Abstract
Ulcerative colitis (UC) is thought to originate from a disbalance in the interplay between the gut microbiota and the innate and adaptive immune system. Apart from the bacterial microbiota, there might be other organisms, such as parasites or viruses, that could play a role in the aetiology of UC. The primary objective of this study was to compare the prevalence of Blastocystis sp. in a cohort of patients with active UC and compare that to the prevalence in healthy controls. We studied patients with active UC confirmed by endoscopy included in a randomised prospective trial on the faecal transplantation for UC. A cohort of healthy subjects who served as donors in randomised trials on faecal transplantation were controls. Healthy subjects did not have gastrointestinal symptoms and were extensively screened for infectious diseases by a screenings questionnaire, extensive serologic assessment for viruses and stool analysis. Potential parasitic infections such as Blastocystis were diagnosed with the triple faeces test (TFT). The prevalence of Blastocystis sp. were compared between groups by Chi-square testing. A total of 168 subjects were included, of whom 45 had active UC [median age 39.0 years, interquartile range (IQR) 32.5–49.0, 49 % male] and 123 were healthy subjects (median age 27 years, IQR 22.0–37.0, 54 % male). Blastocystis sp. was present in the faeces of 40/123 (32.5 %) healthy subjects and 6/45 (13.3 %) UC patients (p = 0.014). Infection with Blastocystis is significantly less frequent in UC patients as compared to healthy controls.
Highlights
The microbiota are believed to play an important role in the interaction between the host and the immune system
Patients with active Ulcerative colitis (UC) participating in a clinical trial between 23-5-2011 and 30-06-2013 were included if they had an exacerbation of their disease, defined by a Simple Clinical Colitis Activity Index (SCCAI) score of ≥4 and ≤11 [14]
We collected all clinical and screening data. These volunteers were screened for faecal donation in either a clinical faecal transplantation trial on faecal microbiota transplantation (FMT) in UC, type I diabetes, type II diabetes/metabolic syndrome or for patients suffering from recurrent Clostridium difficile infection [15]
Summary
The microbiota are believed to play an important role in the interaction between the host and the immune system. Commensal microbes are believed to protect our body against invading pathogens and have an important function in the development of the mucosal immune system [1]. One of the eukaryotes that is still debated with regard to its pathogenic role is Blastocystis sp. In inflammatory bowel disease (IBD), the question remains as to whether eradication of an infection with Blastocystis would relieve abdominal symptoms such as abdominal pain or bloating [10, 11]. Conflicting data exist on the role of this eukaryote in either disease [12, Eur J Clin Microbiol Infect Dis (2015) 34:1039–1044
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