Expression of resistance to isometamidium and diminazene in Trypanosoma congolense in Boran cattle infected by Glossina morsitans centralis

Paratransgenesis applied for control of tsetse transmitted sleeping sickness

African trypanosomiasis (sleeping sickness) is a major cause of morbidity and mortality in Subsaharan Africa for human and animal health. In the absence of effective vaccines and efficacious drugs, vector control is an alternative intervention tool to break the disease cycle. This chapter describes the vectorial and symbiotic biology of tsetse with emphasis on the current knowledge on tsetse symbiont genomics and functional biology, and tsetse's trypanosome transmission capability. The ability to culture one of tsetse's commensal symbiotic microbes, Sodalis in vitro has allowed for the development of a genetic transformation system for this organism. Tsetse can be repopulated with the modified Sodalis symbiont, which can express foreign gene products (an approach we refer to as paratransgenic expression system). Expanding knowledge on tsetse immunity effectors, on genomics of tsetse symbionts and on tsetse's parasite transmission biology stands to enhance the development and potential application of paratransgenesis as a new vector-control strategy. We describe the hallmarks of the paratransgenic transformation technology where the modified symbionts expressing trypanocidal compounds can be used to manipulate host functions and lead to the control of trypanosomiasis by blocking trypanosome transmission in the tsetse vector.

Drug-resistant Trypanosoma congolense in naturally infected donkeys in north Omo Zone, southern Ethiopia

A three-part study was conducted to determine the efficacy of isometamidium chloride in donkey populations naturally infected with trypanosomes in north Omo Zone, southern Ethiopia. In the first, 373 randomly selected donkeys from four villages were examined for trypanosome infections by the dark ground/phase contrast buffy coat technique (BCT) in November 1999. The trypanosome prevalence was 18.2% (95% confidence interval (CI): 14.4, 22.5) and Trypanosoma congolense was the most common species accounting for 66.2% of the overall infections. In the second part, 40 infected donkeys were selected and treated with a prophylactic dose of 1.0mg/kg of isometamidium chloride and thereafter monitored every 14 days for 90 days. Trypanosomes were detected in eight donkeys within 1 month and in 20 donkeys within 2 months of treatment. About 16% (5/32) of donkeys infected with T. congolense were detected parasitemic 1 month after treatment. In addition, the result also revealed that all relapse/breakthrough infections were due to T. congolense. In the third part of this study mice were infected with two T. congolense field isolates from donkeys that were found to be parasitemic within 1 or 2 months after isometamidium treatment. The mice were treated with ranges of doses of isometamidium chloride or diminazene aceturate and thereafter followed for relapse infection. Isometamidium chloride at doses 0.5-4 mg/kg body weight and diminazene aceturate at doses of 3.5-28 mg/kg body weight failed completely to cure T. congolense infections in any of the mice.

Drug resistance in pathogenic African trypanosomes: what hopes for the future?

Trypanosomosis is a serious threat to both man and animals mostly in Africa. Although the first pathogenic trypanosome was discovered over a hundred years ago, there is still no prospect for effective control or eradication of the disease through the development and use of vaccines because of the phenomenon of antigenic variation. Control continues to rely heavily on chemotherapy and vector control strategies. This therapy and prophylaxis depends on the use of drugs which, apart from having been developed over 5 decades ago, suffer from such limitations as toxicity and with their continued use, drug resistance. Resistance to currently used drugs is a serious problem in most fields of anti-microbial chemotherapy, particularly in the case of trypanosomosis where resistance and cross-resistance in animals and man have been developing rapidly. The frequently and widely reported decreasing efficiency of available trypanocides, difficulties of sustaining tsetse control and little hope that a conventional, anti-trypanosome vaccine will be produced in the near future, increase the imperative need for new drugs and alternative effective ways for the control of trypanosomosis. This review examines aspects of drug resistance in pathogenic trypanosomes, measures to minimise it, areas of future research in new drug targets and alternative control strategies. Based on these, it is our opinion that for now the management and control of trypanosomosis will continue to depend on proper usage of the few available trypanocides, especially strategic deployment of the sanative drugs in order to reduce the development of drug resistance, in addition to the continued use of environmentally friendly vector control programmes such tsetse trapping.

Multiple-drug resistant Trypanosoma congolense populations in village cattle of Metekel district, north-west Ethiopia

Investigations were carried out to determine the prophylactic activity of isometamidium chloride in village populations of cattle naturally infected with trypanosomes in Metekel district, northwest Ethiopia. In a cross-sectional study in March 1997, 484 randomly selected cattle from four villages were examined for trypanosome infections by the dark ground/phase contrast buffy coat technique (BCT). The trypanosome prevalence was 17.2%. Trypanosoma congolense was the dominant species accounting for 47.6% of the overall infections. Fifty parasitaemic cattle from two villages were treated with isometainidium chloride (Trypamidium(R)) at a prophylactic dose of 1.0 mg/kg body weight (b.w.) and thereafter monitored on a monthly basis for parasitaemia. Trypanosomes were detected in six cattle within 1 month and in 18 cattle within 2 months of treatment. Twenty three percent (6/26) of cattle infected with T. congolense at the time of treatment were detected parasitaemic with this trypanosome species 1 month after treatment. Mice were infected with three T. congolense isolates obtained from cattle which were detected parasitaemic within one or 2 months after isometamidium treatment. The mice were subsequently treated with ranges of doses of isometamidium chloride or diminazene aceturate (Berenil(R)) and thereafter monitored for parasitaemia for a period of 60 days. Isometamidium chloride at doses of 0.5-4.0 mg/kg b.w. and diminazene aceturate at doses of 3.5-28.0 mg/kg b.w. failed to cure T. congolense infections in any of the animals. Three clones were derived from one of the isolates; each clone expressed high levels of resistance to both trypanocides when tested in mice. Based on these results it is concluded that the prophylactic activity of isometamidium is greatly reduced for some of the T. congolense populations present in the area, and in addition there is resistance to diminazene aceturate in this trypanosome species.

Variation in sensitivity of Trypanosoma congolense to diminazene during the early phase of tsetse-transmitted infection in goats

Twenty-five goats were randomly allocated to five groups of five animals each and infected with Trypanosoma congolense IL 3274 via the bites of infected Glossina morsitans centralis. At intervals of 1, 4, 8, 12 or 19 days following infection, each group of five animals was treated intramuscularly with diminazene aceturate at a dose of 7.0 mg kg-1 body weight (b.w.). While treatment on Day 1 eliminated infections in all five goats, treatment on Day 19 did not cure any of the animals; in groups treated 4, 8 or 12 days following infection, two of five goats in each group were cured. Since the alteration in apparent resistance of T. congolense IL 3274 between Day 1 and Day 19 could have been due to alteration in expression of drug resistance by trypanosomes as the population expanded, the experiment was repeated using trypanosomes that reappeared in the animals that had been treated with diminazene aceturate on Day 19. On Day 36, when all five animals were parasitaemic, five groups of teneral G. m. centralis, each containing 160 flies, were fed on one occasion on each of the five goats (one group of testse flies per goat). Thereafter, each group of tsetse flies was maintained on clean rabbits. When infective, five flies from each group were allowed to feed on two naive goats each (i.e. two goats per group of tsetse flies). One animal in each pair was treated 24 h after infection with diminazene aceturate at a dose of 7.0 mg kg-1 b.w., the other was treated on Day 19, when parasitaemic, with the same drug dosage. As before, treatment 24 h following infection eliminated infections in all animals, but when treatment was delayed until Day 19, trypanosomes in all animals were refractory to treatment. Thus, although tsetse flies were infected with trypanosomes that had arisen in infected goats following treatment with diminazene aceturate at a dose of 7.0 mg kg-1 b.w., when the same flies were allowed to feed on clean goats, the resultant infections were sensitive to treatment with the same drug dosage when administered 24 h following infection. These data therefore indicate that there is a significant alteration in diminazene sensitivity of IL 3274 between Day 1 and Day 19 and that this is associated with an alteration in the resistance phenotype of the trypanosomes.

Development of multiple drug resistance of Trypanosoma congolense in Zebu cattle under high natural tsetse fly challenge in the pastoral zone of Samorogouan, Burkina Faso

Preliminary data from an ongoing epidemiological survey in the pastoral zone of Samorogouan (Kénédougou) indicate the occurrence of multiple-drug-resistant Trypanosoma congolense. Despite frequent trypanocidal drug treatments with diminazene aceturate (Berenil, Hoechst) at 7 mg/kg body weight (bw) at intervals of 2 to 4 weeks, no significant drop in the prevalence of African animal trypanosomosis (AAT) was observed. To examine a suspected drug resistance, 20 Zebu cattle, naturally infected with T. congolense and/or T. vivax, were transferred in December 1989 from Samorogouan into a fly-proof stable. Diminazene aceturate at 7 mg/kg bw cured infections of T. vivax, but was ineffective against T. congolense. Likewise, treatments with homidium bromide (Ethidium, FBC) at 1 mg/kg bw and isometamidium chloride (Trypamidium, Rhône Mérieux) at 1 mg/kg bw, respectively, proved to be ineffective. Corresponding chemotherapeutic trials in previously unexposed Zebu bulls and Sahelian goats infected with one primary T. congolense isolate from Samorogouan demonstrated a high level of resistance to diminazene aceturate (7 mg/kg bw in cattle and 17.5 mg/kg bw in goats), isometamidium chloride (1 and 2 mg/kg bw i.v. in goats) and quinapyramine sulphate (Trypacide'S', Rhône Mérieux) at 5 mg/kg bw in goats. The appearance of a multiple-drug-resistant strain of T. congolense emphasizes the urgent need for new chemical substances as trypanocidal drugs and the increasing importance of efficient vector control.

Trypanosoma congolense: manifestation of resistance to Berenil and Samorin in cloned trypanosomes isolated from Zambian cattle

Four Trypanosoma congolense clones derived from a Mumbwa field isolate proved to be resistant to Berenil with a minimum curative dose (MCD) value of 40 mg/kg and to Samorin with an MCD of 4 mg/kg for mice. Two other clones, one being resistant to Berenil with an MCD of 45 mg/kg but susceptible to 1 mg/kg Samorin, and the other being resistant to Samorin with MCD of 16 mg/kg but susceptible to 7 mg/kg Berenil, were experimentally rendered resistant to each of the respective drugs they were susceptible to by subcurative treatments in mice. The original trypanosome strains and their derivative clones were then screened for their sensitivity to Berenil or Samorin. Three clones derived from the Mumbwa isolate were resistant to Berenil, with MCD's of 14 to 28 mg/kg, and to Samorin, with MCD's of 4 mg/kg. A single Mumbwa derivative clone was relatively sensitive to both Berenil with an MCD of 7 mg/kg and to Samorin with an MCD of 2 mg/kg. The reciprocal drug induction results confirmed that although trypanosomes can acquire tolerance to both Berenil and Samorin, no cross-resistance between the two was evident.

The effect of diminazene aceturate and isometamidium chloride on cultured procyclic forms of susceptible and drug-resistant Trypanosoma congolense

Cultures of insect forms of Trypanosoma congolense stocks and clones with different susceptibilities to trypanocidal drugs in vivo were initiated from bloodstream trypomastigotes harvested from mammalian hosts and maintained axenically in vitro at 27 degrees C. Growth inhibition of procyclic forms of susceptible and drug-resistant T. congolense occurred after incubation for 48 h with 0.1 ng isometamidium chloride ml or 500 ng diminazene aceturate/ml. Procyclic forms were propagated in vitro in the presence of 10 or 100 ng diminazene aceturate/ml for 20 days without or with only minor loss of growth. In the presence of 0.1 or 1 ng isometamidium chloride/ml the trypanocidal effect was detectable after 6-8 days and the cultures died after 10-12 days. Concentrations of 1 or 10 ng isometamidium chloride/ml had an irreversible effect when the trypanosomes were exposed to the drug for 24 h. Both drugs used in this study thus showed antitrypanosomal activity on T. congolense procyclic forms but it was not possible to distinguish between drug-resistant and susceptible stocks or clones employing the criteria of growth inhibition or death of trypanosomes in culture.

Therapeutic and prophylactic activity of isometamidium chloride against a tsetse-transmitted drug-resistant clone of Trypanosoma congolense in Boran cattle

An investigation was conducted on the therapeutic and prophylactic activity of isometamidium chloride (SamorinR) in Boran (Bos indicus) cattle against a Trypanosoma congolense clone, IL 3270. This clone was derived, without drug selection, from a stock originally isolated in Burkina Faso and has previously been shown to be resistant to isometamidium in both cattle and mice using an infection and treatment regimen. A group of 5 cattle were treated intramuscularly with 1.0 mg kg-1 isometamidium chloride and 28 days later challenged with Glossina morsitans centralis infected with T. congolense IL 3270. All 5 cattle and 17 untreated cattle challenged on the same day became parasitaemic by day 16 post challenge, indicating that prophylaxis did not extend to 28 days post treatment. The cattle were then treated with isometamidium chloride at one of the following doses and by different routes of administration; 1.0 or 2.0 mg kg-1 intramuscularly, 0.25, 0.5, 0.75 or 1.0 mg kg-1 intravenously. Infections relapsed in all cattle at an interval of 12-21 days following treatment, with the exception of those treated with 2.0 mg kg-1 intramuscularly in which the development of relapse infections was delayed. Similar studies were also conducted with a highly sensitive clone of T. congolense, IL 1180. Infections in cattle with this clone were eliminated by intravenous treatment with 0.25 mg kg-1 isometamidium chloride or intramuscular treatment with 0.5 mg kg-1 isometamidium chloride. Thus, although intravenous administration of isometamidium eliminated a fully sensitive infection, treatment by this route appeared not to enhance the therapeutic efficacy of the drug in the treatment of a T. congolense clone which expresses a high level of resistance.

Variation in resistance to isometamidium chloride and diminazene aceturate by clones derived from a stock of Trypanosoma congolense

Nine clones were derived from a drug-resistant Trypanosoma congolense stock (IL 2856) and characterized in mice for their sensitivity to isometamidium chloride and diminazene aceturate. All clones were derived from the stock without drug selection and expressed high levels of resistance to isometamidium chloride (50% curative dose [CD50] values ranging from 1.5 to 5.1 mg/kg) and intermediate to high levels of resistance to diminazene aceturate (CD50 values ranging from 5.1 to 21.0 mg/kg). By contrast, the isometamidium chloride and diminazene aceturate CD50 values for a drug-sensitive clone, T. congolense IL 1180, were 0.018 mg/kg and 2.3 mg/kg, respectively. For both drugs, there appeared to be significantly different levels in expression of drug resistance amongst the 9 clones derived from IL 2856. Isoenzyme analysis of 7 enzymes showed that all 9 clones expressed the same electrophoretic variants. Thus, all 9 clones were identical for these phenotypic markers. The clone which expressed the highest level of resistance to isometamidium in mice (IL 3270) was transmitted to Boran cattle via the bite of infected Glossina morsitans centralis. IL 3270 produced an infection rate in tsetse of 5.0%. The resulting infections in cattle were shown to be resistant to intramuscular treatment with 2.0 mg/kg isometamidium chloride and 14.0 mg/kg diminazene aceturate. This contrasts with doses of 0.25 mg/kg isometamidium chloride or 3.5 mg/kg diminazene aceturate which are deemed sufficient to cure fully sensitive infections. Finally, 9 clones (subclones) were derived from IL 3270 and characterized in mice for their sensitivity to isometamidium chloride.(ABSTRACT TRUNCATED AT 250 WORDS)