Echinococcus granulosus: a comparison of free amino acid concentration in hydatid fluid from primary and secondary cysts and host plasma

Metabolomic profiling of early inactive hepatic alveolar and cystic echinococcosis

Hepatic alveolar echinococcosis (AE) and cystic echinococcosis (CE) are severe helminthic zoonoses and leading causes of parasitic liver damage. They pose a high mortality risk due to invisible clinical signs, especially at the early inactive stage. However, the specific metabolic profiles induced by inactive AE and CE lesions remain largely unclear. Therefore, we used gas chromatography-mass spectrometry-based metabolomic profiling to identify the global metabolic variations in AE and CE patient sera to differentiate between the two diseases and reveal the mechanisms underlying their pathogenesis. In addition, specific serum biomarkers of inactive hepatic AE and CE were screened using receiver operating curves, which can contribute to the clinical diagnosis of both diseases, especially in the earlier phase. These differential metabolites are involved in glycine, serine, tyrosine, and phenylalanine metabolism. Further analysis of key metabolic pathways showed that inactive AE lesions strongly alter amino acid metabolism in the host. CE lesions have an altered metabolism of oxidative stress response. These changes suggest these metabolite-associated pathways can serve as biomarkers to distinguish individuals with inactive AE and CE from healthy populations. This study also investigated the differences in serum metabolic profiles in patients with CE and AE. The biomarkers identified belonged to different metabolic pathways, including lipid, carnitine, androgen, and bile acid metabolism. Taken together, by investigating the different phenotypes of CE and AE with metabolomic profiling, serum biomarkers facilitating early diagnosis were identified.

In vitro metabolomic footprint of the Echinococcus multilocularis metacestode

Alveolar echinococcosis (AE) is a zoonotic disease that is deadly if left untreated. AE is caused by the larval metacestode stage of the cestode Echinococcus multilocularis. Better knowledge on the host-parasite interface could yield novel targets for improvement of the treatment against AE. We analyzed culture media incubated with in vitro grown E. multilocularis metacestodes by 1H nuclear magnetic resonance spectroscopy to identify the unknown metabolic footprint of the parasite. Moreover, we quantitatively analyzed all amino acids, acetate, glucose, lactate, and succinate in time-course experiments using liquid chromatography and enzymatic assays. The E. multilocularis metacestodes consumed glucose and, surprisingly, threonine and produced succinate, acetate, and alanine as major fermentation products. The metabolic composition of vesicle fluid (VF) from in vitro grown E. multilocularis metacestodes was different from parasite-incubated culture medium with respect to the abundance, but not the spectrum, of metabolites, and some metabolites, in particular amino acids, accumulated in the VF. Overall, this study presents the first characterization of the in vitro metabolic footprint of E. multilocularis metacestodes and VF composition, and it provides the basis for analyses of potentially targetable pathways for future drug development.

In vitro effects of the neuroactive substances serotonin and γ-aminobutyric acid on leucocytes from sticklebacks (Gasterosteus aculeatus)

The majority of parasites have evolved strategies to evade the immune responses of their hosts. Neuroactive substances produced by cestodes are possible candidate molecules for regulating host immune responses. The neurons of helminths can synthesize a wide range of molecules that are identical to the ones functioning in their host organisms, and host lymphocytes have receptors for these neuroactive substances. We hypothesized that in teleost fish, antihelminthic immune responses are regulated via 5-hydroxytryptamine (5-HT, or serotonin) and γ-aminobutyric acid (GABA). In the present study, we investigated the in vitro influence of serotonin, GABA and Schistocephalus solidus (helminth) antigens on basic characteristics of the three-spined stickleback Schistocephalus solidus cellular immune response. Head kidney leucocytes (HKLs) were analysed by flow cytometry for cell viability and the frequency of leucocyte subsets (the granulocyte-to-lymphocyte ratio) and by a chemiluminescence assay for the production of reactive oxygen species (ROS). In short-term (2-h) HKL cultures, 5-HT did not change the total numbers of live HKLs, but the production of ROS decreased significantly with all 5-HT concentrations. In long-term (96-h) cultures, high 5-HT concentrations induced a decrease in leucocyte viability. This coincided with elevated ROS production in cultures with all 5-HT concentrations. In short-term (2-h) HKL cultures, GABA did not change the total numbers of live HKLs, but the production of ROS decreased significantly with high (100 nmol L^-1) GABA concentrations. In long-term (96-h) cultures, high and medium concentrations of GABA (100 nmol L^-1 and 10 nmol L^-1) elevated the numbers of live HKLs compared to controls. The granulocyte-to-lymphocyte ratios generally increased upon exposure to GABA at all concentrations. All concentrations of GABA alone elevated the ROS production of HKLs compared to controls. In the present work, we showed that the neuroactive substances serotonin and GABA regulate the teleost immune system. Our study supports the hypothesis that these substances might be immunomodulators in tapeworm-fish parasite-host interactions.

Echinococcus-Host Interactions at Cellular and Molecular Levels

The potentially lethal zoonotic diseases alveolar and cystic echinococcosis are caused by the metacestode larval stages of the tapeworms Echinococcus multilocularis and Echinococcus granulosus, respectively. In both cases, metacestode growth and proliferation occurs within the inner organs of mammalian hosts, which is associated with complex molecular host-parasite interactions that regulate nutrient uptake by the parasite as well as metacestode persistence and development. Using in vitro cultivation systems for parasite larvae, and informed by recently released, comprehensive genome and transcriptome data for both parasites, these molecular host-parasite interactions have been subject to significant research during recent years. In this review, we discuss progress in this field, with emphasis on parasite development and proliferation. We review host-parasite interaction mechanisms that occur early during an infection, when the invading oncosphere stage undergoes a metamorphosis towards the metacestode, and outline the decisive role of parasite stem cells during this process. We also discuss special features of metacestode morphology, and how this parasite stage takes up nutrients from the host, utilizing newly evolved or expanded gene families. We comprehensively review mechanisms of host-parasite cross-communication via evolutionarily conserved signalling systems and how the parasite signalling systems might be exploited for the development of novel chemotherapeutics. Finally, we point to an urgent need for the development of functional genomic techniques in this parasite, which will be imperative for hypothesis-driven analyses into Echinococcus stem cell biology, developmental mechanisms and immunomodulatory activities, which are all highly relevant for the development of anti-infective measures.

In vitro lethal effect of ajowan (Trachyspermum ammi L.) essential oil on hydatid cyst protoscoleces

Various chemical scolicidal agents have been used for inactivation of hydatid cyst protoscolices, but most of them are associated with adverse side effects. Since ajowan (Trachyspermum ammi) has been shown to have a number of medicinal properties, in this study the scolicidal effect of the essential oil (EO) from the fruits of this herbal plant was investigated. Ajowan EO was obtained by hydrodistillation method. Gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS) were employed to determine the chemical composition of the EO. Protoscoleces were exposed to various concentrations of EO (3, 5 and 10mg/mL) for 10, 20, 30, and 60 min. Viability of protoscolices was confirmed by 0.1% eosin staining. A total of 18 compounds representing 99.54% of the total oil, were identified. Thymol (50.07%), γ-terpinene (23.92%), and p-cymene (22.9%) were found to be the major EO constituents. While the mortality rate of protoscolices in the control group was 6.67%, scolicidal power of ajowan EO at concentration of 3mg/mL was 31.34, 35.98, 45.17, and 51.58% after 10, 20, 30, and 60 min, respectively. The EO at concentration of 5mg/mL killed 51.89, 72.20, 88.64, and 100% of protoscolices after 10, 20, 30, and 60 min, respectively. One hundred percent scolicidal activity was observed with ajowan EO at concentration of 10mg/mL after 10 min of exposure. The results of this study revealed that the EO of ajowan is rich in thymol, γ-terpinene and p-cymene, has high scolicidal power and it may be used as a natural scolicidal agent.

Fertility assessment of hydatid cyst by proton MR spectroscopy

BACKGROUND

Hydatid cysts, the larvae of the parasite Echinococcus granulosus, may lodge in any organ of intermediate hosts, namely, man and sheep. Complete cyst removal is the treatment of choice; however, spillage of fertile cysts during surgery leads to disease recurrence that may be prevented by preoperative detection of the fertility status of the cyst. With this perspective, ex vivo proton (1H) MR spectroscopy of hydatid fluid of human and sheep origin was performed to differentiate fertile from sterile cysts on the basis of their metabolite pattern.

PATIENTS AND MATERIALS

Cysts of sheep and human origin were used as source of hydatid fluid. A fraction of this fluid was tested for cyst fertility and the rest was used for ex vivo1H spectroscopy. Histopathology of the cyst wall was done as a gold standard for this study.

RESULTS

Of 10 sheep samples, 7 were fertile and 3 were sterile, while among 6 human samples, 5 were fertile and 1 was sterile. Spectroscopic and histopathological results corroborated each other. The fluid from microbiologically proven fertile cysts contained malate and fumarate along with other resonances and the histopathology of the fertile cyst wall demonstrated germinal lining and protoscoleces.

CONCLUSIONS

The ex vivo spectroscopic differentiation of fertile and sterile cysts may be a stepping-stone for their in vivo separation in future and thus help in framing strategies for percutaneous/surgical management.

Oxfendazole treatment for cystic hydatid disease in naturally infected animals

Few chemotherapeutic agents are available for the medical management of hydatid disease caused by the parasite Echinococcus granulosus. In order to test the potential of oxfendazole for the treatment of infection with this parasite, nine infected goats and four sheep were given oxfendazole twice weekly at a dose of 30 mg/kg of body weight for 4 weeks and monitored by ultrasound for an additional 4 weeks. Efficacy was finally evaluated by postmortem examination, including determination of protoscolex viability and cyst wall histology. In treated animals, protoscolices were dead or absent in 97% of cysts from oxfendazole-treated animals compared to 28% of cysts from untreated control animals. On postmortem examination, 53% of cysts from treated animals were found to be grossly degenerate. A sample of those cysts that appeared potentially viable all demonstrated evidence of severe damage to the cyst wall. By light microscopy, cysts showed severe disorganization of the adventitial layer with invasion of inflammatory cells and in some cases frank necrosis with no apparent adventitial layer. The follow-up period for assessment of the drug's ability to cause complete degeneration and resorption of cysts was relatively short. This study, however, indicates that oxfendazole is at least as effective as and is easier to administer than albendazole for the treatment of hydatid disease.

Metabolites of alveolar Echinococcus as determined by [31P]- and [1H]-nuclear magnetic resonance spectroscopy

[31P]-Nuclear magnetic resonance (NMR) in vivo spectra of Echinococcus multilocularis cysts growing subcutaneously in Meriones unguiculatus showed prominent signals due to phosphomonoesters (PME), phosphodiesters (PDE), inorganic phosphate (Pi) and the alpha, beta and gamma phosphate groups of adenosine triphosphate (ATP). The internal pH of the parasite cysts was 6.7-6.8. The 31P spectra of extracts of these subcutaneous cysts showed peaks identified as glucose-6-phosphate (Glu-6-P), glycerol-3-phosphate (Gly-3-P), phosphorylethanolamine (PE), adenosine-5'-monophosphate (5'-AMP), nicotinamide adenine dinucleotide phosphate (NADP), phosphorylcholine (PC), Pi, glycerolphosphorylethanolamine (GPE), glycerolphosphorylcholine (GPC), phosphoenolpyruvate (PEP), adenosine diphosphate (ADP), ATP and diphosphodiesters (DPDE). These metabolites were also detected at comparable concentrations in the extracts of intraperitoneally grown cysts. In addition, significantly more phosphocreatine (PCr), probably of host origin, was detected in the subcutaneous cysts than in the intraperitoneal cysts. [1H]-NMR spectra of cyst extracts revealed that parasites grown in the abdominal cavity contained significantly less glucose but significantly more succinate, acetate, alanine and beta-hydroxybutyrate. Glycogen, creatine, glycine, taurine, betaine, cholines and lactate were present at similar concentrations in cyst material from both locations.