Impact of Ascaris lumbricoides infection on the development of chronic pulmonary aspergillosis in patients with COPD.

The aetiopathogenesis of chronic obstructive pulmonary disease (COPD) remains unclear. The aim of our study was to determine the possible influence of Ascaris lumbricoides on the development of chronic pulmonary aspergillosis (CPA) in patients with COPD. The prevalence of A. lumbricoides in patients with COPD with CPA (19.05%) was significantly higher than that in those without (9.20%) and controls (4.9%) (p < 0.05). Trends in levels of Interleukin-1ß and of tumour necrosis factor α suggest ascariasis increases susceptibility to Aspergillus sp. in patients with COPD and can be considered an additional risk factor for CPA.

Prevalence of chronic pulmonary aspergillosis and the antifungal drug resistance of Aspergillusspp. in pulmonary tuberculosis patients in Uzbekistan.

The aim of our study was to determine the prevalence of chronic pulmonary aspergillosis in pulmonary tuberculosis patients and the antifungal resistance of Aspergillus spp. isolates in Uzbekistan. Chronic pulmonary aspergillosis was detected in 11.4% and 20.0% of smear-positive and smear-negative pulmonary tuberculosis patients, respectively.

Antiprotozoal effect of steroid hormone 20-hydroxyecdysone in giardiosis patients.

The World Health Organization reports that approximately 200 million people are infected with Giardia (G.) lamblia worldwide. Taking into account the emergence of resistance and the high toxicity of conventional drugs, research into new strategies to fight against G. lamblia is increasing. The aim of the study was to assess the antiprotozoal activity of 20-hydroxyecdysone in water sports athletes with giardiosis. A randomized, double-blinded, placebocontrolled clinical study was conducted. Seventy-six athletes with G. lamblia infection participated in the study and were divided into 20-hydroxyecdysone, metronidazole and placebo groups. Clinical, parasitological, haematological and biochemical analyses were performed. Positive results for antiprotozoal therapy were revealed in the 20-hydroxyecdysone and metronidazole groups. After therapy, elimination of G. lamblia was observed in 100.0% of the athletes included in the 20-hydroxyecdysone group. However, G. lamblia was resistant to metronidazole in 4.0% of athletes included in the metronidazole group. A positive clinical response to the therapy occurred in the 20-hydroxyecdysone and metronidazole groups. Our study reveals high antiprotozoal activity of 20-hydroxyecdysone against G. lamblia. Further clinical studies are necessary to evaluate the antiprotozoal efficacy of 20-hydroxyecdysone.

Intestinal protozoa and helminths in ulcerative colitis and the influence of anti-parasitic therapy on the course of the disease.

PURPOSE: The aim of this study is to determine the prevalence of intestinal helminths and protozoa in patients with ulcerative colitis (UC) and to estimate the influence of the anti-parasitic therapy on the course of the disease. METHODS: The study was conducted at the Research Institute of Epidemiology, Microbiology and Infectious Diseases and Coloproctology Department of the Republic Clinical Hospital №1 of the Ministry of Health of the Republic of Uzbekistan. One hundred UC patients and 200 healthy individuals were examined by triple coproscopy. Additionally, 20, 25 and 22 UC patients with Blastocystis infection were treated with nitazoxanide (1.0 g/day), mesalazine (1.5-2 g/day) or a combination of nitazoxanide (1.0 g/day) and mesalazine (≥1.5-2 g/day) for 14 consecutive days, respectively. Parasitological, clinical and endoscopic examinations were conducted before therapy, immediately after and 6 and 12 weeks after therapy completion. RESULTS: The overall prevalence of helminths in UC patients and control individuals was not significantly different: 14±3.4% and 8.5±1.9%, respectively (OR: 1.7524; 95% CI: 0.8258 to 3.7186; P=0.1). Giardia lamblia was the most prevalent parasite in both groups, but the difference compared to the control was insignificant (OR: 0.4565; 95% CI: 0.2020 to 1.0318; P=0.05). A significantly higher prevalence of Blastocystis sp., Chilomastix mesnili and Iodamoeba butschlii in UC patients compared to control individuals was found (P<0.0005): 65.0%, 14.0% and 22.0%, respectively. During all follow-up periods, the clinical response and clinical remission were not statistically different between the groups (P>0.05). Mucosal healing immediately and 6 weeks after therapy with a combination of nitazoxanide with mesalazine was significantly better than with a monotherapy of nitazoxanide, respectively (P<0.05). UC patients treated with a combination of nitazoxanide with mesalazine showed better mucosal healing than in patients treated with a monotherapy of mesalazine (P>0.05). CONCLUSIONS: Diagnosis of Blastocystis sp. should be introduced in the complex examination of UC patients. Further clinical studies are necessary for assessment of the efficiency of anti-Blastocystis therapy in UC patients.

Pityriasis alba: Possible associations with intestinal helminths and pathogenic protozoa.

BACKGROUND: The aetiology of pityriasis alba (PA) remains uncertain, and children are at risk for PA and intestinal parasites. AIM: To determine the prevalence of intestinal parasites in PA patients and to evaluate their possible role in PA pathogenesis. METHODS: Overall, 180 PA patients and 100 healthy individuals were enrolled. Intestinal parasites were diagnosed by triple coproscopy, and the total serum Immunoglobulin E (IgE) levels were determined by ELISA. PA patients with intestinal parasites were treated with conventional antiparasitic drugs. Patient response to antiparasitic therapy was evaluated after 6 weeks. RESULTS: The prevalence of intestinal parasites in PA patients and controls was 60 ± 3.6% and 32 ± 4.6%, respectively (P < .0001). Regardless of the parasite species among the PA patients and control individuals, the total IgE levels were significantly higher in PA patients (P ≤ .05). The highest values of IgE were found in PA patients with Hymenolepis nana (641.7 ± 46.3 IU/mL). The total IgE level in PA patients with parasites decreased after antiparasitic therapy, but the reduction was only significant in patients with H. nana (P < .05). Complete disappearance of hypopigmented patches was observed after the elimination of H. nana, Giardia lamblia and Enterobius vermicularis in 65 ± 10.6%, 48.7 ± 8.0% and 33.3 ± 8.2% of cases, respectively. In total, a positive clinical response to antiparasitic therapy was achieved in 60 ± 4.7% of infected PA patients. CONCLUSION: A positive clinical response to antiparasitic therapy indicates the role of intestinal parasites in PA pathogenesis. Parasitological examination is justified by the recovery of 60 ± 4.7% of infected PA patients after the elimination of intestinal parasites.

Association of the 25(OH) vitamin D status with upper respiratory tract infections morbidity in water sports elite athletes.

BACKGROUND: The aim of this study is to determine seasonal changes of total serum 25(OH) vitamin D (VD) concentration and its influence on upper respiratory tract infection (URTI) morbidity among water sports elite athletes. METHODS: The study was planned as a prospective, non-interventional, observational study. Study participants included 40 elite athletes and 30 control individuals. Serum levels of 25(OH) VD and TNF-α, IFN-γ, IL-4 and IL-6 were detected by ELISA technique. Frequency of acute URTI in participants was determined by medical cards and self-reported questionnaire during the year. RESULTS: VD deficiency/insufficiency dominated in both groups of elite athletes, especially in synchronized swimmers (100%) in comparison with the control individuals (63.3%) (P≤0.05). Prevalence of VD deficiency/insufficiency depends on the season, but independently on the season the highest values were observed among athletes. VD sufficiency was detected in 30% and 13.3% of the control individuals in August and February and only in 10% of swimmers in August. More than 3 episodes of URTI were detected only in elite athletes in winter-spring. The elevation of TNF-α, IL-4, IL-6 and decrease of IFN-γ levels were detected in all athletes, but they were more expressed in swimmers. CONCLUSIONS: VD insufficiency is quite pronounced among elite athletes engaged in synchronized swimming and swimmers. It is accompanied with a decrease of IFN-γ, increase of TNF-α, IL-4 and IL-6 level, and elevation of URTI morbidity. Seasonal monitoring and correction of the VD level for normalization of cytokine profile and decrease of URTI morbidity is definitely advised.

Intestinal helminths and protozoan infections in patients with colorectal cancer: prevalence and possible association with cancer pathogenesis.

The purpose of the present study was to determine the prevalence of intestinal helminths and protozoa in colorectal cancer (CRC) patients and to evaluate the possible association between the prevalence and CRC pathogenesis. A total of 200 CRC patients and 200 residents of Tashkent, who had no complaints related to the gastrointestinal tract, were examined by triple coproscopy using a concentration method and estimations of protozoan infection intensity. Of the CRC patients tested, 144 were classified as T1-4N0M0 (without metastases) and 56 were classified as T1-4N1-2M0-1 (with metastases). Parasitological examination was performed during CRC diagnosis before and after surgery and chemotherapy. A significantly higher prevalence of Blastocystis sp., Chilomastix mesnili, Jodamoeba butschlii, and Endolimax nana was found in CRC patients than in the control population (p < 0.0001), amounting to 80, 20, 22.5, and 11.5%, respectively. The high prevalence of Blastocystis sp., as well as the patterns of infection intensity, was stable at all stages of examination. The ratio of the number of CRC patients with and without Blastocystis sp. in the T1-4N0M0 and T1-4N1-2M0-1 groups amounted to 3.3 and 7.0, respectively. The ratios for C. mesnili, E. coli, J. butschlii, and E. nana in both groups were 0.2 and 0.2, 0.07 and 0.07, 0.3 and 0.16, and 0.18 and 0.01, respectively. The prevalence of helminths and Giardia lamblia in CRC patients and the control population was not significantly different. Taken together, these data indicate a possible role for Blastocystis sp. in CRC pathogenesis. Diagnosis, treatment, and further observation of patients with Blastocystis sp. are necessary at all stages of CRC, including during diagnosis and before and after surgery and chemotherapy.