Vibrio cholerae is one of the most common causes of diarrhea worldwide. While diarrhea associated with V. cholerae is predominately seen in the Indian subcontinent, South East Asia, Africa, and South America, sporadic cases of V. cholerae-induced diarrhea have been reported in the United States. Gastrointestinal disease caused by V. cholerae is due to production of the cholera toxin. Two types of infection occur; cholera, which is a severe illness presents with profuse, “rice-water” diarrhea, vomiting, tachycardia, dehydration, muscle cramps, restlessness or irritability, and vibriosis, which is characterized by abdominal cramps, nausea, vomiting, fever and chills which is a self-limited illness of 3-4 days.

Vibrio species are a group of bacteria commonly found in marine and coastal environments that can enter the gastrointestinal tract through contaminated food or water. Detecting Vibrio species in stool helps assess whether these organisms may be contributing to digestive symptoms, inflammation, or gut microbiome imbalance.

A low or undetectable level of Vibrio species generally suggests that these bacteria are not contributing to current gastrointestinal symptoms. This result is typically considered favorable and consistent with a balanced gut microbiome, particularly when other pathogenic bacteria are also absent.

Helicobacter pylori BabA Adhesin: A Key Virulence Factor in Gastric Disease

Helicobacter pylori is a gram-negative, spiral-shaped bacterium that colonizes the human stomach, affecting approximately 50% of the global population. While many infections remain asymptomatic, H. pylori can cause a spectrum of gastric diseases, ranging from chronic gastritis to peptic ulcers and gastric cancer. The bacterium's ability to persist in the harsh gastric environment is largely attributed to its virulence factors, with BabA (blood group antigen-binding adhesin) playing a crucial role in pathogenesis.

What is cagA?

cagA (cytotoxin-associated gene A) is a virulence factor produced by certain strains of Helicobacter pylori (H. pylori), a bacterium that can colonize the human stomach lining. Not all H. pylori strains carry this gene. When present, cagA significantly increases the bacterium's ability to cause inflammation and damage to the stomach lining.

Duodenal ulcer promoting gene a (dupA) is a virulence factor of H. pylori that is highly associated with duodenal ulcer development and reduced risk of gastric cancer. 

The iceA gene is recognized as a significant virulence factor in the genome of Helicobacter pylori, a Gram-negative, spiral-shaped bacterium implicated in the pathogenesis of various gastrointestinal diseases, including gastritis, peptic ulcers, and is associated with the development of gastric cancer. This gene exists in two main allelic variants: iceA1 and iceA2, each displaying different epidemiological distributions and potential roles in the bacterium's pathogenicity.

H. pylori virulence factor OipA (Outer Inflammatory Protein A) - associated with gastric cancer and peptic ulcer.

The virulence factor genes on GI-MAP are found exclusively on the genome of H. pylori.

These genes code for proteins that will predispose one to more serious H. pylori infections. 

Helicobacter pylori (H. pylori):

Recent studies have shown that nearly 50% of the world’s population may harbor H. pylori. And, although many carriers are asymptomatic, H. pylori is known to have a causative role in ulcers, chronic gastritis, and stomach cancer.

Additionally, in early phases of colonization, patients may experience hypochlorhydria followed by a change to hyper aciduria. Over time, additional H. pylori strains may colonize, including those with Virulence Factors and increased disease potential.

The virulence factor genes on GI-MAP are found exclusively on the genome of H. pylori. These genes code for proteins that will predispose one to more serious H. pylori infections.

Recent studies have shown that nearly 50% of the world’s population may harbor H. pylori. And, although many carriers are asymptomatic, H. pylori is known to have a causative role in ulcers, chronic gastritis, and stomach cancer. Additionally, in early phases of colonization, patients may experience hypochlorhydria followed by a change to hyper aciduria. Over time, additional H. pylori strains may colonize, including those with Virulence Factors and increased disease potential.

Viscosity is an important biomarker assessed in a semen analysis that measures the thickness or fluidity of the semen. It plays a key role in determining the semen's ability to effectively transport sperm through the male reproductive system and into the female reproductive tract during fertilization. Normal viscosity allows semen to liquefy within 15 to 30 minutes after ejaculation, which facilitates sperm movement.

Viscosity refers to the property of fluids that enables them to resist flow. Measuring the viscosity of serum, plasma, or whole blood can be valuable in diagnosing and monitoring patients with hyperviscosity syndromes, which are often associated with conditions like multiple myeloma and Waldenstrom's macroglobulinemia. These measurements are reported as a relative viscosity compared to water, where normal serum and plasma have a relative viscosity of up to 1.6. While values greater than 1.6 are considered abnormal, hyperviscosity syndromes typically do not manifest unless the relative viscosity reaches approximately 4.0 or higher.

The most common cause of serum hyperviscosity is the presence of high concentrations of IgM monoclonal proteins. Waldenstrom's macroglobulinemia is responsible for 80% to 90% of symptomatic hyperviscosity cases. Hyperviscosity syndrome can also be observed in patients with multiple myeloma, and, in rare instances, it may occur in patients with high levels of rheumatoid factors and other proteins that tend to aggregate.

Thiamin is a vitamin that plays a critical role in energy metabolism, especially in the brain and nervous system. Thiamin also plays an important role in muscle contraction and nerve conduction. Faecalibacterium spp utilize thiamine but do not produce it, indicating that there is a competition for vitamins within the gut microbiome.

Vitamin B12 binding capacity, unsaturated (transcobalamin) refers to the ability of transcobalamin, a protein in the blood, to bind to and transport vitamin B12 within the body. Transcobalamin plays a crucial role in the transport of vitamin B12 from the intestines to various tissues where it is utilized in essential physiological processes.

Vitamin B12 (cobalamin) is crucial for healthy red blood cells, brain and nervous system function, DNA regulation, and metabolism. Production of B12 by gut bacteria contribute up to 31% of the daily recommended intake for this nutrient.

Vitamin B2 (riboflavin) is a cofactor needed for energy production and fat metabolism that also plays an important role in immune cell function.

Vitamin B5 (pantothenic acid) is essential for energy production and fat metabolism. Bacteroides fragilis, Prevotella copri, Ruminococcus spp, Salmonella enterica, and Helicobacter pylori can all produce vitamin B5 in the gut. However, there are many species that rely on vitamin B5 for growth but cannot synthesize it, like most Fusobacterium, Bifidobacterium spp, Faecalibacterium spp, Lactobacillus spp, and some strains of Clostridium difficile, suggesting that these bacteria may compete with the host for vitamin B5.

Vitamin B6 is an incredibly versatile nutrient that supports immunity, brain function, and protein metabolism. It is also a necessary, rate limiting cofactor for neurotransmitter production, including dopamine, serotonin, gamma-aminobutyric acid (GABA), noradrenaline, and the hormone melatonin.

This nutrient is found abundantly in foods, particularly fish, chicken, tofu, sweet potato, and avocado.

B6 can also be produced by commensal gut species including Bacteroides fragilis, Prevotella copri, Bacillus clausii, Corynebacterium glutamicum, Listeria monocytogenes, Streptococcus mutans, Bifidobacterium longum, Collinsella aerofaciens, and Helicobacter pylori.

Human gut microflora contribute up to 86% of the daily recommended intake of B6.

Biotin (also known as Vitamin H, Vitamin B7, or Vitamin B8) is a water soluble vitamin necessary for growth, development, and cellular energy production that can support healthy hair, skin, and nails and support healthy immune responses. Biotin is synthesized from tryptophan by intestinal bacteria like Bacteroides fragilis, Prevotella copri, Ruminococcus lactaris, Clostridium difficile, Bifidobacterium infantis, Helicobacter pylori, and Fusobacterium varium. In contrast, some species of Prevotella, Bifidobacterium, Clostridium, Ruminococcus, Faecalibacterium, and Lactobacillus may steal biotin from the host as they need it for survival.