This Month in Blastocystis Research (MAY 2015)

Words cannot describe my gratitude for being part of the 1st International Blastocystis Symposium, which was seen through to marvelous success by Dr Funda Dogruman-Al, her colleagues and students, her professional arrangement committee and the scientific committee, made up by Dr Graham Clark, Dr Kevin Tan, Dr Hisao Yoshikawa, Professor Ibrahim Dogan, Funda Dogruman-Al, and myself.

Funda Dogruman-Al in the middle flanked by some of the delegates outside Gazi Hastanesi.

A total of 70 delegates had registered, comprising 37 national and 33 international attendees. Countries represented included Australia, Japan, Russia, China, Taiwan, India, Pakistan, Qatar, Iran, Iraq, Turkey, Spain, France, Denmark, UK, USA, and Mexico.

Some of the delegates gathering before the gala dinner.

A presymposium workshop taking place the day before the launching of the actual symposium focussed on methods for diagnosis and molecular epidemiological studies of Blastocystis.

The two-day symposium included 13 half-hour lectures, 10 shorter oral presentations, and 27 posters.

Lectures were given by Dr Graham Clark (one of his three talks was on behalf on Prof Andrew Roger and post doc Laura Eme), Dr Kevin Tan, Dr Hisao Yoshikawa, Dr Philippe Poirier, Dr Özgür Kurt, Dr Javed Jakoob, Dr Funda Dogruman-Al, and myself, and covered updates on genomics, cell biology, host-parasite interactions, genetic diversity, epidemiology, clinical significance, treatment, and methods used for detection and molecular characterisation.

We were spoilt with lots of 'Turkish Delight': Here are some of the dancers performing at the gala dinner.

There were six prizes in total; three for the best oral presentations and three for the best posters. Prize money was donated by Elsevier.

The prize winners were as follows: 

Oral presentations:
1st Prize: Erdogan Malatyali, Adnan Menderes University, Aydin, Turkey
2nd Prize: Sitara SR Ajjampur, National University of Singapore, Singapore
3rd Prize: Unaiza Parkar, Murdoch University, Murdoch, Western Australia

Poster presentations:
1st Prize:  John Anthony Yason, National University of Singapore, Singapore
2nd Prize: Joel Martinez-Ocana, Universidad Nacional Autonoma de Mexico, Ciudad Universitaria, Mexico City, Mexico
3rd Prize: Chen-Chieh Liao, National Cheng Kung University, Taiwan

Over the next few months, original manuscripts – seminal papers and reviews – will be developed for a special issue on Blastocystis in of Parasitology International to mark the event.

An important landmark in Blastocystis history has been made, and we are already looking into our chances of developing the 2nd International Blastocystis Symposium, which may be in 2017.

A huge THANK YOU to Funda for all her efforts, and KUDOS to all contributors for making this such a fantastic event!

Expected Social/Cultural Activities at 1st International Blastocystis Symposium

A lot of thrilling activities and ideas are in the making for the 1st International Blastocystis Symposium in Ankara later this month (www.blastomeeting2015.com)!


For instance, the social programme is expected to include the following:

1) Performances of Turkish classical music and folk music by students from Gazi University State Conservatory of Turkish Music at the opening and closing ceremonies
2) Needle work exhibition
3) Traditional Turkish arts exhibition
4) Glass work workshop
5) Marbling workshop
6) Gilding workshop 
7) Reed flute (‘ney’) contest

This should provide the delegates with lots of opportunity to meet different branches of Turkish culture.

Hence, the ceremonies + coffee breaks and lunches will be busy and fun! For the Gala Dinner we are currently trying to engage with two different folk dancer teams from Gazi University… and...(suspense!)...  there might be a chance the Gala Dinner will be free of charge for all participants! Stay tuned!

1st International Blastocystis Symposium - Accommodation Funding!

We are pleased to announce that "Society for General Microbiology" (http://www.sgm.ac.uk/) is going to fund two nights of accommodation for 40 young researchers (below 40 years old) attending the 1st International Blastocystis Symposium (www.blastomeeting2015.com).

Those who apply with a presentation and with no other funding will have priority in application.

Please inform your other colleagues who are interested in Blastocystis research about this important news.

(Please note: Applications should be sent to alfunda[at]yahoo.com)

Looking forward to seeing you in Ankara...

Unstained Blastocystis. Courtesy of Dr Marianne Lebbad.

This Month in Blastocystis Research (APR 2015)

#ECCMID2015 took place in Copenhagen. It was a great venue with a lot of interesting sessions. My favourite presentation was by Dr Paul D Cotter. We have had the pleasure of doing some work together with Dr Pauline D Scanlan as the main driving force. In his talk, Dr Cotter highlighted the emergence of research exploring whether certain organisms are pathobionts or probionts; among these, Blastocystis. Among many things, Dr Cotter reviewed the two recent Blastocystis-specific publications by Scanlan et al. focusing on the commonness and stability of Blastocystis colonisation [1] and on the need to use subtype-specific PCRs to detect and identify mixed subtype colonisation/infection [2].

Based at TEAGASC - Ireland, the Cotter/Scanlan group is one of the teams interested in looking into the ecology of Blastocystis (and other microbial eukaryotes of the gut), including its influence of the parasite on gut microbiota/microbiome (structure and function of our all gut organisms) and vice versa, and I'm sure that there will be a lot of interesting data coming out from their lab in the near future.

Cotter mentioned that Blastocystis has been subject to bad science. This may be due to a number of reasons. When developing hypotheses, we have a tendency of opting for dichotomous outcomes - either it is this or that, - maybe that's the very nature of hypotheses. If the clinical significance of Blastocystis is dependent on a number of different things such as co-colonising microbes (cross-talk), differences in host immunity response, Blastocystis subtype, and host diet for instance, then the true tapestry of physiological/biological/clinical mechanisms is likely to be extremely difficult to uncover. Moreover, despite the fact that so many people are curious about the public health significance of Blastocystis, apparently very little funding for targeted Blastocystis research exists. This means that mostly minor and not so significant studies ("cheap studies") on Blastocystis are available. Relatively little seminal research has been done in the clinical field (including the field of gastroenterology), and most studies on Blastocystis are cross-sectional and descriptive and usually not very well designed/carried out (use of diagnostic tools with limited sensitivity, for instance).

Maybe things will change when more and more people realise that we might be able to use Blastocystis as a biomarker/surrogate marker of intestinal homeostasis...

In my opinion the following topics would make for good research projects:

1) Large studies of both diseased cohorts and healthy individuals, including Blastocystis subtype data and data on accompanying protists, bacteria and fungi (16S/18S/ITS profiling).
2) Manipulaton studies where Blastocytsis (cysts) are introduced in ecosystems (in vitro or in vivo) to monitor potential changes.
3) Animal models using cyst challenge (to look at microbiota profile changing upon challenge, and, if in vivo colitis models are used, impact on host immunity)
4) Longitudinal microbiome studies of patients with and without Blastocystis.
5) Investigation of Blastocystis as a biomarker/surrogate marker of microbiota profiles and gut microbiome homeostasis... similar to my recent blog post: 'Show me your gut bacteria, and I'll tell you if you have Blastocystis!'
6) Comparative genomics (virulence gene identification for instance).
7) Identification of Blastocystis-specific signatures in metagenomics data sets.
8) Identification of drugs that have anti-Blastocystis properties, since currently, there is no drug regimen that consistently enables eradication of Blastocystis.

Speaking of which: We just published data in Journal of Ethnopharmacology on the anti-Blastocystis activity of 24 plant parts from 21 medicinal plants from Ghana [3]. We performed in vitro challenge of 48 h Blastocystis cultured cells (subtype 4) using ethanolic, warm and cold water plant extracts. Screening of these 24 different plant parts showed significant anti-Blastocystis activity of six of the ethanolic extracts: Mallotus oppositifolius, IC₅₀, 24h 27.8 µg/mL; Vemonia colorata, IC₅₀, 24h 117.9 µg/mL; Zanthoxylum zanthoxyloides, cortex IC₅₀, 24h 255.6 µg/mL; Clausena anisata, IC₅₀, 24h 314.0 µg/mL; Z. zanthoxyloides, radix IC₅₀, 24h 335.7 µg/mL and Eythrina senegalensis, IC₅₀, 24h 527.6 µg/mL. The reference anti-protozoal agent metronidazole (MTZ) had an IC₅₀, 24h of 7.6 µg/mL. Since cultures were xenic, antimicrobial activity was tested against two Gram-positive and two Gram-negative bacteria for all 24 plant parts at a final concentration of 1 mg/mL. Only C. anisata showed antimicrobial activity at a concentration of 800 µg/mL.

Hence, M. oppositifolius showed nearly as good activity as the reference anti-protozoal drug MTZ. Historically, the active plants found in this study have been used against dysentery, diarrhoea or other stomach disorders. Nowadays they are not used specifically for dysentery, but they are being used as medicinal plants against various stomach disorders.

Our book 'Biology of Foodborne Parasites' is out and available for ordering.

Incidentally, Blastocystis earned a designated chapter in the book 'Biology of Foodborne Parasites' which is now out and available for ordering here. It was fun writing it up, and hope that the chapter will be of interest to health care professionals and students around the world. The book also contains  introductions to the public health importance of foodborne parasites, molecular biological techniques in studies of foodborne parasites, and detection of parasites in foods.

References:

[1] Scanlan PD, Stensvold CR, Rajilić-Stojanović M, Heilig HG, De Vos WM, O'Toole PW, & Cotter PD (2014). The microbial eukaryote Blastocystis is a prevalent and diverse member of the healthy human gut microbiota. FEMS Microbiology Ecology, 90 (1), 326-30 PMID: 25077936   

[2] Scanlan PD, Stensvold CR, & Cotter PD (2015). Development and application of Blastocystis subtype-specific PCR reveals that mixed subtype infections are common in a healthy human population. Applied and Environmental Microbiology PMID: 25841010

[3] Bremer Christensen C, Soelberg J, Stensvold CR, & Jäger AK (2015). Activity of medicinal plants from Ghana against the parasitic gut protist Blastocystis. Journal of Ethnopharmacology PMID: 25773490

This Month in Blastocystis Research - MAR 2015

"Show me your gut bacteria and I'll tell you if you're infected with Entamoeba"

One of my 'partners in crime', science reporter Jop de Vrieze, made me aware of a study just published now by Elise R Morton and colleagues. The study appeared in bioRxiv—The Preprint Server for Biology, operated by Cold Spring Harbor Laboratory. The study is totally in line with one of the research foci in our lab.

The paper is called 'Variation in rural African gut microbiomes is strongly shaped by parasitism and diet', and can be downloaded here. The backbone in this type of research is the recognition that studies revealing a large contrast between the microbiomes of populations in developing countries and those of populations in urban industrialised areas have shown that geography is an important factor associated with the gut microbiome, but that such studies yet have to disentangle the effects of factors such as climate, diet, host genetics, hygiene and parasitism.

It's very refreshing that for once, 'parasitism' is included in such considerations. As mentioned in one or more of my previous blog posts, we have metagenomics data stongly indicating that Blastocystis colonisation is associated with certain microbial communities. As of yet, we have no idea about cause and effet, but the idea alone is immensely intriguing.

A large and a small cyst of Entamoeba coli. Courtesy of Dr Marianne Lebbad.

Now, Morton et al. have produced data that suggest that the presence of Entamoeba—another gut-associated eukaryotic genus comprising multiple species of varying pathogencitiy—is strongly correlated with microbial composition and diversity. They showed that an individual's liability to being infected by Entamoeba could be predicted with 79% accuracy based on gut microbiome composition.

The authors used 16S PCR and Illumina-based sequencing of 16S amplicons, and I could have wished that molecular assays, e.g., the 18S PCR that we have developed in our lab + associated software, had also been used to test the faecal samples from the 64 individuals enrolled in the study in order to obtain more precise data, not only on Entamoeba but also on other human-associated gut protists, such as Blastocystis.

While alpha (intra-host) diversity of Entamoeba-positive individuals was significantly higher than that of Entamoeba-negative individuals, analysis of the beta (inter-host) diversity revealed that gut communities across Entamoeba-positive individuals were more similar than across Entamoeba-negative individuals, suggesting that, as alpha diversity increases, there are fewer potential stable states for individual gut communities, or that infection by Entamoeba drives changes in the microbiome that are dominant over other factors.

Right—this is Entamoeba, I know, but in principle, the type of analyses that were performed in the present study could be applicable to Blastocystis, Dientamoeba, and other gut parasites, which may help us understand their role in health and disease. Are these parasites able to influence gut microbiota? Can they be used for gut microbiota manipulation? Or do they only infect people with certain microbiota profiles? Time will show... maybe.

For those of you who would like to read more about what is shaping our microbiomes and how the gut microbiota may impact on our gastrointestinal health, I recently did a couple of blog posts for United European Gastroenterology (UEG) Education that might be of some interest:

Are we finally saluting the fungal kingdom as a co-ruler of GI health and disease?

The intestinal microbiome—Rosetta Stone or Tower of Babel?


Reference:

Morton ER, Lynch J, Froment A, Lafosse S, Heyer E, Przeworski M, Blekham R, Segurel L.
Variation in rural African gut microbiomes is strongly shaped by parasitism and diet. bioRxiv doi http://dx.doi.org/10.1101/016949 - accessible here.

This Month in Blastocystis Research (FEB 2015)

Before heading off to visit dear colleagues at the Public Health Agency of Sweden tomorrow morning, I thought I'd do a quick 'This Month...' post.

Tropical Parasitology has published a paper by Elghareeb and colleagues on  'Laboratory Diagnosis of Blastocystis in Diarrheic Patients'. I was asked to do a Guest Commentary on their paper, and if your're interested you can download my comments here for free (html version). The paper by Elghareeb et al. should also be free for download at the website.

I have been very lucky to work together with Dr Prashant K Pandey and his colleauges in Pune, India. Together we just published the first data on Blastocystis subtypes ever to appear in India for what I know. We subtyped Blastocystis in a cohort of healthy Indian individuals, and found ST1 and ST3 in 27/100 adult individuals tested, while other common subtypes, ST2 and ST4, were absent. Remarkably, ST3 was seen in all positive individuals, while ST1 was seen only in mixed infections. The strains (alleles) found in India were no different to those found in for instance Europe.

There is a paper out by Rossen and colleagues from The Netherlands showing that Blastocystis is relatively uncommon in patients with active ulcerative colitis (UC) and significantly less common in UC patients (13.3%) than in healthy individuals (32.5%). This is completely in line with data that we generated in Denmark a couple of years ago. In fact, at two separate occasions we have been able to look into patients with inflammatory bowel disease. In both cases (one study has been submitted for publication), hardly any Blastocystis was found in patients with Crohn's disease, while a few patients with UC were positive; however, mostly patients with inactive disease appeared to have Blastocystis, while those with flare-ups were negative. Therefore, the influence of dysbiosis on Blastocystis colonisation should be subject to further scrutiny.

A lot of action goes on at the official website for the 1st International Blastocystis Symposium in Ankara in May, with exactly three months to go! Why not take a minute to browse the programme for the Pre-Symposium Course and the Scientific Programme for the actual Symposium? Please go here to familiarise yourself with the new content. 
Also, conference abstracts are pouring in, - did you submit yours yet?

References

Elghareeb AS, Younis MS, El Fakahany AF, Nagaty IM, & Nagib MM (2015). Laboratory diagnosis of Blastocystis spp. in diarrheic patients. Tropical Parasitology, 5 (1), 36-41 PMID: 25709951

Stensvold, C. (2015). Laboratory diagnosis of Blastocystis spp Tropical Parasitology, 5 (1) DOI: 10.4103/2229-5070.149885  

Pandey PK, Verma P, Marathe N, Shetty S, Bavdekar A, Patole MS, Stensvold CR, & Shouche YS (2015). Prevalence and subtype analysis of Blastocystis in healthy Indian individuals. Infection, Genetics and Evolution: Journal of Molecular Epidemiology and Evolutionary Genetics in Infectious Diseases PMID: 25701123

Rossen NG, Bart A, Verhaar N, van Nood E, Kootte R, de Groot PF, D'Haens GR, Ponsioen CY, & van Gool T (2015). Low prevalence of Blastocystis sp. in active ulcerative colitis patients. European Journal of Clinical Microbiology & Infectious Diseases: Official Publication of the European Society of Clinical Microbiology PMID: 25680316

Updated programme for the 1st International Blastocystis Symposium + Pre-Symposium Course programme

There has been changes to the programme for the 1st International Blastocystis Symposium (May 28-29), please go here to see the updated programme.

Also, the Pre-Symposium Course programme (May 27) can be viewed here.

We will be absolutely spoilt with speakers!

Please do not forget to visit the official website for updates on the social programme plus abstract/registration deadlines.

Scientific Programme for the 1st International Blastocystis Symposium in Ankara, May 2015, is now available!

The Scientific Programme for the 1st International Blastocystis Symposium in Ankara, May 2015, is now available! Please note that the programme may be subject to change.

Click here to view it!

Go here to view the official website for the symposium.

This Month in Blastcystis Research - JAN 2015

I'm going to dedicate this blog post entirely to the upcoming 1st International Blastocystis Symposium.

I'm not sure how much advertising there is for this congress (our budgets are limited), but the fact that we are already receiving abstracts is a good sign! Abstacts may be submitted until April 1st, 2015. Please note that the 'early bird' registration discount expires at the 15th of February.

You will find the online abstract submission form here.

If you think about going but have not paid a visit to the official conference website, I recommend you to do so, clicking this link. You'll hopefully find most if not all the information that you'd be looking for, and there's a lot to be learned. Please also make sure to browse the social programme in order to be able to make appropriate arrangments.

It's a two-day symposium, running from the 28th to the 29th of May, 2015. Moreover, on the 27th, there will be an all-day workshop on various diagnostic and molecular epidemiological aspects, including a barcoding (subtyping) course. There will be more info on that very soon, - please keep an eye on the website.

We are doing all we can to attract scientists with vast experience in Blastocystis research to cover the floor with exciting and stimulating talks, and I think we're doing more than OK. Some of the speakers will be writing up reviews on their respective topics, and these reviews will appear in a special themed issue in Parasitology International.

There will be a quite a few prizes for best talks and posters, etc., thanks to ELSEVIER among others.

It will be one-track symposium, and the first day will focus mostly on some fundamental topics, such as genomics and biochemistry, while the next day will include talks on clinical and diagnostic data.

It's my clear impression that main organiser Dr Funda Dogruman-Al is working 25 hours a day to make everything come together, and Dr Hisao Yoshikawa has also already invested a lot of energy.

Again: please note that early registration will close at the 15th of February, and abstract submission deadline has been extended to April 1st, 2015.

Looking very much forward to seeing you there!

This Month In Blastocystis Research - Welcome 2015! Edition

2014 is coming to an end, and I'm looking very much forward to 2015, which will be the year of the 1st International Blastocystis Symposium. We are busy making all the preparations, and we hope that many of our colleagues will put priority to the event. For more details, please look up www.blastomeeting2015.com

Just before Christmas, I handed in a funding proposal that will hopefully turn out to be successful; if it is, it will enable me to fund three post docs/experienced scientists who will be working on Blastocystis genomics, animal experimental model work, and Blastocystis in the gut microbiota context, all three projects serving to identify the role of the parasite in health and disease. I've never been crossing my fingers as much as I am now... I will only know in 6 months from now whether I've been successful or not, so it's a long wait!

Two new papers have come to my attention. One deals with identification of a new host for Blastocystis - the brown bear (Ursus arctos); the other one is about the finding of Blastocystis in a case of appendicular peritonitis.

Ursus arctos - new host for Blastocystis (Source).

So far, Blastocystis has been identified in many larger mammals. Mostly synanthropic animals and animals in captivity have been sampled. Meanwhile, we know little about Blastocystis in 'the wild', in sylvatic animals. A team from Slovakia took to collecting 16 stool samples from brown bears in the Poloniny National Park; eight of them were positive for Blastocystis ST3, a subtype found mainly in primates, but also occasionally in a variety of other hosts. Interestingly, the team reported that the ST3 sequence amplified from the samples were identical to a sequence that we have deposited in GenBank (HQ909889) isolated from a human. We have studied ST3 from human and non-human primates, who are both common hosts of ST3. However, we have also come to realise that ST3 strains in humans differ genetically from ST3 of non-human primates, i.e., it appears not to be the same strains circulating in human and non-human primates. I wouldn't have been surprised to find a bear-specific allele of ST3, but apparently, the bears in the study harboured ST3 identical to ST3 in humans.

Blastocystis is a frequent finding in large mammals such as cows, pigs, camels, and, possibly, bears. One of my colleagues recently asked me: How about horses? A parasitologist herself with a vast experience in both human and animal parasitology, she told me that she did not remember coming across Blastocystis in horse manure. And we wondered why... Assuming that exposure does not differ between horses and other larger, synanthropic mammals, the reason why horses might not harbour Blastocystis may be due to factors such as diet, digestion, microbiota, and maybe competing eukaryotic intestinal fauna. However, I believe that horses have been infrequently sampled, and so we need more data to be able to 'ruminate' further on this.

Since parasites such as Dientamoeba and Blastocystis are lodged in the colon, including the coecum, their potential role in e.g. appendicitis and related conditions could warrant scrutiny. Fréalle and colleagues reported a case of appendicitis with suppuration into the recto-uterine pouch and reflex ileus in a 9-year-old girl returning to France after a 1-month stay in Casablanca, Morocco, admitted to Lille University Hospital, France. The authors were unable to detect enteropathogenic bacteria such as Salmonella, Shigella, Campylobacter, Yersinia enterocolitica, adenovirus, and rotavirus, but "multimicrobial flora" was detected in the peritoneal liquid and recto-uterine pouch. It would seem plausible to me that Blastocystis ended up in the peritoneum by chance along with other enteric micro-organisms, although the etiology of the inflammation remains uncertain. Appendicitis usually develops following obstruction of the lumen of the appendix, either due to hyperplasia of lymphoid tissue or faeces becoming incarcerated in the mucosal tissue; however, other causes are have also been observed, e.g. pinworm infection.

It would like to finish off by a ***Happy New Year***, at the same time celebrating page view #300,000!

References:

Fréalle, E., El Safadi, D., Cian, A., Aubry, E., Certad, G., Osman, M., Wacrenier, A., Dutoit, E., Creusy, C., Dubos, F., & Viscogliosi, E. (2015). Acute Blastocystis-Associated Appendicular Peritonitis in a Child, Casablanca, Morocco Emerging Infectious Diseases, 21 (1), 91—94 DOI: 10.3201/eid2101.140544

Valenčáková, A., Kandráčová, P., Kalinová, J., Danišová, O., Hasajová, A. (2014). Detection of Blastocystis hominis subtype 3 in the brown bear in the Slovak Republic. Folia Veterinaria, 58, 3: 175—178. http://www.uvlf.sk/sites/default/files/folia-veterinaria/fv_3_14_web.pdf#page=32