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Estaño LA. Prevalence of Angiostrongylus cantonensis in definitive and intermediate hosts collected from agricultural areas in Ampayon, Butuan City, Southern Philippines. J Parasit Dis 2023; 47:807-814. [PMID: 38009157 PMCID: PMC10667161 DOI: 10.1007/s12639-023-01626-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/26/2023] [Indexed: 11/28/2023] Open
Abstract
Angiostrongyliasis is a parasitic disease and a leading cause of human eosinophilic meningoencephalitis caused by rat lungworm Angiostrongylus cantonensis. This parasite infects a wide range of animal hosts, including snails and rats, which plays a significant role in zoonotic transmission. The study was conducted to determine the prevalence of A. cantonensis infection in freshwater snails and definitive rat hosts in the agricultural area in Ampayon, Butuan City, Philippines. A total of 54 rat samples and 719 snail individuals were collected in June and July 2020. An overall 2.36% prevalence rate of A. cantonensis snail infection was recorded, consisting of Pomacea canaliculata and Melanoides tuberculata, with a prevalence rate of 4.05% and 1.38%, respectively. Results revealed an overall prevalence of 38.9% in rat infection. Rattus tanezumi (48.48%) showed a higher infection than Rattus norvegicus (23.80%). Higher infection rates were found in rice field environments than residential houses, with 44.12% and 30% prevalence rates, respectively. Moreover, male rats showed higher infection rates (50%) than female rats (26.92%). Among age classes, adult rats had significantly higher infection rates (48.57%) than juvenile rats (21.05%). Correlation analysis showed a significant positive correlation between A. cantonensis infection intensity to the body length (r = 0.603; p = 0.001) and body weight (r = 0.715; p = 0.000) of rats. The study exemplifies the critical role of intermediate and definitive hosts for angiostrongyliasis. Infected freshwater snails and rats in rice fields make these agricultural areas a venue for A. cantonensis emergence. Integrated actions, health education campaigns, surveillance, hygiene, and good farming practices will help prevent the potential risk of the transmission of angiostrongyliasis in the area.
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Affiliation(s)
- Leonardo A. Estaño
- Department of Biological Sciences, College of Science and Mathematics, Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines
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Jacob J, Steel A, Howe K, Jarvi S. Management of Rat Lungworm Disease (Neuroangiostrongyliasis) Using Anthelmintics: Recent Updates and Recommendations. Pathogens 2022; 12:pathogens12010023. [PMID: 36678371 PMCID: PMC9863536 DOI: 10.3390/pathogens12010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
While there have been legitimate concerns in the past regarding the use of anthelmintics for the management of neuroangiostrongyliasis (rat lungworm disease), recent studies demonstrate that they can be considered safe and efficacious, particularly albendazole, which is regarded as the choice anthelmintic for its management. However, physician hesitancy to prescribe, as well as problems of availability persist, at least in Hawaii, which is considered the epicenter of this disease in the US. As a result, many patients suffer a diminished quality of life or even death. Here, we discuss recent studies that provide insights into new treatments and preventative interventions, which can be more rigorously used for the management of neuroangiostrongyliasis. In summary, results from recent studies suggest that albendazole and avermectins are beneficial for post-exposure management, pyrantel pamoate is beneficial as a post-exposure prophylactic, and levamisole is deserving of further study for the treatment of neuroangiostrongyliasis.
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Affiliation(s)
| | | | | | - Susan Jarvi
- Correspondence: ; Tel.: +1-(808)-932-7701; Fax: +1-(808)-932-8117
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Cowie RH, Ansdell V, Panosian Dunavan C, Rollins RL. Neuroangiostrongyliasis: Global Spread of an Emerging Tropical Disease. Am J Trop Med Hyg 2022; 107:1166-1172. [PMID: 36343594 PMCID: PMC9768254 DOI: 10.4269/ajtmh.22-0360] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/18/2022] [Indexed: 11/09/2022] Open
Abstract
Neuroangiostrongyliasis (NAS) is an emerging parasitic disease caused by the neurotropic nematode Angiostrongylus cantonensis. Since it was first discovered, in rats in southern China in the 1930s, this tropical to subtropical parasite has spread to much of Southeast Asia, the Pacific Islands (including Hawaii), Australia, Japan, South America, the southeastern United States, the Caribbean, Africa, the Canary Islands, and the Balearic Islands. The parasite completes its natural life cycle in snails and slugs (intermediate hosts), and rats (definitive hosts). Humans become accidental hosts after ingesting infective third-stage larvae contained within uncooked or undercooked intermediate or paratenic hosts, an event that sometimes results in NAS, also known as rat lungworm disease. Although A. cantonensis larvae cannot complete their life cycle in humans, their migration into the brain and spinal cord combined with a powerful inflammatory reaction often leads to eosinophilic meningitis and can, in rare instances, lead to coma, paralysis, and death or, in other cases, chronic, disabling neurologic sequelae. Symptoms of NAS are diverse, which often makes it difficult to diagnose. Treatment may include administration of analgesics, corticosteroids, anthelminthics, and repeat lumbar punctures to reduce intracranial pressure. Unfortunately, few medical providers, even in endemic areas, are familiar with A. cantonensis or its epidemiology, diagnosis, and treatment. As the parasite continues to spread and NAS affects more people, medical practitioners, as well as the general public, must become more aware of this emerging zoonosis and the potentially devastating harm it can cause.
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Affiliation(s)
- Robert H. Cowie
- Pacific Biosciences Research Center, University of Hawaii, Honolulu, Hawaii;,Address correspondence to Robert H. Cowie, Pacific Biosciences Research Center, University of Hawaii, 3050 Maile Way, Gilmore 408, Honolulu, HI 96822. E-mail:
| | - Vernon Ansdell
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
| | | | - Randi L. Rollins
- Pacific Biosciences Research Center, University of Hawaii, Honolulu, Hawaii;,School of Life Sciences, University of Hawaii, Honolulu, Hawaii
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Jacob J, Siraj MA, Steel A, Tan G, Jarvi S. Evaluation of the mechanism of action of albendazole on adult rat lungworm (Angiostrongyluscantonensis). Exp Parasitol 2022; 242:108355. [PMID: 35988809 DOI: 10.1016/j.exppara.2022.108355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 08/03/2022] [Accepted: 08/16/2022] [Indexed: 11/15/2022]
Abstract
Albendazole is considered the anthelmintic of choice for the management of rat lungworm disease (neuroangiostrongyliasis), due to its broad spectrum of nematocidal activity and its ability to cross the blood-brain barrier. Albendazole binds to β-tubulin, preventing its polymerization into microtubules, thereby corrupting the cascade of cell division at metaphase, which ultimately leads to the death of individual cells and eventually the death of the parasite. Inhibition of microtubule formation will also hinder the axoplasmic transport system, affecting the neuronal activities of the parasite. While this mechanism has been explicated in other parasitic and non-parasitic nematodes, it has never been evaluated in Angiostrongylus cantonensis. This study evaluates the antimitotic effects of albendazole sulphoxide (active metabolite) on the microtubules of adult A. cantonensis using the tubulin polymerization assay and measures its effects on worm viability using the colorimetric MTT assay. Three different concentrations of albendazole (62.5 μM, 250 μΜ, and 1 mM) were evaluated. We saw a statistically significant dose-dependent reduction in the band intensity of polymerized tubulins (or microtubules) (P = 0.019), suggesting that albendazole imparts its antimitotic effect in a dose-dependent manner. Similarly, our MTT assay showed a dose-dependent decrease in formazan intensity (proportional to cell viability), suggesting that the rate of nematocidal activity of albendazole is also proportional to its concentration. In compiling the results from both these experiments, a correlation between the microtubule assembly and worm viability is evident.
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Affiliation(s)
- John Jacob
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, HI, 96720, USA
| | - Md Afjalus Siraj
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, HI, 96720, USA
| | - Argon Steel
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, HI, 96720, USA
| | - Ghee Tan
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, HI, 96720, USA
| | - Susan Jarvi
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, HI, 96720, USA.
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Roquini DB, Silva GL, Ferreira LLG, Andricopulo AD, Wilairatana P, De Moraes J. Susceptibility of Angiostrongylus cantonensis Larvae to Anthelmintic Drugs. Front Pharmacol 2022; 13:901459. [PMID: 35800438 PMCID: PMC9255552 DOI: 10.3389/fphar.2022.901459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/31/2022] [Indexed: 01/07/2023] Open
Abstract
Human helminthiasis affects approximately one in five people in the world and disproportionally affects the poorest and most deprived communities. Human angiostrongyliasis, caused by nematode Angiostrongylus cantonensis, is a neglected emerging disease with escalating importance worldwide. Chemotherapy is the main control method for helminthiasis, but the therapeutic arsenal is limited. This study aimed to evaluate the antiparasitic and molecular properties of the major available anthelmintic drugs against A. cantonensis in vitro. The first-stage larvae (L1), isolated from feces of an A. cantonensis-infected rat, were exposed to a set of 12 anthelmintic drugs in vitro. The larvae were monitored, and the concentration- and time-dependent viability alterations were determined. From 12 anthelmintic drugs, six (ivermectin, salamectin, moxidectin, pyrantel pamoate, albendazole and levamisole) were identified to affect the viability of A. cantonensis. The macrocyclic lactones (ivermectin, salamectin, moxidectin) and the imidazothiazole levamisole, were the most effective drugs, with IC50 ranging from 2.2 to 2.9 µM and a rapid onset of action. Albendazole, the most widely used anthelmintic in humans, had a slower onset of action, but an IC50 of 11.3 µM was achieved within 24 h. Molecular properties studies suggest that a less lipophilic character and low molecular weight could be favorable for the biological activity of the non-macrocyclic molecules. Collectively, our study revealed that macrocyclic lactones, levamisole, pyrantel pamoate, and albendazole are important anthelmintic agents against A. cantonensis. The results of this in vitro study also suggest that A. cantonensis L1 may be a particularly sensitive and useful model for anthelmintic studies.
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Affiliation(s)
- Daniel B. Roquini
- Center for Neglected Diseases Research, Guarulhos University, Guarulhos, Brazil
| | - Gabriel L. Silva
- Center for Neglected Diseases Research, Guarulhos University, Guarulhos, Brazil
| | - Leonardo L. G. Ferreira
- Laboratory of Medicinal and Computational Chemistry, Center for Research and Innovation in Biodiversity and Drug Discovery, Physics Institute of Sao Carlos, University of São Paulo, São Carlos, Brazil
| | - Adriano D. Andricopulo
- Laboratory of Medicinal and Computational Chemistry, Center for Research and Innovation in Biodiversity and Drug Discovery, Physics Institute of Sao Carlos, University of São Paulo, São Carlos, Brazil
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- *Correspondence: Polrat Wilairatana, ; Josué De Moraes,
| | - Josué De Moraes
- Center for Neglected Diseases Research, Guarulhos University, Guarulhos, Brazil
- *Correspondence: Polrat Wilairatana, ; Josué De Moraes,
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Jacob J, Steel A, Kaluna L, Hess S, Leinbach I, Antaky C, Sugihara R, Hamilton L, Follett P, Howe K, Jacquier S, Wongwiwatthananukit S, Jarvi S. In vivo efficacy of pyrantel pamoate as a post-exposure prophylactic for rat lungworm (Angiostrongylus cantonensis). Int J Parasitol Drugs Drug Resist 2022; 19:1-5. [PMID: 35436745 PMCID: PMC9027345 DOI: 10.1016/j.ijpddr.2022.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 11/28/2022]
Abstract
Rat lungworm (Angiostrongylus cantonensis) is a neurotropic nematode, and the leading cause of eosinophilic meningitis worldwide. The parasite is usually contracted through ingestion of infected gastropods, often hidden in raw or partially cooked produce. Pharmaceutical grade pyrantel pamoate was evaluated as a post-exposure prophylactic against A. cantonensis. Pyrantel pamoate is readily available over-the-counter in most pharmacies in the USA and possesses anthelmintic activity exclusive to the gastrointestinal tract (GIT). Administering pyrantel pamoate immediately after exposure should theoretically paralyze the larvae in the GIT, causing the larvae to be expelled via peristalsis without entering the systemic circulation. In this study, pyrantel pamoate (11 mg/kg) was orally administered to experimentally infected rats at 0, 2-, 4-, 6-, or 8-h post-infection. The rats were euthanized six weeks post-infection, and worm burden was evaluated from the heart-lung complex. This is the first in vivo study to evaluate its efficacy against A. cantonensis. This study demonstrates that pyrantel pamoate can significantly reduce worm burden by 53–72% (P = 0.004), and thus likely reduce the severity of infection that is known to be associated with worm burden. This paralyzing effect of pyrantel pamoate on the parasite may also be beneficial for delaying the establishment of infection until a more suitable anthelmintic such as albendazole is made available to the patient. Pyrantel pamoate (PP) shows significant in vivo efficacy against A. cantonensis. Efficacy of PP was evaluated for the first time in an experimental animal model. Administering PP between 4 and 8 h post-exposure significantly reduces worm burden. PP is a new post-exposure prophylactic for rat lungworm disease.
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Affiliation(s)
- John Jacob
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, HI, 96720, USA
| | - Argon Steel
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, HI, 96720, USA
| | - Lisa Kaluna
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, HI, 96720, USA
| | - Steven Hess
- USDA APHIS Wildlife Services, National Wildlife Research Center, Hawaii Field Station, Hilo, HI, 96720, USA
| | - Israel Leinbach
- USDA APHIS Wildlife Services, National Wildlife Research Center, Hawaii Field Station, Hilo, HI, 96720, USA
| | - Carmen Antaky
- USDA APHIS Wildlife Services, National Wildlife Research Center, Hawaii Field Station, Hilo, HI, 96720, USA
| | - Robert Sugihara
- USDA APHIS Wildlife Services, National Wildlife Research Center, Hawaii Field Station, Hilo, HI, 96720, USA
| | - Lindsey Hamilton
- USDA ARS, Daniel K. Inouye U.S. Pacific Basin Agricultural Research Center, 64 Nowelo St., Hilo, HI, 96720, USA
| | - Peter Follett
- USDA ARS, Daniel K. Inouye U.S. Pacific Basin Agricultural Research Center, 64 Nowelo St., Hilo, HI, 96720, USA
| | - Kathleen Howe
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, HI, 96720, USA
| | - Steven Jacquier
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, HI, 96720, USA
| | - Supakit Wongwiwatthananukit
- Department of Pharmacy Practice, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, HI, 96720, USA
| | - Susan Jarvi
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, HI, 96720, USA.
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Jacob J, Steel A, Lin Z, Berger F, Zöeller K, Jarvi S. Clinical Efficacy and Safety of Albendazole and Other Benzimidazole Anthelmintics for Rat Lungworm Disease (Neuroangiostrongyliasis): A Systematic Analysis of Clinical Reports and Animal Studies. Clin Infect Dis 2022; 74:1293-1302. [PMID: 34448480 PMCID: PMC8994584 DOI: 10.1093/cid/ciab730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Indexed: 12/25/2022] Open
Abstract
The safety and efficacy of benzimidazole anthelmintics for the treatment of rat lungworm disease (neuroangiostrongyliasis) have been questioned regardless of numerous experimental animal studies and clinical reports. In this review, 40 of these experimental animal studies and 104 clinical reports are compiled with a focus on albendazole. Among the 144 articles involving an estimated 1034 patients and 2561 animals, 4.1% were inconclusive or vague regarding the use of benzimidazoles. Of the remaining 138 articles, 90.5% found benzimidazoles to be safe and effective (885 patients, 2530 animals), 4.3% as safe but ineffective (73 patients, 3 animals), and 5.0% caused adverse reactions (7 patients, 28 animals). Among those clinical reports that described a confirmed diagnosis of neuroangiostrongyliasis in which albendazole monotherapy was used, 100% reported high efficacy (743 patients, 479 animals). In those where albendazole-corticosteroid co-therapy was used, 97.87% reported it to be effective (323 patients, 130 animals).
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Affiliation(s)
- John Jacob
- Daniel K. Inouye College of Pharmacy, University of Hawaii–Hilo, Hilo, Hawaii, USA
| | - Argon Steel
- Daniel K. Inouye College of Pharmacy, University of Hawaii–Hilo, Hilo, Hawaii, USA
| | - Zhain Lin
- Daniel K. Inouye College of Pharmacy, University of Hawaii–Hilo, Hilo, Hawaii, USA
| | - Fiona Berger
- Department of Pharmacy, University Clermont Auvergne, Clermont Ferrand, France
| | - Katrin Zöeller
- Department of Pharmacy, Goethe University Frankfurt, Frankfurt, Germany
| | - Susan Jarvi
- Daniel K. Inouye College of Pharmacy, University of Hawaii–Hilo, Hilo, Hawaii, USA
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Herath HMPD, Taki AC, Rostami A, Jabbar A, Keiser J, Geary TG, Gasser RB. Whole-organism phenotypic screening methods used in early-phase anthelmintic drug discovery. Biotechnol Adv 2022; 57:107937. [PMID: 35271946 DOI: 10.1016/j.biotechadv.2022.107937] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/24/2022] [Accepted: 03/03/2022] [Indexed: 01/17/2023]
Abstract
Diseases caused by parasitic helminths (worms) represent a major global health burden in both humans and animals. As vaccines against helminths have yet to achieve a prominent role in worm control, anthelmintics are the primary tool to limit production losses and disease due to helminth infections in both human and veterinary medicine. However, the excessive and often uncontrolled use of these drugs has led to widespread anthelmintic resistance in these worms - particularly of animals - to almost all commercially available anthelmintics, severely compromising control. Thus, there is a major demand for the discovery and development of new classes of anthelmintics. A key component of the discovery process is screening libraries of compounds for anthelmintic activity. Given the need for, and major interest by the pharmaceutical industry in, novel anthelmintics, we considered it both timely and appropriate to re-examine screening methods used for anthelmintic discovery. Thus, we reviewed current literature (1977-2021) on whole-worm phenotypic screening assays developed and used in academic laboratories, with a particular focus on those employed to discover nematocides. This review reveals that at least 50 distinct phenotypic assays with low-, medium- or high-throughput capacity were developed over this period, with more recently developed methods being quantitative, semi-automated and higher throughput. The main features assessed or measured in these assays include worm motility, growth/development, morphological changes, viability/lethality, pharyngeal pumping, egg hatching, larval migration, CO2- or ATP-production and/or enzyme activity. Recent progress in assay development has led to the routine application of practical, cost-effective, medium- to high-throughput whole-worm screening assays in academic or public-private partnership (PPP) contexts, and major potential for novel high-content, high-throughput platforms in the near future. Complementing this progress are major advances in the molecular data sciences, computational biology and informatics, which are likely to further enable and accelerate anthelmintic drug discovery and development.
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Affiliation(s)
- H M P Dilrukshi Herath
- Department of Veterinary Biosciences, Melbourne Veterinary School, The University of Melbourne, Parkville, Victoria, Australia
| | - Aya C Taki
- Department of Veterinary Biosciences, Melbourne Veterinary School, The University of Melbourne, Parkville, Victoria, Australia
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Abdul Jabbar
- Department of Veterinary Biosciences, Melbourne Veterinary School, The University of Melbourne, Parkville, Victoria, Australia
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, CH-4051 Basel, Switzerland
| | - Timothy G Geary
- Institute of Parasitology, McGill University, Sainte Anne-de-Bellevue, Quebec H9X3V9, Canada; School of Biological Sciences, Queen's University-Belfast, Belfast, Ireland
| | - Robin B Gasser
- Department of Veterinary Biosciences, Melbourne Veterinary School, The University of Melbourne, Parkville, Victoria, Australia.
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Jarvi S, Prociv P. Angiostrongylus cantonensis and neuroangiostrongyliasis (rat lungworm disease): 2020. Parasitology 2021; 148:129-132. [PMID: 33315004 PMCID: PMC11010204 DOI: 10.1017/s003118202000236x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 12/08/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Susan Jarvi
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawai`i at Hilo, Hilo, HI96720, USA
| | - Paul Prociv
- Formerly of Department of Microbiology & Parasitology, University of Queensland, St Lucia, QLD4067, Australia
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