Materiały źródłowe

• #1

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4040727/

  Blastocystis sp. is among the few enteric parasites with a prevalence that often exceeds 5% in the general population of industrialized countries and can reach 3060% in developing countries. […] Recent in vitro and in vivo studies have shed new light on the pathogenic power of this parasite, suggesting that Blastocystis sp. infection is associated with a variety of gastrointestinal disorders, may play a significant role in irritable bowel syndrome, and may be linked with cutaneous lesions (urticaria). […] The pathogenic status of Blastocystis sp. was widely debated in the literature to determine whether this microorganism was a truly pathogenic or commensal organism, although an increasingly number of recent studies cited Blastocystis sp. as an emerging pathogen. […] However, recent in vitro and in vivo studies show that Blastocystis sp. infection is associated with a variety of gastrointestinal disorders (called blastocystosis), especially in irritable bowel syndrome (IBS) and cutaneous lesions.

• #2 Blastocystis – Wikipedia

  https://en.wikipedia.org/wiki/Blastocystis

  Blastocystis is one of the most common human parasites in the world and has a global distribution. […] Although the role of Blastocystis hominis in human disease is often referred to as controversial, a systematic survey of research studies conducted by 11 infectious disease specialists from nine countries, found that over 95% of papers published in the 10 years prior identified it as causing illness in immunocompetent individuals. […] However, Blastocystis has never fulfilled Koch’s postulate that infection of a healthy individual with Blastocystis leads to disease. […] A more likely explanation is the presence of virulent and non-virulent strains since there exists an enormous genetic variation between different strains (or genotypes). […] Some studies have suggested that pathogenicity may be linked to specific subtypes of Blastocystis and experimental infection of animals has reported varying degrees of illness depending on the subtype used.

• #3 Blastocystis hominis: A Pathogenic Parasite

  https://brieflands.com/articles/archcid-97388

  Blastocystis hominis is recognized as a common intestinal parasite. Some studies have reported the effect of phenotypic, serologic, and biochemical indices on the parasites pathogenic characteristics. […] This study showed comprehensive reasons for proving the pathogenesis of the parasite. […] Studies on the pathogenicity of B. hominis have focused on humans infected with this parasite to determine the relationship between the parasite subtype and clinical signs, or laboratory sensitive animals to investigate the clinical signs and pathological and histological changes. […] This study showed that investigating B. hominis had an ever-increasing trend such that 60% of the studies have been carried out in the recent decade. Therefore, it can be considered an emerging parasite. Also, a great portion of studies has been conducted on the pathogenic characteristics of this parasite, which is a required field in medical science.

• #4

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4040727/

  Blastocystis sp. is among the few enteric parasites with a prevalence that often exceeds 5% in the general population of industrialized countries and can reach 3060% in developing countries. […] Recent in vitro and in vivo studies have shed new light on the pathogenic power of this parasite, suggesting that Blastocystis sp. infection is associated with a variety of gastrointestinal disorders, may play a significant role in irritable bowel syndrome, and may be linked with cutaneous lesions (urticaria). […] The pathogenic status of Blastocystis sp. was widely debated in the literature to determine whether this microorganism was a truly pathogenic or commensal organism, although an increasingly number of recent studies cited Blastocystis sp. as an emerging pathogen. […] However, recent in vitro and in vivo studies show that Blastocystis sp. infection is associated with a variety of gastrointestinal disorders (called blastocystosis), especially in irritable bowel syndrome (IBS) and cutaneous lesions.

• #5 Blastocystis Hominis Infection: Treatment & Symptoms

  https://my.clevelandclinic.org/health/diseases/22933-blastocystis-hominis-infection-blastocystosis

  Blastocystis hominis is a single-celled parasite that infects humans and some animals. Infection with Blastocystis hominis is called blastocystosis. […] Scientists discovered Blastocystis in the early 1900s, but dont fully understand if it causes disease. It can live in the digestive tract of healthy people without causing symptoms. In some people, it may cause gastrointestinal illness. […] Blastocystosis is associated with inflammation in the digestive tract (enteritis). However, it is unclear if Blastocystis causes gastrointestinal illness or if its presence in the digestive tract is coincidental. […] The need to treat blastocystosis is unclear since its role in causing illness isn’t fully understood. […] Variable treatment success may be due to antibiotic resistance or variability between the different strains of Blastocystis. Alternatively, symptoms may be caused by another organism. […] Researchers are working to understand Blastocystis and whether it causes disease in humans.

• #6 Blastocystis hominis – Wikipedia

  https://en.wikipedia.org/wiki/Blastocystis_hominis

  Blastocystis hominis is a single-celled eukaryotic organism that inhabits the gastrointestinal tract of humans and various animals. […] Genetic studies have identified several subtypes, each with different host specificities and potential pathogenic abilities. […] The amoeboid stage, while less prevalent, is thought to play a role in pathogenicity. […] There is still disagreement among scientists on Blastocystis hominis’s capacity for pathogenicity. Abdominal pain, recurrent diarrhea, and irritable bowel syndrome (IBS) are among the often reported clinical symptoms. […] Current diagnostic techniques have progressed from basic microscopy to include molecular tools such as PCR-based techniques, since studies have indicated possible links between Blastocystis infections and changes in the gut microbiota.

• #7 Blastocystis – Wikipedia

  https://en.wikipedia.org/wiki/Blastocystis

  Blastocystis is one of the most common human parasites in the world and has a global distribution. […] Although the role of Blastocystis hominis in human disease is often referred to as controversial, a systematic survey of research studies conducted by 11 infectious disease specialists from nine countries, found that over 95% of papers published in the 10 years prior identified it as causing illness in immunocompetent individuals. […] However, Blastocystis has never fulfilled Koch’s postulate that infection of a healthy individual with Blastocystis leads to disease. […] A more likely explanation is the presence of virulent and non-virulent strains since there exists an enormous genetic variation between different strains (or genotypes). […] Some studies have suggested that pathogenicity may be linked to specific subtypes of Blastocystis and experimental infection of animals has reported varying degrees of illness depending on the subtype used.

• #8 Blastocystis hominis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/blastocystis-hominis-infection/symptoms-causes/syc-20351205

  Blastocystis is a microscopic parasite that can live in your digestive tract. Researchers don’t fully understand the role blastocystis plays, if any, in causing disease. […] It’s not clear whether blastocystis causes disease. Most people who carry the organism have no signs or symptoms, but it’s also found in people who have diarrhea and other digestive problems. […] Explanations for this variability include: Some types of blastocystis may be more likely to cause disease than others. Some people may be more vulnerable to blastocystis infection. Disease may be caused by other organisms that coexist with Blastocystis. […] Blastocystis can be passed between people and from animals to people. Transmission may be from: Contaminated food or water, Exposure to human or animal feces.

• #9

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4040727/

  In addition to aspecific gastrointestinal symptoms, studies associated the parasite with cutaneous disorders and chronic or acute urticaria. […] Blastocystis sp. is also suspected to be involved in IBS. […] Studies on the IBS population showed a higher prevalence of ST1 and ST3 isolates of Blastocystis sp. […] The presence of Blastocystis sp. in symptomatic patients can also indicate that this parasite could be involved with other factors in this disease pathophysiology. […] One of the major obstacles to the study of the pathogenesis of Blastocystis sp. is the lack of animal models to test Koch’s postulate. […] Studies on rat models suggest that this species is more suitable for developing an animal model. […] Interestingly, the moderate and severe degrees of pathological changes observed 6 weeks post infection were found only with symptomatic isolates while mild changes were found only with asymptomatic isolates.

• #10 Subtypes and phylogenetic analysis of Blastocystis sp. isolates from West Ismailia, Egypt | Scientific Reports

  https://www.nature.com/articles/s41598-022-23360-0

  The current investigation has revealed that ST3 is responsible for the vast majority of Blastocystis infections in West Ismailia, aligning with observations for other Egyptian governorates across 12 other studies, which have revealed ST3 to be the most prevalent Blastocystis subtype in six distinct Egyptian locations; furthermore, it is the ST most closely related to various gastrointestinal symptoms. […] It is unclear whether Blastocystis directly promotes a healthy gut and microbiome or whether it prefers to colonize and persist in a healthy gut environment. […] The present study’s genetic analysis reveals that all 11 isolates detected in Blastocystis subtypes cross-corresponded to previously observed alleles. […] A phylogenetic tree demonstrated that the 11 nucleotide sequences in this study clustered into the same subtype cluster, with high bootstrap support, and could be classified into three subtypes: ST1, ST2, and ST3.

• #11 Update on the pathogenic potential and treatment options for Blastocystis sp | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17

  A study in Colombia showed that 100% of patients with diarrhoea had ST2 where asymptomatic people all had ST1. […] There have been two previous studies that have suggested ST4 to be a pathogenic strain due to the high incidence of this ST in patients with severe diarrhoea. […] These studies highlight the need for more research in to the relationship between ST and symptoms. […] The whole genome for ST7 has been described. […] This genome has shed light on some important processes identifying genes coding for proteins that are responsible for host protease inhibition. […] Further information will be gathered as more genomes are described that can help determine the role of genes in the potential pathogenicity of Blastocystis. […] Several lines of evidence shed light on the possible mechanisms of pathogenesis.

• #12 Update on the pathogenic potential and treatment options for Blastocystis sp | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17

  A study in Colombia showed that 100% of patients with diarrhoea had ST2 where asymptomatic people all had ST1. […] There have been two previous studies that have suggested ST4 to be a pathogenic strain due to the high incidence of this ST in patients with severe diarrhoea. […] These studies highlight the need for more research in to the relationship between ST and symptoms. […] The whole genome for ST7 has been described. […] This genome has shed light on some important processes identifying genes coding for proteins that are responsible for host protease inhibition. […] Further information will be gathered as more genomes are described that can help determine the role of genes in the potential pathogenicity of Blastocystis. […] Several lines of evidence shed light on the possible mechanisms of pathogenesis.

• #13 Blastocystis hominis: A Pathogenic Parasite

  https://brieflands.com/articles/archcid-97388

  Pathogenic subtypes have larger sizes and coarser surfaces and grow faster in culture medium when compared to the non-pathogenic subtypes. […] Increased secretion of this enzyme leads to greater pathogenicity of the parasite. […] In addition, B. hominis stimulates the apoptosis of host cells, which disturbs their performance. […] The bleeding caused by enteropathy in the rectal area of a four-year-old girl, where B. hominis was the only identified agent that penetrated the superficial layer of the intestinal mucosa and glandular space accompanied by the leakage of inflammatory cells, treated by metronidazole, could verify the claim that this parasite can cause such a disorder. […] All of the above-mentioned materials can partly indicate the role of B. hominis in the development of clinical symptoms and support its pathogenesis.

• #14 Update on the pathogenic potential and treatment options for Blastocystis sp | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17

  Cysteine proteases play important functional roles in invasion of host cells, immune evasion, pathogenesis, virulence and cell cycle regulation. […] These results suggest the possibility of Blastocystis proteases as virulence factors and that they contribute to parasite survival in vivo by degrading neutralising mucosal antibodies. […] A recent study on the effect of Blastocystis on the expression of interferon gamma and proinflammatory cytokines in the cecal mucosa of rats showed a significantly upregulated amount of gene transcription of type 1 and proinflammatory cytokines IFN-, IL-12 and TNF-. […] These studies show how animals can be used as a good model for pathogenicity but it is important to take in to consideration that mice are not naturally infected with Blastocystis unlike rats which are commonly found to harbour Blastocystis.

• #15 Blastocystis hominis: A Pathogenic Parasite

  https://brieflands.com/articles/archcid-97388

  Pathogenic subtypes have larger sizes and coarser surfaces and grow faster in culture medium when compared to the non-pathogenic subtypes. […] Increased secretion of this enzyme leads to greater pathogenicity of the parasite. […] In addition, B. hominis stimulates the apoptosis of host cells, which disturbs their performance. […] The bleeding caused by enteropathy in the rectal area of a four-year-old girl, where B. hominis was the only identified agent that penetrated the superficial layer of the intestinal mucosa and glandular space accompanied by the leakage of inflammatory cells, treated by metronidazole, could verify the claim that this parasite can cause such a disorder. […] All of the above-mentioned materials can partly indicate the role of B. hominis in the development of clinical symptoms and support its pathogenesis.

• #16 Update on the pathogenic potential and treatment options for Blastocystis sp | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17

  Cysteine proteases play important functional roles in invasion of host cells, immune evasion, pathogenesis, virulence and cell cycle regulation. […] These results suggest the possibility of Blastocystis proteases as virulence factors and that they contribute to parasite survival in vivo by degrading neutralising mucosal antibodies. […] A recent study on the effect of Blastocystis on the expression of interferon gamma and proinflammatory cytokines in the cecal mucosa of rats showed a significantly upregulated amount of gene transcription of type 1 and proinflammatory cytokines IFN-, IL-12 and TNF-. […] These studies show how animals can be used as a good model for pathogenicity but it is important to take in to consideration that mice are not naturally infected with Blastocystis unlike rats which are commonly found to harbour Blastocystis.

• #17 Low efficacy of metronidazole in the eradication of Blastocystis hominis in symptomatic patients: Case series and systematic literature review | Gastroenterología y Hepatología (English Edition)

  https://www.elsevier.es/pt-revista-gastroenterologia-hepatologia-english-edition–382-articulo-low-efficacy-metronidazole-in-eradication-S2444382417301049

  Studies in vivo have shown that these proteases may inhibit the production of immunoglobulin A in the intestinal mucosa, thereby contributing to the survival of the parasite. […] The microbiological response to MTZ treatment is insufficient in our geographical setting. […] The systematic review shows that the response to MTZ is very variable. […] In conclusion, there appears to be a relationship between clinical response and microbiological response to B. hominis treatment. This shows the parasite’s causative role.

• #18

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4040727/

  It was suggested that the inflammation induced by Blastocystis sp. had the ability to alter tight junctions between the intestinal epithelial cells and the intestinal content, which led to disturbances of the barrier function and permeability. […] A first study showed that 24h incubation with Blastocystis sp. ST1 cells or culture filtrates induced the production of proinflammatory cytokines interleukin (IL)-8 and granulocyte-macrophage colony-stimulating factor, suggesting that the parasite was able to modulate the host immune response. […] These data suggest that Blastocystis sp. is able to disturb host gut homeostasis. […] Cysteine proteases of Blastocystis sp. should be involved in parasite survival in vivo and represent virulence factors. […] These secreted proteases are serious candidates to explain gut function disruption observed in intestinal pathologies. […] The next challenge is to understand the role of Blastocystis sp. in gut dysfunctions.

• #19

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4040727/

  It was suggested that the inflammation induced by Blastocystis sp. had the ability to alter tight junctions between the intestinal epithelial cells and the intestinal content, which led to disturbances of the barrier function and permeability. […] A first study showed that 24h incubation with Blastocystis sp. ST1 cells or culture filtrates induced the production of proinflammatory cytokines interleukin (IL)-8 and granulocyte-macrophage colony-stimulating factor, suggesting that the parasite was able to modulate the host immune response. […] These data suggest that Blastocystis sp. is able to disturb host gut homeostasis. […] Cysteine proteases of Blastocystis sp. should be involved in parasite survival in vivo and represent virulence factors. […] These secreted proteases are serious candidates to explain gut function disruption observed in intestinal pathologies. […] The next challenge is to understand the role of Blastocystis sp. in gut dysfunctions.

• #20 Update on the pathogenic potential and treatment options for Blastocystis sp | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17

  Cysteine proteases play important functional roles in invasion of host cells, immune evasion, pathogenesis, virulence and cell cycle regulation. […] These results suggest the possibility of Blastocystis proteases as virulence factors and that they contribute to parasite survival in vivo by degrading neutralising mucosal antibodies. […] A recent study on the effect of Blastocystis on the expression of interferon gamma and proinflammatory cytokines in the cecal mucosa of rats showed a significantly upregulated amount of gene transcription of type 1 and proinflammatory cytokines IFN-, IL-12 and TNF-. […] These studies show how animals can be used as a good model for pathogenicity but it is important to take in to consideration that mice are not naturally infected with Blastocystis unlike rats which are commonly found to harbour Blastocystis.

• #21 Update on the pathogenic potential and treatment options for Blastocystis sp | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17

  There have been several hypotheses and increasing studies in the last few years relating the incidence of Blastocystis infections with the prevalence of irritable bowel syndrome (IBS) in patients. […] It has been proposed that a possible mechanism for the IBS- like symptoms might be the low-grade inflammation through persistent antigenic exposure in a chronic Blastocystis infection. […] It has also been suggested that polymorphisms in genes encoding inflammatory cytokines might have a role in the pathophysiology of IBS. […] A recent study has suggested that there is a role in the etiology of IBS from the association between IL-8 and IL-10 gene polymorphisms in IBS-Blastocystis carriers. […] Treatment should be considered if there are chronic symptoms of diarrhoea and abdominal pain in the absence of other pathogens identified from the stool sample. […] There may be a correlation between ST and sensitivity to drugs which is yet to be addressed in studies.

• #22 Blastocystis hominis: A Pathogenic Parasite

  https://brieflands.com/articles/archcid-97388

  Pathogenic subtypes have larger sizes and coarser surfaces and grow faster in culture medium when compared to the non-pathogenic subtypes. […] Increased secretion of this enzyme leads to greater pathogenicity of the parasite. […] In addition, B. hominis stimulates the apoptosis of host cells, which disturbs their performance. […] The bleeding caused by enteropathy in the rectal area of a four-year-old girl, where B. hominis was the only identified agent that penetrated the superficial layer of the intestinal mucosa and glandular space accompanied by the leakage of inflammatory cells, treated by metronidazole, could verify the claim that this parasite can cause such a disorder. […] All of the above-mentioned materials can partly indicate the role of B. hominis in the development of clinical symptoms and support its pathogenesis.

• #23 Site-Specific Incidence Rate of Blastocystis hominis and Its Association with Childhood Malnutrition: Findings from a Multi-Country Birth Cohort Study in: The American Journal of Tropical Medicine and Hygiene Volume 108 Issue 5 (2023)

  https://www.ajtmh.org/view/journals/tpmd/108/5/article-p887.xml

  In this study, we investigated the potential association between the burden of asymptomatic Blastocystis spp. (Blastocystis hominis) infection and nutritional status among children under 2 years of age using the data collected from 1,715 children from eight distinct geographic locations, including Bangladesh, Brazil, India, Peru, Tanzania, Pakistan, Nepal, and South Africa. […] Our analysis further reveals that the presence of additional pathogens may play a pathogenic role in children who have B. hominis infection. […] However, it has also been associated with a decrease in protective bacteria in the feces, such as Bifidobacterium spp. and Faecalibacterium prausnitzii. […] Moreover, other researchers have attributed B. hominis to irritable bowel syndrome and inflammatory bowel disease as well as watery diarrhea, stomach pain, meteorism, a lack of appetite, and constipation.

• #24 Interactions between a pathogenic Blastocystis subtype and gut microbiota: in vitro and in vivo studies | Microbiome | Full Text

  https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-019-0644-3

  Generally, Blastocystis ST7 exerts a positive effect on the viability of representative gut bacteria except on Bifidobacterium longum. […] This study shows that particular isolates of Blastocystis ST7 cause changes in microbiota populations and potentially lead to an imbalance of the gut microbiota. […] This study suggests that certain isolates of Blastocystis exert their pathogenic effects through disruption of the gut microbiota and provides a counterpoint to the increasing reports indicating the commensal nature of this ubiquitous parasite. […] With these in mind, the current study explored the interactions between a particular ST of Blastocystis, ST7, and prokaryotic representatives of the gut microbiota. […] In vitro culture assays also revealed that ST7, but not ST4 isolates, could compromise the intestinal epithelial barrier.

• #25 Interactions between a pathogenic Blastocystis subtype and gut microbiota: in vitro and in vivo studies | Microbiome | Full Text

  https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-019-0644-3

  This ST appears rarely in surveys but has been reported to be strongly associated with gastrointestinal symptoms. […] The results of this study indicated that Blastocystis can disrupt gut microbiota populations particularly decreasing the content of Bifidobacteria and Lactobacillus but increasing Escherichia coli. […] Our data indicates that while Blastocystis spp. may be a member of healthy gut microbiota, specific isolates or rare ST may disrupt homeostasis leading to pathological states in the host. […] The presence of Blastocystis further increased the CFU of E. coli, while B. longum displayed significantly lower colony-forming unit per milliliter compared to controls when incubated with E. coli, which was further reduced by both Blastocystis ST7-B and ST7-H. […] Our results, however, do not exclude other mechanisms of Blastocystis- and E. coli-mediated killing of B. longum.

• #26 Interactions between a pathogenic Blastocystis subtype and gut microbiota: in vitro and in vivo studies | Microbiome | Full Text

  https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-019-0644-3

  This ST appears rarely in surveys but has been reported to be strongly associated with gastrointestinal symptoms. […] The results of this study indicated that Blastocystis can disrupt gut microbiota populations particularly decreasing the content of Bifidobacteria and Lactobacillus but increasing Escherichia coli. […] Our data indicates that while Blastocystis spp. may be a member of healthy gut microbiota, specific isolates or rare ST may disrupt homeostasis leading to pathological states in the host. […] The presence of Blastocystis further increased the CFU of E. coli, while B. longum displayed significantly lower colony-forming unit per milliliter compared to controls when incubated with E. coli, which was further reduced by both Blastocystis ST7-B and ST7-H. […] Our results, however, do not exclude other mechanisms of Blastocystis- and E. coli-mediated killing of B. longum.

• #27 Blastocystis hominis: A Pathogenic Parasite

  https://brieflands.com/articles/archcid-97388

  Pathogenic subtypes have larger sizes and coarser surfaces and grow faster in culture medium when compared to the non-pathogenic subtypes. […] Increased secretion of this enzyme leads to greater pathogenicity of the parasite. […] In addition, B. hominis stimulates the apoptosis of host cells, which disturbs their performance. […] The bleeding caused by enteropathy in the rectal area of a four-year-old girl, where B. hominis was the only identified agent that penetrated the superficial layer of the intestinal mucosa and glandular space accompanied by the leakage of inflammatory cells, treated by metronidazole, could verify the claim that this parasite can cause such a disorder. […] All of the above-mentioned materials can partly indicate the role of B. hominis in the development of clinical symptoms and support its pathogenesis.

• #28

  https://link.springer.com/article/10.1007/s00436-010-1922-y

  Blastocystis hominis is a ubiquitous enteric protozoan whose pathogenic potential is still controversial. […] This study was carried out to clarify the pathogenecity of B. hominis infection and to study the proper number of parasites for mice infection. […] Histopathological examination of large intestine on highly infected group (GIII) showed that B. hominis infiltrated the lamina propria, the submucosa, and the muscle layers in the form of collection of vacuolar forms. […] In conclusion, this study revealed that large number of B. hominis is essential for oral infection of mice and that vacuolar forms of B. hominis can invade the lamina propria, the submucosa, and even the muscle layers.

• #29

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4040727/

  In addition to aspecific gastrointestinal symptoms, studies associated the parasite with cutaneous disorders and chronic or acute urticaria. […] Blastocystis sp. is also suspected to be involved in IBS. […] Studies on the IBS population showed a higher prevalence of ST1 and ST3 isolates of Blastocystis sp. […] The presence of Blastocystis sp. in symptomatic patients can also indicate that this parasite could be involved with other factors in this disease pathophysiology. […] One of the major obstacles to the study of the pathogenesis of Blastocystis sp. is the lack of animal models to test Koch’s postulate. […] Studies on rat models suggest that this species is more suitable for developing an animal model. […] Interestingly, the moderate and severe degrees of pathological changes observed 6 weeks post infection were found only with symptomatic isolates while mild changes were found only with asymptomatic isolates.

• #30

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4040727/

  In addition to aspecific gastrointestinal symptoms, studies associated the parasite with cutaneous disorders and chronic or acute urticaria. […] Blastocystis sp. is also suspected to be involved in IBS. […] Studies on the IBS population showed a higher prevalence of ST1 and ST3 isolates of Blastocystis sp. […] The presence of Blastocystis sp. in symptomatic patients can also indicate that this parasite could be involved with other factors in this disease pathophysiology. […] One of the major obstacles to the study of the pathogenesis of Blastocystis sp. is the lack of animal models to test Koch’s postulate. […] Studies on rat models suggest that this species is more suitable for developing an animal model. […] Interestingly, the moderate and severe degrees of pathological changes observed 6 weeks post infection were found only with symptomatic isolates while mild changes were found only with asymptomatic isolates.

• #31 Stress Exacerbates Infectivity and Pathogenicity of Blastocystis hominis: In Vitro and In Vivo Evidences | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0094567

  Stress alters the oxidant-antioxidant state and immune cell responses which disrupts its function to combat infection. […] The pathogenicity and augmentation of B. hominis infection is enhanced when stress is present. […] Stress increased the susceptibility towards B. hominis infection by suppressing the hosts’ immune system. […] Stress enhanced the susceptibility and pathogenicity of B. hominis by suppressing or dysregulating responses of PBMC and immunoglobulins. […] Stress mediated augmentation of B. hominis by causing imbalance in the host’s oxidant-antioxidant system.

• #32 Stress Exacerbates Infectivity and Pathogenicity of Blastocystis hominis: In Vitro and In Vivo Evidences | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0094567

  Stress alters the oxidant-antioxidant state and immune cell responses which disrupts its function to combat infection. […] The pathogenicity and augmentation of B. hominis infection is enhanced when stress is present. […] Stress increased the susceptibility towards B. hominis infection by suppressing the hosts’ immune system. […] Stress enhanced the susceptibility and pathogenicity of B. hominis by suppressing or dysregulating responses of PBMC and immunoglobulins. […] Stress mediated augmentation of B. hominis by causing imbalance in the host’s oxidant-antioxidant system.

• #33 Blastocystis Hominis – Healthpath

  https://healthpath.com/gut-health/blastocystis-hominis/

  Given that Blastocystis can synthesize tryptophan, researchers hypothesise that infection with these parasites may have the ability to influence behaviour and mood within the host. […] Psychological and emotional stress can influence Blastocystis hominis infection by weakening the immune system and disrupting gut health, creating an environment that may favour the parasites persistence. Chronic stress triggers the hypothalamic-pituitary-adrenal (HPA) axis, leading to increased cortisol production, which can impair immune responses and reduce the body’s ability to eliminate pathogens like Blastocystis. Additionally, stress alters the gut microbiome by promoting dysbiosis (an imbalance of gut bacteria), increasing intestinal permeability (leaky gut), and affecting digestive processes, all of which may contribute to the parasites survival and potential pathogenicity.

• #34 Site-Specific Incidence Rate of Blastocystis hominis and Its Association with Childhood Malnutrition: Findings from a Multi-Country Birth Cohort Study in: The American Journal of Tropical Medicine and Hygiene Volume 108 Issue 5 (2023)

  https://www.ajtmh.org/view/journals/tpmd/108/5/article-p887.xml

  Furthermore, B. hominis may have a pathogenic role in immunocompromised patients. […] Studies have linked the parasite to cutaneous disorders and chronic or acute urticaria, in addition to atypical gastrointestinal symptoms. […] As a result, B. hominis can be an opportunistic organism that can have a negative impact on gut health when other pathogens are present. […] Hence, evidence of its pathogenicity in humans is speculative and inconclusive. […] Although there is still debate about its pathogenicity, recent research supports the pathogenicity of B. hominis in causing clinical symptoms in the absence of other intestinal infections. […] Our findings revealed a significant disparity in the prevalence of asymptomatic B. hominis infections, with incidence rates per 100 child-months being higher in Tanzania, Peru, and South Africa.

• #35 Update on the pathogenic potential and treatment options for Blastocystis sp | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17

  Most of these studies show that Blastocystis is not higher in the HIV/AIDS population than what was previously found in normal populations with Blastocystis incidence ranging from 6-70% in developing counties. […] This study raises the possibility of opportunistic infections of Blastocystis in immunocompromised people. […] These studies show how Blastocystis can easily be an opportunistic infection. […] It has also been proposed that the different STs of Blastocystis have varying susceptibility to antimicrobial drugs. […] Although these studies give varying results in respect to Blastocystis infection in HIV/AIDS patients, this parasite should still be considered as a cause of diarrhoea in these cases and shows the significance of parasite infection in immunosuppressed patients. […] A study on cancer patients and Blastocystis infection showed that Blastocystis was acquired after the commencement of chemotherapy treatment.

• #36 Update on the pathogenic potential and treatment options for Blastocystis sp | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17

  Most of these studies show that Blastocystis is not higher in the HIV/AIDS population than what was previously found in normal populations with Blastocystis incidence ranging from 6-70% in developing counties. […] This study raises the possibility of opportunistic infections of Blastocystis in immunocompromised people. […] These studies show how Blastocystis can easily be an opportunistic infection. […] It has also been proposed that the different STs of Blastocystis have varying susceptibility to antimicrobial drugs. […] Although these studies give varying results in respect to Blastocystis infection in HIV/AIDS patients, this parasite should still be considered as a cause of diarrhoea in these cases and shows the significance of parasite infection in immunosuppressed patients. […] A study on cancer patients and Blastocystis infection showed that Blastocystis was acquired after the commencement of chemotherapy treatment.

• #37 Update on the pathogenic potential and treatment options for Blastocystis sp | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17

  Most of these studies show that Blastocystis is not higher in the HIV/AIDS population than what was previously found in normal populations with Blastocystis incidence ranging from 6-70% in developing counties. […] This study raises the possibility of opportunistic infections of Blastocystis in immunocompromised people. […] These studies show how Blastocystis can easily be an opportunistic infection. […] It has also been proposed that the different STs of Blastocystis have varying susceptibility to antimicrobial drugs. […] Although these studies give varying results in respect to Blastocystis infection in HIV/AIDS patients, this parasite should still be considered as a cause of diarrhoea in these cases and shows the significance of parasite infection in immunosuppressed patients. […] A study on cancer patients and Blastocystis infection showed that Blastocystis was acquired after the commencement of chemotherapy treatment.

• #38 Update on the pathogenic potential and treatment options for Blastocystis sp | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17

  There have been several hypotheses and increasing studies in the last few years relating the incidence of Blastocystis infections with the prevalence of irritable bowel syndrome (IBS) in patients. […] It has been proposed that a possible mechanism for the IBS- like symptoms might be the low-grade inflammation through persistent antigenic exposure in a chronic Blastocystis infection. […] It has also been suggested that polymorphisms in genes encoding inflammatory cytokines might have a role in the pathophysiology of IBS. […] A recent study has suggested that there is a role in the etiology of IBS from the association between IL-8 and IL-10 gene polymorphisms in IBS-Blastocystis carriers. […] Treatment should be considered if there are chronic symptoms of diarrhoea and abdominal pain in the absence of other pathogens identified from the stool sample. […] There may be a correlation between ST and sensitivity to drugs which is yet to be addressed in studies.

• #39 Update on the pathogenic potential and treatment options for Blastocystis sp | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17

  There have been several hypotheses and increasing studies in the last few years relating the incidence of Blastocystis infections with the prevalence of irritable bowel syndrome (IBS) in patients. […] It has been proposed that a possible mechanism for the IBS- like symptoms might be the low-grade inflammation through persistent antigenic exposure in a chronic Blastocystis infection. […] It has also been suggested that polymorphisms in genes encoding inflammatory cytokines might have a role in the pathophysiology of IBS. […] A recent study has suggested that there is a role in the etiology of IBS from the association between IL-8 and IL-10 gene polymorphisms in IBS-Blastocystis carriers. […] Treatment should be considered if there are chronic symptoms of diarrhoea and abdominal pain in the absence of other pathogens identified from the stool sample. […] There may be a correlation between ST and sensitivity to drugs which is yet to be addressed in studies.

• #40 Frontiers | The regulatory function of Blastocystis spp. on the immune inflammatory response in the gut microbiome

  https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2022.967724/full

  Some initial reports indicate that Blastocystis infection might be related to the inflammatory state of the intestine that is typical of the irritable bowel syndrome (IBS). […] Apparently, Blastocystis has developed ways to take advantage of the host immune inflammatory response to settler and to continue host colonization without causing disease. […] The human gut microbial community comprises a highly complex ecosystem. […] In the intestine, Blastocystis has an interplay with the intestinal epithelium and the underlying immune system. […] It seems that the interaction of Blastocystis in the intestine stablished an anti-inflammatory habitat. […] On the basis of these studies and although they are scarce until now, it seems that Blastocystis and some specific subtypes could generate an anti-inflammatory scenario, of course, future research on this issue is required to elucidate how this microorganism interacts with the host immune inflammatory response.

• #41 Update on the pathogenic potential and treatment options for Blastocystis sp | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17

  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. […] 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. […] The most common symptoms associated with Blastocystis infection include diarrhoea, abdominal pain and vomiting. […] There have been several case reports suggesting that Blastocystis is related to urticaria. […] It was recently suggested that gastrointestinal symptoms related to Blastocystis might be ST related but results remain inconclusive.

• #42 Site-Specific Incidence Rate of Blastocystis hominis and Its Association with Childhood Malnutrition: Findings from a Multi-Country Birth Cohort Study in: The American Journal of Tropical Medicine and Hygiene Volume 108 Issue 5 (2023)

  https://www.ajtmh.org/view/journals/tpmd/108/5/article-p887.xml

  Furthermore, B. hominis may have a pathogenic role in immunocompromised patients. […] Studies have linked the parasite to cutaneous disorders and chronic or acute urticaria, in addition to atypical gastrointestinal symptoms. […] As a result, B. hominis can be an opportunistic organism that can have a negative impact on gut health when other pathogens are present. […] Hence, evidence of its pathogenicity in humans is speculative and inconclusive. […] Although there is still debate about its pathogenicity, recent research supports the pathogenicity of B. hominis in causing clinical symptoms in the absence of other intestinal infections. […] Our findings revealed a significant disparity in the prevalence of asymptomatic B. hominis infections, with incidence rates per 100 child-months being higher in Tanzania, Peru, and South Africa.

• #43 Chronic urticaria and blastocystis hominis infection. A case report

  https://www.europeanreview.org/article/119

  We report a case of a 45 year old woman which fulfilled the criteria of chronic urticaria (remitting and relapsing bouts of erythematous and pruriginuos lesions without angioedema, lasted four months). […] Finally coprocolture disclosed the presence of Blastocystis hominis in stool samples thus permitting to associate urticaria to parasitic infection. […] A large number of parasites have been correlated with urticaria but few data exist as regards Blastocystis hominis infection; then our findings may add evidence to the role of this parasite in inducing chronic urticaria. Considering that Blastocystis hominis is a modest pathogen for humans, the mechanism is probably the typical one of cutaneous allergic hypersensitivity; antigen parasites induce the activation of specific clones of Th2 lymphocytes, the release of related cytokines and the consequent IgE production.

• #44 Chronic urticaria and blastocystis hominis infection. A case report

  https://www.europeanreview.org/article/119

  We report a case of a 45 year old woman which fulfilled the criteria of chronic urticaria (remitting and relapsing bouts of erythematous and pruriginuos lesions without angioedema, lasted four months). […] Finally coprocolture disclosed the presence of Blastocystis hominis in stool samples thus permitting to associate urticaria to parasitic infection. […] A large number of parasites have been correlated with urticaria but few data exist as regards Blastocystis hominis infection; then our findings may add evidence to the role of this parasite in inducing chronic urticaria. Considering that Blastocystis hominis is a modest pathogen for humans, the mechanism is probably the typical one of cutaneous allergic hypersensitivity; antigen parasites induce the activation of specific clones of Th2 lymphocytes, the release of related cytokines and the consequent IgE production.

• #45 Reactive Arthritis Caused by Blastocistys hominis | Reumatología Clínica

  https://reumatologiaclinica.org/en-reactive-arthritis-caused-by-blastocistys-articulo-S2173574312000032

  Reactive arthritis is defined as an acute arthritis caused by enteric or genitourinary infection. This infection usually precedes arthritis by a month. […] Here we report a case of reactive arthritis due to Blastocystis hominis in immunocompetent patients. […] Protozoal reactive arthritis is rare. The microorganisms most frequently implicated are Giardia lamblia, Entamoeba histolytica, Trichomonas vaginalis, Toxoplasma gondii, and rarely, B. hominis. This is a protozoa that is transmitted between animals and humans by ingestion of cysts in water or food contaminated by a carrier. Its pathogenic role is not universally accepted, but has been associated with episodes of diarrhea and extraintestinal manifestations, and its relationship with reactive arthritis is less common. […] The mechanisms by which different parasites can cause joint disease are multiple. For example, local invasion from neighboring bones or muscles, via the blood or lymphatic with the presence of adult individuals, larvae or eggs in the joint cavity. They could also trigger a reactive inflammatory reaction to the presence of the parasite in the surrounding tissue, without an actual joint invasion. In our case, we assume that the latter was the most likely mechanism of action of B. hominis. […] On the other hand, some authors use the term parasitic rheumatism in the case of inflammatory conditions without the presence of the parasite in the joint or in its vicinity, probably triggered by an immune mechanism.

• #46 Site-Specific Incidence Rate of Blastocystis hominis and Its Association with Childhood Malnutrition: Findings from a Multi-Country Birth Cohort Study in: The American Journal of Tropical Medicine and Hygiene Volume 108 Issue 5 (2023)

  https://www.ajtmh.org/view/journals/tpmd/108/5/article-p887.xml

  According to a recent study, B. hominis infection can cause growth retardation, deterioration in cognitive and learning abilities, and a reduction in children’s quality of life. […] Infection with B. hominis is becoming increasingly widely recognized as a severe threat to human health, and some B. hominis subtypes are pathogenic. […] Our result is consistent with a recent cross-sectional study of Australian aboriginal children aged 0-2 years that revealed an inverse relationship between B. hominis infection and height-for-age z-scores. […] It can be interpreted that, in the presence of other pathogens, B. hominis damages the intestinal mucosa, resulting in reduced nutrient absorption and growth failure. […] Our analysis also exhibited that the odds of B. hominis infection are higher in the presence of ETEC, aEPEC, and tEPEC (organisms known for causing gut infections and altered intestinal health). […] Consequently, the burden of asymptomatic B. hominis infection was significantly associated with underweight in Bangladesh, Brazil, Nepal, and Tanzania.

• #47 Site-Specific Incidence Rate of Blastocystis hominis and Its Association with Childhood Malnutrition: Findings from a Multi-Country Birth Cohort Study in: The American Journal of Tropical Medicine and Hygiene Volume 108 Issue 5 (2023)

  https://www.ajtmh.org/view/journals/tpmd/108/5/article-p887.xml

  According to a recent study, B. hominis infection can cause growth retardation, deterioration in cognitive and learning abilities, and a reduction in children’s quality of life. […] Infection with B. hominis is becoming increasingly widely recognized as a severe threat to human health, and some B. hominis subtypes are pathogenic. […] Our result is consistent with a recent cross-sectional study of Australian aboriginal children aged 0-2 years that revealed an inverse relationship between B. hominis infection and height-for-age z-scores. […] It can be interpreted that, in the presence of other pathogens, B. hominis damages the intestinal mucosa, resulting in reduced nutrient absorption and growth failure. […] Our analysis also exhibited that the odds of B. hominis infection are higher in the presence of ETEC, aEPEC, and tEPEC (organisms known for causing gut infections and altered intestinal health). […] Consequently, the burden of asymptomatic B. hominis infection was significantly associated with underweight in Bangladesh, Brazil, Nepal, and Tanzania.

• #48 Site-Specific Incidence Rate of Blastocystis hominis and Its Association with Childhood Malnutrition: Findings from a Multi-Country Birth Cohort Study in: The American Journal of Tropical Medicine and Hygiene Volume 108 Issue 5 (2023)

  https://www.ajtmh.org/view/journals/tpmd/108/5/article-p887.xml

  According to a recent study, B. hominis infection can cause growth retardation, deterioration in cognitive and learning abilities, and a reduction in children’s quality of life. […] Infection with B. hominis is becoming increasingly widely recognized as a severe threat to human health, and some B. hominis subtypes are pathogenic. […] Our result is consistent with a recent cross-sectional study of Australian aboriginal children aged 0-2 years that revealed an inverse relationship between B. hominis infection and height-for-age z-scores. […] It can be interpreted that, in the presence of other pathogens, B. hominis damages the intestinal mucosa, resulting in reduced nutrient absorption and growth failure. […] Our analysis also exhibited that the odds of B. hominis infection are higher in the presence of ETEC, aEPEC, and tEPEC (organisms known for causing gut infections and altered intestinal health). […] Consequently, the burden of asymptomatic B. hominis infection was significantly associated with underweight in Bangladesh, Brazil, Nepal, and Tanzania.

• #49 Site-Specific Incidence Rate of Blastocystis hominis and Its Association with Childhood Malnutrition: Findings from a Multi-Country Birth Cohort Study in: The American Journal of Tropical Medicine and Hygiene Volume 108 Issue 5 (2023)

  https://www.ajtmh.org/view/journals/tpmd/108/5/article-p887.xml

  According to a recent study, B. hominis infection can cause growth retardation, deterioration in cognitive and learning abilities, and a reduction in children’s quality of life. […] Infection with B. hominis is becoming increasingly widely recognized as a severe threat to human health, and some B. hominis subtypes are pathogenic. […] Our result is consistent with a recent cross-sectional study of Australian aboriginal children aged 0-2 years that revealed an inverse relationship between B. hominis infection and height-for-age z-scores. […] It can be interpreted that, in the presence of other pathogens, B. hominis damages the intestinal mucosa, resulting in reduced nutrient absorption and growth failure. […] Our analysis also exhibited that the odds of B. hominis infection are higher in the presence of ETEC, aEPEC, and tEPEC (organisms known for causing gut infections and altered intestinal health). […] Consequently, the burden of asymptomatic B. hominis infection was significantly associated with underweight in Bangladesh, Brazil, Nepal, and Tanzania.

• #50 The role of Blastocystis hominis in the activation of ulcerative colitis

  https://turkjgastroenterol.org/en/the-role-of-blastocystis-hominis-in-the-activation-of-ulcerative-colitis-135515

  Several studies have shown that a change in microbiota plays an important role in the pathogenesis of inflammatory bowel disease (IBD). […] The aim of the present study was to determine the role of B. hominis in the acute flare-up of ulcerative colitis (UC). […] B. hominis positivity was determined in 37 (34%) patients with UC. […] The results of the present study showed that while there was no difference between the active and remission phases in respect of B. hominis presence, there was milder involvement in those determined with B. hominis.

• #51 Blastocystosis – Protozoal Diseases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.84.2.5.

  Blastocystosis is a disease of the large intestine caused by the protozoal parasite Blastocystis hominis. […] The pathogenesis of blastocystosis remains unclear and the pathogenicity of B hominis is debatable. Cases with intestinal mucosal edema and inflammation and cases with colonic ulcerations have been reported; however, some data suggest that B hominis may be normal flora in those with healthy diets and is in fact associated with better cardiometabolic outcomes. […] B hominis is a saprophytic protozoan largely considered nonpathogenic, and the infection usually does not require specific treatment. […] Invasive colonic disease and GI bleeding may occur in the very rare cases of acute infection. B hominis may cause exacerbations of ulcerative colitis.

• #52

  https://journals.lww.com/infectdis/fulltext/2021/01000/predominance_of_infection_with_blastocystis.7.aspx?generateEpub=Article%7Cinfectdis:2021:01000:00007%7C10.1097/ipc.0000000000000931%7C

  Blastocystis hominis is a unicellular protozoan parasite with a worldwide distribution. It was hypothesized that the infection with B. hominis plays a role in the pathogenesis of colorectal cancer in humans. […] The findings of our study support the hypothesis that the infection with B. hominis has a possible role in the pathogenesis of colorectal cancer because it increases inflammatory cells infiltration and proinflammatory cytokines (tumor necrosis factor) in the study’s setting. This possibility demands future cohort prospective studies to prove whether the infection induces the colonic tissue to form a tumor or exacerbates the existing tumor.

• #53 Blastocystis Hominis – Healthpath

  https://healthpath.com/gut-health/blastocystis-hominis/

  Blastocystis hominis is a common parasite found in the gastrointestinal tract of humans and animals. Despite being one of the most frequently detected gut parasites globally, its role in health and disease is still debated. Some consider it a harmless commensal organism, while others link it to various gastrointestinal symptoms. […] Some studies link Blastocystis to irritable bowel syndrome (IBS)-like symptoms and inflammatory bowel diseases (IBD). For instance, a higher prevalence of Blastocystis has been observed in patients with IBS. […] Discussed within this review is lab studies (conducted in test tubes) that have shown certain proteins from Blastocystis hominis can cause harmful effects on human colon cancer cells. These effects include damage to the cells and changes in the immune response. The research suggests that an infection with B. hominis might make colon cancer cells grow faster, spread more easily, and become more aggressive.

• #54

  https://mjs.uomustansiriyah.edu.iq/index.php/MJS/article/view/1410

  Blastocystis hominis is a microscopic single-celled organism commonly known as a protist or parasite. […] The objective of this study was to examine the presence of the Blastocystis hominis parasite in the stool samples of patients experiencing diarrhea and to explore its potential physiological effects. […] The physiological examinations were conducted using Spectrophotometer revealed notable findings. There was a significant increase (P0.01) in the levels of cholesterol, low-density lipoproteins-cholesterol (LDL), very low-density lipoproteins (VLDL), and triglycerides (TG), in patients with diarrhea infected with B. hominis compared to the control group. Conversely, concentrations of magnesium, zinc, and high-density lipoproteins (HDL) showed a significant decrease (P0.01) in the same patient group compared to the control group. […] E. Badparva and F. Kheirandish, „Blastocystis hominis: A pathogenic parasite,” Archives of Clinical Infectious Diseases, vol. 15, no. 4, 2020.

• #55 Is Blastocystis Hominis Bad? Diagnosis, Causes & Treatment – SelfDecode Health

  https://health.selfdecode.com/blog/blastocystis-hominis-bad-worried/

  Remember that research hasnt yet determined whether Blastocystis hominis can contribute to any symptom or disease. […] The majority of studies covered in this article deal with associations only, which means that a cause-and-effect relationship hasnt been established. […] In one small study, women found to have Blastocystis Hominis in their intestines were more likely to have iron deficiency anemia than women who were not infected. […] Blastocystis Hominis was shown to lower magnesium levels in one small human study. Larger studies would need to verify this association. […] There are no proven treatments for Blastocystis hominis infection. […] Metronidazole is hypothesized to induce programmed cell death in Blastocystis. […] However, in some patients, the parasite might become resistant to the antibiotic.

• #56 Is Blastocystis Hominis Bad? Diagnosis, Causes & Treatment – SelfDecode Health

  https://health.selfdecode.com/blog/blastocystis-hominis-bad-worried/

  Remember that research hasnt yet determined whether Blastocystis hominis can contribute to any symptom or disease. […] The majority of studies covered in this article deal with associations only, which means that a cause-and-effect relationship hasnt been established. […] In one small study, women found to have Blastocystis Hominis in their intestines were more likely to have iron deficiency anemia than women who were not infected. […] Blastocystis Hominis was shown to lower magnesium levels in one small human study. Larger studies would need to verify this association. […] There are no proven treatments for Blastocystis hominis infection. […] Metronidazole is hypothesized to induce programmed cell death in Blastocystis. […] However, in some patients, the parasite might become resistant to the antibiotic.

• #57 Blastocystis hominis: A Pathogenic Parasite

  https://brieflands.com/articles/archcid-97388

  Many studies have introduced B. hominis as a potential pathogen, with digestive symptoms including diarrhea, abdominal pain, anorexia, bloat, fatigue, and extra gastrointestinal symptoms such as urticaria and itchy skin, as well as joint pain. […] Some people infected with B. hominis show no clinical signs of infection, which cannot be a reason for the non-pathogenic characteristics of this parasite, because there are also other pathogenic parasites with similar conditions. […] On the other hand, it is believed that the increased parasitic load can affect the pathogenicity and clinical signs and induce an acute condition for the disease. […] When the scope of the studies becomes broader, the effective factors in the pathogenicity of B. hominis become more apparent; for example, by conducting genetic studies and determining the subtypes of B. hominis, it was revealed that some subtypes are pathogenic, like subtype ST1, while others are non-pathogenic, such as subtype ST2.

• #58 Blastocystis hominis: A Pathogenic Parasite

  https://brieflands.com/articles/archcid-97388

  Many studies have introduced B. hominis as a potential pathogen, with digestive symptoms including diarrhea, abdominal pain, anorexia, bloat, fatigue, and extra gastrointestinal symptoms such as urticaria and itchy skin, as well as joint pain. […] Some people infected with B. hominis show no clinical signs of infection, which cannot be a reason for the non-pathogenic characteristics of this parasite, because there are also other pathogenic parasites with similar conditions. […] On the other hand, it is believed that the increased parasitic load can affect the pathogenicity and clinical signs and induce an acute condition for the disease. […] When the scope of the studies becomes broader, the effective factors in the pathogenicity of B. hominis become more apparent; for example, by conducting genetic studies and determining the subtypes of B. hominis, it was revealed that some subtypes are pathogenic, like subtype ST1, while others are non-pathogenic, such as subtype ST2.

• #59 Blastocystis hominis: A Pathogenic Parasite

  https://brieflands.com/articles/archcid-97388

  Many studies have introduced B. hominis as a potential pathogen, with digestive symptoms including diarrhea, abdominal pain, anorexia, bloat, fatigue, and extra gastrointestinal symptoms such as urticaria and itchy skin, as well as joint pain. […] Some people infected with B. hominis show no clinical signs of infection, which cannot be a reason for the non-pathogenic characteristics of this parasite, because there are also other pathogenic parasites with similar conditions. […] On the other hand, it is believed that the increased parasitic load can affect the pathogenicity and clinical signs and induce an acute condition for the disease. […] When the scope of the studies becomes broader, the effective factors in the pathogenicity of B. hominis become more apparent; for example, by conducting genetic studies and determining the subtypes of B. hominis, it was revealed that some subtypes are pathogenic, like subtype ST1, while others are non-pathogenic, such as subtype ST2.

• #60 Blastocystis hominis: A Pathogenic Parasite

  https://brieflands.com/articles/archcid-97388

  Many studies have introduced B. hominis as a potential pathogen, with digestive symptoms including diarrhea, abdominal pain, anorexia, bloat, fatigue, and extra gastrointestinal symptoms such as urticaria and itchy skin, as well as joint pain. […] Some people infected with B. hominis show no clinical signs of infection, which cannot be a reason for the non-pathogenic characteristics of this parasite, because there are also other pathogenic parasites with similar conditions. […] On the other hand, it is believed that the increased parasitic load can affect the pathogenicity and clinical signs and induce an acute condition for the disease. […] When the scope of the studies becomes broader, the effective factors in the pathogenicity of B. hominis become more apparent; for example, by conducting genetic studies and determining the subtypes of B. hominis, it was revealed that some subtypes are pathogenic, like subtype ST1, while others are non-pathogenic, such as subtype ST2.

• #61

  https://www.health.nsw.gov.au/Infectious/factsheets/Pages/blastocystis-hominis.aspx

  Blastocystis hominis is a species of one of the most common human intestinal organisms. […] There is still debate about whether Blastocystis species really causes disease in humans, as the organism can be found in both well and unwell individuals. New research suggests that some types of Blastocystis may be more likely to be associated with symptoms. […] Its not certain how Blastocystis is spread. Given that the organism is found in the gastrointestinal tract, transmission is most likely to occur via the faecal-oral route. […] Due to the uncertainty of whether this organism is a pathogen or not, it is difficult for doctors to decide whether to treat the infection.

• #62 Update on the pathogenic potential and treatment options for Blastocystis sp | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17

  There have been several hypotheses and increasing studies in the last few years relating the incidence of Blastocystis infections with the prevalence of irritable bowel syndrome (IBS) in patients. […] It has been proposed that a possible mechanism for the IBS- like symptoms might be the low-grade inflammation through persistent antigenic exposure in a chronic Blastocystis infection. […] It has also been suggested that polymorphisms in genes encoding inflammatory cytokines might have a role in the pathophysiology of IBS. […] A recent study has suggested that there is a role in the etiology of IBS from the association between IL-8 and IL-10 gene polymorphisms in IBS-Blastocystis carriers. […] Treatment should be considered if there are chronic symptoms of diarrhoea and abdominal pain in the absence of other pathogens identified from the stool sample. […] There may be a correlation between ST and sensitivity to drugs which is yet to be addressed in studies.

• #63 Update on the pathogenic potential and treatment options for Blastocystis sp | Gut Pathogens | Full Text

  https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17

  There have been several hypotheses and increasing studies in the last few years relating the incidence of Blastocystis infections with the prevalence of irritable bowel syndrome (IBS) in patients. […] It has been proposed that a possible mechanism for the IBS- like symptoms might be the low-grade inflammation through persistent antigenic exposure in a chronic Blastocystis infection. […] It has also been suggested that polymorphisms in genes encoding inflammatory cytokines might have a role in the pathophysiology of IBS. […] A recent study has suggested that there is a role in the etiology of IBS from the association between IL-8 and IL-10 gene polymorphisms in IBS-Blastocystis carriers. […] Treatment should be considered if there are chronic symptoms of diarrhoea and abdominal pain in the absence of other pathogens identified from the stool sample. […] There may be a correlation between ST and sensitivity to drugs which is yet to be addressed in studies.

• #64 Blastocystis Fact Sheet | Blastocystis Research Foundation

  http://bhomcenter.org/wp/blastocystis-fact-sheet/

  In some patients, Blastocystosis is an acute illness, meaning that symptoms will last for a short time (several weeks). In other patients, the disease may become chronic, and symptoms will last indefinitely. Researchers are working to understand why some infections produce chronic illness, while others clear on their own. […] There is no FDA approved treatment for Blastocystis hominis infection. Physicians have reported success in some patients with several prescription drugs, but the success rates for treatment of Blastocystis hominis are much lower than for other diseases. Many patients remain symptomatic after treatment. […] Because treatments are unreliable, it may not be appropriate to treat an asymptomatic patient. Researchers and patients have also reported that symptoms began after antibiotic treatment, so it is possible that antibiotic treatment could make an individual case worse. […] Yes, Blastocystis hominis infection can be very contagious. Follow these guidelines to avoid spreading Blastocystis hominis to others.

• #65 Blastocystis Fact Sheet | Blastocystis Research Foundation

  http://bhomcenter.org/wp/blastocystis-fact-sheet/

  In some patients, Blastocystosis is an acute illness, meaning that symptoms will last for a short time (several weeks). In other patients, the disease may become chronic, and symptoms will last indefinitely. Researchers are working to understand why some infections produce chronic illness, while others clear on their own. […] There is no FDA approved treatment for Blastocystis hominis infection. Physicians have reported success in some patients with several prescription drugs, but the success rates for treatment of Blastocystis hominis are much lower than for other diseases. Many patients remain symptomatic after treatment. […] Because treatments are unreliable, it may not be appropriate to treat an asymptomatic patient. Researchers and patients have also reported that symptoms began after antibiotic treatment, so it is possible that antibiotic treatment could make an individual case worse. […] Yes, Blastocystis hominis infection can be very contagious. Follow these guidelines to avoid spreading Blastocystis hominis to others.

• #66 Resistance towards metronidazole in Blastocystis sp.: A pathogenic consequence | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212542

  Blastocsytis sp. is a protozoan parasite that has been linked to common gastrointestinal illnesses. Metronidazole, the first line therapy, was reported to show frequent inefficacy. […] The study demonstrates that Blastocystis sp. isolates showed increase in the parasite numbers especially the amoebic forms (only in urban isolates) after treating with metronidazole at the concentration of 0.001 mg/ml. High number of cells in post-treated isolates coincided with increase of apoptosis. […] Metronidazole resistant Blastocystis sp. also showed significant increase in cancer cell proliferation. […] However, an increase in parasite numbers, higher amoebic forms, cysteine protease and ability to proliferate cancer cells implicates a pathogenic role. […] The present study reports on the pathogenic consequence in Blastocystis sp. due to inappropriate treatment administration.

• #67 Resistance towards metronidazole in Blastocystis sp.: A pathogenic consequence | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212542

  In this study we observed at a concentration of 0.001 mg/ml, the parasite was not only resistant but triggered higher parasite growth. […] Cysteine proteases have been reported to play an established role as virulent factor in many protozoan parasites such as Entamoeba histolytica and Giardia sp. […] In the present study, significant increase of cysteine protease levels in metronidazole treated Blastocystis sp. isolated from urban individuals imply that resistance to treatment can enhance the pathogenic potential of Blastocystis sp. […] The current study showed strong evidence of varying response towards metronidazole in Blastocystis sp. isolated from individuals within the Malaysian population (Urban and orang asli). […] This evidence could further suggest increased pathogenicity due to treatment at inappropriate concentration of metronidazole.

• #68 Low efficacy of metronidazole in the eradication of Blastocystis hominis in symptomatic patients: Case series and systematic literature review | Gastroenterología y Hepatología (English Edition)

  https://www.elsevier.es/en-revista-gastroenterologia-hepatologia-english-edition–382-articulo-low-efficacy-metronidazole-in-eradication-S2444382417301049

  Blastocystis hominis (B. hominis) is a protozoan commonly found in the gastrointestinal tract. There are doubts about its clinical significance. […] Although numerous studies have been conducted, the pathogenic role of B. hominis remains controversial. […] Regarding the mechanism of pathogenic action, B. hominis has been reported to express cysteine proteases, which play an essential role in invasion of host cells, immune response and cell cycle regulation. […] The microbiological response to MTZ treatment is insufficient in our geographical setting. […] The systematic review shows that the response to MTZ is very variable. […] In conclusion, there appears to be a relationship between clinical response and microbiological response to B. hominis treatment. This shows the parasite’s causative role.

• #69 Is Blastocystis Hominis Bad? Diagnosis, Causes & Treatment – SelfDecode Health

  https://health.selfdecode.com/blog/blastocystis-hominis-bad-worried/

  Some doctors may prescribe trimethoprim/sulfamethoxazole (TMP-SMX) when metronidazole is not effective. […] Limited studies suggest it has a 90%+ success rate in treating Blastocystis in adults but less than 40% effectiveness in children. […] Nitazoxanide is an antiparasitic agent. Some studies suggest it has high effectiveness rates in children (over 97%, according to one study) infected with human strains of this pathogen.

• #70 Is Blastocystis Hominis Bad? Diagnosis, Causes & Treatment – SelfDecode Health

  https://health.selfdecode.com/blog/blastocystis-hominis-bad-worried/

  Some doctors may prescribe trimethoprim/sulfamethoxazole (TMP-SMX) when metronidazole is not effective. […] Limited studies suggest it has a 90%+ success rate in treating Blastocystis in adults but less than 40% effectiveness in children. […] Nitazoxanide is an antiparasitic agent. Some studies suggest it has high effectiveness rates in children (over 97%, according to one study) infected with human strains of this pathogen.

• #71 Is Blastocystis Hominis Bad? Diagnosis, Causes & Treatment – SelfDecode Health

  https://health.selfdecode.com/blog/blastocystis-hominis-bad-worried/

  Remember that research hasnt yet determined whether Blastocystis hominis can contribute to any symptom or disease. […] The majority of studies covered in this article deal with associations only, which means that a cause-and-effect relationship hasnt been established. […] In one small study, women found to have Blastocystis Hominis in their intestines were more likely to have iron deficiency anemia than women who were not infected. […] Blastocystis Hominis was shown to lower magnesium levels in one small human study. Larger studies would need to verify this association. […] There are no proven treatments for Blastocystis hominis infection. […] Metronidazole is hypothesized to induce programmed cell death in Blastocystis. […] However, in some patients, the parasite might become resistant to the antibiotic.

• #72 Resistance towards metronidazole in Blastocystis sp.: A pathogenic consequence | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212542

  Blastocsytis sp. is a protozoan parasite that has been linked to common gastrointestinal illnesses. Metronidazole, the first line therapy, was reported to show frequent inefficacy. […] The study demonstrates that Blastocystis sp. isolates showed increase in the parasite numbers especially the amoebic forms (only in urban isolates) after treating with metronidazole at the concentration of 0.001 mg/ml. High number of cells in post-treated isolates coincided with increase of apoptosis. […] Metronidazole resistant Blastocystis sp. also showed significant increase in cancer cell proliferation. […] However, an increase in parasite numbers, higher amoebic forms, cysteine protease and ability to proliferate cancer cells implicates a pathogenic role. […] The present study reports on the pathogenic consequence in Blastocystis sp. due to inappropriate treatment administration.

• #73 Resistance towards metronidazole in Blastocystis sp.: A pathogenic consequence | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212542

  Blastocsytis sp. is a protozoan parasite that has been linked to common gastrointestinal illnesses. Metronidazole, the first line therapy, was reported to show frequent inefficacy. […] The study demonstrates that Blastocystis sp. isolates showed increase in the parasite numbers especially the amoebic forms (only in urban isolates) after treating with metronidazole at the concentration of 0.001 mg/ml. High number of cells in post-treated isolates coincided with increase of apoptosis. […] Metronidazole resistant Blastocystis sp. also showed significant increase in cancer cell proliferation. […] However, an increase in parasite numbers, higher amoebic forms, cysteine protease and ability to proliferate cancer cells implicates a pathogenic role. […] The present study reports on the pathogenic consequence in Blastocystis sp. due to inappropriate treatment administration.

• #74 Resistance towards metronidazole in Blastocystis sp.: A pathogenic consequence | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212542

  In this study we observed at a concentration of 0.001 mg/ml, the parasite was not only resistant but triggered higher parasite growth. […] Cysteine proteases have been reported to play an established role as virulent factor in many protozoan parasites such as Entamoeba histolytica and Giardia sp. […] In the present study, significant increase of cysteine protease levels in metronidazole treated Blastocystis sp. isolated from urban individuals imply that resistance to treatment can enhance the pathogenic potential of Blastocystis sp. […] The current study showed strong evidence of varying response towards metronidazole in Blastocystis sp. isolated from individuals within the Malaysian population (Urban and orang asli). […] This evidence could further suggest increased pathogenicity due to treatment at inappropriate concentration of metronidazole.

• #75 Low efficacy of metronidazole in the eradication of Blastocystis hominis in symptomatic patients: Case series and systematic literature review | Gastroenterología y Hepatología (English Edition)

  https://www.elsevier.es/pt-revista-gastroenterologia-hepatologia-english-edition–382-articulo-low-efficacy-metronidazole-in-eradication-S2444382417301049

  Studies in vivo have shown that these proteases may inhibit the production of immunoglobulin A in the intestinal mucosa, thereby contributing to the survival of the parasite. […] The microbiological response to MTZ treatment is insufficient in our geographical setting. […] The systematic review shows that the response to MTZ is very variable. […] In conclusion, there appears to be a relationship between clinical response and microbiological response to B. hominis treatment. This shows the parasite’s causative role.

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