Blastocystis sp. is the most common enteric protist colonizing a wide range of host and is characterized by wide genotypic diversity. Heat Shock Protein 70 (HSP70), a common stress-response protein has been associated with increased proliferation in Blastocystis sp. under thermal stress. However, the extent of HSP70 genetic variation and its link to thermostability remains unexplored. Our study aims to elucidate HSP70 gene variants among different Blastocystis sp. subtypes, analyze their responses to thermal stress, and evaluate their protease activity following the thermal stress. Heat Shock Protein 70 gene from eighteen Blastocystis sp. isolates of varying subtype – ST1, ST3, ST4, ST6, and ST7 – were amplified, sequenced and phylogenetically analyzed. The cells were then subjected to thermal stress at 42°C for 24 hours and the cell viability was monitored for seven days. Protease activity in solubilized antigens (SA) from purified Blastocystis sp. cells was evaluated following exposure to thermal stress. Phylogenetic analysis revealed two distinct clades: ST4 and ST7 (Clade 1) which are mostly thermotolerant, while ST1, ST3, and ST6 (Clade 2) exhibited lower tolerance. Total protease activity was similar across subtypes, suggesting need for further sub-class specific analysis. Our findings suggests that thermal stress adaptation is subtype dependent and may be influenced by HSP70 variation. This insight highlights the importance of HSP70 as a potential molecular marker for stress adaptation in Blastocystis sp. and underscore the need for deeper investigation of its functional role in parasite persistence and pathogenic potential.

Background/Aims: In this meta-analysis, we studied the safety and efficacy of endoscopic submucosal dissection (ESD) for colorectal dysplasia in patients with inflammatory bowel disease (IBD). Methods: Multiple databases were searched, and studies were retrieved based on pre-specified criteria until October 2022. The outcomes assessed were resection rates, procedural complications, local recurrence, metachronous tumors, and the need for surgery after ESD in IBD. Standard meta-analysis methods were followed using the random-effects model, and I2% was used to assess heterogeneity. Results: Twelve studies comprising 291 dysplastic lesions in 274 patients were included with a median follow-up of 25 months. The pooled en-bloc resection, R0 resection, and curative resection rates were 92.5% (95% confidence interval [CI], 87.9%–95.4%; I2=0%), 81.5% (95% CI, 72.5%–88%; I2=43%), and 48.9% (95% CI, 32.1%–65.9%; I2=87%), respectively. The local recurrence rate was 3.9% (95% CI, 2%–7.5%; I2=0%). The pooled rates of bleeding and perforation were 7.7% (95% CI, 4.5%–13%; I2=10%) and 5.3% (95% CI, 3.1%–8.9%; I2=0%), respectively. The rates of metachronous recurrence and additional surgery following ESD were 10% (95% CI, 5.2%–18.2%; I2=55%) and 13% (95% CI, 8.5%–19.3%; I2=54%), respectively. Conclusions ESD is safe and effective for the resection of dysplastic lesions in IBD with an excellent pooled rate of en-bloc and R0 resection.