Detection of Blastocystis sp. in ulcerative colitis, Crohn's and chronic diarrheal patients by microscopy, culture and real-time polymerase chain reaction.

Blastocystis sp. is a zoonotic parasite that is common in humans and animals and settles in the large intestine. The parasite can cause various gastrointestinal system complaints such as indigestion, diarrhea, abdominal pain, bloating, nausea and vomiting. The aim of this study is to determine the distribution of Blastocystis in patients diagnosed with ulcerative colitis, Crohn's and diarrhea from the gastroenterology outpatient clinic and to compare the diagnostic value of the most preferred methods. A total of 100 patients, 47 men and 53 women, were included in the study. Of the cases, 61 had diarrhea, 35 had ulcerative colitis (UC) and four had Crohn's disease. Stool samples of the patients were analyzed by as direct microscopic examination (DM), culture and real-time polymerase chain reaction (qPCR). A total of 42% positivity was detected, 29% positivity in DM and trichrome staining, 28% in culture and 41% in qPCR. 40.4% (20/47) of men and 37.7% (22/53) of women were found to be infected. Blastocystis sp. was found in 75% of Crohn's, 42.6% of diarrheal and 37.1% of UC patients. Diarrhea cases are more common with UC and there is a close relationship between Crohn's and Blastocystis positivity. While DM and trichrome staining showed a sensitivity of 69%, PCR test was found to be the most sensitive diagnostic method with approximately 98%. Diarrhea and UC are often seen together. A close relationship was detected between Crohn's disease and Blastocystis. High prevalence of Blastocystis in cases with clinical symptoms reveals the importance of the parasite. There is a need for studies on the pathogenicity of Blastocystis sp. in various gastrointestinal cases, and it is thought that molecular techniques should be used since PCR is seen to be a much more sensitive.

IL-4, IL-10, TNF-α and IFN-γ Cytokine Levels in Patients with Cystic Echinococcosis and Fascioliasis.

Background: Cytokines are protein substances involved in immune response and inflammation regulation, cell growth, tissue repair and natural and adaptive immunity events such as hematopoiesis. Changes in Th1 and Th2 immune responses provide information on the clinical presentation, pathology and diagnosis of diseases. Methods: This study was conducted on 142 patients, aged 18-95 yr and applied to Parasitology Laboratory of Van Yuzuncu Yil Hospital between Aug 2018 and May 2019. Fifty-one of the patients were serologically diagnosed with CE, 53 with a diagnosis of fascioliasis, and 38 as the control group. Serum samples were taken from patients and levels of IL-4, IL-10, TNF α and IFN γ parameters were investigated by ELISA method. Results were evaluated by spectrophotometer and observed which immunologic parameters increased in which infections. Cytokine results were also evaluated according to patient age groups and genders. Chi-square and/or Fisher's exact test were used to evaluate the results. IL-4 response was detected in 50.9%; IL-10 in 44.2%; TNF-α in 43.3% and IFN-γ in 43.3% of CE seropositive patients. Results: IL-4, IL-10, TNF-α and IFN-responses detected in 50.9%, 44.2%, 43.3% and 43.3% of CE patients, and in 43%, 39.2%, 34.4% and 40.6% of fascioliasis patients, respectively. The presence of Th1 and Th2 responses were detected in both infections. There was a significant relationship between fascioliasis and IL-4 response and between CE and IL-4, IL-10 and TNF-α responses (P≤.05). Conclusion: These cytokine levels may provide information about the immune response to infections, and may be useful for early detection of disease and recurrence and monitoring of treatment.