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Western blot analysis of polyclonal antibodies from experimental animals against Blastocystis antigens

Init I, Prummongkol S, Gan CC, Nissapatorn V, Khairul Anuar A

JUMMEC, 2002;7:142-146.

One (1) anti-Blastocystis serum from a monkey naturally infected with isolate M12 and four (4) hyperimmune sera raised in inbred Balb/c mice against crude antigens of two Blastocystis isolates (C and KPI). one each of Entamoeba histolytica (HK9) and Giardia lamblia (7404) were used to react with several homologous and heterologous Blastocystis isolates, E. histofytica, G. lambfia, Endolimax nana and Bac-4 (Escherichia coli isolated from culture medium of a B. hominis isolate KPl). All anti-Blastocystis sera did not show cross-reactivity with E. histolytica and G. lamblia by western blotting. Similarly, anti-E. histolytica and anti-G. lamblia sera also did not react against all Blastocystis isolates tested, even though these three protozoa are known to produce diarrhoea in humans. Polyclonal sera raised against antigen prepared from xenic culture of Blastocystis produced a smear reaction on the immunoblot, while antibodies raised against antigens prepared from axenic culture (isolate C) gave prominent reaction bands. This may be due to the purity of the immunogen used in inducing the immune response. The cross-reactions of sera from mice immunised with the xenic B. hominis isolates may also due to antibodies against E. coli. Anti-Blastocystis serum from monkey's with natural infection showed several prominent reaction bands together with a smear at above 40 kD were most probably induced by the excretory-secretory antigens of the parasite. A variety of reaction patterns were obtained with these anti-sera and the antigens from different Blastocystis isolates. These may be reflects from differences in antigenic components from various strains of this parasite. KEYWORDS: lJIastocysfis, polycional antibodies, immunoblot, experimental animals

Matched MeSH terms: Blastocystis
Wild hosts and microscopic worlds: Investigating the morphology and surface ultrastructure of Blastocystis sp. in avian and non-human primate species

Sanggari A, Attah AO, Yahaya ZS, Farah Haziqah MT

Trop Biomed, 2023 Dec 01;40(4):392-399.
PMID: 38308825 DOI: 10.47665/tb.40.4.003

Blastocystis is a prevalent infectious agent found in the gastrointestinal tract of humans and animals. While the morphology of Blastocystis has been extensively studied, there is still a lack of comprehensive research on its ultrastructure, especially regarding surface characteristics and their correlation with pathogenic potential. Additionally, the subtyping of Blastocystis does not provide information on the isolate's pathogenicity. This study aimed to examine the morphology and the cell surface of Blastocystis in avian and non-human primates, including peafowl, pheasant, and lion-headed tamarin. By employing light microscopy and scanning electron microscopy (SEM), this study provides the first evidence of the cellular and surface features of Blastocystis in these animal species. Our findings revealed distinct variations in cell size, shape, and surface morphology among the different host species. Notably, the isolates from peafowl exhibited larger cell sizes compared to the isolates from the pheasant. However, interestingly, both animal species were found to exhibit the same Blastocystis ST6. It was also observed that the surface structure of Blastocystis from different hosts displayed a diverse range of patterns, including mesh-like appearances, deep indentations, and attachments to bacteria. Additionally, findings also revealed the presence of a rough surface structure in peafowl, a characteristic that has been previously linked to pathogenicity and symptomatic infection in animals, as indicated by earlier studies. The findings contribute to our understanding of the morphological features and the surface characteristic of Blastocystis in different host species, shedding light on the parasite's adaptations and potential implications for host health.

Matched MeSH terms: Blastocystis*
Fulltext Phenotypic variation in Blastocystis sp. ST3

Ragavan ND, Govind SK, Chye TT, Mahadeva S

Parasit Vectors, 2014;7:404.
PMID: 25174569 DOI: 10.1186/1756-3305-7-404

Blastocystis, is one of the most common human intestinal protozoan, which has many conflicting reports on its pathogenic role. Gut conditions which obviously varies in asymptomatic individuals, symptomatic and irritable bowel syndrome (IBS) patients in terms of gut flora, pH, osmotic pressure and water potentials could play an important role in its pathogenicity. The present study is the first study to investigate phenotypic characteristics of Blastocystis sp. ST3 isolated from asymptomatic, symptomatic and IBS isolates.

Matched MeSH terms: Blastocystis Infections/parasitology*; Blastocystis/physiology*; Blastocystis/ultrastructure*
Fulltext Advantage of using colonic washouts for Blastocystis detection in colorectal cancer patients

Kumarasamy V, Roslani AC, Rani KU, Kumar Govind S

Parasit Vectors, 2014;7:162.
PMID: 24708637 DOI: 10.1186/1756-3305-7-162

There have been previous studies associating microorganisms to cancer and with our recent findings of Blastocytsis antigen having a higher in vitro proliferation of cancer cells strengthens the suspicion. Collecting faecal samples alone to associate this parasite with cancer may not be accurate due to the phenomenon of irregular shedding and the possible treatment administrated to the cancer patients. Hence, this become the basis to search for an alternate method of sample collection. Colonic washout is an almost complete washed up material from colon and rectum which includes various microorganisms such as Blastocystis and other lodged material within the villi. The detection of parasite in colonic washouts will give a better reflection on the association between Blastocystis and CRC.

Matched MeSH terms: Blastocystis Infections/diagnosis; Blastocystis Infections/parasitology*; Blastocystis/isolation & purification*
Fulltext Amoebic forms of Blastocystis spp. - evidence for a pathogenic role

Rajamanikam A, Govind SK

Parasit Vectors, 2013;6(1):295.
PMID: 24499467 DOI: 10.1186/1756-3305-6-295

Blastocystis spp. are one of the most prevalent parasites isolated from patients suffering from diarrhea, flatulence, constipation and vomiting. It's pathogenicity and pathophysiology remains controversial to date. Protease activity and amoebic forms have been reported previously in symptomatic isolates but there has been no conclusive evidence provided to correlate the protease activity and any specific life cycle stage of the parasite thus far.

Matched MeSH terms: Blastocystis Infections/parasitology*; Blastocystis/cytology*; Blastocystis/enzymology; Blastocystis/growth & development; Blastocystis/pathogenicity
Prevalence and subtype distribution of Blastocystis sp. in cattle from Pahang, Malaysia

Kamaruddin SK, Mat Yusof A, Mohammad M

Trop Biomed, 2020 Mar 01;37(1):127-141.
PMID: 33612724

Blastocystis sp. is a common enteric protozoan parasite found in humans and various type of animal worldwide. Recently, genotypic distribution of Blastocystis sp. was revealed in insects, rodents, avian and mammals, which exposed its potential of transmiting the infections to human. However, very little information on current level of Blastocystis sp. infection were reported in cattle from Malaysia. Herein, a total of 120 stool samples of cattles were collected. While the potential risk of infection such as age, gender, body score, diarrheic condition of the cattle were noted, the management of the farms was also recorded. All stool sample were cultured, but 80 samples were selected for PCR sequencing analysis. The cultivation and microscopic examination revealed only 25% of the cattle (30/120) were infected with Blastocystis sp.. But, 43.8% of the cattle (35/80) were found positive upon PCR sequencing. The study also found that age, body score condition, diarrheic condition and certain farm were associated with the infection (p<0.05). Six subtypes (STs) that were discovered during the study were ST10 (21.3%;17/35), ST5 (8.8%;7/35), ST3 (7.5%;6/35), ST1 (2.5%;2/35), ST4 (2.5%;2/35) and ST14 (1.3%;1/35). Thus, moderate infections of Blastocystis sp. and variants in the genotypic distributions of the cattle suggest its potential for zoonotic transmission. Therefore, this findings could be helpful for further understanding the parasite, which assist studies of its pathogenicity.

Matched MeSH terms: Blastocystis Infections/epidemiology; Blastocystis Infections/parasitology; Blastocystis Infections/veterinary*; Blastocystis/classification; Blastocystis/isolation & purification*
Sac-like pouches in Blastocystis from the house lizard Cosymbotus platyurus

Suresh K, Mak JW, Chuong LS, Ragunathan T, Init I

Parasitol Res, 1997;83(6):523-5.
PMID: 9211501
Matched MeSH terms: Blastocystis/isolation & purification; Blastocystis/ultrastructure*
Amoeboid form of Blastocystis hominis - a detailed ultrastructural insight

Tan TC, Suresh KG

Parasitol Res, 2006 Nov;99(6):737-42.
PMID: 16816959

The amoeboid form of Blastocystis hominis has been reported infrequently, and its morphological descriptions have yielded conflicting and confusing reports. In the present study, we used the amoeboid forms seen predominantly in symptomatic patients infected with Blastocystis to provide detailed descriptions on the fine surface structure and intracellular morphology. Scanning electron microscopy revealed the irregular shape of the amoeboid form, with an intercalated fibrillar structure and a highly convoluted surface with deep indentations and projected pseudopodia. Transmission electron microscopy showed the existence of two types of amoeboid forms of B. hominis in in vitro culture, one with a large central vacuole containing tiny electron-dense particles while the other contains multiple small vacuoles in the cytoplasm. A surface coat with varying thickness surrounded the amoeboid form, which also showed prominent, extended pseudopodia of varying shape. Irregularly shaped mitochondrion-like organelles with prominent cristae, lipid inclusions, and multiple vacuoles were frequently seen in close proximity with the pseudopodia. The characteristic nucleus with a crescentic band of electron-dense chromatin material was also seen.

Matched MeSH terms: Blastocystis Infections/parasitology*; Blastocystis hominis/ultrastructure*
Irregular shedding of Blastocystis hominis

Vennila GD, Suresh Kumar G, Khairul Anuar A, Rajah S, Saminathan R, Sivanandan S, et al.

Parasitol Res, 1999 Feb;85(2):162-4.
PMID: 9934969

The shedding pattern of the protozoan parasite, Blastocystis hominis, is investigated in man and in experimental animal infections. The shedding pattern of the vacuolar and cystic forms of Blastocystis hominis in infected individuals have been shown in the present study to be irregular. The study shows that there is marked fluctuation in the shedding of the parasite from day to day, varying from as high as 17 to 0 per x40 microscopic field. The cystic stages when estimated in 8 Blastocystis-infected individuals ranged from as high as 7.4x10(5) cysts per gram of stool to 0. The shedding of cystic and vacuolar forms observed over a period of 20 days in experimentally-infected Wistar rats were not only shown to be irregular but the amount varied from host to host. The study has important diagnostic implications in that the stool samples must be collected more than once from patients showing clinical signs and symptoms to eliminate the cause of it to Blastocystis. The study also shows that there are asymptomatic individuals who pass a large amount of cysts as such individuals should be treated to prevent transmission to others.

Matched MeSH terms: Blastocystis Infections/parasitology; Blastocystis Infections/physiopathology*; Blastocystis Infections/transmission
Rare occurrence of Blastocystis in sea turtles and insects (cockroaches, houseflies, and crickets) from several states in Peninsular Malaysia

Muhammad Hafiz S, Attah AO, Mohd Salleh S, Rusli MU, Farah Haziqah MT

Trop Biomed, 2024 Sep 01;41(3):363-369.
PMID: 39548791 DOI: 10.47665/tb.41.3.017

Blastocystis a single-celled eukaryotic protist, is known to inhabit the intestines of various hosts, including humans, and has been implicated in a wide spectrum of symptoms, ranging from gastrointestinal issues to skin disorders, thereby establishing its status as an emerging infectious agent. In this study, the prevalence of Blastocystis infection was investigated in insects, including cockroaches, houseflies, and crickets, as well as sea turtles. Additionally, the genotypic characteristics of the isolated Blastocystis strains were examined, and the evolutionary relationships between Blastocystis species found in sea turtles, and animals/humans were determined. Microscopic techniques and molecular methods were utilized in this study. The results showed that four out of 90 insects (4.44%) and one out of 13 sea turtles (7.7%) were infected by Blastocystis. Furthermore, detailed observations revealed the presence of characteristic morphological features, such as vacuolar forms in the cockroach, cricket and sea turtle samples and binary fission from cockroach samples, indicative of Blastocystis' mode of reproduction. While the ST8 of Blastocystis in sea turtles were successfully identified, no subtyping was achieved for the infected insects. This study not only establishes the occurrence of Blastocystis infection in sea turtles but also uncovers its ability to infect insects, suggesting a potential reservoir role for these organisms. Overall, this research emphasizes the significance of comprehending the prevalence, genotypic diversity, and evolutionary relationships of Blastocystis across various hosts. Such insights are instrumental in developing effective control measures and public health interventions to mitigate the associated symptoms and prevent future outbreaks.

Matched MeSH terms: Blastocystis Infections/epidemiology; Blastocystis Infections/parasitology; Blastocystis Infections/veterinary
Fulltext Stress exacerbates infectivity and pathogenicity of Blastocystis hominis: in vitro and in vivo evidences

Chandramathi S, Suresh K, Sivanandam S, Kuppusamy UR

PLoS One, 2014;9(5):e94567.
PMID: 24788756 DOI: 10.1371/journal.pone.0094567

Stress alters the oxidant-antioxidant state and immune cell responses which disrupts its function to combat infection. Blastocystis hominis, a common intestinal protozoan has been reported to be opportunistic in immunocompromised patients namely cancer. B. hominis infectivity in other altered immune system conditions especially stress is unknown. We aimed to demonstrate the stress effects towards the susceptibility and pathogenicity of B. hominis infection.

Matched MeSH terms: Blastocystis Infections/blood; Blastocystis Infections/immunology; Blastocystis Infections/physiopathology; Blastocystis Infections/psychology; Blastocystis hominis/pathogenicity*; Blastocystis hominis/physiology
Genetic diversity of caprine Blastocystis from Peninsular Malaysia

Tan TC, Tan PC, Sharma R, Sugnaseelan S, Suresh KG

Parasitol Res, 2013 Jan;112(1):85-9.
PMID: 22961236 DOI: 10.1007/s00436-012-3107-3

Blastocystis sp. is a common intestinal parasite found in humans and animals. The possibility of zoonotic transmission to humans from livestock especially goats led us to investigate the genetic diversity of caprine Blastocystis sp. obtained from five different farms in Peninsular Malaysia. Moreover, there is a lack of information on the prevalence as well as genetic diversity of Blastocystis sp. in goat worldwide. Results showed that 73/236 (30.9 %) of the goats were found to be positive for Blastocystis infection. The most predominant Blastocystis sp. subtype was ST1 (60.3 %) followed by ST7 (41.1 %), ST6 (41.1 %), and ST3 (11.0 %) when amplified by PCR using sequenced-tagged site (STS) primers. Four farms had goats infected only with ST1 whereas the fifth showed mixed infections with multiple STs. The proximity of the fifth farm to human dwellings, nearby domesticated animals and grass land as opposed to a sterile captive environment in the first four farms may account for the multiple STs seen in the fifth farm. Since ST1, ST3, ST6 and ST 7 were previously reported in human infection worldwide in particular Malaysia, the potential of the zoonotic transmission of blastocystosis should not be disregarded. The implications of different farm management systems on the distribution of Blastocystis sp. STs are discussed.

Matched MeSH terms: Blastocystis Infections/epidemiology; Blastocystis Infections/parasitology; Blastocystis Infections/veterinary*; Blastocystis/classification*; Blastocystis/genetics*; Blastocystis/isolation & purification
Phenotypic and genotypic characterisation of Blastocystis hominis isolates implicates subtype 3 as a subtype with pathogenic potential

Tan TC, Suresh KG, Smith HV

Parasitol Res, 2008 Dec;104(1):85-93.
PMID: 18795333 DOI: 10.1007/s00436-008-1163-5

Despite frequent reports on the presence of Blastocystis hominis in human intestinal tract, its pathogenicity remains a matter of intense debate. These discrepancies may be due to the varying pathogenic potential or virulence of the isolates studied. The present study represents the first to investigate both phenotypic and genotypic characteristics of B. hominis obtained from symptomatic and asymptomatic individuals. Symptomatic isolates had a significantly greater size range and lower growth rate in Jones' medium than asymptomatic isolates. The parasite cells of symptomatic isolates exhibited rougher surface topography and greater binding affinity to Canavalia ensiformis (ConA) and Helix pomatia (HPA). The present study also identifies further phenotypic characteristics, which aided in differentiating the pathogenic forms from the non-pathogenic forms of B. hominis. Blastocystis subtype 3 was found to be correlated well with the disease.

Matched MeSH terms: Blastocystis Infections/parasitology*; Blastocystis Infections/physiopathology*; Blastocystis hominis/classification*; Blastocystis hominis/genetics; Blastocystis hominis/isolation & purification; Blastocystis hominis/pathogenicity*
Fulltext Predominance of Blastocystis sp. Infection among School Children in Peninsular Malaysia

Nithyamathi K, Chandramathi S, Kumar S

PLoS One, 2016;11(2):e0136709.
PMID: 26914483 DOI: 10.1371/journal.pone.0136709

BACKGROUND: One of the largest cross-sectional study in recent years was carried out to investigate the prevalence of intestinal parasitic infections among urban and rural school children from five states namely Selangor, Perak, Pahang, Kedah and Johor in Peninsula Malaysia. This information would be vital for school authorities to influence strategies for providing better health especially in terms of reducing intestinal parasitism.
METHODS AND PRINCIPAL FINDINGS: A total of 3776 stool cups was distributed to 26 schools throughout the country. 1760 (46.61%) responded. The overall prevalence of intestinal parasitic infection in both rural and urban areas was 13.3%, with Blastocystis sp (10.6%) being the most predominant, followed by Trichuris trichiura (3.4%), Ascaris lumbricoides (1.5%) and hook worm infection (0.9%). Only rural school children had helminthic infection. In general Perak had the highest infection (37.2%, total, n = 317), followed by Selangor (10.4%, total, n = 729), Pahang (8.6%, total, n = 221), Kedah (6.2%, total, n = 195) and Johor (3.4%, total, n = 298). School children from rural schools had higher infection (13.7%, total, n = 922) than urban school children (7.2%, total, n = 838). Subtype (ST) 3 (54.3%) is the most predominant ST with persons infected with only ST1 and ST3 showing symptoms. Blastocystis sp infection significantly associated with low household income, low parent's education and presence of symptoms (p<0.05).
CONCLUSION: It is critical that we institute deworming and treatment to eradicate the parasite especially in rural school children.

Matched MeSH terms: Blastocystis Infections/epidemiology*; Blastocystis Infections/parasitology; Blastocystis Infections/prevention & control; Blastocystis/classification; Blastocystis/genetics; Blastocystis/isolation & purification
Prevalence and subtypes of Blastocystis among migrant workers from different working sectors in Peninsular Malaysia

Sahimin N, Meor Termizi FH, Rajamanikam A, Mohd Nazri NA, Govind SK, Mohd Zain SN

Parasitol Res, 2020 Oct;119(10):3555-3558.
PMID: 32875397 DOI: 10.1007/s00436-020-06865-3

Blastocystis sp. is a common enteric parasite of humans and animals associated with inadequate sanitation and poor personal hygiene. Over the years, the Malaysian thriving economy has been facilitated largely by migrant workers from developing countries, and there is concern that diseases endemic to their countries may be imported. Therefore, this study aimed to determine the current status of Blastocystis infection as well as subtypes (STs) from fecal samples among migrant workers in Selangor and Kuala Lumpur, Malaysia. Overall, almost a third of the study cohort (30.9%; n = 68/220) screened were infected with Blastocystis sp. predominantly with ST3 (54.5%; n = 12), followed by ST1 (36.4%; n = 8) and ST2 (9.1%; n = 2). Infection levels was almost similar among the different sectors; manufacturing (32.8%), domestic service (32.3%), and food service (27.3%) with common symptoms for infection included stomach and abdominal pain or discomfort and diarrhea (48.5%; n = 33). None of the socio-demographic risk factors evaluated were significant. Therefore, this study warrants continuous monitoring as well as understanding the impact of transmission among the migrant community with the local population especially those involved in food service sector.

Matched MeSH terms: Blastocystis Infections/diagnosis; Blastocystis Infections/epidemiology*; Blastocystis Infections/parasitology*; Blastocystis/classification*; Blastocystis/genetics; Blastocystis/isolation & purification*
Fulltext High lipid storage in vacoular forms of subtype 6 Blastocystis sp. in ostrich

Chandrasekaran H, Govind SK, Panchadcharam C, Bathmanaban P, Raman K, Thergarajan G

Parasit Vectors, 2014;7:469.
PMID: 25358755 DOI: 10.1186/s13071-014-0469-7

Blastocystis sp., a widely prevalent intestinal protozoan parasite is found in a wide range of animals, including humans. The possibility of zoonotic transmission to human from birds especially ostriches led us to investigate on the cross infectivity of Blastocystis sp. isolated from the ostrich feces as well as the phenotypic and subtype characteristics. There is a need to investigate this especially with the rising number of ostrich farms due to the growing global ostrich industry.

Matched MeSH terms: Blastocystis Infections/parasitology; Blastocystis Infections/veterinary*; Blastocystis/classification*; Blastocystis/metabolism*
Urinary hyaluronidase activity in rats infected with Blastocystis hominis--evidence for invasion?

Chandramathi S, Suresh KG, Mahmood AA, Kuppusamy UR

Parasitol Res, 2010 May;106(6):1459-63.
PMID: 20358228 DOI: 10.1007/s00436-010-1825-y

The fact whether Blastocystis hominis can invade has always been in question. Apart from a few sporadic studies such as that done on gnotobiotic guinea pigs which showed surface invasion and mucosal inflammation of the host's intestine caused by B. hominis infection, no real documentation of invasion has been proven. Studies have shown that hyaluronidase is secreted during the penetration into the host's skin and gut by nematode parasites. Hyaluronidase activity in protozoa namely Entamoeba histolytica has also been described previously. This study attempts to determine hyaluronidase in urine samples of B. hominis-infected rats. The presence of hyaluronidase in urine provides an indirect evidence of invasion by B. hominis into colonic epithelium causing the degradation of extracellular matrix proteins namely hyaluronic acid (HA). HA is depolymerized by hyaluronidase which may be used by organisms to invade one another. In this study, the levels of urinary hyaluronidase of Sprague-Dawley rats infected with B. hominis were monitored for 30 days. Hyaluronidase levels in the infected rats were significantly higher on days 28 and 30 compared to the day before inoculation (P < 0.01 and P < 0.05, respectively). During this stage, parasitic burden in infected stools was also at a high level. Proinflammatory cytokines, interleukin-6 and interleukin-8, were also significantly higher (P < 0.05) in the serum of infected rats. The study demonstrates that since no other pathogen was present and that amoeboid forms of the parasites have been shown to exist previously, the elevated levels of hyaluronidase in this preliminary finding suggests that the organism is capable of having invasion or penetration activity in the hosts' intestine.

Matched MeSH terms: Blastocystis Infections/diagnosis; Blastocystis Infections/pathology; Blastocystis Infections/veterinary*; Blastocystis hominis/enzymology*
In vivo encystation of Blastocystis hominis

Suresh K, Venilla GD, Tan TC, Rohela M

Parasitol Res, 2009 Jun;104(6):1373-80.
PMID: 19238443 DOI: 10.1007/s00436-009-1340-1

Blastocystis from infected stools of a person who showed chronic symptoms of abdominal discomfort and diarrhea were examined over a 6-month period, using transmission electron microscopy, for the ultrastructural changes from vacuolar to cystic stage. The study confirms the irregular shedding phenomenon of the organism previously reported, and for the first time, records sequential changes in encystation in stools collected over a time period. The study also confirms the existence of a precystic stage which has an immature cell wall consisting of a layer of a homogenous electron-dense mass surrounding the cell which acts as a intermediatory stage between the vacuolar and cystic stage.

Matched MeSH terms: Blastocystis Infections/parasitology*; Blastocystis hominis/growth & development*; Blastocystis hominis/isolation & purification; Blastocystis hominis/ultrastructure*
Blastocystis in animal handlers

Rajah Salim H, Suresh Kumar G, Vellayan S, Mak JW, Khairul Anuar A, Init I, et al.

Parasitol Res, 1999 Dec;85(12):1032-3.
PMID: 10599928

The present study investigated whether people working closely with animals were at higher risk of getting infected with Blastocystis hominis. The prevalence of the parasite was determined in two population groups, i.e., animal handlers and normal healthy individuals who did not work with animals. In all, 105 stool samples were collected from animal handlers from 2 local research institutions, a local zoo, and a local abattoir and 163 stool samples were collected from normal healthy individuals residing in high-rise flats in the city. The in vitro culture method used in the study detected that 41% of 105 animal handlers and 17% of 163 flat-dwellers in the city were positive for Blastocystis. This statistically significant finding (P = 0.0000313) shows that people who work closely with animals do stand at risk of acquiring Blastocystis infection.

Matched MeSH terms: Blastocystis Infections/epidemiology*; Blastocystis Infections/parasitology; Blastocystis Infections/transmission*; Blastocystis/isolation & purification*
Fulltext Effect of Blastocystis sp. in dengue patients-Increase in the treatment cost and exacerbation of symptoms

Thergarajan G, Kumar S, Bhassu S, Omar SFBS, Rampal S

PLoS One, 2019;14(3):e0211034.
PMID: 30893309 DOI: 10.1371/journal.pone.0211034

Increasing incidences of dengue have become a global health threat with major clinical manifestation including high fever and gastrointestinal symptoms. These symptoms were also expressed among Blastocystis sp. infected individuals, a parasite commonly seen in human stools. This parasite has been previously reported to replicate faster upon exposure to high temperature. The present study is a hospitalized-based cross-sectional study involved the collection of faecal sample from dengue patients. Stool examination was done by in vitro cultivation to isolate Blastocystis sp. Growth pattern of all the positive isolates were analyzed to identify the multiplication rate of Blastocystis sp. isolated from dengue patients. Distribution of Blastocystis sp. among dengue patients was 23.6%. Dengue patients who were positive for Blastocystis sp. infection denoted a significantly higher fever rate reaching 38.73°C (p<0.05) compared to the non-Blastocystis sp. infected patients (38.44°C). It was also found that Blastocystis sp. infected patients complained of frequenting the toilet more than five times a day (p<0.05) compared to those who were non-Blastocystis sp. infected. At the same time, the duration of hospitalization was significantly longer (p<0.05) for Blastocystis sp. infected dengue patients compared to the non-Blastocystis sp. infected patients. Besides, Blastocystis sp. isolated from dengue patients (in vivo thermal stress) showed a higher growth rate compared to the non-dengue isolated which was exposed to high temperature (in vitro thermal stress). Our findings suggest that presence of Blastocystis sp. during dengue infection could trigger the increase of temperature which could be due to highly elevated pro inflammatory cytokines by both parasitic and virus infection. This could justify why the temperature in Blastocystis sp. infected dengue patients is higher compared to the non-Blastocystis sp. infected patients. Higher temperature could have triggered a greater parasite multiplication rate that contributed to the aggravation of the gastrointestinal symptoms.

Matched MeSH terms: Blastocystis Infections/metabolism*; Blastocystis Infections/parasitology; Blastocystis/isolation & purification; Blastocystis/metabolism

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