Blastocystis and urticaria: Examination of subtypes and morphotypes in an unusual clinical manifestation
Rodolfo Daniel Casero1, Florencia Mongi1, Angie Sánchez2
1Departamento de Parasitología, Hospital Nacional de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Argentina.
Abstract:
Blastocystis is a human common enteric protist that may colonize a large variety of non-human hosts linked to symptoms and diseases such as abdominal pain, constipation, diarrhea, urticaria, flatulence and irritable bowel syndrome (IBS). Blastocystis exhibits remarkable genetic diversity and multiple subtypes (STs) within the genus with no absolute associations with clinical symptomatology. Here we analyzed fecal samples from Argentinean patients (n=270) belonging to symptomatic (urticaria and non-specific gastrointestinal symptoms, n=39) and asymptomatic control (n=28). Those patients infected with Blastocystis (n=67) were submitted for morphological analysis, DNA extraction, 18S PCR, sequencing and STs identification according to DNA barcoding. Blastocystis vacuolar forms were the predominant morphotype (75%), ameboid-like forms were evidenced in 1.5% of samples. Blastocystis ST3 was detected in 71.6% (n=48), of which 71.4%, (n=35) and 28.6% (n=14) belonged to symptomatic and asymptomatic respectively. Other subtypes identified were ST1 (14.9%), ST6 (7.5%) and ST2 (5.9%). Blastocystis 18S barcoding evidenced in non-urticaria symptomatic patients and asymptomatic control group the presence of allele 134 (ST3) (p<0.0001), while allele 34 (ST3) was detected in 85.7% (18/21) of symptomatic uricaria as compared with control group (1/21) (p<0.0001). The presence of a particular allele (a34) significantly associated with urticaria patients was detected and the clinical implications of these findings are herein discussed.
Insights
Blastocystis subtypes show genetic diversity, with ST3 being common. A specific Blastocystis allele (a34) is significantly associated with urticaria symptoms in patients, suggesting a potential link between this parasite subtype and the condition.
Area of Science:
- Medical Parasitology
- Human Microbiome Research
- Molecular Epidemiology
Background:
- Blastocystis is a common human gut protist with diverse subtypes (STs).
- Associations between specific Blastocystis STs and clinical symptoms remain unclear.
- Genetic variability within Blastocystis complicates understanding its pathogenic potential.
Purpose of the Study:
- To investigate the genetic diversity of Blastocystis in Argentinean patients.
- To identify specific Blastocystis subtypes and alleles associated with clinical symptoms, particularly urticaria.
- To explore the clinical implications of Blastocystis genetic variations.
Main Methods:
- Analysis of fecal samples from symptomatic and asymptomatic individuals using morphological analysis and DNA extraction.
- Polymerase Chain Reaction (PCR) amplification and sequencing of the 18S ribosomal RNA gene for Blastocystis subtyping (STs).
- Statistical analysis to determine associations between Blastocystis alleles and clinical conditions like urticaria.
Main Results:
- Blastocystis was detected in 67 patients, with vacuolar forms being predominant.
- Blastocystis ST3 was the most prevalent subtype (71.6%), found in both symptomatic and asymptomatic individuals.
- A specific allele (a34) of Blastocystis ST3 was significantly associated with patients presenting with urticaria (p<0.0001).
Conclusions:
- Blastocystis exhibits significant genetic diversity, with ST3 being a common subtype.
- The presence of a specific Blastocystis allele (a34) is strongly linked to urticaria, suggesting a potential etiological role.
- Further research is warranted to elucidate the clinical implications and pathogenic mechanisms of specific Blastocystis genetic variants.
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