites.
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Rajamanikam A, Hooi HS, Kudva M, Samudi C, Kumar S. Resistance towards metronidazole in Blastocystis sp.: A pathogenic consequence. PLoS One 2019; 14:e0212542. [PMID: 30794628 PMCID: PMC6386359 DOI: 10.1371/journal.pone.0212542] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 02/05/2019] [Indexed: 01/13/2023] Open
Abstract
Blastocsytis sp. is a protozoan parasite that has been linked to common gastrointestinal illnesses. Metronidazole, the first line therapy, was reported to show frequent inefficacy. Previously, Blastocystis sp. isolated from different population showed varying metronidazole resistance. However, the effect of metronidazole treatment on pathogenic potentials of Blastocystis sp. isolated from different populations, which is known to have different gut environment, is unclear. This study investigates the in vitro effect of metronidazole on the pathogenic potentials of Blastocystis sp. isolated from urban and orang asli individuals. Blastocystis sp. ST 3 isolated from symptomatic and asymptomatic individuals were treated with a range of metronidazole concentration. The parasites’ growth characteristics, apoptotic rate, specific protease activity and the ability to proliferate cancer cells were analyzed upon treatment with 0.001 mg/l metronidazole. The study demonstrates that Blastocystis sp. isolates showed increase in the parasite numbers especially the amoebic forms (only in urban isolates) after treating with metronidazole at the concentration of 0.001 mg/ml. High number of cells in post-treated isolates coincided with increase of apoptosis. There was a significant increase in cysteine protease of Blastocystis sp. isolates upon treatment despite the initial predominance of serine protease in asymptomatic isolates. Metronidazole resistant Blastocystis sp. also showed significant increase in cancer cell proliferation. Resistance to metronidazole did not show significant different influence on the pathogenicity between Blastocystis sp. isolated from urban and orang asli individual. However, an increase in parasite numbers, higher amoebic forms, cysteine protease and ability to proliferate cancer cells implicates a pathogenic role. The study provides evidence for the first time, the effect of metronidazole towards enhancing pathogenic potentials in Blastocystis sp. when isolated from different gut environment. This necessitates the need for reassessment of metronidazole treatment modalities.
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Affiliation(s)
- Arutchelvan Rajamanikam
- Depatment of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ho Shiaw Hooi
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Madhav Kudva
- Gastroenterology and Hepatology Specialist Clinic, Pantai Hospital, Kuala Lumpur, Malaysia
| | - Chandramathi Samudi
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Suresh Kumar
- Depatment of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
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Dirani G, Zannoli S, Paesini E, Farabegoli P, Dalmo B, Vocale C, Liguori G, Varani S, Sambri V. Easyscreen™ Enteric Protozoa Assay for the Detection of Intestinal Parasites: A Retrospective Bi-Center Study. J Parasitol 2019. [DOI: 10.1645/18-52] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Giorgio Dirani
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Piazzale della Liberazione 60, 47522 Pi
| | - Silvia Zannoli
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Piazzale della Liberazione 60, 47522 Pi
| | - Elena Paesini
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Piazzale della Liberazione 60, 47522 Pi
| | - Patrizia Farabegoli
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Piazzale della Liberazione 60, 47522 Pi
| | - Barbara Dalmo
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Piazzale della Liberazione 60, 47522 Pi
| | - Caterina Vocale
- Regional Reference Center for Microbiological Emergencies (CRREM), Unit of Microbiology, St. Orsola
| | - Giovanna Liguori
- Regional Reference Center for Microbiological Emergencies (CRREM), Unit of Microbiology, St. Orsola
| | - Stefania Varani
- Regional Reference Center for Microbiological Emergencies (CRREM), Unit of Microbiology, St. Orsola
| | - Vittorio Sambri
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Piazzale della Liberazione 60, 47522 Pi
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Viability Screen of LOPAC 1280 Reveals Phosphorylation Inhibitor Auranofin as a Potent Inhibitor of Blastocystis Subtype 1, 4, and 7 Isolates. Antimicrob Agents Chemother 2018; 62:AAC.00208-18. [PMID: 29866860 DOI: 10.1128/aac.00208-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/26/2018] [Indexed: 01/23/2023] Open
Abstract
Blastocystis is an enteric parasite with extensive global prevalence. Studies have linked infection with this protist with a variety of gastrointestinal disorders, including irritable bowel syndrome. Due to the polymorphic nature of Blastocystis, studies on the parasite could be complicated, as results can be easily misinterpreted. Metronidazole is the commonly prescribed drug for Blastocystis infection, although there have been increasing reports of drug resistance. Hence, there is a need to identify alternative drugs to eliminate Blastocystis infection. In this study, LOPAC1280 was screened and drugs that can decrease the viability of three Blastocystis isolates in cultures were identified. Using apoptosis assay and imaging flow cytometry, phenotypic changes in Blastocystis cells after treatment were also analyzed to obtain insights into the possible mechanism of action of these drugs. Three drugs-diphenyleneiodonium chloride, auranofin, and BIX 01294 trihydrochloride hydrate-were effective against all three isolates tested. Repurposing of these drugs for Blastocystis treatment could be a way of combating metronidazole resistance relatively quickly and at a lower cost.
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23
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Lepczyńska M, Białkowska J, Dzika E, Piskorz-Ogórek K, Korycińska J. Blastocystis: how do specific diets and human gut microbiota affect its development and pathogenicity? Eur J Clin Microbiol Infect Dis 2017; 36:1531-1540. [PMID: 28326446 PMCID: PMC5554277 DOI: 10.1007/s10096-017-2965-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 03/08/2017] [Indexed: 12/31/2022]
Abstract
Blastocystis is an enteric parasite that inhabits the gastrointestinal tract of humans and many animals. This emerging parasite has a worldwide distribution. It is often identified as the most common eukaryotic organism reported in human fecal samples. This parasite is recognized and diagnosed more often than ever before. Furthermore, some strains develop resistance against currently recommended drugs, such as metronidazole; therefore, the use of natural remedies or special diets has many positive aspects that may address this problem. The goal of this review is to compare natural treatments and various diets against the efficacy of drugs, and describe their influence on the composition of the gut microbiota, which affects Blastocystis growth and the occurrence of symptoms. This article reviews important work in the literature, including the classification, life cycle, epidemiology, pathogenesis, pathogenicity, genetics, biology, and treatment of Blastocystis. It also includes a review of the current knowledge about human gut microbiota and various diets proposed for Blastocystis eradication. The literature has revealed that garlic, ginger, some medical plants, and many spices contain the most effective organic compounds for parasite eradication. They work by inhibiting parasitic enzymes and nucleic acids, as well as by inhibiting protein synthesis. The efficacy of any specific organic compound depends on the Blastocystis subtype, and, consequently, on its immunity to treatment. In conclusion, the article discusses the findings that human gut microbiota composition triggers important mechanisms at the molecular level, and, thus, has a crucial influence on the parasitic pathogenicity.
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Affiliation(s)
- M Lepczyńska
- Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury, Żołnierska 14 C, Olsztyn, 10-561, Poland.
| | - J Białkowska
- Department of Neurology and Neurosurgery, Faculty of Medical Sciences, University of Warmia and Mazury, Warszawska 30, Olsztyn, Poland
| | - E Dzika
- Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury, Żołnierska 14 C, Olsztyn, 10-561, Poland
| | - K Piskorz-Ogórek
- Department of Nursing, Faculty of Medical Sciences, University of Warmia and Mazury, Żołnierska 14 C, Olsztyn, Poland
- Regional Specialized Children's Hospital in Olsztyn, Żołnierska 18A, Olsztyn, Poland
| | - J Korycińska
- Department of Medical Biology, Faculty of Medical Sciences, University of Warmia and Mazury, Żołnierska 14 C, Olsztyn, 10-561, Poland
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Gyang VP, Chuang TW, Liao CW, Lee YL, Akinwale OP, Orok A, Ajibaye O, Babasola AJ, Cheng PC, Chou CM, Huang YC, Sonko P, Fan CK. Intestinal parasitic infections: Current status and associated risk factors among school aged children in an archetypal African urban slum in Nigeria. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2017; 52:106-113. [PMID: 28711437 DOI: 10.1016/j.jmii.2016.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 08/08/2016] [Accepted: 09/28/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND/PURPOSE Intestinal parasitic infections (IPIs) among school aged children (SAC) in Nigeria remains endemic, hence the need for regular surveillance to attract the attention of policy makers. This cross-sectional study investigated the current prevalence and factors associated with intestinal parasitic infections among school aged children in an urban slum of Lagos City, Nigeria. METHODS Single stool samples from 384 school aged children (188 boys and 196 girls) were examined by employing Merthiolate-iodine-formaldehyde concentration (MIFC) and Kato-Katz methods. Demographic characteristics and risk factors were obtained by questionnaires investigation. RESULTS The overall prevalence was 86.2% in school children, out of them 39.1% had polyparasitism. IPIs showed the highest to the lowest prevalence of 62% (238/384), 25% (97/384), 12.3% (47/384), 11.8% (45/384), 9.9% (38/384), 8.4% (32/384), 3.4% (13/384), and 0.5% (2/384) found in Ascaris lumbricoides, Entamoeba histolytica/dispar, Giardia duodenalis, Endolimax nana, Entamoeba coli, Trichuris trichiura, Blastocystis hominis, and hookworm infections, respectively. MIFC technique showed superiority to Kato-Katz technique in the detection of IPIs (p < 0.0001). Drinking untreated water was a significant risk factor for these school aged children in acquiring protozoan infections after multivariate adjustment (OR = 1.86, 95% CI = 1.08-3.20, p = 0.02). CONCLUSION Intestinal parasitic infections are very severe among school aged children in the urban slums, thus regular mass de-worming programs, health education, and the provision of safe drinking water is recommended to combat IPIs among the school aged children.
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Affiliation(s)
- Vincent P Gyang
- Public Health Division, Molecular Parasitology Research Laboratory, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Ting-Wu Chuang
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chien-Wei Liao
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yueh-Lun Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Olaoluwa P Akinwale
- Public Health Division, Molecular Parasitology Research Laboratory, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Akwaowo Orok
- Biochemistry and Nutrition Division, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Olusola Ajibaye
- Biochemistry and Nutrition Division, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Ajayi J Babasola
- Science Laboratory Department, Ogun State Institute of Technology, Igbesa, Ogun state, Nigeria
| | - Po-Ching Cheng
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chia-Mei Chou
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ying-Chieh Huang
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Pasaiko Sonko
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chia-Kwung Fan
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan; Master Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei, Taiwan.
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Batista L, Pérez Jove J, Rosinach M, Gonzalo V, Sainz E, Loras C, Forné M, Esteve M, Fernández-Bañares F. Escasa eficacia de metronidazol en la erradicación de Blastocystis hominis en pacientes sintomáticos: serie de casos y revisión sistemática de la literatura. GASTROENTEROLOGIA Y HEPATOLOGIA 2017; 40:381-387. [DOI: 10.1016/j.gastrohep.2016.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 10/26/2016] [Accepted: 11/04/2016] [Indexed: 01/26/2023]
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Del Coco VF, Molina NB, Basualdo JA, Córdoba MA. [Blastocystis spp.: Advances, controversies and future challenges]. Rev Argent Microbiol 2017; 49:110-118. [PMID: 28189279 DOI: 10.1016/j.ram.2016.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 08/09/2016] [Accepted: 08/29/2016] [Indexed: 01/24/2023] Open
Abstract
Blastocystis spp. is the most common protozoan detected in human stool samples. In developing countries, infection rates are higher than 20%. The presence of this parasite in the feces of several host species suggests its zoonotic potential. The clinical relevance and the pathogenic role of Blastocystis spp. in the intestinal tract remain unclear. There are several clinical reports that recognize it as the etiologic agent of several intestinal disorders such as diarrhea, inflammatory bowel disease and ulcerative colitis, although the pathogenicity of this parasite has not been proved yet. This wide range of clinical manifestations could be related to the genetic diversity exhibited by this parasite.
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Affiliation(s)
- Valeria F Del Coco
- Centro Universitario de Estudios Microbiológicos y Parasitológicos, Sede Cátedra de Microbiología y Parasitología, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, CABA, Argentina.
| | - Nora B Molina
- Centro Universitario de Estudios Microbiológicos y Parasitológicos, Sede Cátedra de Microbiología y Parasitología, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Argentina
| | - Juan A Basualdo
- Centro Universitario de Estudios Microbiológicos y Parasitológicos, Sede Cátedra de Microbiología y Parasitología, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Argentina
| | - María A Córdoba
- Centro Universitario de Estudios Microbiológicos y Parasitológicos, Sede Cátedra de Microbiología y Parasitología, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Argentina; Comisión de Investigaciones Científicas de la Provincia de Buenos Aires, La Plata, Argentina
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Kurt Ö, Doğruman Al F, Tanyüksel M. Eradication of Blastocystis in humans: Really necessary for all? Parasitol Int 2016; 65:797-801. [PMID: 26780545 DOI: 10.1016/j.parint.2016.01.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 12/30/2015] [Accepted: 01/14/2016] [Indexed: 02/01/2023]
Abstract
Blastocystis (initially named as Blastocystis hominis) has long been known as a protist without any clinical significance. However, there is now a huge pile of case reports where Blastocystis is blamed for the symptoms and the infection described in the patients. Introduction of the presence of as many as 17 Blastocystis subtypes while many infected individuals are non-symptomatic initially brought about the correlation between the subtypes and pathogenicity; however, the outcomes of these trials were not consistent and did not explain its pathogenicity. Today, it is mostly acknowledged that Blastocystis may colonize many individuals but the infection's onset depends on the interaction between the virulence of parasites and host's immune competence. Eradication of Blastocystis is essential in some cases where it is the only infectious agent and patient is suffering from some symptoms. In such cases, metronidazole is the drug of choice but its efficacy is relatively low in some cases. Other agents used include trimethoprim-sulfamethoxazole, paromomycin, and furazolidone. Recent studies on the interactions between human health and the role of gut microbiota introduces new data which may significantly change our point of view against some protists, which we tend to see as "parasites requiring urgent eradication for cure". May the presence or absence of some Blastocystis subtypes necessary for human health, or is the absence or presence of certain Blastocystis subtypes in human gut is associated with certain diseases/infections? The answers of these questions will surely guide us to select patients requiring treatment against Blastocystis infection in future.
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Affiliation(s)
- Özgür Kurt
- Faculty of Medicine, Department of Medical Microbiology, Acibadem University, Istanbul, Turkey.
| | - Funda Doğruman Al
- Faculty of Medicine, Department of Medical Microbiology, Gazi University, Ankara, Turkey.
| | - Mehmet Tanyüksel
- Faculty of Medicine, Department of Medical Microbiology, Gülhane Military Medical Academy, Ankara, Turkey.
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Bremer Christensen C, Soelberg J, Stensvold CR, Jäger AK. Activity of medicinal plants from Ghana against the parasitic gut protist Blastocystis. JOURNAL OF ETHNOPHARMACOLOGY 2015; 174:569-575. [PMID: 25773490 DOI: 10.1016/j.jep.2015.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Revised: 03/01/2015] [Accepted: 03/03/2015] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The plants tested in this study were examples of plants historically used to treat or alleviate several types of stomach disorders manifested by e.g. stomachache, diarrhoea or dysentery. These plants have been consumed typically as a decoction, sometimes mixed with other flavourings. The aim of this study was to evaluate the anti-Blastocystis activity of 24 plant parts from 21 medicinal plants from Ghana. MATERIALS AND METHODS The medicinal plants were collected in the Greater Accra region of Ghana. Every plant part was tested in three different extracts; an ethanolic, a warm, and a cold water extract, at a final concentration of 1 mg/mL for the initial screening, and in a range from 0.0156 to 1mg/mL for determination of inhibitory concentrations. The obligate anaerobic parasitic gut protist Blastocystis (subtype 4) was used as a 48 h old subcultivated isolate in the final concentration of 10(6) cells/mL. Plant extracts inoculated with Blastocystis were incubated at 37 °C for 24 h and 48 h. Both MIC minimum inhibitory concentration (MIC90) assays and minimal lethal concentration (MLC) assays were performed after 24 h and 48 h. The half maximal inhibitory concentration (IC50) was derived after 24 h and 48 h. Antimicrobial activity was tested against two Gram-positive and two Gram-negative bacteria for all 24 plant parts at a final concentration of 1mg/mL. RESULTS Screening of the 24 different plant parts showed significant anti-Blastocystis activity of six of the ethanolic extracts: Mallotus oppositifolius, IC50, 24 h 27.8 µg/mL; Vemonia colorata, IC50, 24 h 117.9 µg/mL; Zanthoxylum zanthoxyloides, cortex IC50, 24 h 255.6 µg/mL; Clausena anisata, IC50, 24 h 314.0 µg/mL; Z. zanthoxyloides, radix IC50, 24 h 335.7 µg/mL and Eythrina senegalensis, IC50, 24 h 527.6 µg/mL. The reference anti-protozoal agent metronidazole (MTZ) had an IC50, 24 h of 7.6 µg/mL. Only C. anisata showed antimicrobial activity at a concentration of 800 µg/mL. CONCLUSION Six ethanolic plant extracts showed significant anti-parasitic activity against Blastocystis. M. oppositifolius showed nearly as good activity as the reference anti-protozoal drug MTZ. Historically, the active plants found in this study have been used against dysentery, diarrhoea or other stomach disorders. Nowadays they are not used specifically for dysentery, but they are being used as medicinal plants against various stomach disorders.
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Affiliation(s)
- Charlotte Bremer Christensen
- Department of Drug Design and Pharmacology, Universitetsparken 2, DK-2100 Copenhagen, Denmark; Laboratory of Parasitology, Department of Microbiology and Infection Control, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
| | - Jens Soelberg
- Department of Drug Design and Pharmacology, Universitetsparken 2, DK-2100 Copenhagen, Denmark; Museum of Natural Medicine, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Christen R Stensvold
- Laboratory of Parasitology, Department of Microbiology and Infection Control, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
| | - Anna K Jäger
- Department of Drug Design and Pharmacology, Universitetsparken 2, DK-2100 Copenhagen, Denmark.
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Girish S, Kumar S, Aminudin N. Tongkat Ali (Eurycoma longifolia): a possible therapeutic candidate against Blastocystis sp. Parasit Vectors 2015; 8:332. [PMID: 26082155 PMCID: PMC4476169 DOI: 10.1186/s13071-015-0942-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 06/08/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the local Malaysian context, herbal plants such as Eurycoma longifolia (Tongkat Ali), Orthosiphon stamineus (MisaiKucing), Ficus deltoidea (Mas Cotek), Zingiber officinale (Halia Bara) and Barringtonia racemosa (Putat) are known and widely used for its therapeutic properties. The first part of this study aims to screen for the anti-protozoal activity of these herbal plant extracts against Blastocystis sp. isolate subtype (ST) 3. Herbal extract with the highest efficacy was further fractionized into water and ethyl acetate fractions and tested against ST1, ST3 and ST5 Blastocystis sp. isolates. These isolates were also exposed to allopathic drugs, Metronidazole (MTZ), Tinidazole, Trimethoprim-sulfamethoxazole(TMP-SMX), Ketoconazole and Nitazoxanide for comparison purpose. METHODS Blastocystis sp. isolates from human-derived stool samples were exposed to herbal extracts and allopathic drugs at a concentration of 0.1 mg/ml and 1.0 mg/ml and were incubated at 37 °C. Growth profile studies were carried out. After 72 h of treatment, the viability of Blastocystis sp. as a result of the effects of the drugs and herbal extracts were assessed. RESULTS Based on the screening process, amongst all the extracts, Tongkat Ali exhibited the highest anti-protozoal activity at 1.0 mg/ml. Between the water and ethyl acetate fractions of Tongkat Ali, the ethyl acetate fraction exhibited a slightly higher percentage of anti-protozoal activity at 1.0 mg/ml across subtypes, ST1 (94.9%), ST3 (95.1%) and ST5 (94.3%). When tested with allopathic drugs, at the same concentration, MTZ exhibited the highest anti-protozoal activity across subtypes, ST1 (95.8%), ST3 (93.4%) and ST5 (90.8%). CONCLUSION This study is the first to describe the anti-protozoal properties of Tongkat Ali against Blastocystis sp. isolates. Ethyl acetate fraction of Tongkat Ali demonstrated the highest anti-protozoal activity against Blastocystis sp. isolates and showed a sizeable reduction in the cell count which was comparable with MTZ. Tongkat Ali also demonstrated a more uniformed sensitivity across subtypes in comparison to the allopathic drugs.
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Affiliation(s)
- Sonal Girish
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Suresh Kumar
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Norhaniza Aminudin
- Institute of Biological Sciences, Faculty of Science & University of Malaya Centre for Proteomics Research, Medical Biotechnology Laboratory, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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In Vitro Antimicrobial Susceptibility Patterns of Blastocystis. Antimicrob Agents Chemother 2015; 59:4417-23. [PMID: 25987633 DOI: 10.1128/aac.04832-14] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 05/04/2015] [Indexed: 02/07/2023] Open
Abstract
Blastocystis is the most common human enteric protist with controversial clinical significance. Metronidazole is considered a first-line treatment for Blastocystis infection; however, there has been increasing evidence for the lack of efficacy of this treatment. Treatment failure has been reported in several clinical cases, and recent in vitro studies have suggested the occurrence of metronidazole-resistant strains. In this study, we tested 12 Blastocystis isolates from 4 common Blastocystis subtypes (ST1, ST3, ST4, and ST8) against 12 commonly used antimicrobials (metronidazole, paromomycin, ornidazole, albendazole, ivermectin, trimethoprim-sulfamethoxazole [TMP-SMX], furazolidone, nitazoxanide, secnidazole, fluconazole, nystatin, and itraconazole) at 10 different concentrations in vitro. It was found that each subtype showed little sensitivity to the commonly used metronidazole, paromomycin, and triple therapy (furazolidone, nitazoxanide, and secnidazole). This study highlights the efficacy of other potential drug treatments, including trimethoprim-sulfamethoxazole and ivermectin, and suggests that current treatment regimens be revised.
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In Vitro Activity of Curcumin and Silver Nanoparticles Against Blastocystis hominis. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2015. [DOI: 10.1097/ipc.0000000000000242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Ihekweazu FD, Ajjarapu A, Kellermayer R. Diagnostic Yield of Routine Enteropathogenic Stool Tests in Pediatric Ulcerative Colitis. ANNALS OF CLINICAL AND LABORATORY SCIENCE 2015; 45:639-642. [PMID: 26663793 PMCID: PMC5358327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
GOALS It can be important to exclude infectious etiologies prior to adjusting immunosuppressive therapy in patients with ulcerative colitis (UC) exacerbation. We sought to determine the diagnostic yield of routine infectious stool studies in pediatric UC patients. PROCEDURES We conducted a retrospective review of 152 pediatric UC patients at Texas Children's Hospital between January 2003 and December 2009. The patient records were followed through July 2014. The number and type of infectious stool studies performed and the results of those were collected. RESULTS Three hundred fifty-four diagnostic stool tests were conducted for Clostridium difficile; 13.6% were positive. Two hundred twenty stool bacterial cultures were performed, and 1.8% were positive, all growing non-typhoid Salmonella. One of 13 (7.7%) Adenovirus PCR tests was positive. Two of 152 examinations (1.3%) for Ova and Parasites were positive. No stool tests for viral culture, viral particles, Yersinia or Rotavirus were positive. CONCLUSIONS Clostridium difficile infection is common in pediatric UC, and routine screening during flares is strongly recommended. Other bacterial and parasitic infections routinely tested for are uncommon, but Salmonella may be a potentially important attribute to disease exacerbations in select patients. In patients without co-morbid conditions, the utility of performing non-specific fecal viral tests is questionable.
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Affiliation(s)
- Faith D Ihekweazu
- Section of Pediatric Gastroenterology, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Texas Children's Hospital, Houston, TX, USA
| | - Avanthi Ajjarapu
- Section of Pediatric Gastroenterology, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Texas Children's Hospital, Houston, TX, USA
| | - Richard Kellermayer
- Section of Pediatric Gastroenterology, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Texas Children's Hospital, Houston, TX, USA
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