GI-MAP – Diagnostic Solutions – Latin America

Optimal health: it all starts with GI-MAP

Research overwhelmingly indicates that gut health impacts overall health. The gut microbiome, in particular, plays a critical role in mediating the effects of diet and other factors on health, including digestive, immune, metabolic, and neuroendocrine functions. Assessing gastrointestinal health with the right tools can help professionals get to the root cause of chronic diseases.

Why is quantification using qPCR technology so important?

Unlike other comprehensive stool tests on the market, GI-MAP can provide professionals with truly quantitative results. qPCR offers a much more accurate way to detect and quantify clinically relevant organisms than standard methods based on PCR, culture, microscopy or DNA sequencing. Accurately assessing how much of an organism's DNA is present in a patient's stool sample is essential to help doctors determine clinical effect. importance of pathogenic organisms and dysbiosis patterns.

Reliability, reproducibility and use of qPCR in clinical research

Although qPCR is becoming more common in in vitro diagnostics (IVD), we are the only laboratory in the United States exclusively using qPCR technology for advanced comprehensive stool testing. This technology is commonly used in clinical and academic research because it provides very precise quantification, as well as high levels of sensitivity and specificity. Standard PCR technology does not offer the same level of sensitivity or the ability to express precise numerical results.

The GI-MAP also provides consistently reproducible results. Reproducibility is of crucial importance for clinicians and patients who rely on the efficacy of GI-MAP. To achieve this, we perform rigorous quality control and have validated all molecular target quantification assays to meet or exceed FDA standards.

GI-MAP allows for personalized treatment plans and informative Retests

The accuracy and reliability of the GI-MAP allows clinicians to create personalized treatment protocols to address gut dysfunction based on which infections are urgent, which areas of the gut are already optimized, and which areas need to be addressed following an infection. >is resolved.

Additionally, quantification offers a remarkable ability to see how treatment modalities are working because a retest after treatment can show whether a parasite has resolved, whether dysbiosis has improved, and more.

Who should have the GI-MAP comprehensive stool analysis?

Almost all patients can benefit from a GI-MAP gut health assessment. Some patients seek to achieve optimal health, while others have suffered from chronic illnesses and have been frustrated without a diagnosis for years.

Some conditions that warrant testing are:

• Autoimmune diseases
• IBS/IBD
• Digestive problems, diarrhea or constipation.
• brain fog
• Skin problems, such as acne and psoriasis.
• Mood disorders, depression and anxiety.
• Diabetes and weight loss problems.

 

Can babies and children benefit from GI-MAP?

Yes. The GI-MAP is commonly used in infants and children and can provide information on conditions related to attention deficit hyperactivity disorder, autism, and digestive disorders. 

What is reported in GI-MAP test results?

The Gastrointestinal Microbial Assay Plus (GI-MAP) is an innovative clinical tool that measures gastrointestinal microbiota DNA from a single stool sample using state-of-the-art quantitative polymerase chain reaction (qPCR) technology.

The GI-MAP was designed to detect microbes that may be disrupting the normal microbial balance or contributing to disease, as well as indicators of digestion, absorption, inflammation and immune function.

Page-by-page listing of microorganisms found in GI-MAP:

Page 1: 

PATHOGENS

GI-MAP includes pathogens (bacterial, parasitic, and viral) commonly known to cause intestinal gastroenteritis. It is important to note that not all people who test positive for pathogens will develop symptoms. Many factors, including the health of the individual, the transient nature of some pathogens, and the presence and expression of virulence factors, contribute to an individual's symptoms.

Toxins are a type of virulence factor produced by certain pathogens. Since GI-MAP is a DNA-based test, the results reflect the levels of pathogenic strains carrying the toxin genes, not the levels of any toxins that may be produced.

BACTERIAL PATHOGENS

• Campylobacter
• C. difficile toxin A
• C. difficile toxin B
• Enterohemorrhagic E. coli
• Escherichia coli O157
• Enteroinvasive E. coli/Shigella
• Enterotoxigenic E. coli LT/ST
• Shiga-type toxin E. coli stx1
• Shiga-type toxin E. coli stx2
• Salmonella
• The vibration of cholera
• Yersinia enterocolitica

 

PARASITIC PATHOGENS

• Cryptosporidium
• entamoeba histolytica
• Giardiana

 

VIRAL PATHOGENS

• Adrenovirus 40/41
• Norovirus GI/II

 

Page 2: 

1. pylori

Recent studies have shown that almost 50% of the world's population can harbor H. pylori. And, although many carriers are asymptomatic, H. pylori is known to play a causal role in ulcers, chronic gastritis, and stomach cancer.

 

Additionally, in the early phases of colonization, patients may experience hypochlorhydria followed by a change to hyperaciduria. Over time, they may colonize additional strains of H. pylori, including those with virulence factors and increased disease potential.

1. PYLORI AND VIRULENCE FACTORS

• Helicobacter pylori
• Virulence factor, babA
• Virulence factor, cagA
• Virulence factor, according to A
• Virulence factor, iceA
• Virulence factor, oipA
• Virulence Factor, vacA
• Virulence factor, virB
• Virulence factor, virD

 

COMMENSAL BACTERIA/KEYSTONE

Millions of microorganisms inhabit the human intestine to form a complex ecosystem that plays an important role in human health. Commensal bacteria extract nutrients and energy from our diet, maintain intestinal barrier function, produce vitamins (biotin and vitamin K), and protect against colonization by potential pathogens.

COMMENSAL BACTERIA

• Bacteroides fragilis
• Bifidobacterium spp.
• Enterococci spp.
• Escherichia spp.
• Lactobacillus spp.
• Enterobacter spp.
• Akkermansia mucinifilia
• Faecalbacterium prausnitzii
• Roseburia spp.

 

BACTERIAL PHYLA

• Bacteroidetes
• Firmicutes
• Firmicutes/Bacteroidetes relationship

 

Page 3: 

OPPORTUNISTIC MICROBES/OVERGROWTH

Many bacteria measured in the GI-MAP are considered opportunistic pathogens, as they only cause disease in some individuals, particularly those who are immunocompromised. Many people come into contact with opportunistic bacteria and do not experience symptoms. Most sources consider these microbes to be normal in stool. However, they can cause gastroenteritis and inflammation at high levels in vulnerable patients. Symptoms may include diarrhea, loose stools, abdominal pain, or even constipation.

Overgrowth and overcolonization by opportunistic bacteria can occur when commensal bacteria are affected by poor diet, antibiotic use, parasitic infection, or a weakened immune system. When there is intestinal permeability (see zonulin), these microbes could escape from the lumen of the intestine and infect extraintestinal sites.

OPPORTUNISTIC MICROBES/OVERGROWTH

• Bicillus spp.
• Enterococcus faecalis
• Enterococcus faecium
• Morganella spp.
• Pseudomonas spp.
• Pseudomonas aeruginosa
• Staphylococcus spp.
• Staphylococcus aureus
• Streptococcus spp.

 

COMMENSAL OVERGROWTH MICROBES

• Desulfovibrio spp.
• Methanobacteria (family)

 

INFLAMMATORY AND AUTOIMMUNE BACTERIA

• Citrobacter spp.
• citrobacter freundii
• Klebsiella spp.
• Klebsiella pneumoniae
• M. avium subsp. paratuberculosis
• Proteus spp.
• Proteus mirabilis

 

INFLAMMATORY AND AUTOIMMUNE COMMENSAL BACTERIA

• Enterobacter spp.
• Escherichia spp.
• Fusobacterium spp.
• prevotella cover

 

FUNGI/Yeast

Fungal organisms are commonly found in the human digestive tract, but fungal overgrowth can cause illness in susceptible people. Fungal growth may be localized in the body. For example, Candida spp. it may be high in the large intestine but normal in the small intestine, and vice versa. In a patient with suspected fungal overgrowth, additional testing may be necessary to understand the full picture of fungal overgrowth. Urinary D-arabinitol or antibodies against Candida are sometimes used.

FUNGI/Yeast

• Candida spp.
• Candida albicans
• Geotricum spp.
• Microsporidia spp.
• Rhodoturula spp.

 

VIRUS

VIRUS

• Cytomegalovirus
• Epstein Barr virus

 

Page 4:

PARASITES

A parasite is an organism that lives and feeds on a host organism at its expense. GI-MAP tests detect pathogenic parasites and protozoa (some of which are non-pathogenic) that occur most frequently in the gastrointestinal tract. Sources of exposure must be identified and eliminated to prevent reinfection.

PROTOZOA

• human blastocyst
• Chilomastix mesnelli
• Ciclospora spp.
• Dientamoeba fragilis
• Endolimax is a mother
• entamoeba coli
• Pentatrichomonas manis

 

WORMS

• Duodenal ancyclostroma
• intestinal worm
• american assassin
• Trichuris trichiura
• Had spp.

 

GUT HEALTH MARKERS

DIGESTION

• steatocrit
• elastase-1

 

GI MARKERS

• β-glucuronidase
• Hidden Blood – FIT

 

IMMUNE RESPONSE

• secretory IgA
• antigliadin IgA
• Eosinophil activation protein (EDN)

 

INFLAMMATION

• Calprotectin

 

ADDITIONAL TESTS

• Zonulin
• gluten peptide
• Universal Antibiotic Resistance Genes – This option is reported on page 6.

 

Page 5:

ANTIBIOTIC RESISTANCE GENES OF H. PYLORI

The GI-MAP includes results for the detection of antibiotic resistance genes in the microbiome. If there is an antibiotic resistance gene, then that class of antibiotics is designated POSITIVE for antibiotic resistance. A positive result for the presence of resistance genes for a given antibiotic indicates that the antibiotic is not an ideal choice for an antibiotic protocol.

Antibiotic resistance genes apply to all microorganisms found in the fecal sample. Since microbes can share DNA rapidly under stress, the presence of antibiotic resistance in any organism is reason enough to avoid that class of drug.

Phenotypes | helobacter

• amoxicillin
• clarithromycin
• Fluroquinolines
• tetracycline

 

Page 6:

UNIVERSAL GENES OF RESISTANCE TO ANTIBIOTICS

The Universal Antibiotic Resistance (AR) Genes panel can be ordered as a complement to the GI-MAP or GI-Pathogens panel. It detects the presence of 55 genetic elements associated with resistance to 10 different classes of antibiotics.

This complementary AR Genes panel detects genes associated with resistance to the most commonly prescribed antibiotics for gastrointestinal infections. The mobile genetic elements of the panel can be found in a variety of different microbes. The presence of these genes in a bacterial population has been associated with moderate to high levels of antibiotic resistance in human gastrointestinal infections.

UNIVERSAL GENES OF RESISTANCE TO ANTIBIOTICS

• β-lactamase
• Fluoroquinolones
• vancomycin
• macrolides
• ciprofloxacin
• 5-Nitroimidazoles (not Helicobacter pylori)
• trimethoprim
• Sulfonamides
• methicillin
• chloramphenicol

 

Methodology

Quantitative PCR (qPCR) or real-time polymerase chain reaction (RT-PCR): gives you real quantitative values. It helps differentiate an organism's trace levels from frank elevations that indicate an active infection.