Blastocystis hominis

Blastocystis from humans and animals can be divided into at least 12 species, of which several are found in humans

Recently, a 29-kDa parasite protein and a parasite-associated protease have received attention as potential markers of pathogenicity

It has been suggested that finding >5 parasites per high-power field (40× objective) or, less commonly, by oil immersion (100× objective) is associated with the presence of gastrointestinal disease

in some studies the clinical presentations have been shown to be subtype dependent

Blastocystis does not seem to be invasive, despite 2 case reports describing its recovery in deep tissue. In both of these cases, there were coexisting conditions predisposing to disruption of the gut barrier that probably led to coinfection with Blastocystis

It has been suggested that low-grade inflammation due to ongoing immune activation caused by carriage or infection with Blastocystisproviding persistent antigenic exposure could play a role in IBS

Remarkably, many laboratories do not report Blastocystis because of the long-held view by some in the medical community that it is always nonpathogenic

In a symptomatic patient, isolation of cysts in stool specimens should trigger a thorough evaluation for other causes of the patient’s gastrointestinal tract complaints, given the possibility for coinfection with other pathogens. Patients withBlastocystis isolated in the stool can be coinfected with other pathogens, such as G. lamblia, Entamoeba histolytica, and D. fragilis

It is quite possible that patients who respond to treatment for Blastocystis with metronidazole or trimethoprim-sulfamethoxazole (TMP-SMX) may actually have clinical improvement owing to treatment of a secondary pathogen.

Metronidazole is considered first-line treatment, but the success of eradicating Blastocystis with this drug has been reported to be anywhere from 0% to 100%

TMP-SMX has been used as a second-line agent in patients who may not be able to tolerate or do not respond to treatment with metronidazole. Blastocystis was eradicated from stool in 36 (94.7%) of 38 children and in 14 (93.3%) of 15 adults. Clinical symptoms resolved in 39 (73.6%) and improved in 10 (18.9%) of 53 patients evaluated

There have been several studies examining the use of alternative agents in the treatment of Blastocystis infection. For example, Yakoob et al [58] studied the in vitro efficacy of garlic and other dietary herbs, compared with that of metronidazole, in the treatment of Blastocystis infection in both control subjects and patients with IBS. The authors evaluated the efficacy of garlic and metronidazole at concentrations of 0.01 and 0.1 mg/mL in suppressing the growth of Blastocystis. They found that garlic and metronidazole were equally effective at both concentrations. The isolates of Blastocystis were not as sensitive to the other herbs tested, which included ginger, black pepper, and white cumin.

Saccharomyces boulardii (a probiotic) has also been studied for Blastocystis treatment [59]. In a study by Dinleyici et al [59], children with a 2-week history of gastrointestinal symptoms and isolation of Blastocystis from the stool were randomized to treatment with Saccharomyces, metronidazole, or placebo for 10 days. Patients were evaluated for clinical and microbiologic cure at days 15 and 30 after initiation of treatment. Clinical cure was found in 77.7% of the Saccharomyces group and 66.6% of the metronidazole group at 15 days, compared with 40% in the placebo group. Persistence of cysts in stool was noted in 20% of the metronidazole group and 27.8% of the Saccharomyces group, compared with 73.4% of the placebo group. Thirty days after initiation of treatment, clinical cure was found in 94.4% of subjects in the Saccharomyces group, compared with 73.3% of those in the metronidazole group. Resolution of cysts in the stool was found in 94.4% in the Saccharomyces group and 93.3% in the metronidazole group, and the difference was not statistically significant (P = .43) [59].

lyophilized S. boulardii(Reflor®, Sanofi-Aventis, Turkey

250 milligrams twice daily for 10 days

http://cid.oxfordjournals.org/content/54/1/105.full

http://link.springer.com/article/10.1007/s00436-010-2095-4

–probiotics help ibs because they kill parasites too?

Harm resulting from untreated eosinophilia potentially varies with cause. During an allergic reaction, the release of histamine from mast cells causes vasodilation which allows eosinophils to migrate from the blood and localize in affected tissues. Accumulation of eosinophils in tissues can be significantly damaging. Eosinophils, like other granulocytes, contain granules (or sacs) filled with digestive enzymes and cytotoxic proteins which under normal conditions are used to destroy parasites but in eosinophilia these agents can damage healthy tissues. In addition to these agents, the granules in eosinophils also contain inflammatory molecules and cytokines which can recruit more eosinophils and other inflammatory cells to the area and hence amplify and perpetuate the damage. This process is generally accepted to be the major inflammatory process in the pathophysiology of atopic or allergic asthma.

In the past, researchers have developed an in vitro model using B. hominis culture filtrates to investigate its ability in triggering inflammatory cytokine responses and transcription factors in human colonic epithelial cells. Studies have also correlated the inflammation by parasitic infection with cancer.Parasitol Res. 2010 Mar;106(4):941-5. Epub 2010 Feb 18.Solubilized antigen of Blastocystis hominis facilitates the growth of human colorectal cancer cells, HCT116. Chandramathi S, Suresh K, Kuppusamy UR.

Through anecdotal reports, it has become evident that there are a significant number of treatment failures with metronidazole. Blastocystis hominis Past & Future. Clinic Micro Reviews. C.H. Zierdt. Jan 1991.

The CDD’s current treatment for Blasto:

Secnidazole 400 mg (30 Capsules) 3 times a day
Diloxanide Furoate 500mg (30 Capsules) 3 times a day
Septrin Forte (20 Tablets) 2 times a day
all for 10 days.

Their secondary treatment for more treatment resistant Blasto.:

Secnidazole 400 mg (30 Capsules) 3 times a day
Furazolidone 100 mg (30 Capsules) 3 times a day
Nitazoxanide 500 mg (20 Capsules) 2 times a day
all combined for 10 days.

In Australia the meds are available, with a prescription, from:

Skinners Compounding Pharmacy, Lindfield, NSW. Australia

and

Sydney Compounding Chemist on (02) 9871 7533

A doctor will need to sign-off on the treatment.

“My advice to anyone with a GP who says IBS? Tell them to Fuck off. I’ve had symptoms for 18 months but they were consistent and I knew something was up. I’m otherwise healthy, not depressed or anxious or stupid, I know when I’m being fobbed off by ignorant fools. I put up with it for a while but got very angry with my GP last week, finally had some stool tests done after having an expensive CT scan and other tests. The result: B hominis. So relieved to know there are options and people who take it seriously.” USA May 2011.

Systemic Mastocytosis (SM). There is no known cause and no cure for SM, but there is an overlap in the symptoms of SM, D.fragilis, Blasto., and IBS:

Abdominal cramping/discomfort, nausea, vomiting, fatigue, food intolerances, feeling faint, vertigo, faintness, rapid heart rate, headache, malabsorption, increased susceptibility to chest colds and ‘flu, hives or other rashes, cognitive and psychiatric symptoms including irritability, depression, changes in mood, brain fog, concentration, learning, retention or anything relying on memory or information processing skills. (From Mastocytosis Society Canada).

Mast cells are more well known for their harmful effects during inflammatory conditions such as asthma and allergy. However, the role of mast cells in GI infections has largely been ignored which is interesting because this reaction seems to have evolved as a defense system against intestinal worm infestations (Mixed Organic Brain Syndrome as a Manifestation of Systemic Mastocytosis. Psychosomatic Medicine Vol. 48, No. 6 (July/August 1986).

 

Mast cells are white blood cells which contain pharmacologically active granules. Located in various parts of the body, including abundantly in the gastrointestinal tact, mast cells are considered the sentinels of the immune system. When a mast cell encounters a bacteria or parasite it perceives as an invader it releases (degranulates) active chemicals – chemicals which induce many of the same symptoms experienced during a D.fragilis and Blasto. infection.

(Mast cells) contribute to pathologic allergic inflammation but also serve an important protective role in bacterial and parasite infections. Given the proinflammatory nature of autoimmune responses, it is not surprising that studies using murine models of autoimmunity clearly implicate mast cells in the initiation and/or progression of autoimmune disease. J Immunol. 2007 Sep 1;179(5):2673-9. The multitasking mast cell: positive and negative roles in the progression of autoimmunity. Christy AL, Brown MA

Doctors with concerns about diagnosing IBS on symptoms alone are assured that the probability of finding inflammatory bowel disease, colorectal cancer or infectious diarrhea in a patient with typical IBS symptoms, is less than 1%

D.fragilis or B.hominis – two parasites shown to colonise the digestive tracts of more than half of patients with IBS (Yakoob J, et al. Parasitol Res. 2010) are never mentioned.

Diagnostic procedures employed currently in laboratories around the UK are not optimal for the detection of D. fragilis and B. hominis. D.fragilis and B. hominis: neglected human protozoa. The Biomedical Scientist. July 2007. Pages 524-27.

Twenty-seven of the 32 persons were later found to have greater than or equal to 1 recognized pathogens–Entamoeba histolytica, Giardia lamblia or Dientamoeba fragilis–and, after receiving appropriate therapy, became asymptomatic. The B hominis infection, however, was unaffected by therapy. Five persons with only B. hominis infection were treated with iodoquinol without effect; these persons fulfilled the medical criteria for irritable bowel syndrome.

For example, Lactobacillus rhamnosus (L. rhamnosus) GG is a specific bacterial strain, which has been shown to be an effective probiotic for several diarrheal diseases, but other strains within the L. rhamnosus species may not be an effective probiotic

taking the outer skin from a tropical fruit (lychee and mangosteens) and cooking them down to make tea. He succeeded in isolating the agent responsible.

Probiotics may be either bacterial or yeast microbes. Yeast probiotics, such as S. boulardii, are different from bacterial probiotics (different physiologic structures, large in size, do not acquire antibiotic-resistant genes and are not affected by antibiotics)[12]. Not only is there a confusing array of probiotic products on the global market, but the taxonomy of Saccharomyces strains has been debated[22

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http://www.wjgnet.com/1007-9327/16/2202.pdf

http://www.wjgnet.com/1007-9327/16/2202.pdf

http://www.wjgnet.com/1007-9327/16/2202.pdf

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