Molecular characterization and subtyping of Blastocystis in urticarial patients in Turkey
Aydin, Merve; Yazici, Mustafa; Demirkazik, Mehtap; Koltas, İsmail Soner; Cikman, Aytekin; Gulhan, Baris; Duran, Tugce; Yilmaz, Aysun; Kara, Murat
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Abstract
Objective: To investigate Blastocystis’ etiologic role and association with gastrointestinal
symptomatology in acute and chronic urticaria patients and to identify Blastocystis subtypes
responsible for urticaria.
Methods: The study included urticaria patients and healthy individuals that presented to our
polyclinic between June 2015 and May 2017. The participants were assigned into Group栺(137 patients), subdivided into acute (72) and chronic urticaria patients (65), and Group栻(129 control inndividuals). Blastocystis presence was investigated by native-Lugol examination,
trichrome staining, PCR using sequence tagged site primers, and DNA sequencing analysis.
The phylogenetic tree was constructed.
Results: The native-Lugol and trichrome staining methods revealed that 16 patients (16/133,
12.0%) had Blastocystis-positive stool samples, of which seven samples (7/133, 5.3%) belonged
acute and nine (9/133, 6.8%) to chronic urticaria patients. Concerning Blastocystis subtypes, of
the acute urticaria patients, three had subtype 1 (ST1), one had ST2, and three had ST3. Of the
chronic urticaria patients, one had ST1 and eight had ST3. Blastocystis positivity was detected
in two control individuals (2/123, 1.6%), both being ST3. All subtypes identified by PCR
were confirmed by the sequencing analysis. The acute and chronic urticaria groups showed no
statistically significant differences for Blastocystis positivity (P=0.60) and subtype distribution
(P=0.15). A statistically significant difference was found between the urticaria patients and the
controls for Blastocystis positivity (P<0.01), but not for subtype distribution (P=0.67) or for
Blastocystis presence and gastrointestinal complaints.
Conclusions: This study on Blastocystis subtype distribution among Turkish urticaria patients
showed results consistent with the literature. It was concluded that Blastocystis should be kept
in mind in patients with urticaria.... Show more Show less