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Asiimwe D, Bangi I, Esanyu J, Ojok D, Okot B, Olong C, Wagubi R, Kisembo G, Sempijja F, Muwanguzi E, Okongo B. Association Between Helicobacter pylori Infection and Anemia Among Adult Dyspeptic Patients Attending Kiryandongo General Hospital, Uganda. J Blood Med 2023; 14:57-66. [PMID: 36718427 PMCID: PMC9883989 DOI: 10.2147/jbm.s392146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/06/2023] [Indexed: 01/25/2023] Open
Abstract
Purpose To determine the prevalence of anemia and its association with Helicobacter pylori infection among adult dyspeptic patients. Patients and Methods A cross-sectional study was conducted among 283 dyspeptic patients at Kiryandongo General Hospital, in Uganda. A structured questionnaire was administered to capture demographic and clinical characteristics of study participants. Four milliliters of blood were then collected into an EDTA vacutainer for Complete Blood Count (CBC) and analyzed using HUMA COUNT 30TS, and peripheral blood smears were made and stained using Giemsa stain. Anemia was defined as hemoglobin levels <12g/dl in females and <13g/dl in men according to the World Health Organization (WHO). Helicobacter pylori (H. pylori) stool antigen test was performed using Whole power H. pylori Ag rapid test device, and saline stool preparation was examined for intestinal parasites. Chi-squared test and Logistic regression were performed to determine association, and a p-value of ≤0.05 was considered statistically significant. Results The overall prevalence of Helicobacter pylori infection was 42.4% (120/283). The prevalence of anemia among H. pylori-infected patients was 25.8% (31/120) and 15.3% (25/163) among H. pylori-negative counterparts. H. pylori infection was significantly associated with anemia (p-value 0.042), age (p-value 0.02, 0.009), water sources (p-value 0.0049,) and intestinal parasitic infestation (p-value 0.02), respectively. Conclusion This study has shown that the prevalence of H. pylori infection and anemia is high among dyspeptic patients at Kiryandongo General Hospital. H. pylori infection was found associated with anemia, age, water sources, and intestinal parasitic infestation. Routine screening of anemia in H. pylori-infected individuals and further studies to explore the relationship between anemia and H. pylori disease is highly recommended.
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Affiliation(s)
- Daisy Asiimwe
- Department of Medical Laboratory Science, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Isaac Bangi
- Department of Medical Laboratory Science, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Jospeh Esanyu
- Department of Medical Laboratory Science, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Daniel Ojok
- Department of Medical Laboratory Science, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Benedict Okot
- Department of Medical Laboratory Science, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Clinton Olong
- Department of Medical Laboratory Science, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Robert Wagubi
- Department of Medical Laboratory Science, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Godfrey Kisembo
- Department of Hospital Administration, Kiryandongo General Hospital, Kiryandongo, Uganda
| | - Fred Sempijja
- Department of Medical Laboratory Technology, Uganda Institute of Allied Health and Management Sciences - Mulago, Kampala City, Uganda
| | - Enoch Muwanguzi
- Department of Medical Laboratory Science, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Benson Okongo
- Department of Medical Laboratory Science, Mbarara University of Science and Technology, Mbarara City, Uganda,Correspondence: Benson Okongo, Department of Medical Laboratory Science, Mbarara University of Science and Technology, P.O. BOX 1410, Mbarara City, Uganda, Tel +256 778 557 867, Fax +256-485-20782, Email
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Behrouz S, Soltani Rad MN, Ganji Z, Behrouz M, Zarenezhad E, Agholi M. Design, synthesis, antigiardial and in silico assessments of novel propargylamines containing nitroimidazole core. Tetrahedron 2022. [DOI: 10.1016/j.tet.2022.133007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Groudan K, Gupta K, Chalhoub J, Singhania R. Giardia lamblia Diagnosed Incidentally by Duodenal Biopsy. J Investig Med High Impact Case Rep 2021; 9:23247096211001649. [PMID: 33733914 PMCID: PMC7983489 DOI: 10.1177/23247096211001649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Giardia lamblia (also referred to as Giardia intestinalis and Giardia duodenalis) is the most common intestinal parasite in the world, affecting approximately 200 million people annually. Symptoms of Giardia include foul-smelling diarrhea, abdominal cramping, bloating, gas, and nausea. Although usually self-limiting, Giardia can progress to dehydration, malnutrition, and failure to thrive, especially in immunocompromised individuals. Early diagnosis and treatment is imperative to prevent and control infection of Giardia. Infectious Disease Society of America diagnostic guidelines recommend obtaining stool studies to diagnose Giardia; when stool studies are negative but suspicion remains high, duodenal aspirate microscopy is the only alternative diagnostic strategy suggested. We report a patient diagnosed incidentally with Giardia from a duodenal biopsy specimen obtained during a workup for a gastrointestinal bleed. There are limited cases of Giardia diagnosed by duodenal biopsy reported in the literature. We review studies that suggest duodenal biopsy can be a very sensitive strategy for the diagnosis of Giardia.
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Kalas MA, Alduaij A, Alkhatib AA. Incidental Diagnosis of Duodenal Giardiasis. Cureus 2021; 13:e15499. [PMID: 34268030 PMCID: PMC8262110 DOI: 10.7759/cureus.15499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 11/25/2022] Open
Abstract
Giardia lamblia is a protozoan that results in the commonly diagnosed giardiasis. Due to its prevalence and incidence worldwide, it is essential to recognize the different presentations of giardiasis, routes of transmission, modalities of diagnosis, treatments, and complications. Diagnostic modalities have evolved over the years and can be achieved reliably through noninvasive stool testing. Endoscopic duodenal aspirate and biopsies can also be used; however, they yield lower sensitivity and specificity rates and are therefore not used as a first-line modality for diagnosing giardiasis. Nonetheless, its use should be considered in cases with high suspicion and unremarkable stool testing. Herein, we discuss the case of a 27-year-old male with chronic weight loss and abdominal pain for six months diagnosed with G. lamblia through a duodenal biopsy.
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Affiliation(s)
- M Ammar Kalas
- Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA
| | - Ahmed Alduaij
- Pathology and Laboratory Medicine, Cleveland Clinic Abu Dhabi, Abu Dhabi, ARE
| | - Amer A Alkhatib
- Gastroenterology and Hepatology, Cleveland Clinic Abu Dhabi, Abu Dhabi, ARE
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Nahn EP, de Oliveira EC, Barbosa MJ, Mareco TCDS, Brígido HA. Brazilian Protocol for Sexually Transmitted Infections, 2020: sexually transmitted enteric infections. Rev Soc Bras Med Trop 2021; 54:e2020598. [PMID: 34008720 PMCID: PMC8210495 DOI: 10.1590/0037-8682-598-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/10/2021] [Indexed: 11/25/2022] Open
Abstract
The sexually transmitted enteric infections topic is one of the chapters of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with specialists. This article presents epidemiological and clinical aspects of these infections and guidance for service managers on their programmatic and operational management. The aim is to assist health professionals with screening, diagnosis, and treatment of people with sexually transmitted enteric infections and their sexual partners, in addition to supporting strategies for their surveillance, prevention, and control. The incidence of anorectal sexually transmitted infections has increased over the last years, mainly due to the increase in the practice of unprotected receptive anal sexual intercourse.
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Giardia lamblia and Helicobacter pylori coinfection in gastrointestinal biopsies: A retrospective single-center analysis from Switzerland. Ann Diagn Pathol 2021; 53:151756. [PMID: 33989960 DOI: 10.1016/j.anndiagpath.2021.151756] [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: 05/06/2021] [Accepted: 05/06/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The protozoan Giardia lamblia (GL) and the bacterium Helicobacter pylori (HP) are common causes of gastrointestinal disease. Coinfection is common and has been reported in studies from Africa, Europe, North America and Asia, but data for Switzerland are scarce. AIM To investigate GL and HP prevalence and coinfection rate in gastrointestinal biopsies from the Zurich area of Switzerland. METHODS Cases were retrieved from the laboratory information system (Medica Institute of Clinical Pathology, Zurich, Switzerland). Histological slides of cases with GL were reviewed, as were the concurrent gastric biopsies, where available. RESULTS Between January 1, 2013 and December 31, 2020, GL was found in 88 (0.14%) of 62,402 patients with a small intestine biopsy and HP in 10,668 (15.5%) of 68,961 patients with a gastric biopsy. 74/88 (84.1%) of patients with GL had unremarkable small intestine biopsies, 13/88 (14.8%) had increased intraepithelial lymphocytes, 5/88 (5.7%) showed villous atrophy and 2/88 (2.3%) acute inflammation. 71/88 patients (80.7%) with GL had an available gastric biopsy, of which 12/71 (16.9%) were unremarkable, 28/71 (39.4%) had HP-associated gastritis, 11/71 (15.5%) showed reactive gastropathy and 1/71 (1.4%) had autoimmune gastritis. CONCLUSION Coinfection with HP is common in patients with GL in gastrointestinal biopsies from the Zurich area of Switzerland. Therefore, gastroenterologists should consider sampling the stomach when GL is suspected for evaluation of possible concurrent HP-associated gastritis. Likewise, pathologists should scrutinize any small intestine biopsy for the presence of GL when HP-associated gastritis is seen, and vice versa.
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Nahn Junior EP, Oliveira ECD, Barbosa MJ, Mareco TCDS, Brígido HA. [Brazilian Protocol for Sexually Transmitted Infections 2020: sexually transmitted enteric infections]. ACTA ACUST UNITED AC 2021; 30:e2020598. [PMID: 33729403 DOI: 10.1590/s1679-4974202100012.esp1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/04/2020] [Indexed: 01/19/2023]
Abstract
The topic of sexually transmitted enteric infections is one of the chapters of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with specialists. This article presents epidemiological and clinical aspects related to these infections, as well as guidance for service managers on their programmatic and operational management. The aim is to assist health professionals with screening, diagnosis and treatment of people with sexually transmitted enteric infections and their sexual partners, in addition to supporting strategies for their surveillance, prevention and control.
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Abstract
The evaluation of gastrointestinal pathology in children often requires a different approach from that in adults. In this concise review, the authors outline 3 diagnostic challenges that are often encountered in daily practice; these include eosinophilic diseases, duodenal intraepithelial lymphocytosis with preserved villous architecture, and terminal ileal inflammation in the setting of idiopathic inflammatory bowel disease.
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Affiliation(s)
- Juan Putra
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada; Division of Pathology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G1X8, Canada
| | - Jeffrey D Goldsmith
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
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Giardia and Cryptosporidium infections in Danish cats: risk factors and zoonotic potential. Parasitol Res 2020; 119:2275-2286. [PMID: 32451716 DOI: 10.1007/s00436-020-06715-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 05/10/2020] [Indexed: 12/17/2022]
Abstract
Giardia and Cryptosporidium infections are common in cats, but knowledge is limited about their clinical importance, risk factors, and the role of cats as a reservoir for human infections. Here, we collected faeces and questionnaire data from 284 cats from shelters and veterinary clinics in the Copenhagen Metropolitan Region (= study population). Additionally, 33 samples were analysed separately from catteries with gastrointestinal clinical signs (= cases). (Oo-)cysts were quantified by immunofluorescence microscopy. All Giardia (n = 34) and Cryptosporidium (n = 29) positive samples were analysed by sequencing of the 18S rRNA, gdh and hsp70 loci, and co-infections were detected by McMaster/inverted microscopy. In the study population, 7.0% and 6.7% were positive for Giardia and Cryptosporidium respectively; 48.5% and 36.4% of the breeder cats (cases) were infected. Increased odds of diarrhoea were demonstrated in Giardia (p = 0.0008) and Cryptosporidium (p = 0.034) positive cats. For Giardia, the odds were positively correlated with infection intensity. Co-infection with Cryptosporidium (OR 12.79; p < 0.001), parasitic co-infections other than Cryptosporidium (OR 5.22; p = 0.009), no deworming (OR 4.67; p = 0.035), and male sex (OR 3.63; p = 0.025) were risk factors for Giardia. For Cryptosporidium, co-infection with Giardia was the only risk factor (OR 11.93; p < 0.0001). Genotyping revealed G. duodenalis assemblages A and F, and C. felis, all of them previously detected in humans. In conclusion, excretion of Giardia and Cryptosporidium was associated with clinical disease. Although a public health risk is likely, studies including larger sample sizes, more discriminatory markers and samples from other animals and humans are needed to reveal the full zoonotic potential.
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The Prevalence and Assemblages of Giardia Duodenalis in Dogs: A Systematic Review in Europe. FOLIA VETERINARIA 2019. [DOI: 10.2478/fv-2019-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Giardiasis is one of the most frequent causes of diarrhoeic diseases in the world. Giardia cysts are most commonly transferred via ingestion of contaminated water or food. On the basis of genetic characteristics Giardia duodenalis is classified in eight assemblages A—H. Zoonotic assemblages A and B are increasingly found in isolates from dogs which may constitute the reservoir of human giardiasis. This article presents a brief review of G. duodenalis assemblages detected in dogs that were documented in European countries.
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Javed IN, Tajammal R, Ijaz SH, Ahmad N, Mahmood S. "Tear Drops in the Duodenum": Uncommon Cause of Iron Deficiency Anemia in Adults. Cureus 2019; 11:e5532. [PMID: 31687306 PMCID: PMC6819067 DOI: 10.7759/cureus.5532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 64-year-old man presented to the internal medicine resident clinic with fatigue and abdominal pain of six-month duration. He did not have diarrhea, hematemesis, melena, or hematochezia. Physical examination was unremarkable. Laboratory findings were consistent with iron deficiency anemia. Upper and lower gastrointestinal (GI) endoscopies revealed normal findings. Duodenal biopsy showed trophozoites (tear-drop-shaped) morphologically consistent with Giardia duodenalis. He was prescribed metronidazole and iron replacement therapy, with a resultant improvement in symptoms as well as lab values at the four-month follow-up visit.
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Affiliation(s)
- Isma N Javed
- Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Rutaba Tajammal
- Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Sardar H Ijaz
- Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Nazir Ahmad
- Internal Medicine, Saint Anthony Hospital, Oklahoma City, USA
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López-Velázquez G, Fernández-Lainez C, de la Mora-de la Mora JI, Caudillo de la Portilla D, Reynoso-Robles R, González-Maciel A, Ridaura C, García-Torres I, Gutiérrez-Castrellón P, Olivos-García A, Flores-López LA, Enríquez-Flores S. On the molecular and cellular effects of omeprazole to further support its effectiveness as an antigiardial drug. Sci Rep 2019; 9:8922. [PMID: 31222100 PMCID: PMC6586891 DOI: 10.1038/s41598-019-45529-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 06/05/2019] [Indexed: 01/09/2023] Open
Abstract
Research on Giardia lamblia has accumulated large information about its molecular cell biology and infection biology. However, giardiasis is still one of the commonest parasitic diarrheal diseases affecting humans. Additionally, an alarming increase in cases refractory to conventional treatment has been reported in low prevalence settings. Consequently, efforts directed toward supporting the efficient use of alternative drugs, and the study of their molecular targets appears promising. Repurposing of proton pump inhibitors is effective in vitro against the parasite and the toxic activity is associated with the inhibition of the G. lamblia triosephosphate isomerase (GlTIM) via the formation of covalent adducts with cysteine residue at position 222. Herein, we evaluate the effectiveness of omeprazole in vitro and in situ on GlTIM mutants lacking the most superficial cysteines. We studied the influence on the glycolysis of Giardia trophozoites treated with omeprazole and characterized, for the first time, the morphological effect caused by this drug on the parasite. Our results support the effectiveness of omeprazole against GlTIM despite of the possibility to mutate the druggable amino acid targets as an adaptive response. Also, we further characterized the effect of omeprazole on trophozoites and discuss the possible mechanism involved in its antigiardial effect.
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Affiliation(s)
- Gabriel López-Velázquez
- Grupo de Investigación en Biomoléculas y Salud Infantil, Laboratorio de EIMyT, Instituto Nacional de Pediatría, Ciudad de México, 04530, Mexico.
| | - Cynthia Fernández-Lainez
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Ciudad de México, 04530, Mexico
| | - José Ignacio de la Mora-de la Mora
- Grupo de Investigación en Biomoléculas y Salud Infantil, Laboratorio de EIMyT, Instituto Nacional de Pediatría, Ciudad de México, 04530, Mexico
| | - Daniela Caudillo de la Portilla
- Grupo de Investigación en Biomoléculas y Salud Infantil, Laboratorio de EIMyT, Instituto Nacional de Pediatría, Ciudad de México, 04530, Mexico
| | - Rafael Reynoso-Robles
- Laboratorio de Morfología Celular y Tisular, Instituto Nacional de Pediatría, Ciudad de México, 04530, Mexico
| | - Angélica González-Maciel
- Laboratorio de Morfología Celular y Tisular, Instituto Nacional de Pediatría, Ciudad de México, 04530, Mexico
| | - Cecilia Ridaura
- Departamento de Patología, Instituto Nacional de Pediatría, Ciudad de México, 04530, Mexico
| | - Itzhel García-Torres
- Grupo de Investigación en Biomoléculas y Salud Infantil, Laboratorio de EIMyT, Instituto Nacional de Pediatría, Ciudad de México, 04530, Mexico
| | | | - Alfonso Olivos-García
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México y Hospital General, Ciudad de México, 04510, Mexico
| | - Luis Antonio Flores-López
- Grupo de Investigación en Biomoléculas y Salud Infantil, Laboratorio de EIMyT, Instituto Nacional de Pediatría, Ciudad de México, 04530, Mexico.,CONACYT-Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de México, 04530, Mexico
| | - Sergio Enríquez-Flores
- Grupo de Investigación en Biomoléculas y Salud Infantil, Laboratorio de EIMyT, Instituto Nacional de Pediatría, Ciudad de México, 04530, Mexico.
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Müller J, Braga S, Heller M, Müller N. Resistance formation to nitro drugs in Giardia lamblia: No common markers identified by comparative proteomics. INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE 2019; 9:112-119. [PMID: 30889439 PMCID: PMC6423486 DOI: 10.1016/j.ijpddr.2019.03.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/15/2019] [Accepted: 03/12/2019] [Indexed: 02/07/2023]
Abstract
In order to elucidate the question whether resistance to nitro drugs in G. lamblia is due to common resistance markers, trophozoites of three resistant G. lamblia strains, namely C4, 1062ID10, and 713M3 were grown in the presence of the two nitro drugs metronidazole and nitazoxanide and compared to their corresponding wild-types WBC6, 106, and 713 by mass spectometry shotgun analysis of their proteomes. Depending on the strain and the nitro drug, more than 200 to 500 differentially expressed proteins were identified, but there were no common patterns across strains and drugs. All resistant strains underwent antigenic variation with distinct surface antigens like variant surface proteins or cysteine rich proteins depending on strain and nitro compound. A closer look on enzymes involved in nitroreduction and detoxification of nitro radicals, NO or O2 suggested the existence of distinct strategies for each drug and each strain. Therefore, we conclude that resistance to nitro drugs in G. lamblia is not correlated with a specific pattern of differentially expressed proteins and therefore seems not to be the result of a directed process. Is resistance to nitro drugs in G. lamblia due to common resistance markers? Three resistant strains were grown in the presence of two nitro drugs separately and compared to wild-types by MS shotgun analysis. More than 200 to 500 differentially expressed proteins identified depending on strain and drug. No common patterns across strains and drugs. Strain specific antigenic variation and strategies linked to nitro reduction.
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Affiliation(s)
- Joachim Müller
- Institute of Parasitology, Vetsuisse Faculty, University of Berne, Länggass-Strasse 122, CH-3012, Berne, Switzerland.
| | - Sophie Braga
- Proteomics & Mass Spectrometry Core Facility, Department for BioMedical Research (DBMR), University of Berne, Freiburgstrasse 15, CH-3010, Berne, Switzerland.
| | - Manfred Heller
- Proteomics & Mass Spectrometry Core Facility, Department for BioMedical Research (DBMR), University of Berne, Freiburgstrasse 15, CH-3010, Berne, Switzerland.
| | - Norbert Müller
- Institute of Parasitology, Vetsuisse Faculty, University of Berne, Länggass-Strasse 122, CH-3012, Berne, Switzerland.
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de la Mora-de la Mora JI, Enríquez-Flores S, Fernández-Lainez C, Gutiérrez-Castrellón P, Olivos-García A, González-Canto A, Hernández R, Luján HD, García-Torres I, López-Velázquez G. Characterization of proteolytic activities of Giardia lamblia with the ability to cleave His-tagged N-terminal sequences. Mol Biochem Parasitol 2019; 228:16-26. [DOI: 10.1016/j.molbiopara.2019.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/24/2018] [Accepted: 01/03/2019] [Indexed: 12/18/2022]
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Corleto VD, Di Marino VP, Galli G, Antonelli G, Coluccio C, Di Cerbo A, Uccini S, Annibale B. Improving basic skills in celiac-like disease diagnosis: a case report. BMC Gastroenterol 2018; 18:162. [PMID: 30390626 PMCID: PMC6215663 DOI: 10.1186/s12876-018-0894-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 10/23/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The diagnosis of Coeliac disease (CD) requires a combination of sign/symptoms, positivity of specific antibodies and duodenal histological evidence of villous atrophy. Duodenal villous atrophy, despite representing the CD landmark, is not specific since it is found in many gastrointestinal disorders. Giardiasis is one of the most common human intestinal protozoan infestations in industrialized countries whose histological duodenal mucosa damage could mimic that of CD. The present report shows how a wise clinical and laboratory assessment led us shortly to a correct diagnosis. CASE PRESENTATION A 42-year-old outpatient woman without previous significant gastrointestinal diseases, was referred with dyspeptic symptoms, fatigue and mild diarrhea from 4 months. Her first investigations including immunoglobulin A (IgA) anti-tissue transglutaminase antibodies (anti-tTG) and stool parasitological and cultural analysis were negative. An esophagogastroduodenoscopy (EGDS) showed no mucosal alteration. But histology demonstrated a Helicobacter Pylori (HP) pan-gastritis while duodenal mucosa showed villous atrophy consistent with a diagnosis of CD Marsh type 3b. While on gluten-free diet (GFD) the patient didn't experience any improvement of symptoms. Duodenal biopsies were then reviewed showing the presence of trophozoites of Giardia on the luminal surface of the duodenal wall and at the same time, a second stool examination revealed the presence of trophozoites and cysts of Giardia. Treated with metronidazole, 500 mg twice daily for 6 days the patient reduced diarrhea after few days. After about 2 months of GFD she was invited to discontinue it. At the same time stool examination was repeated with negative results. She subsequently performed eradication for Hp with triple therapy (Pylera®). Around 6 months later, the patient did not complain any gastrointestinal symptoms. Serological tests were normal and at a follow-up EGDS, duodenal mucosa had normal histology with normal finger-like villi and absence of Giardia trophozoites. CONCLUSION This case report shows how CD diagnosis can sometimes be manifold. Intestinal villous atrophy alone may not automatically establish a diagnosis of CD. In the present case the clinical scenario could be fully explained by giardiasis. Indeed, different diagnostic tools and a multi-step approaches have been used to determine the final correct diagnosis.
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Affiliation(s)
- Vito Domenico Corleto
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
- grid.7841.aDigestive Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Vincenza Patrizia Di Marino
- grid.7841.aPaedriatic Allergology, Allergology Unit, “Policlinico Umberto I” University Hospital, “Sapienza” University of Rome, Rome, Italy
| | - Gloria Galli
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
| | - Giulio Antonelli
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
| | - Chiara Coluccio
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
| | - Arcangelo Di Cerbo
- grid.7841.aPathology Unit, Azienda Ospedaliera Sant’Andrea, “Sapienza” University of Rome, Rome, Italy
| | - Stefania Uccini
- grid.7841.aPathology Unit, Azienda Ospedaliera Sant’Andrea, “Sapienza” University of Rome, Rome, Italy
| | - Bruno Annibale
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
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Aguayo-Ortiz R, Meza-Cervantez P, Castillo R, Hernández-Campos A, Dominguez L, Yépez-Mulia L. Insights into the Giardia intestinalis enolase and human plasminogen interaction. MOLECULAR BIOSYSTEMS 2018; 13:2015-2023. [PMID: 28770921 DOI: 10.1039/c7mb00252a] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Giardia intestinalis is an intestinal parasite that causes diarrhea in humans and animals worldwide. The enolase of G. intestinalis (GiENO) participates in its glycolysis pathway and is abundantly expressed in the parasite cytosol; however, its localization on the surface of trophozoites and cysts has been demonstrated. Enolases from bacteria and parasites can have different functions and are considered moonlighting proteins, for example, as a cell surface plasminogen receptor. In relation to GiENO, no studies have been performed about its possible participation as a plasminogen receptor. In this work, we employed molecular docking and multiscale molecular dynamics (MD) simulations to explore the possible interactions of human plasminogen (HsPLG) with the open and closed GiENO conformations. Our proposed GiENO plasminogen binding site (PLGBs) was identified at Lys266 based on the sequence comparison with bacterial enolase known to act as a plasminogen receptor. Our docking results performed with multiple MD snapshots of the closed GiENO conformation showed that Lys266 preferentially binds to the K5 domain of HsPLG. On the other hand, open GiENO conformations from all-atom and coarse-grained simulations indicated a high preference of the HsPLG K4 domain for lysine residues 186 and 188. Furthermore, we identified a potential N-glycosylation site of GiENO which suggests a possible explanation for the parasite cell surface localization or host mucin oligosaccharide adhesion mechanism. Our study constitutes the first multiscale computational study to explore the plasminogen receptor function of GiENO for its further consideration as a potential therapeutic target for giardiasis treatment.
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Affiliation(s)
- R Aguayo-Ortiz
- Facultad de Química, Departamento de Fisicoquímica, Universidad Nacional Autónoma de México, CDMX, México 04510, Mexico.
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Seid A, Tamir Z, Kasanew B, Senbetay M. Co-infection of intestinal parasites and Helicobacter pylori among upper gastrointestinal symptomatic adult patients attending Mekanesalem Hospital, northeast Ethiopia. BMC Res Notes 2018; 11:144. [PMID: 29463293 PMCID: PMC5819640 DOI: 10.1186/s13104-018-3246-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 02/10/2018] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Intestinal parasites and H. pylori are well-known for their high prevalence worldwide. Thus, the objective of this study waste assess risk factors and co-infection of intestinal parasites and H. pylori among adult patients with upper gastrointestinal complaints. A hospital-based cross sectional study was conducted among 363 consecutive adult patients from December 10, 2015 to February 30,2016. Stool and venous blood were collected for analysis of Intestinal parasites and H. pylori infection, respectively. Data was analyzed using SPSS version 16 and logistic regression analysis was carried out to assess predictors of co-infection. A p ≤ 0.05 was considered as statistically significant. RESULTS Helicobacter pylori IgG and intestinal parasites were detected in 70.25-38.3% of participants, respectively while G. lamblia accounted 22.3%. G. lamblia prevalence was significantly higher among H. pylori infected participants (COR: 2.76; 95% CI: 1.46-5.23), but E. hystolytica/dispar infection didn't show significant variation (p = 0.15). H. pylori and intestinal parasites concomitant co-infection was associated with male sex (AOR: 1.61; 95% CI: 1.01-2.56), consumption of river water (AOR: 1.85; 95% CI: 1.11-3.07) and ground/spring water (AOR: 4.10; 95% CI: 1.97-8.52). Thus, besides H. pylori investigation, upper gastrointestinal symptomatic patients should be screened for G. lamblia infection and other intestinal parasites.
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Yakoob J, Abbas Z, Khan R, Tariq K, Awan S, Beg MA. Association of Helicobacter pylori and protozoal parasites in patients with chronic diarrhoea. Br J Biomed Sci 2018; 75:105-109. [PMID: 29452574 DOI: 10.1080/09674845.2017.1420129] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Introduction An association of Helicobacter pylori and common protozoal parasites in patients with abdominal discomfort and chronic diarrhoea is unclear and may be pathological. Materials and methods One hundred and sixty-one patients with diarrhoea were compared to 114 age and sex matched controls. Stool samples were examined by microscopy and DNA extracted for PCR with specific primers for H. pylori and protozoal parasites Blastocystis sp., Entamoeba sp. (Entamoeba histolytica, Entamoeba dispar and Entamoeba moshkovskii) and Giardia duodenalis (G. duodenalis). Results There was a marked difference in the presence of parasites between patients and controls: no parasite 42/75%, one parasite 42/15%, two or more parasites 16/10%, respectively (p < 0.001). Patients with diarrhoea were more likely to be infected with Blastocystis sp (p < 0.001), E. histolytica (p = 0.027) and E moshkovskii (p = 0.003). There was no difference in the frequency of H. pylori (p = 0.528), G duodenalis (p = 0.697) or E dispar (p = 0.425). Thirty-three patients and 27 controls had H. pylori infection. Of these, 22 patients and 6 controls were infected with Blastocystis sp (p = 0.001), 6 patients and no controls were infected with E. histolytica (p = 0.02), whilst 7 patents and 9 controls were infected with E dispar (p = 0.292). Conclusion In this population, diarrhoea is linked to infection with Blastocystis sp, E. histolytica and E moshkoviskii. In H. pylori infection, diarrhoea is linked to Blastocystis sp and E. histolytica infection. These associations may be linked pathogenically.
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Affiliation(s)
- J Yakoob
- a Department of Medicine , Aga Khan University , Karachi , Pakistan.,b Biological Biomedical Sciences , Aga Khan University , Karachi , Pakistan
| | - Z Abbas
- a Department of Medicine , Aga Khan University , Karachi , Pakistan
| | - R Khan
- a Department of Medicine , Aga Khan University , Karachi , Pakistan
| | - K Tariq
- a Department of Medicine , Aga Khan University , Karachi , Pakistan
| | - S Awan
- a Department of Medicine , Aga Khan University , Karachi , Pakistan
| | - M A Beg
- c Pathology and Laboratory Medicine , Aga Khan University , Karachi , Pakistan
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Jolobe OMP. Caveats in the work-up of iron deficiency anaemia. Eur J Intern Med 2018; 48:e38. [PMID: 28803037 DOI: 10.1016/j.ejim.2017.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 07/26/2017] [Indexed: 02/07/2023]
Affiliation(s)
- Oscar M P Jolobe
- Manchester Medical Society, Simon Building Brunswick Street, Manchester M13 9PL, United Kingdom.
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Giardia duodenalis infection among rural communities in Yemen: A community-based assessment of the prevalence and associated risk factors. ASIAN PAC J TROP MED 2017; 10:987-995. [DOI: 10.1016/j.apjtm.2017.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 08/12/2017] [Accepted: 09/07/2017] [Indexed: 11/22/2022] Open
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