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Lepczyńska M, Dzika E. The influence of probiotic bacteria and human gut microorganisms causing opportunistic infections on Blastocystis ST3. Gut Pathog 2019; 11:6. [PMID: 30815037 PMCID: PMC6376780 DOI: 10.1186/s13099-019-0287-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 02/05/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Blastocystis subtype 3 is an intestinal protist present in humans throughout the world with a controversial pathogenic potential. It has been suggested that probiotic bacteria inhibit the multiplication of gut protozoans, while others are beneficial for their development. This study aimed to evaluate the efficacy of the lactic acid bacteria Lactobacillus rhamnosus, Lactococcus lactis and Enterococcus faecium in Blastocystis ST3 eradication and the relevance of the intestinal microorganisms Escherichia coli, Candida albicans and Candida glabrata in protozoan proliferation. Blastocystis xenic and axenic culture was co-incubated with the above-mentioned microorganisms and their cell free supernatants at different concentrations in vitro. The number of protozoan cells was counted every day. RESULTS Both experiments, with xenic and axenic cultures, showed Blastocystis inhibition by L. rhamnosus and L. lactis and their supernatants from the 2nd day of co-incubation. Furthermore, co-incubation with both E. faecium and E. coli showed a beneficial influence on Blastocystis during the first 2 days. Only after 3 days did the above-mentioned bacteria start to inhibit Blastocystis growth in both cultures. The supernatant containing the metabolites of E. coli was effective to a lesser degree. Compared to the control samples, co-incubation with both C. albicans and C. glabrata showed a faster decrease in Blastocystis proliferation, but this was not statistically significant. CONCLUSIONS This study has shown the potential of using L. rhamnosus and L. lactis, as well as E. faecium as a prophylactic treatment against Blastocystis colonization or as an additional treatment regimen in combination with standard drugs.
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Affiliation(s)
- M. Lepczyńska
- Department of Medical Biology, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury, Żołnierska 14C, 10-561 Olsztyn, Poland
| | - E. Dzika
- Department of Medical Biology, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury, Żołnierska 14C, 10-561 Olsztyn, Poland
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Kurt Ö, Doğruman Al F, Tanyüksel M. Eradication of Blastocystis in humans: Really necessary for all? Parasitol Int 2016; 65:797-801. [PMID: 26780545 DOI: 10.1016/j.parint.2016.01.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 12/30/2015] [Accepted: 01/14/2016] [Indexed: 02/01/2023]
Abstract
Blastocystis (initially named as Blastocystis hominis) has long been known as a protist without any clinical significance. However, there is now a huge pile of case reports where Blastocystis is blamed for the symptoms and the infection described in the patients. Introduction of the presence of as many as 17 Blastocystis subtypes while many infected individuals are non-symptomatic initially brought about the correlation between the subtypes and pathogenicity; however, the outcomes of these trials were not consistent and did not explain its pathogenicity. Today, it is mostly acknowledged that Blastocystis may colonize many individuals but the infection's onset depends on the interaction between the virulence of parasites and host's immune competence. Eradication of Blastocystis is essential in some cases where it is the only infectious agent and patient is suffering from some symptoms. In such cases, metronidazole is the drug of choice but its efficacy is relatively low in some cases. Other agents used include trimethoprim-sulfamethoxazole, paromomycin, and furazolidone. Recent studies on the interactions between human health and the role of gut microbiota introduces new data which may significantly change our point of view against some protists, which we tend to see as "parasites requiring urgent eradication for cure". May the presence or absence of some Blastocystis subtypes necessary for human health, or is the absence or presence of certain Blastocystis subtypes in human gut is associated with certain diseases/infections? The answers of these questions will surely guide us to select patients requiring treatment against Blastocystis infection in future.
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Affiliation(s)
- Özgür Kurt
- Faculty of Medicine, Department of Medical Microbiology, Acibadem University, Istanbul, Turkey.
| | - Funda Doğruman Al
- Faculty of Medicine, Department of Medical Microbiology, Gazi University, Ankara, Turkey.
| | - Mehmet Tanyüksel
- Faculty of Medicine, Department of Medical Microbiology, Gülhane Military Medical Academy, Ankara, Turkey.
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In Vitro Antimicrobial Susceptibility Patterns of Blastocystis. Antimicrob Agents Chemother 2015; 59:4417-23. [PMID: 25987633 DOI: 10.1128/aac.04832-14] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 05/04/2015] [Indexed: 02/07/2023] Open
Abstract
Blastocystis is the most common human enteric protist with controversial clinical significance. Metronidazole is considered a first-line treatment for Blastocystis infection; however, there has been increasing evidence for the lack of efficacy of this treatment. Treatment failure has been reported in several clinical cases, and recent in vitro studies have suggested the occurrence of metronidazole-resistant strains. In this study, we tested 12 Blastocystis isolates from 4 common Blastocystis subtypes (ST1, ST3, ST4, and ST8) against 12 commonly used antimicrobials (metronidazole, paromomycin, ornidazole, albendazole, ivermectin, trimethoprim-sulfamethoxazole [TMP-SMX], furazolidone, nitazoxanide, secnidazole, fluconazole, nystatin, and itraconazole) at 10 different concentrations in vitro. It was found that each subtype showed little sensitivity to the commonly used metronidazole, paromomycin, and triple therapy (furazolidone, nitazoxanide, and secnidazole). This study highlights the efficacy of other potential drug treatments, including trimethoprim-sulfamethoxazole and ivermectin, and suggests that current treatment regimens be revised.
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El-Taweel HA. Understanding drug resistance in human intestinal protozoa. Parasitol Res 2015; 114:1647-59. [DOI: 10.1007/s00436-015-4423-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 03/05/2015] [Indexed: 01/07/2023]
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Nagel R, Bielefeldt-Ohmann H, Traub R. Clinical pilot study: efficacy of triple antibiotic therapy in Blastocystis positive irritable bowel syndrome patients. Gut Pathog 2014; 6:34. [PMID: 25349629 PMCID: PMC4209510 DOI: 10.1186/s13099-014-0034-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 08/07/2014] [Indexed: 02/08/2023] Open
Abstract
Background Blastocystis species are common human enteric parasites. Carriage has been linked to Irritable Bowel Syndrome (IBS). Treatment of Blastocystis spp. with antimicrobials is problematic and insensitive diagnostic methods and re-infection complicate assessment of eradication. We investigated whether triple antibiotic therapy comprising diloxanide furoate, trimethoprim/sulfamethoxazole and secnidazole (TAB) given to diarrhoea-predominant IBS (D-IBS) patients positive for Blastocystis would achieve eradication. Methods In a longitudinal, prospective case study 10 D-IBS Blastocystis-positive patients took 14 days of diloxanide furoate 500 mg thrice daily, trimethoprim/sulfamethoxazole 160/80 mg twice daily and secnidazole 400 mg thrice daily. Faecal specimens were collected at baseline, day 15 and 4 weeks after completion of TAB. Specimens were analysed using faecal smear, culture and polymerase chain reaction (PCR) of the 16 SSU rRNA. Patients kept a concurrent clinical diary. Results Six (60%) patients cleared Blastocystis spp. after TAB, including three who had failed previous therapy. Subtypes detected were ST3 (60%), ST4 (40%), ST1 (20%) and ST7, 8 (10%); four patients had mixed ST infections. Serum immunoglobulin A (IgA) levels were low in 40% of patients. Higher rates of Blastocystis clearance were observed in patients symptomatic for less than a year (Mann–Whitney, p = 0.032, 95% confidence) with no associations found with age, previous antibiotic therapy, faecal parasite load, ST, IgA level or clinical improvement. Conclusions Clearance of Blastocystis spp. was achieved with TAB in 60% of D-IBS patients, an improvement over conventional monotherapy. Higher clearance rates are needed to facilitate investigation of the relevance of this parasite in clinically heterogenous IBS.
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Affiliation(s)
- Robyn Nagel
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia ; Toowoomba Gastroenterology Clinic, Suite 105 Medici Medical Centre, 15 Scott Street, Toowoomba 4350, Queensland, Australia
| | - Helle Bielefeldt-Ohmann
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia ; Australian Infectious Diseases Research Centre, The University of Queensland, St. Lucia, Australia
| | - Rebecca Traub
- Faculty of Veterinary Science, The University of Melbourne, Parkville 3052, Victoria, Australia
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Roberts T, Stark D, Harkness J, Ellis J. Update on the pathogenic potential and treatment options for Blastocystis sp. Gut Pathog 2014; 6:17. [PMID: 24883113 PMCID: PMC4039988 DOI: 10.1186/1757-4749-6-17] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 05/15/2014] [Indexed: 12/23/2022] Open
Abstract
Although Blastocystis is one of the most common enteric parasites, there is still much controversy surrounding the pathogenicity and potential treatment options for this parasite. In this review we look at the evidence supporting Blastocystis as an intestinal pathogen as shown by numerous case studies and several in vivo studies and the evidence against. We describe the chronic nature of some infections and show the role of Blastocystis in immunocompromised patients and the relationship between irritable bowel syndrome and Blastocystis infection. There have been several studies that have suggested that pathogenicity may be subtype related. Metronidazole is the most widely accepted treatment for Blastocystis but several cases of treatment failure and resistance have been described. Other treatment options which have been suggested include paromomycin and trimethroprim- sulfamethoxazole.
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Affiliation(s)
- Tamalee Roberts
- Department of Microbiology, St. Vincent's Hospital, Victoria St, Darlinghurst 2010, NSW, Australia ; School of Medical and Molecular Biosciences, University of Technology, Sydney, Ultimo, NSW 2007, Australia
| | - Damien Stark
- Department of Microbiology, St. Vincent's Hospital, Victoria St, Darlinghurst 2010, NSW, Australia
| | - John Harkness
- Department of Microbiology, St. Vincent's Hospital, Victoria St, Darlinghurst 2010, NSW, Australia
| | - John Ellis
- School of Medical and Molecular Biosciences, University of Technology, Sydney, Ultimo, NSW 2007, Australia
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Wu Z, Mirza H, Tan KSW. Intra-subtype variation in enteroadhesion accounts for differences in epithelial barrier disruption and is associated with metronidazole resistance in Blastocystis subtype-7. PLoS Negl Trop Dis 2014; 8:e2885. [PMID: 24851944 PMCID: PMC4031124 DOI: 10.1371/journal.pntd.0002885] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 04/08/2014] [Indexed: 01/13/2023] Open
Abstract
Blastocystis is an extracellular, enteric pathogen that induces intestinal disorders in a range of hosts including humans. Recent studies have identified potential parasite virulence factors in and host responses to this parasite; however, little is known about Blastocystis-host attachment, which is crucial for colonization and virulence of luminal stages. By utilizing 7 different strains of the parasite belonging to two clinically relevant subtypes ST-4 and ST-7, we investigated Blastocystis-enterocyte adhesion and its association with parasite-induced epithelial barrier disruption. We also suggest that drug resistance in ST-7 strains might result in fitness cost that manifested as impairment of parasite adhesion and, consequently, virulence. ST-7 parasites were generally highly adhesive to Caco-2 cells and preferred binding to intercellular junctions. These strains also induced disruption of ZO-1 and occludin tight junction proteins as well as increased dextran-FITC flux across epithelial monolayers. Interestingly, their adhesion was correlated with metronidazole (Mz) susceptibility. Mz resistant (Mzr) strains were found to be less pathogenic, owing to compromised adhesion. Moreover, tolerance of nitrosative stress was also reduced in the Mzr strains. In conclusion, the findings indicate that Blastocystis attaches to intestinal epithelium and leads to epithelial barrier dysfunction and that drug resistance might entail a fitness cost in parasite virulence by limiting entero-adhesiveness. This is the first study of the cellular basis for strain-to-strain variation in parasite pathogenicity. Intra- and inter-subtype variability in cytopathogenicity provides a possible explanation for the diverse clinical outcomes of Blastocystis infections.
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Affiliation(s)
- Zhaona Wu
- Laboratory of Molecular and Cellular Parasitology, Department of Microbiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Haris Mirza
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Kevin Shyong Wei Tan
- Laboratory of Molecular and Cellular Parasitology, Department of Microbiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Synthesis, biological activity and structure–activity relationship of 4,5-dimethoxybenzene derivatives inhibitor of rhinovirus 14 infection. Eur J Med Chem 2014; 76:445-59. [DOI: 10.1016/j.ejmech.2014.01.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 01/14/2014] [Accepted: 01/18/2014] [Indexed: 11/23/2022]
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Original TDAE strategy using propargylic chloride: rapid access to 1,4-diarylbut-3-ynol derivatives. Molecules 2013; 18:1540-8. [PMID: 23353124 PMCID: PMC6269883 DOI: 10.3390/molecules18021540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 01/16/2013] [Accepted: 01/22/2013] [Indexed: 11/17/2022] Open
Abstract
We report herein the first synthesis of propargylic alcohols using an organic reducing agent. Diarylbutynol derivatives are formed in moderate to good yields under mild conditions from the reaction of 1-(3-chloroprop-1-ynyl)-4-nitrobenzene with various aromatic aldehydes using tetrakis(dimethylamino)ethylene (TDAE) as reductant.
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Abstract
Blastocystis is a common parasite of the human large intestine but has an uncertain role in disease. In this review, we appraise the published evidence addressing this and its weaknesses. Genetic diversity studies have led to the identification of numerous subtypes (STs) within the genus Blastocystis and, recently, methods for studying variation within STs have been developed, with implications for our understanding of host specificity. The geographic distribution of STs is summarised and the impact this may have on investigations into the role of the organism in disease is discussed. Finally, we describe the organelle and nuclear genome characteristics and look to future developments in the field.
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