Blastocystis and the Microbiome

Is Blastocystis a pathogen? Should we eradicate it? How to eradicate it? Does it have any benefits?

General:

Review, Aug 2022: The regulatory function of Blastocystis spp. on the immune inflammatory response in the gut microbiome https://www.frontiersin.org/articles/10.3389/fcimb.2022.967724/full - unclear whether pathogen or not.

There are several sub-genera of blastocystis, some are pathogenic, and some are not. Here is a useful blog on Blasto by a Danish scientist: https://www.blastocystis.net/p/me-and-my-research.html

A quote from his blog:

There is no known efficient eradication strategy for Blastocystis.

Eradication of Blastocystis Carriage With Antimicrobials: Reality or Delusion? (Review, 2010)

FMT:

First Blastocystis Transmission to FMT Recipients Reported. Lack of adverse effects may warrant removing parasite from stool donor exclusion criteria, researchers say (Nov 2019) https://www.medpagetoday.com/gastroenterology/generalgastroenterology/83443. Human transmission of Blastocystis by Fecal Microbiota Transplantation without development of gastrointestinal symptoms in recipients.

In the United States, stool donors are no longer screened for Blastocystis hominis, and CHUV (Lausanne University Hospital) has adopted the same practice. (2023) https://smw.ch/index.php/smw/article/view/3472/5739#d119e205

Harms:

One subtype of the common gut eukaryote Blastocystis directly kills off the good gut bacterium Bifidobacterum, and is linked with reduced numbers of another good microbiome bacterium, Lactobacillus (2019): https://www.genengnews.com/news/gut-microbiome-eukaryote-causes-death-of-good-bacteria/ - Interactions between a pathogenic Blastocystis subtype and gut microbiota: in vitro and in vivo studies.

Presence of Blastocystis in gut microbiota is associated with cognitive traits and decreased executive function (Jun 2022) https://www.nature.com/articles/s41396-022-01262-3

Benefits:

Blastocystis subtype 4 linked to gut microbiota stability (Aug 2022) https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(22)00196-3/fulltext

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