Mysterious chronic urticaria caused by <i>Blastocystis</i> spp.?

Lepczyńska, Małgorzata; Chen, WenChieh; Dzika, Ewa

doi:10.1111/ijd.13064

Cited by 42 publications

(43 citation statements)

References 66 publications

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“…However, this limitation would not apply to helminths, for which the diagnostic approach used in the present study has been assessed several times and has shown high sensitivity and specificity [17, 23, 24, 29]. Nor would it apply to urticaria, which is commonly associated with other helminths including Ascaris lumbricoides , Hymenolepis nana , and Fasciola hepatica , as well as with protozoans including Giardia lamblia and Blastocystis hominis [28, 30, 33, 49, 50]. While we cannot exclude that some protozoan infections were missed, ivermectin is not effective against G .…”

Section: Discussionmentioning

confidence: 99%

Strongyloides stercoralis is associated with significant morbidity in rural Cambodia, including stunting in children

et al. 2017

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BackgroundStrongyloides stercoralis is a soil-transmitted nematode that can replicate within its host, leading to long-lasting and potentially fatal infections. It is ubiquitous and highly prevalent in Cambodia. The extent of morbidity associated with S. stercoralis infection is difficult to assess due to the broad spectrum of symptoms and, thus, remains uncertain.Methodology/Principal findingsClinical signs were compared among S. stercoralis infected vs. non-infected participants in a cross-sectional survey conducted in 2012 in eight villages of Northern Cambodia, and before and after treatment with a single oral dose of ivermectin (200μg/kg BW) among participants harboring S. stercoralis. Growth retardation among schoolchildren and adolescents was assessed using height-for-age and thinness using body mass index-for-age. S. stercoralis prevalence was 31.1% among 2,744 participants. Urticaria (55% vs. 47%, OR: 1.4, 95% CI: 1.1–1.6) and itching (52% vs. 48%, OR: 1.2, 95% CI: 1.0–1.4) were more frequently reported by infected participants. Gastrointestinal, dermatological, and respiratory symptoms were less prevalent in 103 mono-infected participants after treatment. Urticaria (66% vs. 11%, OR: 0.03, 95% CI: 0.01–0.1) and abdominal pain (81 vs. 27%, OR: 0.07, 95% CI: 0.02–0.2) mostly resolved by treatment. S. stercoralis infection was associated with stunting, with 2.5-fold higher odds in case of heavy infection.Conclusions/SignificanceThe morbidity associated with S. stercoralis confirmed the importance of gastrointestinal and dermatological symptoms unrelated to parasite load, and long-term chronic effects when associated with malnutrition. The combination of high prevalence and morbidity calls for the integration of S. stercoralis into ongoing STH control measures in Cambodia.

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Section: Discussionmentioning

confidence: 99%

Strongyloides stercoralis is associated with significant morbidity in rural Cambodia, including stunting in children

et al. 2017

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“…Genomic data by Denoeud et al [38] combined with in-vitro and in-vivo studies of Wu et al [39] and Ajjampur et al [28] allowed the identification of recognized virulence factors and revealed the harmful influences of the parasite on the intestinal barrier, leading to credible models of pathogenesis [40]. Several papers also suggest that this parasite should be related with non-specific gastrointestinal symptoms like diarrhoea, abdominal pain, and vomiting, and additionally, an association between B. hominis and irritable bowel syndrome (IBS) [40] and urticarial [41] is suggested.…”

Section: Pathogenicity Of Blastocystis Sp Is a Relationship Possiblementioning

confidence: 99%

Genetic diversity and pathogenicity of Blastocystis

Skotarczak¹

2018

Ann Agric Environ Med.

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Blastocystis is a unicellular, anaerobic protist which lives in the intestinal tract of diverse animals, including humans. It was found that the host specificity and the pathogenic potential of different isolates are correlated with sequence variations in the SSU-rRNA gene. Identification of the organism to the species level is still an unresolved challenge. Genetic diversity revisions have led to the identification of 17 subtypes (STs) within the Blastocystis genus, and 9 (ST1 to ST9) have been reported in humans with varying prevalence. Since the members of the genus revealed a large genetic diversity, several molecular modalities of subtyping methods have been developed. Numerous studies on conveying the pathogenic potential to the molecular subtypes are available, but they could not be compared or analysed with the different molecular techniques employed. The use of different approaches may give false positives during diagnosis and the possibility of missed infections. A review of recent scientific literature indicates that the development of PCR assays is needed for molecular epidemiology and for mixed infections in health and disease cohorts, and also to help identify sources of Blastocystis transmission to humans, as well as to identify potential animal and environmental reservoirs. This review summarizes some of the recent progress and improvements in Blastocystis research on genetic diversity, taxonomy, molecular epidemiology, pathogenicity and subtyping methods.

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“…colonization was shown to be associated with increased diversity of human gut bacterial microbiota [14], suggesting that the parasite requires high overall microbial diversity to become established in the human colon [3]. Much current data also suggests that this parasite should be associated with non-specific gastrointestinal symptoms including diarrhea, abdominal pain, and vomiting [1], and is suspected to be linked to irritable bowel syndrome [13] and urticaria [15]. …”

Section: Introductionmentioning

confidence: 99%

Molecular Epidemiology of Blastocystis sp. in Various Animal Groups from Two French Zoos and Evaluation of Potential Zoonotic Risk

et al. 2017

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Blastocystis sp. is a common intestinal parasite infecting humans and a wide range of animals worldwide. It exhibits an extensive genetic diversity and 17 subtypes (STs) have thus far been identified in mammalian and avian hosts. Since several STs are common to humans and animals, it was proposed that a proportion of human infections may result from zoonotic transmission. However, the contribution of each animal source to human infection remains to be clarified. Therefore, the aim of this study was to expand our knowledge of the epidemiology and host specificity of this parasite by performing the largest epidemiological survey ever conducted in animal groups in terms of numbers of species screened. A total of 307 stool samples from 161 mammalian and non-mammalian species in two French zoos were screened by real-time PCR for the presence of Blastocystis sp. Overall, 32.2% of the animal samples and 37.9% of the species tested were shown to be infected with the parasite. A total of 111 animal Blastocystis sp. isolates were subtyped, and 11 of the 17 mammalian and avian STs as well as additional STs previously identified in reptiles and insects were found with a varying prevalence according to animal groups. These data were combined with those obtained from previous surveys to evaluate the potential risk of zoonotic transmission of Blastocystis sp. through the comparison of ST distribution between human and animal hosts. This suggests that non-human primates, artiodactyls and birds may serve as reservoirs for human infection, especially in animal handlers. In contrast, other mammals such as carnivores, and non-mammalian groups including reptiles and insects, do not seem to represent significant sources of Blastocystis sp. infection in humans. In further studies, more intensive sampling and screening of potential new animal hosts will reinforce these statements and expand our understanding of the circulation of Blastocystis sp. in animal and human populations.

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Mysterious chronic urticaria caused by Blastocystis spp.?

Cited by 42 publications

References 66 publications

Strongyloides stercoralis is associated with significant morbidity in rural Cambodia, including stunting in children

Strongyloides stercoralis is associated with significant morbidity in rural Cambodia, including stunting in children

Genetic diversity and pathogenicity of Blastocystis

Molecular Epidemiology of Blastocystis sp. in Various Animal Groups from Two French Zoos and Evaluation of Potential Zoonotic Risk

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