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Figure 1.

Intra-and inter-subtype variation among Blastocystis ST-4 and ST-7 strains in inducing permeability increase.

Graph representing epithelial permeability of Caco-2 monolayers after co-incubation with live cells of Blastocystis ST-7 and ST-4 for 24 h. All strains in ST-7 induced significant increase in flux of dextran–FITC across epithelial monolayer of Caco-2 cells compared with control monolayers (p<0.01). No significant change in permeability was observed in Blastocystis ST-4-infected Caco-2.Within ST-7, an intra-subtype variation in the capability of inducing permeability change was observed. Isolates C, G and H induced much higher permeability increase compared to isolates B and E within the same subtype (p<0.01). **, p<0.01 vs. ST-7 (B, E)-infected cells; ##, p<0.01 vs. ST-4-infected cells; ‡, p<0.01 vs. non-infected cells. Each value represents mean of twelve samples, taken from three independent experiments, four samples from each. Error bars represent the standard errors.

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Table 1.

Comparisons of effects of luminal pathogens/toxins on intestinal permeability increase.

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Figure 2.

Differential effects on tight junction protein degradation in Caco-2 cell monolayers by different strains of Blastocystis.

(A) Representative Western blot analysis of occludin and ZO-1 level in Caco-2 epithelium. Monolayers were harvested after infection with Blastocystis ST-4 and ST-7 isolates; normal culture media was used as the negative control. No obvious change in occludin and ZO-1 was observed in ST-4-treated samples. Within ST-7, a more prominent decrease or loss of occludin band could be seen in cells treated by isolates C, G and H, while the changes in B-, E-treated cells were not obvious; for ZO-1 tight junction protein, loss of band was observed in Caco-2 cells after coincubation with ST-7 (C, G, H), whereas a decrease in band intensity was also noticed in B- and E-treated cells. (B) Quantification of tight junction levels through densitometry analysis of Western blot radiographs. Densitometric values of occludin and ZO-1 signals were quantified and expressed as the ratio to α-Tubulin. ST-4-treated samples did not differ significantly from control in occludin and ZO-1 level; ST-7 (C, G, H) induced significant occludin and ZO-1 degradation compared with ST-4 and ST-7 (B, E) isolates (p<0.01). ST-7 (B, E), however, were able to induce significant ZO-1 degradation compared with control and ST-4, but not for occludin. **, p<0.01 vs. ST-7 (B, E)-infected cells; #, p<0.05 vs. ST-4-infected cells; ##, p<0.01 vs. ST-4-infected cells; ‡, p<0.01 vs. non-infected cells. Results were from three independent experiments. Error bars represent the standard errors. (C) Representative confocal micrographs illustrating occludin integrity in Caco-2 monolayers. Caco-2 cells are labelled with DAPI (Blue) and an antibody targeting tight junction protein occludin and Cy3® goat anti-mouse IgG (Red). Corresponding with Western blot results, in ST-4 and ST-7 (B, E)-treated samples, no obvious change in occludin was observed. Infection with ST-7 (C, G, H), however, induced focal disruptions and degradation in occludin, as shown by the decreased occludin staining intensity in Caco-2 cell line. Scale bar = 10 µm. (D) Representative confocal micrographs illustrating ZO-1 integrity in Caco-2 monolayers. Caco-2 cells are labelled with DAPI (Blue) and an antibody targeting tight junction protein ZO-1 and Cy3® goat anti-mouse IgG (Red). Compared with the negative control and ST-4-treated samples, where ZO-1 appeared continuous with sharp pericellular staining patterns, all ST-7 isolates resulted in focal disruption as well as degradation of ZO-1 in Caco-2 cells. In ST-7 (C, G, H)-treated samples, ZO-1 staining almost became invisible, indicating more degradation of the protein, which corresponded with the western blot results. Notably, treatments with ST-7 (B, E) resulted in both focal disruptions (green arrows) as well as reorganizations of ZO-1 (yellow arrows). Scale bar = 10 µm.

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Figure 3.

Blastocystis exhibits intra- and inter-subtype variation in attachment to Caco-2 cells.

(A) Representative confocal micrographs illustrating intra- and inter-subtype variation in Blastocystis attachment to Caco-2 cells. Caco-2 monolayers were grown to confluency on glass converslips and were then co-incubated with the same number of parasites of different strains of Blastocystis pre-stained with CFSE (green). Normal culture media was used as a negative control. After co-incubation, the non-attached parasites were washed away. The Caco-2 monolayers were then stained with DAPI and then were viewed using confocal microscope (Olympus Fluoview FV1000; Olympus, Japan). More green in the field represents more parasites attached to the monolayer. Both ST-4 strains adhere with a negligible number. An intra-subtype variation in the number of attachment within ST-7 is obvious. Isolates C, G, H appeared to attach at a much higher level than B and E to Caco-2 cells. Scale bar = 100 µm. (B) Graph representing number of Blastocystis parasites attached to host cells. ST-7 strains C, G and H exhibited a significantly higher number of attached parasites than ST-4 strains and ST-7 isolates B and E. *, p<0.05 vs. ST-7 (B, E); **, p<0.01 vs. ST-7 (B, E); ##, p<0.01 vs. ST-4. Each value represents a mean of six readings derived from 3 independent experiments. Error bar represents standard error. (C) Relationship between attachment and permeability increase by Blastocystis ST-4 and ST-7 parasites. The data points indicate individual strains. x and y error bars indicate the standard error for the respective measurements (n = 3). The R2 for the trend line shown is 0.8506, and the p value is 0.0031. There is a positive correlation between the level of attachment and permeability increase (R = 0.9223).

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Figure 4.

Blastocystis ST-7 isolate H attaches to an intestinal monolayer.

Caco-2 monolayers were grown to confluency on glass coverslips and were then coincubated with Blastocystis ST-7 (H). Normal culture media was used as the negative control. (A) Representative confocal micrographs illustrating attachment of Blastocystis ST-7 (H) to Caco-2 monolayers. Blastocystis was labelled with legumain antibody-mAb1D5and secondary AlexaFluro 594 goat anti-mouse IgM (red). Phalloidin-FITC (green) was used to label F-actin of Caco-2 cells and DAPI (blue) for nuclei. Compared with the negative control, attachment of Blastocystis ST-7 to Caco-2 apical side could be seen clearly. (B) Expanded section views of epithelium of control and ST-7 (H)-treated-monolayers. Parasites could be seen intimately adhering to the epithelium and it could also be noted that the parasites adhered preferentially to the cell-cell junction site (yellow arrows) and induced an increase in actin polymerization. Compared with the negative control which displayed a properly organized epithelium, there was loss of cellular symmetry in the cells treated by ST-7 (H) (black arrowheads). Scale bar = 20 µm. (C) Quantification of F-actin staining in Blastocystis-infected Caco-2 monolayers. Each cell slice (1–25) corresponds to series of images from Z-stack sections taken at 1 µm thickness through the cell monolayer. X-axis illustrates cell layers from basolateral to apical. Y-axis illustrates the number of pixels present over the entire area of image. Monolayers treated with ST-7 (H) resulted in marked increase in actin intensity compared to the negative control (p<0.01).

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Figure 5.

Inhibition of Blastocystis ST-7 (H) adhesion by galactose rescues Blastocystis ST-7 (H)–induced ZO-1 tight junction degradation.

(A) Dose-dependent inhibition of galactose on Blastocystis ST-7 (H) adhesion to Caco-2 monolayers. Blastocystis ST-7 (H) were incubated with epithelial cells in the presence of different concentrations of galactose and glucose (50 and 100 mM, respectively). A value of 100% was assigned to number of binding parasites without addition of sugars as control. The numbers of attached parasites with galactose addition were normalized to control.*, p<0.01 vs. control. (B) Representative western blot analysis of ZO-1 level in Caco-2 epithelium. Caco-2 monolayers were infected with Blastocystis ST-7 (H) in the presence of saccharides galactose and glucose at 100 mM and incubated for 1 h. Monolayers were washed and prepared for western blotting. Normal culture media with no sugar addition was used as the negative control. Galactose rescued Blastocystis–induced ZO-1 tight junction degradation. (C) Quantification of ZO-1 levels through densitometry analysis of Western blot radiographs. Densitometric values of ZO-1 signals were quantified and expressed as the ratio to α-Tubulin. ZO-1 degradation was significantly rescued by addition of galactose. *, p<0.01 vs. ST-7 (H)-treated sample. Values are the means ± standard errors from data of three experiments. Error bars represent the standard errors. Glu, glucose; Gal, Galactose.

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Figure 6.

Intra- and inter-subtype variations in protease activity in Blastocystis.

Protease activity of Blastocystis ST-4 and ST-7 isolates was determined by azocasein assays. Except isolate G, most of ST-7 strains exhibited significantly higher protease activities than the two ST-4 isolates (p<0.01). PBS as a background control showed activity that was significantly lower when compared to protease activities of all the isolates (p<0.01). Note that cysteine protease inhibitor iodoacetamide (IA) abolished protease activity of all the isolates, which is comparable to PBS. ##, p<0.01 vs. ST-4; ‡, p<0.01 vs. PBS control. Each value represents mean of six samples, taken from three independent experiments. Error bars represent the standard errors.

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Figure 7.

Blastocystis exhibits intra-subtype variation in susceptibility and resistance to Mz.

Graph representing IC50s of Mz against Blastocystis ST-4 and ST-7 isolates tested in the study using the resazurin assay. Y axis was presented on a logarithmic scale in base 5. The IC50s of Mz against ST-7 isolates C, G and H were found to be significantly lower than those of isolates B, E within the same subtype (p<0.01). **, p<0.01 vs. ST-7 (B, E). Each point represents a mean of nine readings derived from three independent experiments, triplicate each. Error bars represent the standard errors.

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Figure 8.

Correlation analyses between Mz resistance and (A) attachment, as well as (B) permeability increase in Blastocystis ST-7 parasites.

(A) Relationship between Mz resistance and attachment for Blastocystis ST-7 parasites. The data points indicate individual strains. Error bars indicate the standard error for the respective measurements (n = 3). There was a negative correlation between the level of resistance and attachment (p<0.05, R2 = 0.8908). (B) Relationship between Mz resistance of Blastocystis ST-7 parasites and their ability in inducing permeability increase. The data points indicate individual strains. Error bars indicate standard errors for the respective measurements (n = 3). There was a negative correlation between the level of resistance and permeability increase (p<0.01, R2 = 0.9644).

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Table 2.

IC50s of Mz and nitric oxide donors against Blastocystis ST-7 isolates (µg/ml).

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Table 3.

Correlation of Mz resistance with attachment, permeability increase and nitric oxide IC-50 in Blastocystis ST-7.

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