Infecção pelo Balantidium coli, estado imunológico e comorbidades: revisão bibliográfica

Abstract

Balantidiasis, a disease caused by the ciliated protozoan Balantidium coli, mainly infects the large intestine and may have extra intestinal spread. The objective of this work was to carry out a bibliographic review about the infection by B. coli and the relationship between the immunological conditions of an infected individual and its comorbidities to identify the factors that may be associated with the establishment of the disease. The research was carried out on the platforms PubMed, LILACS, SciELO and Google Scholar, considering the studies published between 1990 and 2020 in portuguese, english and spanish. There were identified 24 (77,4%) case reports, 6 (19,4%) observational studies and 1 (3,2%) dissertation, mostly presenting the relationship between infection by B. coli and individuals with the Virus of Human Immunodeficiency 10 (32,3%), with predominance of intestinal balantidiasis 16 (51,6%) and urinary 7 (22,6%). Among comorbidities, chronic and autoimmune diseases or others that require immunosuppressive therapy, they were cited as determining factors for the establishment of infection and dissemination to other locations in the body. This can be confirmed by considering the fragility of immune system due to the systemic inflammation generated and unbalance in innate and adaptive responses, including number of T lymphocyte populations and unregulated cytokine profiles. The intestinal microbiota can also play an important role, because when it is dysbiosis, its composition and structure are affected, facilitating the invasion of the mucosa. The review shows that the presence of the parasite and establishment of balantidiasis can influence the clinical picture of chronic and autoimmune diseases, considering the modulation of immune response in presence of B. coli.