Blastocystis subtypes isolated from irritable bowel syndrome patients and co-infection with Helicobacter pylori

Abstract

Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disease presenting clinically by abdominal pain with alteration of bowel habits. Although IBS has uncertain etiology, chronic gut inflammation due to persistent exposure to an infectious agent including Blastocystis sp. was proposed. The aim of this study was to detect the prevalence of Blastocystis sp. subtype (ST) isolated from stool of IBS patients and to assess Blastocystis sp. and H. pylori co-infection in IBS patients from Beni-Suef Governorate, Egypt. Stool samples were collected from 115 IBS patients, following Rome III criteria. All stool samples were microscopically examined by wet mount and permanent trichrome stain, cultured on Jones' medium with further sequencing of positive Blastocystis isolates and screened for detection of H. pylori coproantigen. Blastocystis sp. was the predominant parasite in IBS patients; it had statistical significant association with both rural residence (OR = 10) and flatulence (OR = 8.2). There was a predominance of Blastocystis sp. ST3 (81%) followed by ST1 (19%). Blastocystis culture results (19.1%) were superior than microscopy (16.5%). The majority of Blastocystis-positive IBS patients (72.7%) were co-infected with H. pylori with statistical significance; however, H. pylori was higher in Blastocystis-negative IBS patients (47/64) than in Blastocystis-positive IBS patients (17/64). Interestingly, IBS is usually associated with gut dysbiosis, while the most prevalent parasite in our IBS patients was Blastocystis sp., which is frequently found in asymptomatic individuals. Whether Blastocystis sp. is a cause or a consequence of IBS still needs further investigation, with a particular focus on correlation of IBS with different Blastocystis sp. subtypes and gut microbiomes.

Genetic Diversity and Distribution ofBlastocystisSubtype 3 in Human Populations, with Special Reference to a Rural Population in Central Mexico

“…In some studies, it has been observed that this subtype has been strongly related to rural populations [ 8 , 43 ]. It is possible to hypothesize that the migration phenomenon [ 42 ] occurs mainly from the displacement of these rural communities infected with Blastocystis ST3 haplotype 1 spreading this parasite into the cities.…”

“…This parasite is often transmitted via the oral-fecal route to people who work directly with animals, such as those involved in intensive animal farming or industrial livestock production [ 6 ]. In humans, the signs and symptoms associated with Blastocystis infection range from diarrhea to flatulence, bloating, and abdominal discomfort [ 7 , 8 ], with the “irritable bowel syndrome” (IBS) being the most frequent clinical manifestation [ 8 – 11 ].…”

“…Nine of these subtypes are found in humans, with subtype 3 (ST3 hereafter) being the most common in epidemiological studies worldwide [ 12 – 18 ]. ST3 has been regarded to trigger IBS in humans [ 8 ], and recent research also suggests an association between this subtype and colorectal cancer [ 19 ]. Other studies, however, suggest a lack of association between the ST3 and some type of symptomatology in humans [ 7 , 20 ].…”

Concomitant Infection of Helicobacter pylori and Intestinal Parasites in Adults Attending a Referral Centre for Parasitic Infections in North Eastern Italy

“…Even though the association was not statistically significant, a higher proportion of subjects infected with E. coli and E. nana were found among H. pylori -infected participants. A study conducted in 115 irritable bowel syndrome (IBS) patients from Egypt showed that 27% of H. pylori -infected individuals were coinfected with Blastocystis [ 45 ]. A marked association of Blastocystis and H. pylori (67% coinfection) was also recently found in Pakistani subjects with chronic diarrhea [ 46 ].…”

"The multidisciplinary approach to breast cancer – the role of support specialties before and after mastectomy"

“…ST3 was also found in 9 patients with gastro-intestinal symptoms (34.62%). According to literature data, ST3 has been associated both with acute or chronic urticaria and IBS; however, it has also been isolated from healthy patients [22][23][24] . The numbers of ST3-related Blastocystosis cases in our study are too few to claim a possible statistical correlation between the clinical presentation and Blastocystis subtype in both groups The resulting fragment is 526 nucleotide pairs in length.…”