EVALUATION OF BLASTOCYSTIS SPP. AMONG INFLAMMATORY BOWEL DISEASE PATIENTS WITH DIFFERENT DIAGNOSTIC METHODS AND SUBTYPE ANALYSES

Year 2017, Volume: 80 Issue: 1, 38 - 44, 31.03.2017

Özden Büyükbaba Boral , Deniz Gözde Çelik Raim İliaz Akın Akgül Halim İşsever , Filiz Akyüz

https://doi.org/10.18017/iuitfd.315519

Abstract

Objective: Blastocystis spp; is a protozoon that
can be seen worldwide. Fecal-oral transmission is the most accepted pathway for Blastocystis spp.
infection. Most infected patients show no symptoms of infection, however it can
cause abdominal pain, acute or chronic diarrhea, vomiting, flatulence and nausea.
It is suggested that Blastocystis spp. may cause several pathologies in gut causing an inflammatory response
that may lead to Inflammatory Bowel Diseases.

Materials
and Methods: Our study included 60 IBH patients diagnosed as ulcerative colitis (30)
and Crohn’s Disease (30) in Division of Gastroenterology and 40 healty controls
with no gastrointestinal disease. Stool samples of all patients were examined
for presence of any parasites. Presenceof Blastocystis
spp. was evaluated with microscopy, culture with two different media, ELISA
and PCR methods. For subtype analyses sequencing was performed.

Results: Blastocystis spp. was detected in 6 (10%) IBD patients, 2 (5%) in
controls. Blastocystis spp. antigen
detected in 12 (20%) IBD patients and 3 (7.5%) in controls. Blastocystis spp. DNA was detected in 8
(13.3%) IBD patients and 6 (15%) controls. No statistical significance was
detected between IBD patients and control group in terms of Blastocystis spp positivity. ST3 was the
predominant subtype and abdominal pain was the most common clinical symptom.

Conclusion: These results
suggested that using two different media increases the sensitivity. PCR was the
most sensitive method. ELISA results showed high sensitivity and specificity,
suggested that ELISA method could be an alternative to the microscopy and
culture. No significant relationship between IBD and Blastocystis spp. was determined. Also, no significance was
detected between subtypes and clinical symptoms. Although we could not
determine a relationship between subtypes and IBD or clinical symptoms, further
investigations are needed to clarify this issue.

Key words: Blastocystis spp.; inflammatory bowel disease; IBD; subtype;
clinical symptoms

Keywords

Blastocystis spp, inflammatory bowel disease, IBD, subtype

İNFLAMATUAR BARSAK HASTALIĞI OLAN HASTALARDA BLASTOCYSTIS SPP.'NİN FARKLI TANI YÖNTEMLERİ İLE ARAŞTIRILMASI VE GENOTİPLENDİRİLMESİ

Abstract

Amaç: Blastocystis spp; fekal-oral yolla
özellikle kötü hijyen koşullarında bulaşan, tüm dünyada yaygın bir
protozoondur. Enfeksiyon asemptomatik seyredebildiği gibi karın ağrısı,
kabızlık, bulantı gibi gastrointestinal semptomlara neden olabilmektedir. Blastocystis spp.’nin barsakta çeşitli
patolojilere neden olabileceği, inflamatuar yanıtı uyararak İnflamatuar Barsak
Hastalıkları (IBH)’nın gelişmesi ile ilişkisi olabileceği öne sürülmektedir.

Gereç-Yöntem: Çalışmamıza İ.Ü.
İstanbul Tıp Fakültesi Gastroenteroloji Bilim Dalı’nda 30 Crohn hastalığı (CH),
30 ülseratif kolit (UK) tanısı alan hasta ve 40 gastrointestinal system
hastalığı bulunmayan sağlıklı kontrol grubu dahil edilmiştir. Bu hastaların
dışkı örnekleri tüm parazitler yönünden incelenmiş, mikroskopi, kültür, ELISA
ve PCR ile Blastocystis spp. varlığı
araştırılmıştır. Blastocystis spp.
saptanan örneklerde subtip dağılımı sekanslama yöntemi ile araştırılmıştır.

Bulgular: İBH grubunda
mikroskopi ve kültür yöntemleri ile 6 (%10)’sında, kontrol grubunun 2
(%5)’sinde Blastocystis spp. varlığı
saptanmıştır. ELISA ile Blastocystis spp.
antijeni IBH grubunun 12 (%20)’sinde, kontrol grubunun 3 (%7,5)’ünde
saptanmıştır. Blastocystis spp.
DNA’sı PCR ile IBH grubunun 8 (%13,3)’inde, kontrol grubunun 6 (15%)’sında
bulunmuştur. Gruplar arasında Blastocystis
spp. varlığı yönünden anlamlı bir sonuç saptanamamıştır. Suptipler arasında
ST3 en sık olarak saptanmış, bunlarda en yaygın klinik semptomun karın ağrısı
olduğu gözlenmiştir.

Sonuç: İki farklı besiyeri
kullanılması tanı duyarlılığını arttırmıştır. En duyarlı tanı yöntemi PCR
olarak saptanmış, ELISA yöntemi de oldukça yüksek duyarlılık ve özgüllükte
sonuç vermiş, mikroskopi ve kültüre alternatif bir yöntem olabileceği
gözlenmiştir. Sonuçlarımız subtipler ile klinik bulgular arasında bir bağlantı
olduğunu göstermese de konuyu aydınlatmak için çalışmalara ihtiyaç olduğuna işaret
etmektedir.

Anahtar kelimeler: Blastocystis spp.; inflamatuar barsak hastalığı; IBH; subtip;
klinik semptomlar.

Keywords

Blastocystis spp, inflamatuar barsak hastalığı, IBH, subtip, klinik semptomlar

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