Popruk Supaluk, Adao Davin Edric V, Rivera Windell L
Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Bangkok 10400, Thailand.
Pathogen-Host-Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, Quezon City 1101, Philippines.
Infect Genet Evol. 2021 Nov;95:105085. doi: 10.1016/j.meegid.2021.105085. Epub 2021 Sep 14.
Blastocystis is a commonly encountered gastrointestinal protozoan in humans and animals with uncertain pathogenicity. Despite its potential public health impact, epidemiological data regarding the prevalence and molecular subtype (ST) distribution of Blastocystis have been rarely reported. Among Blastocystis STs, ST1-ST4 are common in humans, including healthy and immunodeficient populations. According to the Chi-squared (χ) association based on the data compiled for this cross-sectional study, the presence of ST1 is associated with asymptomatic infection, whereas the presence of ST4 is associated with symptomatic infection. However, cross-sectional studies cannot clarify the potential pathogenicity of Blastocystis, unlike in vivo and in vitro studies. Poor hygiene, poor sanitation and zoonotic transmission are possible factors associated with high Blastocystis prevalence, although this protozoan may be part of the normal healthy human gastrointestinal microbiota. This review covers the prevalence, STs and distribution of Blastocystis infection in humans. Thus, future epidemiological and subtyping studies could reveal new STs in humans as well as possible associations of STs with disease, drug resistance and related mechanisms such as protease activity. These associations with proper ST identification may facilitate the control of potential threats to host health, including the direct pathogenic effects of Blastocystis or alterations of the gastrointestinal microbiome.
芽囊原虫是人和动物中常见的胃肠道原生动物，其致病性尚不确定。尽管它对公众健康有潜在影响，但关于芽囊原虫的流行率和分子亚型（ST）分布的流行病学数据却鲜有报道。在芽囊原虫的ST亚型中，ST1-ST4在人类中很常见，包括健康人群和免疫缺陷人群。根据为本横断面研究汇编的数据进行的卡方（χ）关联分析，ST1的存在与无症状感染相关，而ST4的存在与有症状感染相关。然而，与体内和体外研究不同，横断面研究无法阐明芽囊原虫的潜在致病性。卫生条件差、环境卫生差和人畜共患病传播可能是芽囊原虫高流行率的相关因素，尽管这种原生动物可能是正常健康人类胃肠道微生物群的一部分。本综述涵盖了人类芽囊原虫感染的流行率、ST亚型和分布情况。因此，未来的流行病学和亚型研究可能会揭示人类中的新ST亚型，以及ST亚型与疾病、耐药性和相关机制（如蛋白酶活性）之间可能存在的关联。这些与正确鉴定ST亚型相关的关联可能有助于控制对宿主健康的潜在威胁，包括芽囊原虫的直接致病作用或胃肠道微生物群的改变。
