Schistosoma japonicum: migration of adult worm pairs within the mesenteric veins of mice

Dietary glycemic and energy load differentially modulates Schistosoma mansoni-induced granulomatous inflammation and response to antiparasitic chemotherapy

The impact of diet composition and energy content on schistosomiasis evolution and treatment efficacy is still controversial. This study compared the impact of sucrose-rich diet and intermittent fasting on Schistosoma mansoni infection and praziquantel (PZQ)-based chemotherapy response in mice. BALB/c mice were infected with S. mansoni and followed for 15 weeks. The animals were randomized into nine groups receiving high glycemic load (high-sucrose diet - HSD), low caloric load (standard chow alternate-day fasting - ADF), and standard chow ad libitum (AL). Eight weeks after S. mansoni infection, these groups remained untreated or were treated with PZQ (300 mg/kg/day) for 3 days. Our results indicated that parasite load (S. mansoni eggs and parasite DNA levels), granulomatous inflammation (granulomas number and size), and liver microstructural damage (reduction in hepatocytes number, increase in nucleus-cytoplasm ratio, connective stroma expansion and fibrosis) were increased in ADF-treated animals. These animals also showed decreased eggs retention, granulomatous inflammation and collagen accumulation in the small intestine. Conversely, HSD diet and PZQ treatment attenuated all these parameters and stimulated hepatic regenerative response. PZQ also stimulated fibrosis resolution in HSD-treated mice, effect that was limited ADF-exposed mice. Our findings indicate that dietary glycemic and energy load can modulate schistosomiasis progression and the severity of hepatic and intestinal granulomatous inflammation in untreated and PZQ-treated mice. Thus, lower intestinal eggs retention may potentially be linked to worsening liver disease in ADF, while attenuation of hepatic and intestinal granulomatous inflammation is consistent with reduced parasite load in HSD- and PZQ-treated animals.

Granuloma formation and tissue pathology in Schistosoma japonicum versus Schistosoma mansoni infections

Schistosomiasis is the most important helminth disease in the world from a public health perspective. S mansoni and S japonicum account for the majority of global intestinal schistosomiasis cases, and the pathogenesis is widely assumed to be fundamentally similar. However, the majority of research on schistosomiasis has been carried out on S mansoni and comparisons between the two species are rarely made. Here, we will discuss aspects of both older and recent literature where such comparisons have been made, with a particular focus on the pathological agent, the host granulomatous response to the egg. Major differences between the two species are apparent in features such as egg production patterns and cellular infiltration; however, it is also clear that even subtle differences in the cascade of various cytokines and chemokines contribute to the different levels of pathology observed between these two main species of intestinal schistosomiasis. A better understanding of such differences at species level will be vital when it comes to the development of new treatment strategies and vaccines.

Schistosome migration in the definitive host

Schistosomes are parasitic blood flukes that infect >200 million people around the world. Free-swimming larval stages penetrate the skin, invade a blood vessel, and migrate through the heart and lungs to the vasculature of the liver, where maturation and mating occurs. From here, the parasite couples migrate to their preferred egg laying sites. Here, we compare and contrast what is known about the migration patterns within the definitive host of the three major species of human schistosome: Schistosoma mansoni, S. japonicum, and S. haematobium. We conclude that intravascular schistosomes are inexorable colonizers whose migration and egg laying strategy is profligate; all three species (and their eggs) can be found throughout the mesenteric venules, the rectal venous plexus, and, to a greater or lesser extent, the urogenital venous plexuses. In addition, it is common for parasite eggs to be deposited in locations that lack easy access to the exterior, further demonstrating the relentless exploratory nature of these intravascular worms.

Schistosome Egg Migration: Mechanisms, Pathogenesis and Host Immune Responses

Many parasitic worms possess complex and intriguing life cycles, and schistosomes are no exception. To exit the human body and progress to their successive snail host, Schistosoma mansoni eggs must migrate from the mesenteric vessels, across the intestinal wall and into the feces. This process is complex and not always successful. A vast proportion of eggs fail to leave their definite host, instead becoming lodged within intestinal or hepatic tissue, where they can evoke potentially life-threatening pathology. Thus, to maximize the likelihood of successful egg passage whilst minimizing host pathology, intriguing egg exit strategies have evolved. Notably, schistosomes actively exert counter-inflammatory influences on the host immune system, discreetly compromise endothelial and epithelial barriers, and modulate granuloma formation around transiting eggs, which is instrumental to their migration. In this review, we discuss new developments in our understanding of schistosome egg migration, with an emphasis on S. mansoni and the intestine, and outline the host-parasite interactions that are thought to make this process possible. In addition, we explore the potential immune implications of egg penetration and discuss the long-term consequences for the host of unsuccessful egg transit, such as fibrosis, co-infection and cancer development.

Reduced [14C]-methionine uptake and fecundity in Schistosoma mansoni females treated with recombinant tumor necrosis factor α in vitro

Recombinant human TNFα (rhTNFα) has previously been shown to reduce fecundity in Schistosoma mansoni adult females maintained in vitro without males, and adversely affect the uptake of [14C]-tyrosine, an amino acid required for schistosome vitellogenesis. Here we report on the effect of rhTNFα on [14C]-methionine uptake in both separated and paired females, and the effect of three different preparations of rTNFα on schistosome oviposition in vitro. In the absence of rhTNFa, separated females incorporated only 30% of the [14C]-methionine incorporated by paired females in a dose and time-dependent manner, suggesting low metabolic activity of females in the absence of males. Separated females and worm-pairs were treated with increasing doses of rhTNFα for 2 or 4 hr and then incubated in RPMI 1640 containing 10% fetal calf serum (FCS) and 5 µCi ml-1[14C]-methionine for 1 hr. Separated females treated with rhTNFa for 4 hr incorporated less methionine than those treated for 2 hr. In contrast, paired females treated with rhTNFa incorporated significantly smaller amounts of [14C]-methionine in a TNFa dose-dependent but time-independent manner [2 hr (P = 0.001) or 4 hr (P = 0.027) One-Way ANOVA]. Worm-pairs maintained in RPMI 1640 containing 10% FCS and 100 ng ml-1 of any of the three rTNFa preparations laid significantly fewer eggs than the worms cultured without rTNFα(P = 0.001; Kruskal-Wallis Test). We also observed that among rTNFα-treated worm-pairs, females were sluggish and tended to separate from their male partners. These observations suggest that TNFa inhibits [14C]-methionine uptake and reduces fecundity in females paired with males. Since paired females incorporate substantially greater amounts of [14C]-methionine, the role of males in stimulating metabolic activity in females is affirmed. Reduced amino acid uptake, and possibly other nutrients, may contribute to the diminished fecundity observed in TNFa-treated females.

Schistosoma prevalence in appendicitis

BACKGROUND

Schistosomiasis is a waterborne trematode with numerous subtypes affecting different areas of the body. Rob Ferreira Hospital is located in an endemic area for schistosomiasis in the Lowveld region of South Africa. We set out to determine the prevalence of Sch istosoma in appendicitis.

METHODS

From 2009 to 2013, all appendix samples removed in theatre were reviewed. A total of 304 cases were retrieved. Viable ova, calcified ova, or schistosomal granulomas was considered proof of exposure.

RESULTS

Thirty-one out of the 304 cases revealed evidence of schistosomal exposure, equating to 10.2 %.

CONCLUSION

A prevalence of more than 10 % is truly significant seeing as how a delayed diagnosis can lead to serious complications, or how a misdiagnosis can result in unnecessary and often protracted treatment with harmful drugs.

Schistosomiasis in the People's Republic of China: prospects and challenges for the 21st century

Schistosomiasis japonica is a serious communicable disease and a major disease risk for more than 30 million people living in the tropical and subtropical zones of China. Infection remains a major public health concern despite 45 years of intensive control efforts. It is estimated that 865,000 people and 100,250 bovines are today infected in the provinces where the disease is endemic, and its transmission continues. Unlike the other schistosome species known to infect humans, the oriental schistosome, Schistosoma japonicum, is a true zoonotic organism, with a range of mammalian reservoirs, making control efforts extremely difficult. Clinical features of schistosomiasis range from fever, headache, and lethargy to severe fibro-obstructive pathology leading to portal hypertension, ascites, and hepatosplenomegaly, which can cause premature death. Infected children are stunted and have cognitive defects impairing memory and learning ability. Current control programs are heavily based on community chemotherapy with a single dose of the drug praziquantel, but vaccines (for use in bovines and humans) in combination with other control strategies are needed to make elimination of the disease possible. In this article, we provide an overview of the biology, epidemiology, clinical features, and prospects for control of oriental schistosomiasis in the People's Republic of China.

A methodological study on egg counts in tissues from pigs infected with Schistosoma japonicum

The present study examined the possibility of using a tissue subsample to estimate the total number of Schistosoma japonicum eggs in the liver or an intestinal section. Sixteen male Landrace/Yorkshire crossbred pigs were each infected with 500 S. japonicum cercariae and killed 12 weeks post infection. Five-gram samples were taken from specific areas of the liver, colon, caecum and rectum, and tissue egg counts (TECs) were determined by digestion of the tissue sample in 3% KOH for 18 h according to a standard procedure. The rest of each tissue was also processed to determine whole tissue egg counts. For the liver, counts from 5-g samples taken from the left medial and left lateral lobes were not significantly different from counts for the whole liver, but counts from 5-g samples from the right lateral, right medial and central lobes differed significantly from whole liver counts. Variable results were obtained for 5-g samples from six specific points in the colon in comparison with the whole colon counts. This latter result corresponded well to observed gross pathological findings indicating patchy egg deposition in the large intestine. One 5 g sample from either the caecum or rectum could not be used to estimate the whole tissue egg count because of the high variability in the counts. The results suggest that the processing time of liver tissue can be greatly diminished by using a 5 g subsample from a specific liver lobe to estimate the TEC of the whole organ.

Experimental infection of Danish Landrace/Yorkshire crossbred pigs with Schistosoma japonicum from the People's Republic of China

This study was undertaken to assess the suitability of Danish Landrace/Yorkshire (L/Y) crossbred pigs as experimental hosts of a Chinese mainland strain of Schistosoma japonicum. Pigs were exposed to 200, 500 or 1000 cercariae and parasite burdens were determined by perfusion after either 8 or 11 weeks. All pigs became infected with onset of faecal egg excretion 6 to 7 weeks following exposure to cercariae. The pattern of faecal egg excretion differed markedly among the individual animals. Gross hepatic pathological lesions of varying degrees were noted in all of the pigs. Schistosome worm recoveries ranged from 1.5-23.4% of the cercarial exposure dose. Most schistosome eggs recovered from the tissues, expressed as eggs/g tissue, were found in the rectum (91%), caecum (3.1%) and liver (5.1%). The results show that Danish L/Y pigs may serve as appropriate experimental final hosts of the Chinese mainland strain of S. japonicum.

Relative distribution of Schistosoma japonicum eggs in the intestine of man: a subject of inconsistency

The relative distribution of Schistosoma japonicum eggs in the intestine of man is inconsistent in the literature. Some scientists believe that the adult S. japonicum worms reside mainly in the superior mesenteric vein and their eggs are deposited predominately in the small intestine, whereas others have shown that the adult worms have a predilection for inhabiting the branches of the inferior mesenteric vein and superior haemorrhoidal vein and their eggs are deposited in much higher density in the large intestine, especially in the rectum, sigmoid and descending colon, than in the small intestine. A review of the literature was made which includes the results from animal experiments as well as from human clinical and pathological studies. The author is in favour of the latter view that in man, S. japonicum eggs are deposited predominately in the large intestine and small intestine involvement is usually slight.

Glycogen metabolism in Schistosoma mansoni worms after their isolation from the host

Adult Schistosoma mansoni worms rapidly degrade their endogenous glycogen stores immediately after isolation from the host. In NCTC 109 or in a diphasic culture medium the glycogen levels slowly recovered again after the initial decrease. The rapid degradation of glycogen could be prevented, even in a simple salt medium, if 100 mM glucose and 1% bovine serum albumin were present. Incubations with 14C-labelled glucose under different conditions revealed that the degradation of glycogen was induced by the limited catabolism of external glucose. Conditions are described which induce glycogen degradation or resynthesis by S. mansoni. The physiological function of the glycogen stores is probably to provide substrate during periods of insufficient supply of external glucose. It is speculated that such periods occur when the worm pair moves into the small mesenteric veins of the host. This hypothesis explains the remarkable wandering behaviour of the parasite in the mesenteric veins, since the schistosomes would have to return to larger vessels when their endogenous glycogen stores are exhausted.

Limitations to schistosome growth and maturation in nonpermissive hosts

The life cycle of schistosomes is reviewed in its various steps, both in permissive hosts (in which the cycle is completed) and in nonpermissive hosts (which excrete no viable eggs as a result of the infection). A large worm loss occurs at (or after) the lung stage in both types of hosts ("normal attrition") and some nonpermissive hosts (like the rat) have an additional elimination of worms from the portal circulation. Worm growth and reproductive maturation are also impaired in several nonpermissive hosts and the possible host-parasite interactions leading to such limitations are discussed, with special reference to hormonal influences. Attention is also given to peculiar phenomena occurring in some hosts, like the late portal worm elimination in rhesus monkeys, the migration from mesenteric veins to lungs in rats, and the block to egg excretion in guinea pigs. The steps of the schistosome life cycle which appear vulnerable in several hosts are contrasted with the steps which are carried out successfully in the majority of hosts studied.

Schistosoma japonicum: the pathology of experimental infection

The pathology of experimental schistosomiasis japonica is reviewed and compared with the pathology of schistosomiasis japonica in man and to some aspects of schistosomiasis mansoni and schistosomiasis haematobia in experimental animals. The induction of granulomas around Schistosoma japonicum eggs depends upon cell mediated immunity, as do the reactions to Schistosoma mansoni and Schistosoma haematobium eggs. However, the modulation of the reaction to S. japonicum eggs can be greatly influenced by antibody, while antibody has no effect on the granulomas around S. mansoni eggs. Adult worm pairs of S. japonicum tend to cluster in the mesenteric venules, and most eggs are laid in a few sites. This leads to large, focal intestinal lesions similar to the discrete lesions produced by S. haematobium in the intestine and urinary tract but in contrast to the widespread, diffuse lesions produced by S. mansoni. Comparison with S. japonicum infection in humans is limited chiefly by our scant knowledge of the pathology produced by S. japonicum in infected persons. Most such comparisons are, in any case, limited by the marked differences in the reactions of various experimental host species to the infection and by differences in the reaction of a given host species to different strains of the parasite.