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Mızrak M, Sarzhanov F, Demirel F, Dinç B, Filik L, Dogruman-Al F. Detection of Blastocystis sp. and Dientamoeba fragilis using conventional and molecular methods in patients with celiac disease. Parasitol Int 2024; 101:102888. [PMID: 38499283 DOI: 10.1016/j.parint.2024.102888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/04/2024] [Accepted: 03/12/2024] [Indexed: 03/20/2024]
Abstract
Blastocystis sp. and Dientamoeba fragilis are intestinal protists, which are common worldwide, but the pathogenic role of these organisms in gastrointestinal diseases is still controversial. This study aimed to investigate the frequency of Blastocystis sp. and D. fragilis in stool samples from adult patients with celiac disease (CD) by using conventional and molecular methods. A total of 75 patients with CD and 75 healthy individuals were included in this study. Fresh stool specimens collected from each individual were analyzed by conventional and molecular methods. The overall prevalence of Blastocystis sp. and D. fragilis was 41.3% (31/75) and 24% (18/75) in patients with CD, and 46.7% (35/75) and 13.3% (10/75) in healthy controls, respectively. There was no statistically significant difference in the prevalence of Blastocystis sp. and D. fragilis between CD patients and healthy individuals. Blastocystis sp. subtypes were identified in 20 CD and 16 control patients and the overall subtype distribution was observed as ST1 13.9%, ST2 30.6%, and ST3 55.6%. The prevalence of Blastocystis sp. and D. fragilis in adults with CD is similar to the prevalence of protozoa in healthy adults. In this study, the most prevalent Blastocystis subtype was ST3 and the most frequent allele was a34 in both CD patients and healthy individuals. No significant difference was found between the two groups in terms of the detection rates of Blastocystis sp. and D. fragilis, and it is thought that both protists may be colonisers of the intestinal microbiome.
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Affiliation(s)
- Muzaffer Mızrak
- Yozgat City Hospital, Department of Microbiology, Yozgat, Turkey
| | - Fakhriddin Sarzhanov
- Khoja Akhmet Yassawi International Kazakh-Turkish University, Faculty of Medicine, Turkistan, Kazakhstan
| | - Filiz Demirel
- Health Science University, Ankara City Hospital, Department of Medical Microbiology, Ankara, Turkey.
| | - Bedia Dinç
- Health Science University, Ankara City Hospital, Department of Medical Microbiology, Ankara, Turkey
| | - Levent Filik
- Ankara Training and Research Hospital, Department of Gastroenterology, Ankara, Turkey
| | - Funda Dogruman-Al
- Gazi University, Faculty of Medicine, Department of Medical Microbiology, Division of Medical Parasitology, Ankara, Turkey
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Kumarasamy V, Kuppusamy UR, Jayalakshmi P, Govind SK. Blastocystis sp. reduces the efficacy of 5-fluorouracil as a colorectal cancer chemotherapeutic treatment. Exp Parasitol 2023:108564. [PMID: 37308003 DOI: 10.1016/j.exppara.2023.108564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 05/09/2023] [Accepted: 05/31/2023] [Indexed: 06/14/2023]
Abstract
Blastocystis is an enteric protozoan parasite with extensive genetic variation and unclear pathogenicity. It is commonly associated with gastrointestinal symptoms such as nausea, diarrhea, vomiting and abdominal pain in immunocompromised individuals. In this study, we explored the in vitro and in vivo effects of Blastocystis on the activity of a commonly used CRC chemotherapeutic agent, 5-FU. The cellular and molecular effects of solubilized antigen of Blastocystis in the presence of 5-FU were investigated using HCT116, human CRC cell line and CCD 18-Co, normal human colon fibroblast cells. For the in vivo study, 30 male Wistar rats were divided into six groups, as follows; Control Group: oral administration of 0.3ml Jones' medium, Group A: rats injected with azoxymethane (AOM), Group A-30FU: Rats injected with AOM and administered 30mg/kg 5-FU, Group B-A-30FU: rats inoculated with Blastocystis cysts, injected with AOM and administered 30mg/kg 5-FU, Group A-60FU: rats injected with AOM and administered 60mg/kg 5-FU and Group B-A-60FU: rats inoculated with Blastocystis cysts, injected with AOM and administered 60mg/kg 5-FU. The in vitro study revealed that the inhibitory potency of 5-FU at 8μM and 10μM was reduced from 57.7% to 31.6% (p < 0.001) and 69.0%-36.7% (p < 0.001) respectively when co-incubated with Blastocystis antigen for 24 h. However, the inhibitory potency of 5-FU in CCD-18Co cells was not significantly affected in the presence of Blastocystis antigen. The reduced inhibitory potency of 5-FU against cancer cell proliferation due to the presence of Blastocystis is consistent with the upregulation of expression of type 2 cytokines, transforming growth factor (TGF-β) and nuclear factor E2-related factor 2 (Nrf2) gene expression. Increased inflammation and abnormal histopathological findings along with a significant cancer multiplicity and adenoma incidence were evident in the intestine of the B-A-30FU and B-A-60FU groups when compared with the A-30FU and A-60FU groups respectively. Our in vitro and in vivo findings indicate that Blastocystis infection could potentially interfere with chemotherapy regimens such as 5-FU in CRC patients undergoing chemotherapy.
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Affiliation(s)
- Vinoth Kumarasamy
- Department of Parasitology & Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, 56000, Kuala Lumpur, Malaysia.
| | - Umah Rani Kuppusamy
- Department of Biomedical Science, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Pailoor Jayalakshmi
- Department of Pathology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Suresh Kumar Govind
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
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Aykur M, Calıskan Kurt C, Dirim Erdogan D, Biray Avcı C, Vardar R, Aydemir S, Girginkardesler N, Gunduz C, Dagci H. Distribution and Phylogenetic Analysis of Subtypes and Alleles of Blastocystis sp. in the Stool Samples Collected from Patients with Gastrointestinal Complaints in İzmir, Turkey. Acta Parasitol 2023. [PMID: 36806111 DOI: 10.1007/s11686-023-00665-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/19/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE Blastocystis sp. is one of the most prevalent intestinal protozoa found in humans and many other animals. The present study aimed to examine the distribution and genetic diversity of Blastocystis sp. in stool samples from patients with gastrointestinal complaints in İzmir, Turkey. METHODS All stool samples of 439 patients with gastrointestinal complaints were examined by native-Lugol and trichrome staining. To investigate the presence of Blastocystis sp. in stool samples, DNA was isolated, and PCR was performed with the barcode region in the SSU rRNA gene. PCR positive samples were sequenced to identify subtypes and alleles of Blastocystis sp. RESULTS The prevalence of Blastocystis sp. was found to be 16.6% (73/439) in patients with gastrointestinal complaints in İzmir, Turkey. Three different Blastocystis sp. subtypes were identified. ST3 (28/55; 51.0%) was the most common subtype followed by ST2 (19/55; 34.5%) and ST1 (8/55; 14.5%). Itching and diarrhea were the most prominent clinical symptoms in Blastocystis sp. positive patients. When clinical symptoms and subtypes were compared, diarrhea was found in 62.5%, 47.4%, and 46.4% of patients with ST1, ST2, and ST3 subtypes, respectively. In addition, itching was found in 37.5%, 32.1%, and 21.1% of patients with ST1, ST3, and ST2, respectively. Six distinct alleles were identified by allele analysis of Blastocystis 18S rRNA gene: allele 4 for ST1, alleles 9, 11, and 12 for ST2, and alleles 34 and 36 for ST3. In this study, Blastocystis sp. was detected in 16 of 21 districts, including the central and rural districts of İzmir. Although ST1 was detected in central districts, it was not found in rural districts. CONCLUSION This study provides comprehensive data on the prevalence and molecular epidemiology of the genetic diversity at the level of subtypes and alleles of Blastocystis sp. in different districts of İzmir province in Turkey. To the best of our knowledge, this is the first study which evaluates the distribution of subtypes and alleles of Blastocystis sp. according to PCR and SSU rRNA gene sequencing in patients with gastrointestinal complaints in different districts of İzmir province in Turkey.
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Labania L, Zoughbor S, Ajab S, Olanda M, Shantour SNM, Al Rasbi Z. The associated risk of Blastocystis infection in cancer: A case control study. Front Oncol 2023; 13:1115835. [PMID: 36890816 PMCID: PMC9986623 DOI: 10.3389/fonc.2023.1115835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/27/2023] [Indexed: 02/25/2023] Open
Abstract
Background Blastocystis is an anaerobic intestinal protozoan. Nine Blastocystis subtypes (STs) were detected in humans. A subtype-dependent association between Blastocystis and different cancer types has been debated in many studies. Thus, this study aims to assess the possible association between Blastocystis infection and cancer, especially colorectal cancer (CRC). We also screened the presence of gut fungi and their association with Blastocystis. Methods We used a case-control design; cancer patients and cancer-free (CF) participants. The cancer group was further sub-group into CRC group and cancers outside the gastrointestinal tract (COGT) group. Macroscopic and microscopic examinations were performed to identify intestinal parasites in participants' stool samples. Molecular and phylogenetic analyses were conducted to identify and subtype Blastocystis. Furthermore, gut fungi were investigated molecularly. Results 104 stool samples were collected and matched between CF (n=52) and cancer patients (n=52); CRC (n=15) and COGT (n=37). As anticipated, Blastocystis prevalence was significantly higher among CRC patients (60%, P=0.002) and insignificant in COGT patients (32.4%, P=0.161) compared to CF group (17.3%). The most common subtypes were ST2 among cancer group and ST3 in the CF group. Conclusion Cancer patients have a higher risk of Blastocystis infection compared to CF individuals (OR=2.98, P=0.022). Increased risk of Blastocystis infection was associated with CRC patients (OR=5.66, P=0.009). Nevertheless, further studies are required to understand the underlying mechanisms of Blastocystis and cancer association.
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Affiliation(s)
- Lena Labania
- Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates.,Zayed Bin Sultan Center for Health Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates
| | - Sumaya Zoughbor
- Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates.,Zayed Bin Sultan Center for Health Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates
| | - Suad Ajab
- Zayed Bin Sultan Center for Health Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates.,Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates
| | - Marie Olanda
- Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates.,Zayed Bin Sultan Center for Health Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates
| | - Sulaiman N M Shantour
- General Surgery Division, Surgery Department, Tawam Hospital, Abu Dhabi, United Arab Emirates
| | - Zakeya Al Rasbi
- Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates.,Zayed Bin Sultan Center for Health Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates
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Öncü Öner T, Karakavuk M, Değirmenci Döşkaya A, Güvendi M, Gül A, Köseoğlu AE, Erkunt Alak S, Gürüz AY, Ün C, Döşkaya M, Can H. Molecular prevalence of Blastocystis sp. and subtype diversity in fecal samples collected from cattle in dairy farms in Turkey. Comp Immunol Microbiol Infect Dis 2022; 87:101850. [PMID: 35751914 DOI: 10.1016/j.cimid.2022.101850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 10/18/2022]
Abstract
Close contact with infected animals is one of the main risk factors for zoonotic transmission of enteric protozoan parasite Blastocystis and thus, several animal species are being screened for the detection of the zoonotic subtypes. For this purpose, 22 fecal samples were collected from healthy cattle aged > 2 months and 39 fecal samples were also collected from cattle (aged <2 months) which are treated with TMP-SMX due to diarrhea. Later, Blastocystis sp. and subtypes were investigated by a PCR targeting the SSU rRNA gene and subsequently by sequencing. Among the 22 fecal samples collected from healthy cattle, Blastocystis was detected in 12 of them with a prevalence rate of 54.5 %. Among Blastocystis-positive samples, five different subtypes (ST3, ST5, ST10, ST12, and ST13) were detected. The predominant subtype was ST10 (allele 152) with a prevalence rate of 50 % (6/12). In the other group treated with TMP-SMX due to diarrhea, Blastocystis was detected in only one (2.56 %;1/39) fecal sample and its subtype was ST1 (allele 2). High prevalence of Blastocystis as well as predominance of ST10 (allele 152) were detected in healthy cattle. The identification of zoonotic ST1, ST3, ST5 and ST12 subtypes among the detected subtypes with a high prevalence (46.1 %; 6/13) showed the importance of cattle as a source for transmission of Blastocystis to humans. It was observed that the efficiency of TMP-SMX on the clearance of Blastocystis in cattle was very strong. Moreover, to our knowledge, this is the first study detecting Blastocystis ST13 subtype in the cattle.
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Affiliation(s)
- Tülay Öncü Öner
- Manisa Celal Bayar University Faculty of Engineering Department of Bioengineering, Manisa, Turkey
| | - Muhammet Karakavuk
- Ege University Odemis Vocational School, İzmir, Turkey; Ege University Vaccine Development Application and Research Center, İzmir, Turkey
| | - Aysu Değirmenci Döşkaya
- Ege University Vaccine Development Application and Research Center, İzmir, Turkey; Ege University Faculty of Medicine Department of Parasitology, İzmir, Turkey
| | - Mervenur Güvendi
- Ege University Faculty of Science Department of Biology Molecular Biology Section, İzmir, Turkey
| | - Aytül Gül
- Ege University Faculty of Engineering Department of Bioengineering, İzmir, Turkey
| | - Ahmet Efe Köseoğlu
- Biruni University, Faculty of Engineering and Natural Sciences, Department of Molecular Biology and Genetics, İstanbul, Turkey
| | - Sedef Erkunt Alak
- Ege University Vaccine Development Application and Research Center, İzmir, Turkey; Ege University Faculty of Science Department of Biology Molecular Biology Section, İzmir, Turkey
| | - Adnan Yüksel Gürüz
- Ege University Vaccine Development Application and Research Center, İzmir, Turkey; Ege University Faculty of Medicine Department of Parasitology, İzmir, Turkey
| | - Cemal Ün
- Ege University Vaccine Development Application and Research Center, İzmir, Turkey; Ege University Faculty of Science Department of Biology Molecular Biology Section, İzmir, Turkey
| | - Mert Döşkaya
- Ege University Vaccine Development Application and Research Center, İzmir, Turkey; Ege University Faculty of Medicine Department of Parasitology, İzmir, Turkey
| | - Hüseyin Can
- Ege University Vaccine Development Application and Research Center, İzmir, Turkey; Ege University Faculty of Science Department of Biology Molecular Biology Section, İzmir, Turkey.
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Taghipour A, Rayatdoost E, Bairami A, Bahadory S, Abdoli A. Are Blastocystis hominis and Cryptosporidium spp. playing a positive role in colorectal cancer risk? A systematic review and meta-analysis. Infect Agent Cancer 2022; 17:32. [PMID: 35715853 PMCID: PMC9206311 DOI: 10.1186/s13027-022-00447-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/11/2022] [Indexed: 11/28/2022] Open
Abstract
Objective Intestinal protozoa Blastocystis hominis and Cryptosporidium spp. are two influential factors in intestinal complications and malignancies. In present study, we estimated the pooled prevalence and odds ratio (OR) of the two parasites in colorectal cancer (CRC) patients and their possible association with the deadly disease. Method Our systematic search was conducted for published researches between January 1, 2000 and April 30, 2022 by using four international databases include Scopus, PubMed, and Web of Science as well as Google scholar search engine. The random- and fixed-effects models were used to estimate the pooled prevalence, OR, and 95% confidence interval (CI) by comprehensive meta-analysis (V2.2, Bio stat) software. Inclusion and exclusion criteria were applied. Results Thirteen papers (seven case–control and six cross-sectional studies) for B. hominis/CRC and six papers (two case–control and four cross-sectional studies) for Cryptosporidium spp./CRC were eligible to include in data synthesis. Pooled prevalence of B. hominis and Cryptosporidium spp. in CRC patients was calculated to be 26.8% (95% CI 19.4–35.7%) and 12.7% (95% CI 6.8–22.5%), respectively. Based on case–control studies, significant difference was found between case and controls in both protozoa (B. hominis OR 2.10; 95% CI 1.39–3.18% vs. Cryptosporidium spp. OR 5.06; 95% CI 1.8–13.6%). Considering the Blastocystis subtypes, ST1 (5/6; 83.33% studies) and ST3 (5/6; 83.33% studies) had the highest number of reports in CRC patients. Regarding the Cryptosporidium species, only C. parvum and C. hominis were reported. Conclusion Given the significant prevalence of both parasites in CRC patients and their statistically significant association, there is a need to pay more attention to these two intestinal parasites in under treatment patients.
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Affiliation(s)
- Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Esmail Rayatdoost
- Department of Emergency Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Amir Bairami
- Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Saeed Bahadory
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.,Department of Medical Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran
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Ali SH, Ismail MAM, El-Badry AA, Abu-Sarea EY, Dewidar AM, Hamdy DA. An Association Between Blastocystis Subtypes and Colorectal Cancer Patients: A Significant Different Profile from Non-cancer Individuals. Acta Parasitol 2022; 67:752-763. [PMID: 35067864 PMCID: PMC8784229 DOI: 10.1007/s11686-021-00508-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/09/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE Blastocystis is a common enteric human parasite of non-conclusive pathogenicity which may be determined by subtype (ST) variation. Colorectal cancer (CRC) is considered one of the primary causes of cancer mortality. Blastocystis ST7 has been shown to reduce beneficial intestinal microbiota and may exacerbate CRC. This study assessed the possible association between Blastocystis STs and CRC in comparison to non-cancer patients. MATERIAL AND METHODS A total of 200 fecal samples were obtained from CRC (100) and non-CRC (100) individuals attending Beni-Suef University Hospital, Egypt. Blastocystis was searched for in all samples using microscopy and culturing. Positive subculture samples were genetically sequenced and subtyped using conventional polymerase chain reaction (PCR). Blastocystis STs were determined by sequencing and a phylogenetic tree was created. Related patient characteristics and tumor stages were analyzed for association with presence of Blastocystis. RESULTS Blastocystis was identified in 52% and 42% of CRC and non-cancer individuals, respectively. ST1, 2, and 3 were isolated from both cancer and non-cancer individuals; however, for the first time, ST7 was only isolated from CRC stool samples with significant association. Associated patient characteristics were evaluated as predictors. CONCLUSION Blastocystosis is highly prevalent in CRC patients, predominantly in the latest CRC grades and stages. To the best of our knowledge, this is the first study to report the identification of Blastocystis ST7 in CRC patients. To determine whether certain STs of Blastocystis are associated with CRC would require further research, including the role played by gut microbiota.
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Affiliation(s)
- Shaimaa H. Ali
- Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Mousa A. M. Ismail
- Department of Medical Parasitology, College of Medicine, Cairo University, Giza, Egypt
| | - Ayman A. El-Badry
- Department of Microbiology-Medical Parasitology Section, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Enas Y. Abu-Sarea
- Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Ahmad M. Dewidar
- Department of Oncology, College of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Doaa A. Hamdy
- Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni Suef, Egypt
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Öner TÖ, Karabey M, Can H, Döşkaya AD, Karakavuk M, Gül A, Köseoğlu AE, Döşkaya M, Ün C, Gürüz AY, Kaya S, Pektaş B, Gökmen AA. Molecular investigation of Blastocystis sp. and its subtypes in cancer patients under chemotherapy in Aegean region, Turkey. Acta Trop 2022. [DOI: 10.1016/j.actatropica.2022.106577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/23/2022] [Accepted: 06/25/2022] [Indexed: 11/19/2022]
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Łanocha A, Łanocha-Arendarczyk N, Wilczyńska D, Zdziarska B, Kosik-Bogacka D. Protozoan Intestinal Parasitic Infection in Patients with Hematological Malignancies. J Clin Med 2022; 11:jcm11102847. [PMID: 35628973 PMCID: PMC9146298 DOI: 10.3390/jcm11102847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/11/2022] [Accepted: 05/16/2022] [Indexed: 02/07/2023] Open
Abstract
The aim of this study was to evaluate the frequency of gastrointestinal protozoan infection in patients with hematological malignancies (HMs) undergoing intensive hemato-oncological treatment and to determine the influence of certain biological factors on the incidence of intestinal parasite infection. Stool samples were collected from hematological malignancy patients (n = 50) hospitalized at the Department of Hematology and Transplantology of the Pomeranian Medical University in Szczecin. The control group consisted of 50 healthy participants. We used a direct smear examination and a commercial immunoenzymatic test. Intestinal protozoans were detected in 16% of patients with hematological malignancies and in 6% of individuals in the control group. In stool samples from patients with HM, cysts of Giardia intestinalis (2%), oocysts of Cryptosporidium spp. (10%), vacuolar forms of potentially pathogenic Blastocystis spp. (2%), and cysts of nonpathogenic Entamoeba coli (2%) were found. Cryptosporidium spp. and Giardia intestinalis coproantigens were detected in 5 (10%) and 1 (2%) patients with HM, respectively. In three participants from the control group, vacuolar forms of Blastocystis spp. were found. In the patients with HM, a significantly higher prevalence of intestinal parasite infection was found in individuals working in the garden without protective gloves and those in contact with animals. In patients with hematological malignancies, intestinal parasites should be excluded, even during intensive chemotherapy treatment.
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Affiliation(s)
- Aleksandra Łanocha
- Department of Hematology with Bone Marrow Transplantation Unit, Pomeranian Medical University in Szczecin, 71-242 Szczecin, Poland; (A.Ł.); (B.Z.)
| | - Natalia Łanocha-Arendarczyk
- Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
- Correspondence:
| | - Dominika Wilczyńska
- Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Barbara Zdziarska
- Department of Hematology with Bone Marrow Transplantation Unit, Pomeranian Medical University in Szczecin, 71-242 Szczecin, Poland; (A.Ł.); (B.Z.)
| | - Danuta Kosik-Bogacka
- Independent Laboratory of Pharmaceutical Botany, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
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Asghari A, Sadeghipour Z, Hassanipour S, Abbasali Z, Ebrahimzadeh-Parikhani H, Hashemzaei M, Alimardani V, Hatam G. Association between Blastocystis sp. infection and immunocompromised patients: a systematic review and meta-analysis. Environ Sci Pollut Res Int 2021; 28:60308-60328. [PMID: 34528202 DOI: 10.1007/s11356-021-16187-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/23/2021] [Indexed: 06/13/2023]
Abstract
The significance of opportunistic infections in immunocompromised patients and the enigmatic pathogenicity of Blastocystis directed us to conduct the first global systematic review and meta-analysis on Blastocystis prevalence, odds ratios (ORs), and subtypes distribution in various immunocompromised patients (HIV/AIDS, cancer and hemodialysis patients, as well as transplant recipients). The systematic searching procedure was done in Web of Science, PubMed, Scopus, and Google Scholar databases for relevant published literature until November 11, 2020. Random-effects model was utilized to calculate the weighted estimates and 95% confidence intervals (95% CIs). The computed pooled prevalence of Blastocystis inferred from 118 papers (128 datasets) on immunocompromised patients was 10.3% (95% CI: 8.7-12.2%), with 16.1% (95% CI: 11.3-22.2%), 12.5% (95% CI: 8.5-18%), 8.4% (95 % CI: 6.6-10.6%), and 6% (95% CI: 2.6-13.3%) for hemodialysis patients, cancer patients, HIV/AIDS patients, and transplant recipients, respectively. Based on 50 case-control studies (54 datasets), the highest ORs were associated with cancer [2.81 (95% CI: 1.24-6.38, P = 0.013)] and hemodialysis patients [2.78 (95% CI: 1.19-6.48, P = 0.018)]. The most frequent subtype being found in immunocompromised patients was ST3 [41.7% (95% CI: 31.4-52.7%)], followed by ST1 [31.7% (95% CI: 23.2-41.8%)] and ST2 [23.1% (95% CI: 14.8-34.1%)]. Also, the weighted frequency of Blastocystis in various subgroups (publication year, WHO regions, geographical distribution, continents, and country income) was analyzed separately. In total, the results of the present meta-analysis highlighted that one's immunodeficiency status is probably associated with an increased Blastocystis infection, underpinning strict preventive measures to be taken.
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Affiliation(s)
- Ali Asghari
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zeinab Sadeghipour
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Abbasali
- Department of Medical Parasitology and Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Hasan Ebrahimzadeh-Parikhani
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Hashemzaei
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Alimardani
- Department of Pharmaceutical Nanotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholamreza Hatam
- Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Hernández PC, Morales L, Chaparro-Olaya J, de Avila J, Bautista-Molano W, Bello-Gualtero J, Beltrán-Ostos A, Romero-Sánchez C. Frequency and distribution of Blastocystis sp. subtypes in patients with spondyloarthritis in Bogotá, Colombia. Parasite Epidemiol Control 2021; 15:e00227. [PMID: 34667886 PMCID: PMC8507199 DOI: 10.1016/j.parepi.2021.e00227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/26/2021] [Accepted: 09/30/2021] [Indexed: 11/04/2022] Open
Abstract
Although Blastocystis sp. is one of the most prevalent intestinal parasites worldwide, its role as a pathogen remains unclear. The use of molecular techniques to assess the genetic heterogeneity of Blastocystis sp. has become important to understand its function in some intestinal pathologies and if it is a key component of intestinal microbiota. Spondyloarthritis is a group of immune-mediated autoinflammatory diseases in which microbial dysbiosis in the gut (including parasites, bacteria and fungi) and intestinal inflammation are common features apparently associated with the pathophysiology of these disorders. This study included 74 patients diagnosed with spondyloarthritis and 57 systemically healthy individuals (included as controls), who were screened for intestinal parasites. Blastocystis sp. was detected in 68% and 73% of the patients with spondyloarthritis and controls, respectively. In faecal samples positive for Blastocystis sp., an 18S rRNA gene fragment of Blastocystis sp. was amplified and sequenced to identify their genetic sub-types. Patients with spondyloarthritis showed similar frequencies of ST1, ST2 and ST3 subtypes of Blastocystis sp. (30% each). The same subtypes were observed in controls, wherein almost 60% of the samples showed ST3. In addition, ST6 was found only in one sample from each group. ST1 subtype showed the greatest genetic variability. Although the same subtypes were detected in both patients with spondyloarthritis and controls, subtype prevalence studies conducted in Colombia indicate an association between ST3 and individuals with irritable bowel syndrome. This opens an interesting research avenue to further study of the epidemiology of Blastocystis sp. and its possible relationship with intestinal conditions in immunocompromised patients.
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Affiliation(s)
- Paula C Hernández
- Universidad El Bosque, Vicerrectoría de Investigaciones, Laboratorio de Parasitología Molecular, Bogotá, Colombia
| | - Liliana Morales
- Universidad El Bosque, Vicerrectoría de Investigaciones, Laboratorio de Parasitología Molecular, Bogotá, Colombia
| | - Jacqueline Chaparro-Olaya
- Universidad El Bosque, Vicerrectoría de Investigaciones, Laboratorio de Parasitología Molecular, Bogotá, Colombia
| | - Juliette de Avila
- Universidad El Bosque, Facultad de Odontología, Grupo de Inmunología Celular y Molecular -INMUBO, Bogotá, Colombia
| | - Wilson Bautista-Molano
- Universidad El Bosque, Facultad de Odontología, Grupo de Inmunología Celular y Molecular -INMUBO, Bogotá, Colombia.,Hospital Militar, Servicio de Reumatología e Inmunología, Universidad Militar Nueva Granada, Facultad de Medicina, Grupo de Inmunología Clínica Aplicada, Bogotá, Colombia
| | - Juan Bello-Gualtero
- Hospital Militar, Servicio de Reumatología e Inmunología, Universidad Militar Nueva Granada, Facultad de Medicina, Grupo de Inmunología Clínica Aplicada, Bogotá, Colombia
| | - Adriana Beltrán-Ostos
- Hospital Militar, Servicio de Reumatología e Inmunología, Universidad Militar Nueva Granada, Facultad de Medicina, Grupo de Inmunología Clínica Aplicada, Bogotá, Colombia
| | - Consuelo Romero-Sánchez
- Universidad El Bosque, Facultad de Odontología, Grupo de Inmunología Celular y Molecular -INMUBO, Bogotá, Colombia.,Hospital Militar, Servicio de Reumatología e Inmunología, Universidad Militar Nueva Granada, Facultad de Medicina, Grupo de Inmunología Clínica Aplicada, Bogotá, Colombia
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12
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Sarzhanov F, Dogruman-Al F, Santin M, Maloney JG, Gureser AS, Karasartova D, Taylan-Ozkan A. Investigation of neglected protists Blastocystis sp. and Dientamoeba fragilis in immunocompetent and immunodeficient diarrheal patients using both conventional and molecular methods. PLoS Negl Trop Dis 2021; 15:e0009779. [PMID: 34613993 PMCID: PMC8494357 DOI: 10.1371/journal.pntd.0009779] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/30/2021] [Indexed: 02/07/2023] Open
Abstract
Introduction The clinical significance of Blastocystis sp. and Dientamoeba fragilis in patients with gastrointestinal symptoms is a controversial issue. Since the pathogenicity of these protists has not been fully elucidated, testing for these organisms is not routinely pursued by most laboratories and clinicians. Thus, the prevalence of these organisms and the subtypes of Blastocystis sp. in human patients in Turkey are not well characterized. This study aimed to determine the prevalence of Blastocystis sp. and D. fragilis in the diarrheic stool samples of immunodeficient and immunocompetent patients using conventional and molecular methods and to identify Blastocystis sp. subtypes using next generation sequencing. Material and methods Individual stool specimens were collected from 245 immunodeficient and 193 immunocompetent diarrheic patients between March 2017 and December 2019 at the Gazi University Training and Research Hospital in Ankara, Turkey. Samples were screened for Blastocystis sp. and D. fragilis by conventional and molecular methods. Molecular detection of both protists was achieved by separate qPCRs targeting a partial fragment of the SSU rRNA gene. Next generation sequencing was used to identify Blastocystis sp. subtypes. Results The prevalence of Blastocystis sp. and D. fragilis was 16.7% and 11.9%, respectively as measured by qPCR. The prevalence of Blastocystis sp. and D. fragilis was lower in immunodeficient patients (12.7% and 10.6%, respectively) compared to immunocompetent patients (21.8% and 13.5%, respectively). Five Blastocystis sp. subtypes were identified and the following subtype distribution was observed: ST3 54.4% (n = 37), ST2 16.2% (n = 11), ST1 4.4% (n = 3), ST6 2.9% (n = 2), ST4 1.5% (n = 1), ST2/ST3 11.8% (n = 8) and ST1/ST3 8.8% (n = 6). There was no statistically significant difference in the distribution of Blastocystis sp. subtypes between immunocompetent and immunodeficient patients. Conclusion and recommendation Our findings demonstrated that Blastocystis sp. and D. fragilis are commonly present in immunocompetent and immunodeficient patients with diarrhea. This study is the first to use next generation sequencing to address the presence of Blastocystis sp. mixed subtypes and intra-subtype variability in clinical samples in Turkey. Blastocystis sp. and Dientamoeba fragilis are single-cell parasites of the human intestine which are common worldwide and reported in cases with gastrointestinal symptoms. However, the role of Blastocystis sp. and D. fragilis in patients with gastrointestinal symptoms is still controversial because their presence is not always associated with symptoms. As some intestinal parasitic infections can cause severe illness in immunocompromised individuals careful consideration of intestinal protist infection is warranted. However, testing for Blastocystis sp. and D. fragilis is not routinely carried out by most laboratories and clinicians. Therefore, this study aimed to determine the prevalence of Blastocystis sp. and D. fragilis in immunocompetent and immunosuppressed patients with diarrhea by conventional and molecular methods. Both Blastocystis sp. and D. fragilis were detected more frequently by quantitative polymerase chain reaction than by conventional methods. Next generation sequencing was used to characterize the diversity and frequency of Blastocystis sp. subtypes and mixed subtypes in patients in Turkey. Five Blastocystis sp. subtypes (ST1, ST2, ST3, ST4 and ST6) were detected. ST3 was the most frequent subtype in both immunocompetent and immunosuppressed patients. Mono-infections were more common than mixed subtype infections. Our findings showed that Blastocystis sp. and D. fragilis are commonly present in immunocompetent and immunodeficient patients with diarrhea.
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Affiliation(s)
- Fakhriddin Sarzhanov
- Division of Medical Parasitology, Department of Medical Microbiology, School of Medicine, Gazi University, Ankara, Turkey
- Akhmet Yassawi International Kazakh-Turkish University, Faculty of Medicine, Turkestan, Kazakhstan
| | - Funda Dogruman-Al
- Division of Medical Parasitology, Department of Medical Microbiology, School of Medicine, Gazi University, Ankara, Turkey
- * E-mail: ,
| | - Monica Santin
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, Maryland, United States of America
| | - Jenny G. Maloney
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, Maryland, United States of America
| | - Ayse Semra Gureser
- Department of Medical Microbiology, School of Medicine, Hitit University, Corum, Turkey
| | - Djursun Karasartova
- Department of Medical Microbiology, School of Medicine, Hitit University, Corum, Turkey
| | - Aysegul Taylan-Ozkan
- Department of Medical Microbiology, School of Medicine, Hitit University, Corum, Turkey
- Department of Medical Microbiology, Faculty of Medicine, TOBB- University of Economics and Technology, Ankara, Turkey
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Rauff-Adedotun AA, Meor Termizi FH, Shaari N, Lee IL. The Coexistence of Blastocystis spp. in Humans, Animals and Environmental Sources from 2010-2021 in Asia. Biology (Basel) 2021; 10:990. [PMID: 34681089 PMCID: PMC8533399 DOI: 10.3390/biology10100990] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/12/2022]
Abstract
Blastocystis spp. are controversial unicellular protists that inhabit the gastrointestinal tract of humans and a wide range of animals worldwide. This review provides an overview of the prevalence and distribution of Blastocystis spp. and their subtypes throughout Asia. Research articles reporting on the presence of Blastocystis spp. in locations within Asia, between 1 January 2010, and 10 May 2021, were obtained from Scopus, PubMed, and Google Scholar. In 427 articles, the prevalence of Blastocystis spp. in 31 countries within the last decade was revealed. Isolates were found in humans, various mammals, birds, reptiles, insects, water sources, vegetables, and ambient air. Prevalence of Blastocystis spp. varied widely across host categories. Subtypes identified throughout Asia were STs 1-14, and ST18-22 (novel subtypes). ST1, ST2, ST3, ST4 were the most frequently isolated in humans; ST5 in pigs; ST10 and ST14 in goats, sheep, and cattle; and ST6 and ST7 in chickens. ST1 and ST3 were most common in water samples. ST1, ST2, ST3, ST4, ST5 and ST6 were shared by humans, animals, and water sources. There is a growing interest in the study of Blastocystis spp. and their subtypes in Asia. Due to the isolation of Blastocystis spp. from biotic and abiotic sources in Asia, the application of the One Health (OH) approach to the study of Blastocystis spp. is proposed for improved perception of this organism.
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Affiliation(s)
| | - Farah Haziqah Meor Termizi
- School of Biological Sciences, Universiti Sains Malaysia, Kuala Lumpur 11800, Malaysia; (A.A.R.-A.); (F.H.M.T.)
| | - Nurshafarina Shaari
- Kulliyyah of Medicine & Health Sciences, Universiti Islam Antarabangsa Sultan Abdul Halim Mu’adzam Shah, Kuala Ketil 09300, Malaysia;
| | - Ii Li Lee
- Kulliyyah of Medicine & Health Sciences, Universiti Islam Antarabangsa Sultan Abdul Halim Mu’adzam Shah, Kuala Ketil 09300, Malaysia;
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Popruk S, Adao DEV, Rivera WL. Epidemiology and subtype distribution of Blastocystis in humans: A review. Infect Genet Evol 2021; 95:105085. [PMID: 34530156 DOI: 10.1016/j.meegid.2021.105085] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 12/19/2022]
Abstract
Blastocystis is a commonly encountered gastrointestinal protozoan in humans and animals with uncertain pathogenicity. Despite its potential public health impact, epidemiological data regarding the prevalence and molecular subtype (ST) distribution of Blastocystis have been rarely reported. Among Blastocystis STs, ST1-ST4 are common in humans, including healthy and immunodeficient populations. According to the Chi-squared (χ2) association based on the data compiled for this cross-sectional study, the presence of ST1 is associated with asymptomatic infection, whereas the presence of ST4 is associated with symptomatic infection. However, cross-sectional studies cannot clarify the potential pathogenicity of Blastocystis, unlike in vivo and in vitro studies. Poor hygiene, poor sanitation and zoonotic transmission are possible factors associated with high Blastocystis prevalence, although this protozoan may be part of the normal healthy human gastrointestinal microbiota. This review covers the prevalence, STs and distribution of Blastocystis infection in humans. Thus, future epidemiological and subtyping studies could reveal new STs in humans as well as possible associations of STs with disease, drug resistance and related mechanisms such as protease activity. These associations with proper ST identification may facilitate the control of potential threats to host health, including the direct pathogenic effects of Blastocystis or alterations of the gastrointestinal microbiome.
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Affiliation(s)
- Supaluk Popruk
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Bangkok 10400, Thailand
| | - Davin Edric V Adao
- Pathogen-Host-Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, Quezon City 1101, Philippines
| | - Windell L Rivera
- Pathogen-Host-Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, Quezon City 1101, Philippines.
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Mülayim S, Aykur M, Dağcı H, Dalkılıç S, Aksoy A, Kaplan M. Investigation of Isolated Blastocystis Subtypes from Cancer Patients in Turkey. Acta Parasitol 2021; 66:584-92. [PMID: 33387270 DOI: 10.1007/s11686-020-00322-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/28/2020] [Indexed: 01/03/2023]
Abstract
PURPOSE It is not clear that Blastocystis remains without damage to the digestive tract or has a pathogenic effect in relation to subtypes in immunocompromised people, such as cancer patients. The present study aimed to investigate the frequency and subtype distribution of Blastocystis in cancer patients who were followed-up and treated in the Oncology clinic of Firat University Hospital and to determine the clinical signs of infected sufferers. METHODS 201 patients aged ≥ 18 with a diagnosis of cancer were enrolled in this cross-sectional study. Patients' stool samples were examined between September 2017 and August 2019 by native-Lugol, trichrome staining. Microscopy-positive stool samples were subjected to DNA isolation and subtyped by Sequence Tagged Site (STS)-PCR analysis. The symptoms and demographic characteristics of the patients were also evaluated. RESULTS Totally, 29 (14.4%) samples were positive for Blastocystis after all methods. 15 (51.7%) out of 29 samples were successfully subtyped by the sequenced-tagged site(STS)-PCR, while 14 (48.3%) could not be typed. Three subtypes of Blastocystis were detected: ST3 (40%), ST2 (33%), ST1 (20%), and one mixed infections with ST1/ST2 (6%). There was no statistically significant difference in terms of clinical findings and demographic characteristics. CONCLUSION The outcomes of our study promote the idea that Blastocystis could be an asymptomatic and harmless commensal organism. However, more comprehensive molecular and clinical studies are needed to fully determine the pathogenicity and epidemiology of Blastocystis in cancer patients.
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16
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Sulżyc-Bielicka V, Kołodziejczyk L, Adamska M, Skotarczak B, Jaczewska S, Safranow K, Bielicki P, Kładny J, Bielicki D. Colorectal cancer and Blastocystis sp. infection. Parasit Vectors 2021; 14:200. [PMID: 33853659 PMCID: PMC8048192 DOI: 10.1186/s13071-021-04681-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 03/15/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Blastocystis sp. is a common intestinal protozoan found worldwide. Based on gene analysis, 17 subtypes (STs, ST1-ST17) have been identified, 9 of which have been isolated from humans. Differences in clinical consequences may depend on differences among the STs. Here, we evaluated the prevalence of Blastocystis sp. in patients with colorectal cancer (CRC) compared to a control group and assessed the relationships between Blastocystis sp. infection and sex; age; and CRC grade, stage, and location. METHODS The study included 107 CRC patients (41 women and 66 men, median age 65 years); 124 subjects without colorectal cancer or a history of oncological disease comprised the control group (55 women and 69 men, median age 63). Stool samples were collected from patients before oncological treatment and examined using light microscopy (iodine-stained smear). Additionally, PCR-based identification of Blastocystis sp. was performed in 95 stool samples from CRC patients and 76 stool samples from the control group. RESULTS Light microscopy showed that the prevalence of Blastocystis sp. was significantly higher in CRC patients than in the control group (12.15% and 2.42%, respectively; p = 0.0041). Multivariate analysis showed that the odds of Blastocystis sp. infection were fivefold higher in the CRC group than in the control group. PCR-based molecular examinations demonstrated that the proportion of patients infected with Blastocystis sp. was significantly higher in the CRC group than in the control group (12.63% and 2.63%, respectively; p = 0.023). The predominant ST in the CRC group was ST3, detected in nine patients (75%), followed by ST1 (2 patients, 16.7%) and ST2 (1 patient, 8.3%). No association was found between Blastocystis sp. infection and age, sex, or CRC stage, grade, or location. CONCLUSIONS The results showed that CRC was associated with an increased risk of opportunistic Blastocystis sp. infection, even before oncological treatment. To the best of our knowledge, this is the first report estimating the prevalence of Blastocystis sp. infection in CRC patients before oncological treatment in Europe.
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Affiliation(s)
| | - Lidia Kołodziejczyk
- Department of Biology and Medical Parasitology, Pomeranian Medical University, Szczecin, Poland
| | | | | | - Sylwia Jaczewska
- Early Phase Clinical Trial Unit. Maria Sklodowska-Curie Memorial Cancer Centre-Institute of Oncology, Warsaw, Poland
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | - Paweł Bielicki
- Department of Radiotherapy, Pomeranian Medical University, Szczecin, Poland
| | - Józef Kładny
- Department of Oncological Surgery, Pomeranian Medical University, Szczecin, Poland
| | - Dariusz Bielicki
- Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland
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Salehi Kahish R, Alghasi A, Hadadi S, Abasi Nasab M, Mafakherzadeh A. The Prevalence of Blastocystis Infection in Pediatric Patients with Malignancy: A Single-Center Study in Ahvaz, Iran. Arch Pediatr Infect Dis 2021; 9. [DOI: 10.5812/pedinfect.104068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Blastocystis spp. is known as one of the few intestinal parasites, prevalent in more than 5% and 30 - 60% of the population in industrialized and developing countries, respectively. In this respect, immunocompromised individuals, such as patients undergoing chemotherapy or those with malignancies, are at risk of the clinical symptoms of Blastocystis infection; however, the given condition is often self-limiting in healthy individuals. Objectives: The current study aimed at evaluating the prevalence of Blastocystis infection in children with malignancies receiving chemo drugs. Methods: The current descriptive, cross-sectional study was conducted on 52 stool specimens collected from patients with cancer admitted to the Oncology Ward of Shahid Baqaei 2 Hospital, Ahvaz, Iran, for six months. A standardized questionnaire was filled out for all cases. Each specimen was also prepared using direct smear, the Lugol iodine staining, and the formalin-ether condensation method. Results: Blastocystis spp. was detected in 21.1% of the cases among them, 11.5% demonstrated gastrointestinal symptoms; therefore, a significant relationship was observed between Blastocystis infection and gastrointestinal symptoms. Conclusion: Patients undergoing chemotherapy should be screened for opportunistic parasitic infections such as Blastocystis to avoid potentially life-threatening outcomes. Besides, further studies are required to identify the subtypes of Blastocystis.
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Khorshidvand Z, Khazaei S, Amiri M, Taherkhani H, Mirzaei A. Worldwide prevalence of emerging parasite Blastocystis in immunocompromised patients: A systematic review and meta-analysis. Microb Pathog 2020; 152:104615. [PMID: 33246090 DOI: 10.1016/j.micpath.2020.104615] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/15/2020] [Accepted: 11/09/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Blastocystis is one of the most common pathogens of the human intestine, caused by an emerging parasite, which can lead to severe symptoms and even death in immunocompromised patients. We aimed to determine the global prevalence of Blastocystosis infection in people with immunodeficiency. A systematic literature search was conducted on Web of Science, Scopus, Google scholar, Science Direct and MEDLINE databases to select all observational studies reporting the prevalence of Blastocystosis infection in Worldwide, based on different diagnostic methods in immunocompromised patients of any age and published from inception to February 2019. Pooled estimates and 95% confidence intervals (95% CIs) were calculated using random effects models and in addition, the I2 statistic was calculated. The geographic distribution of studies was evaluated and the diagnosis of Blastocystis was compared by various techniques. Electronic databases were reviewed for Blastocystosis infection in HIV/AIDS, cancer and other immunocompromised patients, and meta-analyses were conducted to calculate the overall estimated prevalence. Total68 eligible studies were included. The estimated pooled prevalence rate of Blastocystosis infection in immunocompromised patients was overall 10% (95% CI, 7-13%; I2 96.04%) (P < 0.001), of whom 21% [18-25] were in Australia, 12% [4-24] in America, 11% [6-17] in Europe and 10% [5-15], 7% [3-13] in Asia and Africa, respectively. It was calculated that the estimated pooled prevalence rate of Blastocystosis infection in immunocompromised patients was overall 10% and the prevalence estimates ranged from 0.44 to 72.39. Also, overall the prevalence of parasites co-infection in immunocompromised patients was detected as 0.024%. Our finding showed that immunocompromised people show a high prevalence of Blastocystosis infection compared to the control population. Adequate information on the prevalence rate is still missing from many countries. However, current information underscore that Blastocystis should not be neglected.
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Affiliation(s)
- Zohreh Khorshidvand
- Department of Parasitology and Mycology, School of Medicine Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - MohamadReza Amiri
- Department of medical Library and Information Science, Faculty of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Heshmatollah Taherkhani
- Department of Parasitology and Mycology, School of Medicine Hamadan University of Medical Sciences, Hamadan, Iran
| | - Asad Mirzaei
- Department of Parasitology, School of Allied Medical Science, Ilam University of Medical Sciences, Ilam, Iran; Zoonotic Diseases ResearchCenter, Ilam University of Medical sciences, Ilam, Iran.
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Asghari A, Zare M, Hatam G, Shahabi S, Gholizadeh F, Motazedian M. Molecular identification and subtypes distribution of Blastocystis sp. isolated from children and adolescent with cancer in Iran: evaluation of possible risk factors and clinical features. Acta Parasitol 2020; 65:462-73. [PMID: 32124201 DOI: 10.2478/s11686-020-00186-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/17/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE This study aimed to determine the molecular characterization and subtype distribution of Blastocystis sp. isolated from cancer children and adolescents in Shiraz, Fars province, southwestern Iran. METHODS Overall, 200 fecal samples obtained from cancer children and adolescents under 18 years old (107 males and 93 females) and checked by microscopy, culture, and molecular methods (PCR). Possible etiological factors and clinical characteristics of Blastocystis infection were also evaluated and compared between Blastocystis infected and non-infected patients. RESULTS Thirteen of 200 (6.5%) stool samples were positive for Blastocystis by microscopy. While 21 of 200 (10.5%) were positive by culture, and 24 of 200 (12%) were positive by PCR. Out of 24 positive samples tested by PCR and sequencing, ST3 was reported as the most common subtype (nine samples, 37.5%), followed by ST2 (eight samples, 33.3%), ST1 (five samples, 20.9%), and ST7 (two samples, 8.3%). The prevalence of Blastocystis infection in males was significantly higher than females (p = 0.024). Also, Blastocystis was more prevalent in patients who had received at least eight chemotherapy cycles than fewer (p = 0.002). However, no associations were found between Blastocystis-positive rate and age, residence, type of cancers, or contact with animals. Also, there was no significant difference between frequency of Blastocystis subtypes in symptomatic and asymptomatic cancer patients. CONCLUSIONS Various controlled epidemiologic and topographic studies need to confirm or reject these possible associations with Blastocystis infection. The data from this study are an invaluable addition to the growing body of research studies on Blastocystis infection in cancer patients.
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Cervone M, Gavazza A, Zbriger A, Mancianti F, Perrucci S. Intestinal parasite infections in dogs affected by multicentric lymphoma and undergoing chemotherapy. Comp Immunol Microbiol Infect Dis 2019; 63:81-86. [PMID: 30961822 DOI: 10.1016/j.cimid.2019.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/12/2019] [Accepted: 01/14/2019] [Indexed: 01/13/2023]
Abstract
Prevalence and species composition of intestinal parasites were evaluated in dogs affected by high-grade multicentric lymphoma and undergoing chemotherapy and in control healthy dogs. Obtained data were statistically analyzed. The overall prevalence of intestinal parasite infections was 33.3%. In lymphoma dogs, the prevalence of protozoa infections (46.7%) was significantly higher (p < 0.05) than that of helminth infections (6.7%) and Giardia duodenalis, Cryptosporidium spp., Neospora caninum, Cystoisospora ohioensis-complex, Entamoeba sp. and Spirocerca lupi were identified. In the control group, only 3/15 dogs (20%) were found positive and no statistically significant differences emerged regarding helminth (hookworms and Toxocara canis) and protozoa (G. duodenalis) infections. Results from this study may suggest a potential higher prevalence of opportunistic intestinal protozoa, including some potentially zoonotic species, in dogs affected by high-grade multicentric lymphoma, emphasizing the need to monitor lymphoma-affected dogs for these protozoa, especially those undergoing chemotherapy.
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Affiliation(s)
- Mario Cervone
- Université de Lyon, VetAgro Sup, Campus vétérinaire de Lyon, Département des animaux de compagnie de loisir et de sport, 69280, Marcy L'Etoile, France
| | - Alessandra Gavazza
- Scuola di Bioscienze e Medicina Veterinaria, Università di Camerino, Via Circonvallazione 93/95, 62024 Matelica (MC), Italy
| | - Alina Zbriger
- Dipartimento di Scienze Veterinarie, Università di Pisa, Viale delle Piagge 2, 56124, Pisa, Italy
| | - Francesca Mancianti
- Dipartimento di Scienze Veterinarie, Università di Pisa, Viale delle Piagge 2, 56124, Pisa, Italy
| | - Stefania Perrucci
- Dipartimento di Scienze Veterinarie, Università di Pisa, Viale delle Piagge 2, 56124, Pisa, Italy.
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Toychiev A, Abdujapparov S, Imamov A, Navruzov B, Davis N, Badalova N, Osipova S. Intestinal helminths and protozoan infections in patients with colorectal cancer: prevalence and possible association with cancer pathogenesis. Parasitol Res 2018; 117:3715-3723. [PMID: 30220046 DOI: 10.1007/s00436-018-6070-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 08/28/2018] [Indexed: 12/11/2022]
Abstract
The purpose of the present study was to determine the prevalence of intestinal helminths and protozoa in colorectal cancer (CRC) patients and to evaluate the possible association between the prevalence and CRC pathogenesis. A total of 200 CRC patients and 200 residents of Tashkent, who had no complaints related to the gastrointestinal tract, were examined by triple coproscopy using a concentration method and estimations of protozoan infection intensity. Of the CRC patients tested, 144 were classified as T1-4N0M0 (without metastases) and 56 were classified as T1-4N1-2M0-1 (with metastases). Parasitological examination was performed during CRC diagnosis before and after surgery and chemotherapy. A significantly higher prevalence of Blastocystis sp., Chilomastix mesnili, Jodamoeba butschlii, and Endolimax nana was found in CRC patients than in the control population (p < 0.0001), amounting to 80, 20, 22.5, and 11.5%, respectively. The high prevalence of Blastocystis sp., as well as the patterns of infection intensity, was stable at all stages of examination. The ratio of the number of CRC patients with and without Blastocystis sp. in the T1-4N0M0 and T1-4N1-2M0-1 groups amounted to 3.3 and 7.0, respectively. The ratios for C. mesnili, E. coli, J. butschlii, and E. nana in both groups were 0.2 and 0.2, 0.07 and 0.07, 0.3 and 0.16, and 0.18 and 0.01, respectively. The prevalence of helminths and Giardia lamblia in CRC patients and the control population was not significantly different. Taken together, these data indicate a possible role for Blastocystis sp. in CRC pathogenesis. Diagnosis, treatment, and further observation of patients with Blastocystis sp. are necessary at all stages of CRC, including during diagnosis and before and after surgery and chemotherapy.
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Affiliation(s)
- Abdurakhim Toychiev
- Department of Immunology of Parasitic Diseases, The Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan
| | - Sulayman Abdujapparov
- Department of Immunology of Parasitic Diseases, The Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan.,Department of Coloproctology, The Research Center of Oncology, Tashkent, Uzbekistan
| | - Alim Imamov
- Department of Chemotherapy, The Research Center of Oncology, Tashkent, Uzbekistan
| | - Behzod Navruzov
- Department of Immunology of Parasitic Diseases, The Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan.,Department of Surgery, Tashkent Medical Academy, Tashkent, Uzbekistan
| | - Nikolay Davis
- Department of Immunology of Parasitic Diseases, The Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan
| | - Najiya Badalova
- Department of Immunology of Parasitic Diseases, The Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan
| | - Svetlana Osipova
- Department of Immunology of Parasitic Diseases, The Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan.
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22
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Zhang W, Ren G, Zhao W, Yang Z, Shen Y, Sun Y, Liu A, Cao J. Genotyping of Enterocytozoon bieneusi and Subtyping of Blastocystis in Cancer Patients: Relationship to Diarrhea and Assessment of Zoonotic Transmission. Front Microbiol 2017; 8:1835. [PMID: 28983297 PMCID: PMC5613175 DOI: 10.3389/fmicb.2017.01835] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 09/07/2017] [Indexed: 12/12/2022] Open
Abstract
Enterocytozoon bieneusi (E. bieneusi) and Blastocystis are common pathogens responsible for diarrhea in humans, especially in immunocompromised individuals. The number of cancer patients has been increasing and diarrhea is a common clinical symptom in the treatment of cancers. To understand the prevalences and genotypes/subtypes of E. bieneusi and Blastocystis in cancer patients in China, to track the infection sources, and to explore the relationships between E. bieneusi and Blastocystis infections and diarrhea, 381 fecal specimens were collected from cancer patients. Each of them was analyzed for the presence of E. bieneusi and Blastocystis by PCR amplifying and sequencing the ITS region of the rRNA gene and the barcode region of the SSU rRNA gene, respectively. 1.3 and 7.1% of cancer patients were positive for E. bieneusi and Blastocystis, respectively. No statistical differences were observed in the infection rates between the groups by age, gender, and residence. E. bieneusi and Blastocystis were both significantly more common in cancer patients with diarrhea, and significant relationship of Blastocystis to diarrhea was found in chemotherapy group. Two E. bieneusi genotypes (D and a novel one named as HLJ-CP1) and two Blastocystis subtypes (ST1 and ST3) were identified with three novel ST1 sequences. This is the first report of occurrence and molecular characterizations of E. bieneusi and Blastocystis in cancer patients in China. E. bieneusi genotype D and Blastocystis ST1 and ST3 have been identified in humans and animals while one novel E. bieneusi genotype falling into zoonotic group 1, implying a potential of zoonotic transmission.
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Affiliation(s)
- Weizhe Zhang
- Department of Parasitology, Harbin Medical UniversityHarbin, China
| | - Guangxu Ren
- Department of Parasitology, Harbin Medical UniversityHarbin, China
| | - Wei Zhao
- Department of Parasitology, Harbin Medical UniversityHarbin, China
| | - Ziyin Yang
- Department of Parasitology, Harbin Medical UniversityHarbin, China
| | - Yujuan Shen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Centre for Malaria, Schistosomiasis and FilariasisShanghai, China
| | - Yihua Sun
- Department of Clinical Laboratory, Third Affiliated Hospital of Harbin Medical UniversityHarbin, China
| | - Aiqin Liu
- Department of Parasitology, Harbin Medical UniversityHarbin, China
| | - Jianping Cao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Centre for Malaria, Schistosomiasis and FilariasisShanghai, China
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