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Hoogerwerf MA, Janse JJ, Kuiper VP, van Schuijlenburg R, Kruize YC, Sijtsma JC, Nosoh BA, Koopman JPR, Verbeek-Menken PH, Westra IM, Meij P, Brienen EA, Visser LG, van Lieshout L, Jochems SP, Yazdanbakhsh M, Roestenberg M. Protective efficacy of short-term infection with Necator americanus hookworm larvae in healthy volunteers in the Netherlands: a single-centre, placebo-controlled, randomised, controlled, phase 1 trial. THE LANCET. MICROBE 2023; 4:e1024-e1034. [PMID: 38042152 DOI: 10.1016/s2666-5247(23)00218-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 06/24/2023] [Accepted: 07/11/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Vaccine development against hookworm is hampered by the absence of the development of protective immunity in populations repeatedly exposed to hookworm, limiting identification of mechanisms of protective immunity and new vaccine targets. Immunisation with attenuated larvae has proven effective in dogs and partial immunity has been achieved using an irradiated larvae model in healthy volunteers. We aimed to investigate the protective efficacy of immunisation with short-term larval infection against hookworm challenge. METHODS We did a single-centre, placebo-controlled, randomised, controlled, phase 1 trial at Leiden University Medical Center (Leiden, Netherlands). Healthy volunteers (aged 18-45 years) were recruited using advertisements on social media and in publicly accessible areas. Volunteers were randomly assigned (2:1) to receive three short-term infections with 50 infectious Necator americanus third-stage filariform larvae (50L3) or placebo. Infection was abrogated with a 3-day course of albendazole 400 mg, 2 weeks after each exposure. Subsequently all volunteers were challenged with two doses of 50L3 at a 2-week interval. The primary endpoint was egg load (geometric mean per g faeces) measured weekly between weeks 12 and 16 after first challenge, assessed in the per-protocol population, which included all randomly assigned volunteers with available data on egg counts at week 12-16 after challenge. This study is registered with ClinicalTrials.gov, NCT03702530. FINDINGS Between Nov 8 and Dec 14, 2018, 26 volunteers were screened, of whom 23 enrolled in the trial. The first immunisation was conducted on Dec 18, 2018. 23 volunteers were randomly assigned (15 to the intervention group and eight to the placebo group). Egg load after challenge was lower in the intervention group than the placebo group (geometric mean 571 eggs per g [range 372-992] vs 873 eggs per g [268-1484]); however, this difference was not statistically significant (p=0·10). Five volunteers in the intervention group developed a severe skin rash, which was associated with 40% reduction in egg counts after challenge (geometric mean 742 eggs per g [range 268-1484] vs 441 eggs per g [range 380-520] after challenge; p=0·0025) and associated with higher peak IgG1 titres. INTERPRETATION To our knowledge, this is the first study to describe a protective effect of short-term exposure to hookworm larvae and show an association with skin response, eosinophilic response, and IgG1. These findings could inform future hookworm vaccine development. FUNDING Dioraphte Foundation.
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Affiliation(s)
- Marie-Astrid Hoogerwerf
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands; Department of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Jacqueline J Janse
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Vincent P Kuiper
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Yvonne Cm Kruize
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Jeroen C Sijtsma
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Beckley A Nosoh
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Jan-Pieter R Koopman
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Petra H Verbeek-Menken
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Inge M Westra
- Leiden University Center for Infectious Diseases, and Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, Netherlands
| | - Pauline Meij
- Leiden University Center for Infectious Diseases, and Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, Netherlands
| | - Eric At Brienen
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Leo G Visser
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Simon P Jochems
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Meta Roestenberg
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands; Department of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands.
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Ferguson AA, Inclan-Rico JM, Lu D, Bobardt SD, Hung L, Gouil Q, Baker L, Ritchie ME, Jex AR, Schwarz EM, Rossi HL, Nair MG, Dillman AR, Herbert DR. Hookworms dynamically respond to loss of Type 2 immune pressure. PLoS Pathog 2023; 19:e1011797. [PMID: 38079450 PMCID: PMC10735188 DOI: 10.1371/journal.ppat.1011797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 12/21/2023] [Accepted: 11/02/2023] [Indexed: 12/23/2023] Open
Abstract
The impact of the host immune environment on parasite transcription and fitness is currently unknown. It is widely held that hookworm infections have an immunomodulatory impact on the host, but whether the converse is true remains unclear. Immunity against adult-stage hookworms is largely mediated by Type 2 immune responses driven by the transcription factor Signal Transducer and Activator of Transcription 6 (STAT6). This study investigated whether serial passage of the rodent hookworm Nippostrongylus brasiliensis in STAT6-deficient mice (STAT6 KO) caused changes in parasites over time. After adaptation to STAT6 KO hosts, N. brasiliensis increased their reproductive output, feeding capacity, energy content, and body size. Using an improved N. brasiliensis genome, we found that these physiological changes corresponded with a dramatic shift in the transcriptional landscape, including increased expression of gene pathways associated with egg production, but a decrease in genes encoding neuropeptides, proteases, SCP/TAPS proteins, and transthyretin-like proteins; the latter three categories have been repeatedly observed in hookworm excreted/secreted proteins (ESPs) implicated in immunosuppression. Although transcriptional changes started to appear in the first generation of passage in STAT6 KO hosts for both immature and mature adult stages, downregulation of the genes putatively involved in immunosuppression was only observed after multiple generations in this immunodeficient environment. When STAT6 KO-adapted N. brasiliensis were reintroduced to a naive WT host after up to 26 generations, this progressive change in host-adaptation corresponded to increased production of inflammatory cytokines by the WT host. Surprisingly, however, this single exposure of STAT6 KO-adapted N. brasiliensis to WT hosts resulted in worms that were morphologically and transcriptionally indistinguishable from WT-adapted parasites. This work uncovers remarkable plasticity in the ability of hookworms to adapt to their hosts, which may present a general feature of parasitic nematodes.
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Affiliation(s)
- Annabel A. Ferguson
- University of Pennsylvania, School of Veterinary Medicine, Pathobiology Department, Philadelphia, Pennsylvania, United States of America
| | - Juan M. Inclan-Rico
- University of Pennsylvania, School of Veterinary Medicine, Pathobiology Department, Philadelphia, Pennsylvania, United States of America
| | - Dihong Lu
- University of California Riverside, Department of Nematology, Riverside, California, United States of America
| | - Sarah D. Bobardt
- University of California Riverside, School of Medicine, Department of Biomedical Sciences, Riverside, California, United States of America
| | - LiYin Hung
- University of Pennsylvania, School of Veterinary Medicine, Pathobiology Department, Philadelphia, Pennsylvania, United States of America
| | - Quentin Gouil
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- University of Melbourne, Department of Medical Biology, Parkville, Victoria, Australia
| | - Louise Baker
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- University of Melbourne, Department of Veterinary Biosciences, Parkville, Victoria, Australia
| | - Matthew E. Ritchie
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- University of Melbourne, Department of Medical Biology, Parkville, Victoria, Australia
| | - Aaron R. Jex
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- University of Melbourne, Department of Veterinary Biosciences, Parkville, Victoria, Australia
| | - Erich M. Schwarz
- University of Melbourne, Department of Veterinary Biosciences, Parkville, Victoria, Australia
- Cornell University, Department of Molecular Biology and Genetics, Ithaca, New York, United States of America
| | - Heather L. Rossi
- University of Pennsylvania, School of Veterinary Medicine, Pathobiology Department, Philadelphia, Pennsylvania, United States of America
| | - Meera G. Nair
- University of California Riverside, School of Medicine, Department of Biomedical Sciences, Riverside, California, United States of America
| | - Adler R. Dillman
- University of California Riverside, Department of Nematology, Riverside, California, United States of America
| | - De’Broski R. Herbert
- University of Pennsylvania, School of Veterinary Medicine, Pathobiology Department, Philadelphia, Pennsylvania, United States of America
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3
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Tee MZ, Lee SC, Er YX, Yap NJ, Ngui R, Easton AV, Siow VWY, Ng KS, Boey CCM, Chua KH, Cadwell K, Loke P, Lim YAL. Efficacy of triple dose albendazole treatment for soil-transmitted helminth infections. PLoS One 2022; 17:e0272821. [PMID: 35960935 PMCID: PMC9374461 DOI: 10.1371/journal.pone.0272821] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/26/2022] [Indexed: 11/18/2022] Open
Abstract
In Malaysia, soil-transmitted helminth (STH) infections still persist among indigenous communities. In the past, local studies have focused mostly on epidemiologic aspects of STH infections with a scarcity of information on the efficacy of deworming treatment. The present study consisted of 2 phases: a cross-sectional phase on current epidemiological status and risk factors of STH infections and a longitudinal study over 6 weeks on triple dose albendazole efficacy against STH infections. A total of 253 participants were recruited at baseline and a pre-tested questionnaire was administered to obtain information on socio-demographics, environmental and behavioural risk factors. Stool samples were evaluated using a modified Kato-Katz technique. Cure rate (CR) and egg reduction rate (ERR) were assessed at 3 weeks following a 3-day course of 400mg albendazole treatment and infection status were observed again at 6 weeks. Baseline positivity of trichuriasis, ascariasis and hookworm infections were 56.1%, 11.9% and 20.2%, respectively. Multivariate analysis showed age below 18 years old (P = 0.004), without latrine in house (P = 0.042) and indiscriminate defecation (P = 0.032) were associated with STH infections. In the longitudinal study (N = 89), CR for trichuriasis was 64.6%, while CR of 100% was observed for both ascariasis and hookworm. ERR was above 90% for all three STH species. A rapid increased of Trichuris trichiura egg output was observed at 6 weeks. In conclusion, STH infections are highly prevalent among indigenous communities. Children and teenagers, poor sanitation and hygiene behaviour were determinants for STH infections. Triple dose albendazole is found to be efficacious against Ascaris lumbricoides and hookworm infections but has moderate curative effect with high ERR against T. trichiura. Although triple dose albendazole regimen has logistic challenges and may not be a routine option, consideration of this treatment regime may still be necessary in selective communities to reduce high intensity of T. trichiura infection.
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Affiliation(s)
- Mian Zi Tee
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Soo Ching Lee
- Type 2 Immunity Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Yi Xian Er
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nan Jiun Yap
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Romano Ngui
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Alice V. Easton
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Vinnie Wei Yin Siow
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kee Seong Ng
- Department of Gastroenterology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Kek Heng Chua
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ken Cadwell
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, United States of America
- Kimmel Center for Biology and Medicine at the Skirball Institute, New York University Grossman School of Medicine, New York, NY, United States of America
- Division of Gastroenterology, Department of Medicine, New York University Langone Health, New York, NY, United States of America
| | - P’ng Loke
- Type 2 Immunity Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
- * E-mail: (YALL); (PL)
| | - Yvonne Ai Lian Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail: (YALL); (PL)
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HODDA M. Phylum Nematoda: feeding habits for all valid genera using a new, universal scheme encompassing the entire phylum, with descriptions of morphological characteristics of the stoma, a key, and discussion of the evidence for trophic relationships. Zootaxa 2022; 5114:318-451. [DOI: 10.11646/zootaxa.5114.1.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Indexed: 11/04/2022]
Abstract
This paper details a system for classifying the trophic relationships of the entire Phylum Nematoda, together with a table specifying the categories of every valid genus. This system encompasses both the diets of nematodes and how the food is obtained. The types of evidence used to evaluate trophic relationships and the inferences that can be drawn from each are evaluated. The general morphological and ecological characteristics of each trophic type are detailed, and a morphological key is presented. This information will enable the trophic relationships of any valid genus of nematodes to be assessed, along with currently undescribed genera, provided their affinities to existing genera can be ascertained. The system and list can add value to ecological, environmental and biodiversity studies where there is no morphological information, for example in environmental sequencing or metabarcoding studies.
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Bungiro RD, Harrison LM, Dondji B, Cappello M. Comparison of percutaneous vs oral infection of hamsters with the hookworm Ancylostoma ceylanicum: Parasite development, pathology and primary immune response. PLoS Negl Trop Dis 2022; 16:e0010098. [PMID: 34986139 PMCID: PMC8765627 DOI: 10.1371/journal.pntd.0010098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/18/2022] [Accepted: 12/15/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hundreds of millions of people in poor countries continue to suffer from disease caused by bloodfeeding hookworms. While mice and rats are not reliably permissive hosts for any human hookworm species, adult Golden Syrian hamsters are fully permissive for the human and animal pathogen Ancylostoma ceylanicum. Similar to humans, hamsters may be infected with A. ceylanicum third-stage larvae orally or percutaneously. Oral infection typically leads to consistent worm yields in hamsters but may not accurately reflect the clinical and immunological manifestations of human infection resulting from skin penetration. METHODOLOGY/PRINCIPAL FINDINGS In this study we compared host responses following percutaneous infection to those utilizing an established oral infection protocol. Infected hamsters exhibited a dose-dependent pathology, with 1000 percutaneous larvae (L3) causing anemia and adult worm recovery comparable to that of 50 orally administered L3. A delayed arrival and maturity of worms in the intestine was observed, as was variation in measured cellular immune responses. A long-term study found that the decline in blood hemoglobin was more gradual and did not reach levels as low, with the nadir of disease coming later in percutaneously infected hamsters. Both groups exhibited moderate growth delay, an effect that was more persistent in the percutaneously infected group. Fecal egg output also peaked later and at lower levels in the percutaneously infected animals. In contrast to orally infected hamsters, antibody titers to larval antigens continued to increase throughout the course of the experiment in the percutaneous group. CONCLUSIONS/SIGNIFICANCE These results demonstrate that the route of infection with A. ceylanicum impacts disease pathogenesis, as well as humoral and cellular immune responses in an experimental setting. These data further validate the utility of the Golden Syrian hamster as a model of both oral and percutaneous infection with human hookworms.
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Affiliation(s)
- Richard D. Bungiro
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Lisa M. Harrison
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Blaise Dondji
- Laboratory of Cellular Immunology and Parasitology, Department of Biological Sciences, Central Washington University, Ellensburg, Washington, United States of America
| | - Michael Cappello
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, United States of America
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Phasuk N, Apiwattanakul N, Punsawad C. Profiles of CD4 +, CD8 +, and regulatory T cells and circulating cytokines in hookworm-infected children in southern Thailand. Med Microbiol Immunol 2021; 211:19-28. [PMID: 34854999 DOI: 10.1007/s00430-021-00723-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 10/30/2021] [Indexed: 01/15/2023]
Abstract
Hookworm infection is the most common human helminthic infection in the rural areas of southern Thailand. There is little information on the induced cellular immune responses in hookworm-infected children. The present study aimed to investigate the cellular immune responses, regulatory T cells (Tregs), Th1-type cytokines (interleukin (IL)-2 and interferon (IFN)-γ), a Th2-type cytokine (IL-5) and IL-10, which is one of the cytokines secreted by Tregs in hookworm-infected children. Twenty-nine schoolchildren diagnosed with hookworm infections and 28 healthy controls were enrolled in the study. CD4+ and CD8+ T cells and Tregs in whole blood were analyzed using flow cytometry. Plasma IL-2, IL-5, IL-10 and IFN-γ concentrations were quantified by enzyme-linked immunosorbent assay (ELISA). The median CD4+ T cell frequency was significantly higher in hookworm-infected children than healthy controls. Compared to healthy controls, hookworm-infected children had a significantly increased absolute number of Tregs. No differences in circulating CD8+ T cell median frequency or absolute numbers were observed among hookworm-infected children or healthy controls. Elevated IL-2 and IL-10 concentrations were found in hookworm-infected children. Moreover, the absolute number of Tregs was significantly positively correlated with the plasma IL-10 concentration (rs = 0.406, P = 0.029). This study showed that hookworm-infected schoolchildren had significantly different immune responses than healthy controls, including an increase in the CD4+ T cell number, a significant induction of Tregs and significantly elevated circulating IL-10 levels. These alterations could be the mechanism underlying the immunomodulation that alleviates allergic diseases among hookworm-infected individuals.
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Affiliation(s)
- Nonthapan Phasuk
- School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
| | - Nopporn Apiwattanakul
- Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chuchard Punsawad
- School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand.
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Mouwenda YD, Betouke Ongwe ME, Sonnet F, Stam KA, Labuda LA, De Vries S, Grobusch MP, Zinsou FJ, Honkpehedji YJ, Dejon Agobe JC, Diemert DJ, van Leeuwen R, Bottazzi ME, Hotez PJ, Kremsner PG, Bethony JM, Jochems SP, Adegnika AA, Massinga Loembe M, Yazdanbakhsh M. Characterization of T cell responses to co-administered hookworm vaccine candidates Na-GST-1 and Na-APR-1 in healthy adults in Gabon. PLoS Negl Trop Dis 2021; 15:e0009732. [PMID: 34597297 PMCID: PMC8486127 DOI: 10.1371/journal.pntd.0009732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/14/2021] [Indexed: 12/23/2022] Open
Abstract
Two hookworm vaccine candidates, Na-GST-1 and Na-APR-1, formulated with Glucopyranosyl Lipid A (GLA-AF) adjuvant, have been shown to be safe, well tolerated, and to induce antibody responses in a Phase 1 clinical trial (Clinicaltrials.gov NCT02126462) conducted in Gabon. Here, we characterized T cell responses in 24 Gabonese volunteers randomized to get vaccinated three times with Na-GST-1 and Na-APR-1 at doses of 30μg (n = 8) or 100μg (n = 10) and as control Hepatitis B (n = 6). Blood was collected pre- and post-vaccination on days 0, 28, and 180 as well as 2-weeks after each vaccine dose on days 14, 42, and 194 for PBMCs isolation. PBMCs were stimulated with recombinant Na-GST-1 or Na-APR-1, before (days 0, 28 and 180) and two weeks after (days 14, 42 and 194) each vaccination and used to characterize T cell responses by flow and mass cytometry. A significant increase in Na-GST-1 -specific CD4+ T cells producing IL-2 and TNF, correlated with specific IgG antibody levels, after the third vaccination (day 194) was observed. In contrast, no increase in Na-APR-1 specific T cell responses were induced by the vaccine. Mass cytometry revealed that, Na-GST-1 cytokine producing CD4+ T cells were CD161+ memory cells expressing CTLA-4 and CD40-L. Blocking CTLA-4 enhanced the cytokine response to Na-GST-1. In Gabonese volunteers, hookworm vaccine candidate, Na-GST-1, induces detectable CD4+ T cell responses that correlate with specific antibody levels. As these CD4+ T cells express CTLA-4, and blocking this inhibitory molecules resulted in enhanced cytokine production, the question arises whether this pathway can be targeted to enhance vaccine immunogenicity. Two hookworm vaccine candidate (Na-GST-1 and Na-APR-1) have been tested in Gabonese and found to be safe and to induce antibody response. We aimed to study the cellular immune responses among vaccinated and unvaccinated volunteers. We found that Na-GST-1 induced CD4+ T cell responses (IL-2, TNF) among the vaccinated volunteers that received the high vaccine dose (100 ug). Furthermore Na-GST-1 specific memory T cells were found to express the inhibitory molecule CTLA-4. These responses was not observed in those who received the low dose of the Na-GST-1 vaccine, or those who received Na-APR-1 or HBV. By blocking CTLA-4, we observed an increase in TNF production. Our data suggest that an intervention involving blockage of the CTLA-4 molecule in the vaccinated could be beneficial in endemic settings where vaccine responses have been shown to be lower compared to non-endemic settings.
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Affiliation(s)
- Yoanne D. Mouwenda
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
- * E-mail:
| | - Madeleine E. Betouke Ongwe
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
- Centre National de la Recherche Scientifique et Technologique (IRET- CENAREST), Libreville, Gabon
| | - Friederike Sonnet
- Department of Parasitology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Koen A. Stam
- Department of Parasitology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Lucja A. Labuda
- Department of Parasitology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Sophie De Vries
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Center, (AMC), University of Amsterdam, Amsterdam, the Netherlands
| | - Martin P. Grobusch
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Center, (AMC), University of Amsterdam, Amsterdam, the Netherlands
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Frejus J. Zinsou
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Yabo J. Honkpehedji
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Jean-Claude Dejon Agobe
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Center, (AMC), University of Amsterdam, Amsterdam, the Netherlands
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - David J. Diemert
- Department of Microbiology, Immunology and Tropical Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia, United States of America
| | - Remko van Leeuwen
- Amsterdam Institute for Global Development (AIGHD), Amsterdam, The Netherlands
| | - Maria E. Bottazzi
- Texas Children’s Hospital Center for Vaccine Development, Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Peter J. Hotez
- Texas Children’s Hospital Center for Vaccine Development, Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Peter G. Kremsner
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- German Center for Infection Research, Tübingen, Germany
| | - Jeffrey M. Bethony
- Department of Microbiology, Immunology and Tropical Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia, United States of America
| | - Simon P. Jochems
- Department of Parasitology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Ayola A. Adegnika
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- German Center for Infection Research, Tübingen, Germany
| | | | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
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Doyen V, Corazza F, Nhu Thi H, Le Chi T, Truyens C, Nagant C, Tran Thi Mong H, Fils JF, Thi Ngoc Huynh P, Michel O. Hookworm treatment induces a decrease of suppressive regulatory T cell associated with a Th2 inflammatory response. PLoS One 2021; 16:e0252921. [PMID: 34111180 PMCID: PMC8191899 DOI: 10.1371/journal.pone.0252921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/25/2021] [Indexed: 01/04/2023] Open
Abstract
Background Like other helminths, hookworms (HW) induce a regulatory immune response able to modulate and dampen reactivity of the host to antigens. No data about the evolution of the immune response after treatment are available. We aim to phenotype the regulatory immune response during natural HW infection and its evolution after treatment. Methodology Twenty hookworm infected (HW+) and 14 non-infected subjects HW–from endemic area in the periphery of Ho Chi Minh City were included. Blood and feces samples were obtained before, 2 and 4 weeks after treatment with Albendazole 400mg. Additional samples were obtained at 3 and 12 months in the HW+ group. Hematological parameters, Treg (CD4+CD25hiFoxP3hi) and surface molecules (CD39, CD62L, ICOS, PD-1, CD45RA) were measured as well as inflammatory and lymphocytes differentiation cytokines such as IL-1β, IL-6, IFNγ, IL-4, IL-17, IL-10, IL-2 and TGFβ. Results HW+ subjects showed higher Treg, TregICOS+, Treg PD1-, TregCD62L+ and CD45RA+FoxP3lo resting Treg (rTreg). CD45RA-FoxP3lo non-suppressive Treg cells were also increased. No preferential Th1/Th2 orientation was observed, nor difference for IL-10 between two groups. After treatment, Treg, TregICOS+, TregCD62L+, Treg PD1- and rTreg decreased while IL-4 and IL-6 cytokines increased. Conclusion During HW infection, Treg are increased and characterized by a heterogeneous population: a highly suppressive as well as a non-suppressive T cells phenotype. After treatment, Treg with immune-suppressive phenotype exhibited a decrease parallel to an inflammatory Th2 response.
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Affiliation(s)
- Virginie Doyen
- Laboratory of Translational Research, ULB223, CHU Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Clinic of Immunoallergology, CHU Brugmann, ULB, Brussels, Belgium
- * E-mail:
| | - Francis Corazza
- Laboratory of Translational Research, ULB223, CHU Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Immunology Laboratory, LHUB-ULB, Brussels, Belgium
| | - Hoa Nhu Thi
- Parasitology and Mycology Department, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam
| | - Thanh Le Chi
- Immunology Laboratory, Pasteur Institute, Ho Chi Minh, Vietnam
| | - Carine Truyens
- Parasitology Laboratory, ULB Center for Research in immunology (U-CRI), Université Libre de Bruxelles, Brussels, Belgium
| | - Carole Nagant
- Laboratory of Translational Research, ULB223, CHU Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Immunology Laboratory, LHUB-ULB, Brussels, Belgium
| | - Hiep Tran Thi Mong
- Department of Family Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam
| | | | | | - Olivier Michel
- Clinic of Immunoallergology, CHU Brugmann, ULB, Brussels, Belgium
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9
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Hoogerwerf MA, Koopman JPR, Janse JJ, Langenberg MCC, van Schuijlenburg R, Kruize YCM, Brienen EAT, Manurung MD, Verbeek-Menken P, van der Beek MT, Westra IM, Meij P, Visser LG, van Lieshout L, de Vlas SJ, Yazdanbakhsh M, Coffeng LE, Roestenberg M. A Randomized Controlled Trial to Investigate Safety and Variability of Egg Excretion After Repeated Controlled Human Hookworm Infection. J Infect Dis 2020; 223:905-913. [PMID: 32645714 DOI: 10.1093/infdis/jiaa414] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/09/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Controlled human hookworm infections could significantly contribute to the development of a hookworm vaccine. However, current models are hampered by low and unstable egg output, reducing generalizability and increasing sample sizes. This study aims to investigate the safety, tolerability, and egg output of repeated exposure to hookworm larvae. METHODS Twenty-four healthy volunteers were randomized, double-blindly, to 1, 2, or 3 doses of 50 Necator americanus L3 larvae at 2-week intervals. Volunteers were monitored weekly and were treated with albendazole at week 20. RESULTS There was no association between larval dose and number or severity of adverse events. Geometric mean egg loads stabilized at 697, 1668, and 1914 eggs per gram feces for the 1 × 50L3, 2 × 50L3, and 3 × 50L3 group, respectively. Bayesian statistical modeling showed that egg count variability relative to the mean was reduced with a second infectious dose; however, the third dose did not increase egg load or decrease variability. We therefore suggest 2 × 50L3 as an improved challenge dose. Model-based simulations indicates increased frequency of stool sampling optimizes the power of hypothetical vaccine trials. CONCLUSIONS Repeated infection with hookworm larvae increased egg counts to levels comparable to the field and reduced relative variability in egg output without aggravating adverse events. CLINICAL TRIALS REGISTRATION NCT03257072.
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Affiliation(s)
| | - Jan Pieter R Koopman
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jacqueline J Janse
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | | | | | - Yvonne C M Kruize
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Eric A T Brienen
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Mikhael D Manurung
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Petra Verbeek-Menken
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands
| | - Martha T van der Beek
- Clinical Microbiology Laboratory, Leiden University Medical Center, Leiden, the Netherlands
| | - Inge M Westra
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, the Netherlands
| | - Pauline Meij
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, the Netherlands
| | - Leo G Visser
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Luc E Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Meta Roestenberg
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands.,Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands
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10
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Gill N, Somayaji R, Vaughan S. Exploring Tropical Infections: A Focus on Cutaneous Larva Migrans. Adv Skin Wound Care 2020; 33:356-359. [PMID: 32544114 DOI: 10.1097/01.asw.0000662248.18996.b5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
GENERAL PURPOSE To provide information about infection with cutaneous larva migrans (CLM). TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, NPs, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will:1. Distinguish the clinical features, diagnosis, and management of CLM.2. Explain the epidemiology of CLM. ABSTRACT Cutaneous larva migrans is a hookworm infection and one of the most common skin diseases of tourists in tropical countries. Most commonly, the infection is transmitted by contact with feces of dogs and cats containing hookworm eggs. This case-based review explores the epidemiology, diagnosis, clinical features, and management of cutaneous larva migrans infection.
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11
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Seddon JA, Tugume L, Solomons R, Prasad K, Bahr NC. The current global situation for tuberculous meningitis: epidemiology, diagnostics, treatment and outcomes. Wellcome Open Res 2019; 4:167. [PMID: 32118118 PMCID: PMC7029758 DOI: 10.12688/wellcomeopenres.15535.1] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2019] [Indexed: 12/13/2022] Open
Abstract
Tuberculous meningitis (TBM) results from dissemination of M. tuberculosis to the cerebrospinal fluid (CSF) and meninges. Ischaemia, hydrocephalus and raised intracranial pressure frequently result, leading to extensive brain injury and neurodisability. The global burden of TBM is unclear and it is likely that many cases are undiagnosed, with many treated cases unreported. Untreated, TBM is uniformly fatal, and even if treated, mortality and morbidity are high. Young age and human immunodeficiency virus (HIV) infection are potent risk factors for TBM, while Bacillus Calmette-Guérin (BCG) vaccination is protective, particularly in young children. Diagnosis of TBM usually relies on characteristic clinical symptoms and signs, together with consistent neuroimaging and CSF parameters. The ability to confirm the TBM diagnosis via CSF isolation of M. tuberculosis depends on the type of diagnostic tests available. In most cases, the diagnosis remains unconfirmed. GeneXpert MTB/RIF and the next generation Xpert Ultra offer improved sensitivity and rapid turnaround times, and while roll-out has scaled up, availability remains limited. Many locations rely only on acid fast bacilli smear, which is insensitive. Treatment regimens for TBM are based on evidence for pulmonary tuberculosis treatment, with little consideration to CSF penetration or mode of drug action required. The World Health Organization recommends a 12-month treatment course, although data on which to base this duration is lacking. New treatment regimens and drug dosages are under evaluation, with much higher dosages of rifampicin and the inclusion of fluoroquinolones and linezolid identified as promising innovations. The inclusion of corticosteroids at the start of treatment has been demonstrated to reduce mortality in HIV-negative individuals but whether they are universally beneficial is unclear. Other host-directed therapies show promise but evidence for widespread use is lacking. Finally, the management of TBM within health systems is sub-optimal, with drop-offs at every stage in the care cascade.
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Affiliation(s)
- James A Seddon
- Department of Infectious Diseases, Imperial College London, London, W2 1PG, UK
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
| | - Lillian Tugume
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | - Regan Solomons
- Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
| | - Kameshwar Prasad
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Nathan C Bahr
- Department of Infectious Diseases, University of Kansas, Kansas City, KS, USA
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12
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Anderson AS, Trumble BC, Hové C, Kraft TS, Kaplan H, Gurven M, Blackwell AD. Old friends and friendly fire: Pregnancy, hookworm infection, and anemia among tropical horticulturalists. Am J Hum Biol 2019; 32:e23337. [PMID: 31642576 DOI: 10.1002/ajhb.23337] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 08/02/2019] [Accepted: 09/14/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Despite public health concerns about hookworm infection in pregnancy, little is known about immune profiles associated with hookworm (Necator americanus and Ancylostoma duodenale) infection during pregnancy. Fetal tolerance requirements may constrain maternal immune response to hookworm, thereby increasing susceptibility to new infections or increasing hemoglobin loss. To explore this possibility, we study systemic immune response and hemoglobin levels in a natural fertility population with endemic helminthic infection. METHODS We used Bayesian multilevel models to analyze mixed longitudinal data on hemoglobin, hookworm infection, reproductive state, eosinophils, and erythrocyte sedimentation rate (ESR) to examine the effects of pregnancy and hookworm infection on nonspecific inflammation, cellular parasite response, and hemoglobin among 612 Tsimane women aged 15-45 (1016 observations). RESULTS Pregnancy is associated with lower eosinophil counts and lower eosinophil response to hookworm, particularly during the second and third trimesters. Both hookworm and pregnancy are associated with higher ESR, with evidence for an interaction between the two causing further increases in the first trimester. Pregnancy is moderately associated with higher odds of hookworm infection (OR: 1.23, 95% CI: 0.83 to 1.83). Pregnancy and hookworm both decrease hemoglobin and may interact to accentuate this effect in the first-trimester of pregnancy (Interaction: β: -0.30 g/dL; CI: -0.870 to 0.24). CONCLUSIONS Our findings are consistent with a possible trade-off between hookworm immunity and successful pregnancy, and with the suggestion that hookworm and pregnancy may have synergistic effects, particularly in the first trimester.
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Affiliation(s)
- Amy S Anderson
- Department of Anthropology, University of California Santa Barbara, California, Santa Barbara
| | - Benjamin C Trumble
- School of Human Evolution and Social Change, Center for Evolution and Medicine, Arizona State University, Tempe, Arizona
| | - Carmen Hové
- Department of Anthropology, University of California Santa Barbara, California, Santa Barbara
| | - Thomas S Kraft
- Department of Anthropology, University of California Santa Barbara, California, Santa Barbara
| | - Hillard Kaplan
- Economic Science Institute, Chapman University, Orange, California
| | - Michael Gurven
- Department of Anthropology, University of California Santa Barbara, California, Santa Barbara
| | - Aaron D Blackwell
- Department of Anthropology, University of California Santa Barbara, California, Santa Barbara.,Department of Anthropology, Washington State University, Pullman, Washington
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13
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Famakinde DO, Adenusi AA. Involvement of Hookworm Co-Infection in the Pathogenesis and Progression of Podoconiosis: Possible Immunological Mechanism. Trop Med Infect Dis 2018; 3:E37. [PMID: 30274434 PMCID: PMC6073219 DOI: 10.3390/tropicalmed3020037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/16/2018] [Accepted: 03/19/2018] [Indexed: 12/19/2022] Open
Abstract
Podoconiosis is an endemic, non-infectious, geochemical and non-filarial inflammatory cause of tropical elephantiasis. The immunology of podoconiosis is not yet expressly understood. In spite of this, co-infection and co-morbidity with the infectious, soil-transmitted hookworm disease that causes iron deficiency anemia has been found to be predominant among affected individuals living in co-endemic settings, thus creating a more complex immunological interplay that still has not been investigated. Although deworming and iron-rich nutrient supplementation have been suggested in podoconiosis patients living under resource-poor conditions, and it is thought that hookworm infection may help to suppress inflammatory responses, the undisputed link that exists between a non-infectious and an infectious disease may create a scenario whereby during a co-infection, treatment of one exacerbates the other disease condition or is dampened by the debilitation caused by the other. In this paper, we elaborate on the immunopathogenesis of podoconiosis and examine the possible immunological dynamics of hookworm co-infection in the immunopathology of podoconiosis, with a view toward improved management of the disease that will facilitate its feasible elimination.
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Affiliation(s)
- Damilare O Famakinde
- Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Idi-Araba, Surulere P.M.B 12003, Lagos 100254, Nigeria.
| | - Adedotun A Adenusi
- Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Idi-Araba, Surulere P.M.B 12003, Lagos 100254, Nigeria.
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14
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Craig JM, Scott AL. Antecedent Nippostrongylus infection alters the lung immune response to Plasmodium berghei. Parasite Immunol 2017; 39. [PMID: 28475238 DOI: 10.1111/pim.12441] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 04/25/2017] [Indexed: 12/13/2022]
Abstract
In endemic regions, it is not uncommon for patients to be co-infected with soil-transmitted helminths and malaria. Although both malaria and many helminth species use the lungs as a site of development, little attention has been paid to the impact that pulmonary immunity induced by one parasite has on the lung response to the other. To model the consequences of a prior hookworm exposure on the development of immunity to malaria in the lungs, mice were infected with Nippostrongylus brasiliensis and 2 weeks later challenged with Plasmodium berghei. We found that a pre-existing hookworm-induced type 2 immune environment had a measurable but modest impact on the nature of the malaria-driven type 1 cytokine response in the lungs that was associated with a transient effect on parasite development and no significant changes in morbidity and mortality after malaria infection. However, prior hookworm infection did have a lasting effect on lung macrophages, where the malaria-induced M1-like response was blunted by previous M2 polarization. These results demonstrate that, although helminth parasites confer robust changes to the immunological status of the pulmonary microenvironment, lung immunity is plastic and capable of rapidly adapting to consecutive heterologous infections.
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Affiliation(s)
- J M Craig
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - A L Scott
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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15
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Helminth-Tuberculosis Co-infection: An Immunologic Perspective. Trends Immunol 2016; 37:597-607. [PMID: 27501916 DOI: 10.1016/j.it.2016.07.005] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/13/2016] [Accepted: 07/14/2016] [Indexed: 01/15/2023]
Abstract
Over 2 billion people worldwide are infected with helminths (worms). Similarly, infection with Mycobacterium tuberculosis (Mtb) occurs in over a third of the world's population, often with a great degree of geographical overlap with helminth infection. Interestingly, the responses induced by the extracellular helminths and those induced by the intracellular Mtb are often mutually antagonistic and, as a consequence, can result in impaired (or cross-regulated) host responses to either of the infecting pathogens. In this review, we outline the nature of the immune responses induced by infections with helminths and tuberculosis (TB) and then provide data from both experimental models and human studies that illustrate how the immune response engendered by helminth parasites modulates Mtb-specific responses in helminth-TB coinfection.
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16
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Nair MG, Herbert DR. Immune polarization by hookworms: taking cues from T helper type 2, type 2 innate lymphoid cells and alternatively activated macrophages. Immunology 2016; 148:115-24. [PMID: 26928141 PMCID: PMC4863575 DOI: 10.1111/imm.12601] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 02/17/2016] [Accepted: 02/21/2016] [Indexed: 12/15/2022] Open
Abstract
Cellular and molecular investigation of parasitic helminth infections has greatly accelerated the understanding of type 2 immune responses. However, there remains considerable debate regarding the specific leucocytes that kill parasites and whether these mechanisms are distinct from those responsible for tissue repair. Herein, we chronicle discoveries over the past decade highlighting current paradigms in type 2 immunity with a particular emphasis upon how CD4(+) T helper type 2 cells, type 2 innate lymphoid cells and alternatively activated macrophages coordinately control helminth-induced parasitism. Primarily, this review will draw from studies of the murine nematode parasite Nippostrongylus brasiliensis, which bears important similarities to the human hookworms Ancylostoma duodenale and Necator americanus. Given that one or more hookworm species currently infect millions of individuals across the globe, we propose that vaccine and/or pharmaceutical-based cure strategies targeting these affected human populations should incorporate the conceptual advances outlined herein.
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Affiliation(s)
- Meera G Nair
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, CA, USA
| | - De'Broski R Herbert
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
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17
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MHC class II transcription is associated with inflammatory responses in a wild marine mammal. INFECTION GENETICS AND EVOLUTION 2016; 42:77-82. [PMID: 27137083 DOI: 10.1016/j.meegid.2016.04.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 04/14/2016] [Accepted: 04/18/2016] [Indexed: 01/10/2023]
Abstract
Inflammation is one of the most important non-specific and rapid responses that a vertebrate can elicit in response to damage or a foreign insult. To date, despite increasing evidence that the innate and adaptive branches of immunity are more intricately related than previously thought, few have examined interactions between the Major Histocompatibility Complex (MHC, a polymorphic region of the vertebrate genome that is involved with antigen presentation) and inflammation, and even less is known about these interactions in an eco-immunological context. Here, we examined the effect of MHC class II DRB gene multiplicity and transcription on phytohemagglutinin (PHA)-induced inflammation during the early stages of development of California sea lions. Neither constitutive nor expressed ZacaDRB diversity was found to be associated with pup responses to PHA at any of the stages of pup development. However, for two-month-old pups, those with a specific MHC-DRB locus (ZacaDRB-A) tended to have less efficient responsive inflammation. Transcription of distinct MHC-DRB loci was also linked to PHA-induced inflammation, with patterns that varied markedly between ages, and that suggested that ongoing infectious processes could limit the capacity to respond to a secondary challenge. Life history constraints and physiological processes associated with development of California sea lions, in conjunction with their changing pathogenic environment could explain the observed effects of MHC class II transcription on PHA-induced inflammation. To our knowledge, ours is the first study to examine the importance of expressed vs. constitutive MHC loci on inflammation in a natural population.
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18
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Njaanake KH, Vennervald BJ, Simonsen PE, Madsen H, Mukoko DA, Kimani G, Jaoko WG, Estambale BB. Schistosoma haematobium and soil-transmitted Helminths in Tana Delta District of Kenya: infection and morbidity patterns in primary schoolchildren from two isolated villages. BMC Infect Dis 2016; 16:57. [PMID: 26842961 PMCID: PMC4739089 DOI: 10.1186/s12879-016-1387-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 01/27/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schistosomes and soil-transmitted helminths (STH) (hookworm, Trichuris trichiura and Ascaris lumbricoides) are widely distributed in developing countries where they infect over 230 million and 1.5 billion people, respectively. The parasites are frequently co-endemic and many individuals are co-infected with two or more of the species, but information on how the parasites interact in co-infected individuals is scarce. The present study assessed Schistosoma haematobium and STH infection and morbidity patterns among school children in a hyper-endemic focus in the Tana River delta of coastal Kenya. METHODS Two hundred and sixty-two children aged 5-12 years from two primary schools were enrolled in the study. For each child, urine was examined for S. haematobium eggs and haematuria, stool was examined for STH eggs, peripheral blood was examined for eosinophilia and haemoglobin level, the urinary tract was ultrasound-examined for S. haematobium-related pathology, and the height and weight was measured and used to calculate the body mass index (BMI). RESULTS Prevalences of S. haematobium, hookworm, T. trichiura and A. lumbricoides infection were 94, 81, 88 and 46 %, respectively. There was no significant association between S. haematobium and STH infection but intensity of hookworm infection significantly increased with that of T. trichiura. Lower BMI scores were associated with high intensity of S. haematobium (difference =-0.48, p > 0.05) and A. lumbricoides (difference =-0.67, p < 0.05). Haematuria (both macro and micro) was common and associated with S. haematobium infection, while anaemia was associated with high intensity of S. haematobium (OR = 2.08, p < 0.05) and high hookworm infections OR = 4.75; p < 0.001). The majority of children had eosinophilia, which was significantly associated with high intensity of hookworm infection (OR = 5.34, p < 0.05). Overall 38 % of the children had ultrasound-detectable urinary tract morbidity, which was associated with high intensity of S. haematobium infection (OR = 3.13, p < 0.05). CONCLUSION Prevalences of S. haematobium and STH infections among the primary school children were high and the parasites were responsible for significant morbidity. A clear synergistic interaction was observed between hookworm and T. trichiura infections. Increased coverage in administration of praziquantel and albendazole in the area is recommended to control morbidity due to these infections.
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Affiliation(s)
- Kariuki H Njaanake
- Department of Medical Microbiology, College of Health Sciences, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya.
| | - Birgitte J Vennervald
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 100, 1870, Frederiksberg C, Denmark.
| | - Paul E Simonsen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 100, 1870, Frederiksberg C, Denmark.
| | - Henry Madsen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 100, 1870, Frederiksberg C, Denmark.
| | - Dunstan A Mukoko
- Division of Vector Borne & Neglected Tropical Diseases, Ministry of Public Health & Sanitation, P.O. Box 54840-00202, Nairobi, Kenya.
| | - Gachuhi Kimani
- Centre for Biotechnology Research & Development, Kenya Medical Research Institute, P. O. Box 54840-00200, Nairobi, Kenya.
| | - Walter G Jaoko
- Department of Medical Microbiology, College of Health Sciences, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya.
| | - Benson B Estambale
- Jaramogi Oginga Odinga University of Science and Technology, P. O. Box 210-40601, Bondo, Kenya.
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