Increase number of mitochondrion-like organelle in symptomatic Blastocystis subtype 3 due to metronidazole treatment
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Blastocystis sp., an intestinal organism is known to cause diarrhea with metronidazole regarded as the first line of treatment despite reports of its resistance. The conflicting reports of variation in drug treatment have been ascribed to subtype differences. The present study evaluated in vitro responses due to metronidazole on ST3 isolated from three symptomatic and asymptomatic patients, respectively. Symptomatic isolates were obtained from clinical patients who showed symptoms such as diarrhea and abdominal bloating. Asymptomatic isolates from a stool survey carried out in a rural area. These patients had no other pathogens other than Blastocystis. Ultrastructural studies using transmission electron microscopy (TEM) and scanning electron microscopy (SEM) revealed drug-treated ST3 from symptomatic patients were irregular and amoebic with surface showing high-convoluted folding when treated with metronidazole. These organisms had higher number of mitochondrion-like organelle (MLO) with prominent cristae. However, the drug-treated ST3 from asymptomatic persons remained spherical in shape. Asymptomatic ST3 showed increase in the size of its central body with the MLO located at the periphery.
KeywordsBlastocystis Metronidazole Amoeboid Subtype 3 Symptomatic Asymptomatic
This work is supported by the High Impact Research Grant (HIR) (UM.C/HIR/MOHE/MED/44). The authors would like to thank the Department of Parasitology staff, Department of Transmission Electron Microscopy (TEM), Faculty of Medicine at the University of Malaya, Department of Scanning Electron Microscopy (SEM), Faculty of Science at the University of Malaya, and the Institute for Medical Research staff, Mr. Santhana for his assistance in the ultrastructural studies.
KR, SKG, and TTC were involved in all stages of the study, including the conception and designing of the experiment, data collection and analysis, and interpretation of results. KR wrote the manuscript, and all authors read and approved the finalized manuscript.
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Conflict of interest
The authors declare that the have no competing interests.
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