Human toxocariasis - A look at a neglected disease through an epidemiological 'prism'

The global prevalence of Toxocara canis among red foxes (Vulpes vulpes): A systematic review and meta-analysis

Red foxes play a crucial role in the life cycle and transmission of zoonotic pathogens, including Toxocara canis; however, comprehensive information on the prevalence of T. canis in red foxes (Vulpes vulpes) is lacking. In this meta-analysis we aimed to evaluate the global and regional prevalence of T. canis among red foxes. We searched PubMed, Scopus, and Google Scholar for studies reporting prevalence of T. canis in red foxes up to April 1, 2024. Using a random-effects model, we estimated pooled prevalences at global, regional, and national levels and assessed heterogeneity through subgroup and meta-regression analyses. The overall pooled global prevalence of T. canis infection in red foxes was 32.1% (95% CI, 28.5-35.6%), with the highest prevalence in Europe (34.6%, 30.9-38.3%) and the lowest in the Eastern Mediterranean (20.0%, 11.0-29.0%). In other regions, prevalences of Toxocara were as follows: Central Asia (33.1%, 26.8-39.4%), North America (23.6%, 10.6-36.6%), Western Pacific (21.3%, 5.2-37.4%), and Eastern Mediterranean & North Africa (20.0%, 11.0-29.0%). However, data from certain geographical regions are very limited (for example Greece, Austria, China and North Africa). Prevalence rates showed a decreasing trend over time. Subgroup analyses indicated higher prevalences in male red foxes (54.1%, 41.4-66.7%) compared to females (37.5%, 29.9-45.1%), and in juvenile red foxes (56.2%, 39.1-73.3%) compared to adults (33.4%, 23.2-43.6%). T. canis worm burdens were generally low, not exceeding an average of 4 worms per fox in most studies. Our findings reveal a substantial prevalence of T. canis infection in red fox populations worldwide (32.1%), highlighting their potentially significant role in perpetuating the transmission of infection to both companion animals and humans. Continued surveillance is essential to mitigate the risk of Toxocara transmission to companion animals and humans. However, a major remaining challenge is to assess the relative importance of the red fox as a contributor to environmental contamination with Toxocara ova. Further research is also needed to address study limitations and provide a complete global picture of T. canis epidemiology in red foxes and other wild animals, especially in underrepresented regions.

Association between Alzheimer's disease and Toxocara infection/exposure: a case-control study

BACKGROUND

Infections may contribute to Alzheimer's disease (AD) risk. Limited evidence suggests Toxocara spp. infection/exposure could influence AD development.

METHODS

We investigated Toxocara seropositivity and AD in Iranian adults using a matched case-control study. Our sample included 90 AD cases and 91 healthy older adults. Anti-Toxocara immunoglobulin G (IgG) antibodies were assessed via enzyme-linked immunosorbent assay. We computed the odds ratios (ORs) and 95% confidence intervals (CIs) through univariable and multivariable analyses, adjusting for potential confounders.

RESULTS

There were 33/90 (36.67% [95% CI 26.75 to 47.48]) anti-Toxocara IgG seropositive individuals identified among the AD cases and 21/91 (23.07% [95% CI 14.89 to 33.09]) among the healthy controls. In univariable analysis, a significant association was identified between anti-Toxocara IgG seropositivity and AD (OR 1.93 [95% CI 1.01 to 3.69], p<0.001). Moreover, the association remained significant (OR 2.18 [95% CI 1.05 to 4.49], p<0.001) in multivariable analysis after adjustment for covariates. There was no association between anti-Toxocara IgG seropositivity and the severity of AD (OR 0.75 [95% CI 0.21 to 2.61], p=0.47).

CONCLUSIONS

Our findings indicated that Toxocara exposure/infection could be a potential risk factor for development of AD. To better understand a real causality between Toxocara exposure/infection and AD and related dementias, follow-up designed and adequately powered studies are needed.

Evaluation of Somatic Antigens of Adult Toxocara helminthes for Detection of Human Toxocariasis

We aimed to develop an indirect enzyme-linked immunosorbent assay (ELISA) to evaluate the presence of specific IgG against Toxocara canis and Toxocara cati somatic antigens on the serum of patients with toxocariasis. The sensitivity, specificity, positive and negative predictive values for indirect-ELISA were calculated by receiver operating characteristic curve (ROC) analysis and Youden's J using Likelihood ratio. All statistics were analysed and graphs are plotted using GraphPad Prism version 8.4.3 (Graph Pad Software, La Jolla, CA, USA), with 95% confidence interval (CI). The sensitivity, specificity, positive and negative predictive values for T. canis were 100%, 82%, 79% and 100%, respectively. The mentioned variables for T. cati were 97%, 82%, 78% and 98%, respectively. Five immune reactive bands of 38, 40, 72, 100 and 250 kDa were common in both species. Toxocara crude antigens were highly immunogenic in human sera. Immunoreactive bands against T. canis compared to T. cati somatic antigen were about two times more. Unlike Toxocara excretory-secretory antigen, that was homologue in two species, somatic antigens of T. canis and T. cati showed different immunoreactive bands in our western blot.

Alterations of plasma circulating microRNAs in BALB/c mice with Toxocara canis visceral and cerebral larva migrans

BACKGROUND

Human toxocariasis is a neglected parasitic disease characterised by the syndromes visceral, cerebral, and ocular larva migrans. This disease is caused by the migrating larvae of Toxocara roundworms from dogs and cats, affecting 1.4 billion people globally. Via extracellular vesicles (EVs), microRNAs have been demonstrated to play roles in host-parasite interactions and proposed as circulating biomarkers for the diagnosis and follow-up of parasitic diseases.

METHODS

Small RNA-seq was conducted to identify miRNAs in the infective larvae of T. canis and plasma EV-containing preparations of infected BALB/c mice. Differential expression analysis and target prediction were performed to indicate miRNAs involved in host-parasite interactions and miRNAs associated with visceral and/or cerebral larva migrans in the infected mice. Quantitative real-time polymerase chain reaction (PCR) was used to amplify circulating miRNAs from the infected mice.

RESULTS

This study reports host and parasite miRNAs in the plasma of BALB/c mice with visceral and cerebral larva migrans and demonstrates the alterations of these miRNAs during the migration of larvae from the livers through the lungs and to the brains of infected mice. After filtering unspecific changes in an irrelevant control, T. canis-derived miRNAs and T. canis infection-induced differential miRNAs are predicted to modulate genes consistently involved in mitogen-activated protein kinase (MAPK) signalling and pathways regulating axon guidance and pluripotency of stem in the infected mice with visceral and cerebral larva migrans. For these plasma circulating miRNAs predicted to be involved in host-parasite crosstalk, two murine miRNAs (miR-26b-5p and miR-122-5p) are experimentally verified to be responsive to larva migrans and represent circulating biomarker candidates for visceral and cerebral toxocariasis in BALB/c mice.

CONCLUSIONS

Our findings provide novel insights into the crosstalk of T. canis and the mammalian host via plasma circulating miRNAs, and prime agents and indicators for visceral and cerebral larva migrans. A deep understanding of these aspects will underpin the diagnosis and control of toxocariasis in humans and animals.

Understanding the research and practical needs required to control toxocariasis in Iran

Human toxocariasis (HT) is a widespread zoonotic infection globally, notably prevalent in tropical areas. Enhancing our understanding of toxocariasis can lead to increased attention towards the socioeconomic impact and control of this neglected zoonosis. We conducted a comprehensive review of all available articles and official documents on toxocariasis in Iran to identify research gaps and critical needs for its control. This review highlights that despite numerous studies exploring various aspects of toxocariasis in definitive and paratenic hosts, as well as humans and environmental contamination, significant data deficiencies and gaps persist across different regions in the country. These gaps involve investigating the worm burden and reinfection rates in definitive hosts, developing more sensitive methods to detect and differentiate of Toxocara species, and understanding the behavior of definitive host animals. Additionally, identifying potential paratenic hosts for HT and exploring the organ-specific affinity and survival duration of Toxocara larvae within these hosts are essential areas for exploration. It's also imperative to comprehend the sylvatic and domestic cycles of the parasite in paratenic hosts. Furthermore, assessing egg density in the environment, exploring potential new sources such as water, and identifying regions with optimal climatic conditions for the survival and development of Toxocara eggs are crucial for the formulation of effective prevention and control strategies. Identifying at-risk groups, developing early diagnosis techniques, employing imaging methods, and identifying long-term complications in humans are also crucial. Community health organizations should prioritize health education for the public and professionals. Furthermore, accurately estimating definitive host populations, monitoring and preventing their movements in public places, implementing regular deworming practices for pets and stray hosts, and recognizing the infection's significance as a health priority are critical. This comprehensive understanding advocates for a holistic "one health" approach to control of HT.

C-type lectin 4 of Toxocara canis activates NF-ĸB and MAPK pathways by modulating NOD1/2 and RIP2 in murine macrophages in vitro

Toxocara canis is a parasitic zoonose that is distributed worldwide and is one of the two pathogens causing toxocariasis. After infection, it causes serious public health and safety problems, which pose significant veterinary and medical challenges. To better understand the regulatory effects of T. canis infection on the host immune cells, murine macrophages (RAW264.7) were incubated with recombinant T. canis C-type lectin 4 (rTc-CTL-4) protein in vitro. The quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot were used to analyze the nucleotide-binding oligomerization domain-containing protein 1/2 (NOD1/2), receptor-interacting protein 2 (RIP2), nuclear factor kappa-light-chain enhancer of activated B cells (NF-κB), and mitogen-activated protein kinase (MAPK) on mRNA level and protein expression level in macrophages. Our results indicated that 10 μg/mL rTc-CTL-4 protein could modulate the expression of NOD1, NOD2, and RIP2 at both the transcriptional and translational levels. The protein translation levels of NF-κB, P-p65, p38, and P-p38 in macrophages were also modulated by rTc-CTL-4 protein. Macrophages were co-incubated with rTc-CTL-4 protein after siRNA silencing of NOD1, NOD2, and RIP2. The expression levels of NF-κB, P-p65, p38, and P-p38 were significantly changed compared with the negative control groups (Neg. Ctrl.). Taken together, rTc-CTL-4 protein seemed to act on NOD1/2-RIP2-NF-κB and MAPK signaling pathways in macrophages and might activate MAPK and NF-κB signaling pathways by regulating NOD1, NOD2, and RIP2. The insights from the above studies could contribute to our understanding of immune recognition and regulatory mechanisms of T. canis infection in the host animals.

Intestine proteomic and metabolomic alterations in dogs infected with Toxocara canis

Toxocariasis is an important zoonotic parasitic disease. Toxocaris canis adults live and reproduce in the intestinal tract of dogs and other canine hosts, and the infectious eggs are continuously excreted in feces, which causes environmental contamination and has an important public health significance. In this study, TMT proteomic and untargeted metabolomic methods were used to explore the physiological and pathological effects on the intestinal tract of dogs which infected with T. canis, and a series of bioinformatics analyses were conducted to identify differentially expressed proteins (DEPs) and differentially expressed metabolites (DEMs). The proteomics results showed that 198 DEPs were mainly enriched in the immune system and signal transduction pathway, and involved in the regulation of the occurrence and development of cancer and infectious diseases. T. canis could disrupt intestinal permeability by increasing the expression of proteins such as zinc finger protein DZIP1L and myosin heavy chain 10. Additionally, T. canis infection could also inhibit the host immune response by decreasing the expression of MHC-II, NF-κB, DLA and other immune-related molecules. While, the metabolomics results revealed that the expression of oxoglutaric acid, glutamate, d-aspartate, arginine, taurochenodeoxycholic acid and taurocholic acid which participated in tricarboxylic acid (TCA) cycle, glycolysis/gluconeogenesis, bile secretion, biosynthesis of amino acids pathway were significantly decreased. The correlation results of proteomics and metabolomics showed that DEPs and DEMs were mainly co-enriched in bile secretion pathway to regulate intestinal peristalsis. Analyzing DEPs and DEMs will not only provide insights into the mechanisms of host parasite interaction, but also aid in identifying potential targets for therapy and diagnosis, thus setting the groundwork for effectively preventing and managing toxocariasis.

Seroprevalence and Potential Risk Factors of Toxocariasis among General Population in Southwest Iran: Implications on the One Health Approach

Toxocariasis is one of the most common zoonotic diseases distributed worldwide. This study aimed to estimate the seroprevalence of anti-Toxocara immunoglobulin G (IgG) antibodies and the associated risk factors among general populations living in urban and rural areas of Abadan and Khorramshahr cities in Khuzestan Province, Southwest Iran. This cross-sectional study was conducted between March and September 2022. There were 363 participants (190 females and 173 males) aged from <20 to ≥60 years old. Anti-Toxocara IgG antibodies in serum samples were measured using a commercially available enzyme-linked immunosorbent assay (ELISA). A structured questionnaire was employed to collect information regarding sociodemographic status and probable risk factors associated with toxocariasis. It was found that the seroprevalence rate in males (15.0%, 95% CI = 10.47-21.11) was higher than in females (10.5%, 95% CI = 6.92-15.70). Moreover, we observed that the seroprevalence was higher in participants at younger ages compared to other age ranges (COR = 2.55, 95% CI = 0.92-7.12, p =0.073). The findings of the univariate analysis revealed that residency in rural areas (p  < 0.001), using unpurified water (p  < 0.001), contact with dog (p =0.002), contact with soil (p  < 0.001), consumption of improperly washed vegetables (p  < 0.001), and history of drinking untreated water (p  < 0.001) were risk factors associated with toxocariasis. Further comprehensive studies with a focus on humans and animals should be designed in different areas of the Province. The data represented by the current study are useful to health policymakers to consider precise surveillance and effective prevention measures to control this zoonotic infection among general populations.

Epidemiological profile of human toxocariasis in patients examined at Evandro Chagas Institute (IEC/SVSA/MS) between 2014 and 2019

INTRODUCTION

Toxocariasis is caused by nematodes of Toxocara genus, which infest dogs and cats, with humans serving as paratenic hosts.

METHODS

The epidemiological profile of patients examined for toxocariasis between October 2014 and October 2019 at Evandro Chagas Institute (IEC) was outlined. The frequency of anti-T. canis IgG antibodies were evaluated using the Enzyme Linked Immunosorbent Assay (ELISA) method.

RESULTS

From a total of 734 samples, 56% were from male (p < 0.05). Regarding age, the group with the most solicitations were from ≤11 years old individuals (p < 0.05). Pará state had the highest number of exams requested (92%), with the majority from residents of urban areas, accounting for 81.5% of samples (p < 0.05). The overall toxocariasis seroprevalence was 41.8%, the male sex being the most frequent with 60.9% (p < 0.05). The most affected age group was ≤11 years old, with a total of 67.8% of positive samples (p < 0.05).

CONCLUSION

The high rates obtained emphasize the need for complementary studies on toxocariasis in Brazil, especially in Pará state, contributing to epidemiological surveillance actions in the control of this infection. Besides, health campaigns for domestic and stray animals, also can contribute to a more effective surveillance in controlling parasitic infections and encourages the One Health approach.

Toxocarosis in a patient with autism spectrum disorder presenting with severe hypereosinophilia and acute respiratory distress: a case report

A boy with known autism spectrum disorder was transferred to our department due to a rapidly worsening respiratory situation. The patient's history revealed previous treatment with albendazole against a Toxocara infection 2 weeks prior in Poland. Blood analysis showed such severe eosinophilia and markedly elevated levels of IgE that, initially, a hematologic malignancy was suspected. However, diagnostic workup including autoimmune diagnostic, molecular genetic testing, fluorescence in situ hybridization (FISH), bone marrow aspiration, and parasitological testing led to the diagnosis of an insufficiently treated Toxocara infection. Treatment with albendazole and prednisone (six cycles for 4 weeks each) was administered. This treatment regime led to prompt improvement of symptoms and normalization of laboratory findings.

Who Let the Dogs Out? Unmasking the Neglected: A Semi-Systematic Review on the Enduring Impact of Toxocariasis, a Prevalent Zoonotic Infection

Toxocariasis remains an important neglected parasitic infection representing one of the most common zoonotic infections caused by the parasite Toxocara canis or, less frequently, by Toxocara cati. The epidemiology of the disease is complex due to its transmission route by accidental ingestion of embryonated Toxocara eggs or larvae from tissues from domestic or wild paratenic hosts. Even though the World Health Organization and Centers for Disease Control classified toxocariasis amongst the top six parasitic infections of priority to public health, global epidemiological data regarding the relationship between seropositivity and toxocariasis is limited. Although the vast majority of the infected individuals remain asymptomatic or experience a mild disease, the infection is associated with important health and socioeconomic consequences, particularly in underprivileged, tropical, and subtropical areas. Toxocariasis is a disease with multiple clinical presentations, which are classified into five distinct forms: the classical visceral larva migrans, ocular toxocariasis, common toxocariasis, covert toxocariasis, and cerebral toxocariasis or neurotoxocariasis. Anthelmintic agents, for example, albendazole or mebendazole, are the recommended treatment, whereas a combination with topical or systemic corticosteroids for specific forms is suggested. Prevention strategies include educational programs, behavioral and hygienic changes, enhancement of the role of veterinarians, and anthelmintic regimens to control active infections.

One health approach to toxocariasis in quilombola communities of southern Brazil

BACKGROUND

Toxocariasis has been listed among the most neglected parasitic diseases worldwide, with approximately one fifth of the global population exposed, particularly those living under poverty. In Brazil, communities of descendants of enslaved blacks (quilombola) have historically had some of the highest rates of vulnerability and poverty, characterized by lack of health assistance, poor quality of life, and nutritional insecurity.

METHODS

A cross-sectional sampling of quilombola individuals living in four communities of southern Brazil, as well as their dogs and the soil, was carried out from December 2021 to March 2022. Sociodemographic and other information such as water source, alimentary habits, and dog and cat ownership were gathered using a semi-structured questionnaire for assessing toxocariasis risk factors. Human serum samples were tested by ELISA for anti-Toxocara spp. IgG antibody detection was carried out on dog feces and hair, and soil samples were surveyed for presence of Toxocara spp. eggs.

RESULTS

Overall, 172/208 individuals (82.7%, 95% CI = 77.0-87.2) were seropositive, the highest seroprevalence rate to date in Brazil. Male gender (P = 0.029), educational level (P = 0.026), and drinking water source (P = 0.043) were associated with seropositivity by univariate analysis. Final logistic regression revealed increased odds (P = 0.017, OR = 7.6, 95% CI = 1.5-42.7) to have seropositivity in individuals > 50 years old (< 10 years old). As expected, individuals with soil contact were more likely seropositive (P = 0.038, OR = 4.4, 95% CI = 1.1-18.8). Although retrieved in only 5/96 (5.2%) dog feces, Toxocara spp. eggs were found in 18/60 (30.0%) soil samples.

CONCLUSIONS

The high vulnerability and seroprevalence observed in quilombola communities clearly demand a One Health approach for detection, monitoring, and prevention of infection by Toxocara spp. in both human and dog populations.

Seroprevalence of human toxocariasis in Latin America and the Caribbean: a systematic review and meta-analysis

Introduction

The current study aimed to quantitatively synthesize available evidence regarding the seroprevalence of human toxocariasis in Latin America and the Caribbean.

Methods

A systematic research involving six electronic databases was conducted using a research strategy that combined MeSH terms with free terms. Article selection and information extraction were performed using a double and independent approach. The Newcastle-Ottawa tool was used to assess the risk of bias in the included articles. The meta-analysis used the random-effects approach, with subgroup analysis and sensitivity analysis for risk of bias also being performed.

Results

We included 101 articles with a total of 31,123 participants. The studies were conducted between 1990 and 2022, with Brazil accounting for the largest number of studies (n = 37). The overall seroprevalence of human toxocariasis was 31.0% (95% CI: 27.0-35.0%, I2 = 99%). The prevalence of the main characteristics observed in seropositive patients were as follows: ocular toxocariasis (30.0%), asymptomatic (26.0%), and presence of dogs at home (68.0%). In addition, the seroprevalence was lower in studies including only adults than in those including children or both. In contrast, no differences in seroprevalences were found between studies conducted in the community and hospital.

Conclusion

The overall seroprevalence of human toxocariasis in Latin America and the Caribbean was high. Notably, our findings showed that the seroprevalence was increased among populations who kept a dog at home but was decreased in populations comprising only adults. Our findings can be used to establish epidemiological surveillance strategies for the prevention and early identification of toxocariasis.

Long-term impacts of an urban sanitation intervention on enteric pathogens in children in Maputo city, Mozambique: study protocol for a cross-sectional follow-up to the Maputo Sanitation (MapSan) trial 5 years postintervention

INTRODUCTION

We previously assessed the effect of an onsite sanitation intervention in informal neighbourhoods of urban Maputo, Mozambique on enteric pathogen detection in children after 2 years of follow-up (Maputo Sanitation (MapSan) trial, ClinicalTrials.gov: NCT02362932). We found significant reductions in Shigella and Trichuris prevalence but only among children born after the intervention was delivered. In this study, we assess the health impacts of the sanitation intervention after 5 years among children born into study households postintervention.

METHODS AND ANALYSIS

We are conducting a cross-sectional household study of enteric pathogen detection in child stool and the environment at compounds (household clusters sharing sanitation and outdoor living space) that received the pour-flush toilet and septic tank intervention at least 5 years prior or meet the original criteria for trial control sites. We are enrolling at least 400 children (ages 29 days to 60 months) in each treatment arm. Our primary outcome is the prevalence of 22 bacterial, protozoan, and soil transmitted helminth enteric pathogens in child stool using the pooled prevalence ratio across the outcome set to assess the overall intervention effect. Secondary outcomes include the individual pathogen detection prevalence and gene copy density of 27 enteric pathogens (including viruses); mean height-for-age, weight-for-age, and weight-for-height z-scores; prevalence of stunting, underweight, and wasting; and the 7-day period prevalence of caregiver-reported diarrhoea. All analyses are adjusted for prespecified covariates and examined for effect measure modification by age. Environmental samples from study households and the public domain are assessed for pathogens and faecal indicators to explore environmental exposures and monitor disease transmission.

ETHICS AND DISSEMINATION

Study protocols have been reviewed and approved by human subjects review boards at the Ministry of Health, Republic of Mozambique and the University of North Carolina at Chapel Hill. Deidentified study data will be deposited at https://osf.io/e7pvk/.

TRIAL REGISTRATION NUMBER

ISRCTN86084138.

Case report: Ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant (Ozurdex) for peripheral granulomatous ocular toxocariasis in children

Purpose

This article aims to report a case of successful treatment of peripheral granulomatous ocular toxocariasis (OT) in an 8-year-old patient using intravitreal injection of dexamethasone (DEX) implant (Ozurdex) under ultrasound biomicroscopy (UBM) guidance.

Case presentation

A previously healthy 8-year-old boy with a history of long-term close contact with dogs complained of blurring of vision in the right eye for a year. Ophthalmic examination of his right eye showed chronic uveitis. Notably, UBM examination identified granulomas and peripheral vitreous strand in the ciliary body from 3 to 8 o'clock positions. Enzyme-linked immunosorbent assay (ELISA) results of the intraocular fluid (IF) and serum showed increased anti-Toxocara immunoglobulin G (IgG) levels, leading to a diagnosis of peripheral granulomatous OT in the right eye. Intraocular surgery was not indicated in this case. The treatment goal was to alleviate uveitis, improve visual acuity, and prevent complications. He was treated with an intravitreal injection of DEX implant, administered as a single dose every three months, total two doses, combined with albendazole, an oral anthelmintic. Under preoperative UBM guidance, two injections were performed at the 12 and 10 o'clock positions in the pars plana where there were no granulomas and peripheral vitreous strand, successfully preventing complications associated with intravitreal injection. After two injections, the patient's right eye vision improved significantly, with the best-corrected visual acuity (BCVA) increasing from 20/400 to 20/50. Vitreous opacity and retinal edema were reduced, preretinal proliferative membrane was stabilized, and no adverse events occurred.

Conclusion

UBM can accurately determine the location and extent of peripheral granulomas in OT patients, facilitating the avoidance of granulomas during intravitreal injection and preventing complications associated with intravitreal injection. Under the close follow-up and strict adherence to indications, preoperative UBM-guided intravitreal injections of DEX implant treatment for pediatric peripheral granulomatous OT are safe and effective, providing a new therapeutic option for pediatric peripheral granulomatous OT.

Toward anthelmintic drug candidates for toxocariasis: Challenges and recent developments

Infections caused by parasitic helminths rank among the most prevalent infections of humans and animals. Toxocariasis, caused by nematodes of the genus Toxocara, is one of the most widespread and economically important zoonotic parasitic infections that humans share with dogs and cats. Despite the completion of the Toxocara canis draft genome project, which has been an important step towards advancing the understanding of this parasite and the search for drug targets, the treatment of toxocariasis has been dependent on a limited set of drugs, necessitating the search for novel anthelmintic agents, specially against Toxocara larvae in tissues. Given that research, development, and innovation are crucial to finding appropriate solutions in the fight against helminthiasis, this paper reviews the progress made in the discovery of anthelmintic drug candidates for toxocariasis. The main compounds reported in the recent years regards on analogues of albendazole, reactive quinone derivatives and natural produts and its analogues. Nanoparticles and formulations were also reviewed. The in vitro and/or in vivo anthelmintic properties of such alternatives are herein discussed as well as the opportunities and challenges for treatment of human toxocariasis. The performed review clarify that the scarcity of validated molecular targets and limited chemical space explored are the main bottlenecks for advancing in the field of anti-Toxocara agents.

Altered miRNA Expression Profiles in the Serum of Beagle Dogs Experimentally Infected with Toxocara canis

Toxocara canis is a neglected roundworm, which can cause debilitating disease in dogs and humans worldwide. Serum is an excellent material for monitoring the occurrence of many diseases. However, no information is available on the expression of microRNAs (miRNAs) in the serum of dogs infected with T. canis. In this study, RNA-seq analysis was performed to identify the serum miRNA profiles in Beagle dogs infected with T. canis at different stages of infection. A total of 3, 25 and 25 differently expressed miRNAs (DEmiRNAs) were identified in dog serum at 24 h post-infection (hpi), 10 days post-infection (dpi) and 36 dpi, respectively, such as cfa-let-7g, cfa-miR-16, cfa-miR-92b, cfa-miR-93, cfa-miR-122, cfa-miR-485 and cfa-miR-451. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis revealed that these miRNAs could regulate the pathways related to parasitic infectious diseases and immune system, such as amoebiasis, toxoplasmosis, platelet activation, IL-17 signaling pathway and chemokine signaling pathway. These results provide a foundation to explore the underlying regulatory role of miRNAs in definitive hosts after T. canis infection.

Seroprevalence of Toxocariasis Among Hypereosinophilic Children: A Single Center Study, Tehran, Iran

Background: Toxocariasis is a parasitic disease causing hypereosinophilia. This study aimed to investigate the serological prevalence of toxocariasis among hypereosinophilic children in Children’s Medical Center, Tehran, Iran, as well as to explore its relationship with epidemiological variables and some blood indices. Methods: This descriptive cross-sectional study was performed in 2020 on children referred to referral children hospital for routine tests. A total of 282 children diagnosed with hypereosinophilia were selected and included in the study, and then, their serum was collected. After obtaining informed consent from their parents, the parents were asked to fill out a questionnaire. The serological ELISA test was used to assess the anti-Toxocara IgG antibody. Data were analyzed using SPSS software 18. Results: Out of 282 hypereosinophilic children, 17 (6%) had serological results positive for anti-Toxocara antibody. The mean age of children with toxocariasis was higher than that of children without toxocariasis (P = 0.312). Furthermore, ESR and CRP variables were significantly higher in infected children than those in non-infected children (P < 0.05). Conclusions: The results of the present study confirmed the relationship between toxocariasis and hypereosinophilia. Since the symptoms of toxocariasis are non-specific and may go undiagnosed, it was found necessary to examine toxocariasis in cases of hypereosinophilic individuals.

Investigation of Parasitic Nematodes Detected in the Feces of Wild Carnivores in the Eastern Qinghai-Tibet Plateau, China

Wildlife shares grazing areas with herders in the eastern Qinghai-Tibet Plateau, and humans can be infected by zoonotic nematodes through direct contact with animals or contaminated water. In this study, fecal samples (n = 296) from wild carnivores were collected to explore the infection rate and molecular genetic characteristics of nematodes by stratified random sampling in the survey areas. Host species and the nematodes they carried were then identified using 16S rRNA and 18S rRNA gene sequencing, respectively. Statistical analysis, neutrality tests, genetic diversity analysis and Bayesian inferred trees were performed to complete the study. In total, 10 species of nematodes were detected in 240 feces from six species of carnivores identified (including dominant Vulpes ferrilata and Vulpes vulpes), namely Uncinaria stenocephala, Toxascaris sp., Crenosoma vulpis, Parapharyngodon bainae, Oesophagostomum muntiacum, Aspiculuris tetraptera, Mastophorus muris, Nematodirus spathiger, Muellerius capillaris, and Molineus patens. Among these nematodes, U. stenocephala (35.83%, 86/240) and Toxascaris sp. (14.58%, 35/240) were detected at higher rates than the other nematodes (χ2 = 516.909, p < 0.05). Of 17 and 18 haplotypes were found based on the ITS1 gene for U. stenocephala and nad1 gene for Toxascaris sp., respectively. For the first time, using molecular methods, we report the infection of V. ferrilata by U. stenocephala, a potential zoonotic parasite, and suggest Toxascaris sp. may be a newly discovered nematode that lives within the fox intestine.

Lung Lipidomic Alterations in Beagle Dogs Infected with Toxocara canis

Toxocariasis, mainly caused by Toxocara canis, and to a lesser extent, Toxocara cati, is a neglected parasitic zoonosis. The mechanisms that underlie the changes in lipid metabolism of T. canis infection in Beagle dogs' lungs remain unclear. Lipidomics is a rapidly emerging approach that enables the global profiling of lipid composition by mass spectrometry. In this study, we performed a non-targeted lipidomic analysis of the lungs of Beagle dogs infected with the roundworm T. canis using liquid chromatography-tandem mass spectrometry (LC-MS/MS). A total of 1197 lipid species were identified, of which 63, 88, and 157 lipid species were significantly altered at 24 h post-infection (hpi), 96 hpi, and 36 days post-infection (dpi), respectively. This global lipidomic profiling identified infection-specific lipid signatures for lung toxocariasis, and represented a comprehensive comparison between the lipid composition of dogs' lungs in the presence and absence of T. canis infection. The potential roles of the identified lipid species in the pathogenesis of T. canis are discussed, which has important implications for better understanding the interaction mechanism between T. canis and the host lung.

Isolation and Production of Human Monoclonal Antibody Proteins against a Toxocara canis Excretory-Secretory Recombinant Antigen

Toxocariasis is a widespread zoonotic parasitic disease with a significant socioeconomic impact, particularly on underprivileged communities. Limitations of existing diagnostic tools and vague presenting symptoms may lead to misdiagnosis, thus underestimating the actual global impact of the disease. The present study describes the isolation and production of novel recombinant monoclonal antibodies against Toxocara canis recombinant TES-26 antigen (rTES-26) utilizing a human helminth scFv phage display library. The isolated antibody clones were characterized based on their gene sequences and binding characteristics. Three clones representing unique gene families (clone 48: IgHV3-LV1; clone 49: IgHV3-LV3; clone 50: IgHV6-LV3) were isolated, but only clones 48 and 49 showed successful insertion of the full-length scFv antibody sequence after sub-cloning. Both clones produced antibody proteins of good solubility and satisfactory yield and purity. Binding assays via Western blot and ELISA using rTES-26 and Toxocara canis native protein showed that both monoclonal antibodies were highly specific and sensitive to the target antigen. A preliminary antigen detection ELISA showed the diagnostic potential of the monoclonal antibody proteins. The proteins can also be useful in studying host−parasite interactions and therapeutic applications.

Comorbidities involving parasitic diseases: A look at the benefits and complications

Parasitic infections acquired by the population cause substantial morbidity worldwide, with individuals from developing countries being most affected. Some parasites remain in the host for long periods, settling in different organs, manipulating the flow of nutrients and metabolites, and influencing the immune response, favoring their adaptation. The host attempts to counteract the metabolic and immunological alterations and the possible damage caused by infection. These metabolic and immunological changes experienced by the host can influence the progression of other existing morbidities or those that will be acquired in the future. Cancer and metabolic diseases are also frequent causes of morbidity in the world population. The large numbers of individuals affected by cancer and metabolic diseases and the high prevalence of morbidity caused by parasitic diseases favor the development of comorbidity involving these pathologies. This review provides an overview of major advances in research on cancer and metabolic diseases associated with parasitic infections. Information about hosts and parasites such as alterations of the immune response, metabolism and adaptation mechanisms of the parasites, and parasitic molecules with therapeutic potential is provided, as well as the beneficial results or complications related to the comorbidities discussed herein. We emphasize the need to conduct additional studies addressing comorbidities associated with parasitic infections to improve the understanding of the impact of this association on the progression of morbidities, as well as the possibility of the therapeutic use of and therapeutic approaches involving parasites.

Seroprevalence of toxocariasis among allergic patients in Kuwait and its association with eosinophilia

Toxocariasis is a worldwide helminthic infection which is transmitted from infected dogs and cats and has been associated with peripheral blood eosinophilia. The Centers for Disease Control and Prevention (CDC) placed toxocariasis among the top 6 parasitic diseases in the USA which are prioritized for public health action. To our knowledge, there are no reports on human toxocariasis in Kuwait or in the other Gulf Cooperation Council (GCC) countries. This study aims at investigating the seroprevalence of toxocariasis among allergic patients in Kuwait and its association with eosinophilia, age, gender, nationality, and history of direct contact with dogs or cats. From September to December 2021, the laboratory records of allergic patients referred to Al-Rashed Allergy Hospital, Kuwait were reviewed and a total of 400 serum samples were selected: 200 samples from patients with normal eosinophil count (< 500 cells/μl) and 200 samples from patients with eosinophilia (> 500 cells/μl). The sera were screened for anti-Toxocara canis IgG antibodies via antibody enzyme-linked immunosorbent assay (Ab-ELISA). The seropositive patients were asked about their history of direct contact with dogs or cats. Statistical analyses were performed using Microsoft Excel® Analysis ToolPak software. Toxocariasis seropositivity was detected in 10 out of 400 (2.5%) allergic patients. Five patients had eosinophilia while 5 had normal eosinophil count. There was no difference in mean age or gender between Toxocara-seropositive and seronegative patients (p > 0.05). The seroprevalence rate was lower-than-expected among Kuwaiti patients (2/307, 0.7%) in comparison with non-Kuwaiti patients (8/57, 14.0%) (χ2 = 33.603, df = 1, p < 0.001) who originated from endemic South/Southeast Asian countries. Seven out of 8 (87.5%) seropositive patients had a history of direct contact with cats, dogs, or both. The seroprevalence rate of toxocariasis among allergic patients in Kuwait was 2.5%. Raising awareness and early deworming treatment/prophylaxis for juvenile dogs and cats remain crucial for toxocariasis prevention.

A Retrospective Study of the Efficacy of Albendazole and Diethylcarbamazine for the Treatment of Human Toxocariasis

In the Department of Parasitology and Mycology of Toulouse University Hospitals, patients presenting with common/covert toxocariasis were treated either with albendazole (39 cases) or with diethylcarbamazine (32 cases). Albendazole (ABZ) was given at 10 mg/kg b/w daily for 14 days, and diethylcarbamazine (DEC) was given at 4 mg/kg b/w daily for 21 days. In both groups, follow-up consultations occurred approximately 48 days after the end of the anthelmintic therapy. ABZ and DEC displayed a similar efficacy on the kinetics of the clinical picture (−64.5% of reduction vs. −72.7%, respectively) and on the levels of blood eosinophilia, serum eosinophil cationic protein and serum total IgE. However, the effect of the medication on the laboratory parameters was moderate. The rate of adverse reactions was similar in both groups (38% for ABZ vs. 31% for DEC), but DEC-treated patients complained of more intense and long-lasting side effects. The DEC group had more major adverse reactions, resulting in the termination of the anthelmintic treatment. The results from this retrospective study bring further arguments for considering ABZ, given at 10 mg/kg daily for 2 weeks, as the drug of choice in the treatment of human toxocariasis.

Toxocara canis Infection Alters mRNA Expression Profiles of Peripheral Blood Mononuclear Cells in Beagle Dogs at the Lung Infection Period

Simple Summary

Toxocariasis is one of the most neglected zoonoses in the world. Toxocara canis is the main pathogen causing toxocariasis in humans and animals, threatening public health. To date, the mechanism by which the larvae of T. canis escape the attack of immune cells in the blood is still poorly understood. Using RNA-seq technology, the transcriptional alterations of Beagle dog peripheral blood mononuclear cells (PBMCs) between the presence and absence of T. canis infection were analyzed during the lung infection period, and 1066 upregulated genes and 1076 downregulated genes were identified (padj < 0.05 and |log₂ (FoldChange)| > 1). In addition, many immune- or inflammation-related GO terms and KEGG signaling pathways were significantly altered during T. canis infection by GO annotation and KEGG enrichment analysis. The present study revealed that T. canis infection can alter the mRNA profiles of PBMCs in Beagle dogs during the lung infection period, which has important implications for a better understanding of the interaction mechanism between T. canis and host immune cells.

Abstract

Toxocara canis is a neglected zoonotic roundworm distributed all over the world, causing toxocariasis in humans and animals. However, so far, the immune mechanism of T. canis infection in definitive hosts remains to be clarified. In this study, the transcriptional alterations of Beagle dogs’ peripheral blood mononuclear cells (PBMCs) induced by T. canis infection during the lung infection period were analyzed using RNA-seq technology. A total of 2142 differentially expressed genes were identified, with 1066 upregulated genes and 1076 downregulated genes. Many differentially expressed genes participated in the biological process of intracellular signal transduction, as well as the immune- or inflammation-related KEGG signaling pathway, such as the Notch signaling pathway, Toll-like receptor signaling pathway, and NF-kappa B signaling pathway, through KEGG enrichment analysis. This study indicated that T. canis infection could suppress the biological function of Beagle dogs’ PMBCs and provided basic data to further clarify the interaction mechanism between T. canis and host immune cells.

Neuroimmunology of Common Parasitic Infections in Africa

Parasitic infections of the central nervous system are an important cause of morbidity and mortality in Africa. The neurological, cognitive, and psychiatric sequelae of these infections result from a complex interplay between the parasites and the host inflammatory response. Here we review some of the diseases caused by selected parasitic organisms known to infect the nervous system including Plasmodium falciparum, Toxoplasma gondii, Trypanosoma brucei spp., and Taenia solium species. For each parasite, we describe the geographical distribution, prevalence, life cycle, and typical clinical symptoms of infection and pathogenesis. We pay particular attention to how the parasites infect the brain and the interaction between each organism and the host immune system. We describe how an understanding of these processes may guide optimal diagnostic and therapeutic strategies to treat these disorders. Finally, we highlight current gaps in our understanding of disease pathophysiology and call for increased interrogation of these often-neglected disorders of the nervous system.

Therapy and Prevention for Human Toxocariasis

For the last four decades, knowledge about human toxocariasis with regard to its epidemiology, pathophysiology, clinical spectrum, and imaging or laboratory diagnosis has substantially progressed. Knowledge about specific therapy with anthelmintics has lagged behind. To date, only four drugs are registered for human use, and their efficacy has rarely been assessed in prospective controlled trials. It is likely that the repurposing of potent anthelmintics from veterinary medicine will improve this situation. Due to its wide availability and a lack of major side effects during short regimens, albendazole has become the drug of choice. However, its efficacy should be more precisely assessed. The role of anthelmintics in the treatment of neurological or ocular toxocariasis remains to be clarified. Prophylactic measures in humans or companion animals are efficient and represent first-line treatments for the control of this zoonosis. Unfortunately, their implementation in areas or countries where toxocariasis epidemiology is driven by poverty is quite difficult or unrealistic.

Canine and Feline Parasitology: Analogies, Differences, and Relevance for Human Health

Cats and dogs are treated as family members by most pet owners. Therefore, a high quality of veterinary care and preventive medicine is imperative for animal health and welfare and for the protection of humans from zoonotic pathogens. There is a general perception of cats being treated as "small dogs," especially in the field of clinical parasitology. As a result, several important differences between the two animal species are not taken into proper consideration and are often overlooked. Dogs and cats are profoundly different under evolutionary, biological, ethological, behavioral, and immunological standpoints. These differences impact clinical features, diagnosis, and control of canine and feline parasites and transmission risk for humans. This review outlines the most common parasitoses and vector-borne diseases of dogs and cats, with a focus on major convergences and divergences, and discusses parasites that have (i) evolved based on different preys for dogs and cats, (ii) adapted due to different immunological or behavioral animal profiles, and (iii) developed more similarities than differences in canine and feline infections and associated diseases. Differences, similarities, and peculiarities of canine and feline parasitology are herein reviewed in three macrosections: (i) carnivorism, vegetarianism, anatomy, genetics, and parasites, (ii) evolutionary adaptation of nematodes, including veterinary reconsideration and zoonotic importance, and (iii) behavior and immune system driving ectoparasites and transmitted diseases. Emphasis is given to provide further steps toward a more accurate evaluation of canine and feline parasitology in a changing world in terms of public health relevance and One Health approach.

Toxocariasis-associated urinary system diseases: a systematic review of reported cases

BACKGROUND

Toxocariasis is a neglected tropical disease caused by Toxocara canis and Toxocara cati. Toxocara species can involve many organs, such as the brain, heart and lungs, however, the urinary system involvement of toxocariasis is largely unknown.

METHODS

We performed a systematic review to identify cases infected with urinary tract toxocariasis.

RESULTS

We identified seven cases that were eligible to be reviewed. Among the included citations, four studies reported bladder involvement and three reported kidney involvement. Fever, urinary, and abdominal presentations were amongst the most important clinical symptoms. Eosinophilic cystitis and nephrotic syndrome were the most common diagnoses.. The treatment regimen included a combination of anthelmintic drugs and steroids.

CONCLUSIONS

In cases of urinary tract presentations accompanied by eosinophilia or histopathologic findings suggestive of parasitic infection, toxocariasis should be included in the list of differential diagnoses, especially in endemic areas.

Human Toxocariasis in Portugal-An Overview of a Neglected Zoonosis over the Last Decade (2010-2020)

Toxocariasis is one of the most widespread and important zoonotic parasitic diseases, although neglected. Data regarding human Toxocara infection in Portugal are almost absent. This article gives an overview of the situation of toxocariasis in Portugal over the last decade based on casuistic data. A total of 846 serum samples from individuals suspected of toxocariasis, collected from 2010 to 2020, were analyzed at the Institute of Hygiene and Tropical Medicine. Sera were tested for IgG antibodies to Toxocara canis excreted–secreted larval antigens by enzyme-linked immunosorbent assay and counterimmunoelectrophoresis. Positivity was detected in 18.8% (159/846) [CI 95%: 16.3–21.6], with positives detected throughout continental Portugal. Overall, 59.7% of the positives were diagnosed in younger than 20 years (35.2% aged 0–9 years and 24.5% aged 10–19 years). Eosinophilia was the most frequent feature reported (27.7%). Pediatrics (41.5%) and Infectiology (25.8%) were the specialties with the highest number of positives. An average of 77 samples/year were received, recording a maximum positivity in 2012 (41.5%, n = 27/65) and a minimum in 2020 (6.4%, n = 3/47). These numbers may reflect the effectiveness of current preventive measures, highlighting the need to maintain public awareness to control this helminthozoonosis and promote a higher public health standard.

Case-Control Study to Assess the Association between Epilepsy and Toxocara Infection/Exposure

Although causes and etiology of epilepsy are mostly obscure, some zoonotic parasites, such as Toxocara species, have been proposed as a risk factor for this disease. Here, we conducted an age-matched case-control study to evaluate whether there is an association between epilepsy and the presence of serum antibodies to Toxocara in incident cases. We included 94 idiopathic epileptic patients as cases, and—from the same geographical region—88 people with no own history of epilepsy or neurological disease as control subjects. Epilepsy was confirmed by a physician using the International League Against Epilepsy (ILAE) definition. All participants were screened for the anti-Toxocara IgG serum antibody by enzyme-linked immunosorbent assay (ELISA). Univariate and mutltivariate statistical analyses were applied to calculate the crude and adjusted odds ratios (OR) and 95% confidence intervals (CIs). Anti-Toxocara serum antibody was detected in 37 epileptic patients and in 23 control subjects, giving respective seroprevalences of 39.3% (95% CI, 29.4–49.9%) and 26.1% (95% CI, 17.3–36.5%), respectively. Adjusted multivariate logistic regression analysis estimated an OR of 2.38 (95% CI, 1.25–4.63), indicating a significant association between epilepsy and Toxocara seropositivity. There was also a significant association between seropositivity to Toxocara and partial (OR, 2.60; 95% CI, 1.14–6.04) or generalized (OR, 2.17; 95% CI, 1.09–4.40%) seizures. Findings from the present study of incident epileptic cases support previous studies proposing that Toxocara infection/exposure is a risk factor for epilepsy. However, further well-designed population-based surveys and mechanistic/experimental studies in animal models are required to better understand the reason(s) for this association.

Screening of Cystic Echinococcosis and Toxocariasis in Urmia Municipal Workers, Northwest Iran

BACKGROUND

Echinococcus granulosus and Toxocara spp., the causative agents of hydatid cyst and toxocariasis in humans and animals, are zoonotic infections with medical and veterinary significance respectively.

AIM

Herein, we aimed to investigate the seroprevalence of toxocariasis and cystic echinococcosis in Urmia municipal workers (gardeners and sweepers) in 2018 using ELISA assay.

OBJECTIVE

There is no precise report on the seroprevalence of toxocariasis and cystic echinococcosis in Urmia municipal workers using ELISA assay. Therefore, this study found an opportunity to investigate this subject.

METHODS

A total of 220 blood samples were obtained from municipal workers with an average age of 41.31 ± 9.42. Commercial anti-Toxocara canis and hydatid cyst ELISA kits were used to assess the seroprevalence rates.

RESULTS

Approximately, 14.5% and 2.3% of individuals were seropositive for toxocariasis and hydatidosis, respectively. Consuming unboiled milk and/or raw/uncooked meat and rural conditions are risk factors for toxocariasis. Regarding hydatidosis, consuming unwashed vegetables was the only statistically significant risk factor. Toxocara infection (p = 0.01), but not hydatid cyst (p = 0.05), is more prevalent among sweepers than municipal gardeners.

CONCLUSION

Due to the occupational condition of municipal workers, they are exposed to many infectious agents; thus, more researches should be done on these populations.

Serosurvey of anti-Toxocara antibodies and risk factors in adolescent and adult pregnant women of southeastern Brazil

Toxocariasis is worldwide endemic parasitic anthropozoonosis with high risk to those in in vulnerable populations and particularly during pregnancy and childhood. Although the prevalence of anti-Toxocara spp. antibodies has been extensively studied, risk factors of pregnant women of different ages remains to be established. This study was designed to i) assess the presence of anti-Toxocara spp. antibodies in pregnant women that presented to the public health system in a city of southeastern Brazil, and ii) determine the risk factors for toxocariasis in adolescent and adult pregnant women. This cross-sectional study included 280 pregnant women (71 aged up to and including 17 years [adolescents] and 209 aged 18 years and older [adults]). Pregnant women voluntarily agreed to complete a socioeconomic questionnaire and provide serum samples. Anti-Toxocara IgG antibodies were screened by Enzyme-Linked Immunosorbent Assay (ELISA). Univariable and multivariable logistic regression models were performed to assess the risks for toxocariasis. Overall, 20.7% of pregnant women were seropositive (33.8% of adolescents and 16.3% of adults). Prevalence in pregnant adolescents was 2.6-fold higher than in adults (Odds ration [OR]: 2.63; 95% CI: 1.42-4.86, p = 0.003). Multivariate analysis revealed that contact with soil (p = 0.01; OR = 4.76) and being in the first trimester of pregnancy (p = 0.03; OR = 0.17) had significantly greater risk of toxocariasis for adolescents, and attainment of elementary through middle school education level (p = 0.05; OR = 8.33) was a risk factor in adult pregnant women. Toxocariasis is likely underreported and neglected in adolescent pregnant women; this age group should always be monitored for toxocariasis and correspondent clinical signs, particularly at late pregnancy.

Toxocara canis Infection Alters lncRNA and mRNA Expression Profiles of Dog Bone Marrow

Bone marrow is the main hematopoietic organ that produces red blood cells, granulocytes, monocyte/macrophages, megakaryocytes, lymphocytes, and myeloid dendritic cells. Many of these cells play roles in the pathogenesis of Toxocara canis infection, and understanding how infection alters the dynamics of transcription regulation in bone marrow is therefore critical for deciphering the global changes in the dog transcriptional signatures during T. canis infection. In this study, long non-coding RNA (lncRNA) and messenger RNA (mRNA) expression profiles in the bone marrow of Beagle dogs infected with T. canis were determined at 12 h post-infection (hpi), 24 hpi, 96 hpi, and 36 days post-infection (dpi). RNA-sequencing and bioinformatics analysis identified 1,098, 984, 1,120, and 1,305 differentially expressed lncRNAs (DElncRNAs), and 196, 253, 223, and 328 differentially expressed mRNAs (DEmRNAs) at 12 h, 24 h, 96 h, and 36 days after infection, respectively. We also identified 29, 36, 38, and 68 DEmRNAs potentially cis-regulated by 44, 44, 51, and 80 DElncRNAs at 12 hpi, 24 hpi, 96 hpi, and 36 dpi, respectively. To validate the sequencing findings, qRT-PCR was performed on 10 randomly selected transcripts. Many altered genes were involved in the differentiation of bone marrow cells. GO of DElncRNAs and GO and KEGG pathway analyses of DEmRNAs revealed alterations in several signaling pathways, including pathways involved in energy metabolism, amino acid biosynthesis and metabolism, Wnt signaling pathway, Huntington's disease, HIF-1 signaling pathway, cGMP–PKG signaling pathway, dilated cardiomyopathy, and adrenergic signaling in cardiomyocytes. These findings revealed that bone marrow of T. canis-infected dogs exhibits distinct lncRNA and mRNA expression patterns compared to healthy control dogs. Our data provide novel insights into T. canis interaction with the definitive host and shed light on the significance of the non-coding portion of the dog genome in the pathogenesis of toxocariasis.

Development of a low-cost copro-LAMP assay for simultaneous copro-detection of Toxocara canis and Toxocara cati

Toxocariasis is a zoonotic disease caused mainly by Toxocara canis and Toxocara cati and diagnosis in dogs and cats is an important tool for its control. For this reason, a new coprological loop-mediated isothermal amplification (LAMP) assay was developed for the simultaneous detection of these species. The primer set was designed on a region of the mitochondrial cox-1 gene. Amplification conditions were evaluated using a temperature gradient (52°C to 68°C), different incubation times (15–120 min), and different concentrations of malachite green dye (0.004–0.4% w/v). The analytical sensitivity was evaluated with serial dilutions of genomic DNA from T. canis and T. cati adult worms, and with serial dilutions of DNA extracted from feces using a low-cost in-house method. The specificity was evaluated using genomic DNA from Canis lupus familiaris, Felis catus, Escherichia coli, Toxascaris leonina, Ancylostoma caninum, Echinococcus granulosus sensu stricto and Taenia hydatigena. The LAMP assay applied to environmental fecal samples from an endemic area showed an analytical sensitivity of 10–100 fg of genomic DNA and 10−5 serial dilutions of DNA extracted from feces using the low-cost in-house method; with a specificity of 100%. Additionally, the total development of the assay was carried out in a basic laboratory and per-reaction reagent cost decreased by ~80%. This new, low-cost tool can help identify the most common agents of toxocariasis in endemic areas in order to manage prevention strategies without having to rely on a laboratory with sophisticated equipment.

Detection of Cyclospora cayetanensis, Echinococcus multilocularis, Toxocara spp. and microsporidia in fresh produce using molecular methods: - A review

The current trend for a healthy lifestyle corresponds with a healthy diet, which is associated with regular and frequent consumption of raw fruit and vegetables. However, consumption of ready-to-eat (RTE) food without heat treatment or sufficient washing may pose a risk to consumers. Among the well-known protozoan parasites associated with RTE food and water are Cryptosporidium spp., Giardia duodenalis and Toxoplasma gondii. These belong among prioritized parasitic pathogens, as they are associated with numerous disease outbreaks in humans all around the world. Nevertheless, other parasitic agents such as Cyclospora cayetanensis, Toxocara cati, Toxocara canis, Echinococcus multilocularis and zoonotic microsporidia should not be neglected. Although these selected parasites belong to phylogenetically diverse groups, they have common characteristics associated with fresh produce and each of them poses a health risk to humans. Ensuring healthy food is produced requires the standartization of laboratory methods for the detection of parasitic agents. This article reviews the molecular methods currently used in laboratories for detection of Cyclospora cayetanensis, Toxocara cati, Toxocara canis, Echinococcus multilocularis and zoonotic microsporidia in fresh produce.

Cerebral Toxocariasis as a Cause of Epilepsy: A Pediatric Case

Toxocarosis is the consequence of human infection by Toxocara spp. larvae and is one of the most common ascarioses, not only in developing countries, but also in the European region, where its prevalence reaches 14%. Due to their particular behavior, children are at higher risk of this parasitic infection, whose clinical features depend on the localization of the Toxocara larvae. Neurotoxocariasis is very uncommon in children and may take different forms depending on the underlying physiopathologic process: immune reaction against the parasite antigens, vasculitis, treatment complications, or, very rarely, brain localization of Toxocara spp. larvae. The association between neurotoxocariasis and the onset of childhood epilepsy has been postulated but is still debated. Moreover, a Toxocara spp. abscess causing epileptic seizures in children has been rarely described, especially in western countries. Hereby we present a 9-year-old patient with a new diagnosis of epilepsy definitely secondary to brain abscess due to the localization of Toxocara canis larvae. Diagnosis was confirmed by neuroimaging and serological test. The successful treatment with albendazole and steroids was documented with a close and long-term clinical and neuroradiological follow-up. Our experience confirms that every case of cryptogenetic epilepsy in children deserves a neuroimaging study and, in case of cystic images, Toxocara serology is mandatory to avoid further unnecessary invasive diagnostic investigations and to set the specific drug therapy.

Rare case of rapidly reaccumulating ascites

Eosinophilic ascites is a rare type of exudative ascites most commonly caused by eosinophilic gastroenteritis. Here, a 57-year-old man presents with sudden-onset abdominal distension associated with nausea, vomiting and decreased appetite for 10 days. Physical examination revealed significant abdominal distention and fluid wave. Initial labs showed leucocytosis and mild peripheral eosinophilia. Imaging of his abdomen revealed severe ascites, no features of cirrhosis and diffuse inflammatory changes involving the jejunum and ileum. Diagnostic paracentesis showed exudative, ascitic fluid with predominant eosinophilia. Cytology of the ascitic fluid and blind biopsies taken during oesophagogastroduodenoscopy and enteroscopy were both negative for malignancy. The ascites reaccumulated rapidly, requiring five rounds of large-volume paracentesis during hospitalisation. Empiric treatment for suspected eosinophilic gastroenteritis with intravenous steroids improved and stabilised the patient's ascites for discharge. Parasitic workup resulted positively for Toxocara antibodies on ELISA. On 2-week outpatient follow-up, a course of albendazole resolved all gastrointestinal symptoms.

Proteomic alterations in the plasma of Beagle dogs induced by Toxocara canis infection

Toxocara canis causes ocular larva migrans and visceral larva migrans in humans. Knowledge about the molecular mechanism of T. canis-hosts interaction is limited. The proteomic alterations in the plasma of Beagle dogs induced by T. canis infection were studied by the quantitative mass spectrometry-based data-independent acquisition (DIA). 418, 414 and 411 plasma proteins were identified at 24 h post-infection (hpi), 96 hpi and 36 days post-infection (dpi), including 6, 5 and 23 proteins with differential abundance, respectively. At 24 hpi, the altered proteins, retinoic acid receptor responder protein 2 (RARRES2), WD repeat-containing protein 1 (WDR1), moesin and filamin-A, may participate in pro-inflammatory reaction or promote larvae migration. At 96 hpi, the altered protein C and fibroleukin may maintain the stability of the coagulation system to protect the lung. At 36 dpi, the alterations of C-reactive protein (CRP), ficolin (FCN), complement factor H-related protein 5 (CFHR5) and other complements can affect the three traditional complement system, including the classic pathway, lectin pathway and alternative pathway. These proteins may play important roles in the interaction between T. canis and its definitive hosts. Further study on these altered proteins triggered by T. canis infection may discovery novel therapeutic or diagnostic targets for toxocariasis. SIGNIFICANCE OF THE STUDY: Toxocara canis is one of the globally distributed soil-transmitted helminths, which causes ocular larva migrans and visceral larva migrans in humans and a wide range of warm-blooded animals. T. canis adapts to different microenvironments by resisting and adjusting various biological processes of the hosts. Knowledge about the molecular mechanism of T. canis-hosts interaction is limited. Plasma proteins are good marker for monitoring the occurrence and development of diseases. The proteomic alterations in the plasma of Beagle dogs induced by T. canis infection were studied by the quantitative mass spectrometry-based data-independent acquisition (DIA) in this study. A total of 418, 414 and 411 plasma proteins were identified at 24 h post-infection (hpi), 96 hpi and 36 days post-infection, respectively. Ten protein with differential abundances were validated by using parallel reaction monitoring (PRM). Collectively, our deep proteomic analysis of plasma revealed that proteins alterations were affected by disease development, and proteomic analysis is an ideal method for quantifying changes in circulating factors on a global scale in response to pathophysiological perturbations such as T. canis infection.

"Begging the Question"-Does Toxocara Infection/Exposure Associate with Multiple Sclerosis-Risk?

Although the cause of multiple sclerosis (MS) is unclear, infectious agents, including some parasitic roundworms (nematodes), have been proposed as possible risk factors or contributors. Here, we conducted a systematic review and meta-analysis of published observational studies to evaluate whether there is a possible association between infection with, or exposure to, one or more members of the genus Toxocara (phylum Nematoda; superfamily Ascaridoidea) and MS. We undertook a search of public literature databases to identify relevant studies and then used a random-effects meta-analysis model to generate the pooled odds ratio (OR) and 95% confidence intervals (CIs). This search identified six of a total of 1371 articles that were relevant to the topic; these published studies involved totals of 473 MS patients and 647 control subjects. Anti-Toxocara IgG serum antibodies were detected in 62 MS patients and 37 controls, resulting in respective seroprevalences of 13.1% (95% CI: 8.2-20.3) and 4.8% (95% CI: 2.5-9.2), indicating an association (pooled OR, 3.01; 95% CI: 1.46-6.21). Because of the publication bias identified (six eligible studies), well-designed and -controlled studies are required in the future to rigorously test the hypothesis that Toxocara infection/exposure has an association with MS.

Proteomic Insights into the Biology of the Most Important Foodborne Parasites in Europe

Foodborne parasitoses compared with bacterial and viral-caused diseases seem to be neglected, and their unrecognition is a serious issue. Parasitic diseases transmitted by food are currently becoming more common. Constantly changing eating habits, new culinary trends, and easier access to food make foodborne parasites' transmission effortless, and the increase in the diagnosis of foodborne parasitic diseases in noted worldwide. This work presents the applications of numerous proteomic methods into the studies on foodborne parasites and their possible use in targeted diagnostics. Potential directions for the future are also provided.

Soil Contamination with Toxocara Eggs in Public Schools in Rural Areas of Southern Thailand

Soil is considered the primary source of Toxocara transmission to humans, especially children. The status of soil contamination with Toxocara eggs in southern Thailand is unknown. This study aimed at estimating the soil contamination with Toxocara eggs in public schools in Nakhon Si Thammarat province in southern Thailand. Soil samples were collected from 12 public schools between August and September 2017. At each site, ten soil samples were collected from the following five types of locations: (1) playgrounds, (2) football fields, (3) sidewalks, (4) schoolyards, and (5) areas around cafeterias. In total, 120 samples were examined for Toxocara eggs with a modified flotation method using a sucrose solution. Toxocara eggs were detected in 8 (66.7%) of the 12 studied public schools. Of the 120 soil samples, 22 (18.3%; 95% CI: 11.9, 26.4) were contaminated with Toxocara eggs. The highest levels of Toxocara egg contamination were observed in playgrounds (41.7%; 95% CI: 22.1, 63.4), followed by football fields (20.8%; 95% CI: 7.1, 42.2), sidewalks (12.5%; 95% CI: 2.7, 32.4), and schoolyards (12.5%; 95% CI: 2.7, 32.4). There were significant differences in the distribution of Toxocara eggs across location types (p < 0.05). The findings demonstrated that the soil samples from public schools were contaminated with Toxocara eggs. Playgrounds were the most heavily contaminated locations. Teaching children proper handwashing steps and discouraging geophagia should be implemented to reduce the distribution of Toxocara and limit future Toxocara infections.

Factors associated with the presence of helminth eggs in the soil of public areas in Concepción, Chile

The aim of this study was to assess the association between the distance to the nearest feces, the type of substrate to be studied (feces, soil, grass), and whether a given area was licensed or not with the presence of helminth eggs in Concepción, Chile. A total of 256 samples taken from feces and either from soil or grass at 10 cm, 50 cm, and 100 cm from feces (including 16 public areas), were examined for the presence of parasites using the ZnSO4 technique. The association between variables with the presence of eggs was assessed with multifactorial logistic regressions. 24.21% of samples presented at least one egg. The higher odds of Toxocara egg presence was positively associated with the licensed 'area type' and the soil 'sample type' (when compared with feces). The odds of Ancylostomatidae egg presence was positively associated with the licensed 'area type', but negatively associated with the soil 'sample type' (compared with feces). The results suggest that finding eggs must be interpreted differently based on the parasite species and substrate to be analyzed, and that the presence of parasitized dogs is a more important contributing factor than the frequency with which the ground is cleaned of feces.

Excretory/Secretory Metabolome of the Zoonotic Roundworm Parasite Toxocara canis

Toxocariasis is a zoonotic disease affecting humans that is predominantly caused by Toxocara canis and T. cati, primarily parasites of dogs and cats, respectively. Toxocara generally establishes long-term infections by co-opting its host's physiological processes, while at the same time exploiting the nutritional environment. Adult stage T. canis reside in the gut of the definitive canine host where they employ a suite of strategies to combat intestinal immune responses by actively producing and releasing excretory-secretory products (ESPs). The protein component of T. canis ESPs has been widely studied, but characterisation of the non-protein ESP complement remains neglected. To characterize the secreted metabolome of Toxocara ESPs and to shed light on the parasite's metabolic processes, we profiled the ESPs of T. canis using both gas chromatography (GC) and liquid chromatography (LC) mass spectrometry approaches. We successfully identified 61 small molecules, including 41 polar metabolites, 14 medium-long chain fatty acids (MLCFAs) and six short chain fatty acids (SCFAs). We identified talose, stearic acid and isovalerate as the major compounds belonging to the polar, MLCFA and SCFA chemical classes, respectively. Most of the 61 identified metabolites appear to have been produced by T. canis via three distinct metabolic pathways - fatty acid, amino acid and carbohydrate metabolism. The majority of the identified ESPs have known biological properties, especially as immunomodulators. However, there is limited/no information on the biological roles or applications of 31 ESP biomolecules, suggesting that these may have novel activities that merit further investigation.

Exposure to Toxocara spp. and Ascaris lumbricoides infections and risk of allergic rhinitis in children

Background

Substantial experimental studies suggest a role for helminthes infections in the pathogenesis of allergies, but epidemiologic data have been inconsistent. Unlike to asthma, the association between helminthes infection and allergic rhinitis (AR) has been poorly studied. Therefore, we sought to evaluate the association between exposure to Ascaris and Toxocara infections and AR.

Methods

We did an age- and gender-matched case–control study of 81 children with physician-confirmed AR and 101 control subjects in a referral hospital for pediatric diseases in northern Iran. Exposure to Ascaris and Toxocara infections was evaluated by anti-A. lumbricoides- and anti-Toxocara- IgG antibodies using a commercial enzyme-linked immunosorbent assay. Associations were determined using multivariate logistic regression.

Results

Ascaris seropositivity was higher in children with rhinitis than in controls (12.34 vs. 3.96%). Ascaris seropositivity was positively associated with AR in univariate analysis (OR, 3.42; 95% CI 1.03–11.3; P value = 0.035), but this association was not significant after adjustment for potential confounders (OR, 1.85; 95% CI 0.42–8.18). Also Toxocara seropositivity was higher in children with AR than in healthy subjects (3.7% vs. 0.99), indicating non-significant association with AR in both univariate (OR, 3.84; 95% CI 0.39–37.7) and multivariate analyses (OR, 0.8; 95% CI 0.04–15.44).

Conclusion

Our results revealed that AR is not associated with seropositivity to Ascaris and Toxocara infections in general; however, a higher seropositivity rate was found for both parasites in children with AR. More studies with longitudinal design and larger sample size are needed to elucidate this association.

Global Prevalence Estimates of Toxascaris leonina Infection in Dogs and Cats

Toxascaris leonina is an ascaridoid nematode of dogs and cats; this parasite affects the health of these animals. This study estimated the global prevalence of Ta. leonina infection in dogs and cats using random effects meta-analysis as well as subgroup, meta-regression and heterogeneity analyses. The data were stratified according to geographical region, the type of dogs and cats and environmental variables. A quantitative analysis of 135 published studies, involving 119,317 dogs and 25,364 cats, estimated prevalence rates of Ta. leonina in dogs and cats at 2.9% and 3.4%, respectively. Prevalence was highest in the Eastern Mediterranean region (7.2% for dogs and 10.0% for cats) and was significantly higher in stray dogs (7.0% vs. 1.5%) and stray cats (7.5% vs. 1.8%) than in pets. The findings indicate that, worldwide, ~26 million dogs and ~23 million cats are infected with Ta. leonina; these animals would shed substantial numbers of Ta. leonina eggs into the environment each year and might represent reservoirs of infection to other accidental or paratenic hosts. It is important that populations of dogs and cats as well as other canids and felids be monitored and dewormed for Ta. leonina and (other) zoonotic helminths.

A One Health Perspective on the Human-Companion Animal Relationship with Emphasis on Zoonotic Aspects

Over time the human-animal bond has been changed. For instance, the role of pets has changed from work animals (protecting houses, catching mice) to animals with a social function, giving companionship. Pets can be important for the physical and mental health of their owners but may also transmit zoonotic infections. The One Health initiative is a worldwide strategy for expanding collaborations in all aspects of health care for humans, animals, and the environment. However, in One Health communications the role of particularly dogs and cats is often underestimated.

OBJECTIVE

Evaluation of positive and negative One Health issues of the human-companion animal relationship with a focus on zoonotic aspects of cats and dogs in industrialized countries.

METHOD

Literature review.

RESULTS

Pets undoubtedly have a positive effect on human health, while owners are increasing aware of pet's health and welfare. The changing attitude of humans with regard to pets and their environment can also lead to negative effects such as changes in feeding practices, extreme breeding, and behavioral problems, and anthropozoonoses. For the human, there may be a higher risk of the transmission of zoonotic infections due to trends such as sleeping with pets, allowing pets to lick the face or wounds, bite accidents, keeping exotic animals, the importation of rescue dogs, and soil contact.

CONCLUSIONS

One Health issues need frequently re-evaluated as the close human-animal relationship with pet animals can totally differ compared to decennia ago. Because of the changed human-companion animal bond, recommendations regarding responsible pet-ownership, including normal hygienic practices, responsible breeding, feeding, housing, and mental and physical challenges conforming the biology of the animal are required. Education can be performed by vets and physicians as part of the One Health concept.