Vaccines for prevention of cysticercosis

Foodborne Parasites and Their Complex Life Cycles Challenging Food Safety in Different Food Chains

Zoonotic foodborne parasites often represent complex, multi host life cycles with parasite stages in the hosts, but also in the environment. This manuscript aims to provide an overview of important zoonotic foodborne parasites, with a focus on the different food chains in which parasite stages may occur. We have chosen some examples of meat-borne parasites occurring in livestock (Taenia spp., Trichinella spp. and Toxoplasma gondii), as well as Fasciola spp., an example of a zoonotic parasite of livestock, but transmitted to humans via contaminated vegetables or water, covering the 'farm to fork' food chain; and meat-borne parasites occurring in wildlife (Trichinella spp., Toxoplasma gondii), covering the 'forest to fork' food chain. Moreover, fish-borne parasites (Clonorchis spp., Opisthorchis spp. and Anisakidae) covering the 'pond/ocean/freshwater to fork' food chain are reviewed. The increased popularity of consumption of raw and ready-to-eat meat, fish and vegetables may pose a risk for consumers, since most post-harvest processing measures do not always guarantee the complete removal of parasite stages or their effective inactivation. We also highlight the impact of increasing contact between wildlife, livestock and humans on food safety. Risk based approaches, and diagnostics and control/prevention tackled from an integrated, multipathogen and multidisciplinary point of view should be considered as well.

Human Neurocysticercosis: An Overview

Human cysticercosis is caused by ingestion of T. solium eggs from taenia carriers. Neurocysticercosis (NCC), defined as the infection of the CNS and the meninges by the larval stage of Taenia solium, is the most common helminthic infection of the CNS worldwide. Parasites may lodge in brain parenchyma, subarachnoid space, ventricular system, or spinal cord, causing pathological changes that account for the pleomorphism of this disease. Seizures/epilepsy are the most common clinical manifestation, but other patients present with headache, focal deficits, intracranial hypertension, or cognitive decline. Accurate diagnosis of NCC is possible after interpretation of clinical data together with findings of neuroimaging studies and results of immunological tests. However, neuroimaging studies are fundamental for diagnosis because immunological test and clinical manifestations only provide circumstantial evidence of NCC. The introduction of cysticidal drugs changed the prognosis of most NCC patients. These drugs have been shown to reduce the burden of infection and to improve the clinical course of the disease in many patients. Efforts should be directed to eradicate the disease through the implementation of control programs against all the steps in the life cycle of T. solium, including carriers of the adult tapeworm, infected pigs, and eggs in the environment.

Analysis of Immune Responses in Mice Orally Immunized with Recombinant pMG36e-SP-TSOL18/Lactococcus lactis and pMG36e-TSOL18/Lactococcus lactis Vaccines of Taenia solium

Cysticercosis is a cosmopolitan zoonotic parasitic disease infected by larval of Taenia solium (T. solium). Several drugs for the treatment of cysticercosis, such as praziquantel, albendazole, and mebendazole, have certain toxicity and side effects. Considering that there is no vaccine available, we studied a new vaccine for cysticercosis in this study. The complete TSOL18 gene and the optimized SP-TSOL18 gene fragments were obtained using PCR-based accurate synthesis method. The secretory and intracellular recombinant pMG36e-SP-TSOL18/Lactococcus lactis (L. lactis) and pMG36e-TSOL18/L. lactis vaccines of T. solium were prepared. Immune responses in mice orally immunized with these two recombinant L. lactis vaccines were analyzed by the determination of specific antibodies (IgG, IgG1, IgG2a, and sIgA) in serum, spleen lymphocyte proliferation, and cytokines (IL-2, IFN-γ, IL-4, and IL-10) in spleen lymphocyte culture supernatant. Our results showed that, after the first immunization, in these two recombinant L. lactis vaccine groups, the levels of serum specific IgG, IgG2a, and IgG1 increased on 14–56 d and reached the highest level on days 42, 42, and 28, respectively. The level of specific sIgA of intestinal mucosa also increased on 14–56 d and reached the highest level on day 42. The level of spleen lymphocyte proliferation increased on 14–56 d and reached the highest level on day 42. The levels of IL-2, IFN-γ, IL-4, and IL-10 in spleen lymphocyte culture supernatant increased on 14–56 d and reached the highest level on days 42, 42, 28, and 28, respectively. These results indicated that the recombinant pMG36e-SP-TSOL18/L. lactis and pMG36e-TSOL18/L. lactis vaccines can induce specific cellular, humoral, and mucosal immune responses in mice with oral vaccination. More importantly, the recombinant pMG36e-SP-TSOL18/L. lactis vaccine has a better immune effect. In summary, these results demonstrated the possibility of using L. lactis strain as a vector to deliver protective antigens of T. solium.

Genetic and morphometric categorization of Taenia ovis from Sheep in Iran

Little is known about the genetic and morphological characters of Taenia ovis. The purpose of the present study was to characterize sheep isolates of T. ovis using rostellar hook morphometry as well as mitochondrial genes sequence analysis. Ninety sheep specimens of Cysticercus ovis were collected from 18 slaughterhouses in Iran. The mean ± s.d. for total length of large and small hooks were 174.1 ± 6.4 and 116.7 ± 5.4 µm, respectively. CO1 and 12S rRNA sequence analysis showed 11 and nine haplotypes, respectively. The level of pairwise nucleotide variations between individual haplotypes of CO1 and 12S rRNA genes were 0.3-1.1 and 0.2-1.0%, respectively. Level of nucleotide variation in CO1 and 12S rRNA between T. ovis haplotypes from present study and eight other Taenia species was found to be 11.3-17.8 and 5.3-16.3%, respectively. Phylogenetic analysis clustered all T. ovis isolates into a single clade comprised of the all CO1 and 12S rRNA haplotypes. CO1 nucleotide difference between T. ovis ovis and T. asiatica was 13.6% that is lesser than the corresponding difference between T. ovis ovis and T. ovis krabbei, warranting the designation of two separate species as T. ovis and T. krabbei. Interclass correlation coefficients showed that there was no significant association between rostellar hook length variation and the variability of the mitochondrial genes.

Omics and Edible Vaccines

Molecular farming provides an unprecedented approach for the production of metabolites or proteins of medicinal value from plants used previously only in agricultural setting. These plants act as protein factories that can synthesize a variety of proteins free from pathogens such as plasma proteins, growth factors, and vaccines. This method provides a novel, tempting, inexpensive, easy, and safe alternative to other techniques of protein or antigen production. With the advent of transgenic plants, it is possible to produce unlimited amounts of subunit vaccines (for oral use/edible and of parenteral use), protein used for pharmaceutical/medicinal purpose, recombinant proteins, antibodies, and industrial enzymes. Plants have numerous advantages over the production systems on account of scalability, safety, and are economic; for example, less cost of production is involved for Hepatitis B nucleocapsid antigen using transgenic tobacco. Biopharming or molecular farming provides an important resource for cheaper drug production used in the treatment of cancer, heart diseases, and infectious diseases. The pharmaceutical products are manufactured by genetically engineered plants that are extracted and purified, also known as pharmaceuticals produced by plants. Edible vaccines are cheaper in cost, easy to administer mostly by oral route, fail-safe, and are acceptable by society especially in developing countries. These vaccines are targeted to provide systemic as well as mucosal types of immunity. It has been predicted that in future children may get their immunization by munching on foods instead of getting enduring shots. The production of edible vaccines consists of the process of introducing the selected genes of desired quality into plant to induce these altered or transgenic plants to produce the encoded proteins in a natural way. These vaccines provide safer alternatives and help in reduction of cost of production and shipping and also decrease the potential hazards associated with conventional vaccines. However, becoming a reality and readily availability of edible vaccine is challenged by many problems of technical, regulatory, and nonscientific issues, which should be ruled out and rectified. This chapter provides insight into the current scenario and future applications of this new preventive modality.

Isolated intramuscular cysticercosis: Clinicopathological features, diagnosis and management - A review

Cysticercosis is an emerging parasitic disease affecting worldwide population. There is large volume of data present in the literature for neurocysticercosis. The isolated intramuscular involvement of cysticercosis is uncommon and there are only sporadic case reports available. There is no review available in the literature which gives in detail clinicoradiological features and management of isolated intramuscular cysticercosis. Knowledge about such a presentation is important especially in developing countries and to differentiate the condition from a variety of other similar conditions.

Control of cysticercosis in Madagascar: beware of the pitfalls

Taenia solium cysticercosis is a zoonosis of public health importance in areas where the disease is endemic, with significant economic impacts on human health and the swine industry. Several gaps remain in the epidemiology of the parasite and the strategies of control in developing countries. We detail the key factors to consider in Madagascar in terms of the porcine husbandry system, Taenia transmission cycle, and diagnosis of cysticercosis in pigs, in order to better estimate the sanitary and economic impacts of this parasitic disease as well as to define an integrated control program.

A review on diagnostic and preventive aspects of cystic echinococcosis and human cysticercosis

Cystic echinococcosis and human cysticercosis have recently been included in the list of "neglected tropical diseases" by the World Health Organization (WHO). Both are zoonoses which are prevalent throughout the world and lead to considerable mortality, morbidity, and economic losses as well. This review deals with the disease burden of these two neglected cestode infections. Diagnostic modalities with their specific advantages and disadvantages have also been discussed. Recent developments in immunodiagnostic assays for the two diseases have been dealt with. Various control strategies including the use of veterinary vaccines have been highlighted.

The highly antigenic 53/25 kDa Taenia solium protein fraction with cathepsin-L like activity is present in the oncosphere/cysticercus and induces non-protective IgG antibodies in pigs

Cathepsin L-like proteases are secreted by several parasites including Taenia solium. The mechanism used by T. solium oncospheres to degrade and penetrate the intestine and infect the host is incompletely understood. It is assumed that intestinal degradation is driven by the proteolytic activity of enzymes secreted by the oncosphere. Blocking the proteolytic activity by an antibody response would prevent the oncosphere penetration and further infection. Serine and cysteine proteases including chymotrypsin, trypsin, elastase, and cathepsin L, are secreted by T. solium and Taenia saginata oncospheres when cultured in vitro, being potential vaccine candidates. However, the purification of a sufficient quantity of proteases secreted by oncospheres to conduct a vaccine trial is costly and lengthy. A 53/25 kDa cathepsin L-like fraction partially purified from T. solium cyst fluid was described previously as an important antigen for immunodiagnostics. In this study we found that this antigen is present in the T. solium oncosphere and is also secreted by the cysticercus. This protein fraction was tested for its ability to protect pigs against an oral challenge with T. solium oncospheres in a vaccine trial. IgG antibodies against the 53/25 kDa cathepsin L-like protein fraction were elicited in the vaccinated animals but did not confer protection.

Control of important helminthic infections vaccine development as part of the solution

Among the tools available for the control of helminth infections, chemotherapy has come to totally dominate the field. In the veterinary field, development of drug resistance has appeared but this is not (yet) a problem in the control of human diseases. Although there is no vaccine commercially available for any human parasitic infection yet, recent progress in vaccine development is making this a future possibility for several diseases. The goal of chemotherapy is to alleviate infection and morbidity in the definitive host, or reduce transmission, while the effect of available vaccine candidates would mainly be to influence transmission through targeting the intermediate or reservoir host, when the infection is zoonotic. Apart from this general scheme, there are also vaccine candidates targeting the parasites in the definitive host, in particular the early developmental stages, which should reduce the risk of drug failure. Since the biological targets in most cases are different, vaccination would be synergistic with drug therapy. This review covers diseases caused by helminthes in both humans and animals and includes examples of diseases caused by cestodes, nematodes and trematodes. The focus is on infections for which vaccine development has been undertaken for a long time, resulting in products that could realistically become integrated into control strategies in the near future.

Neurocysticercosis: risk and primary prevention strategies update

Neurocysticercosis results from the infestation of the central nervous system with invading tapeworm larvae. Though uncommon in the US prior to 1965, new cases are currently being diagnosed at an unprecedented rate. Drawing on environmental health, intervention and risk data retrieved from standard/alternative databases and in-country sources, we present an update and summary of modifiable risk factors and field-tested primary prevention measures. While points of intervention, subpopulations at risk and overall magnitude of the problem are addressed, particular attention is paid to defining risk reduction measures that can be adopted by individuals and high risk groups in the near-term to interrupt or eliminate pathways of exposure leading to disease transmission. Though global eradication is not attainable in the near future, effective preventative measures exist and should be taken now by international travellers and workers, US/foreign government agencies, and individuals living in endemic regions to reduce human suffering.

Proteomic study of activated Taenia solium oncospheres

Taenia solium cysticerci are a major cause of human seizures and epilepsy in the world. In the gastrointestinal tract of infected individuals, taeniid eggs release the oncospheres, which are then activated by intestinal stimuli, getting ready to penetrate the gut wall and reach distant locations where they transform in cysticerci. Information about oncospheral molecules is scarce, and elucidation of the oncosphere proteome could help understanding the host-parasite relationship during the first steps of infection. In this study, using liquid chromatography and tandem mass spectrometry (LC-MS/MS) analysis, we could identify a set of oncospheral proteins involved in adhesion, protein folding, detoxification and proteolysis, among others. In addition, we have characterized one of the identified molecules, the parasite 14-3-3, by immunoblot and immunolocalization. The identification of these oncospheral proteins represents the first step to elucidate their specific roles in the biology of the host-parasite relationship.

A novel Taenia solium protein that resembles troponin T proteins

Taenia solium Linnaeus, 1758 is responsible for taeniasis and cysticercosis, which are 2 serious health problems, particularly in developing countries. The attempt to identify a 22.5kD possible protective oncospheral antigen by 2-dimensional gel-electrophoresis, micro-sequencing, and cDNA library screening produced a protein of 42kD that possesses a conserved domain similar to that of troponin T. Five variants that showed differences at the 5' end were observed at the cDNA level. Hyper-immune rabbit sera developed against recombinant GST fused protein identified the protein exclusively on activated oncospheres. The 42kD protein was tested in an enzyme-linked immunoassay (ELISA) alone and then together with the Tso31 protein for the diagnosis of human cysticercosis. When both antigens were combined, the test was found to be 85% sensitive and 65% specific. The 42kD is a novel T. solium protein that is present exclusively on activated oncospheres of this parasite, with poor diagnostic activity against taeniasis or human cysticercosis.

Human cysticercosis and Indian scenario: a review

Cysticercosis, caused by Taenia solium larva is a major public health problem,especially in the developing world and neurocysticercosis (NCC) is considered to be the most common parasitic infestation of the central nervous system. NCC is identified as the single most common cause of community acquired active epilepsy; 26.3% to 53.8% active epilepsy cases in the developing world including India and Latin America are due to NCC.It is also becoming more common in the developed world because of increased migration of people with the disease or Taenia solium carriers and frequent travel to the endemic countries. It is estimated that three quarters of the estimated 50 million people with active epilepsy live in the poor countries of the world. Recent Indian studies using neuroimaging techniques suggest that the disease burden in India surpasses many other developing countries. Hence it is important to know the epidemiology,pathogenesis and diagnostic criteria so as to assess the disease burden and adopt interventional strategies for its control.Literature search was done for this review with special emphasis on Indian studies to create awareness about the disease in India,since cysticercosis is preventable and potentially eradicable.

Simulating transmission and control of Taenia solium infections using a Reed-Frost stochastic model

The transmission dynamics of the human-pig zoonotic cestode Taenia solium are explored with both deterministic and stochastic versions of a modified Reed-Frost model. This model, originally developed for microparasitic infections (i.e. bacteria, viruses and protozoa), assumes that random contacts occur between hosts and that hosts can be either susceptible, infected or 'recovered and presumed immune'. Transmission between humans and pigs is modelled as susceptible roaming pigs scavenging on human faeces infected with T. solium eggs. Transmission from pigs to humans is modelled as susceptible humans eating under-cooked pork meat harbouring T. solium metacestodes. Deterministic models of each scenario were first run, followed by stochastic versions of the models to assess the likelihood of infection elimination in the small population modelled. The effects of three groups of interventions were investigated using the model: (i) interventions affecting the transmission parameters such as use of latrines, meat inspection, and cooking habits; (ii) routine interventions including rapid detection and treatment of human carriers or pig vaccination; and (iii) treatment interventions of either humans or pigs. It is concluded that mass-treatment can result in a short term dramatic reduction in prevalence, whereas interventions targeting interruption of the life cycle lead to long-term reduction in prevalence.

Control of Taenia solium cysticercosis/taeniosis

Cysticercosis is emerging as a serious public health and agricultural problem in many poorer countries of Latin America, Africa, and Asia. Caused by the pork tapeworm, Taenia solium, this zoonotic disease forms larval cysts in humans and pigs that can lead to epilepsy and death in humans, reduces the market value of pigs and makes pork unsafe to eat. It occurs where pigs range freely, sanitation is poor, and meat inspection is absent or inadequate, and is thus strongly associated with poverty and smallholder farming. Although theoretically easy to control and declared eradicable cysticercosis remains neglected in most endemic countries due to lack of information and awareness about the extent of the problem, suitable diagnostic and management capacity, and appropriate prevention and control strategies. Human neurocysticercosis occurs when the larval cysts develop in the brain. It is considered to be the most common parasitic infection of the human nervous system and the most frequent preventable cause of epilepsy in the developing world. Thus far the infection has not been eliminated from any region by a specific program, and no national control programs are yet in place. We consider the tools available for combating cysticercosis and suggest simple packages of interventions, which can be conducted utilizing existing services and structures in the endemic countries to provide appropriate and sustainable control of the disease.

An epidemiological study of familial neurocysticercosis in an endemic Mexican community

Neurocysticercosis (NC) caused by Taenia solium is a frequent parasitic disease of the central nervous system. It is highly endemic in many developing countries, where many people are exposed but few become infected. Here, the relevance of age, gender, and genetic and exposure factors on NC susceptibility was studied in 649 inhabitants of a rural community of Mexico. Endemicity was confirmed by the high prevalence of pig cysticercosis (32.8%) and human seroprevalence (43.8%). Human NC cases were diagnosed by computerised tomography scans. A questionnaire to evaluate risk factors was applied and familial relationships between participants were registered. An overall NC frequency of 9.1% (59/649) was found. NC frequency increased with age but did not associate with gender. Most NC cases were asymptomatic. None of the evaluated risk factors were associated with NC. No familial aggregation was detected when studying all cases, although a significant relationship between mother and child in cases with multiple parasites was found. These findings point to the fact that human NC in high exposure conditions is not simply related to exposure factors and they do not support the participation of a major gene in single-cyst NC. Rather, our results point to a complex interaction of genetic and environmental factors involved in NC.

Therapeutic capacity of the synthetic peptide-based vaccine against Taenia solium cysticercosis in pigs

The S3Pvac synthetic vaccine composed of three peptides (GK1, KETc1 and KETc12) effectively protect against pig cysticercosis. Preliminary results point to an additional cysticidal capacity induced by S3Pvac or GK1 immunization. Herein, clear evidences of the cysticidal effect of S3Pvac but not of GK1 are presented. S3Pvac immunization of already experimentally infected pigs induced a reduction in the parasite load, in the vesicular cysticerci and in their viability. It also substantially increases the percent of histological damaged cysticerci more importantly in muscles than in brains, with a concomitant reduction in the antibody levels. Thus, S3Pvac represents a powerful means of controlling cysticercosis infection in pigs.

Recombinant bacteriophage-based multiepitope vaccine against Taenia solium pig cysticercosis

The aim of this study was to test the capacity of recombinant phages to deliver antigens for vaccination against porcine cysticercosis. Thus, three peptides (KETc1, KETc12, GK1) and a recombinant antigen KETc7, previously proven to induce high levels of protection against pig cysticercosis, were expressed on the surface of the M13 bacteriophage at multiple copies. The pool of these four recombinant phages induced high levels of protection against an experimental murine cysticercosis. The immunogenicity of the phage vaccine preparation was therefore, tested in pigs, the natural host of Taenia solium. Subcutaneous or oral vaccination with these phages induced antigen-specific cellular immune responses in pigs. Preliminary data also points to the protective capacity of this recombinant phage vaccine against pig cysticercosis. The immunogenicity of these recombinant phages, together with the low cost of their production, make them a realistic candidate to be tested in pigs as an anti-cysticercus phage vaccine for field trials. This is the first report describing the application of a filamentous bacteriophage as a vaccine in large animals such as pigs, the only intermediate hosts of T. solium, a parasite of major medical importance in developing countries. The potential application of phages as a modern platform for vaccines for human and animal diseases is discussed.