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Yang Y, Azzuolo A, Fodil N, Gros P. Gene: environment interactions in immune and inflammatory responses to severe acute respiratory syndrome coronavirus 2 infection. Curr Opin Immunol 2024; 90:102459. [PMID: 39243725 DOI: 10.1016/j.coi.2024.102459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 08/07/2024] [Accepted: 08/19/2024] [Indexed: 09/09/2024]
Abstract
Despite its devastating human cost, the rapid spread and global establishment of the severe acute respiratory syndrome coronavirus (SARS-CoV-2) pandemic had the benefit of providing unique insights into the intricate interplay between genetic, environmental, and socioeconomic factors, which collectively impact susceptibility to infection with SARS-CoV-2. Preceding the implementation of broad vaccination programs and assuming the absence of significant acquired immunity, examining the innate vulnerability to the virus becomes essential. There is indeed considerable heterogeneity observed at both the population and individual levels for various SARS-CoV-2 infection phenotypes, including emergence, progression, and survival from the coronavirus disease 2019 (COVID-19) syndrome. Particularly intriguing is the seemingly milder course of COVID-19 disease reported for the African continent early during the pandemic. This was characterized by significantly lower mortality rates in SARS-CoV-2 patients compared with the European and American continents and globally. We will discuss some of the demographic and socioeconomic factors that may have contributed to these observations. We review the mapped COVID-19 genetic architecture, including the remarkable association of type I interferon as a single protective mechanism and a major determinant of susceptibility. Furthermore, we speculate on potential 'environmental' modulators of penetrance and expressivity of intrinsic vulnerability factors, with a focus on the microbiome and associated metabolomes. Additionally, this review explores the potential immunomodulatory contribution of helminth parasites to the human host immune and inflammatory responses to respiratory viral infections.
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Affiliation(s)
- Yunxiang Yang
- Department of Biochemistry, McGill Research Center of Complex Traits, and Dahdaleh Institute of Genomic Medicine, McGill University, Montreal, QC, Canada
| | - Alessia Azzuolo
- Department of Biochemistry, McGill Research Center of Complex Traits, and Dahdaleh Institute of Genomic Medicine, McGill University, Montreal, QC, Canada
| | - Nassima Fodil
- Department of Biochemistry, McGill Research Center of Complex Traits, and Dahdaleh Institute of Genomic Medicine, McGill University, Montreal, QC, Canada
| | - Philippe Gros
- Department of Biochemistry, McGill Research Center of Complex Traits, and Dahdaleh Institute of Genomic Medicine, McGill University, Montreal, QC, Canada.
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Grondin JA, Jamal A, Mowna S, Seto T, Khan WI. Interaction between Intestinal Parasites and the Gut Microbiota: Implications for the Intestinal Immune Response and Host Defence. Pathogens 2024; 13:608. [PMID: 39204209 PMCID: PMC11356857 DOI: 10.3390/pathogens13080608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/20/2024] [Accepted: 07/22/2024] [Indexed: 09/03/2024] Open
Abstract
Intestinal parasites, including helminths and protozoa, account for a significant portion of the global health burden. The gastrointestinal (GI) tract not only serves as the stage for these parasitic infections but also as the residence for millions of microbes. As the intricacies of the GI microbial milieu continue to unfold, it is becoming increasingly apparent that the interactions between host, parasite, and resident microbes help dictate parasite survival and, ultimately, disease outcomes. Across both clinical and experimental models, intestinal parasites have been shown to impact microbial composition and diversity. Reciprocally, microbes can directly influence parasitic survival, colonization and expulsion. The gut microbiota can also indirectly impact parasites through the influence and manipulation of the host. Studying this host-parasite-microbiota axis may help bring about novel therapeutic strategies for intestinal parasitic infection as well as conditions such as inflammatory bowel disease (IBD). In this review, we explore the relationship between intestinal parasites, with a particular focus on common protozoa and helminths, and the gut microbiota, and how these interactions can influence the host defence and intestinal immune response. We will also explore the impact of this tripartite relationship in a clinical setting and its broader implications for human health.
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Affiliation(s)
- Jensine A. Grondin
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON L8S 4L8, Canada; (J.A.G.); (A.J.); (S.M.); (T.S.)
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Asif Jamal
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON L8S 4L8, Canada; (J.A.G.); (A.J.); (S.M.); (T.S.)
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Sadrina Mowna
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON L8S 4L8, Canada; (J.A.G.); (A.J.); (S.M.); (T.S.)
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Tyler Seto
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON L8S 4L8, Canada; (J.A.G.); (A.J.); (S.M.); (T.S.)
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Waliul I. Khan
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON L8S 4L8, Canada; (J.A.G.); (A.J.); (S.M.); (T.S.)
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
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Hodžić A, Dheilly NM, Cabezas-Cruz A, Berry D. The helminth holobiont: a multidimensional host-parasite-microbiota interaction. Trends Parasitol 2023; 39:91-100. [PMID: 36503639 DOI: 10.1016/j.pt.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022]
Abstract
Gastrointestinal helminths have developed multiple mechanisms by which they manipulate the host microbiome to make a favorable environment for their long-term survival. While the impact of helminth infections on vertebrate host immunity and its gut microbiota is relatively well studied, little is known about the structure and functioning of microbial populations supported by metazoan parasites. Here we argue that an integrated understanding of the helminth-associated microbiome and its role in the host disease pathogenesis may facilitate the discovery of specific microbial and/or genetic patterns critical for parasite biology and subsequently pave the way for the development of alternative control strategies against parasites and parasitic disease.
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Affiliation(s)
- Adnan Hodžić
- Centre for Microbiology and Environmental Systems Science (CMESS), Department of Microbiology and Ecosystem Science, Division of Microbial Ecology (DoME), University of Vienna, Djerassiplatz 1, 1030 Vienna, Austria.
| | - Nolwenn M Dheilly
- ANSES, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR VIROLOGIE, Laboratoire de Santé Animale, 14 rue Pierre et Marie Curie, 94706 Maisons-Alfort, France
| | - Alejandro Cabezas-Cruz
- UMR BIPAR, INRAE, ANSES, Ecole Nationale Vétérinaire d'Alfort, 14 rue Pierre et Marie Curie, 94706 Maisons-Alfort, France
| | - David Berry
- Centre for Microbiology and Environmental Systems Science (CMESS), Department of Microbiology and Ecosystem Science, Division of Microbial Ecology (DoME), University of Vienna, Djerassiplatz 1, 1030 Vienna, Austria
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Chowdhury F, Akter A, Bhuiyan TR, Biswas R, Firoj MG, Tauheed I, Harris JB, Larocque RC, Ross AG, McMillan NAJ, Charles RC, Ryan ET, Calderwood SB, Qadri F. Long-term sialidase-specific immune responses after natural infection with cholera: Findings from a longitudinal cohort study in Bangladesh. Front Immunol 2022; 13:1067737. [PMID: 36618409 PMCID: PMC9813220 DOI: 10.3389/fimmu.2022.1067737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Background Immune responses that target sialidase occur following natural cholera and have been associated with protection against cholera. Sialidase is a neuraminidase that facilitates the binding of cholera toxin (CT) to intestinal epithelial cells. Despite this, little is known about age-related sialidase-specific immune responses and the impact of nutritional status and co-infection on sialidase-specific immunity. Methods We enrolled 50 culture-confirmed Vibrio cholerae O1 cholera cases presenting to the icddr,b Dhaka hospital with moderate to severe dehydration. We evaluated antibody responses out to 18 months (day 540) following cholera. We assessed immune responses targeting sialidase, lipopolysaccharide (LPS), cholera toxin B subunit (CtxB), and vibriocidal responses. We also explored the association of sialidase-specific immune responses to nutritional parameters and parasitic co-infection of cases. Results This longitudinal cohort study showed age-dependent differences in anti-sialidase immune response after natural cholera infection. Adult patients developed plasma anti-sialidase IgA and IgG responses after acute infection (P<0.05), which gradually decreased from day 30 on. In children, no significant anti-sialidase IgA, IgM, and IgG response was seen with the exception of a late IgG response at study day 540 (p=0.05 compared to adults). There was a correlation between anti-sialidase IgA with vibriocidal titers, as well as anti-sialidase IgA and IgG with anti-LPS and anti-CtxB antibody responses in adult patients, whereas in children, a significant positive correlation was seen only between anti-sialidase IgA and CtxB IgA responses. Stunted children showed significantly lower anti-sialidase IgA, IgG, and IgM antibody responses and higher LPS IgG and IgM antibody responses than healthy children. The anti-sialidase IgA and IgG responses were significantly higher in cases with concomitant parasitic infection. Conclusion Our data suggest that cholera patients develop age-distinct systemic and mucosal immune responses against sialidase. The stunted children have a lower anti-sialidase antibody response which may be associated with gut enteropathy and the neuraminidase plays an important role in augmented immune response in cholera patients infected with parasites.
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Affiliation(s)
- Fahima Chowdhury
- Infectious Diseases Division, icddr, b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Afroza Akter
- Infectious Diseases Division, icddr, b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Taufiqur Rahman Bhuiyan
- Infectious Diseases Division, icddr, b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Rajib Biswas
- Infectious Diseases Division, icddr, b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
- Department of Biology, Xavier University of Louisiana, New Orleans, AK, United States
| | - Md. Golam Firoj
- Infectious Diseases Division, icddr, b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Imam Tauheed
- Infectious Diseases Division, icddr, b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Jason B. Harris
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, United States
| | - Regina C. Larocque
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Allen G. Ross
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | | | - Richelle C. Charles
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, United States
| | - Edward T. Ryan
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, United States
| | - Stephen B. Calderwood
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
- Department of Microbiology, Harvard Medical School, Boston, MA, United States
| | - Firdausi Qadri
- Infectious Diseases Division, icddr, b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
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Naidu A, Lulu S S. Mucosal and systemic immune responses to Vibrio cholerae infection and oral cholera vaccines (OCVs) in humans: a systematic review. Expert Rev Clin Immunol 2022; 18:1307-1318. [PMID: 36255170 DOI: 10.1080/1744666x.2022.2136650] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Cholera is an enteric disease caused by Vibrio cholerae, a water-borne pathogen, and characterized by severe diarrhea. Vaccines have been recommended for use by the WHO in resource-limited settings. Efficacies of the currently licensed cholera vaccines are not optimal in endemic settings and low in children below the age of five, a section of the population most susceptible to the disease. Development of next generation of cholera vaccines would require a detailed understanding of the required protective immune responses. AREA COVERED In this review, we revisit clinical trials which are focused on the early transcriptional mucosal responses elicited during Vibrio cholerae infection and upon vaccination along with summarizing various components of the effector immune response against Vibrio cholerae. EXPERT OPINION The inability of currently licensed killed/inactivated vaccines to elicit key inflammatory pathways locally may explain their restricted efficacy in endemic settings. More studies are required to understand the immunogenicity of the live attenuated cholera vaccine in these regions. Various extrinsic and intrinsic factors influence anti-cholera immunity and need to be considered to develop region-specific next generation vaccines.
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Affiliation(s)
- Akshayata Naidu
- Department of Biotechnology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, India
| | - Sajitha Lulu S
- Department of Biotechnology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, India
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Abstract
Enteric fever and helminth infestation coinfection is commonly seen among children below the age of 5, living in areas with poor sanitation in Africa. These can be explained due to the fact that both enteric fever and ascariasis, are contracted via fecal-oral routes. Although the immune system of children is presumed to be stronger and capable of eliminating several infectious agents, it is not applicable to children below the age of 5. Balanced nutrition also plays a vital role in sustaining strong immunity in children of all age groups and so, it could be one of the contributing factors to high susceptibility to co-infectious diseases among children living in poor countries. Soil-transmitted helminths (STH) are very common in developing countries. They are caused by infection with roundworm, hookworm, or whipworm. Both typhoid fever and helminth infestation in children presents with almost similar clinical symptoms. We present a case of coinfection with typhoid fever caused by Salmonella typhi bacteria and helminth in a 4-year-old child from Nigeria.
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Affiliation(s)
- Nnennaya Opara
- Emergency Medicine, Charleston Area Medical Center (CAMC) Health Education and Research Institute, Charleston, USA
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7
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Ahmed AFM, El-Sayad MH, Ali HS, El-Taweel HA. Impact of Coinfection with Schistosoma mansoni on the Antibody Response to Helicobacter pylori. Acta Parasitol 2021; 66:857-862. [PMID: 33598776 DOI: 10.1007/s11686-020-00330-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/15/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE In many tropical areas, the coinfection of Schistosoma spp. and other pathogens is frequent. The impact of schistosomiasis on other infections has been demonstrated for several organisms. Infection with the widely spread bacterium, Helicobacter pylori, has been linked to ulcers and tumors of the digestive system with the humoral immune response playing possible modulatory roles. The present study investigated the impact of patent S. mansoni infection on the antibody response to H. pylori. METHODS A total of 100 participants from a schistosomiasis endemic area in Egypt were enrolled in the study. Based on the detection of S. mansoni eggs and H. pylori coproantigen in fecal samples, they were equally divided into four groups: schistosomiasis, concomitant S. mansoni and H. pylori infection, H. pylori infection alone, and healthy controls. Anti-H. pylori IgG and IgA were determined in serum samples using ELISA. RESULTS A significantly lower IgA seropositivity rate and significantly lower IgG levels were found in patients with concomitant schistosomiasis (Gp2) compared to those infected only with H. pylori (Gp1). CONCLUSIONS Concomitant S. mansoni infection with light to moderate intensity alters serological responses to H. pylori. In schistosomiasis endemic areas, the routine examination for H. pylori infection should, therefore, rely on coproantigen level rather than antibody levels. Further studies should investigate histopathological changes and other immunological parameters in coinfection.
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Affiliation(s)
- Ashraf Fawzy Mosa Ahmed
- Parasitology Department, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
| | - Mona Hassan El-Sayad
- Parasitology Department, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
| | - Hala Shehata Ali
- Parasitology Department, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
| | - Hend Aly El-Taweel
- Parasitology Department, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt.
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Wolday D, Ndungu FM, Gómez-Pérez GP, de Wit TFR. Chronic Immune Activation and CD4 + T Cell Lymphopenia in Healthy African Individuals: Perspectives for SARS-CoV-2 Vaccine Efficacy. Front Immunol 2021; 12:693269. [PMID: 34220854 PMCID: PMC8249933 DOI: 10.3389/fimmu.2021.693269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/04/2021] [Indexed: 12/14/2022] Open
Abstract
Chronic immune activation has been considered as the driving force for CD4+ T cell depletion in people infected with HIV-1. Interestingly, the normal immune profile of adult HIV-negative individuals living in Africa also exhibit chronic immune activation, reminiscent of that observed in HIV-1 infected individuals. It is characterized by increased levels of soluble immune activation markers, such as the cytokines interleukin (IL)-4, IL-10, TNF-α, and cellular activation markers including HLA-DR, CD-38, CCR5, coupled with reduced naïve and increased memory cells in CD4+ and CD8+ subsets. In addition, it is accompanied by low CD4+ T cell counts when compared to Europeans. There is also evidence that mononuclear cells from African infants secrete less innate cytokines than South and North Americans and Europeans in vitro. Chronic immune activation in Africans is linked to environmental factors such as parasitic infections and could be responsible for previously observed immune hypo-responsiveness to infections and vaccines. It is unclear whether the immunogenicity and effectiveness of anti-SARS-CoV-2 vaccines will also be reduced by similar mechanisms. A review of studies investigating this phenomenon is urgently required as they should inform the design and delivery for vaccines to be used in African populations.
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Affiliation(s)
- Dawit Wolday
- Department of Medicine, Mekelle University College of Health Sciences, Mekelle, Ethiopia
| | - Francis M. Ndungu
- Department of Global Health, Kenyan Medical Research Institute (KEMRI) – Wellcome Research Programme, Nairobi, Kenya
| | - Gloria P. Gómez-Pérez
- Amsterdam Institute of Global Health and Development, Department of Global Health, Amsterdam University, Amsterdam, Netherlands
| | - Tobias F. Rinke de Wit
- Amsterdam Institute of Global Health and Development, Department of Global Health, Amsterdam University, Amsterdam, Netherlands
- Joep-Lange Institute, Amsterdam, Netherlands
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Brosschot TP, Lawrence KM, Moeller BE, Kennedy MHE, FitzPatrick RD, Gauthier CM, Shin D, Gatti DM, Conway KME, Reynolds LA. Impaired host resistance to Salmonella during helminth co-infection is restored by anthelmintic treatment prior to bacterial challenge. PLoS Negl Trop Dis 2021; 15:e0009052. [PMID: 33471793 PMCID: PMC7850471 DOI: 10.1371/journal.pntd.0009052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 02/01/2021] [Accepted: 12/08/2020] [Indexed: 12/29/2022] Open
Abstract
Intestinal helminth infection can impair host resistance to co-infection with enteric bacterial pathogens. However, it is not known whether helminth drug-clearance can restore host resistance to bacterial infection. Using a mouse helminth-Salmonella co-infection system, we show that anthelmintic treatment prior to Salmonella challenge is sufficient to restore host resistance to Salmonella. The presence of the small intestine-dwelling helminth Heligmosomoides polygyrus at the point of Salmonella infection supports the initial establishment of Salmonella in the small intestinal lumen. Interestingly, if helminth drug-clearance is delayed until Salmonella has already established in the small intestinal lumen, anthelmintic treatment does not result in complete clearance of Salmonella. This suggests that while the presence of helminths supports initial Salmonella colonization, helminths are dispensable for Salmonella persistence in the host small intestine. These data contribute to the mechanistic understanding of how an ongoing or prior helminth infection can affect pathogenic bacterial colonization and persistence in the mammalian intestine. In regions where helminth infection is common and sanitation standards are poor, people are at a high risk of exposure to bacterial pathogens. Previous work in animal models has shown that helminth infection can impair host resistance to bacterial infection. The current treatment for helminth infection is the administration of helminth-clearing drugs, yet it is not known whether drug clearance of helminths restores helminth-impaired host resistance to bacterial infection. In this report we use a mouse helminth-Salmonella co-infection model system, where we find that the presence of small intestinal helminths at the point of Salmonella infection aids the establishment of Salmonella in the small intestinal lumen. We show that helminth drug clearance prior to Salmonella infection is sufficient to restore host resistance to Salmonella. However, if helminth drug clearance is delayed until after Salmonella had already established in the small intestinal lumen, helminth elimination does not result in complete clearance of Salmonella from this site. Our work suggests that helminth drug clearance may be beneficial in reducing susceptibility to subsequent intestinal bacterial infections, but that helminth drug clearance after co-infection may not result in clearance of bacterial populations that have firmly established in the intestinal lumen.
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Affiliation(s)
- Tara P Brosschot
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, Canada
| | - Katherine M Lawrence
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, Canada
| | - Brandon E Moeller
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, Canada
| | - Mia H E Kennedy
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, Canada
| | - Rachael D FitzPatrick
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, Canada
| | - Courtney M Gauthier
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, Canada
| | - Dongju Shin
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, Canada
| | - Dominique M Gatti
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, Canada
| | - Kate M E Conway
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, Canada
| | - Lisa A Reynolds
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, Canada
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Mirza Z, Soto ER, Hu Y, Nguyen TT, Koch D, Aroian RV, Ostroff GR. Anthelmintic Activity of Yeast Particle-Encapsulated Terpenes. Molecules 2020; 25:E2958. [PMID: 32605043 PMCID: PMC7411854 DOI: 10.3390/molecules25132958] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 12/31/2022] Open
Abstract
Soil-transmitted nematodes (STN) infect 1-2 billion of the poorest people worldwide. Only benzimidazoles are currently used in mass drug administration, with many instances of reduced activity. Terpenes are a class of compounds with anthelmintic activity. Thymol, a natural monoterpene phenol, was used to help eradicate hookworms in the U.S. South circa 1910. However, the use of terpenes as anthelmintics was discontinued because of adverse side effects associated with high doses and premature stomach absorption. Furthermore, the dose-response activity of specific terpenes against STNs has been understudied. Here we used hollow, porous yeast particles (YPs) to efficiently encapsulate (>95%) high levels of terpenes (52% w/w) and evaluated their anthelmintic activity on hookworms (Ancylostoma ceylanicum), a rodent parasite (Nippostrongylus brasiliensis), and whipworm (Trichuris muris). We identified YP-terpenes that were effective against all three parasites. Further, YP-terpenes overcame albendazole-resistant Caenorhabditis elegans. These results demonstrate that terpenes are broad-acting anthelmintics. Terpenes are predicted to be extremely difficult for parasites to resist, and YP encapsulation provides water-suspendable terpene materials without surfactants and sustained terpene release that could lead to the development of formulations for oral delivery that overcome fast absorption in the stomach, thus reducing dosage and toxic side effects.
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Affiliation(s)
- Zeynep Mirza
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (Z.M.); (E.R.S.); (Y.H.); (T.-T.N.); (D.K.); (R.V.A.)
| | - Ernesto R. Soto
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (Z.M.); (E.R.S.); (Y.H.); (T.-T.N.); (D.K.); (R.V.A.)
| | - Yan Hu
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (Z.M.); (E.R.S.); (Y.H.); (T.-T.N.); (D.K.); (R.V.A.)
- Department of Biology, Worcester State University, Worcester, MA 01602, USA
| | - Thanh-Thanh Nguyen
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (Z.M.); (E.R.S.); (Y.H.); (T.-T.N.); (D.K.); (R.V.A.)
| | - David Koch
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (Z.M.); (E.R.S.); (Y.H.); (T.-T.N.); (D.K.); (R.V.A.)
| | - Raffi V. Aroian
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (Z.M.); (E.R.S.); (Y.H.); (T.-T.N.); (D.K.); (R.V.A.)
| | - Gary R. Ostroff
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (Z.M.); (E.R.S.); (Y.H.); (T.-T.N.); (D.K.); (R.V.A.)
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11
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Long SR, Lanter BB, Pazos MA, Mou H, Barrios J, Su CW, Wang ZQ, Walker WA, Hurley BP, Shi HN. Intestinal helminth infection enhances bacteria-induced recruitment of neutrophils to the airspace. Sci Rep 2019; 9:15703. [PMID: 31673002 PMCID: PMC6823376 DOI: 10.1038/s41598-019-51991-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 10/08/2019] [Indexed: 12/15/2022] Open
Abstract
Intestinal helminth infections elicit Th2-type immunity, which influences host immune responses to additional threats, such as allergens, metabolic disease, and other pathogens. Th2 immunity involves a shift of the CD4+ T-cell population from type-0 to type-2 (Th2) with increased abundance of interleukin (IL)-4 and IL-13. This study sought to investigate if existing gut-restricted intestinal helminth infections impact bacterial-induced acute airway neutrophil recruitment. C57BL/6 mice were divided into four groups: uninfected; helminth-Heligmosomoides polygyrus infected; Pseudomonas aeruginosa infected; and coinfected. Mice infected with H. polygyrus were incubated for 2 weeks, followed by P. aeruginosa intranasal inoculation. Bronchial alveolar lavage, blood, and lung samples were analyzed. Interestingly, infection with gut-restricted helminths resulted in immunological and structural changes in the lung. These changes include increased lung CD4+ T cells, increased Th2 cytokine expression, and airway goblet cell hyperplasia. Furthermore, coinfected mice exhibited significantly more airspace neutrophil infiltration at 6 hours following P. aeruginosa infection and exhibited an improved rate of survival compared with bacterial infected alone. These results suggest that chronic helminth infection of the intestines can influence and enhance acute airway neutrophil responses to P. aeruginosa infection.
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Affiliation(s)
- Shao Rong Long
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
- Department of Parasitology, Medical College of Zhengzhou University, Zhengzhou, Henan, China
| | - Bernard B Lanter
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Michael A Pazos
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Hongmei Mou
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Juliana Barrios
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Chien-Wen Su
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Zhong Quan Wang
- Department of Parasitology, Medical College of Zhengzhou University, Zhengzhou, Henan, China
| | - W Allan Walker
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Bryan P Hurley
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
| | - Hai Ning Shi
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
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12
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Abstract
Purpose of Review This paper constitutes an update of recent studies on the general biology, molecular genetics, and cellular biology of Strongyloides spp. and related parasitic nematodes. Recent Findings Increasingly, human strongyloidiasis is considered the most neglected of neglected tropical diseases. Despite this, the last 5 years has seen remarkable advances in the molecular biology of Strongyloides spp. Genome sequences for S. stercoralis, S. ratti, S. venezuelensis, S. papillosus, and the related parasite Parastrongyloides trichosuri were created, annotated, and analyzed. These genomic resources, along with a practical transgenesis platform for Strongyloides spp., aided a major achievement, the advent of targeted mutagenesis via CRISPR/Cas9 in S. stercoralis and S. ratti. The genome sequences have also enabled significant molecular epidemiologic and phylogenetic findings on human strongyloidiasis, including the first genetic evidence of zoonotic transmission of S. stercoralis between dogs and humans. Studies of molecular signaling pathways identified the nuclear receptor Ss-DAF-12 as one that can be manipulated in the parasite by exogenous application of its steroid ligands. The chemotherapeutic implications of this were unscored by a study in which a Ss-DAF-12 ligand suppressed autoinfection by S. stercoralis in a new murine model of human strongyloidiasis. Summary Seminal advances in genomics of Strongyloides spp. have transformed research into strongyloidiasis, facilitating fundamental phylogenetic and epidemiologic studies and aiding the deployment of CRISPR/Cas9 gene disruption and editing as functional genomic tools in Strongyloides spp. Studies of Ss-DAF-12 signaling in S. stercoralis demonstrated the potential of this pathway as a novel chemotherapeutic target in parasitic nematodes.
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Affiliation(s)
- Tegegn G. Jaleta
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - James B. Lok
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
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13
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Chard AN, Baker KK, Tsai K, Levy K, Sistrunk JR, Chang HH, Freeman MC. Associations between soil-transmitted helminthiasis and viral, bacterial, and protozoal enteroinfections: a cross-sectional study in rural Laos. Parasit Vectors 2019; 12:216. [PMID: 31064387 PMCID: PMC6505259 DOI: 10.1186/s13071-019-3471-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 04/29/2019] [Indexed: 12/12/2022] Open
Abstract
Background Humans are susceptible to over 1400 pathogens. Co-infection by multiple pathogens is common, and can result in a range of neutral, facilitative, or antagonistic interactions within the host. Soil-transmitted helminths (STH) are powerful immunomodulators, but evidence of the effect of STH infection on the direction and magnitude of concurrent enteric microparasite infections is mixed. Methods We collected fecal samples from 891 randomly selected children and adults in rural Laos. Samples were analyzed for 5 STH species, 6 viruses, 9 bacteria, and 5 protozoa using a quantitative reverse transcription polymerase chain reaction (qRT-PCR) assay. We utilized logistic regression, controlling for demographics and household water, sanitation, and hygiene access, to examine the effect of STH infection on concurrent viral, bacterial, and protozoal infection. Results We found that STH infection was associated with lower odds of concurrent viral infection [odds ratio (OR): 0.48, 95% confidence interval (CI): 0.28–0.83], but higher odds of concurrent bacterial infections (OR: 1.81, 95% CI: 1.06–3.07) and concurrent protozoal infections (OR: 1.50, 95% CI: 0.95–2.37). Trends were consistent across STH species. Conclusions The impact of STH on odds of concurrent microparasite co-infection may differ by microparasite taxa, whereby STH infection was negatively associated with viral infections but positively associated with bacterial and protozoal infections. Results suggest that efforts to reduce STH through preventive chemotherapy could have a spillover effect on microparasite infections, though the extent of this impact requires additional study. The associations between STH and concurrent microparasite infection may reflect a reverse effect due to the cross-sectional study design. Additional research is needed to elucidate the exact mechanism of the immunomodulatory effects of STH on concurrent enteric microparasite infection. Electronic supplementary material The online version of this article (10.1186/s13071-019-3471-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna N Chard
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, 30322, USA
| | - Kelly K Baker
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa, 52242, USA
| | - Kevin Tsai
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa, 52242, USA
| | - Karen Levy
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, 30322, USA
| | - Jeticia R Sistrunk
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, 30322, USA
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, 30322, USA
| | - Matthew C Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, 30322, USA.
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14
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Rowan-Nash AD, Korry BJ, Mylonakis E, Belenky P. Cross-Domain and Viral Interactions in the Microbiome. Microbiol Mol Biol Rev 2019; 83:e00044-18. [PMID: 30626617 PMCID: PMC6383444 DOI: 10.1128/mmbr.00044-18] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The importance of the microbiome to human health is increasingly recognized and has become a major focus of recent research. However, much of the work has focused on a few aspects, particularly the bacterial component of the microbiome, most frequently in the gastrointestinal tract. Yet humans and other animals can be colonized by a wide array of organisms spanning all domains of life, including bacteria and archaea, unicellular eukaryotes such as fungi, multicellular eukaryotes such as helminths, and viruses. As they share the same host niches, they can compete with, synergize with, and antagonize each other, with potential impacts on their host. Here, we discuss these major groups making up the human microbiome, with a focus on how they interact with each other and their multicellular host.
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Affiliation(s)
- Aislinn D Rowan-Nash
- Department of Molecular Microbiology and Immunology, Brown University, Providence, Rhode Island, USA
| | - Benjamin J Korry
- Department of Molecular Microbiology and Immunology, Brown University, Providence, Rhode Island, USA
| | - Eleftherios Mylonakis
- Infectious Diseases Division, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Peter Belenky
- Department of Molecular Microbiology and Immunology, Brown University, Providence, Rhode Island, USA
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15
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Brosschot TP, Reynolds LA. The impact of a helminth-modified microbiome on host immunity. Mucosal Immunol 2018; 11:1039-1046. [PMID: 29453411 DOI: 10.1038/s41385-018-0008-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/19/2017] [Accepted: 12/22/2017] [Indexed: 02/04/2023]
Abstract
Intestinal helminths have well-characterized modulatory effects on mammalian immune pathways. Ongoing helminth infection has been associated with both the suppression of allergies and an altered susceptibility to microbial infections. Enteric helminths share a niche with the intestinal microbiota, and the presence of helminths alters the microbiota composition and the metabolic signature of the host. Recent studies have demonstrated that the helminth-modified intestinal microbiome has the capacity to modify host immune responses even in the absence of live helminth infection. This article discusses the mechanisms by which helminths modify the intestinal microbiome of mammals, and reviews the evidence for a helminth-modified microbiome directly influencing host immunity during infectious and inflammatory diseases. Understanding the multifaceted mechanisms that underpin helminth immunomodulation will pave the way for novel therapies to combat infectious and inflammatory diseases.
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Affiliation(s)
- Tara P Brosschot
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, BC, V8P 5C2, Canada
| | - Lisa A Reynolds
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, BC, V8P 5C2, Canada.
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16
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Jutla A, Khan R, Colwell R. Natural Disasters and Cholera Outbreaks: Current Understanding and Future Outlook. Curr Environ Health Rep 2018; 4:99-107. [PMID: 28130661 DOI: 10.1007/s40572-017-0132-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW Diarrheal diseases remain a serious global public health threat, especially for those populations lacking access to safe water and sanitation infrastructure. Although association of several diarrheal diseases, e.g., cholera, shigellosis, etc., with climatic processes has been documented, the global human population remains at heightened risk of outbreak of diseases after natural disasters, such as earthquakes, floods, or droughts. In this review, cholera was selected as a signature diarrheal disease and the role of natural disasters in triggering and transmitting cholera was analyzed. RECENT FINDINGS Key observations include identification of an inherent feedback loop that includes societal structure, prevailing climatic processes, and spatio-temporal seasonal variability of natural disasters. Data obtained from satellite-based remote sensing are concluded to have application, although limited, in predicting risks of a cholera outbreak(s). We argue that with the advent of new high spectral and spatial resolution data, earth observation systems should be seamlessly integrated in a decision support mechanism to be mobilize resources when a region suffers a natural disaster. A framework is proposed that can be used to assess the impact of natural disasters with response to outbreak of cholera, providing assessment of short- and long-term influence of climatic processes on disease outbreaks.
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Affiliation(s)
- Antarpreet Jutla
- Human Health and Hydro-environmental Sustainability Simulation Laboratory, Department of Civil and Environmental Engineering, West Virginia University, Morgantown, WV, 26505, USA.
| | - Rakibul Khan
- Human Health and Hydro-environmental Sustainability Simulation Laboratory, Department of Civil and Environmental Engineering, West Virginia University, Morgantown, WV, 26505, USA
| | - Rita Colwell
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, MD, 20742, USA.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 20742, USA
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17
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Abdoli A, Maspi N. Commentary: Estimates of Global, Regional, and National Morbidity, Mortality, and Aetiologies of Diarrhoeal Diseases: A Systematic Analysis for the Global Burden of Disease Study 2015. Front Med (Lausanne) 2018; 5:11. [PMID: 29435450 PMCID: PMC5796900 DOI: 10.3389/fmed.2018.00011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 01/15/2018] [Indexed: 12/25/2022] Open
Affiliation(s)
- Amir Abdoli
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Nahid Maspi
- Department of Parasitology, Faculty of Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran
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18
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Tran GT, Wilcox PL, Dent LA, Robinson CM, Carter N, Verma ND, Hall BM, Hodgkinson SJ. Interleukin-5 Mediates Parasite-Induced Protection against Experimental Autoimmune Encephalomyelitis: Association with Induction of Antigen-Specific CD4 +CD25 + T Regulatory Cells. Front Immunol 2017; 8:1453. [PMID: 29163523 PMCID: PMC5671975 DOI: 10.3389/fimmu.2017.01453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 10/17/2017] [Indexed: 12/18/2022] Open
Abstract
Objective To examine if the protective effect of parasite infection on experimental autoimmune encephalomyelitis (EAE) was due to interleukin (IL)-5, a cytokine produced by a type-2 response that induces eosinophilia. We hypothesize that, in parasite infections, IL-5 also promotes expansion of antigen-specific T regulatory cells that control autoimmunity. Methods Nippostrongylus brasiliensis larvae were used to infect Lewis rats prior to induction of EAE by myelin basic protein. Animals were sham treated, or given blocking monoclonal antibodies to interleukin 4 or 5 or to deplete CD25+ T cells. Reactivity of CD4+CD25+ T regulatory cells from these animals was examined. Results Parasite-infected hosts had reduced severity and length of EAE. The beneficial effect of parasitic infection was abolished with an anti-IL-5 or an anti-CD25 monoclonal antibody (mAb), but not anti-IL-4 mAb. Parasite-infected animals with EAE developed antigen-specific CD4+CD25+ T regulatory cells earlier than EAE controls and these expressed more Il5ra than controls. Treatment with IL-5 also reduced the severity of EAE and induced Il5ra expressing CD4+CD25+ T regulatory cells. Interpretation The results of this study suggested that IL-5 produced by the type-2 inflammatory response to parasite infection promoted induction of autoantigen-specific CD25+Il5ra+ T regulatory cells that reduced the severity of autoimmunity. Such a mechanism may explain the protective effect of parasite infection in patients with multiple sclerosis where eosinophilia is induced by IL-5, produced by the immune response to parasites.
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Affiliation(s)
- Giang T Tran
- Immune Tolerance Laboratory, UNSW Australia, Department of Neurology, Liverpool Hospital, Sydney, NSW, Australia
| | - Paul L Wilcox
- Immune Tolerance Laboratory, UNSW Australia, Department of Neurology, Liverpool Hospital, Sydney, NSW, Australia
| | - Lindsay A Dent
- Immune Tolerance Laboratory, UNSW Australia, Department of Neurology, Liverpool Hospital, Sydney, NSW, Australia
| | - Catherine M Robinson
- Immune Tolerance Laboratory, UNSW Australia, Department of Neurology, Liverpool Hospital, Sydney, NSW, Australia
| | - Nicole Carter
- Immune Tolerance Laboratory, UNSW Australia, Department of Neurology, Liverpool Hospital, Sydney, NSW, Australia
| | - Nirupama D Verma
- Immune Tolerance Laboratory, UNSW Australia, Department of Neurology, Liverpool Hospital, Sydney, NSW, Australia
| | - Bruce M Hall
- Immune Tolerance Laboratory, UNSW Australia, Department of Neurology, Liverpool Hospital, Sydney, NSW, Australia
| | - Suzanne J Hodgkinson
- Immune Tolerance Laboratory, UNSW Australia, Department of Neurology, Liverpool Hospital, Sydney, NSW, Australia
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19
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Reynolds LA, Redpath SA, Yurist-Doutsch S, Gill N, Brown EM, van der Heijden J, Brosschot TP, Han J, Marshall NC, Woodward SE, Valdez Y, Borchers CH, Perona-Wright G, Finlay BB. Enteric Helminths Promote Salmonella Coinfection by Altering the Intestinal Metabolome. J Infect Dis 2017; 215:1245-1254. [PMID: 28368463 DOI: 10.1093/infdis/jix141] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 03/22/2017] [Indexed: 12/29/2022] Open
Abstract
Intestinal helminth infections occur predominantly in regions where exposure to enteric bacterial pathogens is also common. Helminth infections inhibit host immunity against microbial pathogens, which has largely been attributed to the induction of regulatory or type 2 (Th2) immune responses. Here we demonstrate an additional 3-way interaction in which helminth infection alters the metabolic environment of the host intestine to enhance bacterial pathogenicity. We show that an ongoing helminth infection increased colonization by Salmonella independently of T regulatory or Th2 cells. Instead, helminth infection altered the metabolic profile of the intestine, which directly enhanced bacterial expression of Salmonella pathogenicity island 1 (SPI-1) genes and increased intracellular invasion. These data reveal a novel mechanism by which a helminth-modified metabolome promotes susceptibility to bacterial coinfection.
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Affiliation(s)
- Lisa A Reynolds
- Michael Smith Laboratories, University of British Columbia, Vancouver.,Department of Biochemistry and Microbiology, University of Victoria, British Columbia
| | - Stephen A Redpath
- Department of Microbiology and Immunology, University of British Columbia, Vancouver
| | | | - Navkiran Gill
- Michael Smith Laboratories, University of British Columbia, Vancouver
| | - Eric M Brown
- Michael Smith Laboratories, University of British Columbia, Vancouver.,Department of Microbiology and Immunology, University of British Columbia, Vancouver
| | - Joris van der Heijden
- Michael Smith Laboratories, University of British Columbia, Vancouver.,Department of Microbiology and Immunology, University of British Columbia, Vancouver
| | - Tara P Brosschot
- Michael Smith Laboratories, University of British Columbia, Vancouver
| | - Jun Han
- University of Victoria-Genome British Columbia Proteomics Centre
| | - Natalie C Marshall
- Michael Smith Laboratories, University of British Columbia, Vancouver.,Department of Microbiology and Immunology, University of British Columbia, Vancouver
| | - Sarah E Woodward
- Michael Smith Laboratories, University of British Columbia, Vancouver.,Department of Microbiology and Immunology, University of British Columbia, Vancouver
| | - Yanet Valdez
- Michael Smith Laboratories, University of British Columbia, Vancouver
| | - Christoph H Borchers
- Department of Biochemistry and Microbiology, University of Victoria, British Columbia.,University of Victoria-Genome British Columbia Proteomics Centre.,Gerald Bronfman Department of Oncology and.,Proteomics Centre, Segal Cancer Centre, Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Georgia Perona-Wright
- Department of Microbiology and Immunology, University of British Columbia, Vancouver.,Institute of Infection, Immunity and Inflammation, University of Glasgow, United Kingdom ; and
| | - B Brett Finlay
- Michael Smith Laboratories, University of British Columbia, Vancouver.,Department of Microbiology and Immunology, University of British Columbia, Vancouver.,Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, Canada
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20
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Saha A, Rosewell A, Hayen A, MacIntyre CR, Qadri F. Improving immunization approaches to cholera. Expert Rev Vaccines 2016; 16:235-248. [PMID: 27805467 DOI: 10.1080/14760584.2017.1249470] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Cholera's impact is greatest in resource-limited countries. In the last decade several large epidemics have led to a global push to improve and implement the tools for cholera prevention and control. Areas covered: PubMed, Google Scholar and the WHO website were searched to review the literature and summarize the current status of cholera vaccines to make recommendations on improving immunization approaches to cholera. Oral cholera vaccines (OCVs) have demonstrated their effectiveness in endemic, outbreak response and emergency settings, highlighting their potential for wider adoption. While two doses of the currently available OCVs are recommended by manufacturers, a single dose would be easier to implement. Encouragingly, recent studies have shown that cold chain requirements may no longer be essential. The establishment of the global OCV stockpile in 2013 has been a major advance in cholera preparedness. New killed and live-attenuated vaccines are being actively explored as candidate vaccines for endemic settings and/or as a traveller's vaccine. The recent advances in cholera vaccination approaches should be considered in the global cholera control strategy. Expert commentary: The development of affordable cholera vaccines is a major success to improve cholera control. New vaccines and country specific interventions will further reduce the burden of this disease globally.
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Affiliation(s)
- Amit Saha
- a School of public Health and Community medicine , University of New South Wales , Sydney , NSW , Australia.,b Infectious Diseases Division , International Centre for Diarrhoeal Disease Research Bangladesh (icddr, b) , Dhaka , Bangladesh
| | - Alexander Rosewell
- a School of public Health and Community medicine , University of New South Wales , Sydney , NSW , Australia
| | - Andrew Hayen
- a School of public Health and Community medicine , University of New South Wales , Sydney , NSW , Australia.,c Faculty of Health , University of Technology Sydney , Sydney , NSW , Australia
| | - C Raina MacIntyre
- a School of public Health and Community medicine , University of New South Wales , Sydney , NSW , Australia
| | - Firdausi Qadri
- b Infectious Diseases Division , International Centre for Diarrhoeal Disease Research Bangladesh (icddr, b) , Dhaka , Bangladesh
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21
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Iyer AS, Bouhenia M, Rumunu J, Abubakar A, Gruninger RJ, Pita J, Lino RL, Deng LL, Wamala JF, Ryan ET, Martin S, Legros D, Lessler J, Sack DA, Luquero FJ, Leung DT, Azman AS. Immune Responses to an Oral Cholera Vaccine in Internally Displaced Persons in South Sudan. Sci Rep 2016; 6:35742. [PMID: 27775046 PMCID: PMC5075787 DOI: 10.1038/srep35742] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 10/04/2016] [Indexed: 11/09/2022] Open
Abstract
Despite recent large-scale cholera outbreaks, little is known about the immunogenicity of oral cholera vaccines (OCV) in African populations, particularly among those at highest cholera risk. During a 2015 preemptive OCV campaign among internally displaced persons in South Sudan, a year after a large cholera outbreak, we enrolled 37 young children (1-5 years old), 67 older children (6-17 years old) and 101 adults (≥18 years old), who received two doses of OCV (Shanchol) spaced approximately 3 weeks apart. Cholera-specific antibody responses were determined at days 0, 21 and 35 post-immunization. High baseline vibriocidal titers (>80) were observed in 21% of the participants, suggesting recent cholera exposure or vaccination. Among those with titers ≤80, 90% young children, 73% older children and 72% adults seroconverted (≥4 fold titer rise) after the 1st OCV dose; with no additional seroconversion after the 2nd dose. Post-vaccination immunological endpoints did not differ across age groups. Our results indicate Shanchol was immunogenic in this vulnerable population and that a single dose alone may be sufficient to achieve similar short-term immunological responses to the currently licensed two-dose regimen. While we found no evidence of differential response by age, further immunologic and epidemiologic studies are needed.
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Affiliation(s)
- Anita S Iyer
- Division of Infectious Diseases, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | - John Rumunu
- Republic of South Sudan Ministry of Health, Juba, South Sudan
| | | | - Randon J Gruninger
- Division of Infectious Diseases, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Jane Pita
- World Health Organization, Juba, South Sudan
| | | | - Lul L Deng
- Republic of South Sudan Ministry of Health, Juba, South Sudan
| | | | - Edward T Ryan
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Justin Lessler
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - David A Sack
- Department of International Health, Johns Hopkins University, Baltimore, MD, USA
| | - Francisco J Luquero
- Department of International Health, Johns Hopkins University, Baltimore, MD, USA.,Epicentre, Paris, France
| | - Daniel T Leung
- Division of Infectious Diseases, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.,Division of Microbiology and Immunology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Andrew S Azman
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
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22
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Zhang SX, Zhou YM, Xu W, Tian LG, Chen JX, Chen SH, Dang ZS, Gu WP, Yin JW, Serrano E, Zhou XN. Impact of co-infections with enteric pathogens on children suffering from acute diarrhea in southwest China. Infect Dis Poverty 2016; 5:64. [PMID: 27349521 PMCID: PMC4922062 DOI: 10.1186/s40249-016-0157-2] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 06/20/2016] [Indexed: 12/15/2022] Open
Abstract
Background Acute diarrhea is a global health problem, resulting in high morbidity and mortality in children. It has been suggested that enteric pathogen co-infections play an important role in gastroenteritis, but most research efforts have only focused on a small range of species belonging to a few pathogen groups. This study aimed to assess the impact of co-infections with a broad range of enteric pathogens on children aged below five years who suffer from acute diarrhea in southwest China. Method A total of 1020 subjects (850 diarrhea cases and 170 healthy controls) were selected from four sentinel hospitals in Kunming, Yunnan province, southwest China, from June 2014 to July 2015. Stool specimens were collected to detect five virus (rotavirus group A, RVA; norovirus, NoV; Sapovirus, SaV; astrovirus, As; and adenovirus, Ad), seven bacterial (diarrheagenic Escherichia coli, DEC; non-typhoidal Salmonella, NTS; Shigella spp.; Vibrio cholera; Vibrio parahaemolyticus; Aeromonas spp.; and Plesiomonas spp.), and three protozoan (Cryptosporidium spp., Giardia lamblia, and Blastocystis hominis, B. hominis) species using standard microbiologic and molecular methods. Data were analyzed using the partial least square regression technique and chi-square test. Results At least one enteric pathogen was detected in 46.7 % (n = 397) of acute gastroenteritis cases and 13.5 % (n = 23) of healthy controls (χ2 = 64.4, P < 0.05). Single infection with RVA was associated with acute diarrhea (26.5 % vs. 5.8 %, P < 0.05). The prevalence of a single infection with B. hominis in diarrhea cases was higher than in healthy controls (3.1 % vs. 0.5 %, OR = 4.7, 95 % CI: 1.01–112.0). Single infection with NoV GII was not associated with diarrhea (4.4 % vs. 3.5 %, OR = 1.2, 95 % CI: 0.5–3.3). Single infections with bacterial species were not observed. The prevalence of co-infections with two enteric pathogens in diarrhea cases was higher than in asymptomatic children (20.1 % vs. 5.3 %, P < 0.05). RVA-NoV GII was the most common co-infection in symptomatic children (4.4 %), with it aggravating the severity of diarrhea. Conclusions Although it is clear that RVA has an overwhelming impact on diarrhea illnesses in children, co-infection with other enteric pathogens appears to also aggravate diarrhea severity. These findings should serve as evidence for public health services when planning and developing intervention programs. Electronic supplementary material The online version of this article (doi:10.1186/s40249-016-0157-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shun-Xian Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,Key Laboratory for Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China
| | - Yong-Ming Zhou
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, People's Republic of China
| | - Wen Xu
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, People's Republic of China
| | - Li-Guang Tian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,Key Laboratory for Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China
| | - Jia-Xu Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,Key Laboratory for Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China
| | - Shao-Hong Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,Key Laboratory for Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China
| | - Zhi-Sheng Dang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,Key Laboratory for Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China
| | - Wen-Peng Gu
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, People's Republic of China
| | - Jian-Wen Yin
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, People's Republic of China
| | - Emmanuel Serrano
- Centre for Environmental and Marine Studies, Departamento de Biología, Universidade de Aveiro, Aveiro, Portugal.,Servei d'Ecopatologia de Fauna Salvatge, Departament de Medicina i Cirurgia Animals, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People's Republic of China. .,Key Laboratory for Parasite and Vector Biology, Ministry of Health of China, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025, People's Republic of China.
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Reynolds LA, Finlay BB, Maizels RM. Cohabitation in the Intestine: Interactions among Helminth Parasites, Bacterial Microbiota, and Host Immunity. THE JOURNAL OF IMMUNOLOGY 2016; 195:4059-66. [PMID: 26477048 DOI: 10.4049/jimmunol.1501432] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Both intestinal helminth parasites and certain bacterial microbiota species have been credited with strong immunomodulatory effects. Recent studies reported that the presence of helminth infection alters the composition of the bacterial intestinal microbiota and, conversely, that the presence and composition of the bacterial microbiota affect helminth colonization and persistence within mammalian hosts. This article reviews recent findings on these reciprocal relationships, in both human populations and mouse models, at the level of potential mechanistic pathways and the implications these bear for immunomodulatory effects on allergic and autoimmune disorders. Understanding the multidirectional complex interactions among intestinal microbes, helminth parasites, and the host immune system allows for a more holistic approach when using probiotics, prebiotics, synbiotics, antibiotics, and anthelmintics, as well as when designing treatments for autoimmune and allergic conditions.
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Affiliation(s)
- Lisa A Reynolds
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - B Brett Finlay
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada; Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada; Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada; and
| | - Rick M Maizels
- Centre for Immunity, Infection, and Evolution, Institute of Immunology and Infection Research, Ashworth Laboratories, University of Edinburgh, Edinburgh EH9 3JT, United Kingdom
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Vibrio cholerae Serogroup O139: Isolation from Cholera Patients and Asymptomatic Household Family Members in Bangladesh between 2013 and 2014. PLoS Negl Trop Dis 2015; 9:e0004183. [PMID: 26562418 PMCID: PMC4642977 DOI: 10.1371/journal.pntd.0004183] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 09/30/2015] [Indexed: 11/20/2022] Open
Abstract
Background Cholera is endemic in Bangladesh, with outbreaks reported annually. Currently, the majority of epidemic cholera reported globally is El Tor biotype Vibrio cholerae isolates of the serogroup O1. However, in Bangladesh, outbreaks attributed to V. cholerae serogroup O139 isolates, which fall within the same phylogenetic lineage as the O1 serogroup isolates, were seen between 1992 and 1993 and in 2002 to 2005. Since then, V. cholerae serogroup O139 has only been sporadically isolated in Bangladesh and is now rarely isolated elsewhere. Methods Here, we present case histories of four cholera patients infected with V. cholerae serogroup O139 in 2013 and 2014 in Bangladesh. We comprehensively typed these isolates using conventional approaches, as well as by whole genome sequencing. Phenotypic typing and PCR confirmed all four isolates belonging to the O139 serogroup. Findings Whole genome sequencing revealed that three of the isolates were phylogenetically closely related to previously sequenced El Tor biotype, pandemic 7, toxigenic V. cholerae O139 isolates originating from Bangladesh and elsewhere. The fourth isolate was a non-toxigenic V. cholerae that, by conventional approaches, typed as O139 serogroup but was genetically divergent from previously sequenced pandemic 7 V. cholerae lineages belonging to the O139 or O1 serogroups. Conclusion These results suggest that previously observed lineages of V. cholerae O139 persist in Bangladesh and can cause clinical disease and that a novel disease-causing non-toxigenic O139 isolate also occurs. Vibrio cholerae serogroup O1 is thought to be the sole causative agent for cholera in Bangladesh and most of the high risk developing countries. Whilst historically Vibrio cholerae serogroup O139 has been seen to cause sporadic disease, the overall numbers of reported O139 clinical cases are low, with none reported in Bangladesh since 2005. Here we report four patients suffering from cholera attributed to serogroup O139 V. cholerae. Cases 1 and 2 were symptomatic (isolated strains 1, 2), and cases 3 and 4 were asymptomatic (isolated strains 3, 4). All cases were from urban Dhaka and represented a range of age groups. Cases 2–4 presented with no sign of dehydration whereas case 1 showed some signs of dehydration. Phenotypic and whole genome sequence data indicates that one of the four O139 V. cholerae isolates represents a novel O139 subtype. Since natural infection with V. cholerae O1 or vaccination with currently available licensed cholera vaccines (e.g., Dukoral) provides little protection against O139, we conclude that V. cholerae O139 remains in circulation and is still causing a low incidence of cholera. Therefore, further studies looking at the significance of these isolates towards the total burden of cholera in Bangladesh is warranted, including clinical evaluation, genome sequencing and immunobiochemistry.
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25
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Chowdhury F, Kuchta A, Khan AI, Faruque ASG, Calderwood SB, Ryan ET, Qadri F. The increased severity in patients presenting to hospital with diarrhea in Dhaka, Bangladesh since the emergence of the hybrid strain of Vibrio cholerae O1 is not unique to cholera patients. Int J Infect Dis 2015; 40:9-14. [PMID: 26409202 PMCID: PMC4666742 DOI: 10.1016/j.ijid.2015.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 08/07/2015] [Accepted: 09/06/2015] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND A hybrid strain of Vibrio cholerae O1 El Tor that expresses a classical cholera toxin (CT) emerged in 2001. This hybrid variant rapidly replaced the previous El Tor strain around the world. The global emergence of this variant coincided with anecdotal reports that cholera patients were presenting with more severe dehydration and disease in many locations. METHODS A comparison was made of the severity of disease before and after the emergence of the hybrid strain in cholera patients attending an icddr,b hospital in Dhaka, Bangladesh. RESULTS It was found that cholera patients presented with more severe dehydration and severe disease in the later period. However, this was also true for all non-cholera patients as well. In addition, in sub-analyses of patients who presented with rotavirus and enterotoxigenic Escherichia coli (ETEC), similar results were found. Comparing the two periods for differences in patient characteristics, nutritional status, vaccination status, and income, no plausible cause for patients presenting with more severe disease was identified in the later period. CONCLUSIONS As a shift in severity for both cholera and non-cholera was observed, these results indicate that the altered El Tor strain cannot fully explain the difference in cholera severity before and after 2001.
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Affiliation(s)
- Fahima Chowdhury
- International Centre for Diarrheal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Alison Kuchta
- International Centre for Diarrheal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Ashraful Islam Khan
- International Centre for Diarrheal Disease Research (icddr,b), Dhaka, Bangladesh
| | - A S G Faruque
- International Centre for Diarrheal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Stephen B Calderwood
- Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - Edward T Ryan
- Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA; Harvard School of Public Health, Boston, Massachusetts, USA
| | - Firdausi Qadri
- International Centre for Diarrheal Disease Research (icddr,b), Dhaka, Bangladesh.
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Unknown age in health disorders: A method to account for its cumulative effect and an application to feline viruses interactions. Epidemics 2015; 11:48-55. [PMID: 25979281 DOI: 10.1016/j.epidem.2015.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 02/12/2015] [Accepted: 02/12/2015] [Indexed: 11/23/2022] Open
Abstract
Parasite interactions have been widely evidenced experimentally but field studies remain rare. Such studies are essential to detect interactions of interest and access (co)infection probabilities but face methodological obstacles. Confounding factors can create statistical associations, i.e. false parasite interactions. Among them, host age is a crucial covariate. It influences host exposition and susceptibility to many infections, and has a mechanical effect, older individuals being more at risk because of a longer exposure time. However, age is difficult to estimate in natural populations. Hence, one should be able to deal at least with its cumulative effect. Using a SI type dynamic model, we showed that the cumulative effect of age can generate false interactions theoretically (deterministic modeling) and with a real dataset of feline viruses (stochastic modeling). The risk to wrongly conclude to an association was maximal when parasites induced long-lasting antibodies and had similar forces of infection. We then proposed a method to correct for this effect (and for other potentially confounding shared risk factors) and made it available in a new R package, Interatrix. We also applied the correction to the feline viruses. It offers a way to account for an often neglected confounding factor and should help identifying parasite interactions in the field, a necessary step towards a better understanding of their mechanisms and consequences.
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Price GA, Holmes RK. Immunizing adult female mice with a TcpA-A2-CTB chimera provides a high level of protection for their pups in the infant mouse model of cholera. PLoS Negl Trop Dis 2014; 8:e3356. [PMID: 25474636 PMCID: PMC4256283 DOI: 10.1371/journal.pntd.0003356] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 10/18/2014] [Indexed: 12/11/2022] Open
Abstract
Vibrio cholerae expresses two primary virulence factors, cholera toxin (CT) and the toxin-coregulated pilus (TCP). CT causes profuse watery diarrhea, and TCP (composed of repeating copies of the major pilin TcpA) is required for intestinal colonization by V. cholerae. Antibodies to CT or TcpA can protect against cholera in animal models. We developed a TcpA holotoxin-like chimera (TcpA-A2-CTB) to elicit both anti-TcpA and anti-CTB antibodies and evaluated its immunogenicity and protective efficacy in the infant mouse model of cholera. Adult female CD-1 mice were immunized intraperitoneally three times with the TcpA-A2-CTB chimera and compared with similar groups immunized with a TcpA+CTB mixture, TcpA alone, TcpA with Salmonella typhimurium flagellin subunit FliC as adjuvant, or CTB alone. Blood and fecal samples were analyzed for antigen-specific IgG or IgA, respectively, using quantitative ELISA. Immunized females were mated; their reared offspring were challenged orogastrically with 10 or 20 LD50 of V. cholerae El Tor N16961; and vaccine efficacy was assessed by survival of the challenged pups at 48 hrs. All pups from dams immunized with the TcpA-A2-CTB chimera or the TcpA+CTB mixture survived at both challenge doses. In contrast, no pups from dams immunized with TcpA+FliC or CTB alone survived at the 20 LD50 challenge dose, although the anti-TcpA or anti-CTB antibody level elicited by these immunizations was comparable to the corresponding antibody level achieved by immunization with TcpA-A2-CTB or TcpA+CTB. Taken together, these findings comprise strong preliminary evidence for synergistic action between anti-TcpA and anti-CTB antibodies in protecting mice against cholera. Weight loss analysis showed that only immunization of dams with TcpA-A2-CTB chimera or TcpA+CTB mixture protected their pups against excess weight loss from severe diarrhea. These data support the concept of including both TcpA and CTB as immunogens in development of an effective multivalent subunit vaccine against V. cholerae.
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Affiliation(s)
- Gregory A. Price
- Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Randall K. Holmes
- Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, Colorado, United States of America
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28
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Weil AA, Begum Y, Chowdhury F, Khan AI, Leung DT, LaRocque RC, Charles RC, Ryan ET, Calderwood SB, Qadri F, Harris JB. Bacterial shedding in household contacts of cholera patients in Dhaka, Bangladesh. Am J Trop Med Hyg 2014; 91:738-42. [PMID: 25114012 DOI: 10.4269/ajtmh.14-0095] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Multiple Vibrio cholerae infections within the same household are common. Household contacts of patients with cholera were observed with daily clinical assessments and collection of rectal swab cultures for nine days after presentation of the index case. During the follow-up period, 71 (24%) of 294 household contacts developed a positive V. cholerae rectal swab, signifying bacterial shedding. The average length of bacterial shedding was 2.0 days (95% confidence interval 1.7-2.4). However, 16 (5%) of 294 contacts shed V. cholerae for ≥ 4 days. In a multivariate analysis, malnutrition was predictive of long-term shedding (odds ratio = 1.4, 95% confidence interval = 1.3-13, P = 0.02). High rates of V. cholerae infection and bacterial shedding among household contacts of cholera patients represent an opportunity for intervention to reduce V. cholerae transmission.
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Affiliation(s)
- Ana A Weil
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
| | - Yasmin Begum
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
| | - Fahima Chowdhury
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
| | - Ashraful I Khan
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
| | - Daniel T Leung
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
| | - Regina C LaRocque
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
| | - Richelle C Charles
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
| | - Edward T Ryan
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
| | - Stephen B Calderwood
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
| | - Firdausi Qadri
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
| | - Jason B Harris
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Department of Microbiology and Immunobiology, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts
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Griffiths EC, Pedersen AB, Fenton A, Petchey OL. Analysis of a summary network of co-infection in humans reveals that parasites interact most via shared resources. Proc Biol Sci 2014; 281:20132286. [PMID: 24619434 PMCID: PMC3973251 DOI: 10.1098/rspb.2013.2286] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 02/10/2014] [Indexed: 12/25/2022] Open
Abstract
Simultaneous infection by multiple parasite species (viruses, bacteria, helminths, protozoa or fungi) is commonplace. Most reports show co-infected humans to have worse health than those with single infections. However, we have little understanding of how co-infecting parasites interact within human hosts. We used data from over 300 published studies to construct a network that offers the first broad indications of how groups of co-infecting parasites tend to interact. The network had three levels comprising parasites, the resources they consume and the immune responses they elicit, connected by potential, observed and experimentally proved links. Pairs of parasite species had most potential to interact indirectly through shared resources, rather than through immune responses or other parasites. In addition, the network comprised 10 tightly knit groups, eight of which were associated with particular body parts, and seven of which were dominated by parasite-resource links. Reported co-infection in humans is therefore structured by physical location within the body, with bottom-up, resource-mediated processes most often influencing how, where and which co-infecting parasites interact. The many indirect interactions show how treating an infection could affect other infections in co-infected patients, but the compartmentalized structure of the network will limit how far these indirect effects are likely to spread.
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Affiliation(s)
- Emily C. Griffiths
- Department of Entomology, North Carolina State University, Raleigh, NC 27695-7613, USA
- Department of Animal and Plant Sciences, University of Sheffield, Alfred Denny Building, Western Bank, Sheffield S10 2TN, UK
| | - Amy B. Pedersen
- Centre for Immunology, Infection and Evolution, Institute of Evolutionary Biology, School of Biological Sciences, Ashworth Labs, University of Edinburgh, Kings Buildings, West Mains Road, Edinburgh EH9 3JT, UK
| | - Andy Fenton
- Institute of Integrative Biology, University of Liverpool, Liverpool L69 7ZB, UK
| | - Owen L. Petchey
- Institute of Evolutionary Biology and Environmental Studies, University of Zürich, Winterthurerstrasse 190, Zürich 8057, Switzerland
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Chowdhury MI, Sheikh A, Qadri F. Development of Peru-15 (CholeraGarde®), a live-attenuated oral cholera vaccine: 1991–2009. Expert Rev Vaccines 2014; 8:1643-52. [DOI: 10.1586/erv.09.137] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Singer M, Bulled N. INTERLOCKED INFECTIONS: THE HEALTH BURDENS OF SYNDEMICS OF NEGLECTED TROPICAL DISEASES. ANNALS OF ANTHROPOLOGICAL PRACTICE 2013. [DOI: 10.1111/napa.12007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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32
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Host and parasite diversity jointly control disease risk in complex communities. Proc Natl Acad Sci U S A 2013; 110:16916-21. [PMID: 24082092 DOI: 10.1073/pnas.1310557110] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Host-parasite interactions are embedded within complex communities composed of multiple host species and a cryptic assemblage of other parasites. To date, however, surprisingly few studies have explored the joint effects of host and parasite richness on disease risk, despite growing interest in the diversity-disease relationship. Here, we combined field surveys and mechanistic experiments to test how transmission of the virulent trematode Ribeiroia ondatrae was affected by the diversity of both amphibian hosts and coinfecting parasites. Within natural wetlands, host and parasite species richness correlated positively, consistent with theoretical predictions. Among sites that supported Ribeiroia, however, host and parasite richness interacted to negatively affect Ribeiroia transmission between its snail and amphibian hosts, particularly in species-poor assemblages. In laboratory and outdoor experiments designed to decouple the relative contributions of host and parasite diversity, increases in host richness decreased Ribeiroia infection by 11-65%. Host richness also tended to decrease total infections by other parasite species (four of six instances), such that more diverse host assemblages exhibited ∼40% fewer infections overall. Importantly, parasite richness further reduced both per capita and total Ribeiroia infection by 15-20%, possibly owing to intrahost competition among coinfecting species. These findings provide evidence that parasitic and free-living diversity jointly regulate disease risk, help to resolve apparent contradictions in the diversity-disease relationship, and emphasize the challenges of integrating research on coinfection and host heterogeneity to develop a community ecology-based approach to infectious diseases.
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Nieuwenhuizen NE, Meter JM, Horsnell WG, Hoving JC, Fick L, Sharp MF, Darby MG, Parihar SP, Brombacher F, Lopata AL. A cross-reactive monoclonal antibody to nematode haemoglobin enhances protective immune responses to Nippostrongylus brasiliensis. PLoS Negl Trop Dis 2013; 7:e2395. [PMID: 24009787 PMCID: PMC3757078 DOI: 10.1371/journal.pntd.0002395] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 07/19/2013] [Indexed: 11/18/2022] Open
Abstract
Background Nematode secreted haemoglobins have unusually high affinity for oxygen and possess nitric oxide deoxygenase, and catalase activity thought to be important in protection against host immune responses to infection. In this study, we generated a monoclonal antibody (48Eg) against haemoglobin of the nematode Anisakis pegreffii, and aimed to characterize cross-reactivity of 4E8g against haemoglobins of different nematodes and its potential to mediate protective immunity against a murine hookworm infection. Methodology/Principal Findings Immunoprecipitation was used to isolate the 4E8g-binding antigen in Anisakis and Ascaris extracts, which were identified as haemoglobins by peptide mass fingerprinting and MS/MS. Immunological cross-reactivity was also demonstrated with haemoglobin of the rodent hookworm N. brasiliensis. Immunogenicity of nematode haemoglobin in mice and humans was tested by immunoblotting. Anisakis haemoglobin was recognized by IgG and IgE antibodies of Anisakis-infected mice, while Ascaris haemoglobin was recognized by IgG but not IgE antibodies in mouse and human sera. Sequencing of Anisakis haemoglobin revealed high similarity to haemoglobin of a related marine nematode, Psuedoterranova decipiens, which lacks the four –HKEE repeats of Ascaris haemoglobin important in octamer assembly. The localization of haemoglobin in the different parasites was examined by immunohistochemistry and associated with the excretory-secretary ducts in Anisakis, Ascaris and N. brasiliensis. Anisakis haemoglobin was strongly expressed in the L3 stage, unlike Ascaris haemoglobin, which is reportedly mainly expressed in adult worms. Passive immunization of mice with 4E8g prior to infection with N. brasiliensis enhanced protective Th2 immunity and led to a significant decrease in worm burdens. Conclusion The monoclonal antibody 4E8g targets haemoglobin in broadly equivalent anatomical locations in parasitic nematodes and enhances host immunity to a hookworm infection. Nematode haemoglobins are fascinating molecules with unusually high affinity for oxygen. This is one example of many unique adaptations that nematodes have acquired to survive in their hosts, as nematode haemoglobin is thought to sequester oxygen to maintain an anaerobic environment, and can break down nitric oxide (NO) and hydrogen peroxide produced by host defences. This study describes the characterization of nematode haemoglobins using a novel monoclonal antibody (anti-Hb) generated against Anisakis haemoglobin, which was found to be highly expressed in stage 3 larvae and associated with the excretory-secretary ducts. Anisakis haemoglobin is an IgE-binding molecule in infected mice, while Ascaris haemoglobin was recognized by IgG but not IgE in human sera. Finally, passive immunization of mice with anti-Hb provided protection against Nippostrongylus brasiliens (rodent hookworm), with mice showing reduced worm burden and enhanced Th2 responses, showing that haemoglobin may be a good vaccine target in some nematodes. The monoclonal antibody generated in this study will be useful in further studies to examine the biology of nematode haemoglobins.
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MESH Headings
- Animals
- Anisakis/genetics
- Anisakis/immunology
- Antibodies, Helminth/administration & dosage
- Antibodies, Helminth/immunology
- Antibodies, Helminth/isolation & purification
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/isolation & purification
- Antigens, Helminth/chemistry
- Antigens, Helminth/genetics
- Antigens, Helminth/immunology
- Ascaris/immunology
- Cross Reactions
- Disease Models, Animal
- Hemoglobins/chemistry
- Hemoglobins/genetics
- Hemoglobins/immunology
- Humans
- Immunization, Passive
- Immunoblotting
- Immunoglobulin E/blood
- Immunoglobulin G/blood
- Immunohistochemistry
- Immunoprecipitation
- Mice
- Mice, Inbred BALB C
- Nematoda
- Nippostrongylus/immunology
- Sequence Analysis, DNA
- Strongylida Infections/immunology
- Tandem Mass Spectrometry
- Treatment Outcome
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Affiliation(s)
- Natalie E Nieuwenhuizen
- International Center for Genetic Engineering and Biotechnology, Cape Town Component, and Institute of Infectious Diseases and Molecular Medicine, Medical Research Council, Division of Immunology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa.
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Abstract
Syphilis, cholera and TB have re-emerged and now affect the health of countless humans globally. In this article, we review current information concerning the biology and epidemiology of these bacterial diseases with the goal of developing a better understanding of factors that have led to their resurgence and that threaten to compromise their control. The impact of microbial and environmental change notwithstanding, the main factors common to the re-emergence of syphilis, cholera and TB are human demographics and behavior. This information is critical to developing targeted strategies aimed at preventing and controlling these potentially deadly infectious diseases.
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Affiliation(s)
- Lola V Stamm
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Dances with worms: the ecological and evolutionary impacts of deworming on coinfecting pathogens. Parasitology 2013; 140:1119-32. [PMID: 23714427 PMCID: PMC3695730 DOI: 10.1017/s0031182013000590] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Parasitic helminths are ubiquitous in most host, including human, populations. Helminths
often alter the likelihood of infection and disease progression of coinfecting
microparasitic pathogens (viruses, bacteria, protozoa), and there is great interest in
incorporating deworming into control programmes for many major diseases (e.g. HIV,
tuberculosis, malaria). However, such calls are controversial; studies show the
consequences of deworming for the severity and spread of pathogens to be highly variable.
Hence, the benefits of deworming, although clear for reducing the morbidity due to
helminth infection per se, are unclear regarding the outcome of
coinfections and comorbidities. I develop a theoretical framework to explore how helminth
coinfection with other pathogens affects host mortality and pathogen spread and evolution
under different interspecific parasite interactions. In all cases the outcomes of
coinfection are highly context-dependent, depending on the mechanism of helminth-pathogen
interaction and the quantitative level of helminth infection, with the effects of
deworming potentially switching from beneficial to detrimental depending on helminth
burden. Such context-dependency may explain some of the variation in the benefits of
deworming seen between studies, and highlights the need for obtaining a quantitative
understanding of parasite interactions across realistic helminth infection ranges.
However, despite this complexity, this framework reveals predictable patterns in the
effects of helminths that may aid the development of more effective, integrated management
strategies to combat pathogens in this coinfected world.
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van Hellemond JJ, Vonk AG, de Vogel C, Koelewijn R, Vaessen N, Fahal AH, van Belkum A, van de Sande WWJ. Association of eumycetoma and schistosomiasis. PLoS Negl Trop Dis 2013; 7:e2241. [PMID: 23717704 PMCID: PMC3662663 DOI: 10.1371/journal.pntd.0002241] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 04/16/2013] [Indexed: 01/25/2023] Open
Abstract
Eumycetoma is a morbid chronic granulomatous subcutaneous fungal disease. Despite high environmental exposure to this fungus in certain regions of the world, only few develop eumycetoma for yet unknown reasons. Animal studies suggest that co-infections skewing the immune system to a Th2-type response enhance eumycetoma susceptibility. Since chronic schistosomiasis results in a strong Th2-type response and since endemic areas for eumycetoma and schistosomiasis do regionally overlap, we performed a serological case-control study to identify an association between eumycetoma and schistosomiasis. Compared to endemic controls, eumycetoma patients were significantly more often sero-positive for schistosomiasis (p = 0.03; odds ratio 3.2, 95% CI 1.18-8.46), but not for toxoplasmosis, an infection inducing a Th1-type response (p = 0.6; odds ratio 1.5, 95% CI 0.58-3.83). Here, we show that schistosomiasis is correlated to susceptibility for a fungal disease for the first time.
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Affiliation(s)
- Jaap J. van Hellemond
- Erasmus MC, Department of Medical Microbiology and Infectious Diseases, Rotterdam, The Netherlands
| | - Alieke G. Vonk
- Erasmus MC, Department of Medical Microbiology and Infectious Diseases, Rotterdam, The Netherlands
| | - Corné de Vogel
- Erasmus MC, Department of Medical Microbiology and Infectious Diseases, Rotterdam, The Netherlands
| | - Rob Koelewijn
- Harbour Hospital and Institute for Tropical Diseases, Laboratory for Parasitology, Rotterdam, The Netherlands
| | - Norbert Vaessen
- Erasmus MC, Department of Medical Microbiology and Infectious Diseases, Rotterdam, The Netherlands
| | - Ahmed H. Fahal
- Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan
| | - Alex van Belkum
- Erasmus MC, Department of Medical Microbiology and Infectious Diseases, Rotterdam, The Netherlands
- bioMerieux, Microbiology R&D, La Balme Les Grottes, France
| | - Wendy W. J. van de Sande
- Erasmus MC, Department of Medical Microbiology and Infectious Diseases, Rotterdam, The Netherlands
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37
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Abstract
Helminth parasites infect almost one-third of the world's population, primarily in tropical regions. However, regions where helminth parasites are endemic record much lower prevalences of allergies and autoimmune diseases, suggesting that parasites may protect against immunopathological syndromes. Most helminth diseases are spectral in nature, with a large proportion of relatively asymptomatic cases and a subset of patients who develop severe pathologies. The maintenance of the asymptomatic state is now recognized as reflecting an immunoregulatory environment, which may be promoted by parasites, and involves multiple levels of host regulatory cells and cytokines; a breakdown of this regulation is observed in pathological disease. Currently, there is much interest in whether helminth-associated immune regulation may ameliorate allergy and autoimmunity, with investigations in both laboratory models and human trials. Understanding and exploiting the interactions between these parasites and the host regulatory network are therefore likely to highlight new strategies to control both infectious and immunological diseases.
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Leung DT, Chowdhury F, Calderwood SB, Qadri F, Ryan ET. Immune responses to cholera in children. Expert Rev Anti Infect Ther 2012; 10:435-44. [PMID: 22512753 DOI: 10.1586/eri.12.23] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Cholera is a severe acute dehydrating diarrheal disease caused by Vibrio cholerae O1 or O139 infection, and is associated with significant mortality and morbidity globally. Although young children bear a high burden of the disease, currently available oral vaccines give a lower efficacy and shorter duration of protection in this group than in adults. According to the studies of natural infection, young children achieve comparable systemic anti-V. cholerae antigen-specific antibody, gut-homing antibody-secreting cell and memory B-cell responses as adults. Studies on innate and cell-mediated immune responses are lacking in children, and may offer important insights into differences in vaccine efficacy. The impact of host factors such as malnutrition, genetics and coinfection with other pathogens also remains to be fully defined.
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Affiliation(s)
- Daniel T Leung
- Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
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39
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Abstract
Cholera is an acute, secretory diarrhoea caused by infection with Vibrio cholerae of the O1 or O139 serogroup. It is endemic in more than 50 countries and also causes large epidemics. Since 1817, seven cholera pandemics have spread from Asia to much of the world. The seventh pandemic began in 1961 and affects 3-5 million people each year, killing 120,000. Although mild cholera can be indistinguishable from other diarrhoeal illnesses, the presentation of severe cholera is distinct, with pronounced diarrhoeal purging. Management of patients with cholera involves aggressive fluid replacement; effective therapy can decrease mortality from more than 50% to less than 0·2%. Antibiotic treatment decreases volume and duration of diarrhoea by 50% and is recommended for patients with moderate to severe dehydration. Prevention of cholera depends on access to safe water and sanitation. Two oral cholera vaccines are available and the most effective use of these in integrated prevention programmes is being actively assessed.
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Affiliation(s)
- Jason B Harris
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Regina C LaRocque
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Firdausi Qadri
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Edward T Ryan
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA
| | - Stephen B Calderwood
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, MA, USA.
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40
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Memory B cell responses to Vibrio cholerae O1 lipopolysaccharide are associated with protection against infection from household contacts of patients with cholera in Bangladesh. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2012; 19:842-8. [PMID: 22518009 DOI: 10.1128/cvi.00037-12] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Vibrio cholerae O1 causes cholera, a dehydrating diarrheal disease. We have previously shown that V. cholerae-specific memory B cell responses develop after cholera infection, and we hypothesize that these mediate long-term protective immunity against cholera. We prospectively followed household contacts of cholera patients to determine whether the presence of circulating V. cholerae O1 antigen-specific memory B cells on enrollment was associated with protection against V. cholerae infection over a 30-day period. Two hundred thirty-six household contacts of 122 index patients with cholera were enrolled. The presence of lipopolysaccharide (LPS)-specific IgG memory B cells in peripheral blood on study entry was associated with a 68% decrease in the risk of infection in household contacts (P = 0.032). No protection was associated with cholera toxin B subunit (CtxB)-specific memory B cells or IgA memory B cells specific to LPS. These results suggest that LPS-specific IgG memory B cells may be important in protection against infection with V. cholerae O1.
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41
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Transcutaneous immunization with a Vibrio cholerae O1 Ogawa synthetic hexasaccharide conjugate following oral whole-cell cholera vaccination boosts vibriocidal responses and induces protective immunity in mice. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2012; 19:594-602. [PMID: 22357651 DOI: 10.1128/cvi.05689-11] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A shortcoming of currently available oral cholera vaccines is their induction of relatively short-term protection against cholera compared to that afforded by wild-type disease. We were interested in whether transcutaneous or subcutaneous boosting using a neoglycoconjugate vaccine made from a synthetic terminal hexasaccharide of the O-specific polysaccharide of Vibrio cholerae O1 (Ogawa) coupled to bovine serum albumin as a carrier (CHO-BSA) could boost lipopolysaccharide (LPS)-specific and vibriocidal antibody responses and result in protective immunity following oral priming immunization with whole-cell cholera vaccine. We found that boosting with CHO-BSA with immunoadjuvantative cholera toxin (CT) or Escherichia coli heat-labile toxin (LT) following oral priming with attenuated V. cholerae O1 vaccine strain O395-NT resulted in significant increases in serum anti-V. cholerae LPS IgG, IgM, and IgA (P < 0.01) responses as well as in anti-Ogawa (P < 0.01) and anti-Inaba (P < 0.05) vibriocidal titers in mice. The LPS-specific IgA responses in stool were induced by transcutaneous (P < 0.01) but not subcutaneous immunization. Immune responses following use of CT or LT as an adjuvant were comparable. In a neonatal mouse challenge assay, immune serum from boosted mice was associated with 79% protective efficacy against death. Our results suggest that transcutaneous and subcutaneous boosting with a neoglycoconjugate following oral cholera vaccination may be an effective strategy to prolong protective immune responses against V. cholerae.
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42
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Hellard E, Pontier D, Sauvage F, Poulet H, Fouchet D. True versus false parasite interactions: a robust method to take risk factors into account and its application to feline viruses. PLoS One 2012; 7:e29618. [PMID: 22235312 PMCID: PMC3250451 DOI: 10.1371/journal.pone.0029618] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 12/01/2011] [Indexed: 01/25/2023] Open
Abstract
Background Multiple infections are common in natural host populations and interspecific parasite interactions are therefore likely within a host individual. As they may seriously impact the circulation of certain parasites and the emergence and management of infectious diseases, their study is essential. In the field, detecting parasite interactions is rendered difficult by the fact that a large number of co-infected individuals may also be observed when two parasites share common risk factors. To correct for these “false interactions”, methods accounting for parasite risk factors must be used. Methodology/Principal Findings In the present paper we propose such a method for presence-absence data (i.e., serology). Our method enables the calculation of the expected frequencies of single and double infected individuals under the independence hypothesis, before comparing them to the observed ones using the chi-square statistic. The method is termed “the corrected chi-square.” Its robustness was compared to a pre-existing method based on logistic regression and the corrected chi-square proved to be much more robust for small sample sizes. Since the logistic regression approach is easier to implement, we propose as a rule of thumb to use the latter when the ratio between the sample size and the number of parameters is above ten. Applied to serological data for four viruses infecting cats, the approach revealed pairwise interactions between the Feline Herpesvirus, Parvovirus and Calicivirus, whereas the infection by FIV, the feline equivalent of HIV, did not modify the risk of infection by any of these viruses. Conclusions/Significance This work therefore points out possible interactions that can be further investigated in experimental conditions and, by providing a user-friendly R program and a tutorial example, offers new opportunities for animal and human epidemiologists to detect interactions of interest in the field, a crucial step in the challenge of multiple infections.
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44
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Effects of chronic ascariasis and trichuriasis on cytokine production and gene expression in human blood: a cross-sectional study. PLoS Negl Trop Dis 2011; 5:e1157. [PMID: 21666788 PMCID: PMC3110165 DOI: 10.1371/journal.pntd.0001157] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Accepted: 03/14/2011] [Indexed: 12/21/2022] Open
Abstract
Background Chronic soil-transmitted helminth (STH) infections are associated with effects on systemic immune responses that could be caused by alterations in immune homeostasis. To investigate this, we measured the impact in children of STH infections on cytokine responses and gene expression in unstimulated blood. Methodology/Principal Findings Sixty children were classified as having chronic, light, or no STH infections. Peripheral blood mononuclear cells were cultured in medium for 5 days to measure cytokine accumulation. RNA was isolated from peripheral blood and gene expression analysed using microarrays. Different infection groups were compared for the purpose of analysis: STH infection (combined chronic and light vs. uninfected groups) and chronic STH infection (chronic vs. combined light and uninfected groups). The chronic STH infection effect was associated with elevated production of GM-CSF (P = 0.007), IL-2 (P = 0.03), IL-5 (P = 0.01), and IL-10 (P = 0.01). Data reduction suggested that chronic infections were primarily associated with an immune phenotype characterized by elevated IL-5 and IL-10, typical of a modified Th2-like response. Chronic STH infections were associated with the up-regulation of genes associated with immune homeostasis (IDO, P = 0.03; CCL23, P = 0.008, HRK, P = 0.005), down-regulation of microRNA hsa-let-7d (P = 0.01) and differential regulation of several genes associated with granulocyte-mediated inflammation (IL-8, down-regulated, P = 0.0002; RNASE2, up-regulated, P = 0.009; RNASE3, up-regulated, p = 0.03). Conclusions/Significance Chronic STH infections were associated with a cytokine response indicative of a modified Th2 response. There was evidence that STH infections were associated with a pattern of gene expression suggestive of the induction of homeostatic mechanisms, the differential expression of several inflammatory genes and the down-regulation of microRNA has-let-7d. Effects on immune homeostasis and the development of a modified Th2 immune response during chronic STH infections could explain the systemic immunologic effects that have been associated with these infections such as impaired immune responses to vaccines and the suppression of inflammatory diseases. Soil-transmitted helminth (STH or intestinal worm) infections are extremely common infectious diseases of childhood in developing countries. Infections tend be chronic and may last for many years. Chronic STH infections are associated with modulation of the immune response, a consequence of which may be a reduced prevalence of allergic inflammatory diseases such as asthma. The mechanisms by which STH infections suppress inflammatory responses are poorly understood. In this study, we hypothesized that STH infections may affect immune responses through alterations of immune homeostasis (or the steady-state adjustments of the immune system that maintain equilibrium). We investigated the capacity of blood from children classified as having no, light, or chronic STH infections to produce cytokines at rest (i.e. no immunologic stimulation) and the expression of genes in blood samples. Our data show that blood cells of children with chronic STH infections have an altered immune response that is likely to be associated with less allergic inflammation (the modified Th2 response) and that the expression of some inflammatory genes are reduced. Our findings provide insights into the mechanisms by which STH infections suppress immune responses in children to ensure the survival of the parasite and reduce inflammation.
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45
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Kapulu MC, Simuyandi M, Sianongo S, Mutale M, Katubulushi M, Kelly P. Differential changes in expression of intestinal antimicrobial peptide genes during Ascaris lumbricoides infection in Zambian adults do not respond to helminth eradication. J Infect Dis 2011; 203:1464-73. [PMID: 21357944 PMCID: PMC3080889 DOI: 10.1093/infdis/jir035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background. Intestinal helminthiasis modulates immune responses to vaccines and environmental allergens. To explore the impact on intestinal host defense, we assessed expression of antimicrobial peptide genes, together with T cell subset markers and cytokines, in patients with ascariasis before and after treatment. Methods. Case patients (n = 27) and control subjects (n = 44) underwent enteroscopy for collection of jejunal biopsy specimens, which were used in quantitative, real-time reverse-transcription polymerase chain reaction for a range of host defense genes; blood samples were also analyzed simultaneously. Results. The level of gene expression (mRNA) of HD5, hBD1, and LL-37 was lower in case patients than in control subjects, and the level of expression of HD6 was increased. However, after successful eradication, there was no trend to values seen in control subjects. Helminthiasis was associated with increased intestinal expression of the Th1 genes T-bet and interferon-γ. In peripheral blood mononuclear cells (PBMCs), a mixed profile of T cell markers and cytokines was increased. Ascaris-induced down-regulation of HD5 was observed in individuals with higher RORγt expression in PBMCs, but we found no evidence that this was mediated by circulating interleukin-22. Conclusions. Human ascariasis was associated with changes in antimicrobial peptide gene expression and immunological markers. Such changes may have implications for susceptibility to infectious disease and responsiveness to oral vaccines in tropical populations.
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Affiliation(s)
- Melissa C Kapulu
- Biological Sciences Department, School of Natural Sciences, University of Zambia, Lusaka
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46
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Abstract
PURPOSE OF REVIEW This review summarizes recent developments related to cofactors that may influence response to vaccination. RECENT FINDINGS The unexpected increased HIV acquisition among vaccinees in the Step trial with prior exposure to adenovirus type 5 (Ad5) led to several studies trying to understand whether an underlying biological risk factor may have been responsible for this observation. Demographic factors and genetic background of the human populations in HIV vaccine trials remain a source of potential variation in responses observed in vaccine trials, yet empirical data remain limited on the impact of those factors. Coinfections, particularly those that may modulate the immune response, are a further concern for HIV vaccine trialists, with recent data providing further insight into effects of coinfections on innate and adaptive immunity and vaccine responses. SUMMARY Individuals and human populations display variation in response to vaccination. Key explanatory variables for this variation include host factors, such as host genetics, and environmental factors, such as prior exposure to the vaccine vector, coinfection with other pathogens, and demographic factors. This review will outline some of the recent developments investigating the role of various cofactors on vaccine responses, with a particular emphasis on studies of HIV vaccines.
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47
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Abstract
In wild populations, individuals are regularly exposed to a wide range of pathogens. In this context, organisms must elicit and regulate effective immune responses to protect their health while avoiding immunopathology. However, most of our knowledge about the function and dynamics of immune responses comes from laboratory studies performed on inbred mice in highly controlled environments with limited exposure to infection. Natural populations, on the other hand, exhibit wide genetic and environmental diversity. We argue that now is the time for immunology to be taken into the wild. The goal of 'wild immunology' is to link immune phenotype with host fitness in natural environments. To achieve this requires relevant measures of immune responsiveness that are both applicable to the host-parasite interaction under study and robustly associated with measures of host and parasite fitness. Bringing immunology to nonmodel organisms and linking that knowledge host fitness, and ultimately population dynamics, will face difficult challenges, both technical (lack of reagents and annotated genomes) and statistical (variation among individuals and populations). However, the affordability of new genomic technologies will help immunologists, ecologists and evolutionary biologists work together to translate and test our current knowledge of immune mechanisms in natural systems. From this approach, ecologists will gain new insight into mechanisms relevant to host health and fitness, while immunologists will be given a measure of the real-world health impacts of the immune factors they study. Thus, wild immunology can be the missing link between laboratory-based immunology and human, wildlife and domesticated animal health.
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Affiliation(s)
- Amy B Pedersen
- Centre for Immunity, Infection and Evolution, Institutes of Immunology & Infection Research and Evolutionary Biology, University of Edinburgh, Ashworth Labs, West Mains Road, Edinburgh EH9 3JT, UK.
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48
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Cruz-Chan JV, Rosado-Vallado M, Dumonteil E. Malaria vaccine efficacy: overcoming the helminth hurdle. Expert Rev Vaccines 2010; 9:707-11. [PMID: 20624043 DOI: 10.1586/erv.10.63] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Several studies have documented that helminth infections can interfere with the development of the immune response of vaccines against different diseases, although some results have been contradictory. The mechanisms involved in the inhibition of the immune response to vaccination by helminth are still unclear, and murine models of helminth-malaria coinfections have proven helpful in investigating some aspects of the interactions involved. The study evaluated here focuses on the effect of helminth infection in mice on the immunogenicity and protective efficacy of two distinct malaria vaccine candidates, a transmission-blocking DNA vaccine based on Pfs25 antigen and a pre-erythrocytic vaccine based on irradiated sporozoites. Interestingly, the authors found that helminth infection dramatically reduced DNA vaccine immunogenicity, while immunization with irradiated sporozoites was able to induce a high level of antibodies and protection, independently of helminth infection. Immune suppression by helminth infection affected all IgG isotypes, suggesting no particular polarization of the immune response, but the generation of memory B cells was not affected. It will be of key interest to understand the mechanisms underlying the efficacy of the sporozoite vaccine, and its ability to overcome helminth immunosuppression, as this may help in the design of more effective vaccines.
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Affiliation(s)
- Julio Vladimir Cruz-Chan
- Laboratorio de Parasitología, Centro de Investigaciones Regionales 'Dr. Hideyo Noguchi', Universidad Autónoma de Yucatán, Ave. Itzaes #490 x 59, 97000 Mérida, Yucatan, Mexico
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Fenton A, Viney ME, Lello J. Detecting interspecific macroparasite interactions from ecological data: patterns and process. Ecol Lett 2010; 13:606-15. [PMID: 20529102 DOI: 10.1111/j.1461-0248.2010.01458.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There is great interest in the occurrence and consequences of interspecific interactions among co-infecting parasites. However, the extent to which interactions occur is unknown, because there are no validated methods for their detection. We developed a model that generated abundance data for two interacting macroparasite (e.g., helminth) species, and challenged the data with various approaches to determine whether they could detect the underlying interactions. Current approaches performed poorly - either suggesting there was no interaction when, in reality, there was a strong interaction occurring, or inferring the presence of an interaction when there was none. We suggest the novel application of a generalized linear mixed modelling (GLMM)-based approach, which we show to be more reliable than current approaches, even when infection rates of both parasites are correlated (e.g., via a shared transmission route). We suggest that the lack of clarity regarding the presence or absence of interactions in natural systems may be largely attributed to the unreliable nature of existing methods for detecting them. However, application of the GLMM approach may provide a more robust method of detection for these potentially important interspecific interactions from ecological data.
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Affiliation(s)
- Andy Fenton
- School of Biological Sciences,University of Liverpool, Crown Street, Liverpool, L69 7ZB, UK.
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Discovery of a highly synergistic anthelmintic combination that shows mutual hypersusceptibility. Proc Natl Acad Sci U S A 2010; 107:5955-60. [PMID: 20231450 DOI: 10.1073/pnas.0912327107] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The soil-transmitted helminths or nematodes (hookworms, whipworms, and Ascaris) are roundworms that infect more than 1 billion of the poorest peoples and are leading causes of morbidity worldwide. Few anthelmintics are available for treatment, and only one is commonly used in mass drug administrations. New anthelmintics are urgently needed, and crystal (Cry) proteins made by Bacillus thuringiensis are promising new candidates. Combination drug therapies are considered the ideal treatment for infectious diseases. Surprisingly, little work has been done to define the characteristics of anthelmintic combinations. Here, by means of quantitative assays with wild-type and mutants of the roundworm Caenorhabditis elegans, we establish a paradigm for studying anthelmintic combinations using Cry proteins and nicotinic acetylcholine receptor (nAChR) agonists, e.g., tribendimidine and levamisole. We find that nAChR agonists and Cry proteins, like Cry5B and Cry21A, mutually display what is known in the HIV field as hypersusceptibility--when the nematodes become resistant to either class, they become hypersensitive to the other class. Furthermore, we find that when Cry5B and nAChR agonists are combined, their activities are strongly synergistic, producing combination index values as good or better than seen with antitumor, anti-HIV, and insecticide combinations. Our study provides a powerful means by which anthelmintic combination therapies can be examined and demonstrate that the combination of nAChR agonists and Cry proteins has excellent properties and is predicted to give improved cure rates while being recalcitrant to the development of parasite resistance.
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