Modulation of anaphylaxis by helminth-derived products in animal models

Is Ascaris lumbricoides a risk factor for development of asthma? A systematic review and meta-analysis

There are numerous epidemiological and experimental evidences to suggest that Ascaris lumbricoides infection is a neglected risk factor for development of asthma. For this purpose, we conducted a systematic review and meta-analysis for better understanding of this relationship. Systematic searching (PubMed, Scopus, Web of Science and Google Scholar) was done, up to September 30, 2019 to identify the relevant studies. We applied random-effects meta-analysis model to generate the overall odds ratio (OR) and 95% confidence intervals (CIs). Heterogeneity was assessed with I2 and τ2 statistic. Finally, 19 studies (totally 25 datasets), including 14 datasets with microscopic methods (1830 asthmatic patients (APs) and 3802 healthy controls (HCs)) and 11 datasets with serological methods (1543 APs and 3507 HCs) met the eligibility criteria. Considering to the serological methods, our results demonstrated that the APs had higher seroprevalence rate of A. lumbricoides (48.3% vs. 35.1%) than HCs, showing a significant association (pooled crude OR, 1.53; 95%CI, 1.07-2.18). Moreover, microscopic methods showed a higher prevalence of A. lumbricoides infection in the APs compared to the HCs (37.2% vs. 30.2%), but no significant association was found between APs and HCs (pooled crude OR, 1.19; 95%CI, 0.92-1.55). After adjustment for confounders, results showed no significant association for both serological (pooled adjusted OR, 1.43; 95%CI, 0.93-2.19) and microscopic (pooled adjusted OR, 1.05; 95%CI, 0.78-1.42) methods. Despite heterogeneous results, accurate and better quality studies are needed to determine the effect of A. lumbricoides infection on induction or exacerbation of asthma.

Exposure to Ascaris lumbricoides infection and risk of childhood asthma in north of Iran

BACKGROUND

Asthma and Ascaris lumbricoides infection are common health issues affecting 250 and 700 million people worldwide, respectively. The relationship between ascariasis and asthma is a matter of substantial interest and research.

METHODS

We performed a case-control study to evaluate whether the exposure to Ascaris infection is associated with asthma in children. We also assessed potential risk factors for Ascaris infection and asthma in study area. We enrolled 145 asthmatic children and 115 healthy controls. The Global Initiative for Asthma guideline was used to evaluate asthma symptoms and severity in study participants. Ascaris infection was assessed by the presence of anti-Ascaris IgG ≥ 11 IU/mL measured by enzyme-linked immunosorbent assay.

RESULTS

We have found a significant relationship between exposure to Ascaris and asthma (odds ratio, 2.92; 95% CI 1.04-8.18; P value = 0.034), and this relationship remained significant after adjustment for covariates (adjusted OR, 3.36; 95% CI 1.04-13%; P value = 0.047). Ascaris infection was more frequent in children with mild sustainable asthma (13.2%; 15/113) than in children with moderate sustainable asthma (6.2%, 2/32), although there was a non-significant difference between these groups (OR, 2.3; 95% CI 0.5-10.1; P value = 0.35). Based on results of a multi-regression analysis, contact with soil (OR, 6.7; 95% CI 1.9-23.5), and drinking unsafe water (OR, 4.2; 95% CI 1.2-14.2) were significant risk factors for Ascaris infection in the study area.

CONCLUSION

Results of this study suggest that A. lumbricoides infection might affect susceptibility to asthma in children. These results could be useful in prevention, early diagnosis and management of childhood asthma.

A Proteomic Investigation of Hepatic Resistance to Ascaris in a Murine Model

The helminth Ascaris causes ascariasis in both humans and pigs. Humans, especially children, experience significant morbidity including respiratory complications, growth deficits and intestinal obstruction. Given that 800 million people worldwide are infected by Ascaris, this represents a significant global public health concern. The severity of the symptoms and associated morbidity are related to the parasite burden and not all hosts are infected equally. While the pathology of the disease has been extensively examined, our understanding of the molecular mechanisms underlying resistance and susceptibility to this nematode infection is poor. In order to investigate host differences associated with heavy and light parasite burden, an experimental murine model was developed utilising Ascaris-susceptible and -resistant mice strains, C57BL/6J and CBA/Ca, respectively, which experience differential burdens of migratory Ascaris larvae in the host lungs. Previous studies identified the liver as the site where this difference in susceptibility occurs. Using a label free quantitative proteomic approach, we analysed the hepatic proteomes of day four post infection C57BL/6J and CBA/Ca mice with and without Ascaris infection to identify proteins changes potentially linked to both resistance and susceptibility amongst the two strains, respectively. Over 3000 proteins were identified in total and clear intrinsic differences were elucidated between the two strains. These included a higher abundance of mitochondrial proteins, particularly those associated with the oxidative phosphorylation pathway and reactive oxygen species (ROS) production in the relatively resistant CBA/Ca mice. We hypothesise that the increased ROS levels associated with higher levels of mitochondrial activity results in a highly oxidative cellular environment that has a dramatic effect on the nematode's ability to successfully sustain a parasitic association with its resistant host. Under infection, both strains had increased abundances in proteins associated with the oxidative phosphorylation pathway, as well as the tricarboxylic acid cycle, with respect to their controls, indicating a general stress response to Ascaris infection. Despite the early stage of infection, some immune-associated proteins were identified to be differentially abundant, providing a novel insight into the host response to Ascaris. In general, the susceptible C57BL/6J mice displayed higher abundances in immune-associated proteins, most likely signifying a more active nematode cohort with respect to their CBA/Ca counterparts. The complement component C8a and S100 proteins, S100a8 and S100a9, were highly differentially abundant in both infected strains, signifying a potential innate immune response and the importance of the complement pathway in defence against macroparasite infection. In addition, the signatures of an early adaptive immune response were observed through the presence of proteins, such as plastin-2 and dipeptidyl peptidase 1. A marked decrease in proteins associated with translation was also observed in both C57BL/6J and CBA/Ca mice under infection, indicative of either a general response to Ascaris or a modulatory effect by the nematode itself. Our research provides novel insights into the in vivo host-Ascaris relationship on the molecular level and provides new research perspectives in the development of Ascaris control and treatment strategies.

Vaccination with a genetically modified Brugia malayi cysteine protease inhibitor-2 reduces adult parasite numbers and affects the fertility of female worms following a subcutaneous challenge of Mongolian gerbils (Meriones unguiculatus) with B. malayi infective larvae

Vaccination of Mongolian gerbils with Brugia malayi cysteine protease inhibitor-2 in which the amino acid Asn66 was mutated to Lys66 (Bm-CPI-2M) resulted in reduced parasite numbers of 48.6% and 48.0% at 42 and 90 days p.i. with B. malayi L3s. Fertility of female worms was also affected at 90 days p.i. In vitro killing of L3s observed in the presence of gerbil peritoneal exudate cells and anti-Bm-CPI-2M sera suggests antibody-dependent cell-mediated cytotoxicity as a putative protective mechanism. These observations suggest that Bm-CPI-2M is a promising prophylactic and anti-fecundity vaccine candidate.

Immunosuppressive PAS-1 is an excretory/secretory protein released by larval and adult worms of the ascarid nematodeAscaris suum

Helminths use several strategies to evade and/or modify the host immune response, including suppression or inactivation of the host antigen-specific response. Several helminth immunomodulatory molecules have been identified. Our studies have focused on immunosuppression induced by the roundwormAscaris suumand anA. suum-derived protein named protein 1 fromA. suum(PAS-1). Here we assessed whether PAS-1 is an excretory/secretory (E/S) protein and whether it can suppress lipopolysaccharide-induced inflammation. Larvae from infective eggs were cultured in unsupplemented Dulbecco's modified Eagle medium (DMEM) for 2 weeks. PAS-1 was then measured in the culture supernatants and in adultA. suumbody fluid at different time points by enzyme-linked immunosorbent assay (ELISA) with the monoclonal antibody MAIP-1. Secreted PAS-1 was detected in both larval culture supernatant and adult body fluid. It suppressed lipopolysaccharide (LPS)-induced leucocyte migration and pro-inflammatory cytokine production, and stimulated interleukin (IL)-10 secretion, indicating that larval and adult secreted PAS-1 suppresses inflammation in this model. Moreover, the anti-inflammatory activity of PAS-1 was abolished by treatment with MAIP-1, a PAS-1-specific monoclonal antibody, confirming the crucial role of PAS-1 in suppressing LPS-induced inflammation. These findings demonstrate that PAS-1 is an E/S protein with anti-inflammatory properties likely to be attributable to IL-10 production.

Vaccination with recombinant Brugia malayi cystatin proteins alters worm migration, homing and final niche selection following a subcutaneous challenge of Mongolian gerbils (Meriones unguiculatus) with B. malayi infective larvae

Background

Cysteine protease inhibitors of Brugia malayi have been ascribed to be involved in parasite development as well as to immunomodulate the host’s immune response. In Onchocerca volvulus, Onchocystatin has been shown to induce partial protection in the mouse diffusion chamber vaccination model. In the present study we investigated the impact of vaccination with recombinant Bm-CPI-1 and Bm-CPI-2 proteins on protection against a subcutaneous challenge of B. malayi third stage larvae in gerbils.

Findings

Vaccination with E. coli derived recombinant B. malayi cysteine protease inhibitors (Bm-CPI-1 or -2) did not confer protection against B. malayi L3 challenge infection in gerbils but altered the homing of a significant number of adult worms from the lymphatics to the heart and lungs.

Conclusion

Bm-CPI vaccination-induced alteration in worm migration is consistent with our previous observations in gerbils vaccinated with B. pahangi excretory-secretory (ES) proteins, which resulted in delayed migration of the L3s and altered the final location of adult worms. Similar observations have also been made in dogs vaccinated with Ancylostoma caninum proteins; an increased number of worms were recovered in the colon and not the expected small intestine. A change in the final niche was also reported in immune versus non-immune hosts of two other gut dwelling nematodes. Vaccination induced alteration of the parasite’s final homing might be a rare or a common phenomenon, which unfortunately is rarely recorded. The reason for the alteration in the final niche selection by adult nematode worms following vaccination is unknown and necessitates further investigation.

Parasites induced skin allergy: a strategic manipulation of the host immunity

The absence of a consistent link between parasitoses and skin allergic symptoms in the clinical investigations contrasts to the fact that some parasites are the most potent inducers of immunoglobulin E that exist in nature. To shed some light into this question, this review is focused on the actual knowledge regarding parasites life cycle, interactions with host immunity, the influence on host behavior, and finally the role of all these factors on the skin allergy. The collected data demonstrate that parasites could manipulate the host behavior for its own benefit in different ways, altering its (epi)genetic, biochemical, immunologic or physiologic functions as well as altering its behavior and activity. In this context, skin allergy may be associated with certain stages of the parasites' life cycle and migration into biological barriers, but not necessarily with presence of the parasitosis in the host organism. As compared to T helper (Th) 1 response, the Th2 one, the eosinophilic infiltration and the complement inhibition could assure better conditions for the development of some parasites. Taken together, the suggested hypotheses could be a plausible explanation for the epidemiological puzzle regarding urticaria occurrence, Th2 response and parasitoses, but further studies are necessary to provide better-based conclusions.

KEYWORDS

Eosinophilic Infiltration; Host behavior; Parasites life cycle; Skin allergy; Th1/Th2 response.

Inconsistent protective efficacy and marked polymorphism limits the value of Schistosoma japonicum tetraspanin-2 as a vaccine target

Background

Schistosoma mansoni tetraspanin 2 (Sm-TSP-2) has been shown to be strongly recognized by IgG1 and IgG3 antibodies from individuals putatively resistant to schistosome infection, but not chronically infected people, and to induce high levels of protection against challenge infection in the murine model of schistosomiasis. Amplification by PCR of homologous sequences from male and female S. japonicum worms showed the presence of 7 different clusters or subclasses of S. japonicum TSP-2. We determined the protective efficacy of one subclass – Sj-TSP-2e.

Methodology/Principal Findings

Following the alignment of 211 cDNAs, we identified 7 clusters encoding S. japonicum TSP-2 (Sj-TSP-2) based on sequence variation in the large extracellular loop (LEL) region with differing frequency of transcription in male and female worms. Quantitative PCR analysis revealed elevated expression of Sj-TSP-2 in adult worms compared with other life cycle stages. We expressed in E. coli the LEL region of one of the clusters which exhibited a high frequency of transcription in female worms, and showed the purified recombinant protein (Sj-TSP-2e) was recognised by 43.1% of sera obtained from confirmed schistosomiasis japonica patients. Vaccination of mice with the recombinant protein induced high levels of IgG1 and IgG2 antibodies, but no consistent protective efficacy against challenge infection was elicited in three independent trials.

Conclusions/Significance

The highly polymorphic nature of the Sj-TSP-2 gene at the transcriptional level may limit the value of Sj-TSP-2 as a target for future S. japonicum vaccine development.

Schistosoma mansoni tetraspanin 2 (Sm-TSP-2) is considered a lead target for vaccine development against schistosomiasis mansoni because: (1) It is located in the schistosome tegument and is involved in tegument formation; (2) It is strongly recognized by IgG1 and IgG3 antibodies from individuals putatively resistant to schistosome infection, but not chronically infected people, and (3) It induces high levels of protection against challenge infection in the mouse model. We amplified 211 homologous TSP-2 sequences from male and female S. japonicum worms, which revealed 7 different cDNA subclasses. We expressed in E. coli a region of one of the clusters which exhibited a high frequency of transcription in female worms, and showed the purified recombinant protein (Sj-TSP-2e) was recognised by 43.1% of sera obtained from confirmed schistosomiasis japonica patients. Vaccination of mice with the recombinant protein induced high levels of IgG1 and IgG2 antibodies, but no consistent protective efficacy against challenge infection was elicited in three independent trials. The highly polymorphic nature of the Sj-TSP-2 gene at the transcriptional level may limit the value of Sj-TSP-2 as a target for future S. japonicum vaccine development. Further analysis of the distribution of the different subclasses/alleles of the Sj-TSP-2 gene in S. japonicum populations from different endemic areas would be informative.