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Eissa MM, Salem AE, El Skhawy N. Parasites revive hope for cancer therapy. Eur J Med Res 2024; 29:489. [PMID: 39367471 PMCID: PMC11453045 DOI: 10.1186/s40001-024-02057-2] [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: 06/10/2024] [Accepted: 09/10/2024] [Indexed: 10/06/2024] Open
Abstract
Parasites have attained a life-long stigma of being detrimental organisms with deleterious outcomes. Yet, recently, a creditable twist was verified that can dramatically change our perception of those parasites from being a source of misery to millions of people to a useful anti-cancerous tool. Various parasites have shown promise to combat cancer in different experimental models, including colorectal, lung, and breast cancers, among others. Helminths and protozoan parasites, as well as their derivatives such as Echinococcus granulosus protein KI-1, Toxoplasma gondii GRA15II, and Trypanosoma cruzi calreticulin, have demonstrated the ability to inhibit tumor growth, angiogenesis, and metastasis. This article provides an overview of the literature on various cancer types that have shown promising responses to parasite therapy in both in vitro and in vivo animal studies. Parasites have shown anti-neoplastic activity through a variety of mechanisms that collectively contribute to their anti-cancer properties. These include immunomodulation, inhibition of angiogenesis, and molecular mimicry with cancer cells. This review article sheds light on this intriguing emerging field and emphasizes the value of collaborative multidisciplinary research projects with funding agencies and pharmaceutical companies. Thus, these strategies would secure continuous exploration of this new avenue and accelerate the advancement of cancer therapy research. Although experimental studies are heavily conducted by leaps and bounds, further steps are definitely lagging. Upgrading research from the experimental level to the clinical trial would be a wise progression toward efficient exploitation of the anti-neoplastic capabilities of parasites, ultimately saving countless lives.
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Affiliation(s)
- Maha M Eissa
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Ahmed Ebada Salem
- Department of Radiology and Nuclear Medicine, School of Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, 48123, USA
| | - Nahla El Skhawy
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Lema YL, Prodjinotho UF, Makasi C, Nanyaro MWA, Kilale AM, Mfinanga S, Stelzle D, Schmidt V, Carabin H, Winkler AS, Lyamuya EF, Ngowi BJ, Chachage M, Prazeres da Costa C. Evaluating the modulation of peripheral immune profile in people living with HIV and (Neuro)cysticercosis. PLoS Negl Trop Dis 2024; 18:e0012345. [PMID: 39093864 PMCID: PMC11324146 DOI: 10.1371/journal.pntd.0012345] [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: 11/24/2023] [Revised: 08/14/2024] [Accepted: 07/05/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND The parasitic infection caused by Taenia solium represents a significant public health concern in developing countries. Larval invasion of body tissues leads to cysticercosis (CC), while central nervous system (CNS) involvement results in neurocysticercosis (NCC). Both conditions exhibit diverse clinical manifestations, and the potential impact of concomitant HIV infection especially prevalent in sub-Saharan Africa on peripheral and CNS immune responses remains poorly understood. This study aimed to identify the potential impact of HIV coinfection in CC and NCC patients. METHODOLOGY A nested study within a cross-sectional analysis in two Tanzanian regions was performed and 234 participants (110 HIV+ and 124 HIV-) were tested for cysticercosis antibodies, antigens, CD4 counts and serum Th1 and Th2 cytokines via multiplex bead-based immunoassay. 127 cysticercosis seropositive individuals underwent cranial computed tomography (CCT) and clinical symptoms were assessed. Multiple regression analyses were performed to identify factors associated with cytokine modulation due to HIV in CC and NCC patients. RESULTS Serologically, 18.8% tested positive for cysticercosis antibodies, with no significant difference HIV+ and HIV+. A significantly higher rate of cysticercosis antigen positivity was found in HIV+ individuals (43.6%) compared to HIV- (28.2%) (p = 0.016). CCT scans revealed that overall 10.3% had active brain cysts (NCC+). Our study found no significant changes in the overall cytokine profiles between HIV+ and HIV- participants coinfected CC and NCC, except for IL-5 which was elevated in HIV+ individuals with cysticercosis. Furthermore, HIV infection in general was associated with increased levels of pro-and some anti-inflammatory cytokines e.g. TNF-α, IL-8, and IFN-γ. However, based on the interaction analyses, no cytokine changes were observed due to HIV in CC or NCC patients. CONCLUSIONS In conclusion, while HIV infection itself significantly modulates levels of key cytokines such as TNF-α, IL-8, and IFN-γ, it does not modulate any cytokine changes due to CC or NCC. This underscores the dominant influence of HIV on the immune system and highlights the importance of effective antiretroviral therapy in managing immune responses in individuals coinfected with HIV and CC/NCC.
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Affiliation(s)
- Yakobo Leonard Lema
- Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
| | - Ulrich Fabien Prodjinotho
- Institute for Medical Microbiology, Immunology, and Hygiene, Technical University of Munich (TUM), Munich, Germany
- Center for Global Health, Technical University of Munich, Munich, Germany
| | - Charles Makasi
- Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Mary-Winnie A. Nanyaro
- Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
| | - Andrew Martin Kilale
- Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
| | - Sayoki Mfinanga
- Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
- Kampala International University, Kampala, Tanzania
- School of Public Health, Muhimbili University of Health & Allied Sciences (MUHAS), Dar Es Salaam, Tanzania
| | - Dominik Stelzle
- Center for Global Health, Technical University of Munich, Munich, Germany
- Department of Neurology, School of Medicine and Health, Technical University Munich (TUM), Munich, Germany
| | - Veronika Schmidt
- Center for Global Health, Technical University of Munich, Munich, Germany
- Department of Neurology, School of Medicine and Health, Technical University Munich (TUM), Munich, Germany
| | - Hélène Carabin
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
- School of Public Health, University of Montreal, Montreal, Quebec, Canada
- Research Group on Epidemiology of Zoonoses and Public Health (GREZOSP), Saint-Hyacinthe, Quebec, Canada
- Public Health Research Center of the University of Montreal and the CIUSSS of Center-Sud-de-l’île-de-Montréal (CReSP), Montreal, Quebec, Canada
| | - Andrea Sylvia Winkler
- Center for Global Health, Technical University of Munich, Munich, Germany
- Department of Neurology, School of Medicine and Health, Technical University Munich (TUM), Munich, Germany
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Eligius F. Lyamuya
- Department of Microbiology & Immunology, Muhimbili University of Health & Allied Sciences (MUHAS), Dar Es Salaam, Tanzania
| | - Bernard J. Ngowi
- Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
- Mbeya College of Health & Allied Sciences, University of Dar Es Salaam, Mbeya Tanzania
| | - Mkunde Chachage
- Mbeya College of Health & Allied Sciences, University of Dar Es Salaam, Mbeya Tanzania
- Mbeya Medical Research Center, National Institute for Medical Research (NIMR), Mbeya, Tanzania
| | - Clarissa Prazeres da Costa
- Institute for Medical Microbiology, Immunology, and Hygiene, Technical University of Munich (TUM), Munich, Germany
- Center for Global Health, Technical University of Munich, Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Germany
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Phumrattanaprapin W, Tatiya-apiradee N, Jantaban P, Mahikul W. Assessment of knowledge and practices regarding taeniasis and cysticercosis in Pak Chong, Nakhon Ratchasima, Thailand: A cross-sectional study. PLoS One 2024; 19:e0307240. [PMID: 39008473 PMCID: PMC11249257 DOI: 10.1371/journal.pone.0307240] [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: 08/29/2023] [Accepted: 07/01/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Taeniasis and cysticercosis are parasitic infections caused by Taenia spp., mainly transmitted through the consumption of undercooked pork. Prevention requires increasing knowledge and awareness, improving meat inspection and hygiene, and promoting safe food handling and sanitation. The aim of this study was to evaluate the knowledge and practice (KP) of residents in Pak Chong District, Nakhon Ratchasima, Thailand, regarding taeniasis and cysticercosis. METHODS A cross-sectional study was conducted in Pak Chong District, Nakhon Ratchasima, Thailand, and its 11 subdistrict municipalities. Study participants were selected using a stratified random sampling design. A validated questionnaire (Cronbach's alpha = 0.70) was used to collect socio-demographic information and assess knowledge and practices related to taeniasis and cysticercosis. Descriptive statistics and multiple linear regression were used for the analysis. RESULTS Of the 360 survey respondents, 65.0% (n = 234) were women, 82.2% (n = 296) were aged under 60 years, 99.2% (n = 357) identified as Buddhist, 87.5% (n = 315) had less than a bachelor's degree education level, 54.2% (n = 195) had monthly family income ≥10,000 Thai baht, 10.6% (n = 38) were unemployed, and 26.1% (n = 93) lived in a town municipality. The survey revealed that 98.3% (n = 354) of participants were categorized as having less accurate knowledge and 83.6% (n = 301) were classified as more frequently engaging in correct prevention practices. Our study revealed that pig farmers (1.7%) occasionally permitted the pigs to forage freely. The results of multiple linear regression analysis revealed that knowledge scores were positively associated with household income ≥10,000 Thai baht (βadj = 1.50, 95% confidence interval [CI] 0.65 to 2.36). Practice scores were negatively associated with age over 60 years (βadj = -1.77, 95% CI -3.14 to -0.40) and living in a subdistrict municipality (βadj = -2.58, 95% CI -3.77 to -1.39). There was no association between KP regarding taeniasis and cysticercosis in the population of Pak Chong. CONCLUSIONS Overall, participants' knowledge was lacking. Public education interventions are recommended to improve knowledge among residents with low socioeconomic status. These findings can inform the development of targeted interventions and educational programs in Pak Chong District, especially among elderly people in subdistrict municipalities, to improve practices for the prevention and control of these parasitic infections.
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Affiliation(s)
| | - Nitima Tatiya-apiradee
- Program in Veterinary Technology, Faculty of Technology, Udon Thani Rajabhat University, Udon Thani, Thailand
| | | | - Wiriya Mahikul
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand
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Rawat SS, Keshri AK, Arora N, Kaur R, Mishra A, Kumar R, Prasad A. Taenia solium cysticerci's extracellular vesicles Attenuate the AKT/mTORC1 pathway for Alleviating DSS-induced colitis in a murine model. J Extracell Vesicles 2024; 13:e12448. [PMID: 38779712 PMCID: PMC11112404 DOI: 10.1002/jev2.12448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 03/24/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
The excretory-secretory proteome plays a pivotal role in both intercellular communication during disease progression and immune escape mechanisms of various pathogens including cestode parasites like Taenia solium. The cysticerci of T. solium causes infection in the central nervous system known as neurocysticercosis (NCC), which affects a significant population in developing countries. Extracellular vesicles (EVs) are 30-150-nm-sized particles and constitute a significant part of the secretome. However, the role of EV in NCC pathogenesis remains undetermined. Here, for the first time, we report that EV from T. solium larvae is abundant in metabolites that can negatively regulate PI3K/AKT pathway, efficiently internalized by macrophages to induce AKT and mTOR degradation through auto-lysosomal route with a prominent increase in the ubiquitination of both proteins. This results in less ROS production and diminished bacterial killing capability among EV-treated macrophages. Due to this, both macro-autophagy and caspase-linked apoptosis are upregulated, with a reduction of the autophagy substrate sequestome 1. In summary, we report that T. solium EV from viable cysts attenuates the AKT-mTOR pathway thereby promoting apoptosis in macrophages, and this may exert immunosuppression during an early viable stage of the parasite in NCC, which is primarily asymptomatic. Further investigation on EV-mediated immune suppression revealed that the EV can protect the mice from DSS-induced colitis and improve colon architecture. These findings shed light on the previously unknown role of T. solium EV and the therapeutic role of their immune suppression potential.
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Affiliation(s)
- Suraj Singh Rawat
- School of Biosciences and BioengineeringIndian Institute of Technology MandiMandiHimachal PradeshIndia
| | - Anand Kumar Keshri
- School of Biosciences and BioengineeringIndian Institute of Technology MandiMandiHimachal PradeshIndia
| | - Naina Arora
- School of Biosciences and BioengineeringIndian Institute of Technology MandiMandiHimachal PradeshIndia
| | - Rimanpreet Kaur
- School of Biosciences and BioengineeringIndian Institute of Technology MandiMandiHimachal PradeshIndia
| | - Amit Mishra
- Cellular and Molecular Neurobiology UnitIndian Institute of Technology JodhpurJodhpurRajasthanIndia
| | - Rajiv Kumar
- CSIR‐Institute of Himalayan Bioresource TechnologyPalampurHimachal PradeshIndia
| | - Amit Prasad
- School of Biosciences and BioengineeringIndian Institute of Technology MandiMandiHimachal PradeshIndia
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Jamil Al-Obaidi MM, Desa MNM. Understanding the mechanisms underlying the disruption of the blood-brain barrier in parasitic infections. J Neurosci Res 2024; 102. [PMID: 38284852 DOI: 10.1002/jnr.25288] [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: 08/30/2023] [Revised: 11/16/2023] [Accepted: 12/09/2023] [Indexed: 01/30/2024]
Abstract
Parasites have a significant impact on the neurological, cognitive, and mental well-being of humans, with a global population of over 1 billion individuals affected. The pathogenesis of central nervous system (CNS) injury in parasitic diseases remains limited, and prevention and control of parasitic CNS infections remain significant areas of research. Parasites, encompassing both unicellular and multicellular organisms, have intricate life cycles and possess the ability to infect a diverse range of hosts, including the human population. Parasitic illnesses that impact the central and peripheral nervous systems are a significant contributor to morbidity and mortality in low- to middle-income nations. The precise pathways through which neurotropic parasites infiltrate the CNS by crossing the blood-brain barrier (BBB) and cause neurological harm remain incompletely understood. Investigating brain infections caused by parasites is closely linked to studying neuroinflammation and cerebral impairment. The exact molecular and cellular mechanisms involved in this process remain incomplete, but understanding the exact mechanisms could provide insight into their pathogenesis and potentially reveal novel therapeutic targets. This review paper explores the underlying mechanisms involved in the development of neurological disorders caused by parasites, including parasite-derived elements, host immune responses, and modifications in tight junctions (TJs) proteins.
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Affiliation(s)
- Mazen M Jamil Al-Obaidi
- University of Technology and Applied Sciences, Rustaq College of Education, Science Department (Biology Unit), Rrustaq, Sultante of Oman
| | - Mohd Nasir Mohd Desa
- Department of Biomedical Sciences, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Satyaprakash K, Khan WA, Zade NN, Chaudhari SP, Shinde SV, Kurkure NV, Shembalkar PK. Serological and molecular detection of neurocysticercosis among epileptic patients in Nagpur, Maharashtra state (India). Helminthologia 2023; 60:208-220. [PMID: 38152476 PMCID: PMC10750244 DOI: 10.2478/helm-2023-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/07/2023] [Indexed: 12/29/2023] Open
Abstract
Neurocysticercosis (NCC), one of the most important neuroparasitic diseases in humans, is caused by Cysticercus cellulosae, the metacestode stage of digenetic zoonotic cestode Taenia solium. The present study aims at the detection of anti-cysticercus antibodies in the sera of epileptic patients (n=26) visiting a tertiary care hospital in Nagpur, Maharashtra state, India, by an in-house developed indirect IgG-ELISA and enzyme-linked immunoelectro transfer blot (EITB) assay using different antigens (namely, Whole Cyst Antigen (WCA), Cystic Fluid Antigen (CFA), Scolex Antigen (SA), Excretory-Secretory Antigen (ESA) and Membrane-Body Antigen (MBA)) prepared from T. solium metacestodes to find out the status of NCC. An attempt has also been made for molecular detection of NCC from blood samples of those patients by Polymerase Chain Reaction (PCR) assay targeted at large subunit rRNA gene of T. solium. The IgG ELISA level of anti-cysticercus antibodies against WCA, CFA, SA, ESA and MBA antigens were as follows: 19.23 %, 23.07 %, 38.46 %, 30.76 % and 15.38 %. The seroreactivity to CFA, SA and ESA was found in equal proportions in patients with ring-enhancing lesions. In the EITB assay, the lower and medium molecular weight protein bands of SA and ESA were immunodominant compared to the higher WCA and CFA peptides. PCR positivity could be observed in 34.6 % (9/26) of the patients under study. It is the first report of detecting NCC among epileptic patients of the Nagpur region of Maharashtra state in India using serological and molecular tools.
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Affiliation(s)
- K. Satyaprakash
- Department of Veterinary Public Health & Epidemiology, Nagpur Veterinary College, Nagpur, Maharashtra, India-440006
- Department of Veterinary Public Health & Epidemiology, Faculty of Veterinary and Animal Sciences, Banaras Hindu University, Barkachha, Mirzapur, Uttar Pradesh, India-231001
| | - W. A. Khan
- Department of Veterinary Public Health & Epidemiology, Nagpur Veterinary College, Nagpur, Maharashtra, India-440006
| | - N. N. Zade
- Department of Veterinary Public Health & Epidemiology, Nagpur Veterinary College, Nagpur, Maharashtra, India-440006
| | - S. P. Chaudhari
- Department of Veterinary Public Health & Epidemiology, Nagpur Veterinary College, Nagpur, Maharashtra, India-440006
| | - S. V. Shinde
- Department of Veterinary Public Health & Epidemiology, Nagpur Veterinary College, Nagpur, Maharashtra, India-440006
| | - N. V. Kurkure
- Department of Veterinary Pathology, Nagpur Veterinary College, Nagpur, Maharashtra, India-440006
| | - P. K. Shembalkar
- Get Well Hospital and Research Institute, Nagpur, Maharashtra, India-440012
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Manh BH, Dat T, Hai VT, He DV, Ha DD, Que NV, Duc NM. Spinal cysticercosis: A case report. Radiol Case Rep 2023; 18:3269-3273. [PMID: 37483373 PMCID: PMC10359710 DOI: 10.1016/j.radcr.2023.06.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/24/2023] [Accepted: 06/17/2023] [Indexed: 07/25/2023] Open
Abstract
Spinal cysticercosis is a rare and severe cysticercosis complication. The pathology is from the inflammatory reaction and granuloma formation around the eggs, which cause focal neurological deficits. Because of the rarity of this condition, diagnosis may be delayed and confused with other myelopathies such as neoplasms or myelitis. We report a 42-year-old woman with low back pain and paraplegia. Magnetic resonance imaging showed a lesion in the spinal canal at the level of L4/L5 that was toward the diagnosis of myelitis. The patient underwent an open biopsy, and the result was granulomatosis caused by cysticercosis. The patient was then given an anticysticercosis medication and gradually recovered.
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Affiliation(s)
- Bui Huy Manh
- Neurosurgery Center, Department of Neurosurgery I, Viet Duc Hospital, Hanoi, Viet Nam
| | - Tran Dat
- Neurosurgery Center, Department of Neurosurgery I, Viet Duc Hospital, Hanoi, Viet Nam
- Deparment of Surgery, Hanoi Medical University, Hanoi, Viet Nam
| | - Vu Trung Hai
- Department of Neurosurgery, Hanoi Medical University Hospital, Hanoi, Viet Nam
| | - Dong-Van He
- Neurosurgery Center, Department of Neurosurgery I, Viet Duc Hospital, Hanoi, Viet Nam
| | - Duong Dai Ha
- Neurosurgery Center, Department of Neurosurgery I, Viet Duc Hospital, Hanoi, Viet Nam
- Deparment of Surgery, Hanoi Medical University, Hanoi, Viet Nam
| | - Nguyen-Van Que
- Department of Radiology, Hanoi Medical University Hospital, Hanoi, Viet Nam
| | - Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
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Castillo Y, Wardle MT, Gamboa R, Elizalde M, Vilchez P, Rodriguez S, Gilman RH, Gonzalez AE, O’Neal SE, Garcia HH. Development and Laboratory Evaluation of a Simple, Field-Applicable Coproantigen Enzyme-Linked Immunosorbent Assay for Diagnosis of Taeniasis in Northern Peru. J Clin Microbiol 2023; 61:e0028223. [PMID: 37367233 PMCID: PMC10358167 DOI: 10.1128/jcm.00282-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/06/2023] [Indexed: 06/28/2023] Open
Abstract
Coproantigen detection by enzyme-linked immunosorbent assay (coAg ELISA) is a vital tool for detecting and treating cases of Taenia solium taeniasis. However, the assay's procedures require costly materials and sophisticated equipment, which are typically inaccessible in rural settings where the disease is endemic. To overcome these barriers, we developed and evaluated a field-applicable coAg ELISA. The field coAg ELISA was developed and evaluated across four phases using known positive and negative stool samples collected from northern Peru. Phase I focused on field assay development, phase II on a small-scale performance evaluation, phase III on a large-scale evaluation, and phase IV on the use and reliability of a colorimetric scale card. All samples were processed using the field and standard assay procedures and compared using signal-to-noise ratios, correlation tests, performance characteristics, and agreement statistics where appropriate. The field coAg ELISA using reagents stored at -20°C and commercially available water and milk powder, and relying on spontaneous separation of the supernatant, had performance comparable to the standard assay. The field coAg ELISA was strongly correlated with the standard in both the small- and large-scale laboratory evaluation (r = 0.99 and r = 0.98, respectively). Finally, the field assay had an almost perfect agreement between independent readers (kappa = 0.975) and between each reader and the spectrophotometer. The field coAg ELISA demonstrated performance comparable to the standard, providing a low-cost alternative to the standard assay for identifying cases of intestinal taeniasis in a low-resource setting.
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Affiliation(s)
- Yesenia Castillo
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Melissa T. Wardle
- Oregon Health & Science University - Portland State University School of Public Health, Portland, Oregon, USA
| | - Ricardo Gamboa
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mayra Elizalde
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Percy Vilchez
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Silvia Rodriguez
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Robert H. Gilman
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Seth E. O’Neal
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
- Oregon Health & Science University - Portland State University School of Public Health, Portland, Oregon, USA
| | - Hector H. Garcia
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
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Anisuzzaman, Hossain MS, Hatta T, Labony SS, Kwofie KD, Kawada H, Tsuji N, Alim MA. Food- and vector-borne parasitic zoonoses: Global burden and impacts. ADVANCES IN PARASITOLOGY 2023; 120:87-136. [PMID: 36948728 DOI: 10.1016/bs.apar.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Around 25% of the global population suffer from one or more parasitic infections, of which food- and vector-borne parasitic zoonotic diseases are a major concern. Additionally, zoonoses and communicable diseases, common to man and animals, are drawing increased attention worldwide. Significant changes in climatic conditions, cropping pattern, demography, food habits, increasing international travel, marketing and trade, deforestation, and urbanization play vital roles in the emergence and re-emergence of parasitic zoonoses. Although it is likely to be underestimated, the collective burden of food- and vector-borne parasitic diseases accounts for ∼60 million disability-adjusted life years (DALYs). Out of 20 neglected tropical diseases (NTDs) listed by the World Health Organization (WHO) and the Centres for Disease Control and Prevention (CDC), 13 diseases are of parasitic origin. There are about 200 zoonotic diseases of which the WHO listed eight as neglected zoonotic diseases (NZDs) in the year 2013. Out of these eight NZDs, four diseases, namely cysticercosis, hydatidosis, leishmaniasis, and trypanosomiasis, are caused by parasites. In this review, we discuss the global burden and impacts of food- and vector-borne zoonotic parasitic diseases.
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Affiliation(s)
- Anisuzzaman
- Department of Parasitology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh.
| | - Md Shahadat Hossain
- Department of Parasitology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Takeshi Hatta
- Department of Parasitology and Tropical Medicine, Kitasato University School of Medicine, Minami, Sagamihara, Kanagawa, Japan
| | - Sharmin Shahid Labony
- Department of Parasitology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Kofi Dadzie Kwofie
- Department of Parasitology and Tropical Medicine, Kitasato University School of Medicine, Minami, Sagamihara, Kanagawa, Japan; Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Hayato Kawada
- Department of Parasitology and Tropical Medicine, Kitasato University School of Medicine, Minami, Sagamihara, Kanagawa, Japan
| | - Naotoshi Tsuji
- Department of Parasitology and Tropical Medicine, Kitasato University School of Medicine, Minami, Sagamihara, Kanagawa, Japan.
| | - Md Abdul Alim
- Department of Parasitology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
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Stelzle D, Abraham A, Kaminski M, Schmidt V, De Meijere R, Bustos JA, Garcia HH, Sahu PS, Bobić B, Cretu C, Chiodini P, Dermauw V, Devleesschauwer B, Dorny P, Fonseca A, Gabriël S, Morales MÁG, Laranjo-González M, Hoerauf A, Hunter E, Jambou R, Jurhar-Pavlova M, Reiter-Owona I, Sotiraki S, Trevisan C, Vilhena M, Walker NF, Zammarchi L, Winkler AS. Clinical characteristics and management of neurocysticercosis patients: a retrospective assessment of case reports from Europe. J Travel Med 2023; 30:6759132. [PMID: 36222148 DOI: 10.1093/jtm/taac102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/15/2022] [Accepted: 08/30/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Neurocysticercosis (NCC) is a parasitic disease caused by the larval stage of the tapeworm Taenia solium. NCC mainly occurs in Africa, Latin America and South-East Asia and can cause a variety of clinical signs/symptoms. Although it is a rare disease in Europe, it should nonetheless be considered as a differential diagnosis. The aim of this study was to describe clinical characteristics and management of patients with NCC diagnosed and treated in Europe. METHODS We conducted a systematic search of published and unpublished data on patients diagnosed with NCC in Europe (2000-2019) and extracted demographic, clinical and radiological information on each case, if available. RESULTS Out of 293 identified NCC cases, 59% of patients presented initially with epileptic seizures (21% focal onset); 52% presented with headache and 54% had other neurological signs/symptoms. The majority of patients had a travel or migration history (76%), mostly from/to Latin America (38%), Africa (32%) or Asia (30%). Treatment varied largely depending on cyst location and number. The outcome was favorable in 90% of the cases. CONCLUSIONS Management of NCC in Europe varied considerably but often had a good outcome. Travel and migration to and from areas endemic for T. solium will likely result in continued low prevalence of NCC in Europe. Therefore, training and guidance of clinicians is recommended for optimal patient management.
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Affiliation(s)
- Dominik Stelzle
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
| | - Annette Abraham
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Miriam Kaminski
- Department of Psychiatry and Psychotherapy, Charité University Medical Center, Campus Benjamin Franklin, Berlin, Germany
| | - Veronika Schmidt
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Robert De Meijere
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
| | - Javier A Bustos
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Hector Hugo Garcia
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | | | - Branko Bobić
- Centre of Excellence for Food- and Vector-borne Zoonoses, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Carmen Cretu
- Department of Parasitology, Carol Davila University of Medicine, Bucharest, Romania
| | - Peter Chiodini
- Hospital for Tropical Diseases, University College London Hospitals, London, UK
- Diagnostic Parasitology Laboratory, London School of Hygiene and Tropical Medicine, London, UK
| | - Veronique Dermauw
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ana Fonseca
- Public Health Department, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Sarah Gabriël
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Maria Ángeles Gómez Morales
- Department of Infectious Diseases, European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy
| | - Minerva Laranjo-González
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la UAB, Bellaterra (Cerdanyola del Vallès), Spain
| | - Achim Hoerauf
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Ewan Hunter
- Department of Infection and Tropical Medicine, The Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ronan Jambou
- Global Health Department, Institut Pasteur, Paris, France
| | - Maja Jurhar-Pavlova
- Institute for Microbiology and Parasitology, Medical faculty, University "Ss. Cyril and Methodius", Skopje, Republic of North Macedonia
| | - Ingrid Reiter-Owona
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
| | - Smaragda Sotiraki
- Veterinary Research Institute, Hellenic Agricultural Organisation DIMITRA, Thessaloniki, Greece
| | - Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Manuela Vilhena
- MED-Instituto Mediterrâneo para a Agricultura, Ambiente e Desenvolvimento, Universidade de Évora, Évora, Portugal
| | - Naomi F Walker
- Hospital for Tropical Diseases, University College London Hospitals, London, UK
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Andrea Sylvia Winkler
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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11
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Li L, He W, Fan X, Liu M, Luo B, Yang F, Jiang N, Wang L, Zhou B. Proteomic analysis of Taenia solium cysticercus and adult stages. Front Vet Sci 2023; 9:934197. [PMID: 36699330 PMCID: PMC9868161 DOI: 10.3389/fvets.2022.934197] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 12/07/2022] [Indexed: 01/10/2023] Open
Abstract
Taenia solium (T. solium) cysticercosis is a neglected parasitic zoonosis that occurs in developing countries. Since T. solium has a complex life cycle that includes eggs, oncospheres, cysticerci, and adults, presumably many proteins are produced that enable them to survive and establish an infection within the host. The objectives of this study were to perform a comparative proteomic analysis of two ontogenetic stages of T. solium (cysticerci and adult) and to analyze their differential expression of proteins. Methods proteins were separated by High Performance Liquid Chromatography (HPLC) fractionation, and protein samples were also digested in liquid and identified by liquid chromatography tandem mass spectrometry (LC-MS/MS); the differentially expressed proteins were then processed by a bioinformatics analysis and verified by parallel reaction monitoring (PRM). Results we identified 2,481 proteins by label-free quantitative proteomics. Then differentially expressed proteins were screened under P values < 0.05 and 2 fold change, we found that 293 proteins up-regulated and 265 proteins down-regulated. Discussion through the bioinformatics analysis, we analyzed the differences types and functions of proteins in the Taenia solium and cysticercus, the data will provide reference value for studying the pathogenic mechanism of the two stages and the interaction with the host, and also support for further experimental verification.
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12
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Schneider-Crease IA, Feder JA, Baniel A, McCann C, Haile AA, Abebe B, Fitzgerald L, Gomery MA, Simberloff RA, Petrie ZL, Gabriel S, Dorny P, Fashing PJ, Nguyen N, Bergman TJ, Beehner JC, Snyder-Mackler N, Lu A. Urinary neopterin reflects immunological variation associated with age, helminth parasitism, and the microbiome in a wild primate. Sci Rep 2022; 12:21307. [PMID: 36494454 PMCID: PMC9734142 DOI: 10.1038/s41598-022-25298-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
Neopterin, a product of activated white blood cells, is a marker of nonspecific inflammation that can capture variation in immune investment or disease-related immune activity and can be collected noninvasively in urine. Mounting studies in wildlife point to lifetime patterns in neopterin related to immune development, aging, and certain diseases, but rarely are studies able to assess whether neopterin can capture multiple concurrent dimensions of health and disease in a single system. We assessed the relationship between urinary neopterin stored on filter paper and multiple metrics of health and disease in wild geladas (Theropithecus gelada), primates endemic to the Ethiopian highlands. We tested whether neopterin captures age-related variation in inflammation arising from developing immunity in infancy and chronic inflammation in old age, inflammation related to intramuscular tapeworm infection, helminth-induced anti-inflammatory immunomodulation, and perturbations in the gastrointestinal microbiome. We found that neopterin had a U-shaped relationship with age, no association with larval tapeworm infection, a negative relationship with metrics related to gastrointestinal helminth infection, and a negative relationship with microbial diversity. Together with growing research on neopterin and specific diseases, our results demonstrate that urinary neopterin can be a powerful tool for assessing multiple dimensions of health and disease in wildlife.
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Affiliation(s)
- India A Schneider-Crease
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA.
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA.
| | - Jacob A Feder
- Interdepartmental Doctoral Program in Anthropological Sciences, Stony Brook University, Stony Brook, NY, USA
| | - Alice Baniel
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA
- School of Life Sciences, Arizona State University, Tempe, AZ, USA
| | - Colleen McCann
- Department of Mammals, Bronx Zoo, Wildlife Conservation Society, New York, NY, USA
- New York Consortium in Evolutionary Primatology, New York, NY, USA
| | | | - Belayneh Abebe
- African Wildlife Foundation, Simien Mountains Landscape Conservation and Management Project, Debark, Ethiopia
| | | | - Megan A Gomery
- Simien Mountains Gelada Research Project, Debark, Ethiopia
| | - Ruth A Simberloff
- Department of Ecology and Evolutionary Biology, University of Tennessee, Knoxville, TN, USA
| | | | - Sarah Gabriel
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute for Tropical Medicine, Antwerp, Belgium
| | - Peter J Fashing
- Department of Anthropology, California State University Fullerton, Fullerton, CA, USA
- Centre for Ecological and Evolutionary Synthesis, Department of Biosciences, University of Oslo, Oslo, Norway
| | - Nga Nguyen
- Department of Anthropology, California State University Fullerton, Fullerton, CA, USA
- Centre for Ecological and Evolutionary Synthesis, Department of Biosciences, University of Oslo, Oslo, Norway
| | - Thore J Bergman
- Department of Ecology and Evolution, University of Michigan, Ann Arbor, MI, USA
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Jacinta C Beehner
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
- Department of Anthropology, University of Michigan, Ann Arbor, MI, USA
| | - Noah Snyder-Mackler
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA
- School of Life Sciences, Arizona State University, Tempe, AZ, USA
| | - Amy Lu
- Department of Anthropology, Stony Brook University, Stony Brook, NY, USA
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13
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Dixon MA, Winskill P, Harrison WE, Whittaker C, Schmidt V, Flórez Sánchez AC, Cucunuba ZM, Edia-Asuke AU, Walker M, Basáñez MG. Global variation in force-of-infection trends for human T aenia solium taeniasis/cysticercosis. eLife 2022; 11:76988. [PMID: 35984416 PMCID: PMC9391040 DOI: 10.7554/elife.76988] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 08/07/2022] [Indexed: 12/01/2022] Open
Abstract
Infection by Taenia solium poses a major burden across endemic countries. The World Health Organization (WHO) 2021–2030 Neglected Tropical Diseases roadmap has proposed that 30% of endemic countries achieve intensified T. solium control in hyperendemic areas by 2030. Understanding geographical variation in age-prevalence profiles and force-of-infection (FoI) estimates will inform intervention designs across settings. Human taeniasis (HTT) and human cysticercosis (HCC) age-prevalence data from 16 studies in Latin America, Africa, and Asia were extracted through a systematic review. Catalytic models, incorporating diagnostic performance uncertainty, were fitted to the data using Bayesian methods, to estimate rates of antibody (Ab)-seroconversion, infection acquisition and Ab-seroreversion or infection loss. HCC FoI and Ab-seroreversion rates were also estimated across 23 departments in Colombia from 28,100 individuals. Across settings, there was extensive variation in all-ages seroprevalence. Evidence for Ab-seroreversion or infection loss was found in most settings for both HTT and HCC and for HCC Ab-seroreversion in Colombia. The average duration until humans became Ab-seropositive/infected decreased as all-age (sero)prevalence increased. There was no clear relationship between the average duration humans remain Ab-seropositive and all-age seroprevalence. Marked geographical heterogeneity in T. solium transmission rates indicate the need for setting-specific intervention strategies to achieve the WHO goals.
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Affiliation(s)
- Matthew A Dixon
- Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research (LCNTDR), Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom.,MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom.,SCI Foundation, Edinburgh House, London, United Kingdom
| | - Peter Winskill
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | | | - Charles Whittaker
- Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research (LCNTDR), Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom.,MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Veronika Schmidt
- Department of Neurology, Center for Global Health, Technical University Munich (TUM), Munich, Germany.,Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | | | - Zulma M Cucunuba
- Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research (LCNTDR), Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom.,MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | | | - Martin Walker
- Department of Pathobiology and Population Sciences and London Centre for Neglected Tropical Disease Research (LCNTDR), Royal Veterinary College, Hatfield, United Kingdom
| | - María-Gloria Basáñez
- Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research (LCNTDR), Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom.,MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
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14
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Prodjinotho UF, Gres V, Henkel F, Lacorcia M, Dandl R, Haslbeck M, Schmidt V, Winkler AS, Sikasunge C, Jakobsson PJ, Henneke P, Esser-von Bieren J, Prazeres da Costa C. Helminthic dehydrogenase drives PGE 2 and IL-10 production in monocytes to potentiate Treg induction. EMBO Rep 2022; 23:e54096. [PMID: 35357743 PMCID: PMC9066053 DOI: 10.15252/embr.202154096] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/02/2022] [Accepted: 03/14/2022] [Indexed: 01/03/2023] Open
Abstract
Immunoregulation of inflammatory, infection‐triggered processes in the brain constitutes a central mechanism to control devastating disease manifestations such as epilepsy. Observational studies implicate the viability of Taenia solium cysts as key factor determining severity of neurocysticercosis (NCC), the most common cause of epilepsy, especially in children, in Sub‐Saharan Africa. Viable, in contrast to decaying, cysts mostly remain clinically silent by yet unknown mechanisms, potentially involving Tregs in controlling inflammation. Here, we show that glutamate dehydrogenase from viable cysts instructs tolerogenic monocytes to release IL‐10 and the lipid mediator PGE2. These act in concert, converting naive CD4+ T cells into CD127−CD25hiFoxP3+CTLA‐4+ Tregs, through the G protein‐coupled receptors EP2 and EP4 and the IL‐10 receptor. Moreover, while viable cyst products strongly upregulate IL‐10 and PGE2 transcription in microglia, intravesicular fluid, released during cyst decay, induces pro‐inflammatory microglia and TGF‐β as potential drivers of epilepsy. Inhibition of PGE2 synthesis and IL‐10 signaling prevents Treg induction by viable cyst products. Harnessing the PGE2‐IL‐10 axis and targeting TGF‐ß signaling may offer an important therapeutic strategy in inflammatory epilepsy and NCC.
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Affiliation(s)
- Ulrich Fabien Prodjinotho
- Institute for Medical Microbiology, Immunology and Hygiene, TUM School of Medicine, Technical University of Munich (TUM), Munich, Germany.,Center for Global Health, TUM School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Vitka Gres
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fiona Henkel
- Center of Allergy and Environment (ZAUM), Technical University of Munich and Helmholtz Center Munich, Munich, Germany
| | - Matthew Lacorcia
- Institute for Medical Microbiology, Immunology and Hygiene, TUM School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Ramona Dandl
- Department of Chemistry, Technical University Munich (TUM), Garching, Germany
| | - Martin Haslbeck
- Department of Chemistry, Technical University Munich (TUM), Garching, Germany
| | - Veronika Schmidt
- Center for Global Health, TUM School of Medicine, Technical University of Munich (TUM), Munich, Germany.,Department of Neurology, University Hospital, Klinikum rechts der Isar, Technical University Munich (TUM), Munich, Germany.,Center for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Andrea Sylvia Winkler
- Center for Global Health, TUM School of Medicine, Technical University of Munich (TUM), Munich, Germany.,Department of Neurology, University Hospital, Klinikum rechts der Isar, Technical University Munich (TUM), Munich, Germany.,Center for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Chummy Sikasunge
- Department of Paraclinicals, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Per-Johan Jakobsson
- Rheumatology Unit, Department of Medicine, Solna, Karolinska University Hospital, Stockholm, Sweden
| | - Philipp Henneke
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Pediatrics and Adolescent Medicine, Medical Center, University of Freiburg, Freiburg, Germany.,Centre for Integrative Biological Signalling Studies, University of Freiburg, Freiburg, Germany
| | - Julia Esser-von Bieren
- Center of Allergy and Environment (ZAUM), Technical University of Munich and Helmholtz Center Munich, Munich, Germany
| | - Clarissa Prazeres da Costa
- Institute for Medical Microbiology, Immunology and Hygiene, TUM School of Medicine, Technical University of Munich (TUM), Munich, Germany.,Center for Global Health, TUM School of Medicine, Technical University of Munich (TUM), Munich, Germany.,German Center for Infection and Research (DZIF), Munich, Germany
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15
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Spatial distribution and risk factors for human cysticercosis in Colombia. Parasit Vectors 2021; 14:590. [PMID: 34838117 PMCID: PMC8626945 DOI: 10.1186/s13071-021-05092-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background Cysticercosis is a zoonotic neglected tropical disease (NTD) that affects humans and pigs following the ingestion of Taenia solium eggs. Human cysticercosis poses a substantial public health burden in endemic countries. The World Health Organization (WHO) aims to target high-endemicity settings with enhanced interventions in 17 countries by 2030. Between 2008 and 2010, Colombia undertook a national baseline serosurvey of unprecedented scale, which led to an estimated seroprevalence of T. solium cysticercus antibodies among the general population of 8.6%. Here, we use contemporary geostatistical approaches to analyse this unique dataset with the aim of understanding the spatial distribution and risk factors associated with human cysticercosis in Colombia to inform how best to target intervention strategies. Methods We used a geostatistical model to estimate individual and household risk factors associated with seropositivity to T. solium cysticercus antibodies from 29,253 people from 133 municipalities in Colombia. We used both independent and spatially structured random effects at neighbourhood/village and municipality levels to account for potential clustering of exposure to T. solium. We present estimates of the distribution and residual correlation of seropositivity at the municipality level. Results High seroprevalence was identified in municipalities located in the north and south of Colombia, with spatial correlation in seropositivity estimated up to approximately 140 km. Statistically significant risk factors associated with seropositivity to T. solium cysticercus were related to age, sex, educational level, socioeconomic status, use of rainwater, consumption of partially cooked/raw pork meat and possession of dogs. Conclusions In Colombia, the distribution of human cysticercosis is influenced by socioeconomic considerations, education and environmental factors related to the spread of T. solium eggs. This information can be used to tailor national intervention strategies, such as targeting spatial hotspots and more highly exposed groups, including displaced people and women. Large-scale seroprevalence surveys accompanied by geospatial mapping are an essential step towards reaching the WHO’s 2021‒2030 NTD roadmap targets. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-05092-8.
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16
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Fan X, Zhang Y, Ouyang R, Luo B, Li L, He W, Liu M, Jiang N, Yang F, Wang L, Zhou B. Cysticercus cellulosae Regulates T-Cell Responses and Interacts With the Host Immune System by Excreting and Secreting Antigens. Front Cell Infect Microbiol 2021; 11:728222. [PMID: 34540719 PMCID: PMC8447960 DOI: 10.3389/fcimb.2021.728222] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/06/2021] [Indexed: 11/26/2022] Open
Abstract
Cysticercus cellulosae (C. cellulosae) excretes and secretes antigens during the parasitic process to regulate the host immune response; however, resulting immune response and cytokine production in the host during infection still remains unclear. We used C. cellulosae crude antigens (CAs) as controls to explore the effect of excretory secretory antigens (ESAs) on T-cell immune responses in piglets. C. cellulosae ESAs induced imbalanced CD4+/CD8+ T-cell proportions, increased the CD4+Foxp3+ and CD8+Foxp3+ T-cell frequencies, and induced lymphocytes to produce interleukin-10, which was mainly attributed to CD4+ and CD4-CD8- T cells. The ESAs also induced Th2-type immune responses. The results showed that the ability of C. cellulosae to escape the host immune attacks and establish a persistent infection may be related to host immune response regulation by the ESAs.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Biying Zhou
- Department of Parasitology, School of Basic Medical Sciences, Zunyi Medical University, Zunyi, China
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17
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Foodborne Parasitic Diseases in the Neotropics - A Review. Helminthologia 2021; 58:119-133. [PMID: 34248373 PMCID: PMC8256457 DOI: 10.2478/helm-2021-0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/08/2021] [Indexed: 12/20/2022] Open
Abstract
Within the Universal Declaration of Human Rights, it is stated that everyone has the right to an adequate standard of living, which ensures, as well as their family, health and well-being, and food, thereby ensuring adequate nutrition. One of the major threats to overcome this is to ensure food security, which becomes particularly challenging in developing countries due to the high incidence of parasitic diseases. The World Health Organization (WHO), considers it one of the main causes of morbidity, closely linked to poverty and related to inadequate personal hygiene, consumption of raw food, lack of sanitary services, limited access to drinking water and fecal contamination in the environment. It is estimated that more than a fifth of the world’s population is infected by one or several intestinal parasites, and that in many countries of Central and South America the average percentage of infected people is 45%, being Taenia solium, Echinococcus granulosus, Toxoplasma gondii, Cryptosporidium spp, Entamoeba histolytica, Trichinella spiralis, Ascaris spp, Trypanosoma cruzi and Fasciola hepatica some of the most important ones in the neotropics. One of the main reasons why these diseases are diffi cult to control is t he ignorance of their lifecycles, as well as symptoms and current epidemiology of the disease, which contributes to a late or erroneous diagnosis. The present work aims to discuss and make public the current knowledge as well as the general characteristics of these diseases to the general audience.
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18
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Dixon MA, Winskill P, Harrison WE, Basáñez MG. Taenia solium taeniasis/cysticercosis: From parasite biology and immunology to diagnosis and control. ADVANCES IN PARASITOLOGY 2021; 112:133-217. [PMID: 34024358 DOI: 10.1016/bs.apar.2021.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Infection with the pork tapeworm (Taenia solium) is responsible for a substantial global burden of disease, not only restricted to its impact on human health, but also resulting in a considerable economic burden to smallholder pig farmers due to pig cysticercosis infection. The life-cycle, parasitology and immunology of T. solium are complex, involving pigs (the intermediate host, harbouring the larval metacestode stage), humans (the definitive host, harbouring the adult tapeworm, in addition to acting as accidental intermediate hosts) and the environment (the source of infection with eggs/proglottids). We review the parasitology, immunology, and epidemiology of the infection associated with each of the T. solium life-cycle stages, including the pre-adult/adult tapeworm responsible for human taeniasis; post-oncosphere and cysticercus associated with porcine and human cysticercosis, and the biological characteristics of eggs in the environment. We discuss the burden associated, in endemic settings, with neurocysticercosis (NCC) in humans, and the broader cross-sectoral economic impact associated both with NCC and porcine cysticercosis, the latter impacting food-value chains. Existing tools for diagnostics and control interventions that target different stages of the T. solium transmission cycle are reviewed and their limitations discussed. Currently, no national T. solium control programmes have been established in endemic areas, with further work required to identify optimal strategies according to epidemiological setting. There is increasing evidence suggesting that cross-sectoral interventions which target the parasite in both the human and pig host provide the most effective approaches for achieving control and ultimately elimination. We discuss future avenues for research on T. solium to support the attainment of the goals proposed in the revised World Health Organisation neglected tropical diseases roadmap for 2021-2030 adopted at the 73rd World Health Assembly in November 2020.
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Affiliation(s)
- Matthew A Dixon
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom; Schistosomiasis Control Initiative Foundation (SCI Foundation), London, United Kingdom
| | - Peter Winskill
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Wendy E Harrison
- Schistosomiasis Control Initiative Foundation (SCI Foundation), London, United Kingdom
| | - Maria-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom.
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19
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Abraham A, Bustos JA, Carabin H, de Meijere R, Sahu PS, Rajshekhar V, Singh G, White AC, Chiodini PL, Gabriël S, Homeida M, Nash T, Ngowi B, Zhou XN, Coyle C, Garcia HH, Winkler AS. The effectiveness of anti-inflammatory and anti-seizure medication for individuals with single enhancing lesion neurocysticercosis: A meta-analysis and expert group-based consensus recommendations. PLoS Negl Trop Dis 2021; 15:e0009193. [PMID: 33788843 PMCID: PMC8057605 DOI: 10.1371/journal.pntd.0009193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 04/20/2021] [Accepted: 02/02/2021] [Indexed: 11/18/2022] Open
Abstract
Single brain enhancing lesions (SEL) are the most common presentation of neurocysticercosis (NCC) observed on neuroimaging in people presenting with epileptic seizures not only on the Indian sub-continent and in travelers returning from cysticercosis-endemic regions, but are also present in other parts of the world. The aim of this study, which consisted of a systematic review (CRD42019087665), a meta-analysis and an expert group consultation, was to reach consensus on the best anti-seizure medication and anti-inflammatory treatment for individuals with SEL NCC. Standard literature review methods were used. The Cochrane risk of bias tool was used and random effects model meta-analyses were performed. The quality of the body of evidence was rated using GRADE tables. The expert committee included 12 gender and geographically balanced members and recommendations were reached by applying the GRADE framework for guideline development. The 1-1.5-year cumulative incidence of seizure recurrence, cyst resolution or calcification following anti-seizure medication (ASM) withdrawal was not statistically different between ASM of 6, 12 or 24 months. In contrast, in persons whose cyst calcified post treatment, longer ASM decreased seizure recurrence. The cumulative incidence ratio (CIR) 1-1.5 years after stopping ASM was 1.79 95% CI: (1.00, 3.20) for patients given 6 versus 24 months treatment. Anti-inflammatory treatment with corticosteroids in patients treated with ASM compared to patients treated with ASM only showed a statistically significant beneficial effect on seizure reduction (CIR 0.44, 95% CI 0.23, 0.85) and cyst resolution (CIR 1.37, 95%CI: 1.07, 1.75). Our results indicate that ASM in patients with SEL NCC whose cysts resolved can be withdrawn, while patients whose cysts calcified seem to benefit from prolonged anti-seizure medication. Additional corticosteroid treatment was found to have a beneficial effect both on seizure reduction and cyst resolution.
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Affiliation(s)
- Annette Abraham
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Javier A. Bustos
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru, and Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Hélène Carabin
- Département de Pathologie et de Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Canada
- Département de médecine sociale et préventive, École de santé publique, université de Montréal, Montréal, Canada
- Centre de Recherche en Santé Publique de l’Université de Montréal et du Centre Intégré Universitaire de Santé et des Services Sociaux de sud de l’île de Montréal, Montréal, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Montréal, Canada
| | - Robert de Meijere
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
| | - Priyadarshi S. Sahu
- Department of Microbiology & Immunology, Medical University of the Americas, Nevis, West Indies
| | - Vedantam Rajshekhar
- Department of Neurological Sciences, Christian Medical College, Vellore, India
| | | | - A. Clinton White
- Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Peter L. Chiodini
- Hospital for Tropical Diseases and the London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Mamoun Homeida
- University of Medical Sciences and Technology, Khartoum, Sudan
| | - Theodore Nash
- Laboratory of Parasitic Diseases, National Institutes of Allergy and Infectious Diseases, National Institute of Health, United States of America
| | - Bernard Ngowi
- National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania
- University of Dar es Salaam, Mbeya College of Health and Allied Sciences, Mbeya, Tanzania
| | - Xiao Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China
| | - Christina Coyle
- Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Hector H. Garcia
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru, and Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Andrea S. Winkler
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany
- Centre for Global Health, Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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Porras-Silesky C, Mejías-Alpízar MJ, Mora J, Baneth G, Rojas A. Spirocerca lupi Proteomics and Its Role in Cancer Development: An Overview of Spirocercosis-Induced Sarcomas and Revision of Helminth-Induced Carcinomas. Pathogens 2021; 10:pathogens10020124. [PMID: 33530324 PMCID: PMC7911836 DOI: 10.3390/pathogens10020124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 12/19/2022] Open
Abstract
Spirocerca lupi is a parasitic nematode of canids that induces a myriad of clinical manifestations in its host and, in 25% of infections, leads to the formation of sarcomas. The description of the protein composition of the excretory and secretory products (Sl-ESP) of S. lupi has shed light on its possible interactions with the host environment, including migration within the host and mechanisms of immunomodulation. Despite this, the process by which S. lupi induces cancer in the dog remains poorly understood, and some hypotheses have arisen regarding these possible mechanisms. In this review, we discuss the role of specific ESP from the carcinogenic helminths Clonorchis sinensis, Opisthorchis viverrini and Schistosoma haematobium in inducing chronic inflammation and cancer in their host’s tissues. The parasitic worms Taenia solium, Echinococcus granulosus, Heterakis gallinarum, Trichuris muris and Strongyloides stercoralis, which have less-characterized mechanisms of cancer induction, are also analyzed. Based on the pathological findings in spirocercosis and the mechanisms by which other parasitic helminths induce cancer, we propose that the sustained inflammatory response in the dog´s tissues produced in response to the release of Sl-ESP homologous to those of other carcinogenic worms may lead to the malignant process in infected dogs.
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Affiliation(s)
- Catalina Porras-Silesky
- Laboratory of Helminthology, Centro de Investigación en Enfermedades Tropicales, University of Costa Rica, 11501-2060 San José, Costa Rica; (C.P.-S.); (M.J.M.-A.); (J.M.)
| | - María José Mejías-Alpízar
- Laboratory of Helminthology, Centro de Investigación en Enfermedades Tropicales, University of Costa Rica, 11501-2060 San José, Costa Rica; (C.P.-S.); (M.J.M.-A.); (J.M.)
| | - Javier Mora
- Laboratory of Helminthology, Centro de Investigación en Enfermedades Tropicales, University of Costa Rica, 11501-2060 San José, Costa Rica; (C.P.-S.); (M.J.M.-A.); (J.M.)
| | - Gad Baneth
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot 7610001, Israel;
| | - Alicia Rojas
- Laboratory of Helminthology, Centro de Investigación en Enfermedades Tropicales, University of Costa Rica, 11501-2060 San José, Costa Rica; (C.P.-S.); (M.J.M.-A.); (J.M.)
- Correspondence: ; Tel.: +506-2511-8644
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21
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Marinho GLDOC, Schwarz DGG, Trigo BB, Nunes CM, Romeiro ET, de Azevedo EO, da Silva JEM, Farias MPO, Oliveira JF, Faustino MADG. Swine cysticercosis and associated risk factors in non-technified pig breeding in semi-arid region of Sergipe state, Brazil. Trop Anim Health Prod 2020; 53:37. [PMID: 33230578 DOI: 10.1007/s11250-020-02441-0] [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: 07/14/2020] [Accepted: 10/14/2020] [Indexed: 11/26/2022]
Abstract
The aim of this study was to determine the frequency of Taenia solium anti-metacestode antibodies in slaughtered pigs in a semi-arid region of the "Alto Sertão" of Sergipe state, Brazil, and verify the risk factors associated with swine cysticercosis. For this, 230 samples of swine blood from two slaughterhouses were collected and analyzed by indirect ELISA. The pigs came from five non-technical properties in the semi-arid region of the Alto Sertão of Sergipe state. Searches for cysts in the skeletal muscles of the pigs were performed during slaughter. In addition, an epidemiological questionnaire was applied to the pigs' original properties to determine risk factors. Besides that, the official health services database was evaluated for confirmed cases of neurocysticercosis and taeniasis in humans in the last 5 years, living in the studied region. Seropositivity in pigs was 12.6%, with no significant difference between males and females. No cysts were found in the carcasses of the slaughtered pigs. A positive association was found for properties that discharge domestic sewage into the environment, in river or streams, increasing the risk of positivity by 5.72 times. When analyzing the database of official agencies, there were no records of cases of neurocysticercosis or taeniasis in the resident population in the last 5 years. However, there were frequent cases of idiopathic epilepsy. The results demonstrate that study area is endemic for swine cysticercosis and serves as a warning of the possibility of the occurrence of the taeniasis-cysticercosis complex.
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Affiliation(s)
- Glenda Lídice de O C Marinho
- Veterinary Medicine, Universidade Federal do Piauí (UFPI), Campus Professora Cinobelina Elvas (CPCE), Bom Jesus, PI, Brazil.
| | - David Germano G Schwarz
- Veterinary Medicine, Universidade Federal do Piauí (UFPI), Campus Professora Cinobelina Elvas (CPCE), Bom Jesus, PI, Brazil
| | - Beatriz B Trigo
- Faculdade de Medicina Veterinária, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Aracatuba, SP, Brazil
| | - Caris M Nunes
- Faculdade de Medicina Veterinária, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Aracatuba, SP, Brazil
| | - Edenilze T Romeiro
- Department of Veterinary Medicine, Universidade Federal Rural de Pernambuco (UFRPE), Recife, PE, Brazil
| | | | | | - Márcia Paula O Farias
- Veterinary Medicine, Universidade Federal do Piauí (UFPI), Campus Professora Cinobelina Elvas (CPCE), Bom Jesus, PI, Brazil
| | - Juliana F Oliveira
- Instituto Federal de Educação, Ciência e Tecnologia de Minas Gerais, IFMG - Campus Avançado Ponte Nova, Ponte Nova, Minas Gerais, Brazil
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Garcia HH, Gonzalez AE, Gilman RH. Taenia solium Cysticercosis and Its Impact in Neurological Disease. Clin Microbiol Rev 2020; 33:e00085-19. [PMID: 32461308 PMCID: PMC7254859 DOI: 10.1128/cmr.00085-19] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Taenia solium neurocysticercosis (NCC) is endemic in most of the world and contributes significantly to the burden of epilepsy and other neurological morbidity. Also present in developed countries because of immigration and travel, NCC is one of few diseases targeted for eradication. This paper reviews all aspects of its life cycle (taeniasis, porcine cysticercosis, human cysticercosis), with a focus on recent advances in its diagnosis, management, and control. Diagnosis of taeniasis is limited by poor availability of immunological or molecular assays. Diagnosis of NCC rests on neuroimaging findings, supported by serological assays. The treatment of NCC should be approached in the context of the particular type of infection (intra- or extraparenchymal; number, location, and stage of lesions) and has evolved toward combined symptomatic and antiparasitic management, with particular attention to modulating inflammation. Research on NCC and particularly the use of recently available genome data and animal models of infection should help to elucidate mechanisms of brain inflammation, damage, and epileptogenesis.
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Affiliation(s)
- Hector H Garcia
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Armando E Gonzalez
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Robert H Gilman
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
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23
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Gondim BLC, da Silva Catarino J, de Sousa MAD, de Oliveira Silva M, Lemes MR, de Carvalho-Costa TM, de Lima Nascimento TR, Machado JR, Rodrigues V, Oliveira CJF, Cançado Castellano LR, da Silva MV. Nanoparticle-Mediated Drug Delivery: Blood-Brain Barrier as the Main Obstacle to Treating Infectious Diseases in CNS. Curr Pharm Des 2020; 25:3983-3996. [PMID: 31612822 DOI: 10.2174/1381612825666191014171354] [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: 08/06/2019] [Accepted: 09/19/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Parasitic infections affecting the central nervous system (CNS) present high morbidity and mortality rates and affect millions of people worldwide. The most important parasites affecting the CNS are protozoans (Plasmodium sp., Toxoplasma gondii, Trypanosoma brucei), cestodes (Taenia solium) and free-living amoebae (Acantamoeba spp., Balamuthia mandrillaris and Naegleria fowleri). Current therapeutic regimens include the use of traditional chemicals or natural compounds that have very limited access to the CNS, despite their elevated toxicity to the host. Improvements are needed in drug administration and formulations to treat these infections and to allow the drug to cross the blood-brain barrier (BBB). METHODS This work aims to elucidate the recent advancements in the use of nanoparticles as nanoscaled drug delivery systems (NDDS) for treating and controlling the parasitic infections that affect the CNS, addressing not only the nature and composition of the polymer chosen, but also the mechanisms by which these nanoparticles may cross the BBB and reach the infected tissue. RESULTS There is a strong evidence in the literature demonstrating the potential usefulness of polymeric nanoparticles as functional carriers of drugs to the CNS. Some of them demonstrated the mechanisms by which drugloaded nanoparticles access the CNS and control the infection by using in vivo models, while others only describe the pharmacological ability of these particles to be utilized in in vitro environments. CONCLUSION The scarcity of the studies trying to elucidate the compatibility as well as the exact mechanisms by which NDDS might be entering the CNS infected by parasites reveals new possibilities for further exploratory projects. There is an urgent need for new investments and motivations for applying nanotechnology to control parasitic infectious diseases worldwide.
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Affiliation(s)
- Brenna Louise Cavalcanti Gondim
- Human Immunology Research and Education Group-GEPIH, Technical School of Health, Federal University of Paraiba, Joao Pessoa, Paraiba, Brazil.,Post-Graduation Program in Dentistry, Department of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil
| | - Jonatas da Silva Catarino
- Department of Microbiology, Immunology and Parasitology, Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
| | | | - Mariana de Oliveira Silva
- Department of Microbiology, Immunology and Parasitology, Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Marcela Rezende Lemes
- Department of Microbiology, Immunology and Parasitology, Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
| | | | - Tatiana Rita de Lima Nascimento
- Human Immunology Research and Education Group-GEPIH, Technical School of Health, Federal University of Paraiba, Joao Pessoa, Paraiba, Brazil
| | - Juliana Reis Machado
- Department of Pathology, Genetics and Evolution, Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Virmondes Rodrigues
- Department of Microbiology, Immunology and Parasitology, Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Carlo José Freire Oliveira
- Department of Microbiology, Immunology and Parasitology, Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Lúcio Roberto Cançado Castellano
- Human Immunology Research and Education Group-GEPIH, Technical School of Health, Federal University of Paraiba, Joao Pessoa, Paraiba, Brazil
| | - Marcos Vinicius da Silva
- Department of Microbiology, Immunology and Parasitology, Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil
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Zoonotic and vector-borne parasites and epilepsy in low-income and middle-income countries. Nat Rev Neurol 2020; 16:333-345. [PMID: 32427939 DOI: 10.1038/s41582-020-0361-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2020] [Indexed: 12/22/2022]
Abstract
Zoonotic and vector-borne parasites are important preventable risk factors for epilepsy. Three parasitic infections - cerebral malaria, Taenia solium cysticercosis and onchocerciasis - have an established association with epilepsy. Parasitoses are widely prevalent in low-income and middle-income countries, which are home to 80% of the people with epilepsy in the world. Once a parasitic infection has taken hold in the brain, therapeutic measures do not seem to influence the development of epilepsy in the long term. Consequently, strategies to control, eliminate and eradicate parasites represent the most feasible way to reduce the epilepsy burden at present. The elucidation of immune mechanisms underpinning the parasitic infections, some of which are parasite-specific, opens up new therapeutic possibilities. In this Review, we explore the pathophysiological basis of the link between parasitic infections and epilepsy, and we consider preventive and therapeutic approaches to reduce the burden of epilepsy attributable to parasitic disorders. We conclude that a concerted approach involving medical, veterinary, parasitological and ecological experts, backed by robust political support and sustainable funding, is the key to reducing this burden.
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25
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Abstract
Taenia solium cysticercosis and taeniasis (TSCT), caused by the tapeworm T. solium, is a foodborne and zoonotic disease classified since 2010 by WHO as a neglected tropical isease. It causes considerable impact on health and economy and is one of the leading causes of acquired epilepsy in most endemic countries of Latin America, Sub-Saharan Africa, and Asia. There is some evidence that the prevalence of TSCT in high-income countries has recently increased, mainly due to immigration from endemic areas. In regions endemic for TSCT, human cysticercosis can manifest clinically as neurocysticercosis (NCC), resulting in epileptic seizures and severe progressive headaches, amongst other neurological signs and/or symptoms. The development of these symptoms results from a complex interplay between anatomical cyst localization, environmental factors, parasite's infective potential, host genetics, and, especially, host immune responses. Treatment of individuals with active NCC (presence of viable cerebral cysts) with anthelmintic drugs together with steroids is usually effective and, in the majority, reduces the number and/or size of cerebral lesions as well as the neurological symptoms. However, in some cases, treatment may profoundly enhance anthelmintic inflammatory responses with ensuing symptoms, which, otherwise, would have remained silent as long as the cysts are viable. This intriguing silencing process is not yet fully understood but may involve active modulation of host responses by cyst-derived immunomodulatory components released directly into the surrounding brain tissue or by the induction of regulatory networks including regulatory T cells (Treg) or regulatory B cells (Breg). These processes might be disturbed once the cysts undergo treatment-induced apoptosis and necrosis or in a coinfection setting such as HIV. Herein, we review the current literature regarding the immunology and pathogenesis of NCC with a highlight on the mobilization of immune cells during human NCC and their interaction with viable and degenerating cysticerci. Moreover, the immunological parameters associated with NCC in people living with HIV/AIDS and treatments are discussed. Eventually, we propose open questions to understand the role of the immune system and its impact in this intriguing host-parasite crosstalk.
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26
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Neurocysticercosis Among Zambian Children and Adolescents With Human Immunodeficiency Virus: A Geographic Information Systems Approach. Pediatr Neurol 2020; 102:36-43. [PMID: 31492585 PMCID: PMC7864625 DOI: 10.1016/j.pediatrneurol.2019.07.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/27/2019] [Accepted: 07/29/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Neurocysticercosis is the most common parasitic infection of the brain and a leading cause of epilepsy in resource-limited settings. Although neurocysticercosis and human immunodeficiency virus coinfections have commonly been reported, there are few data on how they interact. As part of an observational study of human immunodeficiency virus and cognition in Lusaka, Zambia, we identified a cluster of subjects with neurocysticercosis. We hypothesized that the neighborhood of residence may be an important factor driving clustering of neurocysticercosis and used a geographic information systems approach to investigate this association. METHODS A total of 34 subjects with human immunodeficiency virus and 13 subjects without human immunodeficiency virus (aged eight to 17 years) enrolled in the HIV-Associated Neurocognitive Disorders in Zambia study, had magnetic resonance imaging of the brain performed, and were evaluated for neurocysticercosis. Quantitative geographic information systems was utilized to investigate the relationship between neighborhood of residence, HIV, and neurocysticercosis. RESULTS Three of 34 subjects with human immunodeficiency virus (8.82%) and one of 13 controls were found to have neurocysticercosis. Geographic cluster analysis demonstrated that all subjects with neurocysticercosis were clustered in two adjacent neighborhoods (Chawama and Kanyama) with lower rates of piped water (Chawama: 22.8%, Kanyama: 26.7%) and flush toilets (Chawama: 14.0%, Kanyama: 14.0%) than the surrounding neighborhoods. CONCLUSION We describe a cluster of patients with both neurocysticercosis and human immunodeficiency virus in Lusaka. Cases of neurocysticercosis clustered in neighborhoods with low rates of piped water and limited access to flush toilets. Geographic information systems may be a useful approach for studying the relationship between human immunodeficiency virus and neurocysticercosis. Larger studies are necessary to further investigate this association.
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27
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Akyeampong A, Solomon N, Boire NA, Baqui AA. Cryptococcal Meningitis Presenting as New-Onset Seizures in an Immunocompetent Patient. J Investig Med High Impact Case Rep 2019; 7:2324709619861129. [PMID: 31353954 PMCID: PMC6661782 DOI: 10.1177/2324709619861129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This report describes a 30-year-old immunocompetent male with new-onset seizures, later found on imaging to have 2 enhancing lesions in the brain. The patient underwent a left parietal craniectomy with resection of one of the masses, which demonstrated focal areas of necrosis and many small cystic structures positive for periodic acid-Schiff and Gomori's methenamine silver special stain. Numerous laboratory examinations, including HIV test, rapid plasma reagin, toxoplasma immunoglobulin G and immunoglobulin M, Lyme, cytomegalovirus, tuberculosis, cysticercosis, and Echinococcus serology, were all negative. Despite negative cerebrospinal fluid (CSF) culture and several negative CSF antigen tests, continued investigation, and follow-up, CSF antigen testing ultimately revealed Cryptococcus as the causative agent. In light of the mysterious and unusual presentation, the authors discuss potential infectious differential diagnoses in patients with atypical clinical presentation, laboratory tests, and surgical pathology.
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Affiliation(s)
| | | | | | - Aam A Baqui
- 2 The Brooklyn Hospital Center, Brooklyn, NY, USA
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28
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Zhou H, Wang Q, Zhou J, Li T, Medina A, Felt SA, Rozelle S, Openshaw JJ. Structural Equation Modeling (SEM) of Cysticercosis in School-Aged Children in Tibetan Rural Farming Areas of Western China: Implications for Intervention Planning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050780. [PMID: 30836642 PMCID: PMC6427563 DOI: 10.3390/ijerph16050780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/26/2019] [Accepted: 02/28/2019] [Indexed: 11/17/2022]
Abstract
Neurocysticercosis (NCC) significantly contributes to morbidity in developing countries. We recently published a study of prevalence and risk factors in school-aged children in three mountainous areas in Sichuan province of western China. Using structural equation modeling (SEM) on data from that study to guide intervention planning, here we examine risk factors grouped into three broad interventional categories: sociodemographics, human behavior, and sources of pork and pig husbandry. Because neuroimaging is not easily available, using SEM allows for the use of multiple observed variables (serological tests and symptoms) to represent probable NCC cases. Data collected from 2608 students was included in this analysis. Within this group, seroprevalence of cysticercosis IgG antibodies was 5.4%. SEM results showed that sociodemographic factors (β = 0.33, p < 0.05), sources of pork and pig husbandry (β = 0.26, p < 0.001), and behavioral factors (β = 0.33, p < 0.05) were all directly related to probable NCC in school-aged children. Sociodemographic factors affected probable NCC indirectly via sources of pork and pig husbandry factors (β = 0.07, p < 0.001) and behavioral variables (β = 0.07, p < 0.001). Both sociodemographic factors (β = 0.07, p < 0.05) and sources of pork and pig husbandry factors (β = 0.10, p < 0.01) affected probable NCC indirectly via behavioral variables. Because behavioral variables not only had a large direct effect but also served as a critical bridge to strengthen the effect of sociodemographics and sources of pork and pig husbandry on probable NCC, our findings suggest that interventions targeting behavioral factors may be the most effective in reducing disease.
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Affiliation(s)
- Huan Zhou
- West China School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Qingzhi Wang
- West China School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Junmin Zhou
- West China School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Tiaoying Li
- Institute of Parasitic Diseases, Sichuan Centers for Disease Control and Prevention, Chengdu 610041, China.
| | - Alexis Medina
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA 94305, USA.
| | - Stephen A Felt
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
| | - Scott Rozelle
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA 94305, USA.
| | - John J Openshaw
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA.
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29
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León-Janampa N, Liendo R, Gilman RH, Padilla C, García HH, Gonzales A, Sheen P, Pajuelo MJ, Zimic M. Characterization of a novel cathepsin L-like protease from Taenia solium metacestodes for the immunodiagnosis of porcine cysticercosis. Vet Parasitol 2019; 267:9-16. [PMID: 30878092 PMCID: PMC7010362 DOI: 10.1016/j.vetpar.2019.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 01/12/2019] [Accepted: 01/14/2019] [Indexed: 11/19/2022]
Abstract
Porcine cysticercosis is an endemic parasitic disease caused by infection with Taenia solium that is found predominantly in developing countries. In order to aid in the development of simple diagnostic approaches, identification and characterization of potential new antigens for immunodiagnostic purposes is desired. The cysteine protease family has previously been found to have important immunodiagnostic properties. These proteases are expressed as zymogens which contain a signal peptide, pro-peptide, and an active domain. Subsequent catalytic cleavage of the pro-peptide converts these zymogens into enzymes. With the use of bioinformatic tools we identified an active domain of a novel cathepsin L-like cysteine protease (TsolCL) in the T. solium genome. The TsolCL gene includes 705 nucleotides (nt) within a single intron and a 633 nt exonic sequence encoding an active protein of 211 amino acids. Sequence alignment and phylogenetic analysis suggest that the TsolCL gene is closely related to genes found in Echinoccocus granulosus and E. multiloculars. In addition, TsolCL was found to have a 61.9%-99.0% similarity to other cathepsin L proteins found in other helminths and mammals. We cloned, expressed, purified, and characterized the recombinant active TsolCL (27 kDa) using the baculovirus-insect cell expression system. TsolCL showed cysteine protease enzymatic activity with the capacity to hydrolyze the Z-Phe-Arg-AMC substrate as well as bovine serum albumin. However, TsolCL was not able to hydrolyze human immunoglobulin. In addition, TsolCL has cathepsin L conserved amino acid residues in the catalytic site (Gln8, Cys14, His159, Asn179 and Trp181) and the motif GCNGG. Using ELISA, TsolCL was able to distinguish circulating IgG antibodies between healthy animals and naturally infected pigs with cysticercosis, showing a moderate sensitivity of 83.33% (40/48; 95% CI: [69.8%-92.5 %]), and a specificity of 83.78% (31/37; 95% CI: [67.9%-93.8%]). In conclusion, a novel cathepsin L-like cysteine protease from a T. solium metacestode was expressed successfully in Baculovirus system and was evaluated as a candidate antigen to diagnose porcine cysticercosis using the ELISA immunoassay.
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Affiliation(s)
- Nancy León-Janampa
- Laboratorio de Bioinformática y Biología Molecular, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Ruddy Liendo
- Laboratorio de Bioinformática y Biología Molecular, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Robert H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
| | | | - Hector H García
- Cysticercosis Unit, Instituto de Ciencias Neurológicas, Lima, Peru.
| | - Armando Gonzales
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru.
| | - Patricia Sheen
- Laboratorio de Bioinformática y Biología Molecular, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Mónica J Pajuelo
- Laboratorio de Bioinformática y Biología Molecular, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
| | - Mirko Zimic
- Laboratorio de Bioinformática y Biología Molecular, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Openshaw JJ, Medina A, Felt SA, Li T, Huan Z, Rozelle S, Luby SP. Prevalence and risk factors for Taenia solium cysticercosis in school-aged children: A school based study in western Sichuan, People's Republic of China. PLoS Negl Trop Dis 2018; 12:e0006465. [PMID: 29738570 PMCID: PMC5959190 DOI: 10.1371/journal.pntd.0006465] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 05/18/2018] [Accepted: 04/19/2018] [Indexed: 12/16/2022] Open
Abstract
Background Taenia solium cysticercosis affects millions of impoverished people worldwide and can cause neurocysticercosis, an infection of the central nervous system which is potentially fatal. Children may represent an especially vulnerable population to neurocysticercosis, due to the risk of cognitive impairment during formative school years. While previous epidemiologic studies have suggested high prevalence in rural China, the prevalence in children as well as risk factors and impact of disease in low-resource areas remain poorly characterized. Methodology/Principal findings Utilizing school based sampling, we conducted a cross-sectional study, administering a questionnaire and collecting blood for T. solium cysticercosis antibodies in 2867 fifth and sixth grade students across 27 schools in west Sichuan. We used mixed-effects logistic regression models controlling for school-level clustering to study associations between risk factors and to characterize factors influencing the administration of deworming medication. Overall prevalence of cysticercosis antibodies was 6%, but prevalence was significantly higher in three schools which all had prevalences of 15% or higher. Students from households owning pigs (adjusted odds ratio [OR] 1.81, 95% CI 1.08–3.03), from households reporting feeding their pigs human feces (adjusted OR 1.49, 95% CI 1.03–2.16), and self-reporting worms in their feces (adjusted OR 1.85, 95% CI 1.18–2.91) were more likely to have cysticercosis IgG antibodies. Students attending high prevalence schools were more likely to come from households allowing pigs to freely forage for food (OR 2.26, 95% CI 1.72–2.98) and lacking a toilet (OR 1.84, 95% CI 1.38–2.46). Children who were boarding at school were less likely to have received treatment for gastrointestinal worms (adjusted OR 0.58, 95% CI 0.42–0.80). Conclusions/Significance Our study indicates high prevalences of cysticercosis antibodies in young school aged children in rural China. While further studies to assess potential for school-based transmission are needed, school-based disease control may be an important intervention to ensure the health of vulnerable pediatric populations in T. solium endemic areas. The zoonotic tapeworm, Taenia solium, affects millions of impoverished people worldwide and can cause neurocysticercosis (NCC), an infection of the central nervous system which is potentially fatal. Hypothetically, children may be a vulnerable population to infection as neurological problems and cognitive impairment caused by NCC during formative school years may lead to poor academic performance, contributing to drop-out rates and, eventually, propagating cycles of poverty. We carried out a school-based study of T. solium cysticerosis in primary school-aged children in rural western Sichuan. Our results indicate high levels of T. solium exposure in young school-aged children in rural China. While further studies to assess disease transmission within schools are needed, school-based disease control may be an important intervention to ensure the health of pediatric populations at risk for infection.
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Affiliation(s)
- John J. Openshaw
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA, United States of America
| | - Alexis Medina
- Freeman Spogli Institute, Stanford University, Stanford, CA, United States of America
| | - Stephen A. Felt
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Tiaoying Li
- Institute of Parasitic Diseases, Sichuan Centers for Disease Control and Prevention, Sichuan Province, Chengdu, Sichuan, People’s Republic of China
- * E-mail:
| | - Zhou Huan
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Scott Rozelle
- Freeman Spogli Institute, Stanford University, Stanford, CA, United States of America
| | - Stephen P. Luby
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, CA, United States of America
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Díaz Á, Sagasti C, Casaravilla C. Granulomatous responses in larval taeniid infections. Parasite Immunol 2018. [DOI: 10.1111/pim.12523] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Á. Díaz
- Área/Cátedra de Inmunología; Departamento de Biociencias (Facultad de Química) e Instituto de Química Biológica (Facultad de Ciencias); Universidad de la República; Montevideo Uruguay
| | - C. Sagasti
- Área/Cátedra de Inmunología; Departamento de Biociencias (Facultad de Química) e Instituto de Química Biológica (Facultad de Ciencias); Universidad de la República; Montevideo Uruguay
| | - C. Casaravilla
- Área/Cátedra de Inmunología; Departamento de Biociencias (Facultad de Química) e Instituto de Química Biológica (Facultad de Ciencias); Universidad de la República; Montevideo Uruguay
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TNF-α blockade suppresses pericystic inflammation following anthelmintic treatment in porcine neurocysticercosis. PLoS Negl Trop Dis 2017; 11:e0006059. [PMID: 29190292 PMCID: PMC5708608 DOI: 10.1371/journal.pntd.0006059] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 10/20/2017] [Indexed: 02/06/2023] Open
Abstract
Background Neurocysticercosis (NCC) is an infection of the brain with the larval cyst of the tapeworm, Taenia solium. Cysticidal treatment induces parasite killing resulting in a post inflammatory response and seizures, which generally requires corticosteroid treatment to control inflammation. The nature of this response and how to best control it is unclear. We investigated the anti-inflammatory effects of pretreatment with etanercept (ETN), an anti-tumor necrosis factor agent, or dexamethasone (DEX), a high potency corticosteroid, on the post treatment inflammatory response in naturally infected pigs with neurocysticercosis after a single dose of the cysticidal drug praziquantel (PZQ). Methodology/Principal findings We followed the methods from a previously developed treatment model of NCC in naturally infected swine. The four study groups of infected pigs included 3 groups treated with PZQ on day 0: PZQ-treated alone (100 mg/kg PO; n = 9), pretreated with dexamethasone (DEX, 0.2 mg/kg IM administered on days -1, +1 and +3; n = 6), and pretreated with etanercept (ETN, 25 mg IM per animal on days -7 and 0; n = 6). The fourth group remained untreated (n = 3). As measured by quantitative RT-PCR, ETN pretreatment depressed transcription of a wide range of proinflammatory, regulatory and matrix protease encoding genes at 120 hr post PZQ treatment in capsules of cysts that demonstrated extravasated Evans Blue (EB) (a measure of blood brain barrier dysfunction) compared to animals not receiving ETN. Transcription was significantly depressed for the proinflammatory genes tumor necrosis factor (TNF)-α, and interferon (IFN)-γ; the inflammation regulating genes cytotoxic T-lymphocyte-associated protein (CTLA)4, interleukin (IL)-13 and transforming growth factor (TGF)-β; the tissue remodeling genes matrix metalloprotease (MMP)1 and 9, tissue inhibitors of metalloproteases (TIMP)1 and 2, and the genes regulating endothelial function vascular endothelial growth factor (VEGF)1, angiopoietin (Ang)1, Ang 2, and platelet endothelial cell adhesion molecule (PECAM)-1. In contrast, transcription was only modestly decreased in the DEX pretreated pigs compared to PZQ alone, and only for TNF-α, IL-6, IFN-γ, TGF-β and Ang1. IL-10 was not affected by either ETN or DEX pretreatments. The degree of inflammation, assessed by semi-quantitative inflammatory scores, was modestly decreased in both ETN and DEX pretreated animals compared to PZQ treated pigs whereas cyst damage scores were moderately decreased only in cysts from DEX pretreated pigs. However, the proportion of cysts with EB extravasation was not significantly changed in ETN and DEX pretreated groups. Conclusions/Significance Overall, TNF-α blockade using ETN treatment modulated expression of a large variety of genes that play a role in induction and control of inflammation and structural changes. In contrast the number of inflammatory cells was only moderately decreased suggesting weaker effects on cell migration into the inflammatory capsules surrounding cysts than on release of modulatory molecules. Taken together, these data suggest that TNF-α blockade may provide a viable strategy to manage post-treatment pericystic inflammation that follows antiparasitic therapy for neurocysticercosis. Infection of the brain with larvae of the tapeworm Taenia solium is called neurocysticercosis (NCC), a disease with varied and serious neurological symptoms. Therapy requires antiparasitic drugs and corticosteroids to prevent seizures caused by treatment due to inflammation around dying parasites. The gene expression of the proinflammatory molecule tumor necrosis factor alpha (TNF-α) is increased in NCC. We treated three groups of naturally infected pigs with an antiparasitic drug: one group was also pretreated with an anti-TNF-α inhibitor, the second one with a corticosteroid, and the third was not pretreated. All pigs were infused with Evans blue dye (EB), which leaks where the blood brain barrier is damaged by inflammation around cysts. We compared the expression of several genes involved in inflammation, healing and fibrosis and regulation of vascular function in tissues surrounding cysts. In inflamed samples showing leaked EB, the inhibition of TNF-α suppressed nearly all the genes assessed, and this suppression was significantly stronger than the moderate decrease caused by corticosteroid pretreatment on most of the genes. On microscopic examination, the inflammation observed was slightly decreased with both pretreatments in relation to the group that was not pretreated. We believe that the inflammatory route that includes TNF-α should be further explored in the search for better management of inflammation directed to degenerating cysts.
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Reddy DS, Volkmer R. Neurocysticercosis as an infectious acquired epilepsy worldwide. Seizure 2017; 52:176-181. [DOI: 10.1016/j.seizure.2017.10.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/05/2017] [Accepted: 10/07/2017] [Indexed: 10/18/2022] Open
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Garcia HH, Del Brutto OH. Antiparasitic treatment of neurocysticercosis - The effect of cyst destruction in seizure evolution. Epilepsy Behav 2017; 76:158-162. [PMID: 28606690 PMCID: PMC5675823 DOI: 10.1016/j.yebeh.2017.03.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/06/2017] [Accepted: 03/06/2017] [Indexed: 11/20/2022]
Abstract
Antiparasitic agents against Taenia solium cysticercosis have been in use since 1979, although its use has been questioned on the basis that cysts would die naturally and thus treatment-induced inflammation is unnecessary. In addition, isolated reports have also questioned whether neurocysticercosis (NCC) is a cause of epilepsy. After more than three and a half decades, a large body of evidence is available. Little if any doubt exists about NCC as a cause of seizures - NCC is consistently associated with seizures when appropriate groups are compared, and in a large subset of cases, seizure semiology correlates with the anatomical location of lesions. Cyst degeneration and the subsequent inflammatory reaction increase seizure expression, although patients with non-inflamed cysts may have seizures, as do patients with long-standing, not inflamed calcified scars. Assessment of the evidence on cysticidal efficacy, safety, and the impact of cyst destruction in decreasing seizures leads to the conclusion that the benefits of antiparasitic treatment in parenchymal brain cysticercosis clearly outweigh the risks, and have provided substantive evidence of the role of NCC as a cause of seizures and epilepsy. Antiparasitic therapy should be considered a primary option in the management of patients with live or degenerating brain NCC cysts. This article is part of a Special Issue entitled "Neurocysticercosis and Epilepsy".
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Affiliation(s)
- Hector H Garcia
- Center for Global Health, Tumbes and the Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru.
| | - Oscar H Del Brutto
- School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador
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Gómez-Morales MA, Gárate T, Blocher J, Devleesschauwer B, Smit GSA, Schmidt V, Perteguer MJ, Ludovisi A, Pozio E, Dorny P, Gabriël S, Winkler AS. Present status of laboratory diagnosis of human taeniosis/cysticercosis in Europe. Eur J Clin Microbiol Infect Dis 2017; 36:2029-2040. [PMID: 28669015 PMCID: PMC5653711 DOI: 10.1007/s10096-017-3029-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 05/23/2017] [Indexed: 11/08/2022]
Abstract
Human cysticercosis (CC) is a parasitic zoonosis caused by the larval stage (cyst) of the Taenia solium. Cysts can establish in the human central nervous system (neurocysticercosis, NCC) and other organs and tissues; they also develop in pigs, the natural intermediate host. Human taeniosis may be caused by T. solium, Taenia saginata and Taenia asiatica tapeworms; these infections are usually asymptomatic, but show a significant relevance as they perpetuate the parasites’ life cycle, and, in the case of T. solium, they are the origin of (N)CC. In European Union (EU) member states and associated countries, the occurrence of autochthonous T. solium cases is debated, and imported cases have significantly increased lately; the status of T. asiatica has been never reported, whereas T. saginata is prevalent and causes an economic impact due to condemned carcasses. Based on their effects on the EU society, the specific diagnosis of these pathologies is relevant for their prevention and control. The aims of this study were to know the diagnostic tests used in European laboratories for human taeniosis/cysticercosis by means of a questionnaire, to determine potential gaps in their detection, and to obtain preliminary data on the number of diagnosed taeniosis/CC cases.
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Affiliation(s)
- M A Gómez-Morales
- Department of Infectious Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy.
| | - T Gárate
- Instituto de Salud Carlos III, Centro Nacional de Microbiología, Majadahonda, 28220, Madrid, Spain.
| | - J Blocher
- Institute of Acute Neurology, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
| | - B Devleesschauwer
- Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Rue Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - G S A Smit
- Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.,Faculty of Veterinary Medicine, Department of Virology, Parasitology and Immunology, Ghent University, Merelbeke, Belgium.,Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - V Schmidt
- Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675, Munich, Germany.,Centre for Global Health, Institute of Health and Society, University of Oslo, Kirkeveien 166, 0450, Oslo, Norway
| | - M J Perteguer
- Instituto de Salud Carlos III, Centro Nacional de Microbiología, Majadahonda, 28220, Madrid, Spain
| | - A Ludovisi
- Department of Infectious Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy
| | - E Pozio
- Department of Infectious Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy
| | - P Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - S Gabriël
- Faculty of Veterinary Medicine, Department of Veterinary Public Health and Food Safety, Ghent University, Ghent, Belgium
| | - A S Winkler
- Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675, Munich, Germany. .,Centre for Global Health, Institute of Health and Society, University of Oslo, Kirkeveien 166, 0450, Oslo, Norway.
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Minciullo PL, Cascio A, Isola S, Gangemi S. Different clinical allergological features of Taenia solium infestation. Clin Mol Allergy 2016; 14:18. [PMID: 27980457 PMCID: PMC5143454 DOI: 10.1186/s12948-016-0056-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 11/29/2016] [Indexed: 12/21/2022] Open
Abstract
The tapeworm Taenia (T.) solium can be responsible for two different conditions: taeniasis and cysticercosis. Helminth infections in human host cause an immune response associated with elevated levels of IgE, tissue eosinophilia and mastocytosis, and with the presence of CD4+ T cells that preferentially produce IL-4, IL-5, and IL-13. Individuals exposed to helminth infections may have allergic inflammatory responses to parasites and parasite antigens. PubMed search of human cases of allergic reactions occurring during T. solium infestation was performed combining the terms (allergy, urticaria, angioedema, asthma, anaphylaxis) with T. solium. A study was considered eligible for inclusion in the review if it reported data on patients with T. solium infestation who had signs or symptoms of allergy. In literature we found six articles reporting the association between an allergic reaction and T. solium infestation: two cases of urticaria, two cases of relapsing angioedema, one case of asthma and two cases of anaphylaxis. Despite the large diffusion of T. solium infestation, we found only a few cases of concomitant allergic reaction and the presence of Taenia in the host. The association between T. solium infestation and allergic manifestations has never been clearly demonstrated, and in absence of a well-documented causality the hypotheses are merely speculative. Therefore, the association between Taenia infection and allergy needs to be thoroughly studied to better clarify if this association may really exist and which is the pathogenetic mechanism supported.
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Affiliation(s)
- Paola Lucia Minciullo
- School and Division of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University Hospital "G. Martino", Messina, Italy
| | - Antonio Cascio
- Department of Health Promotion Sciences and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Stefania Isola
- School and Division of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University Hospital "G. Martino", Messina, Italy
| | - Sebastiano Gangemi
- School and Division of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University Hospital "G. Martino", Messina, Italy ; Institute of Applied Sciences and Intelligent Systems (ISASI), Messina Unit, Messina, Italy
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Peón AN, Ledesma-Soto Y, Terrazas LI. Regulation of immunity by Taeniids: lessons from animal models and in vitro studies. Parasite Immunol 2016; 38:124-35. [PMID: 26457989 DOI: 10.1111/pim.12289] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 10/01/2015] [Indexed: 02/06/2023]
Abstract
Taeniidae is the largest family of the Cyclophyllidea order of parasites despite being composed of just two genera: Taenia spp and Echinococcus spp. These parasites are flatworms with a terrestrial life cycle, having an immature or larval stage called metacestode, which develops into the mature form within the intestine of the primary host after being consumed in raw or poorly cooked meat. Consumed eggs hatch into oncospheres, penetrate the intestinal walls and are transported via the bloodstream to later develop into metacestodes within the muscles and internal organs of secondary and sometimes primary hosts, thereby initiating the cycle again. Larval stages of both Taenia spp and Echinococcus spp are well known to produce tissue-dwelling, long-lasting infections; in this stage, these parasites can reach centimetres (macroparasites) and both genera may cause life-threatening diseases in humans. Establishing such long-term infections requires an exceptional ability to modulate host immunity for long periods of time. In this review, we analyse the immunoregulatory mechanisms induced by these tapeworms and their products, mainly discussing the importance of taeniid strategies to successfully colonize their hosts, such as antigen-presenting cell phenotype manipulation and the consequent induction of T-cell anergy, among others.
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Affiliation(s)
- A N Peón
- Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Estado de México, México
| | - Y Ledesma-Soto
- Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Estado de México, México
| | - L I Terrazas
- Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Estado de México, México
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38
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Gonzales I, Rivera JT, Garcia HH. Pathogenesis of Taenia solium taeniasis and cysticercosis. Parasite Immunol 2016; 38:136-46. [PMID: 26824681 DOI: 10.1111/pim.12307] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 01/25/2016] [Indexed: 12/22/2022]
Abstract
Taenia solium infections (taeniasis/cysticercosis) are a major scourge to most developing countries. Neurocysticercosis, the infection of the human nervous system by the cystic larvae of this parasite, has a protean array of clinical manifestations varying from entirely asymptomatic infections to aggressive, lethal courses. The diversity of clinical manifestations reflects a series of contributing factors which include the number, size and location of the invading parasites, and particularly the inflammatory response of the host. This manuscript reviews the different presentations of T. solium infections in the human host with a focus on the mechanisms or processes responsible for their clinical expression.
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Affiliation(s)
- I Gonzales
- Cysticercosis Unit, Department of Transmissible Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - J T Rivera
- Department of Microbiology and Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - H H Garcia
- Cysticercosis Unit, Department of Transmissible Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, Peru.,Department of Microbiology and Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
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Perilesional Inflammation in Neurocysticercosis - Relationship Between Contrast-Enhanced Magnetic Resonance Imaging, Evans Blue Staining and Histopathology in the Pig Model. PLoS Negl Trop Dis 2016; 10:e0004869. [PMID: 27459388 PMCID: PMC4961384 DOI: 10.1371/journal.pntd.0004869] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 06/30/2016] [Indexed: 11/19/2022] Open
Abstract
Background Disease manifestations in neurocysticercosis (NCC) are frequently due to inflammation of degenerating Taenia solium brain cysts. Exacerbated inflammation post anthelmintic treatment is associated with leakage of the blood brain barrier (BBB) using Evans blue (EB) staining. How well EB extravasation into the brain correlates with magnetic resonance imaging (MRI) using gadolinium (Gd) enhancement as a contrast agent and pericystic inflammation was analyzed in pigs harboring brain cysts of Taenia solium. Methodology/Principal Findings Three groups of 4 naturally infected pigs were assessed. The first and second groups were treated with both praziquantel plus albendazole and sacrificed two and five days post treatment, respectively. A third untreated group remained untreated. Pigs were injected with EB two hours prior to evaluation by Gd-enhanced T1-MRI, and euthanized. The EB staining for each cyst capsule was scored (EB grades were 0: 0%; 1: up to 50%; 2: over 50% but less than 100%; 3: 100%). Similarly, the Gd enhancement around each cyst was qualitatively and quantitatively scored from the MRI. The extent of pericystic inflammation on histology was scored in increasing severity as IS1, IS2, IS3 and IS4. Grade 3 EB staining and enhancement was only seen in treated capsules. Also, treated groups had higher Gd intensity than the untreated group. Grades of enhancement correlated significantly with Gd enhancement intensity. EB staining was correlated with Gd enhancement intensity and with IS4 in the treated groups. These correlations were stronger in internally located cysts compared to superficial cysts in treated groups. Significance EB staining and Gd enhancement strongly correlate. The intensity of enhancement determined by MRI is a good indication of the degree of inflammation. Similarly, EB staining highly correlates with the degree of inflammation and may be applied to study inflammation in the pig model of NCC. Neurocysticercosis (NCC) is a frequent parasitic infection of the human brain in developing countries. The symptomatology of human NCC after antiparasitic treatment is generally related to inflammation. The presence and degree of enhancement after intravascular injection of the contrast agent gadolinium in magnetic resonance imaging (MRI) is commonly considered an evidence of blood brain barrier (BBB) leakage. Experimentally, the presence and degree of extravasation of Evans blue (EB) after intravascular injection into the tissues of the brain is a direct measure of blood brain barrier leakage. The BBB leakage of gadolinium in neurocysticercosis is commonly used as an indirect measure of inflammation but has never been experimentally proven. Here we evaluated the relationship between contrast T1-MRI, EB staining and histology findings in naturally infected pigs. There was a strong correlation between EB staining, contrast MRI and histopathology findings after antiparasitic treatment. This correlation was stronger when cysts were internally located in the brain than in superficial cysts partly located in the subarachnoid space (meninges). Contrast-enhanced MRI is a non invasive tool used in diagnosis and follow up of NCC patients. This study shows that the use of EB staining allows for the same conclusions as when using MRI post-treatment, and that both techniques correlate with histopathology findings. These results support the use of EB staining to study NCC using the porcine model as well as validate MRI enhancement to assess brain inflammation in patients.
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Cangalaya C, Zimic M, Marzal M, González AE, Guerra-Giraldez C, Mahanty S, Nash TE, García HH. Inflammation Caused by Praziquantel Treatment Depends on the Location of the Taenia solium Cysticercus in Porcine Neurocysticercosis. PLoS Negl Trop Dis 2015; 9:e0004207. [PMID: 26658257 PMCID: PMC4689503 DOI: 10.1371/journal.pntd.0004207] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 10/12/2015] [Indexed: 12/04/2022] Open
Abstract
Background Neurocysticercosis (NCC), infection of the central nervous system by Taenia solium cysticerci, is a pleomorphic disease. Inflammation around cysticerci is the major cause of disease but is variably present. One factor modulating the inflammatory responses may be the location and characteristics of the brain tissue adjacent to cysticerci. We analyzed and compared the inflammatory responses to cysticerci located in the parenchyma to those in the meninges or cysticerci partially in contact with both the parenchyma and the meninges (corticomeningeal). Methodology/Principal Findings Histological specimens of brain cysticerci (n = 196) from 11 pigs naturally infected with Taenia solium cysticerci were used. Four pigs were sacrificed after 2 days and four after 5 days of a single dose of praziquantel; 3 pigs did not receive treatment. All pigs were intravenously injected with Evans Blue to assess disruption of the blood-brain barrier. The degree of inflammation was estimated by use of a histological score (ISC) based on the extent of the inflammation in the pericystic areas as assessed in an image composed of several photomicrographs taken at 40X amplification. Parenchymal cysticerci provoked a significantly greater level of pericystic inflammation (higher ISC) after antiparasitic treatment compared to meningeal and corticomeningeal cysticerci. ISC of meningeal cysticerci was not significantly affected by treatment. In corticomeningeal cysticerci, the increase in ISC score was correlated to the extent of the cysticercus adjacent to the brain parenchyma. Disruption of the blood-brain barrier was associated with treatment only in parenchymal tissue. Significance Inflammatory response to cysticerci located in the meninges was significantly decreased compared to parenchymal cysticerci. The suboptimal inflammatory response to cysticidal drugs may be the reason subarachnoid NCC is generally refractory to treatment compared to parenchymal NCC. The cystic larvae of the pork tapeworm Taenia solium may affect the human brain causing neurocysticercosis (NCC), a very frequent cause of neurological symptoms in developing countries. The clinical expression and response to treatment of human NCC are related to the location of cysticerci inside (intraparenchymal) or outside the brain parenchyma (extraparenchymal NCC). We used a naturally infected pig model to assess the characteristics of inflammation around brain cysticerci of parenchymal, meningeal and mixed locations. There were no major differences in inflammation without treatment. After antiparasitic treatment with praziquantel, inflammation around parenchymal brain cysticerci increased in comparison to meningeal located cysticerci. Cysticerci partially surrounded by both brain parenchyma and meninges showed increased inflammation in relation to the extent of the cysticercus in the brain parenchyma. The location of cysticerci within the brain is a factor that determines the extent and degree of the immune response following anticysticidal treatment. Similar changes may occur in treated human infections. Our work could contribute to explain the differences in response to antiparasitic treatment in different forms of human neurocysticercosis.
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Affiliation(s)
- Carla Cangalaya
- Laboratorio de Inmunopatología en Neurocisticercosis, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
- * E-mail:
| | - Mirko Zimic
- Laboratorio de Bioinformática y Biología Molecular, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
- Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Miguel Marzal
- Laboratorio de Inmunopatología en Neurocisticercosis, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Armando E. González
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Cristina Guerra-Giraldez
- Laboratorio de Inmunopatología en Neurocisticercosis, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
- Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Siddhartha Mahanty
- Laboratorio de Inmunopatología en Neurocisticercosis, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Theodore E. Nash
- Laboratorio de Inmunopatología en Neurocisticercosis, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Hector H. García
- Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
- Unidad de Cisticercosis, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
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Abstract
SUMMARYNeurocysticercosis (NCC) is considered a neglected parasitic infection of the human central nervous system. Its pathogenesis is due to the host immune response, stage of evolution and location of the parasite. The aim of this study was to evaluate thein situand systemic immune response through cytokines dosage (IL-4, IL-10, IL-17 and IFN-γ) as well as the local inflammatory response of the experimental NCC withTaenia crassiceps. Thein situand systemic cellular and inflammatory immune response were evaluated through the cytokines quantification at 7, 30, 60 and 90 days after inoculation and histopathological analysis. All cysticerci were found within the cerebral ventricles. There was a discrete intensity of inflammatory cells of mixed immune profile, polymorphonuclear and mononuclear cells, at the beginning of the infection and predominance of mononuclear cells at the end. The systemic immune response showed a significant increase in all the analysed cytokines and predominance of the Th2 immune profile cytokines at the end of the infection. These results indicate that the location of the cysticerci may lead to ventriculomegaly. The acute phase of the infection showed a mixed Th1/Th17 profile accompanied by high levels of IL-10 while the late phase showed a Th2 immune profile.
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Chan HT, Daniell H. Plant-made oral vaccines against human infectious diseases-Are we there yet? PLANT BIOTECHNOLOGY JOURNAL 2015; 13:1056-70. [PMID: 26387509 PMCID: PMC4769796 DOI: 10.1111/pbi.12471] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 08/12/2015] [Accepted: 08/14/2015] [Indexed: 05/13/2023]
Abstract
Although the plant-made vaccine field started three decades ago with the promise of developing low-cost vaccines to prevent infectious disease outbreaks and epidemics around the globe, this goal has not yet been achieved. Plants offer several major advantages in vaccine generation, including low-cost production by eliminating expensive fermentation and purification systems, sterile delivery and cold storage/transportation. Most importantly, oral vaccination using plant-made antigens confers both mucosal (IgA) and systemic (IgG) immunity. Studies in the past 5 years have made significant progress in expressing vaccine antigens in edible leaves (especially lettuce), processing leaves or seeds through lyophilization and achieving antigen stability and efficacy after prolonged storage at ambient temperatures. Bioencapsulation of antigens in plant cells protects them from the digestive system; the fusion of antigens to transmucosal carriers enhances efficiency of their delivery to the immune system and facilitates successful development of plant vaccines as oral boosters. However, the lack of oral priming approaches diminishes these advantages because purified antigens, cold storage/transportation and limited shelf life are still major challenges for priming with adjuvants and for antigen delivery by injection. Yet another challenge is the risk of inducing tolerance without priming the host immune system. Therefore, mechanistic aspects of these two opposing processes (antibody production or suppression) are discussed in this review. In addition, we summarize recent progress made in oral delivery of vaccine antigens expressed in plant cells via the chloroplast or nuclear genomes and potential challenges in achieving immunity against infectious diseases using cold-chain-free vaccine delivery approaches.
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Affiliation(s)
| | - Henry Daniell
- Correspondence (Tel 215 746 2563; fax 215 898 3695; )
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Ito A. Basic and applied problems in developmental biology and immunobiology of cestode infections:Hymenolepis,TaeniaandEchinococcus. Parasite Immunol 2015; 37:53-69. [DOI: 10.1111/pim.12167] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 12/15/2014] [Indexed: 12/21/2022]
Affiliation(s)
- A. Ito
- Department of Parasitology and NTD Research Laboratory; Asahikawa Medical University; Asahikawa Japan
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