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Abstract
INTRODUCTION Human babesiosis is reported throughout the world and is endemic in the northeastern and northern Midwestern United States and northeastern China. Transmission is primarily through hard bodied ticks. Most cases of severe disease occur in immunocompromised individuals and may result in prolonged relapsing disease or death. AREAS COVERED We provide a summary of evidence supporting current treatment recommendations for immunocompetent and immunocompromised individuals experiencing babesiosis. EXPERT OPINION Most cases of human babesiosis are successfully treated with atovaquone and azithromycin or clindamycin and quinine. Severe disease may require prolonged treatment.
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Affiliation(s)
- Robert P Smith
- Division of Infectious Diseases, Maine Medical Center, Portland, Maine; Tufts University School of Medicine , Boston, MA, USA
| | - Klaus-Peter Hunfeld
- Institute for Laboratory Medicine, Microbiology & Infection Control, Northwest Medical Centre, Medical Faculty, Goethe University , Frankfurt/Main, Germany
| | - Peter J Krause
- Yale School of Public Health and Yale School of Medicine , New Haven, CT, USA
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Efstratiou A, Galon EMS, Wang G, Umeda K, Kondoh D, Terkawi MA, Kume A, Liu M, Ringo AE, Guo H, Gao Y, Lee SH, Li J, Moumouni PFA, Nishikawa Y, Suzuki H, Igarashi I, Xuan X. Babesia microti Confers Macrophage-Based Cross-Protective Immunity Against Murine Malaria. Front Cell Infect Microbiol 2020; 10:193. [PMID: 32411624 PMCID: PMC7200999 DOI: 10.3389/fcimb.2020.00193] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 04/09/2020] [Indexed: 01/26/2023] Open
Abstract
Malaria and babesiosis, the two primary intraerythrocytic protozoan diseases of humans, have been reported in multiple cases of co-infection in endemic regions. As the geographic range and incidence of arthropod-borne infectious diseases is being affected by climate change, co-infection cases with Plasmodium and Babesia are likely to increase. The two parasites have been used in experimental settings, where prior infection with Babesia microti has been shown to protect against fatal malarial infections in mice and primates. However, the immunological mechanisms behind such phenomena of cross-protection remain unknown. Here, we investigated the effect of a primary B. microti infection on the outcome of a lethal P. chabaudi challenge infection using a murine model. Simultaneous infection with both pathogens led to high mortality rates in immunocompetent BALB/c mice, similar to control mice infected with P. chabaudi alone. On the other hand, mice with various stages of B. microti primary infection were thoroughly immune to a subsequent P. chabaudi challenge. Protected mice exhibited decreased levels of serum antibodies and pro-inflammatory cytokines during early stages of challenge infection. Mice repeatedly immunized with dead B. microti quickly succumbed to P. chabaudi infection, despite induction of high antibody responses. Notably, cross-protection was observed in mice lacking functional B and T lymphocytes. When the role of other innate immune effector cells was examined, NK cell-depleted mice with chronic B. microti infection were also found to be protected against P. chabaudi. Conversely, in vivo macrophage depletion rendered the mice vulnerable to P. chabaudi. The above results show that the mechanism of cross-protection conferred by B. microti against P. chabaudi is innate immunity-based, and suggest that it relies predominantly upon the function of macrophages. Further research is needed for elucidating the malaria-suppressing effects of babesiosis, with a vision toward development of novel tools to control malaria.
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Affiliation(s)
- Artemis Efstratiou
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Eloiza May S Galon
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Guanbo Wang
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Kousuke Umeda
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Daisuke Kondoh
- Department of Basic Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Mohamad Alaa Terkawi
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan.,Department of Orthopedic Surgery, Hokkaido University, Sapporo, Japan
| | - Aiko Kume
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Mingming Liu
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Aaron Edmond Ringo
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Huanping Guo
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Yang Gao
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Seung-Hun Lee
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Jixu Li
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Paul Franck Adjou Moumouni
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Yoshifumi Nishikawa
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Hiroshi Suzuki
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Ikuo Igarashi
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Xuenan Xuan
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
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53
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Guirao-Arrabal E, González LM, García-Fogeda JL, Miralles-Adell C, Sánchez-Moreno G, Chueca N, Anguita-Santos F, Muñoz-Medina L, Vinuesa-García D, Hernández-Quero J, Montero E. Imported babesiosis caused by Babesia microti-A case report. Ticks Tick Borne Dis 2020; 11:101435. [PMID: 32249191 DOI: 10.1016/j.ttbdis.2020.101435] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/05/2020] [Accepted: 03/26/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Emilio Guirao-Arrabal
- Infectious Diseases Unit, Hospital Universitario San Cecilio, Avenida de la Investigación, s/n, 18016, Granada, Spain.
| | - Luis Miguel González
- Parasitology Reference and Research Laboratory, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain.
| | - José Luís García-Fogeda
- Infectious Diseases Unit, Hospital Universitario San Cecilio, Avenida de la Investigación, s/n, 18016, Granada, Spain.
| | - Claudia Miralles-Adell
- Laboratory Unit, Hospital Universitario San Cecilio, Avenida de la Investigación, s/n, 18016 Granada, Spain.
| | - Guacimara Sánchez-Moreno
- Hematology Unit, Hospital Universitario San Cecilio, Avenida de la Investigación, s/n, 18016 Granada, Spain.
| | - Natalia Chueca
- Hematology Unit, Hospital Universitario San Cecilio, Avenida de la Investigación, s/n, 18016 Granada, Spain.
| | - Francisco Anguita-Santos
- Infectious Diseases Unit, Hospital Universitario San Cecilio, Avenida de la Investigación, s/n, 18016, Granada, Spain.
| | - Leopoldo Muñoz-Medina
- Infectious Diseases Unit, Hospital Universitario San Cecilio, Avenida de la Investigación, s/n, 18016, Granada, Spain.
| | - David Vinuesa-García
- Infectious Diseases Unit, Hospital Universitario San Cecilio, Avenida de la Investigación, s/n, 18016, Granada, Spain.
| | - José Hernández-Quero
- Infectious Diseases Unit, Hospital Universitario San Cecilio, Avenida de la Investigación, s/n, 18016, Granada, Spain.
| | - Estrella Montero
- Parasitology Reference and Research Laboratory, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain.
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54
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Zhao L, Jiang R, Jia N, Ning N, Zheng Y, Huo Q, Sun Y, Yuan T, Jiang B, Li T, Liu H, Liu X, Chu Y, Wei R, Bian C, Wang H, Song J, Wang H, Jiang J, Cao W. Human Case Infected With Babesia venatorum: A 5-Year Follow-Up Study. Open Forum Infect Dis 2020; 7:ofaa062. [PMID: 32190710 PMCID: PMC7066795 DOI: 10.1093/ofid/ofaa062] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/15/2020] [Indexed: 12/18/2022] Open
Abstract
Background Human babesiosis is a common zoonosis caused by Babesia and is attracting an increasing concern worldwide. The natural course of babesiosis infection and how the human immune system changes during the course of babesiosis infection are not clear. Methods We followed up 1 case infected with Babesia venatorum for 5 years. The patient was immune-intact and received no standard treatment. Clinical data were obtained from medical records. Microbiological tests, ribonucleic acid (RNA) sequence, and serum cytokines and chemokines were detected at different time points. Results The patient was confirmed as B venatorum infection based on his tick-bite history, clinical manifestations, and positive results of microbiological tests. The parasitemia of the patient persisted for approximately 2 months. With flu-like symptoms aggravating, most cytokines and chemokines in RNA and protein levels increased progressively and reached the peak when fever occurred; and their concentrations decreased to baseline during the same time as clearance of babesia parasites. Conclusions Babesia venatorum infection could take a mild self-limited course in immune-intact individuals. The natural changes of most cytokines and chemokines demonstrated very similar trends, which correlated with blood parasitemia and clinical manifestations. Cytokine profiles involving multiple inflammatory cytokines might be a good indicator of babesia infection.
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Affiliation(s)
- Lin Zhao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China.,Institute of EcoHealth, School of Public Health, Shandong University, Jinan, People's Republic of China
| | - Ruiruo Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China.,Institute of NBC Defense, Beijing, People's Republic of China
| | - Na Jia
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Nianzhi Ning
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Yuanchun Zheng
- Mudanjiang Forestry Central Hospital, Mudanjiang, People's Republic of China
| | - Qiubo Huo
- Mudanjiang Forestry Central Hospital, Mudanjiang, People's Republic of China
| | - Yi Sun
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Tingting Yuan
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Baogui Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Tao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Hongbo Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China.,Center for Disease Control and Prevention of PLA, Beijing, People's Republic of China
| | - Xiong Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China.,Center for Disease Control and Prevention of PLA, Beijing, People's Republic of China
| | - Yanli Chu
- Mudanjiang Forestry Central Hospital, Mudanjiang, People's Republic of China
| | - Ran Wei
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Cai Bian
- Mudanjiang Forestry Central Hospital, Mudanjiang, People's Republic of China
| | - Hong Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Juliang Song
- Mudanjiang Forestry Central Hospital, Mudanjiang, People's Republic of China
| | - Hui Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Jiafu Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Wuchun Cao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China.,Institute of EcoHealth, School of Public Health, Shandong University, Jinan, People's Republic of China
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Transient Transfection of the Zoonotic Parasite Babesia microti. Pathogens 2020; 9:pathogens9020108. [PMID: 32050586 PMCID: PMC7169379 DOI: 10.3390/pathogens9020108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/08/2020] [Accepted: 02/10/2020] [Indexed: 02/07/2023] Open
Abstract
The development of genetic manipulation techniques has been reported in many protozoan parasites over the past few years. However, these techniques have not been established for Babesia microti. Here, we report the first successful transient transfection of B. microti. The plasmids containing the firefly luciferase reporter gene were transfected into B. microti by an AMAXA 4D Nucleofection system. Twenty-four-hour synchronization, the 5'-actin promoter, program FA100, and 50 μg of plasmid DNA constituted the best conditions for the transient transfection of B. microti. This finding is the first step towards a stable transfection method for B. microti, which may contribute to a better understanding of the biology of the parasite.
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Quantitative analysis of Anaplasma marginale acquisition and transmission by Dermacentor andersoni fed in vitro. Sci Rep 2020; 10:470. [PMID: 31949241 PMCID: PMC6965182 DOI: 10.1038/s41598-019-57390-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 12/29/2019] [Indexed: 02/03/2023] Open
Abstract
In this study, we describe a new in vitro tick feeding system that facilitates the study of ticks and tick-borne pathogens. To optimize the system, we used Dermacentor andersoni and Anaplasma marginale as a tick-pathogen interaction model. Ticks were fed on bovine blood containing 10-fold dilutions of the pathogen to determine the effect of dose on tick infection rate. After feeding on infected blood, ticks were transferred to uninfected blood to stimulate bacterial replication within the tick vector. During stimulation feeding, blood samples were collected daily to determine if infected ticks secreted viable A. marginale. The results demonstrated similar attachment rates between the first and second tick feeding. Tick midgut and salivary glands were infected with A. marginale. However, salivary gland infection rates decreased as the percentage of parasitized erythrocytes decreased during tick acquisition feeding. Bacteria recovered from the in vitro system were able to infect a naïve bovine host. Using the highly transmissible A. marginale St. Maries strain, we demonstrated that the artificial tick feeding system is a suitable tool to study tick-pathogen interactions and that A. marginale tick salivary gland infection is dose dependent. This work demonstrates the utility of an artificial tick feeding system to directly study the association between the number of acquired pathogens and transmissibility by ticks.
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