Antigen expression during development of the human hookworm, Necator americanus (Nematoda)

The accumulated and de novo synthesized antigens expressed by L3, L4 and adult Necator americanus, recognized by both the natural host, man, and the experimental host, the hamster, were identified by immunoblotting and immunoprecipitation analysis. Following infection of neonatal hamsters serum samples were taken on days 17, 35 and 117. Only serum taken 117 days after infection showed significant reactivity in immunoblotting experiments, recognizing adult epitopes of 30,000, 33,000, 48,000 and 69,000 mol. wt thereby suggesting that few accumulated antigens are shared between developmental stages. By contrast, immunoprecipitation analysis of metabolically labelled proteins suggested that L3 and in particular L4 larvae synthesize some antigens which comigrate with those synthesized and accumulated by adult worms. In addition, L4 larvae synthesize a 41,000 mol. wt excretory/secretory (ES) stage specific antigen. Parallel experiments using serum samples from infected humans, demonstrated that hamsters and man recognize many antigens of identical molecular weight. Notable in this respect are accumulated adult antigens of 30,000, 33,000, 48,000 and 69,000 and de novo synthesized antigens of 30,000, 33,000, 44,000, 46,000 and 69,000 mol. wt. Some individual human sera mainly recognized L3 antigens of 47,000-69,000 mol. wt in immunoblotting experiments whilst others simultaneously recognized adult epitopes. This differential recognition of developmental stages by individual human sera suggests that genetic or epidemiological factors are operative and warrants further study. Overall, these studies confirm the pronounced immunogenicity of Necator americanus in both man and an animal model and pave the way for analysis of the relevance of these antigens to field situations.

The recognition of antigens on the surface of adult and L4 Necator americanus by human and hamster post-infection sera

The surface antigens of adult Necator americanus were recognized by post-infection hamster sera and resolved at molecular weight 93,000, 67,000, 46,000, 43,000, 32,000 and 25,000. L4 larvae in contrast had one major surface antigen, resolving at 93,000. These antigens were also recognized by a range of human sera, although on a differential basis. This suggests that the human sera tion. However, the results do indicate that the hamster model might be of immunological relevance to the human disease state, in that infected hamster recognized the full cuticular antigen spectrum of adult Necator. This, at least, gives the experimenter a convenient reference point from which to conduct further experiments incorporating parameters such as re-infection, anthelmintic treatment and genetic variability to study the effect of these modifications on the serological response.

Site of resistance to Necator americanus in hamsters

Resistance to the development of human hookworm, Necator americanus was examined in 3- to 6-week-old young adult hamsters. Only 3% of N. americanus infective third stage larvae (NaL3) reached maturity in the intestines of young adults as opposed to as many as 60% in 2-day-old baby hamsters. This seemingly effective resistance prevailing in young adults was investigated in some detail. The skin, the first site of contact for the invading NaL3, was bypassed during the infection process. Completely in vitro exsheathed NaL3 (ExNaL3) were used, and young adult hamsters were infected parenterally, by-passing the skin. Even after exsheathing the larvae artificially before infection and by-passing the skin, no improvement was seen in the development of N. americanus in the intestines of young adults. Higher infection doses also did not increase the worm burden. Some of the factors limiting the development of parasites in young adults were examined. N. americanus were monitored in lungs and intestines during various intervals after infection. Similar parasite burdens were apparent in lungs of baby as well as young adult hamsters. In the intestines, a significantly lower burden of N. americanus was seen during various intervals in young adults compared to the baby hamsters. Moreover, N. americanus were expelled soon after reaching the intestine. This comparative monitoring revealed the intestine as the seat of resistance against the establishment of N. americanus in young adult hamsters.

Hookworm disease: host-pathogen biology

The hallmark of hookworm infection, a common helminthic disease, is iron deficiency anemia. The development of anemia is dependent on the intensity of infection, the species of hookworm, and the ability of the host to resist infection and to maintain adequate stores of iron. When conditions are appropriate, the incidence of anemia caused by hookworm is high and has a significant economic impact since it results in a reduction of worker productivity. Loss of blood is caused by direct ingestion of red cells and by tissue trauma produced by worm attachment and feeding. This focal trauma may involve multiple villi and is characterized by local hemorrhage, tissue cytolysis, and neutrophilic response. Although focal intestinal lesions are apparent, their significance is questionable since diffuse mucosal changes are absent in intestinal biopsies of patients with heavy hookworm infection. Short-range control measures protecting against hookworm infection have not succeeded. Development of a vaccine against hookworm infection in humans is problematic since functional protective immunity in humans has not yet been demonstrated and no suitable animal model of hookworm infection in humans is available. At present, the most effective method of intervention appears to be supplementation of food staples with iron.

Necator americanus in infant rabbits: complete development, humoral antibody, leukocyte response and serum protein changes following infection

Necator americanus, originally isolated from man, developed completely in infant rabbits (RSG-1). This infection was serially passed in infant rabbits up to the 6th generation without using any immunosuppressant. Two day old infant rabbits demonstrated a high degree of susceptibility to N. americanus. Studies revealed the retention of worms in the intestine for more than 150 days during which egg production was high. In this experimental model the leukocyte, antibody and serum protein responses due to N. americanus infection were monitored. Results showed that eosinophil numbers rose significantly from day 28 to 170. A maximum was observed on day 80 (41%) in rabbits of the fourth generation. Antibodies to N. americanus were detectable in infected rabbits by counterimmunoelectrophoresis using third stage larval antigen (Rabbit strain). Generally, total globulins increased with decrease in albumin. Serum protein increase was associated with alpha-2, beta and gamma globulin components.

IgE levels in intestinal juice

This investigation was performed to determine the possible significance of the IgE levels in intestinal secretions for the recognition of type I food allergy (immediate hypersensitivity). Four groups of individuals were studied and compared with each other: (1) healthy controls and patients with gastrointestinal disorders not affecting the small intestine; (2) patients with small intestinal disease; (3) patients with various manifestations of allergy but without food intolerance; and (4) patients with atopic sensitivity to foods. Despite the presence of proteolysis in the intestinal fluid, a statistically highly significant increase of the intestinal IgE level was observed in patients of group 4 with type I food allergy and in patients of group 3 as compared with normals. This was associated with an increase in the serum IgE level. An increased synthesis of the IgE in the lamina propria of the small intestine is most probable, but not yet adequately established.

Non-specific potentiation of IgE by parasitic infections in man

Infection with the helminthic parasites Ascaris lumbricoides and/or Necator americanus (hookworm) induces the production in man of high levels of serum IgE. The specificity of this IgE antibody when measured by RAST to a wide range of allergens was restricted in general to the helminthic antigens. Absorption of the sera with immunosorbents produced by coupling extracts of A. lumbricoides to CNBr activated Sepharose 4B established that Ascaris antigen specific IgE antibodies contributed a minor fraction of the total serum IgE. These observations suggest that parasitic infections in man as in laboratory animals potentiate the production of high levels of IgE with specificity unrelated to that of the parasite antigens. While the specificity of this potentiated IgE was not established, it is not directed towards inhalant allergens.

Antibody responses in self-infections with Necator americanus

Antibody responses were measured in a volunteer infected four times with Necator americanus over a 27-month period. The main source of antigen was culture fluid in which living adult N. americanus had been maintained for several days. Antibodies to worm acetylcholinesterase and IgE antibodies were detected only with this material, but antibodies were identified by the enzyme-linked immunosorbent (ELISA) assay, with either adult worm secretions or extracts of third-stage infective larvae. The total serum IgE level fell after the first infection, but although it then increased during subsequent infections, it never rose above 600 U per ml. None of the antibody responses suppressed the rat of worm development to maturity, or reduced the fecundity of the parasites. However, it is suggested that the development of the immune response may be associated with the waning of the severe gastro-intestinal symptoms which were experienced in this infection, and which are frequently characteristic of hookworm infections.

Increased resistance to helminth infestation in an atopic population

Faecal egg counts were compared in three groups in an area of universal hookworm infestation. Egg counts were lower in asthmatic and atopic non-asthmatic subjects than in a non-atopic population. The atopic population was defined by skin testing for immediate hypersensitivity responses. It is suggested that the atopic state may confer increased resistance to helminth infestation.