Human African trypanosomiasis (sleeping sickness): new endemic foci in Bendel State, Nigeria

Human African Trypanosomiasis (Sleeping Sickness) surveys were conducted in five communities in Ethiope and Ndokwa Local Government Areas of Bendel State, Southern Nigeria. Of 670 individuals screened for the disease with the Card Agglutination Test for Trypanosomiasis (CATT), 84 (12.53%) were positive while 45 (6.72%) had traces of antibodies against Trypanosoma brucei gambiense in their blood. Trypanosomes were also demonstrated in the gland juices of 22 individuals following gland punctures and microscopic examination of the aspirates. Analysis of 86 serum samples obtained from the blood randomly collected from individuals in the localities, using the qualitative methods of CATT and Cellognost (Indirect Haemagglutination - IHA) showed that 58 (67.44%) and 57 (66.28%), were seropositive for sleeping sickness, respectively. Further titration of 72 of these serum samples using the Cellognost quantitative method showed 50 samples with antibody titres above 1:20. The clinical manifestations of sleeping sickness recorded in positive individuals included cervical lymphadenopathy, somnolence, psychosis, unsteady gait and tremors, and reproductive abnormalities reflected by secondary amenorrhea and poor obstetric histories. Our observations indicate that the parts of Bendel State surveyed are probably endemic foci of sleeping sickness hitherto unreported. The effectiveness of the CATT in mass screening of populations at risk from the disease is also highlighted.

Production of metacyclic forms by cyclical transmission of west African Trypanosoma (T.) brucei isolates from man and animals

Fifteen West African Trypanosoma (T.) brucei isolates from man and animals were cyclically transmitted. Five stocks, belonging to the non-gambiense group, could easily be transmitted through Glossina morsitans morsitans or Glossina m. centralis infected on mice, whereas successful transmission of the 10 isolates, identified as Trypanosoma brucei gambiense, was performed using G. palpalis gambiensis as vector. Glossina p. gambiensis was infected with culture-derived procyclic trypanosomes by repeated membrane feeding. In both cases, metacyclic forms could normally be detected in saliva samples of positive flies 3 to 4 weeks after first infection. These forms of major interest were subsequently characterized relative to their resistance/sensitivity against normal human serum in vitro and their antigenic properties, using indirect immunofluorescence: Metacyclic forms of all the T. b. gambiense isolates were determined by a stable human serum resistance and a restricted metacyclic variable antigen type (mVAT) repertoire, whereas representatives of the non-gambiense group (including TH162/78E 021) were sensitive against the trypanolytic factors of normal human serum and expressed a heterogeneous metacyclic antigen profile.

Polyclonal B-cell stimulative and immunosuppressive activities at different developmental stages of Trypanosoma gambiense

Bloodstream trypomastigote and cultured procyclic (insect midgut) forms of a monomophic strain of Trypanosoma gambiense were tested for their abilities to induce polyclonal B-cell activation (PBA) and immunosuppression (IS) in mice. Injection of a cell homogenate of bloodstream trypomastigotes induced both PBA and IS, while neither PBA nor IS was observed in mice injected with a cell homogenate of cultured procyclics. The results indicate that the substance(s) inducing PBA or IS is related to the developmental stage of the parasites.

Immune response to minor variant antigen types (VATs) in a mixed VAT infection of the African trypanosomes

It has been shown that soon after the onset of acute infection with Trypanosoma brucei gambiense, mice are able to detect immunologically small numbers of minor variant antigen types (VATs) within the population. However, in more longstanding infections, considerably larger populations of minor VATs are required to stimulate an effective immune response. As a result, larger populations of minor VATs evade immune detection and, following a decrease in parasitaemia, become part of the relapse population. We hypothesize that the development of immunosuppression increases the effectiveness of antigenic variation as an escape mechanism.

Trypanosoma brucei sspp.: cleavage of variant specific and common glycoproteins during exposure of live cells to trypsin

Intact bloodstream forms of Trypanosoma brucei brucei, T.b. gambiense, and T.b. rhodesiense and procyclic forms of T.b. brucei and T.b. gambiense were incubated in trypsin, solubilized for gel electrophoresis, and analyzed for removal of surface molecules. Silver-stained gels and transfer blots probed with horseradish peroxidase-conjugated or radiolabeled lectins revealed that only three glycoproteins, Gp120p, Gp91p, and Gp23p, were removed from the surface of procyclic forms by trypsin. The variant specific glycoproteins, Gp23b, Gp120b, and in some clones Gp91b were surface molecules cleaved from bloodstream forms. Greater than 90% of the variant specific glycoprotein (VSG) was removed from the surface of all clones studied within 1 hr following the addition of trypsin. The removal of VSG was coincident with appearance of 37 to 50 kDa glycopeptide fragments of VSG with different clones yielding different sized fragments. Detailed kinetic analysis of proteins from whole cell extracts and supernatants of the DuTat 1.1 clone of T.b. rhodesiense using concanavalin A (Con A) and polyclonal antibodies revealed that three major VSG fragments were released during trypsinization. The electrophoretic mobility of the three VSG fragments of DuTat 1.1 was not altered when samples were boiled in sodium dodecyl sulfate to inhibit the endogenous phospholipase C. Antiserum to the cross-reactive determinant bound to intact VSG, but did not bind VSG fragments. Thus, the major Con A binding fragments of DuTat 1.1 VSG and perhaps those of the other clones we studied were probably derived from the N-terminal domain of the molecule. The data suggest that VSG is cleaved by trypsin in situ at the hinge region, but remains attached to the cell surface via weak interaction with neighboring molecules.

Polyclonal B-cell-activating factors produced by spleen cells of mice stimulated with a cell homogenate of Trypanosoma gambiense

The effect of injection of a cell homogenate of Trypanosoma gambiense into mice on the production of soluble factors responsible for the induction of polyclonal B-cell activation (PBA) by their spleen cells was examined. PBA was induced by injection of the cell homogenate and was also detected in mice treated with either the serum or the spleen cells of mice treated with the cell homogenate. PBA-inducing activity became detectable in the serum and spleen cells as early as 12 h after injection of the cell homogenate, reached a peak on day 2, and then decreased. This activity was also detected in the culture medium of spleen cells obtained 2 days after injection of the cell homogenate. For determination of the type of spleen cells producing the PBA-inducing factor, the day 2 spleen cells were fractionated on the basis of differences in their adhesive properties. Spleen cells in the effluents from a Sephadex G-10 column (T and B cells) and a nylon wool column (T cells) and those adhering to a plastic flask (macrophages) all produced the PBA-inducing factor. The production of PBA-inducing factor by whole spleen cells and by cells adherent to the plastic flask was not affected by treatment with anti-Thy-1.2 antibody and complement. These data suggest that soluble factors derived from macrophages and T cells could contribute to the induction of PBA. The PBA-inducing activity in the conditioned medium was completely inactivated by treatment at pH 2.0, heating at 56 degrees C for 30 min, or exposure to 0.1% sodium dodecyl sulfate. The results are discussed in relation to cytokines that could affect B-cell activation.

The genome and the antigen gene repertoire of Trypanosoma brucei gambiense are smaller than those of T. b. brucei

The amount of nuclear DNA of Trypanosoma brucei gambiense is only 70% of that of T. b. brucei. The difference is partially due to depletion of 50-150 kb mini-chromosomes in T. b. gambiense, as well as a reduction in the content of some repetitive DNA families. Quantitation of 'barren' DNA regions characteristic of the 5' environment of telomeric antigen genes confirms that the T. b. gambiense genome contains fewer chromosome ends, and thus most probably fewer telomeric antigen genes, than T. b. brucei. The extent of the antigen gene repertoire of the two subspecies has been estimated by hybridization with probes specific for the conserved 3' region of antigen genes. It appears that the repertoire of the gambiense subspecies is only about 50% of that of T. b. brucei. These observations are discussed with regard to the stability of the T. b. gambiense repertoire.

Purification and characterization of a tyrosine aminotransferase from Crithidia fasciculata

Tyrosine aminotransferase (TAT, EC 2.6.1.5) from the kinetoplastid, Crithidia fasciculata, was purified over 2000 fold to electrophoretic homogeneity. The native form of the enzyme had a molecular weight of approximately 100,000, whereas under denaturing conditions it produced two polypeptides of approximately 50,000 and 48,000, respectively. Absence of a reaction with the periodic acid-Schiff stain suggested that the crithidial enzyme was not a glycoprotein. It was relatively stable and remained active over a wide range of pH and temperature. It exhibited a broad substrate specificity and was able to utilize L-tyrosine, L-tryptophan, and L-phenylalanine as amino donors. Antiserum produced against partially purified crithidial tyrosine aminotransferase failed to inhibit the enzymatic activity. The same antiserum cross-reacted with a soluble extract from Trypanosoma brucei gambiense, but not with that from normal mouse liver, confirming evolutionary conservatism between the two protozoa.

Comparison between bloodstream and procyclic form trypanosomes for serological diagnosis of African human trypanosomiasis

Trypanosoma brucei brucei MiTat 1.2 bloodstream and corresponding procyclic forms, as well as procyclics of T. b. gambiense and T. b. rhodesiense, were fixed, in suspension, using a mixture of 80% acetone and 0.25% (v/v) formalin in saline and used as antigens for diagnosis of African human trypanosomiasis by the indirect immunofluorescent antibody test. T. b. brucei bloodstream forms detected 41/42 and 37/41 parasitologically diagnosed cases of T. b. rhodesiense and T. b. gambiense trypanosomiasis, respectively, while the procyclic stages detected the same number (41/42) of T. b. rhodesiense, but fewer (29/41) T. b. gambiense infections.

In vivo interaction between Trypanosoma gambiense and leucocytes in mice

Naturally occurring phagocytosis of Trypanosoma gambiense by mouse eosinophils and neutrophils was reported. In vivo and in vitro experiments using monoclonal antibodies confirmed that the phagocytosis is triggered by G1 class antibodies against variable surface antigen. Ultrastructural observation revealed the mode of entry and the intracellular fate of T. gambiense: initial attachment, pseudopodia formation and complete invagination. This phagocytosis resulted in the killing of T. gambiense by mouse eosinophils and neutrophils, suggesting that eosinophils and neutrophils give at least partial protection against infection with T. gambiense in combination with the specific antibodies.

The rate of proliferation among African trypanosomes is a stable trait that is directly related to virulence

The relationship between the growth rate of Trypanosoma brucei gambiense and its virulence was investigated. A cloned, monomorphic, slow growing, and relatively avirulent line of T. b. gambiense was serially passaged at 3- to 5-day intervals through immunosuppressed mice. The growth rate measured within the first 2 patent days of infection did not vary significantly through the first 25 passages but by passage 50 had decreased significantly from 11.9 +/- 1.1 hr to 9.0 +/- 0.7 hr. A clone from passage 50 and three different second peak heterologous variants all had statistically similar growth rates, indicating that the rate of proliferation was a stable trait. With the faster rate of proliferation there was a corresponding increase in virulence. The inoculum necessary to kill 50% of normal outbred mice in the first peak of parasitemia (LD50) dropped significantly from 3 X 10(6) first passage parasites to 4 X 10(5) passage 50 parasites. The lethal load for both fast and slow growing organisms was the same (greater than 2 X 10(9) trypanosomes/ml of blood). To further link virulence and growth rate, a strong correlation (r = 0.89) was measured when generation times of 10 closely related lines of T. b. gambiense, and 2 lines of pleomorphic T. b. rhodesiense were compared to their LD50 values. While the rate of trypanosomal proliferation was similar between the day of inoculation through the second patent day, it slowed to 64% of that level once parasitemias exceeded 3 X 10(8) organisms/ml of host blood.(ABSTRACT TRUNCATED AT 250 WORDS)

Contribution of the complement system to antibody-mediated binding of Trypanosoma gambiense to macrophages

The role of complement in the process of binding of trypanosomes to macrophages in the presence of specific antibody was studied. The aggregation of trypanosomes observed at the optimal antigen-antibody ratio or in the presence of excess antigen inhibited the binding. Complement caused clumped trypanosomes to dissociate, and the free trypanosomes, which were presumed to be coated with antibody that had fixed complement, readily attached to surfaces of phagocytes. Thus, complement was shown to contribute at the site of the antigen-antibody reaction to the creation of an environment suitable for the binding. It seems likely that the trypanosomes dissociated by complement adhered to C3 receptors of the macrophage. However, in the absence of complement and in regions of antibody excess, free trypanosomes also attached to phagocytes. Thus phagocytes may also have receptors for the Fc portion of aggregated antibody. Complement activated by the alternate pathway also enhanced attachment of trypanosomes to phagocytes, but the effect was not as rapid as it was when complement was activated by classical means.

Restriction of the alternative pathway of human complement by intact Trypanosoma brucei subsp. gambiense

We studied the interaction of African trypanosomes with human complement. Bloodstream forms of Trypanosoma brucei subsp. gambiense isolated from mice activated the alternative pathway of complement during a 30-min incubation in vitro. In human serum, all cells remained intact and motile during this period. C3 was detected on the surface by a direct binding assay with a monoclonal antibody which recognizes C3b and iC3b. C3 deposition could also be detected by this radioimmunoassay when parasites were incubated with purified C3. Such C3 binding was enhanced by factor B, factor D, and magnesium. Surface deposition of factor B was demonstrated both by flow immunofluorescence analysis and binding of radiolabeled factor B. C3 binding and factor B binding were inhibitable by EDTA but not by ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N' -tetraacetic acid (EGTA). The inhibited binding could be restored by addition of magnesium. No human immunoglobulin G or mouse immunoglobulin was detected on the trypanosome surface. By flow cytometry, neither human C5 nor polymerized C9 was detected on trypanosomes incubated in serum, although this assay was able to detect C5 and C9 on the surface of complement-treated human erythrocytes. Using a radioimmunoassay which measures C5b-9 in serum, we found that there was no generation of SC5b-9 in serum which had been incubated with trypanosomes. We concluded that, although trypanosomes activate the alternative pathway of complement, they are not lysed, because the cascade does not continue beyond the establishment of C3 convertase.

Suppression of immune response to sheep red blood cells in rats experimentally infected with Trypanosoma brucei gambiense

A direct haemagglutination assay for antibodies to sheep red blood cells (SRBC) was used to assess the response of rats infected with Trypanosoma brucei gambiense. Whereas uninfected rats showed an efficient primary and secondary immune response to SRBC, trypanosome-infected rats displayed depressed antibody response starting about six days after infection. Infected rats failed to respond to a challenge dose of SRBC given 14 days after infection while uninfected control animals responded with an increased level of antibody production. These observations showed that T. b. gambiense infection inhibited both primary and secondary immune response to SRBC in rats. The result of this experiment is very important with regard to serological methods used to detect increasing levels of antibody production for diagnosis of diseases caused by bacterial and viral pathogens. In a concurrent trypanosome infection such increasing antibody levels would not be observed, leading to inaccurate diagnosis. Thus trypanosomiasis infection should be excluded under field conditions before the value of a serological diagnosis can be fully utilized.

Comparison of African trypanosomes of different antigenic phenotypes, subspecies and life cycle stages by two-dimensional gel electrophoresis

High resolution two-dimensional polyacrylamide gel (2D gel) electrophoresis and autoradiography were used to analyze the protein gene products of African trypanosomes biosynthetically labelled with [35S]methionine. Using cloned populations of parasites it was found that: antigenically different bloodstream trypanosomes from the same serodeme differed only in their variant surface glycoproteins; Trypanosoma brucei, T.b. rhodesiense and T.b. gambiense subspecies could be distinguished on the basis of differences in expressed proteins; transformation from bloodstream trypomastigotes to procyclic epimastigote culture forms was accompanied by loss of variant surface glycoproteins and several other qualitative and quantitative changes in minor proteins. The results indicate that 2D gel analysis may allow improved classification of African trypanosomes (based on the observation of hundreds of protein markers) and may also provide a general technique for the identification of lifecycle stage specific markers.

Expression of two variant surface glycoproteins on individual African trypanosomes during antigen switching

Individual Trypanosoma brucei rhodesiense organisms were observed in the process of switching variant surface glycoproteins (VSG's). During this switch, trypanosomes simultaneously expressed both pre- and postswitch VSG's uniformly over their surface as detected with monoclonal antibodies. Analysis of this switching event showed that trypanosomes expressing any one of three distinct preswitch VSG's could switch to expression of from one to three different postswitch VSG's. Up to 2.7 percent of the trypanosome population was in the process of switching at one time.

Field evaluation of Cellognost indirect haemagglutination test in the diagnosis of human trypanosomiasis (sleeping sickness) in Kura local government area of Kano State, Nigeria

The Cellognost indirect haemagglutination (IHA) test was compared with conventional techniques, namely, wet blood film examination, stained thin and thick films, animal inoculation and the microhaematocrit centrifugation, for detecting sleeping sickness cases. Sixty-four out of 245 serum samples collected from suspected and some diagnosed cases of the disease were positive by the Cellognost screening test, while only three cases were detected by stained thin film or microhaematocrit centrifugation. Of the 64 cases 45 strongly positive samples were subjected to quantitative assay. Twenty-five of these had anti-Trypanosoma gambiense antibody titres above 1:20 representing active infection in the population. This represented 10.2% of the total sample, and strongly suggested the persistence of the disease in the population.

Trypanosoma brucei: immunogenicity of the variant surface coat glycoprotein of virulent and avirulent subspecies

Comparative analyses were made to define the immunogenic role in mice of the variant surface coat glycoprotein (VSG) of African trypanosomes. Less than 10 micrograms of the glycoprotein fixed to trypanosomes or covalently linked to sheep erythrocytes were 100 times more immunogenic than soluble VSG. Therefore, although VSG is present on the parasites and in the blood of infected hosts, the cell-bound form most likely elicits immunity. Intravenous administration of soluble or cell-bound VSG was a better route of immunization than the subcutaneous route. Therefore, although parasites grow at the site of infection, in tissue spaces, and in the blood, control of blood parasitemia is best developed if the antigen is introduced to the vascular bed. Full protection against homologous challenge occurred by 4 days and was maintained through 30 days. Trypanosome-agglutinating antibody titers could be measured at 3 days, peaked at 5 days, and remained high through 14 days after immunization. Therefore, mice immunized with an optimal dosage of VSG, 2 days before challenge, should have had ample time to elicit a protective response. Most of these mice, however, developed patent infections, and one-third died during the first peak of parasitemia at about the same time as untreated control mice. This indicates that active infection inhibits the early phases of induction of immunity. Mice, suboptimally immunized against and challenged with an avirulent isolate of Trypanosoma brucei gambiense, survived at higher rates than mice immunized and challenged with a virulent clone of T. b. rhodesiense. Cell-fixed and soluble VSG from both parasites elicited similar agglutinating-antibody titers, indicating that the two trypanosomes were equally antigenic. Results from neutralization tests, however, revealed that, per unit of immune mouse serum, 400 times more T. b. gambiense became noninfective than T. b. rhodesiense. Apparently, virulence is related to relative sensitivity of the trypanosomes to immunological assault.

Growth and antigenic variation of Trypanosoma brucei, T. rhodesiense and T. gambiense in subcutaneous millipore chambers

The inability to cultivate infective bloodstream forms of the African trypanosomes in cell-free media has complicated studies of the biology of trypanosomes and the pathogenesis of trypanosomiasis. We attempted to overcome this problem by subcutaneous implantation in mice of Millipore chambers that isolate trypanosomes from cells but permit diffusion of soluble substances across their membranes. Chambers were inoculated with 5 X 10(4) to 5 X 10(5) per ml Trypanosoma brucei, T. rhodesiense or T. gambiense; the trypanosomes multiplied rapidly, persisted for as long as five weeks, and remained infective, even when the original inocula were freed of donor cells by ion-exchange. The presence of anti-trypanosomal IgG and IgM in the sera and chambers of recipient mice proved that trypanosomal and mammalian products crossed the membranes. Chamber trypanosomes also expressed two important aspects of normal in vivo biological behaviour: (i) differentiation from long slender to short stumpy bloodstream forms and (ii) antigenic variation. Death of trypanosomes was associated with the presence of IgM antibody in the chambers. This model provides a system for study of an entire population of trypanosomes in an extravascular, cell-free environment.

Trypanosoma gambiense: immunosuppression and polyclonal B-cell activation in mice

The relationship between the suppression of antibody response and polyclonal B-cell activation was studied in mice treated with a cell homogenate of Trypanosoma gambiense. The cell homogenate injection in mice caused a progressive increase in splenic background plaque-forming cell response to sheep erythrocyte. In the mice with markedly increased background plaque-forming cell response, the different reactivity in the primary antibody response to sheep erythrocytes was observed between the intraperitoneal and intravenous immunization with sheep erythrocytes. The intraperitoneal immunization of mice with sheep erythrocytes strongly suppressed the antibody response, while the intravenous immunization with sheep erythrocytes led to an enhancement of the antibody response. The intraperitoneal injection of silica particles, a toxic agent to macrophages, 30 min before intraperitoneal immunization with sheep erythrocytes abolished the suppression of the antibody response completely. In addition, restoration of the suppressed antibody response was found in mice immunized intraperitoneally with a high dose of sheep erythrocytes. It appears that the suppression of antibody response is not attributable to polyclonal B-cell activation, and is associated with the elevation of the phagocytic activity of peritoneal macrophages.

Evaluation of immunoassays for diagnosis and management of sleeping sickness in Liberia

Nineteen parasitologically confirmed Liberian sleeping sickness patients were observed for up to 40 months. Efficacy of suramin therapy was indicated by decrease of serum and CSF immunoglobulins as well as by decreasing IgG and IgM serum antibody levels as determined by ELISA and fluorescence antibody tests. The tendency of serum antibody concentrations to increase again during the second and third years after treatment could be explained in one patient only who experienced relapse or reinfection, confirmed by demonstration of blood trypanosomes. Known endemic and nonendemic areas in Liberia could not be discriminated by the prevalence of Trypanosoma IgG antibodies. Furthermore, IgM antibody was present in 18% of a random sample of sera from non-endemic ares. The possibility of trypanosomes other than T.b. gambiense to stimulate antibody production in man is discussed.