Giardia intestinalis and Fructose Malabsorption: A Frequent Association

Trelis, María; Taroncher-Ferrer, Silvia; Gozalbo, Mónica; Ortiz, Vicente; Castillo, José Miguel Soriano del; Osuna, Antonio; Merino-Torres, Juan Francisco

doi:10.3390/nu11122973

Cited by 24 publications

(18 citation statements)

References 55 publications

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“…2a). The helminth-only group with decreased Prevotella proportions relative to the Giardiaonly group U (25) = 41, Z = 2.0125, P = 0.0457, but similar to the control group (Fig. 2b).…”

Section: Change In Bacterial Abundancementioning

confidence: 61%

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Impact of intestinal parasites on microbiota and cobalamin gene sequences: a pilot study

et al. 2020

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Background: Approximately 30% of children worldwide are infected with gastrointestinal parasites. Depending on the species, parasites can disrupt intestinal bacterial microbiota affecting essential vitamin biosynthesis.Methods: Stool samples were collected from 37 asymptomatic children from a previous cross-sectional Argentinian study. A multi-parallel real-time quantitative PCR was implemented for Ascaris lumbricoides, Ancylostoma duodenale, Necator americanus, Strongyloides stercoralis, Trichuris trichiura, Cryptosporidium spp., Entamoeba histolytica and Giardia duodenalis. In addition, whole-genome sequencing analysis was conducted for bacterial microbiota on all samples and analyzed using Livermore Metagenomic Analysis Toolkit and DIAMOND software. Separate analyses were carried out for uninfected, Giardia-only, Giardia + helminth co-infections, and helminth-only groups. Results:For Giardia-only infected children compared to uninfected children, DNA sequencing data showed a decrease in microbiota biodiversity that correlated with increasing Giardia burden and was statistically significant using Shannonʼs alpha diversity (Giardia-only > 1 fg/µl 2.346; non-infected group 3.253, P = 0.0317). An increase in diversity was observed for helminth-only infections with a decrease in diversity for Giardia + helminth co-infections (P = 0.00178). In Giardia-only infections, microbiome taxonomy changed from Firmicutes towards increasing proportions of Prevotella, with the degree of change related to the intensity of infection compared to uninfected (P = 0.0317). The abundance of Prevotella bacteria was decreased in the helminths-only group but increased for Giardia + helminth co-infections (P = 0.0262). Metagenomic analysis determined cobalamin synthesis was decreased in the Giardia > 1 fg/µl group compared to both the Giardia < 1 fg/µl and the uninfected group (P = 0.0369). Giardia + helminth group also had a decrease in cobalamin CbiM genes from helminth-only infections (P = 0.000754). Conclusion:The study results may provide evidence for an effect of parasitic infections enabling the permissive growth of anaerobic bacteria such as Prevotella, suggesting an altered capacity of vitamin B12 (cobalamin) biosynthesis and potential impact on growth and development in children .

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“…2a). The helminth-only group with decreased Prevotella proportions relative to the Giardiaonly group U (25) = 41, Z = 2.0125, P = 0.0457, but similar to the control group (Fig. 2b).…”

Section: Change In Bacterial Abundancementioning

confidence: 61%

“…Gastrointestinal parasites may modulate intestinal inflammation, malabsorption, and microbiome changes [22][23][24][25][26]. The microbiome is associated with digestion, nutrition and health, but alterations in biodiversity can increase disease states and induce intestinal inflammation [27].…”

mentioning

confidence: 99%

Impact of intestinal parasites on microbiota and cobalamin gene sequences: a pilot study

et al. 2020

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“…Only few studies have reported on combined occurrence of LIT with FM. Approximately 30% of patients with FNNGIC and carbohydrate intolerance/malabsorption may have a combination of these [4,17]. A parallel occurrence, serum DAO values <10 U/mL in more than 50% combined LIT and FM patients, indicative of additional HIT, was described [18].…”

Section: Discussionmentioning

confidence: 99%

“…These functional abdominal, symptom-based, syndromes have a symptom profile comparable to food intolerance/malabsorption including fructose malabsorption (FM), histamine intolerance (HIT), and lactose intolerance (LIT) [2]. Combined appearance of these is increasingly reported and occurs in more than 30% of patients with FNNGIC and food intolerance/malabsorption [3,4]. For the clinical diagnosis of LIT and FM proved hydrogen (H 2 ) breath tests useful.…”

Section: Introductionmentioning

confidence: 99%

Increasing Expiratory Hydrogen in Lactose Intolerance Is Associated with Additional Food Intolerance/Malabsorption

Schnedl¹,

Meier-Allard

Lackner

et al. 2020

Nutrients

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Single and/or combined food intolerance/malabsorption may cause nonspecific, functional gastrointestinal (GI) complaints. In lactose-intolerant patients we evaluated the influence of additional food intolerance/malabsorption with hydrogen (H2) breath tests. In a retrospective analysis of charts from 279 lactose-intolerant patients, we found 128 patients with only lactose intolerance (LIT). Then, we identified 106 LIT patients with additional histamine intolerance (HIT). Additionally, 45 LIT and HIT patients also had fructose malabsorption (FM). A hydrogen (H2) breath test was performed to evaluate LIT and FM. A serum diamine oxidase value of <10 U/mL and a response to a histamine-reduced diet was used to identify HIT. Using pairwise comparison with the Kruskal–Wallis test to associate the area under the curve (AUC) of LIT patients and, LIT with HIT, to LIT with HIT and FM it was found, that the exhaled hydrogen values were significantly higher in patients with two-fold and triple combined food intolerance/malabsorption (p < 0.004 and p < 0.001, respectively). Within the pool of 170 LIT patients with >20 ppm increase of expiratory H2 from baseline, there were 74 LIT-only patients, 60 LIT with HIT patients, and 36 LIT patients with additional HIT and FM. With the Kruskal–Wallis test AUCs demonstrated a significant difference between all three groups (p = 0.024). In patients with LIT, the presence of additional food intolerance/malabsorption, significantly increases expiratory H2 values. We demonstrate evidence, which may suggest HIT to embody an own GI disorder as food intolerance/malabsorption.

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“…Giardia intesztinális parazitózis esetén a betegek 89,5%-ában észleltek fruktózmalabszorpciót. Kró-nikus hasi panaszok esetén, amennyiben szénhidrát-intolerancia mellett zsíroldékony vitaminok alacsony szintjét észleljük, részletes direkt és indirekt parazitológiai vizsgálat elvégzése javasolt (14).…”

Section: Fruktózmalabszorpció éS Parazitózisunclassified

Fruktóz és az emésztőrendszeri panaszok: diagnózistól a kezelésig

Schäfer¹

2020

CEU-JGH

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Giardia intestinalis and Fructose Malabsorption: A Frequent Association

Cited by 24 publications

References 55 publications

Impact of intestinal parasites on microbiota and cobalamin gene sequences: a pilot study

Impact of intestinal parasites on microbiota and cobalamin gene sequences: a pilot study

Increasing Expiratory Hydrogen in Lactose Intolerance Is Associated with Additional Food Intolerance/Malabsorption

Fruktóz és az emésztőrendszeri panaszok: diagnózistól a kezelésig

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