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Abushattal MAK, Sale S, Subramaniam S, Mohamad Taib MNA, Rajamanikam A, Termizi FHM, Hassan NH, Mad' Atari MF. The effects of LED Spectra on synthesis of antiparasitic bioactive compound in Eurycoma longifolia hairy root culture against Blastocystis Sp. Sci Rep 2025; 15:14662. [PMID: 40287563 PMCID: PMC12033243 DOI: 10.1038/s41598-025-99906-9] [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: 08/22/2024] [Accepted: 04/23/2025] [Indexed: 04/29/2025] Open
Abstract
Eurycoma longifolia (also known as Tongkat Ali) is one of the valuable medicinal plants frequently used as traditional medicine in Malaysia. Its alkaloids and quassinoids reportedly confers antiparasitic activities. The effect of different Light Emitting Diode (LED) spectra treatments on E. longifolia hairy root cultures (ELHRCs) on alkaloid synthesis remains unexplored and its consequent antiparasitic effect on Blastocystis sp., a common intestinal protozoan parasite, is still unknown. In this study, the ELHRCs were irradiated to white, blue, red, blue plus red (1:1) and mint green LED illumination in vitro. The variation of alkaloids was assessed by using High-Performance Liquid Chromatography (HPLC) and employed to quantify 9-hydroxycanthin-6-one and 9-methoxycanthin-6-one. Subsequently, antiparasitic effect on Blastocystis sp. was assessed in in vitro parasite culture and the minimum inhibitory concentration (MIC90) was measured. Results showed the yields of high-value 9-hydroxycanthin-6-one in hairy roots increased by 1.17-fold, 2.74-fold, and 1.91-fold after 8, 10, and 12 weeks of culture under white, mint green, and blue lights relative to dark (control), respectively. In addition, 9-methoxycanthin-6-one yield in hairy roots increase by 1.07-fold and 1.34-fold after 8 and 12 weeks of culture under white light than in dark. Moreover, the ELHRCs crude extraction exhibited the highest anti-protozoal activity at 0.1 mg/ml against Blastocystis sp, ST3 compared to Metronidazole (MTZ). These results indicate that LED treatments alters alkaloid composition and are promising for obtaining higher yields of antiparasitic agents from the ELHRCs and thus can be considered a potential complementary and alternative antimicrobial agent.
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Affiliation(s)
| | - Sani Sale
- School of Biological Sciences, Universiti Sains Malaysia (USM), Georgetown, 11800, Penang, Malaysia
- Department of Botany, Gombe State University, Gombe P.M.B 127, Gombe, Nigeria
| | - Sreeramanan Subramaniam
- School of Biological Sciences, Universiti Sains Malaysia (USM), Georgetown, 11800, Penang, Malaysia
- Centre for Chemical Biology (CCB), Universiti Sains Malaysia (USM), Bayan Lepas, 11900, Penang, Malaysia
- Department of Biology, Faculty of Science and Technology Universitas Airlangga, Surabaya, 60115, Indonesia
| | | | - Arutchelvan Rajamanikam
- Department of Parasitology, Faculty of Medicine, Universiti of Malaya, Kuala Lumpur, 50603, Malaysia.
| | | | - Nor Hasnida Hassan
- Forest Biotechnology Division, Forest Research Institute Malaysia (FRIM), Kepong, 52109, Selangor, Malaysia
| | - Mohamad Fadhli Mad' Atari
- School of Biological Sciences, Universiti Sains Malaysia (USM), Georgetown, 11800, Penang, Malaysia.
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Pawelec-Pęciak O, Łanocha-Arendarczyk N, Grzeszczak K, Kosik-Bogacka D. The Role of Blastocystis spp. in the Etiology of Gastrointestinal and Autoimmune Diseases. Pathogens 2025; 14:313. [PMID: 40333047 PMCID: PMC12030515 DOI: 10.3390/pathogens14040313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2025] [Revised: 03/20/2025] [Accepted: 03/23/2025] [Indexed: 05/09/2025] Open
Abstract
Blastocystis spp. has been linked to gastrointestinal symptoms, yet its pathogenicity remains uncertain. In addition, the roles of virulence factors, pathogenic potential, and host-specific traits associated with symptomatic infections are still not well understood. The growing number of immunocompromised patients has contributed to an increasing prevalence of Blastocystis spp. infections, which may be implicated in the development of various inflammatory diseases, including irritable bowel syndrome (IBS), colorectal cancer, and autoimmune disorders such as Hashimoto's disease and ulcerative colitis. However, the presence of nonspecific symptoms often complicates diagnosis. This study aimed to present current data on the impact of Blastocystis spp. on the development and progression of gastrointestinal and autoimmune diseases, as well as to explore potential treatment options for Blastocystis spp. infections. A literature review was conducted to analyze the role of Blastocystis spp. in the pathogenesis of specific diseases and to investigate potential mechanisms of its interaction with the host organism. Advances in diagnostic techniques, particularly PCR, allow not only for the detection of Blastocystis spp. but also for the identification of specific subtypes, improving treatment precision. Beyond conventional therapies like metronidazole, there is a growing emphasis on alternative treatments, including the use of medicinal plants and probiotics.
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Affiliation(s)
- Oliwia Pawelec-Pęciak
- Department of Biology, Parasitology and Pharmaceutical Botany, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111 Szczecin, Poland; (O.P.-P.); (D.K.-B.)
| | - Natalia Łanocha-Arendarczyk
- Department of Biology, Parasitology and Pharmaceutical Botany, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111 Szczecin, Poland; (O.P.-P.); (D.K.-B.)
| | - Konrad Grzeszczak
- Department of Medical Analytics, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Danuta Kosik-Bogacka
- Department of Biology, Parasitology and Pharmaceutical Botany, Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72, 70-111 Szczecin, Poland; (O.P.-P.); (D.K.-B.)
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Tocci S, Das S, Sayed IM. An Update on Blastocystis: Possible Mechanisms of Blastocystis-Mediated Colorectal Cancer. Microorganisms 2024; 12:1924. [PMID: 39338600 PMCID: PMC11433781 DOI: 10.3390/microorganisms12091924] [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: 08/28/2024] [Revised: 09/15/2024] [Accepted: 09/18/2024] [Indexed: 09/30/2024] Open
Abstract
Blastocystis is an anaerobic parasite that colonizes the intestinal tract of humans and animals. When it was first discovered, Blastocystis was considered to be a normal flora with beneficial effects on human health, such as maintaining gut hemostasis and improving intestinal barrier integrity. Later, with increasing research on Blastocystis, reports showed that Blastocystis sp. is associated with gastrointestinal disorders, colorectal cancer (CRC), and neurological disorders. The association between Blastocystis sp. and CRC has been confirmed in several countries. Blastocystis sp. can mediate CRC via similar mechanisms to CRC-associated bacteria, including infection-mediated inflammation, increased oxidative stress, induced gut dysbiosis, and damage to intestinal integrity, leading to a leaky gut. IL-8 is the main inflammatory cytokine released from epithelial cells and can promote CRC development. The causal association of Blastocystis sp. with other diseases needs further investigation. In this review, we have provided an update on Blastocystis sp. and summarized the debate about the beneficial and harmful effects of this parasite. We have also highlighted the possible mechanisms of Blastocystis-mediated CRC.
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Affiliation(s)
- Stefania Tocci
- Department of Biomedical & Nutritional Sciences, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Soumita Das
- Department of Biomedical & Nutritional Sciences, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Ibrahim M Sayed
- Department of Biomedical & Nutritional Sciences, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
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Amoak S, Soldera J. Blastocystis hominis as a cause of chronic diarrhea in low-resource settings: A systematic review. World J Meta-Anal 2024; 12:95631. [DOI: 10.13105/wjma.v12.i3.95631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 08/24/2024] [Accepted: 09/04/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Blastocystis hominis (B. hominis), an anaerobic unicellular protist parasite, is known for its diverse clinical manifestations upon infecting the human gastrointestinal tract. Although globally distributed, it is particularly prevalent in developing nations. Examining the symptoms and treatment outcomes of B. hominis infection in low-resource settings holds immense significance, providing healthcare practitioners with valuable insights to enhance patient care.
AIM To synthesize existing evidence on the symptomatology and treatment outcomes of B. hominis infection in low-resource settings.
METHODS Following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, a systematic review was conducted. The search spanned electronic databases including PubMed, Scopus, and Google Scholar. After a comprehensive screening process, a thorough examination of the papers, adhering to inclusion and exclusion criteria, and data extraction from eligible studies was conducted. The findings underwent summarization through simple descriptive analysis.
RESULTS The search yielded 1200 papers, with 17 meeting inclusion criteria. Chronic diarrhea due to B. hominis infection was reported in only two studies, while abdominal pain, diarrhea, flatulence, constipation, and nausea/vomiting emerged as the most commonly documented symptoms. Recovery rates after one week of treatment ranged from 71.8% to 100%, and after two weeks, from 60% to 100%.
CONCLUSION In low-resource settings, chronic diarrhea resulting from B. hominis infection is infrequent. Common symptoms include abdominal pain, diarrhea, flatulence, constipation, and nausea/vomiting. Post-treatment, clinical outcomes are notably favorable, supporting the recommendation for treatment. Metronidazole is advocated as the first-line agent, with consideration for switching to a second-line option in cases of treatment failure or poor response.
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Affiliation(s)
| | - Jonathan Soldera
- Acute Medicine and Gastroenterology, University of South Wales, Cardiff CF37 1DL, United Kingdom
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Liao CC, Chen CH, Shin JW, Lin WC, Chen CC, Chu CT. Lipid Accumulation in Blastocystis Increases Cell Damage in Co-Cultured Cells. Microorganisms 2023; 11:1582. [PMID: 37375084 DOI: 10.3390/microorganisms11061582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/14/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
Blastocystis hominis is an intestinal protozoan that is often neglected, despite causing abdominal pain and diarrhea. Previous research has demonstrated that lipids can be synthesized by B. hominis or can accumulate in growth medium, but their function and mechanisms in the pathogenesis of Blastocystis remain unclear. Our study found that lipid-rich Blastocystis ST7-B can increase inflammation and disrupt Caco-2 cells more than the same parasite without the lipovenoes supplement. Additionally, the cysteine protease of Blastocystis, a virulence factor, is upregulated and has higher activity in lipid-rich Blastocystis. In order to better understand the effects of lipids on Blastocystis pathogenesis, we treated lipid-lowering pravastatin during Blastocystis ST7-B culturing with a lipovenoes supplement, which decreased the lipid levels of the Blastocystis and reduced the Blastocystis-induced inflammation and cell disruption of Caco-2 cells. We also analyzed the fatty acid composition and possible synthesis pathway in Blastocystis ST7-B, finding significantly higher ratios of arachidonic acid, oleic acid, and palmitic acid than in the other lipid components in lipid-rich Blastocystis ST7-B. These results suggest that lipids play a significant role in the pathogenesis of Blastocystis and provide important information on the molecular mechanisms of and potential treatments for Blastocystis infection.
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Affiliation(s)
- Chen-Chieh Liao
- Department of Parasitology, Institute of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Chun-Hsien Chen
- Department of Parasitology, Institute of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Physiology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Jyh-Wei Shin
- Department of Parasitology, Institute of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Wei-Chen Lin
- Department of Parasitology, Institute of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Chien-Chin Chen
- Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600, Taiwan
- Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan 717, Taiwan
- Department of Biotechnology and Bioindustry Sciences, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan 701, Taiwan
- Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan
| | - Chun-Ting Chu
- Division of ColoRectal Surgery, Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600, Taiwan
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Unalan-Altintop T, Vahabov C, Ergunay K, Kurt O, Kav T, Akyon Y, Erguven S. Investigation of Dientamoeba fragilis and Blastocystis in patients from Turkey with ulcerative colitis and irritable bowel syndrome: Any relation with genotypes? Acta Trop 2022; 231:106451. [PMID: 35390312 DOI: 10.1016/j.actatropica.2022.106451] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/12/2022] [Accepted: 04/03/2022] [Indexed: 12/17/2022]
Abstract
Blastocystis sp. and Dientamoeba fragilis are two most common protists worldwide, whose pathogenic potentials are a matter of debate since their discovery. This study aims to investigate the relationship between the activation of ulcerative colitis (UC) and irritable bowel syndrome (IBS) with these protists. A total of 100 patients (35 IBS, 35 active UC, and 30 remittent UC), diagnosed at Hacettepe University Adult Hospital (Ankara, Turkey), were screened for D. fragilis and Blastocystis sp. with microscopic examination using the methods of wet mount, trichrome staining, conventional PCR, nested PCR, real-time PCR and genotyping. Eight patients (4 IBS, 2 active, and 2 remittent UC patients) were found to be D. fragilis positive. 18S rRNA region of the parasite was amplified in four of the patients, whereas cathepsin L-like cysteine peptidase; clan Sc, family S9, serine peptidase; and clan MH, family M20 metallopeptidase in six different patients. All isolates were Genotype 1. Sequence results showed very limited diversity. A total of nine patients (3 IBS, 5 active UC, 1 remittent UC) were found to be positive for Blastocystis sp., all of which were Subtype 3. One active UC and one IBS patient were found to be positive for both parasites. No statistically significant difference was detected between the patient groups in means of parasite detection. D. fragilis was found to be related to older age (p=0,045). In our study, no significant correlation was identified between D. fragilis and Blastocystis sp., and the activation of UC and IBS. More studies are needed on the host-parasite relationship, including the role of gut microbiota, together with transcriptomic and metabolomic assessments to unveil the pathogenicity of both protists.
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Nemati S, Zali MR, Johnson P, Mirjalali H, Karanis P. Molecular prevalence and subtype distribution of Blastocystis sp. in Asia and in Australia. JOURNAL OF WATER AND HEALTH 2021; 19:687-704. [PMID: 34665764 DOI: 10.2166/wh.2021.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Blastocystis is a prevalent protozoan parasite reported in humans, animals, and environmental samples. Over the past decade, numerous studies have investigated the prevalence and subtype distribution of Blastocystis sp. alongside with its genetic and biochemical features. However, studies on subtype distribution of this protozoan in humans, animals, and environmental samples represent the potential transmission routes. In this review, we evaluated studies performed in Asian countries and in Australia to provide an overview of environmental factors on the prevalence and subtype distribution of Blastocystis sp. among humans, animals, and the environment.
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Affiliation(s)
- Sara Nemati
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail:
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Paul Johnson
- Department of Basic and Clinical Sciences, Nicosia University Medical School, Nicosia 2408, Cyprus
| | - Hamed Mirjalali
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail:
| | - Panagiotis Karanis
- Department of Basic and Clinical Sciences, Nicosia University Medical School, Nicosia 2408, Cyprus; Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Abedi SH, Fazlzadeh A, Mollalo A, Sartip B, Mahjour S, Bahadory S, Taghipour A, Rostami A. The neglected role of Blastocystis sp. and Giardia lamblia in development of irritable bowel syndrome: A systematic review and meta-analysis. Microb Pathog 2021; 162:105215. [PMID: 34592369 DOI: 10.1016/j.micpath.2021.105215] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/22/2021] [Accepted: 09/25/2021] [Indexed: 02/08/2023]
Abstract
The possible role of Blastocystis sp. and Giardia lamblia infections in the development of irritable bowel syndrome (IBS) has long been controversial. In this study, we conducted a systematic review and meta-analysis to investigate whether these protozoan infections are associated with IBS development. We systematically searched international databases for all studies that reported these protozoa in IBS patients published by May 10, 2021. Studies were included in the review if they were observational studies with confirmed patients with IBS (in case-control and cross-sectional studies) or parasitic infections (cohort studies) with an appropriate control group. Pooled odds ratios (ORs) and 95% confidence intervals were estimated using a random-effects meta-analysis model for included studies. A total of 32 papers (42 datasets), including 29 papers (31 datasets) for Blastocystis sp./IBS and 11 papers (11 datasets) for G. lamblia/IBS met the eligibility criteria. Our results indicated that the individuals with Blastocystis sp. infection were significantly at a higher risk of IBS development (OR, 1.78; 95%CI, 1.29-2.44). Moreover, cohort studies indicated a significant positive association between G. lamblia infection and IBS risk (OR, 5.47; 95%CI, 4.23-7.08); while an increasing but no statistically significant risk was observed in case-control studies (OR, 1.19; 95%CI, 0.75-1.87). Our findings suggested that Blastocystis sp. and G. lamblia infections are associated with the increased risk of developing IBS. Despite these results, further studies are needed to determine the effect of these protozoa on IBS development.
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Affiliation(s)
- Seyed Hasan Abedi
- Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Aylar Fazlzadeh
- Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abolfazl Mollalo
- Department of Public Health and Prevention Science, School of Health Sciences, Baldwin Wallace University, Berea, OH, USA
| | - Behnam Sartip
- Department of Internal Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Sanaz Mahjour
- Department of Psychiatry and Behavioral Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Saeed Bahadory
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Taghipour
- Zoonoses Research Center, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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Pérez MR, Yáñez CM, Hernández AM, Sustaita JJD, Jiménez EG, Andrade MR, Vargas GGG, Gómez JOG. Blastocystis infection frequency and subtype distribution in university students. Heliyon 2020; 6:e05729. [PMID: 33385079 PMCID: PMC7770537 DOI: 10.1016/j.heliyon.2020.e05729] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/26/2020] [Accepted: 12/11/2020] [Indexed: 12/21/2022] Open
Abstract
Blastocystis is a parasite commonly found in the gut of humans and animals; there are 22 known subtypes (STs). STs 1-9 and 12 have been found in humans. This parasite has a faecal-oral route of transmission; its high infection prevalence in developing countries is due to poor hygiene practices, exposure to infected animals, and intake of contaminated water or food. Its pathogenicity has not been established, because it has been found in symptomatic and asymptomatic patients. The goal of this study was to analyze the frequency of Blastocystis and its subtypes (1, 2, 3, 4, 5, and 7), and assess the relationship between these subtypes and abdominal pain and distension. 202 university students participated in this study. A questionnaire was applied to assess the gastrointestinal symptoms, and subsequently the students were asked to provide faecal samples. The presence of parasites was determined by optical microscopy. Blastocystis-positive samples had their DNA extracted and end-point PCR was performed to corroborate the presence of Blastocystis and determine its subtypes. Among the samples, 47.03% were positive according to PCR analysis. The most prevalent subtypes were ST3 (29.79%), ST4 (16.84%), and ST1 (14.89%). We found a relationship between ST1 and abdominal pain (OR = 0.196; CI = 0.0533-0.7318; p = 0.015), and between ST4 and abdominal distension (OR = 0.2928; CI = 0.1017-0.8429; p = 0.023). However, the presence of this parasite and the probable relationship with gastrointestinal symptoms suggest the need to determine its role within intestinal microbiota in order to confirm whether its eradication is really necessary or not.
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Affiliation(s)
- Marcela Ramírez Pérez
- Facultad de Ciencias de la Salud, UJED, Calz. Palmas 1, Revolución, 35050 Gómez Palacio, Durango, Mexico
| | - Claudia Muñoz Yáñez
- Facultad de Ciencias de la Salud, UJED, Calz. Palmas 1, Revolución, 35050 Gómez Palacio, Durango, Mexico
| | - Alejandra Méndez Hernández
- Facultad de Ciencias de la Salud, UJED, Calz. Palmas 1, Revolución, 35050 Gómez Palacio, Durango, Mexico
| | | | - Efraín Gaytan Jiménez
- Facultad de Ciencias de la Salud, UJED, Calz. Palmas 1, Revolución, 35050 Gómez Palacio, Durango, Mexico
| | - Marisela Rubio Andrade
- Facultad de Ciencias de la Salud, UJED, Calz. Palmas 1, Revolución, 35050 Gómez Palacio, Durango, Mexico
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10
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Defaye M, Nourrisson C, Baudu E, Lashermes A, Meynier M, Meleine M, Wawrzyniak I, Bonnin V, Barbier J, Chassaing B, Godfraind C, Gelot A, Barnich N, Ardid D, Bonnet M, Delbac F, Carvalho FA, Poirier P. Fecal dysbiosis associated with colonic hypersensitivity and behavioral alterations in chronically Blastocystis-infected rats. Sci Rep 2020; 10:9146. [PMID: 32499543 PMCID: PMC7272397 DOI: 10.1038/s41598-020-66156-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 04/11/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Infectious gastroenteritis is a risk factor for the development of post-infectious Irritable Bowel Syndrome (PI-IBS). Recent clinical studies reported a higher prevalence of the intestinal parasite Blastocystis in IBS patients. Using a rat model, we investigated the possible association between Blastocystis infection, colonic hypersensitivity (CHS), behavioral disturbances and gut microbiota changes. METHODS Rats were orally infected with Blastocystis subtype 4 (ST4) cysts, isolated from human stool samples. Colonic sensitivity was assessed by colorectal distension and animal behavior with an automatic behavior recognition system (PhenoTyper), the Elevated Plus Maze test and the Forced Swimming tests. Feces were collected at different time points after infection to study microbiota composition by 16 S rRNA amplicon sequencing and for short-chain fatty acid (SFCA) analysis. RESULTS Blastocystis-infected animals had non-inflammatory CHS with increased serine protease activity. Infection was also associated with anxiety- and depressive-like behaviors. Analysis of fecal microbiota composition showed an increase in bacterial richness associated with altered microbiota composition. These changes included an increase in the relative abundance of Oscillospira and a decrease in Clostridium, which seem to be associated with lower levels of SCFAs in the feces from infected rats. CONCLUSIONS Our findings suggest that experimental infection of rats with Blastocystis mimics IBS symptoms with the establishment of CHS related to microbiota and metabolic shifts.
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Affiliation(s)
- Manon Defaye
- Université Clermont Auvergne, 3iHP, CNRS, Laboratoire Microorganismes: Génome et Environnement, F-63000, Clermont-Ferrand, France
- Université Clermont Auvergne, 3iHP, Inserm U1107, NeuroDol, Clermont-Ferrand, France
| | - Céline Nourrisson
- Université Clermont Auvergne, 3iHP, CNRS, Laboratoire Microorganismes: Génome et Environnement, F-63000, Clermont-Ferrand, France
- Université Clermont Auvergne, CHU, 3iHP, CNRS, Laboratoire Microorganismes: Génome et Environnement, F-63000, Clermont-Ferrand, France
| | - Elodie Baudu
- Université Clermont Auvergne, 3iHP, Inserm U1107, NeuroDol, Clermont-Ferrand, France
- Université Clermont Auvergne, 3iHP, Inserm U1071, USC INRA 2018, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte, Clermont-Ferrand, France
| | - Amandine Lashermes
- Université Clermont Auvergne, 3iHP, Inserm U1107, NeuroDol, Clermont-Ferrand, France
| | - Maëva Meynier
- Université Clermont Auvergne, 3iHP, Inserm U1107, NeuroDol, Clermont-Ferrand, France
| | - Mathieu Meleine
- Université Clermont Auvergne, 3iHP, Inserm U1107, NeuroDol, Clermont-Ferrand, France
| | - Ivan Wawrzyniak
- Université Clermont Auvergne, 3iHP, CNRS, Laboratoire Microorganismes: Génome et Environnement, F-63000, Clermont-Ferrand, France
| | - Virginie Bonnin
- Université Clermont Auvergne, 3iHP, Inserm U1071, USC INRA 2018, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte, Clermont-Ferrand, France
| | - Julie Barbier
- Université Clermont Auvergne, 3iHP, Inserm U1107, NeuroDol, Clermont-Ferrand, France
| | - Benoit Chassaing
- Center for Inflammation, Immunity and Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA, USA
- Neuroscience Institute, Georgia State University, Atlanta, GA, USA
- INSERM, U1016, team "Mucosal microbiota in chronic inflammatory diseases", Paris, France
- Université de Paris, Paris, France
| | - Catherine Godfraind
- CHU Clermont-Ferrand, Service d'Anatomopathologie, 63003, Clermont-Ferrand, France
| | - Agathe Gelot
- Université Clermont Auvergne, 3iHP, Inserm U1107, NeuroDol, Clermont-Ferrand, France
| | - Nicolas Barnich
- Université Clermont Auvergne, 3iHP, Inserm U1071, USC INRA 2018, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte, Clermont-Ferrand, France
| | - Denis Ardid
- Université Clermont Auvergne, 3iHP, Inserm U1107, NeuroDol, Clermont-Ferrand, France
| | - Mathilde Bonnet
- Université Clermont Auvergne, 3iHP, Inserm U1071, USC INRA 2018, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte, Clermont-Ferrand, France
| | - Frédéric Delbac
- Université Clermont Auvergne, 3iHP, CNRS, Laboratoire Microorganismes: Génome et Environnement, F-63000, Clermont-Ferrand, France
| | | | - Philippe Poirier
- Université Clermont Auvergne, 3iHP, CNRS, Laboratoire Microorganismes: Génome et Environnement, F-63000, Clermont-Ferrand, France.
- Université Clermont Auvergne, CHU, 3iHP, CNRS, Laboratoire Microorganismes: Génome et Environnement, F-63000, Clermont-Ferrand, France.
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11
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Saccharomyces boulardii inhibits the expression of pro-inflammatory cytokines and inducible nitric oxide synthase genes in the colonic mucosa of rats experimentally-infected with Blastocystis subtype-3 cysts. Parasitology 2019; 146:1532-1540. [PMID: 31109390 DOI: 10.1017/s0031182019000696] [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] [Indexed: 11/05/2022]
Abstract
Blastocystis spp. is the most frequent infectious unicellular, luminal parasite in all species of animals and humans. It has been linked to diarrhoea and irritable bowel syndrome. Saccharomyces boulardii (Sb) is a widely used probiotic that previously showed efficacy against several intestinal pathogens. The aim of this study was to investigate the therapeutic role of Sb on Blastocystis spp. Methods: Five groups of Blastocystis subtype-3 infected rats were treated with either live Sb alone, metronidazole (MTZ) alone, Sb extract, both Sb and MTZ, or placebo-treated besides the noninfected control group. Assessment of treatment effectiveness was done by study of parasitological cure rate, histopathological effect and analysis of the colonic mucosal level of mRNAs expressions for the proinflammatory cytokines interleukin-6 (IL-6), IL-8, tumour necrosis factor alpha (TNF-α) and Inducible nitric oxide synthase (iNOS) by real-time reverse transcription-polymerase chain reaction (real-time RT-PCR). Results showed that live Sb significantly improved the histological characteristics and decreased the cytokines and iNOS in the colonic mucosa. Co-administration of live Sb together with MTZ gave a better effect than other treatments and had early efficacy and revealed a 100% reduction of the parasite stages from both the stool and intestinal wash fluid.
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12
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Shariati A, Fallah F, Pormohammad A, Taghipour A, Safari H, Chirani AS, Sabour S, Alizadeh-Sani M, Azimi T. The possible role of bacteria, viruses, and parasites in initiation and exacerbation of irritable bowel syndrome. J Cell Physiol 2018; 234:8550-8569. [PMID: 30480810 DOI: 10.1002/jcp.27828] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/06/2018] [Indexed: 12/11/2022]
Abstract
Irritable bowel syndrome (IBS) is a prolonged and disabling functional gastrointestinal disorder with the incidence rate of 18% in the world. IBS could seriously affect lifetime of patients and cause high economic burden on the community. The pathophysiology of the IBS is hardly understood, whereas several possible mechanisms, such as visceral hypersensitivity, irregular gut motility, abnormal brain-gut relations, and the role of infectious agents, are implicated in initiation and development of this syndrome. Different studies demonstrated an alteration in B-lymphocytes, mast cells (MC), T-lymphocytes, and cytokine concentrations in intestinal mucosa or systemic circulation that are likely to contribute to the formation of the IBS. Therefore, IBS could be developed in those with genetic predisposition. Infections' role in initiation and exacerbation of IBS has been investigated by quite several clinical studies; moreover, the possible role of some pathogens in development and exacerbation of this disease has been described. It appears that the main obligatory pathogens correspond with the IBS disease, Clostridium difficile, Escherichia coli, Mycobacterium avium subspecies paratuberculosis, Campylobacter concisus, Campylobacter jejuni, Chlamydia trachomatis, Helicobacter pylori, Pseudomonas aeruginosa, Salmonella spp, Shigella spp, and viruses, particularly noroviruses. A number of pathogenic parasites (Blastocystis, Dientamoeba fragilis, and Giardia lamblia) may also be involved in the progression and exacerbation of the disease. Based on the current knowledge, the current study concludes that the most common bacterial, viral, and parasitic pathogens may be involved in the development and progression of IBS.
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Affiliation(s)
- Aref Shariati
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fateme Fallah
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Pormohammad
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Taghipour
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Safari
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Salami Chirani
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Sabour
- Department of Microbiology, School of Medicine, Ardebil University of Medical Science, Ardebil, Iran
| | - Mahmood Alizadeh-Sani
- Student Research Committee, Department of Food Sciences and Technology, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Taher Azimi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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13
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Asymptomatic Intestinal Colonization with Protist Blastocystis Is Strongly Associated with Distinct Microbiome Ecological Patterns. mSystems 2018; 3:mSystems00007-18. [PMID: 29963639 PMCID: PMC6020473 DOI: 10.1128/msystems.00007-18] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/02/2018] [Indexed: 12/25/2022] Open
Abstract
Given the results of our study and other reports of the effects of the most common human gut protist on the diversity and composition of the bacterial microbiome, Blastocystis and, possibly, other gut protists should be studied as ecosystem engineers that drive community diversity and composition. Blastocystis is the most prevalent protist of the human intestine, colonizing approximately 20% of the North American population and up to 100% in some nonindustrialized settings. Blastocystis is associated with gastrointestinal and systemic disease but can also be an asymptomatic colonizer in large populations. While recent findings in humans have shown bacterial microbiota changes associated with this protist, it is unknown whether these occur due to the presence of Blastocystis or as a result of inflammation. To explore this, we evaluated the fecal bacterial and eukaryotic microbiota in 156 asymptomatic adult subjects from a rural population in Xoxocotla, Mexico. Colonization with Blastocystis was strongly associated with an increase in bacterial alpha diversity and broad changes in beta diversity and with more discrete changes to the microbial eukaryome. More than 230 operational taxonomic units (OTUs), including those of dominant species Prevotella copri and Ruminococcus bromii, were differentially abundant in Blastocystis-colonized individuals. Large functional changes accompanied these observations, with differential abundances of 202 (out of 266) predicted metabolic pathways (PICRUSt), as well as lower fecal concentrations of acetate, butyrate, and propionate in colonized individuals. Fecal calprotectin was markedly decreased in association with Blastocystis colonization, suggesting that this ecological shift induces subclinical immune consequences to the asymptomatic host. This work is the first to show a direct association between the presence of Blastocystis and shifts in the gut bacterial and eukaryotic microbiome in the absence of gastrointestinal disease or inflammation. These results prompt further investigation of the role Blastocystis and other eukaryotes play within the human microbiome. IMPORTANCE Given the results of our study and other reports of the effects of the most common human gut protist on the diversity and composition of the bacterial microbiome, Blastocystis and, possibly, other gut protists should be studied as ecosystem engineers that drive community diversity and composition.
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14
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IBRAHIM AN, AL-ASHKAR AM, NAZEER JT. Additional Glance on the Role of Dientamoeba fragilis & Blastocystis hominis in Patients with Irritable Bowel Syndrome. IRANIAN JOURNAL OF PARASITOLOGY 2018; 13:100-107. [PMID: 29963091 PMCID: PMC6019581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a functional gastrointestinal disease with high population prevalence. Dientamoeba fragilis and Blastocystis hominis are reported worldwide as a cause of human gastrointestinal symptoms. This study evaluated the possible link between this syndrome and the infection with D. fragilis and B. hominis in Egypt. METHODS Overall, 310 stool samples (160 from IBS patients and 150 from controls) were obtained from Tropical Medicine Outpatient Clinic, Faculty of Medicine, Ain Shams University, Cairo, Egypt between Mar 2015 and Feb 2016. All the stool specimens underwent direct examination and Trichrome staining. Each sample was cultivated on Jones and Robinson's media. RESULTS Overall, 42 cases (28%) showed B. hominis and 2 cases (1.3%) for D. fragilis infections. After performing the culture methods for B. hominis and D. fragilis, detections increased to 50 cases (33.3%) and 3 cases (2%), respectively. While among 150 controls 18 (12%) positive samples were detected as B. hominis. CONCLUSION There may be a possible relationship between the presentation of irritable bowel syndrome and D. fragilis and B. hominis infections, which have to be excluded first.
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15
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Partida-Rodríguez O, Serrano-Vázquez A, Nieves-Ramírez ME, Moran P, Rojas L, Portillo T, González E, Hernández E, Finlay BB, Ximenez C. Human Intestinal Microbiota: Interaction Between Parasites and the Host Immune Response. Arch Med Res 2017; 48:690-700. [PMID: 29290328 DOI: 10.1016/j.arcmed.2017.11.015] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 11/24/2017] [Indexed: 02/07/2023]
Abstract
The human gut is a highly complex ecosystem with an extensive microbial community, and the influence of the intestinal microbiota reaches the entire host organism. For example, the microbiome regulates fat storage, stimulates or renews epithelial cells, and influences the development and maturation of the brain and the immune system. Intestinal microbes can protect against infection by pathogenic bacteria, viruses, fungi and parasites. Hence, the maintenance of homeostasis between the gut microbiota and the rest of the body is crucial for health, with dysbiosis affecting disease. This review focuses on intestinal protozoa, especially those still representing a public health problem in Mexico, and their interactions with the microbiome and the host. The decrease in prevalence of intestinal helminthes in humans left a vacant ecological niche that was quickly occupied by protozoa. Although the mechanisms governing the interaction between intestinal microbiota and protozoa are poorly understood, it is known that the composition of the intestinal bacterial populations modulates the progression of protozoan infection and the outcome of parasitic disease. Most reports on the complex interactions between intestinal bacteria, protozoa and the immune system emphasize the protective role of the microbiota against protozoan infection. Insights into such protection may facilitate the manipulation of microbiota components to prevent and treat intestinal protozoan infections. Here we discuss recent findings about the immunoregulatory effect of intestinal microbiota with regards to intestinal colonization by protozoa, focusing on infections by Entamoeba histolytica, Blastocystis spp, Giardia duodenalis, Toxoplasma gondii and Cryptosporidium parvum. The possible consequences of the microbiota on parasitic, allergic and autoimmune disorders are also considered.
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Affiliation(s)
- Oswaldo Partida-Rodríguez
- Unidad de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México; Michael Smith Laboratories, University of Brithish Columbia, Vancouver, Canada
| | - Angélica Serrano-Vázquez
- Unidad de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Miriam E Nieves-Ramírez
- Unidad de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Patricia Moran
- Unidad de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Liliana Rojas
- Unidad de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Tobias Portillo
- Unidad de Bioinformática, Bioestadística y Biología Computacional. Red de Apoyo a la Investigación Científica, Universidad Nacional Autónoma de México, Instituto Nacional De Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - Enrique González
- Unidad de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Eric Hernández
- Unidad de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - B Brett Finlay
- Michael Smith Laboratories, University of Brithish Columbia, Vancouver, Canada
| | - Cecilia Ximenez
- Unidad de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México.
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16
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Mirjalali H, Abbasi MR, Naderi N, Hasani Z, Mirsamadi ES, Stensvold CR, Balaii H, Asadzadeh Aghdaei H, Zali MR. Distribution and phylogenetic analysis of Blastocystis sp. subtypes isolated from IBD patients and healthy individuals in Iran. Eur J Clin Microbiol Infect Dis 2017; 36:2335-2342. [PMID: 28741097 DOI: 10.1007/s10096-017-3065-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/04/2017] [Indexed: 12/19/2022]
Abstract
Blastocystis is a single-celled intestinal parasite commonly found in humans and a broad range of animals all over the world. In humans, its role in health and disease remains unsettled. The aim of our study was to investigate the distribution of Blastocystis and Blastocystis subtypes (ST) in patients with inflammatory bowel disease (IBD) and control subjects. A total of 71 stool samples were collected from IBD patients, 69 and 2 of whom had ulcerative colitis (UC) and Crohn's Disease (CD), respectively. Moreover, 166 stool samples from healthy subjects were included as control samples. All stool samples were cultivated, and 550-bp fragments of the small subunit ribosomal RNA gene was amplified from Blastocystis-positive cultures. All PCR-positive samples were sequenced. Blastocystis was observed in 9 (12.67%) and 35 (21.1%) IBD patients and healthy controls, respectively. There was no statistically significant correlation between IBD and presence of Blastocystis (P = 0.147). There was a statistically significant correlation between age and Blastocystis colonization in the IBD group (P < 0.05), but not among healthy controls. No significant correlation between gender and colonization was observed. ST1 and ST3 were obtained from 1 (12.5%) and 7 (87.5%) IBD patients, respectively, while in the healthy control group, subtypes 1, 2, and 3 were found in 14 (40%), 12 (34.28%), and 9 (25.72%), respectively. Phylogenetic analysis showed no variation in the distribution of subtypes nor intra-subtype genetic diversity between samples acquired from IBD patients and healthy controls. This study showed a trend towards a lower prevalence of Blastocystis in IBD patients than in control subjects. ST3 sequences isolated from IBD patients and control individuals did not appear to differ genetically.
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Affiliation(s)
- H Mirjalali
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M R Abbasi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - N Naderi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Z Hasani
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - E S Mirsamadi
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - C R Stensvold
- Department of Bacteria, Parasites & Fungi, Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - H Balaii
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - H Asadzadeh Aghdaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - M R Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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17
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Rahman MM, Mahadeva S, Ghoshal UC. Epidemiological and clinical perspectives on irritable bowel syndrome in India, Bangladesh and Malaysia: A review. World J Gastroenterol 2017; 23:6788-6801. [PMID: 29085223 PMCID: PMC5645613 DOI: 10.3748/wjg.v23.i37.6788] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 08/23/2017] [Accepted: 09/13/2017] [Indexed: 02/06/2023] Open
Abstract
Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients' quality of life. The epidemiology, clinical presentation, and management of IBS may vary in different geographical regions due to differences in diet, gastrointestinal infection, socio-cultural and psycho-social factors, religious and illness beliefs, symptom perception and reporting. Although previous reviews and consensus reports on IBS in Asia have been published, Asia is quite diverse socio-demographically. In this context, India, Bangladesh and Malaysia share some similarities, including: (1) large proportion of the population living in rural areas; (2) rapid development and associated lifestyle changes in urban areas; and (3) dietary, cultural and religious practices. The present review explores the clinical and epidemiological data on IBS from these three major nations in South and South-East Asia. In-depth review of the literature revealed important differences between IBS in the East, as revealed by studies from these three countries, and the West; these include a predominantly rural profile, differences in bowel habit and symptom profile, raising concern with regards to diagnostic criteria and subtyping of IBS, higher dietary fiber consumption, frequent lactose malabsorption, parasitosis, and possible overlap between post-infectious IBS and tropical sprue. Moreover, the current perception on difference in prevalence of the disorder in these countries, as compared to the West, might be related to variation in survey methods.
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Affiliation(s)
- M Masudur Rahman
- Department of Gastroenterology, Dhaka Medical College and Hospital, Dhaka 1000, Bangladesh
| | - Sanjiv Mahadeva
- Division of Gastroenterology, Department of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Uday C Ghoshal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
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18
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Rostami A, Riahi SM, Haghighi A, Saber V, Armon B, Seyyedtabaei SJ. The role of Blastocystis sp. and Dientamoeba fragilis in irritable bowel syndrome: a systematic review and meta-analysis. Parasitol Res 2017; 116:2361-2371. [PMID: 28668983 DOI: 10.1007/s00436-017-5535-6] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 06/14/2017] [Indexed: 12/14/2022]
Abstract
Irritable bowel syndrome (IBS) is globally one of the most prevalent gastrointestinal disorders with a negative impact on quality of life and socio-economic status of patients. Recently, controversial evidences suggest that Blastocystis sp. and Dientamoeba fragilis infections may be implicated in the development of IBS. We performed a systematic review and meta-analysis to examine the possible association regarding this issue. PubMed, ScienceDirect, Scopus, Web of Science, and Cochrane electronic databases were searched (up to February 2017) to identify the relevant studies. Pooled odds ratio (OR) and 95% confidence intervals were estimated using a random effects meta-analysis model on data from included studies. A total of 17 studies including 5882 participants (2527 patients and 3310 controls) met the eligibility criteria. Individuals with Blastocystis infection were found to have a positive association with IBS (OR, 2.19; 95% CI, 1.54-3.13), while this association was not observed for D. fragilis infection (OR, 1.13; 95% CI, 0.22-5.72). In subgroup analysis for Blastocystis infection, the pooled ORs were OR 2.29, 95% CI 1.55-3.41; OR 1.70, 95% CI 0.83-3.44; and OR 3.83, 95% CI 2.34-6.27 for hospital-based, healthy volunteers, and combined controls, respectively. Considering the subtypes, meta-analysis result demonstrated significant positive ORs for ST1 (OR, 4.40; 95% CI, 2.81-6.90) and ST3 (OR, 1.94; 95% CI, 1.36-2.77) to be potential risk factors for IBS. Our results support the existence of a positive association between Blastocystis sp. and IBS. Further studies with more sample size should be performed to better investigate the real impact of these parasites on the occurrence of IBS.
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Affiliation(s)
- Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran. .,Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Seyed Mohammad Riahi
- Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran.,Department of Epidemiology, School of Public health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Haghighi
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vafa Saber
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Armon
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyyed Javad Seyyedtabaei
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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19
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Ak S, Eroğlu F, Nergiz Aİ, Hıyamlı F. Are soil and waterborne parasitic infections health risk for worker populations in southeast Turkey? DICLE MEDICAL JOURNAL 2017. [DOI: 10.5798/dicletip.319779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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