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Puchner KP, Bottazzi ME, Periago V, Grobusch M, Maizels R, McCarthy J, Lee B, Gaspari E, Diemert D, Hotez P. Vaccine value profile for Hookworm. Vaccine 2024; 42:S25-S41. [PMID: 37863671 DOI: 10.1016/j.vaccine.2023.05.013] [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: 07/04/2022] [Revised: 04/24/2023] [Accepted: 05/03/2023] [Indexed: 10/22/2023]
Abstract
Hookworm, a parasitic infection, retains a considerable burden of disease, affecting the most underprivileged segments of the general population in endemic countries and remains one of the leading causes of mild to severe anemia in Low and Middle Income Countries (LMICs), particularly in pregnancy and children under 5. Despite repeated large scale Preventive Chemotherapy (PC) interventions since more than 3 decades, there is broad consensus among scholars that elimination targets set in the newly launched NTD roadmap will require additional tools and interventions. Development of a vaccine could constitute a promising expansion of the existing arsenal against hookworm. Therefore, we have evaluated the biological and implementation feasibility of the vaccine development as well as the added value of such a novel tool. Based on pipeline landscaping and the current knowledge on key biological aspects of the pathogen and its interactions with the host, we found biological feasibility of development of a hookworm vaccine to be moderate. Also, our analysis on manufacturing and regulatory issues as well as potential uptake yielded moderate implementation feasibility. Modelling studies suggest a that introduction of a vaccine in parallel with ongoing integrated interventions (PC, WASH, shoe campaigns), could substantially reduce burden of disease in a cost - saving mode. Finally a set of actions are recommended that might impact positively the likelihood of timely development and introduction of a hookworm vaccine.
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Affiliation(s)
| | - Maria Elena Bottazzi
- National School of Tropical Medicine, Baylor College of Medicine, Baylor, TX, USA
| | | | - Martin Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Location AMC, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Rick Maizels
- Wellcome Centre for Integrative Parasitology, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - James McCarthy
- The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Bruce Lee
- Public Health Informatics, Computational, and Operations Research, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Erika Gaspari
- European & Developing Countries Clinical Trials Partnership (EDCTP), The Hague, The Netherlands
| | - David Diemert
- Department of Microbiology, Immunology & Tropical Medicine, George Washington University Medical Center, Washington, DC, USA
| | - Peter Hotez
- National School of Tropical Medicine, Baylor College of Medicine, Baylor, TX, USA
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Kim ES, Adriko M, Oseku KC, Lokure D, Webb EL, Sabapathy K. Factors associated with hookworm and Schistosoma mansoni infections among school-aged children in Mayuge district, Uganda. BMC Public Health 2024; 24:1620. [PMID: 38886749 PMCID: PMC11184691 DOI: 10.1186/s12889-024-19092-7] [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: 04/04/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Hookworm infection and schistosomiasis are two of sub-Saharan Africa's most common neglected tropical diseases. An annual mass drug administration (MDA) program against schistosomiasis and soil-transmitted helminths (STHs), including hookworm, has been implemented in Mayuge district, Uganda, since 2003 to date. However, hookworm and schistosomiasis remain prevalent in Mayuge district. Understanding the factors that predispose children to these infections in the context of MDA could inform interventions to reduce prevalence in Uganda and similar settings. METHOD This cross-sectional study took place in 33 randomly selected primary schools in the Mayuge district from January to February 2022. Children in primary classes 4 or 5, in the selected schools provided single stool samples and completed questionnaires. Stool specimens were examined using the Kato-Katz method to determine the prevalence of hookworm and schistosomiasis. We performed univariable and multivariable logistic regression to assess the associations of each infection with potential risk factors. RESULT A total of 1,617 students (mean age 12.1 years, 50.1% male) were enrolled. The prevalence of hookworm infection and schistosomiasis was 21.8% (95% confidence interval (CI): 19.8-23.9%) and 18.7% (95% CI: 16.8-20.7%), respectively. In multivariable analysis, longer water fetching time (over 30 min versus less than 30 min) and working daily in the soil were associated with increased odds of hookworm infection (adjusted odds ratio (AOR): 1.49, 95% CI: 1.13-1.96 and 1.37, 95% CI: 1.03-1.82, respectively). Higher odds of schistosomiasis were linked to proximity to water bodies within a one-hour walking distance (AOR: 1.84, 95% CI: 1.35-2.50), and not always washing hands before eating (AOR: 2.00, 95% CI: 1.50-2.67). Swimming, bathing, or washing in water bodies twice a week, compared to never, also increased schistosomiasis odds (AOR: 2.91, 95% CI: 1.66-5.13). CONCLUSION Consistent with the mechanisms of acquisition, hookworm infection increased with exposure to soil, and schistosomiasis increased with exposure to unclean water. Our findings highlight the importance of Water, Sanitation, and Hygiene programs and strategies aimed at reducing exposure within the framework of Neglected Tropical Disease elimination programs.
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Affiliation(s)
- Eun Seok Kim
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
- World Vision Korea, Seoul, Korea.
| | - Moses Adriko
- Vector-Borne and NTDs Control Division, Ministry of Health, Kampala, Uganda
| | | | - David Lokure
- Information and Technology Sector, Kotido District Local Government, Kotido, Uganda
| | - Emily L Webb
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Kalpana Sabapathy
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Alghanmi M, Minshawi F, Altorki TA, Zawawi A, Alsaady I, Naser AY, Alwafi H, Alsulami SM, Azhari AA, Hashem AM, Alhabbab R. Helminth-derived proteins as immune system regulators: a systematic review of their promise in alleviating colitis. BMC Immunol 2024; 25:21. [PMID: 38637733 PMCID: PMC11025257 DOI: 10.1186/s12865-024-00614-2] [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: 12/04/2023] [Accepted: 03/30/2024] [Indexed: 04/20/2024] Open
Abstract
Helminth-derived proteins have immunomodulatory properties, influencing the host's immune response as an adaptive strategy for helminth survival. Helminth-derived proteins modulate the immune response by inducing anti-inflammatory cytokines, promoting regulatory T-cell development, and ultimately favouring a Th2-biased immune response. This systematic review focused on helminth-derived proteins and explored their impact on reducing inflammatory responses in mouse models of colitis. A systematic search across Medline, EMBASE, Web of Science, and Cochrane Library identified fourteen relevant studies. These studies reported immunomodulatory changes, including increased production of anti-inflammatory cells and cytokines. In mouse models of colitis treated with on helminth-derived proteins, significant improvements in pathological parameters such as body weight, colon length, and microscopic inflammatory scores were observed compared to control groups. Moreover, helminth-derived proteins can enhance the function of Tregs and alleviate the severity of inflammatory conditions. The findings underscore the pivotal role of helminth-derived proteins in immunomodulation, specifically in the axis of cytokine secretion and immune cell polarization. The findings offer new opportunities for treating chronic inflammatory conditions such Crohn's disease.
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Grants
- IFPRC-408160-290-2020 the Ministry of Education and King Abdulaziz University, Jeddah, Saudi Arabia
- IFPRC-408160-290-2020 the Ministry of Education and King Abdulaziz University, Jeddah, Saudi Arabia
- IFPRC-408160-290-2020 the Ministry of Education and King Abdulaziz University, Jeddah, Saudi Arabia
- IFPRC-408160-290-2020 the Ministry of Education and King Abdulaziz University, Jeddah, Saudi Arabia
- IFPRC-408160-290-2020 the Ministry of Education and King Abdulaziz University, Jeddah, Saudi Arabia
- IFPRC-408160-290-2020 the Ministry of Education and King Abdulaziz University, Jeddah, Saudi Arabia
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Affiliation(s)
- Maimonah Alghanmi
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Faisal Minshawi
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Tarfa A Altorki
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ayat Zawawi
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Isra Alsaady
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Special Infectious Agent Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Hassan Alwafi
- Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Soa'ad M Alsulami
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Clinical and Molecular Microbiology Laboratories, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Ala A Azhari
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Anwar M Hashem
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rowa Alhabbab
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
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Zhuang T, Abuzeid AMI, Chen X, Zhu S, Li G. In vitro immunoregulatory role of recombinant Ancylostoma ceylanicum calreticulin. PARASITES, HOSTS AND DISEASES 2024; 62:75-84. [PMID: 38443772 PMCID: PMC10915272 DOI: 10.3347/phd.23108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/28/2024] [Indexed: 03/07/2024]
Abstract
Ancylostoma ceylanicum is a zoonotic soil-derived nematode that parasitizes the intestines of humans and animals (dogs and cats), leading to malnutrition and iron-deficiency anemia. Helminth parasites secrete calreticulin (CRT), which regulates or blocks the host's immune response. However, no data on A. ceylanicum calreticulin (Ace-CRT) are available. We investigated the biological function of recombinant Ace-CRT (rAce-CRT). rAce-CRT showed reliable antigenicity and stimulated the proliferation of mouse splenocytes and canine peripheral blood mononuclear cells. Quantitative reverse-transcription PCR assays revealed that rAce-CRT primarily promoted the expression of T helper 2 cytokines, particularly IL-13, in canine peripheral blood lymphocytes. rAce-CRT inhibited complement-mediated sheep erythrocyte hemolysis in vitro. Our findings indicate that Ace-CRT plays an immunomodulatory role and may be a promising candidate molecule for a hookworm vaccine.
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Affiliation(s)
- Tingting Zhuang
- Guangdong Provincial Zoonosis Prevention and Control Key Laboratory, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510542,
China
| | - Asmaa M. I. Abuzeid
- Guangdong Provincial Zoonosis Prevention and Control Key Laboratory, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510542,
China
- Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522,
Egypt
| | - Xiaoyu Chen
- Guangdong Provincial Zoonosis Prevention and Control Key Laboratory, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510542,
China
| | - Shilan Zhu
- Guangdong Provincial Zoonosis Prevention and Control Key Laboratory, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510542,
China
| | - Guoqing Li
- Guangdong Provincial Zoonosis Prevention and Control Key Laboratory, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510542,
China
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Hoogerwerf MA, Janse JJ, Kuiper VP, van Schuijlenburg R, Kruize YC, Sijtsma JC, Nosoh BA, Koopman JPR, Verbeek-Menken PH, Westra IM, Meij P, Brienen EA, Visser LG, van Lieshout L, Jochems SP, Yazdanbakhsh M, Roestenberg M. Protective efficacy of short-term infection with Necator americanus hookworm larvae in healthy volunteers in the Netherlands: a single-centre, placebo-controlled, randomised, controlled, phase 1 trial. THE LANCET. MICROBE 2023; 4:e1024-e1034. [PMID: 38042152 DOI: 10.1016/s2666-5247(23)00218-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 06/24/2023] [Accepted: 07/11/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Vaccine development against hookworm is hampered by the absence of the development of protective immunity in populations repeatedly exposed to hookworm, limiting identification of mechanisms of protective immunity and new vaccine targets. Immunisation with attenuated larvae has proven effective in dogs and partial immunity has been achieved using an irradiated larvae model in healthy volunteers. We aimed to investigate the protective efficacy of immunisation with short-term larval infection against hookworm challenge. METHODS We did a single-centre, placebo-controlled, randomised, controlled, phase 1 trial at Leiden University Medical Center (Leiden, Netherlands). Healthy volunteers (aged 18-45 years) were recruited using advertisements on social media and in publicly accessible areas. Volunteers were randomly assigned (2:1) to receive three short-term infections with 50 infectious Necator americanus third-stage filariform larvae (50L3) or placebo. Infection was abrogated with a 3-day course of albendazole 400 mg, 2 weeks after each exposure. Subsequently all volunteers were challenged with two doses of 50L3 at a 2-week interval. The primary endpoint was egg load (geometric mean per g faeces) measured weekly between weeks 12 and 16 after first challenge, assessed in the per-protocol population, which included all randomly assigned volunteers with available data on egg counts at week 12-16 after challenge. This study is registered with ClinicalTrials.gov, NCT03702530. FINDINGS Between Nov 8 and Dec 14, 2018, 26 volunteers were screened, of whom 23 enrolled in the trial. The first immunisation was conducted on Dec 18, 2018. 23 volunteers were randomly assigned (15 to the intervention group and eight to the placebo group). Egg load after challenge was lower in the intervention group than the placebo group (geometric mean 571 eggs per g [range 372-992] vs 873 eggs per g [268-1484]); however, this difference was not statistically significant (p=0·10). Five volunteers in the intervention group developed a severe skin rash, which was associated with 40% reduction in egg counts after challenge (geometric mean 742 eggs per g [range 268-1484] vs 441 eggs per g [range 380-520] after challenge; p=0·0025) and associated with higher peak IgG1 titres. INTERPRETATION To our knowledge, this is the first study to describe a protective effect of short-term exposure to hookworm larvae and show an association with skin response, eosinophilic response, and IgG1. These findings could inform future hookworm vaccine development. FUNDING Dioraphte Foundation.
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Affiliation(s)
- Marie-Astrid Hoogerwerf
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands; Department of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Jacqueline J Janse
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Vincent P Kuiper
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Yvonne Cm Kruize
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Jeroen C Sijtsma
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Beckley A Nosoh
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Jan-Pieter R Koopman
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Petra H Verbeek-Menken
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Inge M Westra
- Leiden University Center for Infectious Diseases, and Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, Netherlands
| | - Pauline Meij
- Leiden University Center for Infectious Diseases, and Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, Netherlands
| | - Eric At Brienen
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Leo G Visser
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Simon P Jochems
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Meta Roestenberg
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands; Department of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands.
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Ferguson AA, Inclan-Rico JM, Lu D, Bobardt SD, Hung L, Gouil Q, Baker L, Ritchie ME, Jex AR, Schwarz EM, Rossi HL, Nair MG, Dillman AR, Herbert DR. Hookworms dynamically respond to loss of Type 2 immune pressure. PLoS Pathog 2023; 19:e1011797. [PMID: 38079450 PMCID: PMC10735188 DOI: 10.1371/journal.ppat.1011797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 12/21/2023] [Accepted: 11/02/2023] [Indexed: 12/23/2023] Open
Abstract
The impact of the host immune environment on parasite transcription and fitness is currently unknown. It is widely held that hookworm infections have an immunomodulatory impact on the host, but whether the converse is true remains unclear. Immunity against adult-stage hookworms is largely mediated by Type 2 immune responses driven by the transcription factor Signal Transducer and Activator of Transcription 6 (STAT6). This study investigated whether serial passage of the rodent hookworm Nippostrongylus brasiliensis in STAT6-deficient mice (STAT6 KO) caused changes in parasites over time. After adaptation to STAT6 KO hosts, N. brasiliensis increased their reproductive output, feeding capacity, energy content, and body size. Using an improved N. brasiliensis genome, we found that these physiological changes corresponded with a dramatic shift in the transcriptional landscape, including increased expression of gene pathways associated with egg production, but a decrease in genes encoding neuropeptides, proteases, SCP/TAPS proteins, and transthyretin-like proteins; the latter three categories have been repeatedly observed in hookworm excreted/secreted proteins (ESPs) implicated in immunosuppression. Although transcriptional changes started to appear in the first generation of passage in STAT6 KO hosts for both immature and mature adult stages, downregulation of the genes putatively involved in immunosuppression was only observed after multiple generations in this immunodeficient environment. When STAT6 KO-adapted N. brasiliensis were reintroduced to a naive WT host after up to 26 generations, this progressive change in host-adaptation corresponded to increased production of inflammatory cytokines by the WT host. Surprisingly, however, this single exposure of STAT6 KO-adapted N. brasiliensis to WT hosts resulted in worms that were morphologically and transcriptionally indistinguishable from WT-adapted parasites. This work uncovers remarkable plasticity in the ability of hookworms to adapt to their hosts, which may present a general feature of parasitic nematodes.
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Affiliation(s)
- Annabel A. Ferguson
- University of Pennsylvania, School of Veterinary Medicine, Pathobiology Department, Philadelphia, Pennsylvania, United States of America
| | - Juan M. Inclan-Rico
- University of Pennsylvania, School of Veterinary Medicine, Pathobiology Department, Philadelphia, Pennsylvania, United States of America
| | - Dihong Lu
- University of California Riverside, Department of Nematology, Riverside, California, United States of America
| | - Sarah D. Bobardt
- University of California Riverside, School of Medicine, Department of Biomedical Sciences, Riverside, California, United States of America
| | - LiYin Hung
- University of Pennsylvania, School of Veterinary Medicine, Pathobiology Department, Philadelphia, Pennsylvania, United States of America
| | - Quentin Gouil
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- University of Melbourne, Department of Medical Biology, Parkville, Victoria, Australia
| | - Louise Baker
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- University of Melbourne, Department of Veterinary Biosciences, Parkville, Victoria, Australia
| | - Matthew E. Ritchie
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- University of Melbourne, Department of Medical Biology, Parkville, Victoria, Australia
| | - Aaron R. Jex
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- University of Melbourne, Department of Veterinary Biosciences, Parkville, Victoria, Australia
| | - Erich M. Schwarz
- University of Melbourne, Department of Veterinary Biosciences, Parkville, Victoria, Australia
- Cornell University, Department of Molecular Biology and Genetics, Ithaca, New York, United States of America
| | - Heather L. Rossi
- University of Pennsylvania, School of Veterinary Medicine, Pathobiology Department, Philadelphia, Pennsylvania, United States of America
| | - Meera G. Nair
- University of California Riverside, School of Medicine, Department of Biomedical Sciences, Riverside, California, United States of America
| | - Adler R. Dillman
- University of California Riverside, Department of Nematology, Riverside, California, United States of America
| | - De’Broski R. Herbert
- University of Pennsylvania, School of Veterinary Medicine, Pathobiology Department, Philadelphia, Pennsylvania, United States of America
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Pollo SMJ, Leon-Coria A, Liu H, Cruces-Gonzalez D, Finney CAM, Wasmuth JD. Transcriptional patterns of sexual dimorphism and in host developmental programs in the model parasitic nematode Heligmosomoides bakeri. Parasit Vectors 2023; 16:171. [PMID: 37246221 DOI: 10.1186/s13071-023-05785-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/24/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Heligmosomoides bakeri (often mistaken for Heligmosomoides polygyrus) is a promising model for parasitic nematodes with the key advantage of being amenable to study and manipulation within a controlled laboratory environment. While draft genome sequences are available for this worm, which allow for comparative genomic analyses between nematodes, there is a notable lack of information on its gene expression. METHODS We generated biologically replicated RNA-seq datasets from samples taken throughout the parasitic life of H. bakeri. RNA from tissue-dwelling and lumen-dwelling worms, collected under a dissection microscope, was sequenced on an Illumina platform. RESULTS We find extensive transcriptional sexual dimorphism throughout the fourth larval and adult stages of this parasite and identify alternative splicing, glycosylation, and ubiquitination as particularly important processes for establishing and/or maintaining sex-specific gene expression in this species. We find sex-linked differences in transcription related to aging and oxidative and osmotic stress responses. We observe a starvation-like signature among transcripts whose expression is consistently upregulated in males, which may reflect a higher energy expenditure by male worms. We detect evidence of increased importance for anaerobic respiration among the adult worms, which coincides with the parasite's migration into the physiologically hypoxic environment of the intestinal lumen. Furthermore, we hypothesize that oxygen concentration may be an important driver of the worms encysting in the intestinal mucosa as larvae, which not only fully exposes the worms to their host's immune system but also shapes many of the interactions between the host and parasite. We find stage- and sex-specific variation in the expression of immunomodulatory genes and in anthelmintic targets. CONCLUSIONS We examine how different the male and female worms are at the molecular level and describe major developmental events that occur in the worm, which extend our understanding of the interactions between this parasite and its host. In addition to generating new hypotheses for follow-up experiments into the worm's behavior, physiology, and metabolism, our datasets enable future more in-depth comparisons between nematodes to better define the utility of H. bakeri as a model for parasitic nematodes in general.
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Affiliation(s)
- Stephen M J Pollo
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- Host-Parasite Interactions Research Training Network, University of Calgary, Calgary, AB, Canada
| | - Aralia Leon-Coria
- Host-Parasite Interactions Research Training Network, University of Calgary, Calgary, AB, Canada
- Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, AB, Canada
| | - Hongrui Liu
- Host-Parasite Interactions Research Training Network, University of Calgary, Calgary, AB, Canada
- Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, AB, Canada
| | - David Cruces-Gonzalez
- Host-Parasite Interactions Research Training Network, University of Calgary, Calgary, AB, Canada
- Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, AB, Canada
| | - Constance A M Finney
- Host-Parasite Interactions Research Training Network, University of Calgary, Calgary, AB, Canada
- Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, AB, Canada
| | - James D Wasmuth
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada.
- Host-Parasite Interactions Research Training Network, University of Calgary, Calgary, AB, Canada.
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Smith CJ, Ashford JW. Apolipoprotein ɛ4-Associated Protection Against Pediatric Enteric Infections is a Survival Advantage in Pre-Industrial Populations. J Alzheimers Dis 2023:JAD221218. [PMID: 37125551 DOI: 10.3233/jad-221218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Until 300,000 years ago, ancestors of modern humans ubiquitously carried the apolipoprotein E (APOE) ɛ4/ɛ4 genotype, when the ɛ3 allele mutated from the ancestral ɛ4, which elevates the risk of Alzheimer's disease. Modern humans living today predominantly carry the ɛ3 allele, which provides protection against heart disease and dementia in long-lived populations. The ancestral ɛ4 allele has been highly preserved in isolated populations in tropical and Arctic regions with high pathogen burdens, e.g., helminths. Early humans experienced serious enteric infections that exerted evolutionary selection pressure, and factors that mitigate infant and childhood mortality from enteric infections also exert selection pressure. Some bacteria can exploit the host's defensive inflammatory response to colonize and invade the host. Pathogen-induced inflammation associated with infant and childhood diarrhea can damage the gut wall long after the invading organisms are no longer present. Inflammation not only resides in the mucosal wall, but also induces systemic inflammation. Baseline systemic inflammation is lower in ɛ4 carriers, yet ɛ4 carriers display a stronger host inflammatory response that reduces pathogen burdens, increasing infant and early childhood survival. Evolutionary selection of the ɛ3 allele likely occurred after humans moved into temperate zones with lower pathogen burdens, unrelated to protection from Alzheimer's disease.
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Affiliation(s)
| | - J Wesson Ashford
- Stanford University and VA Palo Alto Health Care System, Palo Alto, CA, USA
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9
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Zhuang T, Abuzeid AMI, Hu J, Zhu S, Lu J, Zhou X, Chen X, Li G. Eukaryotic expression and immunogenicity of Ancylostoma ceylanicum calreticulin. Parasitol Int 2022; 91:102633. [PMID: 35872299 DOI: 10.1016/j.parint.2022.102633] [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: 04/24/2022] [Revised: 06/30/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022]
Abstract
Ancylostoma ceylanicum is a zoonotic soil-derived nematode that parasitizes human and animal intestines, causing malnutrition and iron-deficiency anemia. Calreticulin is a multifunctional protein involved in all stages of parasitic infection. Studies have found that parasites can secret calreticulin to regulate the host's immune response. To explore the immunogenicity of the eukaryotic expression plasmid of Ancylostoma ceylanicum calreticulin (Ace-CRT), we constructed a recombinant Ace-CRT eukaryotic expression plasmid (pEGFP-N3-Ace-CRT). Successful expression of the target protein in Human Embryonic Kidney (HEK) 293 T cells was confirmed by indirect immunofluorescence and Western blot analysis. BALB/c mice were immunized with pEGFP-N3-Ace-CRT plasmid. Measuring IgG antibody levels in immunized mice sera by ELISA showed that the recombinant plasmid stimulated IgG antibody production in mice. Spleen lymphocytes were collected from vaccinated mice to determine the proportion of T cell subsets and the expression levels of cytokines. Flow cytometry revealed that the percentage of CD3 + CD4+ and CD3 + CD8+ T cells in mice spleen in the immunization group was significantly higher than that in the control group. Recombinant plasmid immunization increased IL-4, IL-10, IL-12, and IL-13 expression while decreasing IL-5, IL-6, and INF-γ in mice spleens. These results indicate that the eukaryotic plasmid constructed in this study had good immunogenicity and mainly induced a T helper 2 response in the host, laying a foundation for screening candidate molecules for anti-hookworm vaccines.
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Affiliation(s)
- Tingting Zhuang
- Guangdong Provincial Key Laboratory of Zoonosis Prevention and Control, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510542, China
| | - Asmaa M I Abuzeid
- Guangdong Provincial Key Laboratory of Zoonosis Prevention and Control, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510542, China; Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Junjing Hu
- Guangdong Provincial Key Laboratory of Zoonosis Prevention and Control, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510542, China
| | - Shilan Zhu
- Guangdong Provincial Key Laboratory of Zoonosis Prevention and Control, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510542, China
| | - Jinmiao Lu
- Guangdong Provincial Key Laboratory of Zoonosis Prevention and Control, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510542, China
| | - Xue Zhou
- Guangdong Provincial Key Laboratory of Zoonosis Prevention and Control, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510542, China
| | - Xiaoyu Chen
- Guangdong Provincial Key Laboratory of Zoonosis Prevention and Control, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510542, China
| | - Guoqing Li
- Guangdong Provincial Key Laboratory of Zoonosis Prevention and Control, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510542, China.
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10
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Meza Cerda MI, Gray R, Thomson PC, Butcher L, Simpson K, Cameron A, Marcus AD, Higgins DP. Developing Immune Profiles of Endangered Australian Sea Lion ( Neophoca cinerea) Pups Within the Context of Endemic Hookworm ( Uncinaria sanguinis) Infection. Front Vet Sci 2022; 9:824584. [PMID: 35529837 PMCID: PMC9069138 DOI: 10.3389/fvets.2022.824584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
As a top predator, the endangered Australian sea lion (Neophoca cinerea) is a sentinel of ecosystem change, where population trends can reflect broader shifts in the marine environment. The population of this endemic pinniped was historically diminished by commercial sealing, and recovery has been slowed by fishery interactions, disease and, potentially, pollutants. Hookworm infects 100% of neonatal pups and has been identified as a contributor to population decline. Here, a multivariable approach using traditional serological and novel molecular tools such as qPCR and ddPCR was used to examine immune phenotypes of developing Australian sea lion pups infected with the endemic hookworm (Uncinaria sanguinis) from two South Australian colonies. Results show changing immunophenotypes throughout the patent period of infection represented by pro-inflammatory cytokines (IL-6), IgG and acute-phase proteins. Although cytokines may prove useful as markers of resistance, in this study, IL-6 is determined to be an early biomarker of inflammation in Australian sea lion pups, excluding the alternative hypothesis. Additionally, immunological differences between animals from high- and low-intensity hookworm seasons, as well as ivermectin-treated animals, indicate hookworm infection modulation of the host immune response, as evidenced by a lower IL-6 mRNA expression in the non-treated groups. This study of the Australian sea lion is an example of an ecoimmunological approach to disease investigation, which can be applied to evaluate the impact of environmental and anthropogenic factors on susceptibility to infectious diseases in free-ranging species
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Affiliation(s)
- María-Ignacia Meza Cerda
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW, Australia
| | - Rachael Gray
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW, Australia
| | - Peter C Thomson
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW, Australia
| | - Loreena Butcher
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW, Australia
| | - Kelly Simpson
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW, Australia
| | - Abby Cameron
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW, Australia
| | - Alan D Marcus
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW, Australia
| | - Damien P Higgins
- Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW, Australia
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11
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Intestinal permeability before and after albendazole treatment in low and high socioeconomic status schoolchildren in Makassar, Indonesia. Sci Rep 2022; 12:3394. [PMID: 35233023 PMCID: PMC8888571 DOI: 10.1038/s41598-022-07086-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 02/07/2022] [Indexed: 11/08/2022] Open
Abstract
Intestinal helminths are highly prevalent in low-SES children and could contribute to poor health outcomes either directly or via alteration of the gut microbiome and gut barrier function. We analysed parasitic infections and gut microbiota composition in 325 children attending high- and low-SES schools in Makassar, Indonesia before and after albendazole treatment. Lactulose/Mannitol Ratio (LMR, a marker of gut permeability); I-FABP (a surrogate marker of intestinal damage) as well as inflammatory markers (LBP) were measured. Helminth infections were highly prevalent (65.6%) in low-SES children. LMR and I-FABP levels were higher in low-SES children (geomean (95%CI): 4.03 (3.67-4.42) vs. 3.22 (2.91-3.57); p. adj < 0.001; and 1.57 (1.42-1.74) vs. 1.25 (1.13-1.38); p. adj = 0.02, respectively) while LBP levels were lower compared to the high-SES (19.39 (17.09-22.01) vs. 22.74 (20.07-26.12); p.adj = 0.01). Albendazole reduced helminth infections in low-SES and also decreased LMR with 11% reduction but only in helminth-uninfected children (estimated treatment effect: 0.89; p.adj = 0.01). Following treatment, I-FABP decreased in high- (0.91, p.adj < 0.001) but increased (1.12, p.adj = 0.004) in low-SES children. Albendazole did not alter the levels of LBP. Microbiota analysis showed no contribution from specific bacterial-taxa to the changes observed. Intestinal permeability and epithelial damage are higher while peripheral blood inflammatory marker is lower in children of low-SES in Indonesia. Furthermore, treatment decreased LMR in helminth-uninfected only.
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12
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Shalash AO, Hussein WM, Skwarczynski M, Toth I. Hookworm infection: Toward development of safe and effective peptide vaccines. J Allergy Clin Immunol 2021; 148:1394-1419.e6. [PMID: 34872650 DOI: 10.1016/j.jaci.2021.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/07/2021] [Accepted: 10/18/2021] [Indexed: 11/28/2022]
Abstract
Hookworms are hematophagous nematode parasites that have infected a billion people worldwide. Anthelmintic drugs have limited efficacy and do not prevent reinfection. Therefore, prophylactic vaccines are in high demand. Whole parasite vaccines are allergic and unsafe; thus, research into subunit vaccines has been warranted. A comprehensive overview of protein or peptide subunit vaccines' safety, protective efficacy, and associated immune responses is provided herein. The differences between the immune responses against hookworm infection by patients from epidemic versus nonepidemic areas are discussed in detail. Moreover, the different immunologic mechanisms of protection are discussed, including those that rely on allergic and nonallergic humoral and antibody-dependent cellular responses. The allergic and autoimmune potential of hookworm antigens is also explored, as are the immunoregulatory responses induced by the hookworm secretome. The potential of oral mucosal immunizations has been overlooked. Oral immunity against hookworms is a long-lived and safer immune response that is associated with elimination of infection and protective against reinfections. However, the harsh conditions of the gastrointestinal environment necessitates special oral delivery systems to unlock vaccines' protective potential. The potential for development of safer and more effective peptide- and protein-based anthelmintic vaccines is explored herein.
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Affiliation(s)
- Ahmed O Shalash
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Waleed M Hussein
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Mariusz Skwarczynski
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia.
| | - Istvan Toth
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia; School of Pharmacy, The University of Queensland, Woolloongabba, Queensland, Australia.
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13
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Colella V, Khieu V, Worsley A, Senevirathna D, Muth S, Huy R, Odermatt P, Traub RJ. Risk profiling and efficacy of albendazole against the hookworms Necator americanus and Ancylostoma ceylanicum in Cambodia to support control programs in Southeast Asia and the Western Pacific. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 16:100258. [PMID: 34590062 PMCID: PMC8403762 DOI: 10.1016/j.lanwpc.2021.100258] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/17/2021] [Accepted: 07/26/2021] [Indexed: 11/18/2022]
Abstract
Background: Hookworm disease is endemic throughout many parts of the Asia Pacific, despite targeted control programs of at-risk populations. The success of these programs has been hindered by the limited efficacy of widely-used mebendazole, rapid re-infection rates linked to persistent reservoirs of untreated people and dogs, and the low sensitivity of conventional coprodiagnostic techniques employed. Methods: Here, we used standard faecal flotation (SFF) and a multiplex qPCR (mqPCR) assay to calculate and compare species-specific cure and egg reduction rates of single dose albendazole (400 mg) against hookworm infections at community level. Data from a cross-sectional survey in 1,232 people from Cambodia were used to inform a generalised linear mixed model to identify risk factors linked to hookworm infection(s) at baseline. Furthermore, we calculated risk factors associated to the probability of being cured after albendazole administration. Findings: Overall, 13·5% of all 1,232 people tested by SFF were positive for hookworm infection(s). Most (80·1%) infected people were >12 years of age, hence above the age targeted by the WHO control program. We estimate that as age increases, the odds of being infected increases at a faster rate for females than for males. We revealed a substantial difference in cure rate of hookworm infection(s) following albendazole treatment using the SFF (81·5%) and mqPCR (46·4%) assays, and provide the first data on the efficacy of this drug against the zoonotic hookworm Ancylostoma ceylanicum. We estimated that as age increases by one year, the odds of being cured decreases by 0·4%-3·7%. Similarly, the odds of being cured for people who boiled drinking water was estimated to be between 1·02 and 6·82. Interpretation: These findings show that the adoption of refined diagnostic techniques is central to monitoring hookworm infection(s) and the success of control strategies, which can ultimately aid in reducing associated morbidity in human populations. The approach taken is likely to be directly applicable to other parts of Southeast Asia and the Western Pacific, where specific epidemiological conditions might hamper the success of targeted treatment programs. Funding: Faculty of Veterinary and Agricultural Sciences Strategic Research Funds, The University of Melbourne.
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Affiliation(s)
- Vito Colella
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Australia
| | - Virak Khieu
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | | | - Dammika Senevirathna
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Australia
| | - Sinuon Muth
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Rekol Huy
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Peter Odermatt
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Rebecca J. Traub
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Australia
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14
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Amoani B, Gyan B, Sakyi SA, Abu EK, Nuvor SV, Barnes P, Sarkodie-Addo T, Ahenkorah B, Sewor C, Dwomoh D, Theisen M, Cappello M, Wilson MD, Adu B. Effect of hookworm infection and anthelmintic treatment on naturally acquired antibody responses against the GMZ2 malaria vaccine candidate and constituent antigens. BMC Infect Dis 2021; 21:332. [PMID: 33832450 PMCID: PMC8028774 DOI: 10.1186/s12879-021-06027-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/30/2021] [Indexed: 11/30/2022] Open
Abstract
Background Malaria and helminths diseases are co-endemic in most parts of sub-Saharan Africa. Immune responses from each of these pathogens interact, and these interactions may have implications on vaccines. The GMZ2 malaria vaccine candidate is a fusion protein of Plasmodium falciparum merozoite surface protein 3 (MSP3) and glutamate rich protein (GLURP R0). GMZ2 has recently showed modest efficacy in a phase IIb multicenter trial. Here, we assessed the effect of hookworm (Necator americanus) infection and anthelmintic treatment on naturally acquired antibody responses against GMZ2 and constituent antigens. Methods This longitudinal cross-sectional study was conducted in the Kintampo North Municipality of Ghana. Blood and stool samples were taken from 158 individuals (4–88 years old) infected with either P. falciparum alone (n = 59) or both hookworm and P. falciparum (n = 63) and uninfected endemic controls (n = 36). Stool hookworm infection was detected by the Kato-Katz method and PCR. Malaria parasitaemia was detected by RDT, light microscopy and P. falciparum-specific 18S rRNA gene PCR. Serum samples were obtained prior to hookworm treatment with a single dose of albendazole (400 mg) and 3 weeks (21 days) after treatment. Levels of IgG1, IgG3 and IgM against GMZ2, MSP3 and GLURP R0 were measured by ELISA and compared among the groups, before and after treatment. Results Participants with P. falciparum and hookworm co-infection had significantly higher IgG3 levels to GMZ2 than those with only P. falciparum infection and negative control (p < 0.05) at baseline. Treatment with albendazole led to a significant reduction in IgG3 levels against both GMZ2 and GLURP R0. Similarly, IgM and IgG1 levels against MSP3 also decreased following deworming treatment. Conclusion Individuals with co-infection had higher antibody responses to GMZ2 antigen. Treatment of hookworm/malaria co-infection resulted in a reduction in antibody responses against GMZ2 and constituent antigens after albendazole treatment. Thus, hookworm infection and treatment could have a potential implication on malaria vaccine efficacy.
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Affiliation(s)
- Benjamin Amoani
- Department of Biomedical Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.,Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ben Gyan
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Samuel Asamoah Sakyi
- Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Emmanuel Kwasi Abu
- Department of Optometry, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Victor Nuvor
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Precious Barnes
- Department of Physician Assistant, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Tracy Sarkodie-Addo
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Benjamin Ahenkorah
- Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Medical Laboratory Science, Bolgatanga Technical University, Bolgatanga, Upper East Region, Ghana
| | - Christian Sewor
- Department of Biomedical Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Duah Dwomoh
- Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana
| | - Michael Theisen
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark.,Centre for Medical Parasitology at Department of International Health, Immunology, and Microbiology, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Michael Cappello
- Partnerships for Global Health, Department of Pediatrics, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Michael D Wilson
- Parasitology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Bright Adu
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
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15
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Patel C, Keller L, Welsche S, Hattendorf J, Sayasone S, Ali SM, Ame SM, Coulibaly JT, Hürlimann E, Keiser J. Assessment of fecal calprotectin and fecal occult blood as point-of-care markers for soil-transmitted helminth attributable intestinal morbidity in a case-control substudy conducted in Côte d'Ivoire, Lao PDR and Pemba Island, Tanzania. EClinicalMedicine 2021; 32:100724. [PMID: 33554091 PMCID: PMC7851339 DOI: 10.1016/j.eclinm.2021.100724] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Infections with soil-transmitted helminths (STHs) may result in chronic inflammatory disorders affecting the human host. The objective of this study was to evaluate Fecal Calprotectin (FC) and Fecal Occult Blood (FOB) in individuals infected and non-infected with STHs to identify potential intestinal morbidity markers. METHODS Stool from participants diagnosed positive for Trichuris trichiura and concomitant STH infections from three countries was used to perform FC and FOB point-of-care assays. Simultaneously, identified STH negative participants underwent FC and FOB testing as controls. Potential associations between test results and determinants were analyzed using multivariable logistic regression. FINDINGS In total, 1034 T. trichiura infected cases (mostly light infections) and 157 STH negative controls were tested for FC and FOB. Among all participants tested, 18·5% had ≥ 50 µg/g FC concentration, while 14 (1·2%) were positive for FOB. No statistically significant association was found between T. trichiura infection or Ascaris lumbricoides co-infection and FC concentration, while an inverse association (odds ratio (OR): 0·45, 95% credible intervals (CrI): 0·26, 0·75) was found between hookworm co-infection and FC concentration. In Lao PDR, the proportion of participants in the ≥ 50 µg/g FC category was significantly higher in the oldest age category compared to the 5-11 years group (OR: 3·31, 95% CrI: 1·62, 7·24). Too few participants were found positive for FOB to derive any conclusions. INTERPRETATION Studies are needed to better understand the relationship between intestinal morbidity and STH infections. Suitable, standardized, low-cost markers of STH attributable morbidity to better monitor the impact of STH control interventions are necessary. FUNDING BMGF (OPP1153928).
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Affiliation(s)
- Chandni Patel
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Ladina Keller
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sophie Welsche
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jan Hattendorf
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Somphou Sayasone
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of International Program for Health in the Tropics, Lao Tropical and Public Health Institute, Vientiane, Lao People's Democratic Republic
| | - Said M. Ali
- Public Health Laboratory Ivo de Carneri, Chake Chake, Pemba, Zanzibar, Tanzania
| | - Shaali M. Ame
- Public Health Laboratory Ivo de Carneri, Chake Chake, Pemba, Zanzibar, Tanzania
| | - Jean Tenena Coulibaly
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
- Department of Research and Development, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Eveline Hürlimann
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jennifer Keiser
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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16
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El Atab O, Darwiche R, Truax NJ, Schneiter R, Hull KG, Romo D, Asojo OA. Necator americanus Ancylostoma Secreted Protein-2 ( Na-ASP-2) Binds an Ascaroside (ascr#3) in Its Fatty Acid Binding Site. Front Chem 2020; 8:608296. [PMID: 33392151 PMCID: PMC7773830 DOI: 10.3389/fchem.2020.608296] [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: 09/20/2020] [Accepted: 11/25/2020] [Indexed: 11/28/2022] Open
Abstract
During their infective stages, hookworms release excretory-secretory (E-S) products, small molecules, and proteins to help evade and suppress the host's immune system. Small molecules found in E-S products of mammalian hookworms include nematode derived metabolites like ascarosides, which are composed of the sugar ascarylose linked to a fatty acid side chain. The most abundant proteins found in hookworm E-S products are members of the protein family known as Ancylostoma secreted protein (ASP). In this study, two ascarosides and their fatty acid moieties were synthesized and tested for in vitro binding to Na-ASP-2 using both a ligand competition assay and microscale thermophoresis. The fatty acid moieties of both ascarosides tested and ascr#3, an ascaroside found in rat hookworm E-S products, bind to Na-ASP-2's palmitate binding cavity. These molecules were confirmed to bind to the palmitate but not the sterol binding sites. An ascaroside, oscr#10, which is not found in hookworm E-S products, does not bind to Na-ASP-2. More studies are required to determine the structural basis of ascarosides binding by Na-ASP-2 and to understand the physiological significance of these observations.
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Affiliation(s)
- Ola El Atab
- Division of Biochemistry, Department of Biology, University of Fribourg, Fribourg, Switzerland
| | - Rabih Darwiche
- Division of Biochemistry, Department of Biology, University of Fribourg, Fribourg, Switzerland
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, United States
| | - Nathanyal J. Truax
- Department of Chemistry and Biochemistry & The CPRIT Synthesis and Drug-Lead Discovery Laboratory, Baylor University, Waco, TX, United States
| | - Roger Schneiter
- Division of Biochemistry, Department of Biology, University of Fribourg, Fribourg, Switzerland
| | - Kenneth G. Hull
- Department of Chemistry and Biochemistry & The CPRIT Synthesis and Drug-Lead Discovery Laboratory, Baylor University, Waco, TX, United States
| | - Daniel Romo
- Department of Chemistry and Biochemistry & The CPRIT Synthesis and Drug-Lead Discovery Laboratory, Baylor University, Waco, TX, United States
| | - Oluwatoyin A. Asojo
- Department of Chemistry and Biochemistry, Hampton University, Hampton, VA, United States
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
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17
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Farrant O, Marlais T, Houghton J, Goncalves A, Teixeira da Silva Cassama E, Cabral MG, Nakutum J, Manjuba C, Rodrigues A, Mabey D, Bailey R, Last A. Prevalence, risk factors and health consequences of soil-transmitted helminth infection on the Bijagos Islands, Guinea Bissau: A community-wide cross-sectional study. PLoS Negl Trop Dis 2020; 14:e0008938. [PMID: 33326420 PMCID: PMC7773412 DOI: 10.1371/journal.pntd.0008938] [Citation(s) in RCA: 5] [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: 06/24/2020] [Revised: 12/30/2020] [Accepted: 10/30/2020] [Indexed: 11/19/2022] Open
Abstract
Soil-transmitted helminths (STH) are endemic and widespread across Sub-Saharan Africa. A community wide soil-transmitted helminth (STH) prevalence survey was performed on the island of Bubaque in Guinea-Bissau using both Kato-katz microscopy and qPCR methodology. Predictors of infection and morbidity indicators were identified using multivariable logistic regression, and diagnostic methods were compared using k statistics. Among 396 participants, prevalence of STH by microscopy was 23.2%, hookworm was the only species identified by this method and the mean infection intensity was 312 eggs per gram. qPCR analysis revealed an overall prevalence of any STH infection of 47.3%, with the majority A. duodenale (32.3%), followed by N. americanus (15.01%) and S. stercoralis (13.2%). A. lumbricoides, and T. trichiura infections were negligible, with a prevalence of 0.25% each. Agreement between diagnostic tests was k = 0.22, interpreted as fair agreement, and infection intensity measured by both methods was only minimally correlated (Rs = -0.03). STH infection overall was more common in females and adults aged 31-40. STH infection was associated with open defaecation, low socio-economic status and further distance to a water-source. The prevalence of anaemia (defined as a binary outcome by the WHO standards for age and sex) was 69.1%, and 44.2% of children were malnourished according to WHO child growth standards. Hookworm infection intensity by faecal egg count showed no statistically significant association with age (Rs 0.06) but S. Stercoralis infection intensity by qPCR cycle threshold was higher in pre-school aged children (Rs = 0.30, p-value 0.03) There was no statistically significant association between STH infection and anaemia (OR 1.0 p = 0.8), stunting (OR 1.9, p-value 0.5) and wasting (OR 2.0, p-value 0.2) in children. This study reveals a persistent reservoir of STH infection across the community, with high rates of anaemia and malnutrition, despite high-coverage of mebendazole mass-drug administration in pre-school children. This reflects the need for a new strategy to soil-transmitted helminth control, to reduce infections and ultimately eliminate transmission.
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Affiliation(s)
- Olivia Farrant
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Tegwen Marlais
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Joanna Houghton
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Adriana Goncalves
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | - Jose Nakutum
- Region Sanitaria Bolama-Bijagós, Bubaque, Guinea Bissau
| | | | | | - David Mabey
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Robin Bailey
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Anna Last
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
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18
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Ness TE, Agrawal V, Bedard K, Ouellette L, Erickson TA, Hotez P, Weatherhead JE. Maternal Hookworm Infection and Its Effects on Maternal Health: A Systematic Review and Meta-Analysis. Am J Trop Med Hyg 2020; 103:1958-1968. [PMID: 32840198 DOI: 10.4269/ajtmh.20-0503] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Hookworm is an intestinal parasite that infects nearly 230 million people, with another 5.1 billion at risk, especially in poverty-stricken tropical and subtropical regions. Pregnancy is an especially vulnerable time for hookworm infection because of its effect on both maternal and subsequently fetal health. A systematic review and meta-analysis was conducted. The meta-analysis was performed on the association between maternal hookworm and maternal anemia, as well as maternal hookworm coinfection with malaria. The prevalence of hookworm ranged from 1% to 78% in pregnant women, whereas malaria prevalence ranged from 11% to 81%. Pregnant women with hookworm infection were more likely to have anemia (combined odds ratio [cOR] 2.55 [2.20, 2.96], P < 0.001). In addition, pregnant woman with hookworm were more likely to have malaria coinfection (cOR 1.60 [1.38, 1.86], P < 0.001). Other effects on maternal and child health were investigated and summarized without systematic review or meta-analysis because of the limited study numbers. Despite current deworming recommendations in pregnant women, heavy hookworm burden, coinfection with malaria, and subsequent anemia persist. Although this is likely due, in part, to a lack of implementation of preventive chemotherapy, additional interventions such as health education, proper waste management, or linking malaria and soil-transmitted helminth treatment and prevention programs may also be needed. Further investigations on maternal-child outcomes as a result of hookworm infection during pregnancy will highlight public health interventional targets to reduce morbidity in pregnant women and children globally.
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Affiliation(s)
- Tara E Ness
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Vedika Agrawal
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Kathryn Bedard
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | | | - Timothy A Erickson
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Peter Hotez
- Department of Biology, Baylor University, Waco, Texas.,Hagler Institute for Advanced Study at Texas A&M University, College Station, Texas.,National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas.,Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jill E Weatherhead
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas.,Department of Medicine, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
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Mourão Dias Magalhães L, Silva Araújo Passos L, Toshio Fujiwara R, Lacerda Bueno L. Immunopathology and modulation induced by hookworms: From understanding to intervention. Parasite Immunol 2020; 43:e12798. [PMID: 33012113 DOI: 10.1111/pim.12798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/21/2020] [Accepted: 09/25/2020] [Indexed: 12/15/2022]
Abstract
Hookworm infection is considered the most prevalent human soil-transmitted helminth infection affecting approximately 500 million people and accounting for 3.2 million disability-adjusted life years lost annually. As with many other neglected tropical diseases, no international surveillance mechanisms that show accurate data on the prevalence of hookworm infection are in place, thus hindering strategies to control parasite transmission. In this review, we unravel the current knowledge in immunopathology and immunoregulation of hookworm infection and present discoveries in drug therapies based on the capability of hookworms to regulate inflammation to treat allergic, inflammatory and metabolic diseases. Additionally, we highlight potential vaccine development and treatments and propose avenues for further inquiry.
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Affiliation(s)
| | - Livia Silva Araújo Passos
- Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Toshio Fujiwara
- Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lilian Lacerda Bueno
- Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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20
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Zawawi A, Else KJ. Soil-Transmitted Helminth Vaccines: Are We Getting Closer? Front Immunol 2020; 11:576748. [PMID: 33133094 PMCID: PMC7565266 DOI: 10.3389/fimmu.2020.576748] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/02/2020] [Indexed: 01/07/2023] Open
Abstract
Parasitic helminths infect over one-fourth of the human population resulting in significant morbidity, and in some cases, death in endemic countries. Despite mass drug administration (MDA) to school-aged children and other control measures, helminth infections are spreading into new areas. Thus, there is a strong rationale for developing anthelminthic vaccines as cost-effective, long-term immunological control strategies, which, unlike MDA, are not haunted by the threat of emerging drug-resistant helminths nor limited by reinfection risk. Advances in vaccinology, immunology, and immunomics include the development of new tools that improve the safety, immunogenicity, and efficacy of vaccines; and some of these tools have been used in the development of helminth vaccines. The development of anthelminthic vaccines is fraught with difficulty. Multiple lifecycle stages exist each presenting stage-specific antigens. Further, helminth parasites are notorious for their ability to dampen down and regulate host immunity. One of the first significant challenges in developing any vaccine is identifying suitable candidate protective antigens. This review explores our current knowledge in lead antigen identification and reports on recent pre-clinical and clinical trials in the context of the soil-transmitted helminths Trichuris, the hookworms and Ascaris. Ultimately, a multivalent anthelminthic vaccine could become an essential tool for achieving the medium-to long-term goal of controlling, or even eliminating helminth infections.
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Affiliation(s)
- Ayat Zawawi
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia,*Correspondence: Ayat Zawawi
| | - Kathryn J. Else
- Manchester Academic Health Science Centre, Faculty of Biology, Medicine, and Health, School of Biological Sciences, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom,Kathryn J. Else
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21
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Stracke K, Jex AR, Traub RJ. Zoonotic Ancylostomiasis: An Update of a Continually Neglected Zoonosis. Am J Trop Med Hyg 2020; 103:64-68. [PMID: 32342850 PMCID: PMC7356431 DOI: 10.4269/ajtmh.20-0060] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/16/2020] [Indexed: 12/30/2022] Open
Abstract
Hookworm infections are classified as the most impactful of the human soil-transmitted helminth (STH) infections, causing a disease burden of ∼4 million disability-adjusted life years, with a global prevalence of 406-480 million infections. Until a decade ago, epidemiological surveys largely assumed Necator americanus and Ancylostoma duodenale as the relevant human hookworm species implicated as contributing to iron-deficiency anemia. This assumption was based on the indistinguishable morphology of the Ancylostoma spp. eggs in stool and the absence of awareness of a third zoonotic hookworm species, Ancylostoma ceylanicum. The expanded use of molecular diagnostic assays for differentiating hookworm species infections during STH surveys has now implicated A. ceylanicum, a predominant hookworm of dogs in Asia, as the second most common hookworm species infecting humans in Southeast Asia and the Pacific. Despite this, with the exception of sporadic case reports, there is a paucity of data available on the impact of this emerging zoonosis on human health at a population level. This situation also challenges the current paradigm, necessitating a One Health approach to hookworm control in populations in which this zoonosis is endemic. Here, we have summarized the available research studies and case reports on human A. ceylanicum infections in Southeast Asia and the Pacific after 2013 using a systematic review approach. We summarized eight research articles and five clinical case studies, highlighting the importance of future in-depth investigation of zoonotic A. ceylanicum infections using sensitive and cost-effective diagnostic tools.
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Affiliation(s)
- Katharina Stracke
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
- The Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Aaron R. Jex
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
- Faculty for Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Australia
| | - Rebecca J. Traub
- Faculty for Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Australia
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22
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Fairley JK, Ferreira JA, de Oliveira ALG, de Filippis T, de Faria Grossi MA, Chaves LP, Caldeira LN, Dos Santos PS, Costa RR, Diniz MC, Duarte CS, Bomjardim Pôrto LA, Suchdev PS, Negrão-Corrêa DA, do Carmo Magalhães F, Peixoto Moreira JM, de Melo Freire Júnior A, Cerqueira MC, Kitron U, Lyon S. The Burden of Helminth Coinfections and Micronutrient Deficiencies in Patients with and without Leprosy Reactions: A Pilot Study in Minas Gerais, Brazil. Am J Trop Med Hyg 2020; 101:1058-1065. [PMID: 31549606 DOI: 10.4269/ajtmh.18-0502] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Leprosy reactions are immune-mediated complications occurring in up to 50% of patients. The immune consequences of helminth infections and micronutrient deficiencies suggest a potential role in type 1 reactions (T1R) or type 2 reactions (T2R). We conducted a case-control study in Minas Gerais, Brazil, to evaluate whether comorbidities and other factors are associated with reactions in patients with multibacillary leprosy. Stool and serum were tested for helminth infections. Deficiencies of vitamin A, D, and iron were measured using serum retinol, 25-hydroxyvitamin D, and ferritin, respectively. Logistic regression models identified associations between reactions and helminth infections, micronutrient deficiencies, and other variables. Seventy-three patients were enrolled, 24 (33%) with T1R, 21 (29%) with T2R, 8 (15%) with mixed T1R/T2R, and 20 (27%) without reactions. Evidence of helminth infections were found in 11 participants (15%) and included IgG4 reactivity against Schistosoma mansoni, Strongyloides, and Ascaris antigens. Thirty-eight (52%) had vitamin D deficiency, eight (11%) had vitamin A insufficiency, 21 (29%) had anemia, and one (1.4%) had iron deficiency. Multivariable logistic regression showed no statistically significant associations between helminth coinfections and total reactions (adjusted odds ratios [aOR]: 1.36, 95% CI: 0.22, 8.33), T1R (aOR: 0.85, 95% CI: 0.17, 4.17), or T2R (aOR: 2.41, 95% CI: 0.29, 20.0). Vitamin D deficiency and vitamin A insufficiency were also not statistically associated with reactions. However, vitamin deficiencies and helminth infections were prevalent in these patients, suggesting a potential role for additional treatment interventions. Studying reactions prospectively may further clarify the role of comorbidities in the clinical presentation of leprosy.
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Affiliation(s)
- Jessica K Fairley
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Jose A Ferreira
- Faculdade Saúde e Ecologia Humana (FASEH), Vespasiano, Brazil
| | | | | | | | | | | | | | | | | | | | | | - Parminder S Suchdev
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | | | | | | | | | | | - Uriel Kitron
- Department of Environmental Sciences, Emory University, Atlanta, Georgia
| | - Sandra Lyon
- Faculdade Saúde e Ecologia Humana (FASEH), Vespasiano, Brazil
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Abuzeid AMI, Zhou X, Huang Y, Li G. Twenty-five-year research progress in hookworm excretory/secretory products. Parasit Vectors 2020; 13:136. [PMID: 32171305 PMCID: PMC7071665 DOI: 10.1186/s13071-020-04010-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 03/06/2020] [Indexed: 11/16/2022] Open
Abstract
Hookworm infection is a major public health problem that threatens about 500 million people throughout tropical areas of the world. Adult hookworms survive for many years in the host intestine, where they suck blood, causing iron deficiency anemia and malnutrition. Numerous molecules, named excretory/secretory (ES) products, are secreted by hookworm adults and/or larvae to aid in parasite survival and pathobiology. Although the molecular cloning and characterization of hookworm ES products began 25 years ago, the biological role and molecular nature of many of them are still unclear. Hookworm ES products, with distinct structures and functions, have been linked to many essential events in the disease pathogenesis. These events include host invasion and tissue migration, parasite nourishment and reproduction, and immune modulation. Several of these products represent promising vaccine targets for controlling hookworm disease and therapeutic targets for many inflammatory diseases. This review aims to summarize our present knowledge about hookworm ES products, including their role in parasite biology, host-parasite interactions, and as vaccine and pharmaceutical targets and to identify research gaps and future research directions in this field.![]()
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Affiliation(s)
- Asmaa M I Abuzeid
- Guangdong Provincial Zoonosis Prevention and Control Key Laboratory, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, China
| | - Xue Zhou
- Guangdong Provincial Zoonosis Prevention and Control Key Laboratory, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, China
| | - Yue Huang
- Guangdong Provincial Zoonosis Prevention and Control Key Laboratory, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, China
| | - Guoqing Li
- Guangdong Provincial Zoonosis Prevention and Control Key Laboratory, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, China.
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24
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Toychiev A, Mirzoeva M, Davis N, Islamova J, Osipova S. Pityriasis alba: Possible associations with intestinal helminths and pathogenic protozoa. Int J Clin Pract 2020; 74:e13441. [PMID: 31633268 DOI: 10.1111/ijcp.13441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/22/2019] [Accepted: 10/16/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The aetiology of pityriasis alba (PA) remains uncertain, and children are at risk for PA and intestinal parasites. AIM To determine the prevalence of intestinal parasites in PA patients and to evaluate their possible role in PA pathogenesis. METHODS Overall, 180 PA patients and 100 healthy individuals were enrolled. Intestinal parasites were diagnosed by triple coproscopy, and the total serum Immunoglobulin E (IgE) levels were determined by ELISA. PA patients with intestinal parasites were treated with conventional antiparasitic drugs. Patient response to antiparasitic therapy was evaluated after 6 weeks. RESULTS The prevalence of intestinal parasites in PA patients and controls was 60 ± 3.6% and 32 ± 4.6%, respectively (P < .0001). Regardless of the parasite species among the PA patients and control individuals, the total IgE levels were significantly higher in PA patients (P ≤ .05). The highest values of IgE were found in PA patients with Hymenolepis nana (641.7 ± 46.3 IU/mL). The total IgE level in PA patients with parasites decreased after antiparasitic therapy, but the reduction was only significant in patients with H. nana (P < .05). Complete disappearance of hypopigmented patches was observed after the elimination of H. nana, Giardia lamblia and Enterobius vermicularis in 65 ± 10.6%, 48.7 ± 8.0% and 33.3 ± 8.2% of cases, respectively. In total, a positive clinical response to antiparasitic therapy was achieved in 60 ± 4.7% of infected PA patients. CONCLUSION A positive clinical response to antiparasitic therapy indicates the role of intestinal parasites in PA pathogenesis. Parasitological examination is justified by the recovery of 60 ± 4.7% of infected PA patients after the elimination of intestinal parasites.
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Affiliation(s)
- Abdurakhim Toychiev
- Department of Immunology of Parasitic Diseases, the Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan
| | - Mexriniso Mirzoeva
- Department of Infectious Diseases, Bukhara state medical institute, Bukhara, Uzbekistan
| | - Nikolay Davis
- Department of Immunology of Parasitic Diseases, the Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan
| | - Jannat Islamova
- Department of Pharmacology and Toxicology, the Institute of the Chemistry of Plant Substances named acad. S. Yu. Yunusov, Tashkent, Uzbekistan
| | - Svetlana Osipova
- Department of Immunology of Parasitic Diseases, the Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan
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25
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Jimenez Castro PD, Howell SB, Schaefer JJ, Avramenko RW, Gilleard JS, Kaplan RM. Multiple drug resistance in the canine hookworm Ancylostoma caninum: an emerging threat? Parasit Vectors 2019; 12:576. [PMID: 31818311 PMCID: PMC6902405 DOI: 10.1186/s13071-019-3828-6] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 11/30/2019] [Indexed: 12/21/2022] Open
Abstract
Background The canine hookworm, Ancylostoma caninum is the most prevalent and important intestinal nematode parasite of dogs in the USA. Hookworms are typically well controlled by treatment with all commonly used anthelmintics that are approved for this use in dogs. However, in the past few years, cases of recurrent/persistent canine hookworm infections appear to have dramatically increased, suggesting that anthelmintic resistance (AR) may have evolved in this parasite. These cases are highly overrepresented by greyhounds, but multiple other breeds are also represented. The aim of this study was to characterize several of these suspected resistant isolates using in vitro, genetic and clinical testing to determine if these cases represent true anthelmintic resistance in A. caninum. Methods Fecal samples containing hookworm eggs from three cases of persistent hookworm infections; one from a greyhound, one from a miniature schnauzer and one from a hound-mix, were received by our laboratory. These were then used to establish infections in laboratory dogs and to perform egg hatch assays (EHA) and larval development assays (LDA) for detecting resistance to benzimidazoles and macrocyclic lactones, respectively. Additional EHA and LDA were performed on eggs recovered from the laboratory-induced infections. Fecal egg count reduction tests were performed to detect resistance to pyrantel. Deep amplicon sequencing assays were developed to measure the frequency of non-synonymous single nucleotide polymorphisms (SNP) at codons 167, 198 and 200 of the A. caninum isotype-1 β-tubulin gene. Results Resistance ratios for the three A. caninum isolates tested ranged from 6.0 to > 100 and 5.5 to 69.8 for the EHA and LDA, respectively. Following treatment with pyrantel, reduction in faecal egg counts was negative or 0%. Deep amplicon sequencing of the isotype-1 β-tubulin gene identified a high frequency of resistance-associated SNPs at codon 167 in all three resistant isolates and in two additional clinical cases. Conclusions These data conclusively demonstrate multiple anthelmintic resistance in multiple independent isolates of A. caninum, strongly suggesting that this is an emerging problem in the USA. Furthermore, evidence suggest that these resistant hookworms originate from racing greyhound farms and kennels, though additional research is needed to confirm this. ![]()
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Affiliation(s)
- Pablo D Jimenez Castro
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602, USA. .,Grupo de Parasitología Veterinaria, Universidad Nacional de Colombia, Bogotá, Colombia.
| | - Sue B Howell
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602, USA
| | - John J Schaefer
- School of Veterinary Medicine, Department of Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, USA
| | - Russell W Avramenko
- Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - John S Gilleard
- Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ray M Kaplan
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602, USA
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Amoani B, Adu B, Frempong MT, Sarkodie-Addo T, Nuvor SV, Wilson MD, Gyan B. Levels of serum eosinophil cationic protein are associated with hookworm infection and intensity in endemic communities in Ghana. PLoS One 2019; 14:e0222382. [PMID: 31513658 PMCID: PMC6742367 DOI: 10.1371/journal.pone.0222382] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 08/28/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The eosinophil cationic protein (ECP) is a cytotoxic protein mainly secreted by eosinophils granulocytes and plays a role in host defense against parasitic infections. Infection with Necator americanus (hookworm) is traditionally diagnosed by the Kato-Katz method which is inherently tedious, subjective and known to underestimate infection intensity. This study aimed to assess levels of serum ECP in relation to hookworm infection intensity. METHODS Stool samples from 984 (aged 4 to 80 years) participants in a cross-sectional study conducted in the Kintampo North Municipality of Ghana were examined using the Kato-Katz and formol-ether concentration methods. Serum ECP levels were measured by ECP assay kit and compared between 40 individuals infected with hookworm only, 63 with hookworm- Plasmodium falciparum co-infection, 59 with P. falciparum infection and 36 with no infection. RESULTS Hookworm infection prevalence was 18.1% (178/984). ECP levels were significantly higher in individuals infected with hookworm only (β = 2.96, 95%CI = 2.69, 3.23, p<0.001) or co-infected with P. falciparum (β = 3.15, 95%CI = 2.91, 3.39, p<0.001) compared to the negative control. Levels of ECP were similar between those with only P. falciparum infection and the uninfected control (p>0.05). Increased hookworm intensity was associated with a significant increase in ECP level (β = 4.45, 95%CI = 2.25, 9.11, rs = 0.193, n = 103, p<0.01). ECP threshold of 84.98ng/ml was associated with a positive predictive value (PPV) of 98% (95% CI = 92, 100), and negative predictive value (NPV) of 76% (95% CI = 62, 87) in classifying hookworm infection status with an AUROC of 96.3%. CONCLUSION Serum ECP level may be a good biomarker of hookworm infection and intensity and warrant further investigations to help improve current hookworm diagnosis.
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Affiliation(s)
- Benjamin Amoani
- Department of Biomedical Science, College of Health Sciences, University of Cape Coast, Cape Coast, Ghana
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
- Molecular Medicine Department, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Ghana
| | - Bright Adu
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Margaret T. Frempong
- Molecular Medicine Department, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Ghana
| | - Tracy Sarkodie-Addo
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Samuel Victor Nuvor
- Department of Microbiology, College of Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Michael D. Wilson
- Parasitology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Ben Gyan
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
- * E-mail:
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da Silva VJ, Dias SRC, Alves WP, Furtado LFV, Serafim LR, Moreira TB, de Aguiar PHN, de Faria AMC, Rabelo ÉML. Hookworm infection aggravates metabolic disorder in obesity. Mol Biochem Parasitol 2019; 232:111200. [DOI: 10.1016/j.molbiopara.2019.111200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 07/01/2019] [Accepted: 07/10/2019] [Indexed: 12/20/2022]
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28
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Morales-Yanez FJ, Sariego I, Vincke C, Hassanzadeh-Ghassabeh G, Polman K, Muyldermans S. An innovative approach in the detection of Toxocara canis excretory/secretory antigens using specific nanobodies. Int J Parasitol 2019; 49:635-645. [PMID: 31150611 DOI: 10.1016/j.ijpara.2019.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/13/2019] [Accepted: 03/11/2019] [Indexed: 10/26/2022]
Abstract
Human toxocariasis is a zoonosis resulting from the migration of larval stages of the dog parasite Toxocara canis into the human paratenic host. Despite its well-known limitations, serology remains the most important tool to diagnose the disease. Our objective was to employ camelid single domain antibody fragments also known as nanobodies (Nbs) for a specific and sensitive detection of Toxocara canis excretory/secretory (TES) antigens. From an alpaca immune Nb library, we retrieved different Nbs with specificity for TES antigens. Based on ELISA experiments, these Nbs did not show any cross-reactivity with Ascaris lumbricoides, Ascaris suum, Pseudoterranova decipiens, Anisakis simplex and Angiostrongylus cantonensis larval antigens. Western blot and immunocapturing revealed that Nbs 1TCE39, 1TCE52 and 2TCE49 recognise shared epitopes on different components of TES antigen. The presence of disulphide bonds in the target antigen seems to be essential for recognition of the epitopes by these three Nbs. Three separate sandwich ELISA formats, using monovalent and bivalent Nbs, were assessed to maximise the detection of TES antigens in solution. The combination of biotinylated, bivalent Nb 2TCE49 on a streptavidin pre-coated plate to capture TES antigens, and Nb 1TCE39 chemically coupled to horseradish peroxidase for detection of the captured TES antigens, yielded the most sensitive ELISA with a limit of detection of 0.650 ng/ml of TES antigen, spiked in serum. Moreover, the assay was able to detect TES antigens in sera from mice, taken 3 days after the animals were experimentally infected with T. canis. The specific characteristics of Nbs make this ELISA not only a promising tool for the detection of TES antigens in clinical samples, but also for a detailed structural and functional study of TES antigens.
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Affiliation(s)
- Francisco J Morales-Yanez
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium; Department of Biomedical Sciences, Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Idalia Sariego
- Institute of Tropical Medicine "Pedro Kourí", Havana, Cuba
| | - Cécile Vincke
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Katja Polman
- Department of Biomedical Sciences, Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium; Department of Health Sciences, Section Infectious Diseases, VU University Amsterdam, The Netherlands
| | - Serge Muyldermans
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
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Biological role of excretory-secretory proteins in endemic parasites of Latin America and the Caribbean. J Helminthol 2019; 94:e53. [PMID: 31092301 DOI: 10.1017/s0022149x19000312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Neglected tropical diseases (NTDs) share certain traits: they are parasitic infections, prevailing in tropical environments and affecting marginalized sectors of the population. Six NTDs - ascariasis, cysticercosis, echinococcosis, hookworm infection, onchocerciasis and trichuriasis - all of them endemic in Latin America and the Caribbean (LAC), are analysed in this work. This review aims to discuss key information on the function of excretory/secretory (E/S) proteins from these parasites in their infectivity, pathogeny and diagnosis. The modulation of the host immune system to favour the permanence and survival of the parasite is also discussed. An updated knowledge on the function of E/S molecules in endemic parasitoses in LAC may lead to new approaches for the clinical management and diagnosis of these diseases. In turn, this could allow us to optimize their treatment and make it more affordable - a relevant goal given the economic constraints that the region is facing.
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Noon JB, Schwarz EM, Ostroff GR, Aroian RV. A highly expressed intestinal cysteine protease of Ancylostoma ceylanicum protects vaccinated hamsters from hookworm infection. PLoS Negl Trop Dis 2019; 13:e0007345. [PMID: 31009474 PMCID: PMC6497320 DOI: 10.1371/journal.pntd.0007345] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/02/2019] [Accepted: 03/28/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Human hookworms (Necator americanus, Ancylostoma duodenale, and Ancylostoma ceylanicum) are intestinal blood-feeding parasites that infect ~500 million people worldwide and are among the leading causes of iron-deficiency anemia in the developing world. Drugs are useful against hookworm infections, but hookworms rapidly reinfect people, and the parasites can develop drug resistance. Therefore, having a hookworm vaccine would be of tremendous benefit. METHODOLOGY/PRINCIPAL FINDINGS We investigated the vaccine efficacy in outbred Syrian hamsters of three A. ceylanicum hookworm antigen candidates from two classes of proteins previously identified as promising vaccine candidates. These include two intestinally-enriched, putatively secreted cathepsin B cysteine proteases (AceyCP1, AceyCPL) and one small Kunitz-type protease inhibitor (AceySKPI3). Recombinant proteins were produced in Pichia pastoris, and adsorbed to Alhydrogel. Recombinant AceyCPL (rAceyCPL)/Alhydrogel and rAceySKPI3/Alhydrogel induced high serum immunoglobulin G (IgG) titers in 8/8 vaccinates, but were not protective. rAceyCP1/Alhydrogel induced intermediate serum IgG titers in ~60% of vaccinates in two different trials. rAceyCP1 serum IgG responders had highly significantly decreased hookworm burdens, fecal egg counts and clinical pathology compared to Alhydrogel controls and nonresponders. Protection was highly correlated with rAceyCP1 serum IgG titer. Antisera from rAceyCP1 serum IgG responders, but not nonresponders or rAceyCPL/Alhydrogel vaccinates, significantly reduced adult A. ceylanicum motility in vitro. Furthermore, rAceyCP1 serum IgG responders had canonical Th2-specific recall responses (IL4, IL5, IL13) in splenocytes stimulated ex vivo. CONCLUSIONS/SIGNIFICANCE These findings indicate that rAceyCP1 is a promising vaccine candidate and validates a genomic/transcriptomic approach to human hookworm vaccine discovery.
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Affiliation(s)
- Jason B. Noon
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Erich M. Schwarz
- Department of Molecular Biology and Genetics, Cornell University, Ithaca, New York, United States of America
| | - Gary R. Ostroff
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Raffi V. Aroian
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
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Furtado LFV, de Aguiar PHN, Zuccherato LW, Teixeira TTG, Alves WP, da Silva VJ, Gasser RB, Rabelo ÉML. Albendazole resistance induced in Ancylostoma ceylanicum is not due to single-nucleotide polymorphisms (SNPs) at codons 167, 198, or 200 of the beta-tubulin gene, indicating another resistance mechanism. Parasitol Res 2019; 118:837-849. [PMID: 30697644 DOI: 10.1007/s00436-019-06218-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 01/17/2019] [Indexed: 12/12/2022]
Abstract
Mass drug administration has been implicated as the major cause of drug resistance in nematodes of ruminants. Single-nucleotide polymorphisms (SNPs) at codons 167, 198, and 200 of the beta-tubulin isotype 1 gene are associated with albendazole resistance mechanisms. Although drug resistance is suspected to occur in nematodes of the same order, at present, there is no evidence of a strong correlation between these canonical SNPs and albendazole resistance in hookworms. In the absence of a hookworm strain that is naturally resistant to albendazole, we produced an albendazole-resistant Ancylostoma ceylanicum strain by selective drug pressure. Restriction fragment length polymorphism-PCR (RFLP-PCR) was employed to identify the presence of SNPs previously associated with drug resistance in other nematodes. However, none of the benzimidazole resistance-associated SNPs known in other nematodes were found. A beta-tubulin isotype 1 gene mini-cDNA library was constructed to obtain the complete cDNA gene sequence for the analysis of the entire gene to identify distinct SNPs associated with resistance. Some SNPs were found, but the resulting sequences were not reproducibly detected among the different clones, preventing their association with the resistance mechanism. The parasitological and hematological parameters of the albendazole-resistant strain were characterized and compared to those of the sensitive strain. Although the albendazole-resistant strain was less adapted to its host, with fewer worms recovered, all other parameters analyzed were similar between both strains. The results of the present study indicate that the mechanism of albendazole resistance of the resistant strain described herein must differ from those that have previously been characterized. Thus, new mechanistic studies are needed in the future.
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Affiliation(s)
- Luis Fernando Viana Furtado
- Departamento de Parasitologia, L4 237, Laboratório de Parasitologia Molecular, Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Avenida Presidente Antônio Carlos, 6627, Pampulha, CEP 31270-901, Belo Horizonte, Minas Gerais, Brazil
| | - Pedro Henrique Nascimento de Aguiar
- Departamento de Parasitologia, L4 237, Laboratório de Parasitologia Molecular, Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Avenida Presidente Antônio Carlos, 6627, Pampulha, CEP 31270-901, Belo Horizonte, Minas Gerais, Brazil
| | - Luciana Werneck Zuccherato
- Departamento de Parasitologia, L4 237, Laboratório de Parasitologia Molecular, Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Avenida Presidente Antônio Carlos, 6627, Pampulha, CEP 31270-901, Belo Horizonte, Minas Gerais, Brazil
| | - Talita Tatiana Guimarães Teixeira
- Departamento de Parasitologia, L4 237, Laboratório de Parasitologia Molecular, Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Avenida Presidente Antônio Carlos, 6627, Pampulha, CEP 31270-901, Belo Horizonte, Minas Gerais, Brazil
| | - William Pereira Alves
- Departamento de Parasitologia, L4 237, Laboratório de Parasitologia Molecular, Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Avenida Presidente Antônio Carlos, 6627, Pampulha, CEP 31270-901, Belo Horizonte, Minas Gerais, Brazil
| | - Vivian Jordania da Silva
- Departamento de Parasitologia, L4 237, Laboratório de Parasitologia Molecular, Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Avenida Presidente Antônio Carlos, 6627, Pampulha, CEP 31270-901, Belo Horizonte, Minas Gerais, Brazil
| | - Robin B Gasser
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Élida Mara Leite Rabelo
- Departamento de Parasitologia, L4 237, Laboratório de Parasitologia Molecular, Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Avenida Presidente Antônio Carlos, 6627, Pampulha, CEP 31270-901, Belo Horizonte, Minas Gerais, Brazil.
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Doulberis M, Papaefthymiou A, Kountouras J, Polyzos SA, Srivastava DS, Perrig M, Katsinelos P, Özgüler O, Kotronis G, Gialamprinou D, Papamichos S, Ingold J, Xanthis A, Exadaktylos AK. Hookworms in Emergency Department: The "Vampire" Within. J Acute Med 2018; 8:135-148. [PMID: 32995216 PMCID: PMC7517929 DOI: 10.6705/j.jacme.201812_8(4).0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 09/27/2018] [Indexed: 06/11/2023]
Abstract
Hookworms infection is a soil-transmitted helminthic disease particularly endemic in developing counties of tropical regions. It is attributed mainly to two human pathogens nematodes namely Necator americanus and Ancylostoma duodenale. Although the disease has been characterized as "neglected" is very diffi cult to be eliminated and the economic consequences are great. Worms are fed with blood of hosts in small intestine and cause typically iron deficiency anemia with relevant symptoms as well as eosinophilia. Patients admitted in emergency department claim often diffuse general symptoms, whereas cases with obscure gastrointestinal bleeding can be seen. Within this brief review, after introducing some basic elements of hookworms' epidemiology, taxonomy and socioeconomic problem is emphasized, pathogenesis, and life cycle of parasite are concisely explained. Furthermore, clinical manifestations often or rarely seen in emergency department are described. Therapeutic options are also enclosed. Awareness of the problem and critical thinking of patients coming from endemic regions could result to identifying more hookworm cases and their therapy will efficiently alleviate not only the patients per se but health system and societies as well.
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Affiliation(s)
- Michael Doulberis
- University Hospital Inselspital Bern Department of General Internal Medicine Bern Switzerland
- Aristotle University of Thessaloniki Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital Thessaloniki, Macedonia Greece
| | | | - Jannis Kountouras
- Aristotle University of Thessaloniki Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital Thessaloniki, Macedonia Greece
| | - Stergios A Polyzos
- Thessaloniki First Department of Pharmacology, Medical School, Aristotle University of Thessaloniki Macedonia Greece
| | | | - Martin Perrig
- University Hospital Inselspital Bern Department of General Internal Medicine Bern Switzerland
| | - Panagiotis Katsinelos
- Aristotle University of Thessaloniki Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital Thessaloniki, Macedonia Greece
| | - Onur Özgüler
- General Hospital Bürgerspital Department of Emergency Medicine Solothurn Switzerland
| | - Georgios Kotronis
- General Hospital Agios Pavlos of Thessaloniki Department of Internal Medicine Thessaloniki, Macedonia Greece
| | - Dimitra Gialamprinou
- Aristotle University of Thessaloniki Department of Pediatrics, Papageorgiou University Hospital Thessaloniki, Macedonia Greece
| | - Spyros Papamichos
- University Hospital Inselspital Bern Department of Hematology Bern Switzerland
| | - Jonas Ingold
- Tiefenau Hospital of Bern Department of General Internal Medicine Bern Switzerland
| | - Andreas Xanthis
- Aristotle University of Thessaloniki Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital Thessaloniki, Macedonia Greece
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Seguel M, Montalva F, Perez-Venegas D, Gutiérrez J, Paves HJ, Müller A, Valencia-Soto C, Howerth E, Mendiola V, Gottdenker N. Immune-mediated hookworm clearance and survival of a marine mammal decrease with warmer ocean temperatures. eLife 2018; 7:38432. [PMID: 30398149 PMCID: PMC6245726 DOI: 10.7554/elife.38432] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 10/26/2018] [Indexed: 11/13/2022] Open
Abstract
Increases in ocean temperature are associated with changes in the distribution of fish stocks, and the foraging regimes and maternal attendance patterns of marine mammals. However, it is not well understood how these changes affect offspring health and survival. The maternal attendance patterns and immunity of South American fur seals were assessed in a rookery where hookworm disease is the main cause of pup mortality. Pups receiving higher levels of maternal attendance had a positive energy balance and a more reactive immune system. These pups were able to expel hookworms through a specific immune mediated mechanism and survived the infection. Maternal attendance was higher in years with low sea surface temperature, therefore, the mean hookworm burden and mortality increased with sea surface temperature over a 10-year period. We provide a mechanistic explanation regarding how changes in ocean temperature and maternal care affect infectious diseases dynamics in a marine mammal.
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Affiliation(s)
- Mauricio Seguel
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, United States
| | - Felipe Montalva
- Facultad de Ciencias Biologicas, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Diego Perez-Venegas
- PhD Program in Conservation Medicine, Facultad de Ecología y Recursos Naturales, Universidad Andrés Bello, Santiago, Chile
| | - Josefina Gutiérrez
- Programa de Investigación Aplicada en Fauna Silvestre, Facultad de Ciencias Veterinarias, Universidad Austral de Chile, Valdivia, Chile.,Facultad de Ciencias Veterinarias, Instituto de Patología Animal, Universidad Austral de Chile, Valdivia, Chile
| | - Hector J Paves
- Departamento de Ciencias Básicas, Universidad Santo Tomas, Osorno, Chile
| | - Ananda Müller
- Instituto de Ciencias Clínicas Veterinarias, Universidad Austral de Chile, Valdivia, Chile
| | - Carola Valencia-Soto
- Programa de Investigación Aplicada en Fauna Silvestre, Facultad de Ciencias Veterinarias, Universidad Austral de Chile, Valdivia, Chile
| | - Elizabeth Howerth
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, United States
| | - Victoria Mendiola
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, United States
| | - Nicole Gottdenker
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, United States
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Homan EJ, Bremel RD. A Role for Epitope Networking in Immunomodulation by Helminths. Front Immunol 2018; 9:1763. [PMID: 30108588 PMCID: PMC6079203 DOI: 10.3389/fimmu.2018.01763] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 07/17/2018] [Indexed: 12/19/2022] Open
Abstract
Helminth infections, by nematodes, trematodes, or cestodes, can lead to the modulation of host immune responses. This allows long-duration parasite infections and also impacts responses to co-infections. Surface, secreted, excreted, and shed proteins are thought to play a major role in modulation. A commonly reported feature of such immune modulation is the role of T regulatory (Treg) cells and IL-10. Efforts to identify helminth proteins, which cause immunomodulation, have identified candidates but not provided clarity as to a uniform mechanism driving modulation. In this study, we applied a bioinformatics systems approach, allowing us to analyze predicted T-cell epitopes of 17 helminth species and the responses to their surface proteins. In addition to major histocompatibility complex (MHC) binding, we analyzed amino acid motifs that would be recognized by T-cell receptors [T-cell-exposed motifs (TCEMs)]. All the helminth species examined have, within their surface proteins, peptides, which combine very common TCEMs with predicted high affinity binding to many human MHC alleles. This combination of features would result in large cognate T cell and a high probability of eliciting Treg responses. The TCEMs, which determine recognition by responding T-cell clones, are shared to a high degree between helminth species and with Plasmodium falciparum and Mycobacterium tuberculosis, both common co-infecting organisms. The implication of our observations is not only that Treg cells play a significant role in helminth-induced immune modulation but also that the epitope specificities of Treg responses are shared across species and genera of helminth. Hence, the immune response to a given helminth cannot be considered in isolation but rather forms part of an epitope ecosystem, or microenvironment, in which potentially immunosuppressive peptides in the helminth network via their common T-cell receptor recognition signals with T-cell epitopes in self proteins, microbiome, other helminths, and taxonomically unrelated pathogens. Such a systems approach provides a high-level view of the antigen-immune system signaling dynamics that may bias a host's immune response to helminth infections toward immune modulation. It may indicate how helminths have evolved to select for peptides that favor long-term parasite host coexistence.
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Li P, Rios Coronado PE, Longstaff XRR, Tarashansky AJ, Wang B. Nanomedicine Approaches Against Parasitic Worm Infections. Adv Healthc Mater 2018; 7:e1701494. [PMID: 29602254 DOI: 10.1002/adhm.201701494] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/01/2018] [Indexed: 01/10/2023]
Abstract
Nanomedicine approaches have the potential to transform the battle against parasitic worm (helminth) infections, a major global health scourge from which billions are currently suffering. It is anticipated that the intersection of two currently disparate fields, nanomedicine and helminth biology, will constitute a new frontier in science and technology. This progress report surveys current innovations in these research fields and discusses research opportunities. In particular, the focus is on: (1) major challenges that helminth infections impose on mankind; (2) key aspects of helminth biology that inform future research directions; (3) efforts to construct nanodelivery platforms to target drugs and genes to helminths hidden in their hosts; (4) attempts in applying nanotechnology to enable vaccination against helminth infections; (5) outlooks in utilizing nanoparticles to enhance immunomodulatory activities of worm-derived factors to cure allergy and autoimmune diseases. In each section, achievements are summarized, limitations are explored, and future directions are assessed.
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Affiliation(s)
- Pengyang Li
- Department of Bioengineering; Stanford University; Stanford CA 94305 USA
| | | | | | | | - Bo Wang
- Department of Bioengineering; Stanford University; Stanford CA 94305 USA
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de Gier B, Pita-Rodríguez GM, Campos-Ponce M, van de Bor M, Chamnan C, Junco-Díaz R, Doak CM, Fiorentino M, Kuong K, Angel-Núñez F, Parker ME, Perignon M, Rojas-Rivero L, Berger J, Polman K, Wieringa FT. Soil-transmitted helminth infections and intestinal and systemic inflammation in schoolchildren. Acta Trop 2018; 182:124-127. [PMID: 29486173 DOI: 10.1016/j.actatropica.2018.02.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 09/26/2017] [Accepted: 02/23/2018] [Indexed: 01/16/2023]
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Abstract
The presence and distribution of various species of canine hookworms in Africa are poorly known. The main objective of this study, therefore, was to identify the hookworm species present in canine faecal samples from Morogoro, Tanzania, using molecular techniques. Faecal samples from 160 local dogs were collected and hookworm positive samples processed to recover larvae for further molecular characterization. DNA was extracted from pools of larvae from individual samples (n = 66), which were analysed subsequently using two different molecular approaches, polymerase chain reaction-linked restriction fragment length polymorphism (PCR-RFLP) and species-specific PCR coupled with Sanger sequencing. The PCR-RFLP technique detected only the presence of the ubiquitous Ancylostoma caninum in the 66 samples. However, by species-specific PCR coupled with Sanger sequencing we identified ten samples with A. braziliense, two with Uncinaria stenocephala and five with A. ceylanicum. Thus, all four known species of canine hookworms were identified in Morogoro, Tanzania. To our knowledge this is the first report of the detection of the presence of U. stenocephala and A. ceylanicum in Africa using molecular techniques. In addition to their veterinary importance, canine hookworms have zoonotic potential and are of public health concern.
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Famakinde DO, Adenusi AA. Involvement of Hookworm Co-Infection in the Pathogenesis and Progression of Podoconiosis: Possible Immunological Mechanism. Trop Med Infect Dis 2018; 3:E37. [PMID: 30274434 PMCID: PMC6073219 DOI: 10.3390/tropicalmed3020037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/16/2018] [Accepted: 03/19/2018] [Indexed: 12/19/2022] Open
Abstract
Podoconiosis is an endemic, non-infectious, geochemical and non-filarial inflammatory cause of tropical elephantiasis. The immunology of podoconiosis is not yet expressly understood. In spite of this, co-infection and co-morbidity with the infectious, soil-transmitted hookworm disease that causes iron deficiency anemia has been found to be predominant among affected individuals living in co-endemic settings, thus creating a more complex immunological interplay that still has not been investigated. Although deworming and iron-rich nutrient supplementation have been suggested in podoconiosis patients living under resource-poor conditions, and it is thought that hookworm infection may help to suppress inflammatory responses, the undisputed link that exists between a non-infectious and an infectious disease may create a scenario whereby during a co-infection, treatment of one exacerbates the other disease condition or is dampened by the debilitation caused by the other. In this paper, we elaborate on the immunopathogenesis of podoconiosis and examine the possible immunological dynamics of hookworm co-infection in the immunopathology of podoconiosis, with a view toward improved management of the disease that will facilitate its feasible elimination.
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Affiliation(s)
- Damilare O Famakinde
- Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Idi-Araba, Surulere P.M.B 12003, Lagos 100254, Nigeria.
| | - Adedotun A Adenusi
- Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Idi-Araba, Surulere P.M.B 12003, Lagos 100254, Nigeria.
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Human dendritic cell sequestration onto the Necator americanus larval sheath during ex-sheathing: a possible mechanism for immune privilege. Parasitology 2018; 145:1183-1190. [PMID: 29455681 DOI: 10.1017/s0031182018000136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Despite the profound health implications of Necator americanus infection in humans, many aspects of its interaction with the host immune system are poorly understood. Here we investigated the early events at the interface of N. americanus larvae (L3) and human dendritic cells (DCs). Our data show that co-culturing DCs and the larvae trigger ex-sheathing of hookworms rapidly where a majority of DCs are sequestered onto the larval sheath allowing the ex-sheathed larvae to migrate away unchallenged. Intriguingly, DCs show negligible interaction with the ex-sheathed larvae, alluding to differences between the surface chemistry of the larva and its sheath. Furthermore, blocking of two key C-type lectin receptors on DC surface (i.e. DC-SIGN and mannose receptor) resulted in inhibition of ex-sheathing process and DC sequestration, highlighting the importance of C-type lectins on DCs in the induction of the ex-sheathing. Analyses of DC phenotype and cytokine profile after co-culture with the N. americanus larvae showed an immature phenotype as evidenced by the low expression of the maturation markers and cytokines. These data provide new insights into early events at the interface of human DCs and N. americanus larvae and could explain how L3 evade immune recognition upon initial interaction with DCs.
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Shepherd C, Wangchuk P, Loukas A. Of dogs and hookworms: man's best friend and his parasites as a model for translational biomedical research. Parasit Vectors 2018; 11:59. [PMID: 29370855 PMCID: PMC5785905 DOI: 10.1186/s13071-018-2621-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/03/2018] [Indexed: 02/06/2023] Open
Abstract
We present evidence that the dog hookworm (Ancylostoma caninum) is underutilised in the study of host-parasite interactions, particularly as a proxy for the human-hookworm relationship. The inability to passage hookworms through all life stages in vitro means that adult stage hookworms have to be harvested from the gut of their definitive hosts for ex vivo research. This makes study of the human-hookworm interface difficult for technical and ethical reasons. The historical association of humans, dogs and hookworms presents a unique triad of positive evolutionary pressure to drive the A. caninum-canine interaction to reflect that of the human-hookworm relationship. Here we discuss A. caninum as a proxy for human hookworm infection and situate this hookworm model within the current research agenda, including the various 'omics' applications and the search for next generation biologics to treat a plethora of human diseases. Historically, the dog hookworm has been well described on a physiological and biochemical level, with an increasing understanding of its role as a human zoonosis. With its similarity to human hookworm, the recent publications of hookworm genomes and other omics databases, as well as the ready availability of these parasites for ex vivo culture, the dog hookworm presents itself as a valuable tool for discovery and translational research.
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Affiliation(s)
- Catherine Shepherd
- Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia.
| | - Phurpa Wangchuk
- Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Alex Loukas
- Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia.
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Feather CM, Hawdon JM, March JC. Ancylostoma ceylanicum infective third-stage larvae are activated by co-culture with HT-29-MTX intestinal epithelial cells. Parasit Vectors 2017; 10:606. [PMID: 29246169 PMCID: PMC5731058 DOI: 10.1186/s13071-017-2513-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 10/31/2017] [Indexed: 12/19/2022] Open
Abstract
Background Human hookworm larvae arrest development until they enter an appropriate host. This makes it difficult to access the larvae for studying larval development or host-parasite interactions. While there are in vivo and in vitro animal models of human hookworm infection, there is currently no human, in vitro model. While animal models have provided much insight into hookworm biology, there are limitations to how closely this can replicate human infection. Therefore, we have developed a human, in vitro model of the initial phase of hookworm infection using intestinal epithelial cell culture. Results Co-culture of the human hookworm Ancylostoma ceylanicum with the mucus-secreting, human intestinal epithelial cell line HT-29-MTX resulted in activation of infective third-stage larvae, as measured by resumption of feeding. Larvae were maximally activated by direct contact with fully differentiated HT-29-MTX intestinal epithelial cells. HT-29-MTX cells treated with A. ceylanicum larvae showed differential gene expression of several immunity-related genes. Conclusions Co-culture with HT-29-MTX can be used to activate A. ceylanicum larvae. This provides an opportunity to study the interaction of activated larvae with the human intestinal epithelium.
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Affiliation(s)
- Caitlin M Feather
- Department of Biological and Environmental Engineering, Cornell University, Ithaca, NY, USA
| | - John M Hawdon
- Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, D.C., USA
| | - John C March
- Department of Biological and Environmental Engineering, Cornell University, Ithaca, NY, USA.
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Chauhan VM, Scurr DJ, Christie T, Telford G, Aylott JW, Pritchard DI. The physicochemical fingerprint of Necator americanus. PLoS Negl Trop Dis 2017; 11:e0005971. [PMID: 29216182 PMCID: PMC5720516 DOI: 10.1371/journal.pntd.0005971] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 09/18/2017] [Indexed: 11/18/2022] Open
Abstract
Necator americanus, a haematophagous hookworm parasite, infects ~10% of the world's population and is considered to be a significant public health risk. Its lifecycle has distinct stages, permitting its successful transit from the skin via the lungs (L3) to the intestinal tract (L4 maturing to adult). It has been hypothesised that the L3 larval sheath, which is shed during percutaneous infection (exsheathment), diverts the immune system to allow successful infection and reinfection in endemic areas. However, the physicochemical properties of the L3 larval cuticle and sheath, which are in direct contact with the skin and its immune defences, are unknown. In the present study, we controlled exsheathment, to characterise the sheath and underlying cuticle surfaces in situ, using atomic force microscopy (AFM) and time-of-flight secondary ion mass spectrometry (ToF-SIMS). AFM revealed previously unseen surface area enhancing nano-annuli exclusive to the sheath surface and confirmed greater adhesion forces exist between cationic surfaces and the sheath, when compared to the emergent L3 cuticle. Furthermore, ToF-SIMS elucidated different chemistries between the surfaces of the cuticle and sheath which could be of biological significance. For example, the phosphatidylglycerol rich cuticle surface may support the onward migration of a lubricated infective stage, while the anionic and potentially immunologically active heparan sulphate rich deposited sheath could result in the diversion of immune defences to an inanimate antigenic nidus. We propose that our initial studies into the surface analysis of this hookworm provides a timely insight into the physicochemical properties of a globally important human pathogen at its infective stage and anticipate that the development and application of this analytical methodology will support translation of these findings into a biological context.
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Affiliation(s)
- Veeren M. Chauhan
- School of Pharmacy, Boots Science Building, University of Nottingham, Nottingham, United Kingdom
- * E-mail: (VMC); (JWA); (DIP)
| | - David J. Scurr
- School of Pharmacy, Boots Science Building, University of Nottingham, Nottingham, United Kingdom
| | - Thomas Christie
- School of Pharmacy, Boots Science Building, University of Nottingham, Nottingham, United Kingdom
| | - Gary Telford
- School of Pharmacy, Boots Science Building, University of Nottingham, Nottingham, United Kingdom
| | - Jonathan W. Aylott
- School of Pharmacy, Boots Science Building, University of Nottingham, Nottingham, United Kingdom
- * E-mail: (VMC); (JWA); (DIP)
| | - David I. Pritchard
- School of Pharmacy, Boots Science Building, University of Nottingham, Nottingham, United Kingdom
- * E-mail: (VMC); (JWA); (DIP)
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Nieuwenhuizen NE. Anisakis - immunology of a foodborne parasitosis. Parasite Immunol 2017; 38:548-57. [PMID: 27428817 DOI: 10.1111/pim.12349] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 07/13/2016] [Indexed: 01/28/2023]
Abstract
Anisakis species are marine nematodes which can cause zoonotic infection in humans if consumed in raw, pickled or undercooked fish and seafood. Infection with Anisakis is associated with abdominal pain, nausea and diarrhoea and can lead to massive infiltration of eosinophils and formation of granulomas in the gastrointestinal tract if the larvae are not removed. Re-infection leads to systemic allergic reactions such as urticarial or anaphylaxis in some individuals, making Anisakis an important source of hidden allergens in seafood. This review summarizes the immunopathology associated with Anisakis infection. Anisakiasis and gastroallergic reactions can be prevented by consuming only fish that has been frozen to -20°C to the core for at least 24 hours before preparation. Sensitization to Anisakis proteins can also occur, primarily due to occupational exposure to infested fish, and can lead to dermatitis, rhinoconjunctivitis or asthma. In this case, exposure to fish should be avoided.
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Salzer HJF, Rolling T, Vinnemeier CD, Tannich E, Schmiedel S, Addo MM, Cramer JP. Helminthic infections in returning travelers and migrants with eosinophilia: Diagnostic value of medical history, eosinophil count and IgE. Travel Med Infect Dis 2017; 20:49-55. [PMID: 28882532 DOI: 10.1016/j.tmaid.2017.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 07/26/2017] [Accepted: 09/01/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Eosinophilia in travelers and migrants returning from the tropics is often associated with invasive helminthic infections. Total IgE is considered a useful additional diagnostic parameter; however, both parameters are also increased in various other non-helminthic diseases. METHODS We retrospectively evaluated travelers and migrants seen at our department between September 2007 and May 2014. Patients with an absolute eosinophil count ≥500 cells/μl were considered for further analyses. RESULTS Among 6618 returned travelers and migrants, 154 (2.3%) had a total eosinophil count ≥500 cells/μL. Of these, 71 patients (46%) were diagnosed with helminthic infection. In an additional 62 patients (40%) with eosinophilia a final diagnosis was found, including non-helminthic infections in 34 patients and non-infectious causes in 28 patients, while in 21 patients (14%) no diagnosis was made. Patients with helminthic infections had higher eosinophil counts than travelers and migrants with other diagnoses (median 981 vs. 710 cells/μl; p = 0.001), while total IgE levels (n = 70; 172 vs. 152 kU/l; p = 0.731) were similar in both groups. CONCLUSION Eosinophil count but not total IgE levels are associated with helminthic infections in returning travelers and migrants with eosinophilia. Our results do not support the use of total IgE to differentiate helminthic infections from other causes of eosinophilia in this population.
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Affiliation(s)
- Helmut J F Salzer
- Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Division of Clinical Infectious Diseases and German Center for Infection Research Tuberculosis Unit, Research Center Borstel Borstel, Germany.
| | - Thierry Rolling
- Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Clinical Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.
| | - Christof D Vinnemeier
- Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Clinical Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.
| | - Egbert Tannich
- Department of Molecular Parasitology, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany; National Reference Centre for Tropical Infections, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.
| | - Stefan Schmiedel
- Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Marylyn M Addo
- Sections of Infectious Diseases and Tropical Medicine, I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Jakob P Cramer
- Department of Clinical Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.
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Madinga J, Polman K, Kanobana K, van Lieshout L, Brienen E, Praet N, Kabwe C, Gabriël S, Dorny P, Lutumba P, Speybroeck N. Epidemiology of polyparasitism with Taenia solium, schistosomes and soil-transmitted helminths in the co-endemic village of Malanga, Democratic Republic of Congo. Acta Trop 2017; 171:186-193. [PMID: 28336269 DOI: 10.1016/j.actatropica.2017.03.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 03/10/2017] [Accepted: 03/18/2017] [Indexed: 11/27/2022]
Abstract
Helminth co-infections are common in sub-Saharan Africa. However, little is known about the distribution and determinants of co-infections with Taenia solium taeniasis/cysticercosis. Building on a previous community-based study on human cysticercosis in Malanga village, we investigated co-infections with Taenia solium, soil-transmitted helminths (STHs) and Schistosoma spp and associated risk factors in a random subsample of 330 participants. Real time PCR assays were used to detect DNA of soil-transmitted helminths (STHs), T. solium and Schistosoma in stool samples and Schistosoma DNA in urine samples. Serum samples were tested for T. solium cysticercosis using the B158/B60 monoclonal antibody-based antigen ELISA. Bivariate analysis and logistic regression were applied to assess associations of single and co-infections with common risk factors (age, sex, area, hygiene) as well as pair wise associations between helminth species. Overall, 240 (72.7%) participants were infected with at least one helminth species; 128 (38.8%) harbored at least two helminth species (16.1% with STHs-Schistosoma, 14.5% with STHs-T. solium taeniasis/cysticercosis and 8.2% with Schistosoma-T. solium taeniasis/cysticercosis co-infections). No significant associations were found between Schistosoma-T. solium taeniasis/cysticercosis co-infection and any of the risk factors studied. Males (OR=2 (95%CI=1.1-5), p=0.03) and open defecation behavior (OR=3.8 (95%CI=1.1-6.5), p=0.04) were associated with higher odds of STHs-T. solium taeniasis/cysticercosis co-infection. Village districts that were found at high risk of T. solium taeniasis/cysticercosis were also at high risk of co-infection with STHs and T. solium taeniasis/cysticercosis (OR=3.2 (95%CI=1.1-7.8), p=0.03). Significant pair-wise associations were found between T. solium cysticerci and Necator americanus (OR=2.2 (95%CI=1.2-3.8), p<0.01) as well as Strongyloides stercoralis (OR=2.7 (95%CI=1.1-6.5), p=0.02). These findings show that co-infections with T. solium are common in this polyparasitic community in DRC. Our results on risk factors of helminth co-infections and specific associations between helminths may contribute to a better integration of control within programmes that target more than one NTD.
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Morawski BM, Yunus M, Kerukadho E, Turyasingura G, Barbra L, Ojok AM, DiNardo AR, Sowinski S, Boulware DR, Mejia R. Hookworm infection is associated with decreased CD4+ T cell counts in HIV-infected adult Ugandans. PLoS Negl Trop Dis 2017; 11:e0005634. [PMID: 28542260 PMCID: PMC5462474 DOI: 10.1371/journal.pntd.0005634] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 06/07/2017] [Accepted: 05/10/2017] [Indexed: 01/02/2023] Open
Abstract
Most studies evaluating epidemiologic relationships between helminths and HIV have been conducted in the pre-ART era, and evidence of the impact of helminth infections on HIV disease progression remains conflicting. Less is known about helminth infection and clinical outcomes in HIV-infected adults receiving antiretroviral therapy (ART). We sampled HIV-infected adults for eight gastrointestinal parasites and correlated parasitic infection with demographic predictors, and clinical and immunologic outcomes. Contrasting with previous studies, we measured parasitic infection with a quantitative, highly sensitive and specific polymerase chain reaction (PCR) method. This cohort study enrolled HIV-infected Ugandans from August-September 2013 in Mbale, Uganda and collected stool and blood samples at enrollment. Real-time PCR quantified stool: Ascaris lumbricoides, Ancylostoma duodenale, Necator americanus, Strongyloides stercoralis, Trichuris trichiura, Cryptosporidium spp., Entamoeba histolytica, and Giardia intestinalis infection. Generalized linear models assessed relationships between parasitic infection and clinical or demographic data. 35% of participants (71/202) tested positive for ≥1 helminth, mainly N. americanus (55/199, 28%), and 4.5% (9/202) were infected with ≥2 stool parasites. Participants with hookworm infection had lower average CD4+ cell counts (-94 cells/mcL, 95%CI: -141, -48 cells/mcL; p<0.001) after adjustment for sex, CD4+ nadir at clinic entry, and time on ART. The high prevalence of parasitic infection and correlation with decreased CD4+ concentrations highlight the need to re-examine the effects of invasive helminth co-infection in rural, HIV-infected populations in the era of widely available ART. Elucidating the relationship between hookworm infection and immune recovery could provide opportunities for health optimization, e.g. integrated deworming, in these vulnerable populations.
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Affiliation(s)
- Bozena M. Morawski
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
| | - Miya Yunus
- The AIDS Support Organization, Kampala, Uganda
| | | | | | | | | | - Andrew R. DiNardo
- Division of Global and Immigrant Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States of America
| | - Stefanie Sowinski
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
- The Gladstone Institute of Virology and Immunology, University of California, San Francisco, San Francisco, CA, United States of America
| | - David R. Boulware
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
| | - Rojelio Mejia
- Section of Tropical Medicine, Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States of America
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Passos LSA, Gazzinelli-Guimarães PH, Oliveira Mendes TAD, Guimarães ACG, Silveira Lemos DD, Ricci ND, Gonçalves R, Bartholomeu DC, Fujiwara RT, Bueno LL. Regulatory monocytes in helminth infections: insights from the modulation during human hookworm infection. BMC Infect Dis 2017; 17:253. [PMID: 28390393 PMCID: PMC5385058 DOI: 10.1186/s12879-017-2366-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 03/29/2017] [Indexed: 12/25/2022] Open
Abstract
Background While the macrophage polarization is well characterized in helminth infections, the natural heterogeneity of monocytes with multiple cell phenotypes might influence the outcome of neglected diseases, such hookworm infection. Here, we report the profile of monocytes in human hookworm infections as a model to study the regulatory subpopulation of monocytes in helminth infections. Methods Blood samples were collected from 19 Necator americanus-infected individuals and 13 healthy individuals. Peripheral blood mononuclear cells (PBMCs) were isolated, and immunophenotyping was conducted by flow cytometry. The expressions of genes encoding human nitric oxide synthase (iNOS), interleukin 4 (IL-4), arginase-1 (Arg-1) and glyceraldehyde 3-phosphate dehydrogenase were quantified by qPCR. Plasma levels of IL-4 were determined by sandwich ELISA. Unpaired t-tests or Mann-Whitney tests were used depending on the data distribution. Results Hookworm infected individuals (HWI) showed a significant increase in the number of monocytes/mm3 (555.2 ± 191.0) compared to that of the non-infected (NI) individuals (120.4 ± 44.7) (p < 0.0001). While the frequencies of CD14+IL-10+ and CD14+IL-12+ cells were significantly reduced in the HWI compared to NI group (p = 0.0289 and p < 0.0001, respectively), the ratio between IL-10/IL-12 producing monocytes was significantly elevated in HWI (p = 0.0004), indicating the potential regulatory activity of these cells. Measurement of IL-4 levels and gene expression of IL-4 and Arg-1 (highly expressed in alternatively activated macrophages) revealed no significant differences between the NI and HWI groups. Interestingly, individuals from the HWI group had higher expression of the iNOS gene (associated with a regulatory profile) (20.27 ± 2.97) compared to the NI group (11.28 ± 1.18, p = 0.0409). Finally, individuals from the HWI group had a significantly higher frequency of CD206+CD23+IL-10+ (7.57 ± 1.96) cells compared to individuals from the NI group (0.35 ± 0.09) (p < 0.001), suggesting that activated monocytes are a potential source of regulatory cytokines during hookworm infection. Conclusions Natural hookworm infection induces a high frequency of circulating monocytes that present a regulatory profile and promote the downmodulation of the proinflammatory response, which may contribute to prolonged survival of the parasite in the host.
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Affiliation(s)
- Lívia Silva Araújo Passos
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Pedro Henrique Gazzinelli-Guimarães
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Ana Clara Gazzinelli Guimarães
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Denise da Silveira Lemos
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Natasha Delaqua Ricci
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Gonçalves
- Department of General Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Daniella Castanheira Bartholomeu
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Toshio Fujiwara
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lilian Lacerda Bueno
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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Truscott JE, Turner HC, Farrell SH, Anderson RM. Soil-Transmitted Helminths: Mathematical Models of Transmission, the Impact of Mass Drug Administration and Transmission Elimination Criteria. ADVANCES IN PARASITOLOGY 2016; 94:133-198. [PMID: 27756454 DOI: 10.1016/bs.apar.2016.08.002] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Infections caused by soil-transmitted helminthias (STHs) affect over a billion people worldwide, causing anaemia and having a large social and economic impact through poor educational outcomes. They are identified in the World Health Organization (WHO) 2020 goals for neglected tropical diseases as a target for renewed effort to ameliorate their global public health burden through mass drug administration (MDA) and water and hygiene improvement. In this chapter, we review the underlying biology and epidemiology of the three causative intestinal nematode species that are mostly considered under the STH umbrella term. We review efforts to model the transmission cycle of these helminths in populations and the effects of preventative chemotherapy on their control and elimination. Recent modelling shows that the different epidemiological characteristics of the parasitic nematode species that make up the STH group can lead to quite distinct responses to any given form of MDA. When connected with models of treatment cost-effectiveness, these models are potentially a powerful tool for informing public policy. A number of shortcomings are identified; lack of critical types of data and poor understanding of diagnostic sensitivities hamper efforts to test and hence improve models.
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Affiliation(s)
- J E Truscott
- London Centre for Neglected Tropical Disease Research, London, United Kingdom; School of Public Health, Imperial College London, London, United Kingdom
| | - H C Turner
- London Centre for Neglected Tropical Disease Research, London, United Kingdom; School of Public Health, Imperial College London, London, United Kingdom
| | - S H Farrell
- London Centre for Neglected Tropical Disease Research, London, United Kingdom; School of Public Health, Imperial College London, London, United Kingdom
| | - R M Anderson
- London Centre for Neglected Tropical Disease Research, London, United Kingdom; School of Public Health, Imperial College London, London, United Kingdom
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Nair MG, Herbert DR. Immune polarization by hookworms: taking cues from T helper type 2, type 2 innate lymphoid cells and alternatively activated macrophages. Immunology 2016; 148:115-24. [PMID: 26928141 PMCID: PMC4863575 DOI: 10.1111/imm.12601] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 02/17/2016] [Accepted: 02/21/2016] [Indexed: 12/15/2022] Open
Abstract
Cellular and molecular investigation of parasitic helminth infections has greatly accelerated the understanding of type 2 immune responses. However, there remains considerable debate regarding the specific leucocytes that kill parasites and whether these mechanisms are distinct from those responsible for tissue repair. Herein, we chronicle discoveries over the past decade highlighting current paradigms in type 2 immunity with a particular emphasis upon how CD4(+) T helper type 2 cells, type 2 innate lymphoid cells and alternatively activated macrophages coordinately control helminth-induced parasitism. Primarily, this review will draw from studies of the murine nematode parasite Nippostrongylus brasiliensis, which bears important similarities to the human hookworms Ancylostoma duodenale and Necator americanus. Given that one or more hookworm species currently infect millions of individuals across the globe, we propose that vaccine and/or pharmaceutical-based cure strategies targeting these affected human populations should incorporate the conceptual advances outlined herein.
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Affiliation(s)
- Meera G Nair
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, CA, USA
| | - De'Broski R Herbert
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
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50
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Saravanan M, Sarma K, Mondal DB, Ranjith Kumar M, Vijayakumar H. Concomitant infestation of Toxocara cati and Ancylostoma tubaeforme in a mongrel cat. J Parasit Dis 2016; 40:205-7. [PMID: 27065627 DOI: 10.1007/s12639-014-0451-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 02/19/2014] [Indexed: 11/26/2022] Open
Abstract
A 3½ years old mongrel female cat was brought with the history of inappetence, seizure and lateral recumbency since 4 days and motion sickness since 2 days. Faecal examination confirmed Toxocara cati and Ancylostoma tubaeforme along with un-hatched live Toxocara cati larvae. Treatment has been initiated with Pyrantel pamoate and along with supportive therapy.
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Affiliation(s)
- M Saravanan
- Teaching Veterinary Clinical Complex, VCRI, Orathanadu, Tamil Nadu India
| | - K Sarma
- Department of Veterinary Medicine, College of Veterinary Sciences & Animal Husbandry Central Agricultural University, Selesih, Aizawl, Mizoram 796014 India
| | - D B Mondal
- Division of Medicine, Indian Veterinary Research Institute, Izatnagar, 243122 UP India
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