Blastocystis in Health and Disease: Are We Moving from a Clinical to a Public Health Perspective?

Abstract

Blastocystis is a genus of common single-celled intestinal parasitic protists with an unsettled role in human health and disease. Being a stable component of intestinal microbiota, once established, the Blastocystis parasite appears more common in healthy individuals than in patients with infectious, functional, or inflammatory bowel disease. Recent data suggest that the parasite is associated with certain gut microbiota profiles and health indices. Convincing data and tools differentiating asymptomatic colonization from infection are yet to be demonstrated. Although the parasite may elicit disease under certain circumstances, the focus on Blastocystis may be shifting from a clinical to a public health perspective.

Recruitment of feces donors among blood donors: Results from an observational cohort study

“…Notably, controversy exists to whether certain protozoa such as Blastocystis species may be more prevalent in healthy individuals and linked to certain beneficial health indices. 22 , 23 For now, however, our data are consistent with the findings of diverse pathogens reported by others 14 , 15 and support the current broad-spectrum screening approach for pathogens.…”

Prevalence and genetic diversity of Blastocystis in family units living in the United States

“…A renewed research interest in the microbial eukaryote Blastocystis has been largely driven by a greater appreciation of its genetic and phenotypic diversity, ubiquity in human and animal populations, and its potential role in both human health and disease (Andersen and Stensvold, 2015;Tan et al, 2010). Currently, there is little information on…”

“…It is estimated that more than one billion people worldwide are colonised by Blastocystis (Andersen and Stensvold, 2016). However, there is considerable variation in prevalence rates between different populations; for example, recent reports have given positive prevalence rates of anywhere between ~24-100% for different populations living in Europe, the Middle East, India and Africa (AbuOdeh et al, 2016;Alfellani et al, 2013;Bart et al, 2013;El Safadi et al, 2014;Krogsgaard et al, 2015;Pandey et al, 2015;Scanlan and Stensvold, 2013;Scanlan et al, 2014).…”

“…As a consequence of the controversial and unresolved role of Blastocystis in human intestinal disease and the increased awareness of the importance of the gut microbiome (and specific components of the gut microbiome) in human health and disease, research into Blastocystis has increased greatly in recent years (Andersen and Stensvold, 2015;Guinane and Cotter, 2013;Roberts et al, 2014;Scanlan, 2012;Scanlan and Stensvold, 2013;Sekirov et al, 2010). Although the application of sensitive molecular PCR based techniques has faciltated a better appreciation of the prevalence of Blastocystis in human populations, there remains a lack of reliable epidemiological data on the prevalence and genetic diversity of Blastocystis from many regions of the world including the United States.…”

Challenges in fecal donor selection and screening for fecal microbiota transplantation: A review

“…29 Much higher rates have been reported in other studies ranging from 50-100% Blastocystis colonization in healthy individuals in industrialized countries and Senegalese children respectively. 30 Detection of Blastocystis by PCR has been associated with higher microbiota diversity and lower abundance of Enterobacteriaceae, and has inconsistently been associated with irritable bowel syndrome (IBS). [31][32][33] However, the literature on this topic is inconsistent.…”