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Parkouda S, Saidou M, Bisseye C. Microfilariae Prevalence and its Association with Anemia Among First-time Blood Donors in Lambaréné, Gabon. Balkan Med J 2024; 41:139-143. [PMID: 38259115 PMCID: PMC10913112 DOI: 10.4274/balkanmedj.galenos.2023.2023-9-86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
Background Anemia remains a significant public health concern in Gabon, particularly among children, adolescents, and females. Gabon is also home to two major species of filarial worms, Loa and Mansonella spp., which cause microfilaremia. The epidemiological nexus between hemoglobin (Hb) concentrations and microfilaremia in Gabonese first-time blood donors remains unknown. Aims To understand better the epidemiological relationship between anemia and microfilaremia to improve donor selection and management protocols. Study Design A retrospective cohort study. Methods This study was conducted among first-time blood donors in Lambaréné between March 2018 and October 2019. Participants aged 16-65 years old and weighing a minimum of 50 kg were enrolled using standard donor selection criteria. An automatic hematological analyzer was used to quantify Hb concentrations, and microscopy techniques were used to detect the presence of microfilariae. Results Microfilariae were found in 4.8% (35/723) of the 723 first-time blood donors from Lambaréné. Anemia was classified as mild in 35.5% (257/723) and moderate in 1% (7/723). No significant associations were found between the distribution of microfilariae and variables such as age, sex, socioprofessional classification, marital status, or residence. Blood group O donors had a higher prevalence of microfilariae (6%) than non-O donors (2.7%). However, the observed difference was not statistically significant (AOR =2.3, p = 0.052). Furthermore, microfilariae were associated with increased moderate anemia (3.7% vs. 29%, AOR =15.6, p = 0.003). Conclusion Our findings highlight microfilaremia as a possible etiological cause of anemia among Gabonese blood donors, emphasizing the need for further research and a potential review of donor management strategies.
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Affiliation(s)
- Soulemane Parkouda
- Biomedical Laboratory, Centre Hospitalier Régional Georges Rawiri, Lambaréné, Gabon
| | - Mahmoudou Saidou
- Biostatistiques, Centre de Recherches Medicales de Lambaréné, Lambaréné, Gabon
| | - Cyrille Bisseye
- Biologie/Unité de Recherche en Sciences Biologiques, Université des Sciences et Techniques de Masuku, Franceville, Gabon
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Kotepui M, Mala W, Kwankaew P, Mahittikorn A, Ramirez Masangkay F, Uthaisar Kotepui K. A systematic review and meta-analysis of changes in interleukin-8 levels in malaria infection. Cytokine 2023; 169:156262. [PMID: 37327530 DOI: 10.1016/j.cyto.2023.156262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/23/2023] [Accepted: 06/02/2023] [Indexed: 06/18/2023]
Abstract
The roles of interleukin-8 (IL-8) in malaria are inconsistent and unclear. This study synthesised evidence for differences in IL-8 levels in patients with malaria of various levels of severity. Relevant studies were searched in Scopus, MEDLINE, Embase, CENTRAL and PubMed from inception to 22 April 2022. Pooled mean differences (MDs) and 95% confidence intervals (CIs) were estimated using the random effects model. Of 1083 articles retrieved from the databases, 34 were included for syntheses. The meta-analysis revealed increased IL-8 levels in individuals with uncomplicated malaria compared with those without malaria (P = 0.04; MD, 25.57 pg/mL; 95% CI, 1.70 to 49.43 pg/mL; I2, 99.53, 4 studies; 400 uncomplicated malaria, 204 uninfected controls). The meta-analysis revealed comparable levels of IL-8 between the two groups (P = 0.10; MD, 74.46 pg/mL; 95% CI, -15.08 to 164.0 pg/mL; I2, 9.03; 4 studies; 133 severe malaria cases, 568 uncomplicated malaria cases). The study found evidence of increased IL-8 levels in individuals with malaria compared with those without malaria. However, no differences were found in IL-8 levels between patients with severe and non-severe malaria. Further research is needed to investigate the IL-8 cytokine levels in patients with malaria of different levels of severity.
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Affiliation(s)
- Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
| | - Wanida Mala
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
| | - Pattamaporn Kwankaew
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
| | - Aongart Mahittikorn
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | | | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
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Chaccour C, Casellas A, Hammann F, Ruiz-Castillo P, Nicolas P, Montaña J, Mael M, Selvaraj P, Duthaler U, Mrema S, Kakolwa M, Lyimo I, Okumu F, Marathe A, Schürch R, Elobolobo E, Sacoor C, Saute F, Xia K, Jones C, Rist C, Maia M, Rabinovich NR. BOHEMIA: Broad One Health Endectocide-based Malaria Intervention in Africa-a phase III cluster-randomized, open-label, clinical trial to study the safety and efficacy of ivermectin mass drug administration to reduce malaria transmission in two African settings. Trials 2023; 24:128. [PMID: 36810194 PMCID: PMC9942013 DOI: 10.1186/s13063-023-07098-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 01/17/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Residual malaria transmission is the result of adaptive mosquito behavior that allows malaria vectors to thrive and sustain transmission in the presence of good access to bed nets or insecticide residual spraying. These behaviors include crepuscular and outdoor feeding as well as intermittent feeding upon livestock. Ivermectin is a broadly used antiparasitic drug that kills mosquitoes feeding on a treated subject for a dose-dependent period. Mass drug administration with ivermectin has been proposed as a complementary strategy to reduce malaria transmission. METHODS A cluster randomized, parallel arm, superiority trial conducted in two settings with distinct eco-epidemiological conditions in East and Southern Africa. There will be three groups: human intervention, consisting of a dose of ivermectin (400 mcg/kg) administered monthly for 3 months to all the eligible population in the cluster (>15 kg, non-pregnant and no medical contraindication); human and livestock intervention, consisting human treatment as above plus treatment of livestock in the area with a single dose of injectable ivermectin (200 mcg/kg) monthly for 3 months; and controls, consisting of a dose of albendazole (400 mg) monthly for 3 months. The main outcome measure will be malaria incidence in a cohort of children under five living in the core of each cluster followed prospectively with monthly RDTs DISCUSSION: The second site for the implementation of this protocol has changed from Tanzania to Kenya. This summary presents the Mozambique-specific protocol while the updated master protocol and the adapted Kenya-specific protocol undergo national approval in Kenya. BOHEMIA will be the first large-scale trial evaluating the impact of ivermectin-only mass drug administration to humans or humans and cattle on local malaria transmission TRIAL REGISTRATION: ClinicalTrials.gov NCT04966702 . Registered on July 19, 2021. Pan African Clinical Trials Registry PACTR202106695877303.
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Affiliation(s)
- Carlos Chaccour
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain. .,Universidda de Navarra, Pamplona, Spain. .,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain.
| | - Aina Casellas
- grid.434607.20000 0004 1763 3517ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | - Felix Hammann
- grid.411656.10000 0004 0479 0855University Hospital of Bern, Inselspital, Bern, Switzerland
| | - Paula Ruiz-Castillo
- grid.434607.20000 0004 1763 3517ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | - Patricia Nicolas
- grid.434607.20000 0004 1763 3517ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | - Julia Montaña
- grid.434607.20000 0004 1763 3517ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | - Mary Mael
- grid.434607.20000 0004 1763 3517ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | - Prashant Selvaraj
- grid.418309.70000 0000 8990 8592Bill and Melinda Gates Foundation, Seattle, USA
| | - Urs Duthaler
- grid.6612.30000 0004 1937 0642University Basel, Basel, Switzerland
| | - Sigilbert Mrema
- grid.414543.30000 0000 9144 642XIfakara Health Institute, Ifakara, Tanzania
| | - Mwaka Kakolwa
- grid.414543.30000 0000 9144 642XIfakara Health Institute, Ifakara, Tanzania
| | - Issa Lyimo
- grid.414543.30000 0000 9144 642XIfakara Health Institute, Ifakara, Tanzania
| | - Fredros Okumu
- grid.414543.30000 0000 9144 642XIfakara Health Institute, Ifakara, Tanzania
| | - Achla Marathe
- grid.27755.320000 0000 9136 933XUniversity of Virginia, Charlottesville, USA
| | - Roger Schürch
- grid.438526.e0000 0001 0694 4940Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Eldo Elobolobo
- grid.452366.00000 0000 9638 9567Centro de Investigação em Saúde de Manhiça, Manhica, Mozambique
| | - Charfudin Sacoor
- grid.452366.00000 0000 9638 9567Centro de Investigação em Saúde de Manhiça, Manhica, Mozambique
| | - Francisco Saute
- grid.452366.00000 0000 9638 9567Centro de Investigação em Saúde de Manhiça, Manhica, Mozambique
| | - Kang Xia
- grid.438526.e0000 0001 0694 4940Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Caroline Jones
- grid.33058.3d0000 0001 0155 5938KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Cassidy Rist
- grid.438526.e0000 0001 0694 4940Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Marta Maia
- grid.33058.3d0000 0001 0155 5938KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - N. Regina Rabinovich
- grid.434607.20000 0004 1763 3517ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain ,grid.38142.3c000000041936754XTH Chan Harvard School of Public Health, Boston, USA
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Kotepui M, Mala W, Kwankaew P, Kotepui KU, Masangkay FR, Wilairatana P. Distinct cytokine profiles in malaria coinfections: A systematic review. PLoS Negl Trop Dis 2023; 17:e0011061. [PMID: 36716305 PMCID: PMC9886258 DOI: 10.1371/journal.pntd.0011061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/23/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Few data exist on the distinct cytokine profiles of individuals with malaria coinfections and other diseases. This study focuses on data collation of distinct cytokine profiles between individuals with malaria coinfections and monoinfections to provide evidence for further diagnostic or prognostic studies. METHODS We searched five medical databases, including Embase, MEDLINE, PubMed, Ovid, and Scopus, for articles on cytokines in malaria coinfections published from January 1, 1983 to May 3, 2022, after which the distinct cytokine patterns between malaria coinfection and monoinfection were illustrated in heat maps. RESULTS Preliminary searches identified 2127 articles, of which 34 were included in the systematic review. Distinct cytokine profiles in malaria coinfections with bacteremia; HIV; HBV; dengue; filariasis; intestinal parasites; and schistosomiasis were tumor necrosis factor (TNF), interferon (IFN)-γ, IFN-α, interleukin (IL)-1, IL-1 receptor antagonist (Ra), IL-4, IL-7, IL-12, IL-15, IL-17; TNF, IL-1Ra, IL-4, IL-10, IL-12, IL-18, CCL3, CCL5, CXCL8, CXCL9, CXCL11, granulocyte colony-stimulating factor (G-CSF); TNF, IFN-γ, IL-4, IL-6, IL-10, IL-12, CCL2; IFN-γ, IL-1, IL-4, IL-6, IL-10, IL-12, IL-13, IL-17, CCL2, CCL3, CCL4, G-CSF; IL-1Ra, IL-10, CXCL5, CXCL8, CXCL10; TNF, IL-2, IL-4, IL-6, IL-10; and TNF, IFN-γ, IL-4, IL-5, IL-10, transforming growth factor-β, CXCL8, respectively. CONCLUSION This systematic review provides information on distinct cytokine profiles of malaria coinfections and malaria monoinfections. Further studies should investigate whether specific cytokines for each coinfection type could serve as essential diagnostic or prognostic biomarkers for malaria coinfections.
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Affiliation(s)
- Manas Kotepui
- Medical Technology Program, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
- * E-mail: (MK); (PW)
| | - Wanida Mala
- Medical Technology Program, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Pattamaporn Kwankaew
- Medical Technology Program, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Kwuntida Uthaisar Kotepui
- Medical Technology Program, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | | | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- * E-mail: (MK); (PW)
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Pérez-Ramírez RD, Lugo-Vargas R, Petano-Duque JM, Cruz-Méndez JS, Rondón-Barragán IS. First study on microscopic and molecular detection of Acanthocheilonema reconditum and Leishmania infantum coinfection in dogs in Southwest Colombia. Vet World 2023; 16:94-103. [PMID: 36855357 PMCID: PMC9967715 DOI: 10.14202/vetworld.2023.94-103] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/22/2022] [Indexed: 01/14/2023] Open
Abstract
Background and Aim Canine vector-borne diseases represent an important issue for the welfare and health of animals, but also have great zoonotic potential. These diseases are caused by bacteria, nematodes such as filariae, and other parasites such as Leishmania spp. Given the difficulty in differentiating common microfilariae in dogs by microscopy and serological methods, molecular techniques such as polymerase chain reaction (PCR) and sequencing should be valuable for reaching a reliable diagnosis. This study aimed to use microscopy and PCR to identify the microfilarial species in dogs from Valle del Cauca, Colombia, and a possible association with Leishmania infantum parasites. Materials and Methods This study was conducted on 270 dogs from Pradera and Florida municipalities. Microfilariae were detected in dogs by optical microscopy and amplification with 5.8S-ITS2-28S. Species identification was achieved through the amplification of the gene cytochrome oxidase I (COX1). Results Microscopic detection of microfilariae was possible in 4.81% (13/270) of the dogs. In addition, by PCR of COX1 and Sanger sequencing of ITS2, Acanthocheilonema reconditum was identified as the circulating microfilarial species in 12 dogs, coinfecting with the species L. infantum (Leishmania donovani complex). Conclusion To the best of our knowledge, this is the first report on A. reconditum and L. infantum mixed infection in dogs in Colombia, particularly in the Valle del Cauca.
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Affiliation(s)
- Ruben Dario Pérez-Ramírez
- Research Group in Immunobiology and Pathogenesis, Laboratory of Immunology and Molecular Biology, Faculty of Veterinary Medicine and Zootechnics, Universidad del Tolima, Santa Helena Highs, Ibagué-Tolima, Colombia
| | - Rodrigo Lugo-Vargas
- Research Group in Immunobiology and Pathogenesis, Laboratory of Immunology and Molecular Biology, Faculty of Veterinary Medicine and Zootechnics, Universidad del Tolima, Santa Helena Highs, Ibagué-Tolima, Colombia
| | - Julieth Michel Petano-Duque
- Research Group in Immunobiology and Pathogenesis, Laboratory of Immunology and Molecular Biology, Faculty of Veterinary Medicine and Zootechnics, Universidad del Tolima, Santa Helena Highs, Ibagué-Tolima, Colombia
| | - Juan Sebastian Cruz-Méndez
- Research Group in Immunobiology and Pathogenesis, Laboratory of Immunology and Molecular Biology, Faculty of Veterinary Medicine and Zootechnics, Universidad del Tolima, Santa Helena Highs, Ibagué-Tolima, Colombia,Poultry Research Group, Laboratory of Immunology and Molecular Biology, Faculty of Veterinary Medicine and Zootechnics, Universidad del Tolima, Santa Helena Highs, Ibagué-Tolima, Colombia
| | - Iang Schroniltgen Rondón-Barragán
- Research Group in Immunobiology and Pathogenesis, Laboratory of Immunology and Molecular Biology, Faculty of Veterinary Medicine and Zootechnics, Universidad del Tolima, Santa Helena Highs, Ibagué-Tolima, Colombia,Poultry Research Group, Laboratory of Immunology and Molecular Biology, Faculty of Veterinary Medicine and Zootechnics, Universidad del Tolima, Santa Helena Highs, Ibagué-Tolima, Colombia,Corresponding author: Iang Schroniltgen Rondón-Barragán, e-mail: Co-authors: RDP: , RL: , JMP: , JSC:
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Pongui Ngondza B, Koumba Lengongo JV, Mickala P, M'bondoukwé NP, Ndong Ngomo JM, Moutombi Ditombi BC, Mawili-Mboumba DP, Bouyou-Akotet MK. Prevalence and risk factors for blood filariasis among HIV-infected adults in Gabon, Central Africa: a pilot study. Trans R Soc Trop Med Hyg 2022; 116:1015-1021. [PMID: 35474144 DOI: 10.1093/trstmh/trac034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/20/2022] [Accepted: 03/28/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The level of blood filariasis parasitaemia as well as the frequency of and the relationship between cotrimoxazole prophylaxis (CTX-P), antiretroviral therapy (ART) intake and CD4 cell count among people living with human immunodeficiency virus (PLHIV) in rural areas of Gabon were being studied. METHODS Sociodemographic data and recent biological tests of PLHIV and HIV-negative participants were collected. Loa loa and Mansonella perstans microfilaria were detected by direct microscopy examination and leucoconcentration. RESULTS Overall, 209 HIV-positive and 148 HIV-negative subjects were enrolled. The overall prevalence of microfilaria was comparable between PLHIV (19.9% [n=41/206]) and HIV-negative participants (14.8% [n=22/148]) (p=0.2). The L. loa infection rate was comparable between HIV-positive (9.2%) and HIV-negative participants (6.8%) (p=0.2), while the M. perstans infection rate was 14-fold higher among PLHIV (p<0.01). L. loa parasitaemia was 6-fold lower in PLHIV receiving CTX-P (median 150 mf/mL [interquartile range {IQR} 125-350]) than in patients without (900 [550-2225]) (p<0.01). Among subjects with a CD4 cell count <200 cells/μL, the prevalence of M. perstans was 7-fold higher than that of L. loa (20.6% vs 2.9%). CONCLUSIONS This study suggests a similar exposure to L. loa infection of PLHIV and HIV-negative patients while M. perstans is more frequently found in HIV-positive individuals, notably those with a CD4 count <200 cells/μL.
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Affiliation(s)
- B Pongui Ngondza
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
| | - J V Koumba Lengongo
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
| | - P Mickala
- Department of Biology, Faculty of Sciences, Université des Sciences et Techniques de Masuku, BP 901, Franceville, Gabon
| | - N P M'bondoukwé
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
| | - J M Ndong Ngomo
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
| | - B C Moutombi Ditombi
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
| | - D P Mawili-Mboumba
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
| | - M K Bouyou-Akotet
- Department of Parasitology-Mycology and Tropical Medicine, Faculty of Medicine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
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Prevalence, probability, and characteristics of malaria and filariasis co-infections: A systematic review and meta-analysis. PLoS Negl Trop Dis 2022; 16:e0010857. [PMID: 36269701 PMCID: PMC9586402 DOI: 10.1371/journal.pntd.0010857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/29/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Malaria and filariasis are significant vector-borne diseases that are co-endemic in the same human populations. This study aims to collate the evidence, probability, and characteristics of malaria and filariasis co-infections in participants among studies reporting the co-occurrence of both diseases. METHODS We searched for potentially relevant articles reporting the co-occurrence of malaria and filariasis in five electronic databases (Embase, PubMed, Scopus, Medline, and CENTRAL) from inception to May 22, 2022. We estimated the pooled prevalence and probability of malaria and filariasis co-infections among study participants using random-effects meta-analyses and synthesized the characteristics of patients with co-infections narratively. RESULTS We identified 951 articles, 24 of which (96,838 participants) met eligibility criteria and were included in the systematic review. Results of the meta-analysis showed a pooled prevalence of malaria and filariasis co-infections among participants of 11%. The prevalence of co-infections was 2.3% in Africa, 0.2% in Asia, and 1.6% in South America. The pooled prevalences of malaria and Wuchereria bancrofti, malaria and Loa loa, malaria and Mansonella perstans co-infections were 0.7%, 1.2%, and 1.0%, respectively. The meta-analysis results showed that the co-infections between two parasites occurred by probability (P = 0.001). Patients with co-infections were at increased risk of having an enlarged spleen, a lower rate of severe anemia, lower parasite density, and more asymptomatic clinical status. Patients with co-infections had decreased levels of C-X-C motif chemokine 5, tumor necrosis factor-α, interleukin-4, c4 complement, and interleukin-10. In addition, patients with co-infections had a lower interleukin-10/tumor necrosis factor-α ratio and higher interleukin-10/interleukin-6 ratio. CONCLUSION The present study showed that the prevalence of malaria and filariasis co-infections was low and varied between geographical areas in the selected articles. Co-infections tended to occur with a low probability. Further studies investigating the outcomes and characteristics of co-infections are needed.
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Tamarozzi F, Buonfrate D, Ricaboni D, Ursini T, Foti G, Gobbi F. Spleen nodules in Loa loa infection: re-emerging knowledge and future perspectives. THE LANCET. INFECTIOUS DISEASES 2022; 22:e197-e206. [PMID: 35219405 DOI: 10.1016/s1473-3099(21)00632-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/24/2021] [Accepted: 09/28/2021] [Indexed: 06/14/2023]
Abstract
Loiasis, the infection with the vector-borne filarial nematode Loa loa, is widely distributed in central and west Africa. Long considered a rather benign infection, recently loiasis with high microfilarial burden was associated with increased mortality risk. Eyeworm and Calabar swelling are pathognomonic signs of the infection, but other atypical, non-specific manifestations can also occur. For instance, splenic nodules have been seldom reported. In this Grand Round, we report two cases of loiasis in migrants who presented with spleen nodules, which could be followed up over time (up to 27 months) with multiple imaging techniques until their resolution. We comment on the clinical implications of these observations, including differential diagnosis with similar imaging findings, and critically review the evidence of spleen involvement in loiasis and other filarial infections.
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Affiliation(s)
- Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy.
| | - Dora Buonfrate
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | | | - Tamara Ursini
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Giovanni Foti
- Department of Radiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Federico Gobbi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy
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Pousibet-Puerto J, Lozano-Serrano AB, Soriano-Pérez MJ, Vázquez-Villegas J, Giménez-López MJ, Cabeza-Barrera MI, Cuenca-Gómez JÁ, Palanca-Giménez M, Luzón-García MP, Castillo-Fernández N, Cabezas-Fernández MT, Salas-Coronas J. Migration-associated malaria from Africa in southern Spain. Parasit Vectors 2021; 14:240. [PMID: 33962647 PMCID: PMC8103587 DOI: 10.1186/s13071-021-04727-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background The western area of the province of Almeria, sited in southern Spain, has one of the highest immigrant population rates in Spain, mainly dedicated to agricultural work. In recent years, there has been a significant increase in the number of cases of imported malaria associated with migrants from countries belonging to sub-Saharan Africa. The objective of our study is to describe the epidemiological, clinical and analytical characteristics of malaria patients treated in a specialized tropical unit, paying special attention to the differences between VFR and non-VFR migrants and also to the peculiarities of microscopic malaria cases compared to submicroscopic ones. Methods Retrospective observational study of migrants over 14 years of age with imported malaria treated from October 2004 to May 2019. Characteristics of VFR and non-VFR migrants were compared. Malaria cases were divided into microscopic malaria (MM) and submicroscopic malaria (SMM). SMM was defined as the presence of a positive malaria PCR test together with a negative direct microscopic examination and a negative rapid diagnostic test (RDT). Microscopic malaria was defined as the presence of a positive RDT and/or a positive smear examination. Results Three hundred thirty-six cases of malaria were diagnosed, 329 in sub-Saharan immigrants. Of these, 78.1% were VFR migrants, in whom MM predominated (85.2% of cases). In non-VFR migrants, SMM represented 72.2% of the cases. Overall, 239 (72.6%) patients presented MM and 90 (27.4%) SMM. Fever was the most frequent clinical manifestation (64.4%), mainly in the MM group (MM: 81.1% vs SMM: 20.0%; p < 0.01). The most frequent species was P. falciparum. Patients with SMM presented fewer cytopenias and a greater number of coinfections due to soil-transmitted helminths, filarial and intestinal protozoa compared to patients with MM. Conclusions Imported malaria in our area is closely related to sub-Saharan migration. VFR migrants are the main risk group, highlighting the need for actions aimed at improving disease prevention measures. On the other hand, almost a third of the cases are due to SMM. This fact could justify its systematic screening, at least for those travelers at greater risk. Graphic Abstract ![]()
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Joaquín Salas-Coronas
- Tropical Medicine Unit. Hospital de Poniente, El Ejido, Almería, Spain. .,CEMyRI (Center for the Study of Migration and Intercultural Relations) of the University of Almeria, Almería, Spain.
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10
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Cepon-Robins TJ, Gildner TE. Old friends meet a new foe: A potential role for immune-priming parasites in mitigating COVID-19 morbidity and mortality. Evol Med Public Health 2020; 2020:234-248. [PMID: 33235797 PMCID: PMC7665448 DOI: 10.1093/emph/eoaa037] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/07/2020] [Indexed: 02/06/2023] Open
Abstract
The novel virus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and the associated Coronavirus Disease 2019 (COVID-19) represent a pathogen to which human beings have limited to no evolved immune response. The most severe symptoms are associated with overactive inflammatory immune responses, leading to a cytokine storm, tissue damage, and death, if not balanced and controlled. Hypotheses within Evolutionary Medicine, including the Hygiene/Old Friends Hypothesis, provide an important lens through which to understand and possibly control this overactive immune response. In this article, we explore the role that infection with soil-transmitted helminths (STHs; i.e. intestinal parasitic worms) may play in dampening SARS-CoV-2 symptoms and mitigating the worst COVID-19 outcomes. Specifically, STHs stimulate the immunosuppressive and regulatory T-helper 2 (TH2) branch of the immune system, which decreases ACE2-receptor expression (i.e. receptors SARS-CoV-2 uses to infect host cells), balances the inflammatory TH1/TH17 branches of the immune system triggered by SARS-CoV-2 infection, and reduces inflammation through the release of anti-inflammatory/regulatory cytokines. Because STHs are common and affect the most vulnerable and marginalized members of society, it is especially important to consider how these parasites may impact COVID-19 outcomes. Areas experiencing endemic STH infections are often characterized by a lack of preventative infrastructure and medical care, which may further exacerbate risk of SARS-CoV-2 infection and COVID-19 development. For this reason, we also explore biocultural factors that contribute to disease outcomes for both SARS-CoV-2 and STH infections. Biocultural and Evolutionary Medicine perspectives on COVID-19 are crucial for understanding the global impact of the disease. Lay summary: An evolutionary perspective is required to understand the global impact and various presentations of COVID-19. We consider how coinfection with soil-transmitted helminths (common parasitic worms that coevolved with humans) may suppress inflammatory immune activity, thereby potentially reducing COVID-19 disease severity. Structural and lifestyle factors shaping coinfection patterns are also discussed.
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Affiliation(s)
- Tara J Cepon-Robins
- Department of Anthropology, University of Colorado Colorado Springs, Centennial Hall 120, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918, USA
| | - Theresa E Gildner
- Department of Anthropology, Dartmouth College, Silsby Hall, 3 Tuck Drive, Hanover, NH 03755, USA
- Department of Anthropology, Washington University, Campus Box 1114, One Brookings Drive, St. Louis, MO 63130, USA
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11
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Puente S, Lago M, Subirats M, Sanz-Esteban I, Arsuaga M, Vicente B, Alonso-Sardon M, Belhassen-Garcia M, Muro A. Imported Mansonella perstans infection in Spain. Infect Dis Poverty 2020; 9:105. [PMID: 32703283 PMCID: PMC7376953 DOI: 10.1186/s40249-020-00729-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/15/2020] [Indexed: 01/05/2023] Open
Abstract
Background Mansonella perstans infection can be considered one of the most neglected tropical infectious diseases. Very few studies have reported on the clinical picture caused by infection with this nematode. Therefore, our study was aimed to describe the clinical patterns and treatment of imported M. perstans infection by migrants from Africa. Methods The present study evaluated a large cohort of migrants who have been diagnosed, examined and treated for imported M. perstans infection at a Spanish reference center (Hospital Carlos III Tropical Medicine Unit, Madrid, Spain) over a 19-year period. Most patients voluntarily attend the emergency unit or are referred from primary care or general hospitals in Madrid. Chi-square test was used to compare the association between categorical variables. The continuous variables were compared by Student’s t-test or the Mann–Whitney test. The corresponding regression models were used for multivariate analysis. Results Five hundred three cases of migrants from tropical and subtropical areas with M. perstans infection were identified. Two hundred sixty-four patients were female (52.5%). The mean age (± SD) was 44.6 ± 18.2 years (range: 16–93 years). The mean time (± SD) between the arrival in Spain and the first consultation was 8.6 ± 18.0 months. The major origin of the patients was Equatorial Guinea (97.6%). Regarding the clinical picture, 257 patients were asymptomatic (54.7%) and 228 were symptomatic (45.3%); 190 patients had pruritus (37.8%), 50 (9.9%) had arthralgia, 18 patients had Calabar-like swelling (3.6%), and 15 (3%) had abdominal pain. Four hundred forty-two (87.9%) migrants had hyper-IgE, and 340 (67.6%) had eosinophilia. One hundred ninety-five patients had coinfections with other filarial nematodes (38.8%), and 308 migrants had only M. perstans infection (61.2%). Four hundred thirty-seven cases (86.9%) had been treated with anti-filarial drugs; 292 cases were treated with one anti-filarial drug, and 145 cases were treated with combined anti-filarial therapy. Additionally, 20 (4%) cases received steroids and 38 (7.6%) cases received antihistamines. Conclusions A long series of M. perstans infections is presented in sub-Saharan immigrants whose data indicate that it should be included in the differential diagnosis in patients with pruritus or analytical alterations such as eosinophilia or hyper-IgE presentation, and they also have a high number of coinfections with other microorganisms whose treatment needs to be protocolized.
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Affiliation(s)
- Sabino Puente
- Unidad de Medicina Tropical, Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, Spain
| | - Mar Lago
- Unidad de Medicina Tropical, Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, Spain
| | | | | | - Marta Arsuaga
- Unidad de Medicina Tropical, Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, Spain
| | - Belén Vicente
- Laboratorio de Inmunología Parasitaria y Molecular, CIETUS, IBSAL, Facultad de Farmacia, Universidad de Salamanca, 37007, Salamanca, Spain
| | - Montserrat Alonso-Sardon
- Área de Medicina Preventiva y Salud Pública, IBSAL, CIETUS, Universidad de Salamanca, Salamanca, Spain
| | - Moncef Belhassen-Garcia
- Servicio de Medicina Interna, Sección de Enfermedades Infecciosas, CAUSA, IBSAL, CIETUS, Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain.
| | - Antonio Muro
- Laboratorio de Inmunología Parasitaria y Molecular, CIETUS, IBSAL, Facultad de Farmacia, Universidad de Salamanca, 37007, Salamanca, Spain
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12
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Moutongo Mouandza R, M'bondoukwe NP, Obiang Ndong GP, Nzaou Nziengui A, Batchy Ognagosso FB, Nziengui Tirogo C, Moutombi Ditombi B, Mawili-Mboumba DP, Bouyou-Akotet MK. Anaemia in asymptomatic parasite carriers living in urban, rural and peri-urban settings of Gabon. Trans R Soc Trop Med Hyg 2020; 114:618-626. [DOI: 10.1093/trstmh/traa047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/19/2019] [Accepted: 06/05/2020] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
This cross-sectional study was carried out in different settlements of Gabon to determine the influence of single or multiple parasite carriage on haemoglobin (Hb) levels.
Methods
Between April 2015 and June 2016, healthy volunteers from urban, peri-urban and rural areas were screened for malaria, blood filariasis and intestinal parasitic infections using microscopic methods. Hb concentration was measured with a Hemocue analyser. The association between parasite carriage and anaemia was assessed.
Results
Among the 775 volunteers examined, 319 (41.2%) were from rural villages and 76.0% were adults. Filariasis, intestinal parasitic infections, Plasmodium falciparum and polyparasitism were detected in 15.6, 14.6, 9.5 and 6.8% of participants, respectively. Anaemia prevalence was 72.6%, with rates of mild, moderate and severe anaemia being 30.9, 61.1 and 8.0%, respectively. The median Hb level was lowest in the presence of hookworms (7.1 g/dl [interquartile range {IQR} 6.8–7.5]), Schistosoma intercalatum (6.9 g/dl), Trichuris trichiura (10.1 g/dl [IQR 8.9–11.5]) and Plasmodium falciparum (10.0 g/dl [IQR 9.1–11.2]) compared with filariaemia (12.1 g/dl [IQR 10.5–13.2]) (p=0.03). Moderate to severe anaemia predominated among those single-infected with P. falciparum (69.5%) or co-infected with intestinal parasitic infections and P. falciparum (76.2%), while it was found in only 23.2% of individuals with filariasis. All participants with soil-transmitted helminths and more than half with a Blastocystis sp. (68.8%) infection had moderate anaemia.
Conclusions
The prevalence of anaemia is high. Asymptomatic parasite carriage is associated with anaemia in this surveyed population in Gabon.
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Affiliation(s)
- R Moutongo Mouandza
- Département de Parasitologie-Mycologie-Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
| | - N P M'bondoukwe
- Département de Parasitologie-Mycologie-Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
| | | | - A Nzaou Nziengui
- Département de Parasitologie-Mycologie-Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
| | - F B Batchy Ognagosso
- Département de Parasitologie-Mycologie-Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
| | - C Nziengui Tirogo
- Département de Parasitologie-Mycologie-Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
| | - B Moutombi Ditombi
- Département de Parasitologie-Mycologie-Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
| | - D P Mawili-Mboumba
- Département de Parasitologie-Mycologie-Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
| | - M K Bouyou-Akotet
- Département de Parasitologie-Mycologie-Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
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13
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Alvar J, Alves F, Bucheton B, Burrows L, Büscher P, Carrillo E, Felger I, Hübner MP, Moreno J, Pinazo MJ, Ribeiro I, Sosa-Estani S, Specht S, Tarral A, Wourgaft NS, Bilbe G. Implications of asymptomatic infection for the natural history of selected parasitic tropical diseases. Semin Immunopathol 2020; 42:231-246. [PMID: 32189034 PMCID: PMC7299918 DOI: 10.1007/s00281-020-00796-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 03/03/2020] [Indexed: 12/18/2022]
Abstract
Progress has been made in the control or elimination of tropical diseases, with a significant reduction of incidence. However, there is a risk of re-emergence if the factors fueling transmission are not dealt with. Although it is essential to understand these underlying factors for each disease, asymptomatic carriers are a common element that may promote resurgence; their impact in terms of proportion in the population and role in transmission needs to be determined. In this paper, we review the current evidence on whether or not to treat asymptomatic carriers given the relevance of their role in the transmission of a specific disease, the efficacy and toxicity of existing drugs, the Public Health interest, and the benefit at an individual level, for example, in Chagas disease, to prevent irreversible organ damage. In the absence of other control tools such as vaccines, there is a need for safer drugs with good risk/benefit profiles in order to change the paradigm so that it addresses the complete infectious process beyond manifest disease to include treatment of non-symptomatic infected persons.
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Affiliation(s)
- Jorge Alvar
- Drugs for Neglected Diseases initiative, Geneva, Switzerland.
| | - Fabiana Alves
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - Bruno Bucheton
- Institut de Recherche pour le Développement, Université de Montpellier, Montpellier, France
| | - Louise Burrows
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | | | - Eugenia Carrillo
- WHO Collaborating Cenre for Leishmaniasis, Instituto de Sakud Carlos III, Madrid, Spain
| | - Ingrid Felger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Marc P Hübner
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Javier Moreno
- WHO Collaborating Cenre for Leishmaniasis, Instituto de Sakud Carlos III, Madrid, Spain
| | | | - Isabela Ribeiro
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - Sergio Sosa-Estani
- Drugs for Neglected Diseases initiative, Centro de Investigación de Epidemiología y Salud Pública (CIESP-IECS), CONICET, Buenos Aires, Argentina
| | - Sabine Specht
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - Antoine Tarral
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | | | - Graeme Bilbe
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
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14
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Junaid OQ, Vythilingam I, Khaw LT, Sivanandam S, Mahmud R. Effect of Brugia pahangi co-infection with Plasmodium berghei ANKA in gerbils (Meriones unguiculatus). Parasitol Res 2020; 119:1301-1315. [PMID: 32179986 DOI: 10.1007/s00436-020-06632-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 02/18/2020] [Indexed: 11/30/2022]
Abstract
Malaria and lymphatic filariasis (LF) are two leading and common mosquito-borne parasitic diseases worldwide. These two diseases are co-endemic in many tropical and sub-tropical regions and are known to share vectors. The interactions between malaria and filarial parasites are poorly understood. Thus, this study aimed at establishing the interactions that occur between Brugia pahangi and Plasmodium berghei ANKA (PbA) co-infection in gerbils. Briefly, the gerbils were matched according to age, sex, and weight and grouped into filarial-only infection, PbA-only infection, co-infection, and control group. The parasitemia, survival and clinical assessment of the gerbils were monitored for a period of 30 days post Plasmodium infection. The immune responses of gerbils to both mono and co-infection were monitored. Findings show that co-infected gerbils have higher survival rate than PbA-infected gerbils. Food and water consumption were significantly reduced in both PbA-infected and co-infected gerbils, although loss of body weight, hypothermia, and anemia were less severe in co-infected gerbils. Plasmodium-infected gerbils also suffered hypoglycemia, which was not observed in co-infected gerbils. Furthermore, gerbil cytokine responses to co-infection were significantly higher than PbA-only-infected gerbils, which is being suggested as a factor for their increased longevity. Co-infected gerbils had significantly elicited interleukin-4, interferon-gamma, and tumor necrotic factor at early stage of infection than PbA-infected gerbils. Findings from this study suggest that B. pahangi infection protect against severe anemia and hypoglycemia, which are manifestations of PbA infection.
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Affiliation(s)
- Olawale Quazim Junaid
- Department of Parasitology, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia. .,Department of Biological Sciences, Faculty of Science, Federal University of Kashere, PMB 0182, Gombe, Gombe State, Nigeria.
| | - Indra Vythilingam
- Department of Parasitology, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
| | - Loke Tim Khaw
- Department of Parasitology, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.,Department of Pathology, School of Medicine, International Medical University, 57000, Kuala Lumpur, Malaysia
| | - Sinnadurai Sivanandam
- Department of Parasitology, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
| | - Rohela Mahmud
- Department of Parasitology, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
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15
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Batsa Debrah L, Phillips RO, Pfarr K, Klarmann-Schulz U, Opoku VS, Nausch N, Owusu W, Mubarik Y, Sander AL, Lämmer C, Ritter M, Layland LE, Jacobsen M, Debrah AY, Hoerauf A. The Efficacy of Doxycycline Treatment on Mansonella perstans Infection: An Open-Label, Randomized Trial in Ghana. Am J Trop Med Hyg 2020; 101:84-92. [PMID: 31162017 PMCID: PMC6609185 DOI: 10.4269/ajtmh.18-0491] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Treating Mansonella perstans is challenged by the low efficacy of registered antihelminthics. Wolbachia endobacteria provide an alternative treatment target because depletion results in amicrofilaremia in filarial infections with Wuchereria bancrofti and Onchocerca volvulus infections. This open-label, randomized study sought to confirm that i) Wolbachia are present in M. perstans in Ghana and ii) doxycycline treatment will deplete Wolbachia and cause a slow, sustained decline in microfilariae (MF). Two hundred and two Ghanaians with M. perstans infection were randomized into early (immediate) and delayed (6 months deferred) treatment groups, given doxycycline 200 mg/day for 6 weeks, and monitored for MF and Wolbachia levels at baseline, 4, 12, and 24 months after the study onset (= time of randomization and start of treatment for the early group). Per protocol analysis revealed that the median MF/mL in the early group declined from 138 at baseline to 64 at month 4 and further to 0 at month 12. In the delayed group, MF load did not change from a baseline median of 97 to 102 at month 4 but declined to 42 at month 12, that is, 6 months after receiving treatment, trailing the early group as expected. By month 24, both treatment groups had reached a median MF level of 0. After treatment, Wolbachia were depleted from MF by ≥ 1-log drop compared with baseline levels. We conclude that M. perstans in Ghana harbor Wolbachia that are effectively depleted by doxycycline with subsequent reduction in MF loads, most likely because of interruption of fertility of adult worms.
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Affiliation(s)
- Linda Batsa Debrah
- Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Richard O Phillips
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana.,Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kenneth Pfarr
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany.,German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany
| | - Ute Klarmann-Schulz
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany.,Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Vera Serwaa Opoku
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Norman Nausch
- Department of General Paediatrics, Neonatology, and Paediatric Cardiology, University Children's Hospital, Heinrich-Heine University, Düsseldorf, Germany
| | - Wellington Owusu
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Yusif Mubarik
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Anna-Lena Sander
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Christine Lämmer
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Manuel Ritter
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Laura E Layland
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Marc Jacobsen
- Department of General Paediatrics, Neonatology, and Paediatric Cardiology, University Children's Hospital, Heinrich-Heine University, Düsseldorf, Germany
| | - Alexander Yaw Debrah
- Faculty of Allied Health Sciences of Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Achim Hoerauf
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany.,Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
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16
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Norman FF, Comeche B, Chamorro S, López-Vélez R. Overcoming challenges in the diagnosis and treatment of parasitic infectious diseases in migrants. Expert Rev Anti Infect Ther 2020; 18:127-143. [PMID: 31914335 DOI: 10.1080/14787210.2020.1713099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Introduction: Recent increases in population movements have created novel health challenges in many areas of the World, and health policies have been adapted accordingly in several countries. However, screening guidelines for infectious diseases are not standardized and generally do not include comprehensive screening for parasitic infections.Areas covered: Malaria, Chagas disease, leishmaniasis, amebiasis, filariases, strongyloidiasis, and schistosomiasis are reviewed, focusing on the challenges posed for their diagnosis and management in vulnerable populations such as migrants. The methodology included literature searches in public databases such as PubMed.gov and Google Scholar and search of the US National Library of Medicine online database of privately and publicly funded clinical studies (ClinicalTrials.gov) until November 2019.Expert opinion: Parasitic infections which may remain asymptomatic for prolonged periods, leading to chronic infection and complications, and/or may be transmitted in non-endemic areas are ideal candidates for screening. Proposed strategies to improve diagnosis in vulnerable groups such as migrants include facilitating access to healthcare in a multi-dimensional manner considering location, individual characteristics, and timing. Limitations and availability of specific diagnostic techniques should be addressed and focus on drug and vaccine development for these neglected infections should be prioritized through collaborative initiatives with public disclosure of results.
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Affiliation(s)
- Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Belen Comeche
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Sandra Chamorro
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
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17
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Pousibet-Puerto J, Cabezas-Fernández MT, Lozano-Serrano AB, Vázquez-Villegas J, Soriano-Pérez MJ, Cabeza-Barrera I, Cuenca-Gómez JA, Salas-Coronas J. Submicroscopic Malaria in Migrants from Sub-Saharan Africa, Spain. Emerg Infect Dis 2019; 25:349-352. [PMID: 30666945 PMCID: PMC6346455 DOI: 10.3201/eid2502.180717] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In a screening program, we detected submicroscopic malaria in 8.9% of recent migrants to Spain from sub-Saharan Africa. Hemoglobinopathies and filarial infection occurred more frequently in newly arrived migrants with submicroscopic malaria than in those without. Our findings could justify systematic screening in immigrants and recent travelers from malaria-endemic areas.
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18
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Wangala B, Gantin RG, Voßberg PS, Vovor A, Poutouli WP, Komlan K, Banla M, Köhler C, Soboslay PT. Inflammatory and regulatory CCL and CXCL chemokine and cytokine cellular responses in patients with patent Mansonella perstans filariasis. Clin Exp Immunol 2019; 196:111-122. [PMID: 30561772 DOI: 10.1111/cei.13251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2018] [Indexed: 12/17/2022] Open
Abstract
Mansonella perstans (Mp) filariasis is present in large populations in sub-Saharan Africa, and to what extent patent Mp infection modulates the expression of immunity in patients, notably their cellular cytokine and chemokine response profile, remains not well known. We studied the spontaneous and inducible cellular production of chemokines (C-X-C motif) ligand 9 (CXCL9) [monokine induced by interferon (IFN)-γ (MIG)], CXCL-10 [inducible protein (IP)-10], chemokine (C-C motif) ligand 24 (CCL24) (eotaxin-2), CCL22 [macrophage-derived chemokine (MDC)], CCL13 [monocyte chemotactic protein-4 (MCP-4)], CCL18 [pulmonary and activation-regulated chemokine (PARC)], CCL17 [thymus- and activation-regulated chemokine (TARC)] and interleukin (IL)-27 in mansonelliasis patients (Mp-PAT) and mansonelliasis-free controls (CTRL). Freshly isolated peripheral mononuclear blood cells (PBMC) were stimulated with helminth, protozoan and bacterial antigens and mitogen [phytohaemagglutinin (PHA)]. PBMC from Mp-PAT produced spontaneously (without antigen stimulation) significantly higher levels of eotaxin-2, IL-27, IL-8, MCP-4 and MDC than cells from CTRL, while IFN-γ-IP-10 was lower in Mp-PAT. Helminth antigens activated IL-27 and MCP-4 only in CTRL, while Ascaris antigen, Onchocerca antigen, Schistosoma antigen, Entamoeba antigen, Streptococcus antigen, Mycobacteria antigen and PHA stimulated MIG release in CTRL and Mp-PAT. Notably, Entamoeba antigen and PHA strongly depressed (P < 0·0001) eotaxin-2 (CCL24) production in both study groups. Multiple regression analyses disclosed in Mp-PAT and CTRL dissimilar cellular chemokine and cytokine production levels being higher in Mp-PAT for CCL24, IL-27, IL-8, MCP-4, MDC and PARC (for all P < 0·0001), at baseline (P < 0·0001), in response to Entamoeba histolytica strain HM1 antigen (EhAg) (P < 0·0001), Onchocerca volvulus adult worm-derived antigen (OvAg) (P = 0·005), PHA (P < 0·0001) and purified protein derivative (PPD) (P < 0·0001) stimulation. In Mp-PAT with hookworm co-infection, the cellular chemokine production of CXCL10 (IP-10) was diminished. In summary, the chemokine and cytokine responses in Mp-PAT were in general not depressed, PBMC from Mp-PAT produced spontaneously and selectively inducible inflammatory and regulatory chemokines and cytokines at higher levels than CTRL and such diverse and distinctive reactivity supports that patent M. perstans infection will not polarize innate and adaptive cellular immune responsiveness in patients.
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Affiliation(s)
- B Wangala
- National Institute of Hygiene, Onchocerciasis Reference Laboratory, Sokodé, Togo
| | - R G Gantin
- National Institute of Hygiene, Onchocerciasis Reference Laboratory, Sokodé, Togo.,Institute for Tropical Medicine, University Clinics of Tübingen, Tübingen, Germany
| | - P S Voßberg
- National Institute of Hygiene, Onchocerciasis Reference Laboratory, Sokodé, Togo.,Institute for Tropical Medicine, University Clinics of Tübingen, Tübingen, Germany
| | - A Vovor
- Centre Hospitalier Universitaire Sylvanus Olympio, Laboratory for Hematology, Université de Lomé, Togo
| | - W P Poutouli
- Faculté de Sciences, Université de Lomé, Lomé, Togo
| | - K Komlan
- National Institute of Hygiene, Onchocerciasis Reference Laboratory, Sokodé, Togo
| | - M Banla
- National Institute of Hygiene, Onchocerciasis Reference Laboratory, Sokodé, Togo.,Centre Hospitalier Universitaire Campus, Université de Lomé, Togo
| | - C Köhler
- Institute for Tropical Medicine, University Clinics of Tübingen, Tübingen, Germany
| | - P T Soboslay
- National Institute of Hygiene, Onchocerciasis Reference Laboratory, Sokodé, Togo.,Institute for Tropical Medicine, University Clinics of Tübingen, Tübingen, Germany
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Abrahim CMM, Py-Daniel V, Luz SLB, Fraiji NA, Stefani MMA. Detection of Mansonella ozzardi
among blood donors from highly endemic interior cities of Amazonas state, northern Brazil. Transfusion 2018; 59:1044-1051. [DOI: 10.1111/trf.15101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 10/22/2018] [Accepted: 10/25/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Claudia M. M. Abrahim
- HEMOAM, Departamento de Pesquisa; Fundação Hospitalar de Hematologia e Hemoterapia do Estado do Amazonas; Manaus Brasil
| | - Victor Py-Daniel
- Departamento de Zoologia; Universidade de Brasília, Instituto de Ciências Biológicas; Brasilia Brasil
| | - Sergio L. B. Luz
- Fundação Oswaldo Cruz; Instituto Leônidas e Maria Deane; Manaus Brasil
| | - Nelson A. Fraiji
- HEMOAM, Departamento de Pesquisa; Fundação Hospitalar de Hematologia e Hemoterapia do Estado do Amazonas; Manaus Brasil
| | - Mariane M. A. Stefani
- Departamento de Imunologia, Microbiologia; Patologia Geral e Parasitologia, Instituto de Patologia Tropical e Saúde Pública, IPTSP, Universidade Federal de Goiás UFG; Goiânia Brasil
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20
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Salazar-Castañón VH, Juárez-Avelar I, Legorreta-Herrera M, Govezensky T, Rodriguez-Sosa M. Co-infection: the outcome of Plasmodium infection differs according to the time of pre-existing helminth infection. Parasitol Res 2018; 117:2767-2784. [PMID: 29938323 DOI: 10.1007/s00436-018-5965-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 06/07/2018] [Indexed: 01/28/2023]
Abstract
Although helminth-Plasmodium coinfections are common in tropical regions, the implications of this co-existence for the host immune response are poorly understood. In order to understand the effect of helminth infection at different times of coinfection on the immune response against Plasmodium infection, BALB/c mice were intraperitoneally infected with Taenia crassiceps (Tc). At 2 (Tc2) or 8 (Tc8) weeks post-infection, mice were intravenously infected with 1 × 103 Plasmodium yoelii (Py) 17XL-parasitized red blood cells. Py 17XL-single-infected mice developed cachexia, splenomegaly, and anemia, and died at 11 days post-infection. Importantly, Tc2 + Py-coinfected mice showed increased survival of 58% on day 11, but developed pathology (cachexia and splenomegaly) and succumbed on day 18 post-coinfection, this latter associated with high levels of IL-1β and IL-12, and reduced IFN-γ in serum compared with Py 17XL-single-infected mice. Interestingly, Tc8 + Py-coinfected mice showed increased survival up to 80% on day 11 and succumbed on day 30 post-coinfection. This increased survival rate conferred by chronic helminth infection was associated with a decreased pathology and mixed inflammatory-type 1/anti-inflammatory-type 2 immune profile as evidenced by the production of high levels of IL-12 and IL-10, and reduced TNF-α from macrophages, high levels of IL-4 and IL-10, and low levels of IFN-γ from spleen cells. Also high serum levels of IL-1β, TNF-α, IL-12, IL-4, and IL-10, but a significant reduction of IFN-γ were observed. Together, these data indicate that polarization of the cell-mediated response modulated by a pre-existing helminth infection differentially impacts on the host immune response to Py 17XL in a time-dependent manner.
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Affiliation(s)
- Víctor H Salazar-Castañón
- Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México (UNAM), Avenida de los Barrios Número 1, Colonia Los Reyes Iztacala, C.P. 54090, Tlalnepantla, Estado de México, Mexico
| | - Imelda Juárez-Avelar
- Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México (UNAM), Avenida de los Barrios Número 1, Colonia Los Reyes Iztacala, C.P. 54090, Tlalnepantla, Estado de México, Mexico
| | - Martha Legorreta-Herrera
- Laboratorio de Inmunología Molecular, Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México (UNAM), Batalla 5 de mayo s/n, Col. Ejército de Oriente, Iztapalapa, C.P. 09230, Ciudad de México, Mexico
| | - Tzipe Govezensky
- Departamento de Biología Molecular, Instituto de Investigaciones Biomédicas, Universidad Nacional Autònoma de México (UNAM), Ciudad de México, Mexico
| | - Miriam Rodriguez-Sosa
- Unidad de Biomedicina, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México (UNAM), Avenida de los Barrios Número 1, Colonia Los Reyes Iztacala, C.P. 54090, Tlalnepantla, Estado de México, Mexico.
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21
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Costa AG, Sadahiro A, Monteiro Tarragô A, Pessoa FAC, Pires Loiola B, Malheiro A, Medeiros JF. Immune response in Mansonella ozzardi infection modulated by IL-6/IL-10 axis in Amazon region of Brazil. Cytokine 2018; 104:98-103. [DOI: 10.1016/j.cyto.2017.09.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 09/27/2017] [Accepted: 09/28/2017] [Indexed: 01/27/2023]
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22
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Bwanika R, Kato CD, Welishe J, Mwandah DC. Cytokine profiles among patients co-infected with Plasmodium falciparum malaria and soil borne helminths attending Kampala International University Teaching Hospital, in Uganda. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2018; 14:10. [PMID: 29560020 PMCID: PMC5858126 DOI: 10.1186/s13223-018-0235-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 02/06/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND Malaria and helminths share the same geographical distribution in tropical Africa. Studies of the interaction of helminth and malaria co-infection in humans have been few and are mainly epidemiological, with little information on cellular immune responses. This study aimed to determine Cytokine profiles among patients co-infected with Plasmodium falciparum malaria and soil borne helminth attending Kampala International University Teaching Hospital (KIU). METHODS A case control study of 240 patients were recruited at KIU teaching hospital. Patients with Plasmodium falciparum malaria were 55 (22.9%) and those with soil-borne helminths were 63 (26.3%). The controls were 89 (37.1%), while those co-infected with Plasmodium falciparum malaria and soil-borne helminths were 33 (13.8%). Cases were defined as having a positive blood smear for P. falciparum malaria, those with helminths or co-infections of the two. Negative controls were those with a negative blood smear for P. falciparum malaria and those with no stool parasitic infections. Patients presenting with signs and symptoms of malaria or those suspected of having helminths were recruited for the study. A panel of five cytokines (IFN-γ, TNF-α, IL-6, TGF-β and IL-10) were assayed from plasma samples in patients with and without Plasmodium falciparum malaria, patients with and without helminth, and then those co-infected with the two diseases diagnosis was done using thick blood smears stained with 10% Giemsa and stool examination was done following the Kato Katz technique following standard procedures. RESULTS The prevalence of Plasmodium falciparum malaria by sex was 28 (11.7%) and 27 (11.3%) in male and female respectively. The overall prevalence of soil borne helminth was 26.3%, and among those harbouring helminths, 13.8% were co-infected with Plasmodium falciparum. Cytokine levels significantly differed across Plasmodium falciparum malaria, soil borne helminth infected patients and health controls for IFN-γ (P = 0.023), IL-10 (P = 0.008) and TGF-β (P = 0.0001). Cytokine levels significantly differed across Plasmodium falciparum malaria, soil borne helminth infected patients and patients co-infected with Plasmodium falciparum malaria and soil borne helminth for IL-10 (P = 0.004), IL-6 (P = 0.011) and TGF-β (P = 0.003). CONCLUSION An up-regulation of IFN-γ during Plasmodium falciparum malaria and an up-regulation of IL-10 and TGF-β in soil borne helminth infections was demonstrated. We demonstrate that co-infections of Plasmodium falciparum and soil borne helminth lead to an up-regulation of IL-10 and IL-6 and a down-regulation of TGF-β.Trial registration No17/10-16.
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Affiliation(s)
- Richard Bwanika
- School of Biomedical Sciences, Department of Microbiology, Kampala International University, Western Campus, Ishaka, Box 71, Bushenyi, Uganda
| | - Charles D. Kato
- School of Biomedical Sciences, Department of Microbiology, Kampala International University, Western Campus, Ishaka, Box 71, Bushenyi, Uganda
- School of Bio-security, Biotechnical & Laboratory Sciences, College of Veterinary Medicine, Animal Resources & Bio-security, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Johnson Welishe
- School of Biomedical Sciences, Department of Microbiology, Kampala International University, Western Campus, Ishaka, Box 71, Bushenyi, Uganda
- School of Bio-security, Biotechnical & Laboratory Sciences, College of Veterinary Medicine, Animal Resources & Bio-security, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Daniel C. Mwandah
- School of Biomedical Sciences, Department of Microbiology, Kampala International University, Western Campus, Ishaka, Box 71, Bushenyi, Uganda
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23
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Lima NF, Gonçalves-Lopes RM, Kruize YCM, Yazdanbakhsh M, Ferreira MU. CD39 and immune regulation in a chronic helminth infection: The puzzling case of Mansonella ozzardi. PLoS Negl Trop Dis 2018; 12:e0006327. [PMID: 29505582 PMCID: PMC5854421 DOI: 10.1371/journal.pntd.0006327] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 03/15/2018] [Accepted: 02/19/2018] [Indexed: 12/13/2022] Open
Abstract
Background Chronic helminth infections typically induce an immunoregulatory environment, with markedly reduced immune responses to both parasite-specific and unrelated bystander antigens. Here we tested whether these changes are also observed in human infections with Mansonella ozzardi, a neglected filarial nematode widely distributed across Latin America. Methods CD4+ T cell populations from microfilaremic (Fil+) and uninfected (Fil-) inhabitants in M. ozzardi-endemic riverine communities in Brazil were characterized by flow cytometry analysis. Plasma concentrations of a wide range of cytokines and chemokines were measured. We examined whether M. ozzardi infection is associated with suppressed in vitro lymphoproliferative and inflammatory cytokine responses upon stimulation with filarial antigen, unrelated antigens or mitogens. Principal findings/Conclusions Fil+ subjects had lower plasma levels of selected inflammatory cytokines, such as TNF-α, IL-8, and IL-6, than their Fil- counterparts. However, we found no evidence for attenuated T-cell responses to filarial antigens or co-endemic pathogens, such as malaria parasites and Toxoplasma gondii. CD4+ T cells expressing CD39, an ectonucleosidase involved in the generation of the anti-inflammatory molecule adenosine, were increased in frequency in Fil+ subjects, compared to uninfected controls. Significantly, such an expansion was directly proportional to microfilarial loads. Surprisingly, CD39 blocking with a neutralizing antibody suppressed antigen-driven lymphoproliferation in vitro, while decreasing inflammatory cytokine responses, in Fil+ and Fil- individuals. These findings suggest that circulating CD4+ CD39+ T cells comprise subsets with both regulatory and stimulatory roles that contribute to the immune homeostasis in chronic M. ozzardi infection. Helminth infections downregulate immunity and reduce host’s inflammatory responses, but the filarial nematode Mansonella ozzardi, which is widely distributed across Latin America, appears to represent an exception to this rule. We found similar lymphoproliferative responses to filarial and unrelated antigens and comparable regulatory cytokine responses in subjects harboring M. ozzardi microfilariae, compared to local uninfected controls. The proportion of CD4+ T cell subtypes expressing CD39 was significantly increased in infected subjects and correlated positively with their microfilarial density. However, antibody blocking of CD39, an ectonucleosidase involved in the synthesis of the immunosuppresive molecule adenosine, paradoxically reduced, rather than promoted, antigen-driven lymphoproliferation in vitro. We suggest that CD39+ CD4+ T cells circulating in microfilaremics comprise both regulatory and stimulatory cell subsets that are concomitantly expanded. The balance between these cell subsets with opposing regulatory functions may be crucial to maintain immune homeostasis during chronic M. ozzardi infections.
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Affiliation(s)
- Nathália F. Lima
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Raquel M. Gonçalves-Lopes
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Yvonne C. M. Kruize
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marcelo U. Ferreira
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
- * E-mail:
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24
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Abstract
Mansonellosis is a filarial disease caused by three species of filarial (nematode) parasites (Mansonella perstans, Mansonella streptocerca, and Mansonella ozzardi) that use humans as their main definitive hosts. These parasites are transmitted from person to person by bloodsucking females from two families of flies (Diptera). Biting midges (Ceratopogonidae) transmit all three species of Mansonella, but blackflies (Simuliidae) are also known to play a role in the transmission of M. ozzardi in parts of Latin America. M. perstans and M. streptocerca are endemic in western, eastern, and central Africa, and M. perstans is also present in the neotropical region from equatorial Brazil to the Caribbean coast. M. ozzardi has a patchy distribution in Latin America and the Caribbean. Mansonellosis infections are thought to have little pathogenicity and to be almost always asymptomatic, but occasionally causing itching, joint pains, enlarged lymph glands, and vague abdominal symptoms. In Brazil, M. ozzardi infections are also associated with corneal lesions. Diagnosis is usually performed by detecting microfilariae in peripheral blood or skin without any periodicity. There is no standard treatment at present for mansonellosis. The combination therapy of diethylcarbamazine plus mebendazole for M. perstans microfilaremia is presently one of the most widely used, but the use of ivermectin has also been proven to be very effective against microfilariae. Recently, doxycycline has shown excellent efficacy and safety when used as an antimicrobial against endosymbiotic Wolbachia bacteria harbored by some strains of M. perstans and M. ozzardi. Diethylcarbamazine and ivermectin have been used effectively to treat M. streptocerca infection. There are at present no estimates of the disease burden caused by mansonellosis, and thus its importance to many global health professionals and policy makers is presently limited to how it can interfere with diagnostic tools used in modern filarial disease control and elimination programs aimed at other species of filariae.
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Affiliation(s)
- Thuy-Huong Ta-Tang
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Majadahonda, Spain,
| | - James L Crainey
- Laboratory of Infectious Disease Ecology in the Amazon, Oswaldo Cruz Foundation, Instituto Leônidas e Maria Deane, Manaus, Brazil
| | - Rory J Post
- School of Natural Sciences and Psychology, John Moores University, Liverpool
- Department of Disease Control, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Sergio Lb Luz
- Laboratory of Infectious Disease Ecology in the Amazon, Oswaldo Cruz Foundation, Instituto Leônidas e Maria Deane, Manaus, Brazil
| | - José M Rubio
- Malaria and Emerging Parasitic Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Majadahonda, Spain,
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25
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Sangare MB, Coulibaly YI, Coulibaly SY, Coulibaly ME, Traore B, Dicko I, Sissoko IM, Samake S, Traore SF, Nutman TB, Valenzuela JG, Faye O, Kamhawi S, Oliveira F, Semnani RT, Doumbia S. A cross-sectional study of the filarial and Leishmania co-endemicity in two ecologically distinct settings in Mali. Parasit Vectors 2018; 11:18. [PMID: 29310700 PMCID: PMC5759231 DOI: 10.1186/s13071-017-2531-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 11/12/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Filariasis and leishmaniasis are two neglected tropical diseases in Mali. Due to distribution and associated clinical features, both diseases are of concern to public health. The goal of this study was to determine the prevalence of co-infection with filarial (Wuchereria bancrofti and Mansonella perstans) and Leishmania major parasites in two ecologically distinct areas of Mali, the Kolokani district (villages of Tieneguebougou and Bougoudiana) in North Sudan Savanna area, and the district of Kolondieba (village of Boundioba) in the South Sudan Savanna area. METHODS The prevalence of co-infection (filarial and Leishmania) was measured based on (i) Mansonella perstans microfilaremia count and/or filariasis immunochromatographic test (ICT) for Wuchereria bancrofti-specific circulating antigen, and (ii) the prevalence of delayed type hypersensitivity (DTH) responses to Leishmania measured by leishmanin skin test (LST). RESULTS In this study, a total of 930 volunteers between the age of 18 and 65 were included from the two endemic areas of Kolokani and Kolondieba. In general, in both areas, filarial infection was more prevalent than Leishmania infection with an overall prevalence of 15.27% (142/930) including 8.7% (81/930) for Mansonella perstans and 8% (74/930) for Wuchereria bancrofti-specific circulating antigen. The prevalence of Leishmania major infection was 7.7% (72/930) and was significantly higher in Tieneguebougou and Bougoudiana (15.05%; 64/425) than in Boundioba (2.04%; 8/505) (χ2 = 58.66, P < 0.0001). Among the filarial infected population, nearly 10% (14/142) were also positive for Leishmania with an overall prevalence of co-infection of 1.50% (14/930) varying from 2.82% (12/425) in Tieneguebougou and Bougoudiana to 0.39% (2/505) in Boundioba (P = 0.0048). CONCLUSION This study established the existence of co-endemicity of filarial and Leishmania infections in specific regions of Mali. Since both filarial and Leishmania infections are vector-borne with mosquitoes and sand flies as respective vectors, an integrated vector control approach should be considered in co-endemic areas. The effect of potential interaction between filarial and Leishmania parasites on the disease outcomes may be further studied.
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Affiliation(s)
- Moussa Brema Sangare
- International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Yaya Ibrahim Coulibaly
- International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Siaka Yamoussa Coulibaly
- International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Michel Emmanuel Coulibaly
- International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Bourama Traore
- International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Ilo Dicko
- International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Ibrahim Moussa Sissoko
- International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Sibiry Samake
- International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | - Sekou Fantamady Traore
- International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
| | | | | | - Ousmane Faye
- Centre National d’Appui à la lutte contre la Maladie (CNAM), Bamako, Mali
| | | | | | | | - Seydou Doumbia
- International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali
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Ritter M, Ndongmo WPC, Njouendou AJ, Nghochuzie NN, Nchang LC, Tayong DB, Arndts K, Nausch N, Jacobsen M, Wanji S, Layland LE, Hoerauf A. Mansonella perstans microfilaremic individuals are characterized by enhanced type 2 helper T and regulatory T and B cell subsets and dampened systemic innate and adaptive immune responses. PLoS Negl Trop Dis 2018; 12:e0006184. [PMID: 29324739 PMCID: PMC5783424 DOI: 10.1371/journal.pntd.0006184] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 01/24/2018] [Accepted: 12/20/2017] [Indexed: 11/19/2022] Open
Abstract
The filarial nematode Mansonella perstans is endemic throughout Africa, northern South America and the Caribbean. Interestingly, M. perstans-infected individuals present no distinct clinical picture associated with certain pathology. Due to its relatively silent nature, research on this tropical disease has been neglected, especially M. perstans-driven immune responses. A hindrance in obtaining data on M. perstans-specific responses has been the inability to obtain adult worms since their habitats in serous cavities are difficult to access. Thus, in this study, for the first time, we used Mansonella perstans worm antigen extract as stimulant to obtain filarial-specific recall and immunoglobulin responses from M. perstans microfilaremic individuals (Mp MF+) from Cameroon. Moreover, systemic immune profiles in sera and immune cell composition in peripheral blood from Mp MF+ and amicrofilaremic individuals (Mp MF-) were obtained. Our data reveal that Mp MF+ individuals showed significantly reduced cytokine (IL-4, IL-6 and IL-12p70) and chemokine levels (IL-8 and RANTES), but significantly higher MIP-1β as well as increased M. perstans-specific IgG4 levels compared to Mp MF- individuals. In contrast, upon re-stimulation with worm antigen extract, IFN-γ, IL-13, IL-10 and IL-17A secretion was enhanced in cell cultures from Mp MF+ individuals when compared to those from cultures of healthy European individuals. Moreover, analysis of immune cell composition in peripheral blood from Mp MF+ individuals revealed increased type 2 helper T (Th2), natural killer (NK), regulatory B and T cell (Breg and Treg) subsets but decreased type 1 regulatory T (Tr1) cells. In summary, this study deciphers for the first time, M. perstans-specific immune responses using worm antigen extract and shows that patent M. perstans infections have distinct Th2, Breg and Treg subsets accompanied with reduced systemic innate and adaptive immune responses and dominant filarial-specific IgG4 levels.
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Affiliation(s)
- Manuel Ritter
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Germany
| | - Winston Patrick Chounna Ndongmo
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Abdel Jelil Njouendou
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Nora Nganyewo Nghochuzie
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Lucy Cho Nchang
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Dizzle Bita Tayong
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Kathrin Arndts
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Germany
| | - Norman Nausch
- Department of General Pediatrics, Neonatology, and Pediatric Cardiology, University Children’s Hospital, Medical Faculty, Duesseldorf, Germany
| | - Marc Jacobsen
- Department of General Pediatrics, Neonatology, and Pediatric Cardiology, University Children’s Hospital, Medical Faculty, Duesseldorf, Germany
| | - Samuel Wanji
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Laura E. Layland
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Germany
- German Centre for Infection Research (DZIF), partner site, Bonn-Cologne, Bonn, Germany
| | - Achim Hoerauf
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Germany
- German Centre for Infection Research (DZIF), partner site, Bonn-Cologne, Bonn, Germany
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27
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Njouendou AJ, Ritter M, Ndongmo WPC, Kien CA, Narcisse GTV, Fombad FF, Tayong DB, Pfarr K, Layland LE, Hoerauf A, Wanji S. Successful long-term maintenance of Mansonella perstans in an in vitro culture system. Parasit Vectors 2017; 10:563. [PMID: 29126431 PMCID: PMC5681788 DOI: 10.1186/s13071-017-2515-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 10/31/2017] [Indexed: 12/02/2022] Open
Abstract
Background Approximately 114 million people are infected with Mansonella perstans in large proportions of Africa. In contrast to other filariae that infect humans, M. perstans-infected individuals show no distinct pathology or specific clinical picture, indicating a well-tuned adaptation to the host. In addition, since M. perstans adult worms reside in serous cavities which are difficult to access, research has been hindered and there is a paucity of knowledge about the biology of M. perstans, especially the development of the different life stages as well as M. perstans-driven immune responses. Thus in this study, an in vitro culture system was developed which allows an in-depth analysis of M. perstans. Results Culicoides species were caught in Ediki (Kumba), Southwest Region within Cameroon following a blood meal on a microfilaremic donor that had 1500 microfilariae/ml of peripheral blood and kept in captivity for 12 days at 23 °C. In a pilot experiment, 15 infective larvae were obtained from the midges and co-cultured with a confluent monolayer of monkey kidney epithelial cells (LLC-MK2) in DMEM medium supplemented with 10% FBS for up to 77 days. The resulting survival rates of 33% revealed that the cell-conditioned medium was suitable for long-term maintenance of M. perstans worms. To confirm these preliminary observations, 249 infective larvae were cultured for 50 days and their development was monitored daily and microscopically graded for motility. In total, 170 (68.3%) filariae survived and 124 (49.8%) larvae moulted between days 21–30 to become L5 stage larvae which were motile and showed continuous vigorous movement. Conclusion We have established an in vitro culture system for the generation and long-term maintenance of viable M. perstans worms. This technique will be an important tool to study parasite biology and development, the role in host immunity, and might be helpful to discover novel treatment strategies against this filariae. Electronic supplementary material The online version of this article (10.1186/s13071-017-2515-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abdel Jelil Njouendou
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.,Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Manuel Ritter
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany.
| | - Winston Patrick Chounna Ndongmo
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.,Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Chi Anizette Kien
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Gandjui Tchamatchoua Victor Narcisse
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.,Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Fanny Fri Fombad
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.,Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Dizzle Bita Tayong
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.,Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Kenneth Pfarr
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany.,German Centre for Infection Research (DZIF), Bonn-Cologne partner site, Bonn, Germany
| | - Laura E Layland
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany.,German Centre for Infection Research (DZIF), Bonn-Cologne partner site, Bonn, Germany
| | - Achim Hoerauf
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany.,German Centre for Infection Research (DZIF), Bonn-Cologne partner site, Bonn, Germany
| | - Samuel Wanji
- Parasite and Vector Research Unit (PAVRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.,Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
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Debrah LB, Nausch N, Opoku VS, Owusu W, Mubarik Y, Berko DA, Wanji S, Layland LE, Hoerauf A, Jacobsen M, Debrah AY, Phillips RO. Epidemiology of Mansonella perstans in the middle belt of Ghana. Parasit Vectors 2017; 10:15. [PMID: 28061905 PMCID: PMC5219801 DOI: 10.1186/s13071-016-1960-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 12/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mansonellosis was first reported in Ghana by Awadzi in the 1990s. Co-infections of Mansonella perstans have also been reported in a small cohort of patients with Buruli ulcer and their contacts. However, no study has assessed the exact prevalence of the disease in a larger study population. This study therefore aimed to find out the prevalence of M. perstans infection in some districts in Ghana and to determine the diversity of Culicoides that could be potential vectors for transmission. METHODS From each participant screened in the Asante Akim North (Ashanti Region), Sene West and Atebubu Amantin (Brong Ahafo Region) districts, a total of 70 μl of finger prick blood was collected for assessment of M. perstans microfilariae. Centre for Disease Control (CDC) light traps as well as the Human Landing Catch (HLC) method were used to assess the species diversity of Culicoides present in the study communities. RESULTS From 2,247 participants, an overall prevalence of 32% was recorded although up to 75% prevalence was demonstrated in some of the communities. Culicoides inornatipennis was the only species of Culicoides caught with the HLC method. By contrast, C. imicola (47%), C. neavei (25%) and C. schultzei (15%) were caught by the CDC light trap method. A wide diversity of other Culicoides spp. was also identified but correlation was only found between the prevalence of C. inornatipennis and M. perstans during the dry season. CONCLUSIONS Here we demonstrate for the first time that M. perstans is highly prevalent in three districts in Ghana. We found a wide spectrum of Culicoides spp. Culicoides inornatipennis was the most anthropophilic and is therefore likely to be the species responsible for transmission of infection but formal proof has yet to be obtained. TRIAL REGISTRATION NCT02281643 . Registered October 26, 2014. 'Retrospectively registered'. TRIAL REGISTRY ClinicalTrials.gov.
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Affiliation(s)
- Linda Batsa Debrah
- Kumasi Centre for Collaborative Research into Tropical Medicine (KCCR), Kumasi, Ghana. .,Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Norman Nausch
- Department of General Pediatrics, Neonatology, and Pediatric Cardiology, University Children's Hospital, Duesseldorf, Germany
| | - Vera Serwaa Opoku
- Kumasi Centre for Collaborative Research into Tropical Medicine (KCCR), Kumasi, Ghana
| | - Wellington Owusu
- Kumasi Centre for Collaborative Research into Tropical Medicine (KCCR), Kumasi, Ghana
| | - Yusif Mubarik
- Kumasi Centre for Collaborative Research into Tropical Medicine (KCCR), Kumasi, Ghana
| | - Daniel Antwi Berko
- Kumasi Centre for Collaborative Research into Tropical Medicine (KCCR), Kumasi, Ghana
| | - Samuel Wanji
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Laura E Layland
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Bonn, Germany
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Bonn, Germany
| | - Marc Jacobsen
- Department of General Pediatrics, Neonatology, and Pediatric Cardiology, University Children's Hospital, Duesseldorf, Germany
| | - Alexander Yaw Debrah
- Faculty of Allied Health Sciences of Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard O Phillips
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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29
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Maizels RM, McSorley HJ. Regulation of the host immune system by helminth parasites. J Allergy Clin Immunol 2016; 138:666-675. [PMID: 27476889 PMCID: PMC5010150 DOI: 10.1016/j.jaci.2016.07.007] [Citation(s) in RCA: 336] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 07/25/2016] [Accepted: 07/25/2016] [Indexed: 01/01/2023]
Abstract
Helminth parasite infections are associated with a battery of immunomodulatory mechanisms that affect all facets of the host immune response to ensure their persistence within the host. This broad-spectrum modulation of host immunity has intended and unintended consequences, both advantageous and disadvantageous. Thus the host can benefit from suppression of collateral damage during parasite infection and from reduced allergic, autoimmune, and inflammatory reactions. However, helminth infection can also be detrimental in reducing vaccine responses, increasing susceptibility to coinfection and potentially reducing tumor immunosurveillance. In this review we will summarize the panoply of immunomodulatory mechanisms used by helminths, their potential utility in human disease, and prospective areas of future research.
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Affiliation(s)
- Rick M Maizels
- Wellcome Trust Centre for Molecular Parasitology, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom.
| | - Henry J McSorley
- Centre for Inflammation Research, University of Edinburgh, Queen's Medical Research Institute, Edinburgh, United Kingdom
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30
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Ateba-Ngoa U, Jones S, Zinsou JF, Honkpehedji J, Adegnika AA, Agobe JCD, Massinga-Loembe M, Mordmüller B, Bousema T, Yazdanbakhsh M. Associations Between Helminth Infections, Plasmodium falciparum Parasite Carriage and Antibody Responses to Sexual and Asexual Stage Malarial Antigens. Am J Trop Med Hyg 2016; 95:394-400. [PMID: 27273645 DOI: 10.4269/ajtmh.15-0703] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 12/28/2015] [Indexed: 12/28/2022] Open
Abstract
Infections with helminths and Plasmodium spp. overlap in their geographical distribution. It has been postulated that helminth infections may influence malarial transmission by altering Plasmodium falciparum gametocytogenesis. This cross-sectional study assessed the effect of helminth infections on P. falciparum gametocyte carriage and on humoral immune responses to sexual stage antigens in Gabon. Schistosoma haematobium and filarial infections as well as P. falciparum asexual forms and gametocyte carriage were determined. The antibody responses measured were to sexual (Pfs230, Pfs48/45) and asexual P. falciparum antigens (AMA1, MSP1, and GLURP). A total of 287 subjects were included. The prevalence of microscopically detectable P. falciparum asexual parasites was higher in S. haematobium-infected subjects in comparison to their uninfected counterparts (47% versus 26%, P = 0.003), but this was not different when filarial infections were considered. Plasmodium falciparum gametocyte carriage was similar between Schistosoma- or filaria-infected and uninfected subjects. We observed a significant decrease of Pfs48/45 immunoglobulin G titer in S. haematobium-infected subjects (P = 0.037), whereas no difference was seen for Pfs230 antibody titer, nor for antibodies to AMA1, MSP1, or GLURP. Our findings suggest an effect of S. haematobium on antibody responses to some P. falciparum gametocyte antigens that may have consequences for transmission-blocking immunity.
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Affiliation(s)
- Ulysse Ateba-Ngoa
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands. Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.
| | - Sophie Jones
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jeannot Fréjus Zinsou
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Josiane Honkpehedji
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Ayola Akim Adegnika
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands. Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Jean-Claude Dejon Agobe
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Marguerite Massinga-Loembe
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Benjamin Mordmüller
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Teun Bousema
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom. Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
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31
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Drame PM, Montavon C, Pion SD, Kubofcik J, Fay MP, Nutman TB. Molecular Epidemiology of Blood-Borne Human Parasites in a Loa loa-, Mansonella perstans-, and Plasmodium falciparum-Endemic Region of Cameroon. Am J Trop Med Hyg 2016; 94:1301-1308. [PMID: 27044568 PMCID: PMC4889748 DOI: 10.4269/ajtmh.15-0746] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 11/23/2015] [Indexed: 12/17/2022] Open
Abstract
The study of the interactions among parasites within their hosts is crucial to the understanding of epidemiology of disease and for the design of effective control strategies. We have conducted an assessment of infections with Loa loa, Mansonella perstans, Wuchereria bancrofti, and Plasmodium falciparum in eastern Cameroon using a highly sensitive and specific quantitative polymerase chain reaction assay using archived dried whole blood spots. The resident population (N = 1,085) was parasitized with M. perstans (76%), L. loa (39%), and P. falciparum (33%), but not with W. bancrofti Compared with single infections (40.1%), coinfection was more common (48.8%): 21.0% had L. loa-M. perstans (Ll(+)/Mp(+)/Pf(-)), 2.7% had L. loa-P. falciparum (Ll(+)/Pf(+)/Mp(-)), 15.1% had M. perstans-P. falciparum (Mp(+)/Pf(+)/Ll(-)), and 10.0% had L. loa-M. perstans-P. falciparum (Ll(+)/Mp(+)/Pf(+)). Interestingly, those with all three infections (Ll(+)/Mp(+)/Pf(+)) had significantly higher L. loa microfilaria (mf) counts than either single Ll(+) (P = 0.004) or double Ll(+)/Mp(+) (P = 0.024) infected individuals. Of those infected with L. loa, the mean estimated counts of L. loa mf varied based on location and were positively correlated with estimated intensities of M. perstans mf. Finally, at a community level, heavy L. loa infections were concentrated in a few individuals whereby they were likely the major reservoir for infection.
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Affiliation(s)
- Papa M. Drame
- *Address correspondence to Papa M. Drame, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 4 Center Drive, Bethesda, MD 20892. E-mail:
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Mendonça VRD, Barral-Netto M. Immunoregulation in human malaria: the challenge of understanding asymptomatic infection. Mem Inst Oswaldo Cruz 2015; 110:945-55. [PMID: 26676319 PMCID: PMC4708013 DOI: 10.1590/0074-02760150241] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/23/2015] [Indexed: 12/21/2022] Open
Abstract
Asymptomatic Plasmodium infection carriers represent a major threat
to malaria control worldwide as they are silent natural reservoirs and do not seek
medical care. There are no standard criteria for
asymptomaticPlasmodium infection; therefore, its diagnosis relies
on the presence of the parasite during a specific period of symptomless infection.
The antiparasitic immune response can result in reducedPlasmodium
sp. load with control of disease manifestations, which leads to asymptomatic
infection. Both the innate and adaptive immune responses seem to play major roles in
asymptomatic Plasmodiuminfection; T regulatory cell activity
(through the production of interleukin-10 and transforming growth factor-β) and
B-cells (with a broad antibody response) both play prominent roles. Furthermore,
molecules involved in the haem detoxification pathway (such as haptoglobin and haeme
oxygenase-1) and iron metabolism (ferritin and activated c-Jun N-terminal kinase)
have emerged in recent years as potential biomarkers and thus are helping to unravel
the immune response underlying asymptomatic Plasmodium infection.
The acquisition of large data sets and the use of robust statistical tools, including
network analysis, associated with well-designed malaria studies will likely help
elucidate the immune mechanisms responsible for asymptomatic infection.
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Affiliation(s)
- Vitor R de Mendonça
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brasil
| | - Manoel Barral-Netto
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brasil
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33
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Springer A, Fichtel C, Calvignac-Spencer S, Leendertz FH, Kappeler PM. Hemoparasites in a wild primate: Infection patterns suggest interaction of Plasmodium and Babesia in a lemur species. Int J Parasitol Parasites Wildl 2015; 4:385-95. [PMID: 26767166 PMCID: PMC4683568 DOI: 10.1016/j.ijppaw.2015.10.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/21/2015] [Accepted: 10/16/2015] [Indexed: 01/11/2023]
Abstract
Hemoparasites can cause serious morbidity in humans and animals and often involve wildlife reservoirs. Understanding patterns of hemoparasite infections in natural populations can therefore inform about emerging disease risks, especially in the light of climate change and human disruption of natural ecosystems. We investigated the effects of host age, sex, host group size and season on infection patterns of Plasmodium sp., Babesia sp. and filarial nematodes in a population of wild Malagasy primates, Verreaux's sifakas (Propithecus verreauxi), as well as the effects of these infections on hematological variables. We tested 45 blood samples from 36 individuals and identified two species of Plasmodium, one species of Babesia and two species of filarial nematodes. Plasmodium spp. and Babesia sp. infections showed opposite patterns of age-dependency, with babesiosis being prevalent among young animals, while older animals were infected with Plasmodium sp. In addition, Babesia sp. infection was a statistically significant negative predictor of Plasmodium sp. infection. These results suggest that Plasmodium and Babesia parasites may interact within the host, either through cross-immunity or via resource competition, so that Plasmodium infections can only establish after babesiosis has resolved. We found no effects of host sex, host group size and season on hemoparasite infections. Infections showed high prevalences and did not influence hematological variables. This preliminary evidence supports the impression that the hosts and parasites considered in this study appear to be well-adapted to each other, resulting in persistent infections with low pathogenic and probably low zoonotic potential. Our results illustrate the crucial role of biodiversity in host-parasite relationships, specifically how within-host pathogen diversity may regulate the abundance of parasites.
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Affiliation(s)
- Andrea Springer
- Behavioral Ecology and Sociobiology Unit, German Primate Center, Kellnerweg 4, 37077 Göttingen, Germany
| | - Claudia Fichtel
- Behavioral Ecology and Sociobiology Unit, German Primate Center, Kellnerweg 4, 37077 Göttingen, Germany
| | - Sébastien Calvignac-Spencer
- Project Group “Epidemiology of Highly Pathogenic Microorganisms”, Robert-Koch-Institut, Seestraße 10, 13353 Berlin, Germany
| | - Fabian H. Leendertz
- Project Group “Epidemiology of Highly Pathogenic Microorganisms”, Robert-Koch-Institut, Seestraße 10, 13353 Berlin, Germany
| | - Peter M. Kappeler
- Behavioral Ecology and Sociobiology Unit, German Primate Center, Kellnerweg 4, 37077 Göttingen, Germany
- Department of Sociobiology and Anthropology, University of Göttingen, Kellnerweg 6, 30077 Göttingen, Germany
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Mansonella, including a Potential New Species, as Common Parasites in Children in Gabon. PLoS Negl Trop Dis 2015; 9:e0004155. [PMID: 26484866 PMCID: PMC4618925 DOI: 10.1371/journal.pntd.0004155] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 09/21/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Like other tropical African countries, Gabon is afflicted by many parasitic diseases, including filariases such as loiasis and mansonellosis. This study aimed to assess the prevalence of these two filarial diseases in febrile and afebrile children using quantitative real-time PCR and standard PCR assays coupled with sequencing. METHODOLOGY/PRINCIPAL FINDINGS DNA from blood specimens of 1,418 Gabonese children (1,258 febrile and 160 afebrile) were analyzed. Overall, filarial DNA was detected in 95 (6.7%) children, including 67 positive for M. perstans (4.7%), which was the most common. M. perstans was detected in 61/1,258 febrile children (4.8%) and 6/160 afebrile children (3.8%, P = 0.6). Its prevalence increased statistically with age: 3.5%, 7.7% and 10.6% in children aged ≤ 5, 6-10 and 11-15 years, respectively. M. perstans prevalence was significantly higher in Koulamoutou and Lastourville (12% and 10.5%, respectively) than in Franceville and Fougamou (2.6% and 2.4%, respectively). Loa loa was detected in seven febrile children including one co-infection with M. perstans. Finally, 21 filarial DNA positive were negative for M. perstans and Loa loa, but ITS sequencing could be performed for 12 and allowed the identification of a potential new species of Mansonella provisionally called "DEUX". Mansonella sp. "DEUX" was detected only in febrile children. CONCLUSIONS/SIGNIFICANCE Further study should be performed to characterize Mansonella sp. "DEUX" and evaluate the clinical significance of mansonellosis in humans.
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Onkoba NW, Chimbari MJ, Mukaratirwa S. Malaria endemicity and co-infection with tissue-dwelling parasites in Sub-Saharan Africa: a review. Infect Dis Poverty 2015; 4:35. [PMID: 26377900 PMCID: PMC4571070 DOI: 10.1186/s40249-015-0070-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/03/2015] [Indexed: 02/08/2023] Open
Abstract
Mechanisms and outcomes of host-parasite interactions during malaria co-infections with gastrointestinal helminths are reasonably understood. In contrast, very little is known about such mechanisms in cases of malaria co-infections with tissue-dwelling parasites. This is lack of knowledge is exacerbated by misdiagnosis, lack of pathognomonic clinical signs and the chronic nature of tissue-dwelling helminthic infections. A good understanding of the implications of tissue-dwelling parasitic co-infections with malaria will contribute towards the improvement of the control and management of such co-infections in endemic areas. This review summarises and discusses current information available and gaps in research on malaria co-infection with gastro-intestinal helminths and tissue-dwelling parasites with emphasis on helminthic infections, in terms of the effects of migrating larval stages and intra and extracellular localisations of protozoan parasites and helminths in organs, tissues, and vascular and lymphatic circulations.
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Affiliation(s)
- Nyamongo W Onkoba
- College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Howard Campus, Durban, South Africa.
- Departmet of Tropical Infectious Diseases, Institute of Primate Research, Karen, Nairobi, Kenya.
| | - Moses J Chimbari
- College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Howard Campus, Durban, South Africa.
| | - Samson Mukaratirwa
- School of Life Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa.
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The relationship between microfilaraemic and amicrofilaraemic loiasis involving co-infection with Mansonella perstans and clinical symptoms in an exposed population from Gabon. J Helminthol 2015; 90:469-75. [DOI: 10.1017/s0022149x15000607] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThe relationship between the frequency of loiasis objective symptoms and microfilaraemic or amicrofilaraemic infection was assessed in 1148 exposed patients also infected, or not, with Mansonella perstans. Filarial infections were detected by direct microscopy, leucoconcentration and serology, with prevalence values of 39.5% Loa loa, 5.6% M. perstans and 3.4% co-infection with both filarial species. Amicrofilaraemic or occult loiasis (OL) predominated among L. loa-infected individuals, with a prevalence of 58.2%. Hypermicrofilaraemia (>8000 microfilariae (mf)/ml) was found in 18.4% of L. loa microfilaraemic patients, with 25.7% of them harbouring more than 30,000 mf/ml. Up to 34% of patients with OL showed evidence of Calabar swelling, compared with 26.3% of microfilaraemic patients (P= 0.03). Overall 5.3% of patients presented with adult worm migration across the eye, representing 16.3% of microfilaraemic individuals and 11.4% of amicrofilaraemic patients (P= 0.13). This symptom was similarly found in patients with more than 30,000 mf/ml (22%), those with microfilaraemia between 8 and 30,000 mf/ml (15.4%) and also in individuals with low or without microfilaraemia (16.1%) (P= 0.7). Five (14.3%) hypermicrofilaraemic patients did not present any L. loa-specific objective symptoms, as well as all the patients with single M. perstans infection. The presence of adult eye worm migration as a strong predictor of high microfilaraemia density would obscure the real burden of L. loa hypermicrofilaraemia in exposed individuals. For epidemiological purposes and control strategies, the mapping of L. loa in endemic areas should also take into account the group of patients with occult loiasis.
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Medeiros JF, Almeida TAP, Silva LBT, Rubio JM, Crainey JL, Pessoa FAC, Luz SLB. A field trial of a PCR-based Mansonella ozzardi diagnosis assay detects high-levels of submicroscopic M. ozzardi infections in both venous blood samples and FTA card dried blood spots. Parasit Vectors 2015; 8:280. [PMID: 25990611 PMCID: PMC4472411 DOI: 10.1186/s13071-015-0889-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 05/08/2015] [Indexed: 12/13/2022] Open
Abstract
Background Mansonella ozzardi is a poorly understood human filarial parasite with a broad distribution throughout Latin America. Most of what is known about its parasitism has come from epidemiological studies that have estimated parasite incidence using light microscopy. Light microscopy can, however, miss lighter, submicroscopic, infections. In this study we have compared M. ozzardi incidence estimates made using light microscopy, with estimates made using PCR. Methods 214 DNA extracts made from Large Volume Venous Blood Samples (LVVBS) were taken from volunteers from two study sites in the Rio Solimões region: Codajás [n = 109] and Tefé [n = 105] and were subsequently assayed for M. ozzardi parasitism using a diagnostic PCR (Mo-dPCR). Peripheral finger-prick blood samples were taken from the same individuals and used for microscopic examination. Finger-prick blood, taken from individuals from Tefé, was also used for the creation of FTA®card dried blood spots (DBS) that were subsequently subjected to Mo-dPCR. Results Overall M. ozzardi incidence estimates made with LVVBS PCRs were 1.8 times higher than those made using microscopy (44.9 % [96/214] compared with 24.3 % [52/214]) and 1.5 times higher than the PCR estimates made from FTA®card DBS (48/105 versus 31/105). PCR-based detection of FTA®card DBS proved 1.3 times more sensitive at diagnosing infections from peripheral blood samples than light microscopy did: detecting 24/105 compared with 31/105. PCR of LVVBS reported the fewest number of false negatives, detecting: 44 of 52 (84.6 %) individuals diagnosed by microscopy; 27 of 31 (87.1 %) of those diagnosed positive from DBSs and 17 out of 18 (94.4 %) of those diagnosed as positive by both alternative methodologies. Conclusions In this study, Mo-dPCR of LVVBS was by far the most sensitive method of detecting M. ozzardi infections and detected submicroscopic infections. Mo-dPCR FTA®card DBS also provided a more sensitive test for M. ozzardi diagnosis than light microscopy based diagnosis did and thus in settings where only finger-prick assays can be carried-out, it may be a more reliable method of detection. Most existing M. ozzardi incidence estimates, which are often based on light microscope diagnosis, are likely to dramatically underestimate true M. ozzardi parasitism incidence levels.
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Affiliation(s)
| | - Tatiana Amaral Pires Almeida
- Research Programme on Infectious Disease Ecology in the Amazon (RP-IDEA), Leônidas & Maria Deane Institute - Fiocruz Amazônia, Manaus, AM, Brazil.
| | - Lucyane Bastos Tavares Silva
- Research Programme on Infectious Disease Ecology in the Amazon (RP-IDEA), Leônidas & Maria Deane Institute - Fiocruz Amazônia, Manaus, AM, Brazil. .,Health and Endemic Diseases in the Amazon, Multi Institutional Graduate Program, Federal University of Amazonas (UFAM), Manaus, AM, Brazil.
| | - Jose Miguel Rubio
- Malaria & Emerging Parasitic Diseases Laboratory, Parasitology Department, National Centre of Microbiology. Carlos III Health Institute, Madrid, Spain.
| | - James Lee Crainey
- Research Programme on Infectious Disease Ecology in the Amazon (RP-IDEA), Leônidas & Maria Deane Institute - Fiocruz Amazônia, Manaus, AM, Brazil.
| | - Felipe Arley Costa Pessoa
- Research Programme on Infectious Disease Ecology in the Amazon (RP-IDEA), Leônidas & Maria Deane Institute - Fiocruz Amazônia, Manaus, AM, Brazil.
| | - Sergio Luiz Bessa Luz
- Research Programme on Infectious Disease Ecology in the Amazon (RP-IDEA), Leônidas & Maria Deane Institute - Fiocruz Amazônia, Manaus, AM, Brazil.
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Arndts K, Klarmann-Schulz U, Batsa L, Debrah AY, Epp C, Fimmers R, Specht S, Layland LE, Hoerauf A. Reductions in microfilaridermia by repeated ivermectin treatment are associated with lower Plasmodium-specific Th17 immune responses in Onchocerca volvulus-infected individuals. Parasit Vectors 2015; 8:184. [PMID: 25889652 PMCID: PMC4391604 DOI: 10.1186/s13071-015-0786-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 03/05/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND 37 million individuals are currently infected with Onchocerca volvulus (O. volvulus), a parasitic nematode that elicits various dermal manifestations and eye damage in man. Disease control is primarily based on distributing ivermectin in mass drug administration (MDA) programmes which aim at breaking transmission by eliminating microfilariae (MF), the worm's offspring. The majority of infected individuals present generalized onchocerciasis, which is characterized by hyporesponsive immune responses and high parasite burden including MF. Recently, in areas that have been part of MDA programmes, individuals have been identified that present nodules but are amicrofilaridermic (a-MF) and our previous study showed that this group has a distinct immune profile. Expanding on those findings we determined the immune responses of O. volvulus-infected individuals to a Plasmodium-derived antigen MSP-1 (merozoite surface protein-1), which is required by the parasite to enter erythrocytes. METHODS Isolated PBMCs from O. volvulus-infected individuals (164 MF(+) and 46 a-MF) and non-infected volunteers from the same region (NEN), were stimulated with MSP-1 and the resulting supernatant screened for the presence of IL-5, IL-13, IFN-γ, TNF-α, IL-6, IL-17A and IL-10. These findings were then further analyzed following regression analysis using the covariates MF, ivermectin (IVM) and region. The latter referred to the Central or Ashanti regions of Ghana, which, at the time sampling, had received 8 or 1 round of MDA respectively. RESULTS IL-5, IL-13 and IFN-γ responses to MSP-1 were not altered between NEN and O. volvulus-infected individuals nor were any associations revealed in the regression analysis. IL-10, IL-6 and TNF-α MSP-1 responses were, however, significantly elevated in cultures from infected individuals. Interestingly, when compared to a-MF individuals, MSP-induced IL-17A responses were significantly higher in MF(+) patients. Following multivariable regression analysis these IL-10, IL-6, TNF-α and IL-17A responses were all dominantly associated with the regional covariate. CONCLUSIONS Consequently, areas with a lowered infection pressure due to IVM MDA appear to influence bystander responses to Plasmodium-derived antigens in community members even if they have not regularly participated in the therapy.
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Affiliation(s)
- Kathrin Arndts
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Sigmund Freud Straße 25, Bonn, 53105, Germany.
| | - Ute Klarmann-Schulz
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Sigmund Freud Straße 25, Bonn, 53105, Germany.
- Institute of Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, Bonn, Germany.
| | - Linda Batsa
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana.
| | - Alexander Y Debrah
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana.
- Faculty of Allied Health Sciences of the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Christian Epp
- Centre for Infectious Diseases - Parasitology, University Hospital Heidelberg, Heidelberg, Germany.
| | - Rolf Fimmers
- Institute of Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, Bonn, Germany.
| | - Sabine Specht
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Sigmund Freud Straße 25, Bonn, 53105, Germany.
| | - Laura E Layland
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Sigmund Freud Straße 25, Bonn, 53105, Germany.
| | - Achim Hoerauf
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Sigmund Freud Straße 25, Bonn, 53105, Germany.
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Talaat KR, Babu S, Menon P, Kumarasamy N, Sharma J, Arumugam J, Dhakshinamurthy K, Srinivasan R, Poongulali S, Gu W, Fay MP, Swaminathan S, Nutman TB. Treatment of W. bancrofti (Wb) in HIV/Wb coinfections in South India. PLoS Negl Trop Dis 2015; 9:e0003622. [PMID: 25793933 PMCID: PMC4368731 DOI: 10.1371/journal.pntd.0003622] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 02/13/2015] [Indexed: 11/30/2022] Open
Abstract
Background The disease course of human immunodeficiency virus (HIV) is often altered by existing or newly acquired coincident infections. Methodology/Principal Findings To assess the influence of pre-existing Wuchereria bancrofti infection on HIV progression, we performed a case-controlled treatment study of HIV positive individuals with (FIL+) or without (FIL-) W. bancrofti infection. Twenty-eight HIV+/FIL+ and 51 matched HIV+/FIL- subjects were treated with a single dose of diethylcarbamazine and albendazole (DEC/Alb) and followed for a year at regular intervals. Sixteen of the HIV+/FIL+ subjects (54%) and 28 of the HIV+/FIL- controls (57%) were on antiretroviral therapy (ART) during the study. Following treatment, no differences were noted in clinical outcomes between the 2 groups. There also was no significant difference between the groups in the HIV viral load at 12 months as a percentage of baseline viral load (HIV+/FIL+ group had on average 0.97 times the response of the HIV+/FIL- group, 95% CI 0.88, 1.07) between the groups. Furthermore, there were no significant differences found in either the change in viral load at 1, 3, or 6 months or in the change in CD4 count at 3, 6, or 12 months between the 2 groups. Conclusions/Significance We were unable to find a significant effect of W. bancrofti infection or its treatment on HIV clinical course or surrogate markers of HIV disease progression though we recognized that our study was limited by the smaller than predicted sample size and by the use of ART in half of the patients. Treatment of W. bancrofti coinfection in HIV positive subjects (as is usual in mass drug administration campaigns) did not represent an increased risk to the subjects, and should therefore be considered for PLWHA living in W. bancrofti endemic areas. Trial Registration ClinicalTrials.gov NCT00344279 In people living with HIV infection, simultaneous infections can adversely affect HIV disease. This has been seen with bacterial (tuberculosis), viral (cytomegalovirus), and parasitic infections (toxoplasmosis). Lymphatic filariasis is caused by a thin thread-like parasite that lives in the lymph vessels of infected people. It can cause significant disability. This infection is found in much of the same areas that high levels of HIV infection. We were interested in knowing if lymphatic filariasis changed the course of HIV infection in people with both diseases. In this study, the authors enrolled people in India who were living with HIV who either had or didn’t have filarial infection. All patients were treated for filariasis with 2 drugs, and then were followed for 1 year to see how their HIV disease progressed. No difference in HIV disease progression was found between the groups that did or did not have filariasis before treatment. The patients with HIV did well with the medicine for filariasis.
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Affiliation(s)
- Kawsar R. Talaat
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland, United States of America
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- * E-mail:
| | - Subash Babu
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Pradeep Menon
- National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Indian Council of Medical Research, Chennai, India
| | | | | | | | - Kalaivani Dhakshinamurthy
- National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Indian Council of Medical Research, Chennai, India
| | - Ramalingam Srinivasan
- National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Indian Council of Medical Research, Chennai, India
| | | | - Wenjuan Gu
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - Michael P. Fay
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - Soumya Swaminathan
- National Institute for Research in Tuberculosis (formerly Tuberculosis Research Centre), Indian Council of Medical Research, Chennai, India
| | - Thomas B. Nutman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Helminth parasites alter protection against Plasmodium infection. BIOMED RESEARCH INTERNATIONAL 2014; 2014:913696. [PMID: 25276830 PMCID: PMC4170705 DOI: 10.1155/2014/913696] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 08/06/2014] [Indexed: 12/17/2022]
Abstract
More than one-third of the world's population is infected with one or more helminthic parasites. Helminth infections are prevalent throughout tropical and subtropical regions where malaria pathogens are transmitted. Malaria is the most widespread and deadliest parasitic disease. The severity of the disease is strongly related to parasite density and the host's immune responses. Furthermore, coinfections between both parasites occur frequently. However, little is known regarding how concomitant infection with helminths and Plasmodium affects the host's immune response. Helminthic infections are frequently massive, chronic, and strong inductors of a Th2-type response. This implies that infection by such parasites could alter the host's susceptibility to subsequent infections by Plasmodium. There are a number of reports on the interactions between helminths and Plasmodium; in some, the burden of Plasmodium parasites increased, but others reported a reduction in the parasite. This review focuses on explaining many of these discrepancies regarding helminth-Plasmodium coinfections in terms of the effects that helminths have on the immune system. In particular, it focuses on helminth-induced immunosuppression and the effects of cytokines controlling polarization toward the Th1 or Th2 arms of the immune response.
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Spottiswoode N, Duffy PE, Drakesmith H. Iron, anemia and hepcidin in malaria. Front Pharmacol 2014; 5:125. [PMID: 24910614 PMCID: PMC4039013 DOI: 10.3389/fphar.2014.00125] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 05/11/2014] [Indexed: 12/21/2022] Open
Abstract
Malaria and iron have a complex but important relationship. Plasmodium proliferation requires iron, both during the clinically silent liver stage of growth and in the disease-associated phase of erythrocyte infection. Precisely how the protozoan acquires its iron from its mammalian host remains unclear, but iron chelators can inhibit pathogen growth in vitro and in animal models. In humans, iron deficiency appears to protect against severe malaria, while iron supplementation increases risks of infection and disease. Malaria itself causes profound disturbances in physiological iron distribution and utilization, through mechanisms that include hemolysis, release of heme, dyserythropoiesis, anemia, deposition of iron in macrophages, and inhibition of dietary iron absorption. These effects have significant consequences. Malarial anemia is a major global health problem, especially in children, that remains incompletely understood and is not straightforward to treat. Furthermore, the changes in iron metabolism during a malaria infection may modulate susceptibility to co-infections. The release of heme and accumulation of iron in granulocytes may explain increased vulnerability to non-typhoidal Salmonella during malaria. The redistribution of iron away from hepatocytes and into macrophages may confer host resistance to superinfection, whereby blood-stage parasitemia prevents the development of a second liver-stage Plasmodium infection in the same organism. Key to understanding the pathophysiology of iron metabolism in malaria is the activity of the iron regulatory hormone hepcidin. Hepcidin is upregulated during blood-stage parasitemia and likely mediates much of the iron redistribution that accompanies disease. Understanding the regulation and role of hepcidin may offer new opportunities to combat malaria and formulate better approaches to treat anemia in the developing world.
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Affiliation(s)
- Natasha Spottiswoode
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of HealthBethesda, MD, USA
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of OxfordOxford, UK
| | - Patrick E. Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of HealthBethesda, MD, USA
| | - Hal Drakesmith
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of OxfordOxford, UK
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Gonçalves RM, Lima NF, Ferreira MU. Parasite virulence, co-infections and cytokine balance in malaria. Pathog Glob Health 2014; 108:173-8. [PMID: 24854175 DOI: 10.1179/2047773214y.0000000139] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Strong early inflammatory responses followed by a timely production of regulatory cytokines are required to control malaria parasite multiplication without inducing major host pathology. Here, we briefly examine the homeostasis of inflammatory responses to malaria parasite species with varying virulence levels and discuss how co-infections with bacteria, viruses, and helminths can modulate inflammation, either aggravating or alleviating malaria-related morbidity.
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Bouyou-Akotet M, Moussavou Boussougou M, Ovono-Abessolo F, Owono-Medang M, Kombila M. Influence of Mansonella perstans microfilaraemia on total IgE levels in Gabonese patients co-infected with Loa loa. Acta Trop 2014; 131:11-5. [PMID: 24280145 DOI: 10.1016/j.actatropica.2013.11.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 11/12/2013] [Accepted: 11/15/2013] [Indexed: 11/25/2022]
Abstract
Mansonella (M.) perstans filariasis is widely found in Africa, including Gabon where Loa loa is also endemic. This study reports the total IgE titres according to different bioclinical forms of single or co-infection with L. loa and M. perstans in 138 patients and 20 healthy controls. The median parasite density was significantly higher in cases of loiasis. IgE titres were higher in patients with microscopic dual-infection and in the group of patients with occult loiasis plus M. perstans microfilaraemia (8425 [5292-20,679]KUI/L and 6304 [1045-10,326]KUI/L, respectively), compared to individuals with either microfilaraemic Loa loa (3368 [1414-7074]KUI/L) or Mansonella (4370 [1478-7334]KUI/L) single infections (p<0.01). IgE levels were positively correlated with M. perstans microfilaraemia (rho=0.27; p<0.01). Compared to single infections, dual M. perstans-L. loa infection induces very high total IgE titres. Studies correlating IgE titres and clinical symptoms are needed to confirm the involvement of this immunoglobulin in the pathological processes during filariasis.
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Helpful or a Hindrance: Co-infections with Helminths During Malaria. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 828:99-129. [DOI: 10.1007/978-1-4939-1489-0_5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Salgame P, Yap GS, Gause WC. Effect of helminth-induced immunity on infections with microbial pathogens. Nat Immunol 2013; 14:1118-1126. [PMID: 24145791 DOI: 10.1038/ni.2736] [Citation(s) in RCA: 199] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 09/11/2013] [Indexed: 02/06/2023]
Abstract
Helminth infections are ubiquitous worldwide and can trigger potent immune responses that differ from and potentially antagonize host protective responses to microbial pathogens. In this Review we focus on the three main killers in infectious disease-AIDS, tuberculosis and malaria-and critically assesses whether helminths adversely influence host control of these diseases. We also discuss emerging concepts for how M2 macrophages and helminth-modulated dendritic cells can potentially influence the protective immune response to concurrent infections. Finally, we present evidence advocating for more efforts to determine how and to what extent helminths interfere with the successful control of specific concurrent coinfections.
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Affiliation(s)
- Padmini Salgame
- Department of Medicine, Center for Emerging Pathogens, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
| | - George S Yap
- Department of Medicine, Center for Immunity and Inflammation, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
| | - William C Gause
- Department of Medicine, Center for Immunity and Inflammation, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, New Jersey, USA
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