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Santoro A, Santolamazza F, Cacciò SM, La Rosa G, Antolová D, Auer H, Bagrade G, Bandelj P, Basso W, Beck R, Citterio CV, Davidson RK, Deksne G, Frey CF, Fuglei E, Glawischnig W, Gottstein B, Harna J, Huus Petersen H, Karamon J, Jansen F, Jarošová J, Jokelainen P, Lundström-Stadelmann B, Maksimov P, Miljević M, Miterpáková M, Moks E, Origgi F, Ozolina Z, Ryser MP, Romig T, Šarkūnas M, Scorrano N, Saarma U, Šnábel V, Sréter T, Umhang G, Vengušt G, Žele Vengušt D, Casulli A. Mitochondrial genetic diversity and phylogenetic relationships of Echinococcus multilocularis in Europe. Int J Parasitol 2024; 54:233-245. [PMID: 38246405 DOI: 10.1016/j.ijpara.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/09/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
The cestode Echinococcus multilocularis is the causative agent of alveolar echinococcosis, a fatal zoonotic parasitic disease of the northern hemisphere. Red foxes are the main reservoir hosts and, likely, the main drivers of the geographic spread of the disease in Europe. Knowledge of genetic relationships among E. multilocularis isolates at a European scale is key to understanding the dispersal characteristics of E. multilocularis. Hence, the present study aimed to describe the genetic diversity of E. multilocularis isolates obtained from different host species in 19 European countries. Based on the analysis of complete nucleotide sequences of the cob, atp6, nad2, nad1 and cox1 mitochondrial genes (4,968 bp), 43 haplotypes were inferred. Four haplotypes represented 62.56 % of the examined isolates (142/227), and one of these four haplotypes was found in each country investigated, except Svalbard, Norway. While the haplotypes from Svalbard were markedly different from all the others, mainland Europe appeared to be dominated by two main clusters, represented by most western, central and eastern European countries, and the Baltic countries and northeastern Poland, respectively. Moreover, one Asian-like haplotype was identified in Latvia and northeastern Poland. To better elucidate the presence of Asian genetic variants of E. multilocularis in Europe, and to obtain a more comprehensive Europe-wide coverage, further studies, including samples from endemic regions not investigated in the present study, especially some eastern European countries, are needed. Further, the present work proposes historical causes that may have contributed to shaping the current genetic variability of E. multilocularis in Europe.
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Affiliation(s)
- Azzurra Santoro
- European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Federica Santolamazza
- European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Simone M Cacciò
- European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Giuseppe La Rosa
- European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Daniela Antolová
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Hlinkova 3, 040 01 Košice, Slovakia
| | - Herbert Auer
- Medical Parasitology, Institute of Specific Prophylaxis and Tropical Medicine, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Guna Bagrade
- Latvian State Forest Research Institute "Silava", Wildlife Management Research Group, Salaspils, Rigas Street 111, LV-2169 Salaspils, Latvia
| | - Petra Bandelj
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - Walter Basso
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland
| | - Relja Beck
- Croatian Veterinary Institute, Laboratory for Parasitology, 10000 Zagreb, Croatia
| | - Carlo V Citterio
- Centro Specialistico Fauna Selvatica, SCT2-Belluno, Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), Via Cappellari 44/A, 32100 Belluno, Italy
| | | | - Gunita Deksne
- Institute of Food Safety, Animal Health and Environment "BIOR", Lejupes Street 3, Riga LV-1076, Latvia; Faculty of Biology, University of Lavia, Jelgavas Street 1, Riga LV-1004, Latvia
| | - Caroline F Frey
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland
| | - Eva Fuglei
- Norwegian Polar Institute, Fram Centre, NO-9296 Tromsø, Norway
| | - Walter Glawischnig
- Institute for Veterinary Disease Control Innsbruck, Austrian Agency for Health and Food Safety, Technikerstraße 70, 6020 Innsbruck, Austria
| | - Bruno Gottstein
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland; Institute of Infectious Diseases, Faculty of Medicine, University of Bern, CH-3012 Bern, Switzerland
| | - Jiří Harna
- State Veterinary Institute Olomouc, Jakoubka ze Stribra 1, 779 00 Olomouc, Czech Republic
| | - Heidi Huus Petersen
- Danish Veterinary and Food Administration, Ministry of Food, Agriculture and Fisheries of Denmark, Stationsparken 31-33 2600, Glostrup, Denmark
| | - Jacek Karamon
- National Veterinary Research Institute, Department of Parasitology and Invasive Diseases, Partyzantow Avenue 57, 24-100 Pulawy, Poland
| | - Famke Jansen
- Institute of Tropical Medicine (ITM), Department of Biomedical Sciences, 155 Nationalestraat, B-2000 Antwerp, Belgium
| | - Júlia Jarošová
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Hlinkova 3, 040 01 Košice, Slovakia
| | - Pikka Jokelainen
- Infectious Disease Preparedness, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
| | - Britta Lundström-Stadelmann
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland; Multidisciplinary Center for Infectious Diseases, University of Bern, Länggass-Strasse 122, 3012 Bern, Switzerland
| | - Pavlo Maksimov
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Südufer 10, 17493 Greifswald‑Insel Riems, Germany
| | - Milan Miljević
- Department of Genetic Research, Institute for Biological Research "Siniša Stanković", National Institute of Republic of Serbia, University of Belgrade, Bulevar Despota Stefana 142, 11000 Belgrade, Serbia
| | - Martina Miterpáková
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Hlinkova 3, 040 01 Košice, Slovakia
| | - Epp Moks
- National Centre for Laboratory Research and Risk Assessment, Fr. R. Kreutzwaldi 30, Tartu, Estonia
| | - Francesco Origgi
- Institute for Fish and Wildlife Health (FIWI), Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Längassstrasse 122, 3012 Bern, Switzerland
| | - Zanda Ozolina
- Institute of Food Safety, Animal Health and Environment "BIOR", Lejupes Street 3, Riga LV-1076, Latvia
| | - Marie-Pierre Ryser
- Institute for Fish and Wildlife Health (FIWI), Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Längassstrasse 122, 3012 Bern, Switzerland
| | - Thomas Romig
- Parasitology Unit, Institute of Biology, University of Hohenheim, 70593 Stuttgart, Germany
| | - Mindaugas Šarkūnas
- Department of Veterinary Pathobiology, Veterinary Academy, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania
| | - Nathalie Scorrano
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland
| | - Urmas Saarma
- Department of Zoology, Institute of Ecology and Earth Sciences, University of Tartu, J. Liivi 2, 50409 Tartu, Estonia
| | - Viliam Šnábel
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Hlinkova 3, 040 01 Košice, Slovakia
| | - Tamás Sréter
- National Reference Laboratory of Medical Parasitology, National Public Health Center, Albert Flórián út 2-6, Budapest, Hungary
| | - Gèrald Umhang
- Anses, Nancy Laboratory for Rabies and Wildlife, National Reference Laboratory Echinococcus spp, 54220 Malzéville, France
| | - Gorazd Vengušt
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - Diana Žele Vengušt
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - Adriano Casulli
- European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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Gloor S, Jiang W, Maurer MH, Gottstein B, Oberli A, Hagemann JB, Hotz JF, Candinas D, Lachenmayer A, Grüner B, Beldi G. The trajectory of anti-recEm18 antibody levels determines follow-up after curative resection of hepatic alveolar echinococcosis. HPB (Oxford) 2024; 26:224-233. [PMID: 37867084 DOI: 10.1016/j.hpb.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/15/2023] [Accepted: 10/03/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION Recurrence after curative resection of hepatic alveolar echinococcosis remains a clinical challenge. The current study tested if assessment of anti-recEm18 allows for postsurgical patient surveillance. METHODS A retrospective study with patients undergoing liver resection for alveolar echinococcosis (n = 88) at the University Hospital Bern from 2002 to 2020 and at the University Hospital and Medical Center Ulm from 2011 to 2017 was performed. Analysis was directed to determine a potential association of pre- and postoperative values of anti-recEm18 with clinical outcomes. RESULTS Anti-recEm18 had a linear correlation to the maximum lesion diameter (R2 = 0.558). Three trajectories of anti-recEm18 were identified based on a threshold of 10 AU/ml: "Em18-low" (n = 31), "responders" (n = 53) and "residual disease" (n = 4). The decline of anti-recEm18 in "responders" reached a plateau after 10.9 months at which levels decreased by 90%. The only patient with recurrence in the entire population was also the only patient with a secondary increase of anti-recEm18. CONCLUSION In patients with preoperative elevated values, anti-recEm18 confirms curative surgery at 12 months follow-up and allows for long-term surveillance.
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Affiliation(s)
- Severin Gloor
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Wanjie Jiang
- Department of Internal Medicine III, Division of Infectious Diseases, University Hospital of Ulm, Ulm, Germany
| | - Martin H Maurer
- Department for Diagnostic, Interventional, and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Institute for Diagnostic and Interventional Radiology, University Oldenburg, Oldenburg, Germany
| | - Bruno Gottstein
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland; Institute for Infectious Diseases, Medical Faculty, University of Bern, Bern, Switzerland
| | - Alexander Oberli
- Institute for Infectious Diseases, Medical Faculty, University of Bern, Bern, Switzerland
| | - Jürgen B Hagemann
- Institute of Medical Microbiology and Hygiene, University Hospital of Ulm, Ulm, Germany
| | - Julian F Hotz
- Department of Internal Medicine III, Division of Infectious Diseases, University Hospital of Ulm, Ulm, Germany; Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Daniel Candinas
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Anja Lachenmayer
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Beate Grüner
- Department of Internal Medicine III, Division of Infectious Diseases, University Hospital of Ulm, Ulm, Germany
| | - Guido Beldi
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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Oberli A, Furrer L, Skoko L, Müller N, Gottstein B, Bittel P. A novel multiplex real-time polymerase chain reaction for the molecular diagnosis of metacestode infections in human patients. Clin Microbiol Infect 2023:S1198-743X(23)00360-9. [PMID: 37544608 DOI: 10.1016/j.cmi.2023.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVES The diagnosis of larval cestodiases in humans primarily depends on using imaging techniques in combination with serological tests. However, in case of atypical imaging results, negative serology results due to immunosuppression, or infection with rare taeniid species, traditional diagnostic tools may not provide a definitive species-level diagnosis. We aimed to validate a rapid, reliable, and cost-effective single-step real-time PCR method that can identify and differentiate larval cestodiases from biopsy material. METHODS We validated a real-time PCR technique able to distinguish Echinococcus multilocularis, E. granulosus sensu lato (s.l.), and Taenia spp. from biopsy or cytology material in a single-step analysis. Further Sanger sequencing of E. granulosus s.l. and Taenia spp. amplicons enables differentiation of various Echinococcus and Taenia species. The assay was validated on (a) a reference sample collection of 69 clinical and veterinary cases confirmed by imaging, serology, and morphological analysis, (b) 38 routine human patient samples confirmed for aforementioned pathogens by a conventional end-point PCR, and (c) 127 samples from patients with suspected echinococcosis that were submitted to our laboratory for diagnostic analysis. RESULTS Compared to a conventional reference end-point PCR approach, the quadruplex real-time PCR exhibited a lower limit of detection in a serial dilution with 5-log dilutions for all three targets (2 log for E. multilocularis, 1 log for E. granulosus s.s., and 1 log for T. saginata). We were able to detect DNA from E. multilocularis, E. granulosus s.l. (E. granulosus s.s., E. canadensis, E. ortleppi, and E. felidis), a wide range of Taenia spp., as well as from non-echinococcal metacestodes such as Hydatigera taeniaformis, Hymenolepis spp., Versteria sp., and Spirometra erinaceieuropaei. DISCUSSION We suggest that the presented real-time PCR method is a suitable tool to be routinely used in a clinical microbiology laboratory to rapidly detect and identify larval cestodiases in human tissue.
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Affiliation(s)
- Alexander Oberli
- University of Bern, Institute for Infectious Diseases, Bern, Switzerland.
| | - Lavinia Furrer
- University of Bern, Institute for Infectious Diseases, Bern, Switzerland
| | - Lena Skoko
- University of Bern, Institute for Infectious Diseases, Bern, Switzerland
| | - Norbert Müller
- University of Bern, Institute for Infectious Diseases, Bern, Switzerland; Institute of Parasitology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Bruno Gottstein
- University of Bern, Institute for Infectious Diseases, Bern, Switzerland
| | - Pascal Bittel
- University of Bern, Institute for Infectious Diseases, Bern, Switzerland
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Kronenberg PA, Reinehr M, Eichenberger RM, Hasler S, Laurimäe T, Weber A, Deibel A, Müllhaupt B, Gottstein B, Müller N, Hemphill A, Deplazes P. Monoclonal antibody-based localization of major diagnostic antigens in metacestode tissue, excretory/secretory products, and extracellular vesicles of Echinococcus species. Front Cell Infect Microbiol 2023; 13:1162530. [PMID: 37009502 PMCID: PMC10061086 DOI: 10.3389/fcimb.2023.1162530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/03/2023] [Indexed: 03/18/2023] Open
Abstract
Alveolar (AE) and cystic echinococcosis (CE) are severe parasitic zoonoses caused by the larval stages of Echinococcus multilocularis and E. granulosus sensu lato, respectively. A panel of 7 monoclonal antibodies (mAbs) was selected against major diagnostic epitopes of both species. The binding capacity of the mAbs to Echinococcus spp. excretory/secretory products (ESP) was analyzed by sandwich-ELISA, where mAb Em2G11 and mAb EmG3 detected in vitro extravesicular ESP of both E. multilocularis and E. granulosus s.s. These findings were subsequently confirmed by the detection of circulating ESP in a subset of serum samples from infected hosts including humans. Extracellular vesicles (EVs) were purified, and the binding to mAbs was analyzed by sandwich-ELISA. Transmission electron microscopy (TEM) was used to confirm the binding of mAb EmG3 to EVs from intravesicular fluid of Echinococcus spp. vesicles. The specificity of the mAbs in ELISA corresponded to the immunohistochemical staining (IHC-S) patterns performed on human AE and CE liver sections. Antigenic small particles designated as ‘‘spems’’ for E. multilocularis and ‘‘spegs’’ for E. granulosus s.l. were stained by the mAb EmG3IgM, mAb EmG3IgG1, mAb AgB, and mAb 2B2, while mAb Em2G11 reacted with spems and mAb Eg2 with spegs only. The laminated layer (LL) of both species was strongly visualized by using mAb EmG3IgM, mAb EmG3IgG1, mAb AgB, and mAb 2B2. The LL was specifically stained by mAb Em2G11 in E. multilocularis and by mAb Eg2 in E. granulosus s.l. In the germinal layer (GL), including the protoscoleces, a wide staining pattern with all structures of both species was observed with mAb EmG3IgG1, mAb EmG3IgM, mAb AgB, mAb 2B2, and mAb Em18. In the GL and protoscoleces, the mAb Eg2 displayed a strong E. granulosus s.l. specific binding, while mAb Em2G11 exhibited a weak granular E. multilocularis specific reaction. The most notable staining pattern in IHC-S was found with mAb Em18, which solely bound to the GL and protoscoleces of Echinococcus species and potentially to primary cells. To conclude, mAbs represent valuable tools for the visualization of major antigens in the most important Echinococcus species, as well as providing insights into parasite-host interactions and pathogenesis.
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Affiliation(s)
- Philipp A. Kronenberg
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, Zurich, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
- *Correspondence: Philipp A. Kronenberg, ; Peter Deplazes,
| | - Michael Reinehr
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ramon Marc Eichenberger
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, Zurich, Switzerland
- Microbiology and Molecular Biology, Institute of Chemistry and Biotechnology, Zurich University of Applied Sciences, Zurich University of Applied Sciences’ (ZHAW), Wädenswil, Switzerland
| | - Sina Hasler
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Teivi Laurimäe
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Achim Weber
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ansgar Deibel
- Department of Gastroenterology and Hepatology and Swiss HPB and Transplant Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Beat Müllhaupt
- Department of Gastroenterology and Hepatology and Swiss HPB and Transplant Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bruno Gottstein
- Institute for Infectious Diseases, Medical Faculty, University of Bern, Bern, Switzerland
| | - Norbert Müller
- Institute for Infectious Diseases, Medical Faculty, University of Bern, Bern, Switzerland
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Andrew Hemphill
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Peter Deplazes
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, Zurich, Switzerland
- Department of Gastroenterology and Hepatology and Swiss HPB and Transplant Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- *Correspondence: Philipp A. Kronenberg, ; Peter Deplazes,
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Autier B, Manuel C, Lundstroem-Stadelmann B, Girard JP, Gottstein B, Gangneux JP, Samson M, Robert-Gangneux F, Dion S. Endogenous IL-33 Accelerates Metacestode Growth during Late-Stage Alveolar Echinococcosis. Microbiol Spectr 2023; 11:e0423922. [PMID: 36786637 PMCID: PMC10101030 DOI: 10.1128/spectrum.04239-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/28/2023] [Indexed: 02/15/2023] Open
Abstract
During the course of the infectious disease alveolar echinococcosis (AE), the larval stage of Echinococcus multilocularis develops in the liver, where an initial Th1/Th17 immune response may allow its elimination in resistant individuals. In patients susceptible to infection and disease, the Th2 response initiates later, inducing tolerance to the parasite. The role of interleukin 33 (IL-33), an alarmin released during necrosis and known to drive a Th2 immune response, has not yet been described during AE. Wild-type (WT) and IL-33-/- C57BL/6J mice were infected by peritoneal inoculation with E. multilocularis metacestodes and euthanized 4 months later, and their immune response were analyzed. Immunofluorescence staining and IL-33 enzyme-linked immunosorbent assay (ELISA) were also performed on liver samples from human patients with AE. Overall, metacestode lesions were smaller in IL-33-/- mice than in WT mice. IL-33 was detected in periparasitic tissues, but not in mouse or human serum. In infected mice, endogenous IL-33 modified peritoneal macrophage polarization and cytokine profiles. Th2 cytokine concentrations were positively correlated with parasite mass in WT mice, but not in IL-33-/- mice. In human AE patients, IL-33 concentrations were higher in parasitic tissues than in distant liver parenchyma. The main sources of IL-33 were CD31+ endothelial cells of the neovasculature, present within lymphoid periparasitic infiltrates together with FOXP3+ Tregs. In the murine model, periparasitic IL-33 correlated with accelerated parasite growth putatively through the polarization of M2-like macrophages and release of immunosuppressive cytokines IL-10 and transforming growth factor β1 (TGF-β1). We concluded that IL-33 is a key alarmin in AE that contributes to the tolerogenic effect of systemic Th2 cytokines. IMPORTANCE Infection with the metacestode stage of Echinococcus multilocularis, known as alveolar echinococcosis, is the most severe cestodosis worldwide. However, less than 1% of exposed individuals, in which the immune system is unable to control the parasite, develop the disease. The factors responsible for this interindividual variability are not fully understood. In this in vivo study comparing wild-type and IL-33-/- infected mice, together with data from human clinical samples, we determined that IL-33, an alarmin released following tissue injury and involved in the pathogenesis of cancer and asthma, accelerates the progression of the disease by modulating the periparasitic microenvironment. This suggests that targeting IL-33 could be of interest for the management of patients with AE, and that IL-33 polymorphisms could be responsible for increased susceptibility to AE.
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Affiliation(s)
- Brice Autier
- IRSET (UMR_S 1085), INSERM (Institut de recherche en santé, environnement et travail), EHESP, CHU Rennes, University of Rennes, Rennes, France
| | - Christelle Manuel
- IRSET (UMR_S 1085), INSERM (Institut de recherche en santé, environnement et travail), EHESP, University of Rennes, Rennes, France
| | - Britta Lundstroem-Stadelmann
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Jean-Philippe Girard
- Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, Toulouse, France
| | - Bruno Gottstein
- Institute of Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Jean-Pierre Gangneux
- IRSET (UMR_S 1085), INSERM (Institut de recherche en santé, environnement et travail), EHESP, CHU Rennes, University of Rennes, Rennes, France
| | - Michel Samson
- IRSET (UMR_S 1085), INSERM (Institut de recherche en santé, environnement et travail), EHESP, University of Rennes, Rennes, France
| | - Florence Robert-Gangneux
- IRSET (UMR_S 1085), INSERM (Institut de recherche en santé, environnement et travail), EHESP, CHU Rennes, University of Rennes, Rennes, France
| | - Sarah Dion
- IRSET (UMR_S 1085), INSERM (Institut de recherche en santé, environnement et travail), EHESP, University of Rennes, Rennes, France
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Autier B, Gottstein B, Millon L, Ramharter M, Gruener B, Bresson-Hadni S, Dion S, Robert-Gangneux F. Alveolar echinococcosis in immunocompromised hosts. Clin Microbiol Infect 2022; 29:593-599. [PMID: 36528295 DOI: 10.1016/j.cmi.2022.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Alveolar echinococcosis (AE) results of an infection with the larval stage of Echinococcus multilocularis. It has been increasingly described in individuals with impaired immune responsiveness. OBJECTIVES This narrative review aims at describing the presentation of AE according to the type of immune impairment, based on retrospective cohorts and case reports. Implications for patient management and future research are proposed accordingly. SOURCES Targeted search was conducted in PubMed using ((alveolar echinococcosis) OR (multilocularis)) AND ((immunosuppressive) OR (immunodeficiency) OR (AIDS) OR (solid organ transplant) OR (autoimmunity) OR (immune deficiency)). Only publications in English were considered. CONTENT Seventeen publications were found, including 13 reports of 55 AE in immunocompromised patients (AE/IS) and 4 retrospective studies of 755 AE immunocompetent patients and 115 AE/IS (13%). The cohorts included 9 (1%) solid organ transplantation (SOT) recipients, 2 (0.2%) HIV patients, 41 (4.7%) with chronic inflammatory/autoimmune diseases (I/AID) and 72 (8.3%) with malignancies. SOT, I/AID and malignancies, but not HIV infection, were significantly associated with AE (odds ratios of 10.8, 1.6, 5.9, and 1.3, respectively). Compared to AE immunocompetent patients, AE/IS was associated with earlier diagnosis (PNM stages I-II: 49/85 (58%) vs. 137/348 (39%), p < 0.001), high rate of atypical imaging (24/50 (48%) vs. 106/375 (28%), p < 0.01), and low sensitivity of serology (19/77 (25%) vs. 265/329 (81%), p < 0.001). Unusually extensive or disseminated infections were described in SOT and I/AID patients. IMPLICATIONS Patients who live in endemic areas should benefit from serology before onset of a long-term immunosuppressive therapy, even if the cost-benefit ratio has to be evaluated. Physicians should explain AE to immunocompromised patients and think about AE when finding a liver lesion. Further research should address gaps in knowledge of AE/IS. Especially, extensive and accurate records of AE cases have to be collected by multinational registries.
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Affiliation(s)
- Brice Autier
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, Rennes, France.
| | - Bruno Gottstein
- Institute of Infectious Diseases, Faculty of Medicine, University of Bern, CH-3012, Bern, Switzerland
| | - Laurence Millon
- Department of Parasitology-Mycology, National Reference Centre for Echinococcoses, University Hospital of Besançon, France; UMR CNRS 6249 Laboratoire Chrono-environnement, Université Bourgogne-Franche-Comté, Besançon, France; European Study Group of Clinical Parasitology, ESCMID, Basel, Switzerland
| | - Michael Ramharter
- European Study Group of Clinical Parasitology, ESCMID, Basel, Switzerland; Center for Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Dept. of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Beate Gruener
- Division of Infectious Diseases, Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
| | - Solange Bresson-Hadni
- Department of Parasitology-Mycology, National Reference Centre for Echinococcoses, University Hospital of Besançon, France; Division of Tropical and Humanitarian Medicine and Gastroenterology and Hepatology Unit, Faculty of Medicine, University Hospitals of Geneva, Switzerland
| | - Sarah Dion
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Florence Robert-Gangneux
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, Rennes, France; European Study Group of Clinical Parasitology, ESCMID, Basel, Switzerland
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7
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Polish LB, O'Connell EM, Barth TFE, Gottstein B, Zajac A, Gibson PC, Bah A, Kirchgessner M, Estrada M, Seguin MA, Ramirez-Barrios R. European Haplotype of <i>Echinococcus multilocularis</i> in the United States. N Engl J Med 2022; 387:1902-1904. [PMID: 36383717 PMCID: PMC10072850 DOI: 10.1056/nejmc2210000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Louis B Polish
- University of Vermont Larner College of Medicine, Burlington, VT
| | | | | | | | - Anne Zajac
- Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA
| | - Pamela C Gibson
- University of Vermont Larner College of Medicine, Burlington, VT
| | - Aissatou Bah
- National Institute of Allergy and Infectious Diseases, Bethesda, MD
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8
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Young BC, Bush SJ, Lipworth S, George S, Dingle KE, Sanderson N, Brankin A, Walker T, Sharma S, Leong J, Plaha P, Hofer M, Chiodini P, Gottstein B, Furrer L, Crook D, Brent A. Modern Solutions for Ancient Pathogens: Direct Pathogen Sequencing for Diagnosis of Lepromatous Leprosy and Cerebral Coenurosis. Open Forum Infect Dis 2022; 9:ofac428. [PMID: 36119959 PMCID: PMC9472670 DOI: 10.1093/ofid/ofac428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/21/2022] [Indexed: 11/26/2022] Open
Abstract
Microbes unculturable in vitro remain diagnostically challenging, dependent historically on clinical findings, histology, or targeted molecular detection. We applied whole-genome sequencing directly from tissue to diagnose infections with mycobacteria (leprosy) and parasites (coenurosis). Direct pathogen DNA sequencing provides flexible solutions to diagnosis of difficult pathogens in diverse contexts.
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Affiliation(s)
- Bernadette C Young
- Correspondence: Bernadette Young, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK ()
| | - Stephen J Bush
- Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Sam Lipworth
- Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Sophie George
- Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Kate E Dingle
- Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Nick Sanderson
- Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Alice Brankin
- Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Timothy Walker
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Srilakshmi Sharma
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
| | - James Leong
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
| | - Puneet Plaha
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Monika Hofer
- Department of Neuropathology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
| | - Peter Chiodini
- Hospital of Tropical Diseases and the London School of Hygiene and Tropical Medicine London, London, United Kingdom
| | - B Gottstein
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Lavinia Furrer
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Derrick Crook
- Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
- Microbiology and Infectious Diseases Department, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom
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9
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Kronenberg PA, Deibel A, Gottstein B, Grimm F, Müllhaupt B, Meyer zu Schwabedissen C, Aitbaev S, Omorov RA, Abdykerimov KK, Minbaeva G, Usubalieva J, Siles-Lucas M, Pepe P, Rinaldi L, Spiliotis M, Wang J, Müller N, Torgerson PR, Deplazes P. Serological Assays for Alveolar and Cystic Echinococcosis—A Comparative Multi-Test Study in Switzerland and Kyrgyzstan. Pathogens 2022; 11:pathogens11050518. [PMID: 35631039 PMCID: PMC9146094 DOI: 10.3390/pathogens11050518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/22/2022] [Accepted: 04/24/2022] [Indexed: 12/04/2022] Open
Abstract
Both alveolar (AE) and cystic echinococcosis (CE) are lacking pathognomonic clinical signs; consequently imaging technologies and serology remain the main pillars for diagnosis. The present study included 100 confirmed treatment-naïve AE and 64 CE patients that were diagnosed in Switzerland or Kyrgyzstan. Overall, 10 native Echinococcus spp. antigens, 3 recombinant antigens, and 4 commercial assays were comparatively evaluated. All native E. multilocularis antigens were produced in duplicates with a European and a Kyrgyz isolate and showed identical test values for the diagnosis of AE and CE. Native antigens and three commercial tests showed high diagnostic sensitivities (Se: 86–96%) and specificities (Sp: 96–99%) for the diagnosis of AE and CE in Swiss patients. In Kyrgyz patients, values of sensitivities and specificities were 10–20% lower as compared to the Swiss patients’ findings. For the sero-diagnosis of AE in Kyrgyzstan, a test-combination of an E. multilocularis protoscolex antigen and the recombinant antigen Em95 appears to be the most suitable test strategy (Se: 98%, Sp: 87%). For the diagnosis of CE in both countries, test performances were hampered by major cross-reactions with AE patients and other parasitic diseases as well as by limited diagnostic sensitivities (93% in Switzerland and 76% in Kyrgyzstan, respectively).
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Affiliation(s)
- Philipp A. Kronenberg
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, 8075 Zurich, Switzerland;
- Graduate School for Cellular and Biomedical Sciences, University of Bern, 3012 Bern, Switzerland
- Correspondence: (P.A.K.); (P.D.); Tel.: +41-(0)44-635-87-01 (P.A.K.)
| | - Ansgar Deibel
- Clinics of Hepatology and Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland; (A.D.); (B.M.); (C.M.z.S.)
| | - Bruno Gottstein
- Laboratory of Parasitology, Institute for Infectious Diseases, Medical Faculty, University of Bern, 3001 Bern, Switzerland; (B.G.); (M.S.); (J.W.)
| | - Felix Grimm
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, 8075 Zurich, Switzerland;
| | - Beat Müllhaupt
- Clinics of Hepatology and Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland; (A.D.); (B.M.); (C.M.z.S.)
| | - Cordula Meyer zu Schwabedissen
- Clinics of Hepatology and Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland; (A.D.); (B.M.); (C.M.z.S.)
| | - Sezdbek Aitbaev
- City Clinical Hospital #1, Surgical Department, Faculty of Surgery of the Kyrgyz State Medical Academy, Bishkek 720054, Kyrgyzstan; (S.A.); (R.A.O.)
| | - Rakhatbek A. Omorov
- City Clinical Hospital #1, Surgical Department, Faculty of Surgery of the Kyrgyz State Medical Academy, Bishkek 720054, Kyrgyzstan; (S.A.); (R.A.O.)
| | - Kubanychbek K. Abdykerimov
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland; (K.K.A.); (P.R.T.)
- Life Science Zürich Graduate School, University of Zürich, 8057 Zurich, Switzerland
| | - Gulnara Minbaeva
- Government Sanito-Epidemiology Unit, Kyrgyz Ministry of Health, Bishkek 720033, Kyrgyzstan; (G.M.); (J.U.)
| | - Jumagul Usubalieva
- Government Sanito-Epidemiology Unit, Kyrgyz Ministry of Health, Bishkek 720033, Kyrgyzstan; (G.M.); (J.U.)
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales y Agrobiologia (IRNASA-CSIC), 37008 Salamanca, Spain;
| | - Paola Pepe
- Unit of Parasitology and Parasitic Diseases, Department of Veterinary Medicine and Animal Production, University of Naples Federico II, 80138 Naples, Italy; (P.P.); (L.R.)
| | - Laura Rinaldi
- Unit of Parasitology and Parasitic Diseases, Department of Veterinary Medicine and Animal Production, University of Naples Federico II, 80138 Naples, Italy; (P.P.); (L.R.)
| | - Markus Spiliotis
- Laboratory of Parasitology, Institute for Infectious Diseases, Medical Faculty, University of Bern, 3001 Bern, Switzerland; (B.G.); (M.S.); (J.W.)
| | - Junhua Wang
- Laboratory of Parasitology, Institute for Infectious Diseases, Medical Faculty, University of Bern, 3001 Bern, Switzerland; (B.G.); (M.S.); (J.W.)
| | - Norbert Müller
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland;
| | - Paul R. Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland; (K.K.A.); (P.R.T.)
| | - Peter Deplazes
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, 8075 Zurich, Switzerland;
- Correspondence: (P.A.K.); (P.D.); Tel.: +41-(0)44-635-87-01 (P.A.K.)
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10
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Weingartner M, Stücheli S, Jebbawi F, Gottstein B, Beldi G, Lundström-Stadelmann B, Wang J, Odermatt A. Albendazole reduces hepatic inflammation and endoplasmic reticulum-stress in a mouse model of chronic Echinococcus multilocularis infection. PLoS Negl Trop Dis 2022; 16:e0009192. [PMID: 35030165 PMCID: PMC8794265 DOI: 10.1371/journal.pntd.0009192] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 01/27/2022] [Accepted: 12/20/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Echinococcus multilocularis causes alveolar echinococcosis (AE), a rising zoonotic disease in the northern hemisphere. Treatment of this fatal disease is limited to chemotherapy using benzimidazoles and surgical intervention, with frequent disease recurrence in cases without radical surgery. Elucidating the molecular mechanisms underlying E. multilocularis infections and host-parasite interactions ultimately aids developing novel therapeutic options. This study explored an involvement of unfolded protein response (UPR) and endoplasmic reticulum-stress (ERS) during E. multilocularis infection in mice. METHODS E. multilocularis- and mock-infected C57BL/6 mice were subdivided into vehicle, albendazole (ABZ) and anti-programmed death ligand 1 (αPD-L1) treated groups. To mimic a chronic infection, treatments of mice started six weeks post i.p. infection and continued for another eight weeks. Liver tissue was then collected to examine inflammatory cytokines and the expression of UPR- and ERS-related genes. RESULTS E. multilocularis infection led to an upregulation of UPR- and ERS-related proteins in the liver, including ATF6, CHOP, GRP78, ERp72, H6PD and calreticulin, whilst PERK and its target eIF2α were not affected, and IRE1α and ATF4 were downregulated. ABZ treatment in E. multilocularis infected mice reversed, or at least tended to reverse, these protein expression changes to levels seen in mock-infected mice. Furthermore, ABZ treatment reversed the elevated levels of interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α and interferon (IFN)-γ in the liver of infected mice. Similar to ABZ, αPD-L1 immune-treatment tended to reverse the increased CHOP and decreased ATF4 and IRE1α expression levels. CONCLUSIONS AND SIGNIFICANCE AE caused chronic inflammation, UPR activation and ERS in mice. The E. multilocularis-induced inflammation and consecutive ERS was ameliorated by ABZ and αPD-L1 treatment, indicating their effectiveness to inhibit parasite proliferation and downregulate its activity status. Neither ABZ nor αPD-L1 themselves affected UPR in control mice. Further research is needed to elucidate the link between inflammation, UPR and ERS, and if these pathways offer potential for improved therapies of patients with AE.
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Affiliation(s)
- Michael Weingartner
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Simon Stücheli
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Fadi Jebbawi
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Bruno Gottstein
- Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Guido Beldi
- Department of Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland
| | | | - Junhua Wang
- Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Alex Odermatt
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
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11
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Diem S, Gottstein B, Beldi G, Semmo N, Diem LF. Accelerated Course of Alveolar Echinococcosis After Treatment With Steroids in a Patient With Autoimmune Encephalitis. Cureus 2021; 13:e18831. [PMID: 34820209 PMCID: PMC8596569 DOI: 10.7759/cureus.18831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2021] [Indexed: 01/11/2023] Open
Abstract
Human alveolar echinococcosis (AE) is a zoonotic infection caused by the fox tapeworm Echinococcus multilocularis. We report the case of a patient who developed an accelerated course of AE with diffuse liver involvement after high-dose steroid treatment for autoimmune encephalitis. Immunosuppressive therapies present us with new challenges regarding the management of AE. With this article, we would like to draw attention to the importance of a screening program for AE before planned immunosuppressive therapy.
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Affiliation(s)
- Stefan Diem
- Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, CHE
| | - Bruno Gottstein
- Institute of Infectious Disease, Faculty of Medicine, University of Bern, Bern, CHE
| | - Guido Beldi
- Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, CHE
| | - Nasser Semmo
- Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, CHE
| | - Lara F Diem
- Department of Neurology, Bern University Hospital, University of Bern, Bern, CHE
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12
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Herzig M, Maksimov P, Staubach C, Romig T, Knapp J, Gottstein B, Conraths FJ. Red foxes harbor two genetically distinct, spatially separated Echinococcus multilocularis clusters in Brandenburg, Germany. Parasit Vectors 2021; 14:535. [PMID: 34649615 PMCID: PMC8518320 DOI: 10.1186/s13071-021-05038-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/24/2021] [Indexed: 12/28/2022] Open
Abstract
Background Alveolar echinococcosis (AE) is a clinically serious zoonosis caused by the fox tapeworm Echinococcus multilocularis. We studied the diversity and the distribution of genotypes of E. multilocularis isolated from foxes in Brandenburg, Germany, and in comparison to a hunting ground in North Rhine-Westphalia. Methods Echinococcus multilocularis specimens from 101 foxes, 91 derived from Brandenburg and 10 derived from North Rhine-Westphalia, were examined. To detect potential mixed infections with different genotypes of E. multilocularis, five worms per fox were analyzed. For genotyping, three mitochondrial markers, namely cytochrome c oxidase subunit 1 (Cox1), NADH dehydrogenase subunit 1 (Nad1), and ATP synthase subunit 6 (ATP6), and the nuclear microsatellite marker EmsB were used. To identify nucleotide polymorphisms, the mitochondrial markers were sequenced and the data were compared, including with published sequences from other regions. EmsB fragment length profiles were determined and confirmed by Kohonen network analysis and grouping of Sammon’s nonlinear mapping with k-means clustering. The spatial distribution of genotypes was analyzed by SaTScan for the EmsB profiles found in Brandenburg. Results With both the mitochondrial makers and the EmsB microsatellite fragment length profile analyses, mixed infections with different E. multilocularis genotypes were detected in foxes from Brandenburg and North Rhine-Westphalia. Genotyping using the mitochondrial markers showed that the examined parasite specimens belong to the European haplotype of E. multilocularis, but a detailed spatial analysis was not possible due to the limited heterogeneity of these markers in the parasite population. Four (D, E, G, and H) out of the five EmsB profiles described in Europe so far were detected in the samples from Brandenburg and North Rhine-Westphalia. The EmsB profile G was the most common. A spatial cluster of the E. multilocularis genotype with the EmsB profile G was found in northeastern Brandenburg, and a cluster of profile D was found in southern parts of this state. Conclusions Genotyping of E. multilocularis showed that individual foxes may harbor different genotypes of the parasite. EmsB profiles allowed the identification of spatial clusters, which may help in understanding the distribution and spread of the infection in wildlife, and in relatively small endemic areas. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-05038-0.
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Affiliation(s)
- Mandy Herzig
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Südufer 10, 17493, Greifswald-Insel Riems, Germany
| | - Pavlo Maksimov
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Südufer 10, 17493, Greifswald-Insel Riems, Germany
| | - Christoph Staubach
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Südufer 10, 17493, Greifswald-Insel Riems, Germany
| | - Thomas Romig
- Universität Hohenheim, Institut Für Biologie, Fachgebiet Parasitologie, Emil-Wolff-Straße 34, 70599, Stuttgart, Germany
| | - Jenny Knapp
- UMR CNRS 6249 Laboratoire Chrono-Environnement, Université Bourgogne Franche-Comté, 16 Route de Gray, 25030, Besançon, France.,Department of Parasitology-Mycology, National Reference Centre for Echinococcoses, University Hospital of Besançon, 25030, Besançon, France
| | - Bruno Gottstein
- Institute for Infectious Diseases, Faculty of Medicine, University of Berne, 3001, Berne, Switzerland
| | - Franz J Conraths
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Südufer 10, 17493, Greifswald-Insel Riems, Germany.
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13
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Ben Salah E, Barrera C, Sakly W, Mosbahi S, Balliau T, Franche N, Gottstein B, Ben Youssef S, Mekki M, Babba H, Millon L. Novel biomarkers for the early prediction of pediatric cystic echinococcosis post-surgical outcomes. J Infect 2021; 84:87-93. [PMID: 34614401 DOI: 10.1016/j.jinf.2021.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aims to search for reliable serological biomarkers allowing the early prediction of cystic echinococcosis (CE) post-operative outcomes. METHODS We applied immunoprecipitation (IP) of Echinococcus granulosus protoscolex antigens with pediatric CE patients' plasma collected at 1-month and 1-year post-surgery, followed by Liquid Chromatography with tandem mass spectrometry (LC-MS/MS). We compared IP proteomic content from relapsed patients within the first-year post-surgery (RCE) to cases with no relapses until 3 post-operative years (NRCE). Selected proteins were recombinantly synthesized and assessed for their prognostic performance by Enzyme-linked immunosorbent assay (ELISA). RESULTS A total of 305 immunoreactive parasitic proteins were identified, 59 of which were significantly more abundant in RCE than NRCE for both time-points. Four proteins showed the most promising characteristics for predicting CE outcomes: cytoplasmic malate dehydrogenase (Eg-cMDH), citrate synthase (Eg-CS), annexin A6 and severin. ELISA-IgG against the four markers were significantly lower at 1-year post-surgery than 1-month in NRCE, in contrast to RCE that displayed either stable or higher levels. The Eg-cMDH and Eg-CS showed the best prognostic performance, with respective probabilities of being "relapse-free" of 83% and 81%, if a decrease of IgG levels occurred between 1-month and 1-year post-surgery. CONCLUSION The Eg-cMDH and Eg-CS are promising biomarkers to predict early CE post-surgical outcomes.
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Affiliation(s)
- Eya Ben Salah
- Département de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire LR12ES08, Université de Monastir, Monastir, Tunisia; National French Reference Centre for Echinococcosis, University Hospital, University Bourgogne Franche-Comté, Bd Fleming, Besançon F-25000, France; Department of Parasitology Mycology, University Hospital of Besançon, UMR/ CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France.
| | - Coralie Barrera
- National French Reference Centre for Echinococcosis, University Hospital, University Bourgogne Franche-Comté, Bd Fleming, Besançon F-25000, France; Department of Parasitology Mycology, University Hospital of Besançon, UMR/ CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France.
| | - Wahiba Sakly
- Département de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire LR12ES08, Université de Monastir, Monastir, Tunisia.
| | - Sana Mosbahi
- Paediatric Surgery Department, Laboratory of Malformative and Tumor Pathology in Children (LR12SP13), Medical School, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Thierry Balliau
- PAPPSO, INRAE, CNRS, AgroParisTech, Université Paris-Saclay, GQE-Le Moulon, Gif-sur-Yvette 91190, France.
| | - Nathalie Franche
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/ CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France.
| | - Bruno Gottstein
- Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland.
| | - Sabrine Ben Youssef
- Paediatric Surgery Department, Laboratory of Malformative and Tumor Pathology in Children (LR12SP13), Medical School, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Mongi Mekki
- Paediatric Surgery Department, Laboratory of Malformative and Tumor Pathology in Children (LR12SP13), Medical School, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Hamouda Babba
- Département de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire LR12ES08, Université de Monastir, Monastir, Tunisia.
| | - Laurence Millon
- National French Reference Centre for Echinococcosis, University Hospital, University Bourgogne Franche-Comté, Bd Fleming, Besançon F-25000, France; Department of Parasitology Mycology, University Hospital of Besançon, UMR/ CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France.
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14
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Abstract
PURPOSE OF REVIEW Infection with the larval (metacestode) stage of Echinococcus multilocularis causes alveolar echinococcosis (AE), a serious hepatic disorder. The parasite has increased its infection extensity in wildlife and domestic dogs, mainly due to urbanization and spatial extension of wildlife hosts in Europe, Asia as well as North America, resulting in emerging infection risk for humans. RECENT FINDINGS In hyperendemic areas such as Kyrgyzstan and China, ecological and socioeconomic changes have been associated with the unpredictable increase of AE cases. In North America, the appearance of the European-like genotype is of concern. In Europe, the annual increase of human case numbers reached a plateau even in hyperendemic situations. Therefore, we conclude that most of the exposed individuals are resistant to parasite invasion and/or to disease development. Thus, AE develops in a few healthy individuals, but preferentially in immunosuppressed patients. SUMMARY In the future, improved diagnostic strategies will allow more precise estimations of transmission routes including the role of food, water and direct dog contact, which should yield improved public health recommendations. Finally, understanding protective innate and acquired immune mechanisms as well as parasite-driven immune-evasion processes will be essential to develop curative therapies in nonoperable patients and, futuristically, appropriate vaccines.
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Affiliation(s)
- Bruno Gottstein
- Institute of Infectious Diseases, Faculty of Medicine, University of Bern, Bern
| | - Peter Deplazes
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Zurich, Zurich, Switzerland
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15
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Jebbawi F, Bellanger AP, Lunström-Stadelmann B, Rufener R, Dosch M, Goepfert C, Gottstein B, Millon L, Grandgirard D, Leib SL, Beldi G, Wang J. Innate and adaptive immune responses following PD-L1 blockade in treating chronic murine alveolar echinococcosis. Parasite Immunol 2021; 43:e12834. [PMID: 33754355 DOI: 10.1111/pim.12834] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/10/2021] [Accepted: 03/17/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) immune checkpoint blockade are efficacious in certain cancer therapies. OBJECTIVES The present study aimed to provide a picture about the development of innate and adaptive immune responses upon PD-L1 blockade in treating chronic murine AE. METHODS Immune treatment started at 6 weeks post-E. multilocularis infection, and was maintained for 8 weeks with twice per week anti-PD-L1 administration (intraperitoneal). The study included an outgroup-control with mice perorally medicated with albendazole 5 d/wk, and another one with both treatments combined. Assessment of treatment efficacy was based on determining parasite weight, innate and adaptive immune cell profiles, histopathology and liver tissue cytokine levels. RESULTS/CONCLUSIONS Findings showed that the parasite load was significantly reduced in response to PD-L1 blockade, and this blockade (a) contributed to T-cell activity by increasing CD4+ /CD8+ effector T cells, and decreasing Tregs; (b) had the capacity to restore DCs and Kupffer cells/Macrophages; (c) suppressed NKT and NK cells; and thus (d) lead to an improved control of E. multilocularis infection in mice. This study suggests that the PD-L1 pathway plays an important role by regulating adaptive and innate immune cells against E. multilocularis infection, with significant modulation of tissue inflammation.
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Affiliation(s)
- Fadi Jebbawi
- Department of Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Anne-Pauline Bellanger
- Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France
| | - Britta Lunström-Stadelmann
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Reto Rufener
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Michel Dosch
- Department of Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Christine Goepfert
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Animal Pathology, COMPATH, University of Bern, Switzerland
| | - Bruno Gottstein
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Laurence Millon
- Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France
| | - Denis Grandgirard
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Stephen L Leib
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Guido Beldi
- Department of Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Junhua Wang
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland.,Institute for Infectious Diseases, University of Bern, Bern, Switzerland
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16
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Houston S, Belga S, Buttenschoen K, Cooper R, Girgis S, Gottstein B, Low G, Massolo A, MacDonald C, Müller N, Preiksaitis J, Sarlieve P, Vaughan S, Kowalewska-Grochowska K. Epidemiological and Clinical Characteristics of Alveolar Echinococcosis: An Emerging Infectious Disease in Alberta, Canada. Am J Trop Med Hyg 2021; 104:1863-1869. [PMID: 33755579 PMCID: PMC8103444 DOI: 10.4269/ajtmh.20-1577] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/26/2021] [Indexed: 01/29/2023] Open
Abstract
Human alveolar echinococcosis (AE) is a zoonotic cestode infection which is usually fatal in the absence of treatment. Treatment involves major surgery or indefinite antiparasitic therapy. The incidence is rising in Europe and Asia, with an increased risk observed in immunocompromised individuals. Previously, AE acquisition in North America was extremely rare, except for one remote Alaskan Island. Recent studies have demonstrated a new European-like strain of Echinococcus multilocularis (Em) in wildlife and in human AE in western Canada. We report the experience of all AE patients diagnosed in Alberta. Each was diagnosed by histopathology, serology, and PCR-confirmed by a reference laboratory. Seventeen cases of human AE, aged 19-78 years, nine females, were diagnosed between 2013 and 2020: all definitely or probably acquired in Alberta. Six lived in urban areas, and 14 had kept dogs. In eight, the lesions were found incidentally on abdominal imaging performed for other indications. Six were immunocompromised to varying degrees. Six were first diagnosed at surgery. All have been recommended benzimidazole therapy. One died of surgical complications. Clinicians should be aware of this diagnostic possibility in patients presenting with focal nonmalignant hepatic mass lesions. Greater urbanization of coyotes, the predominant definitive host of Em in Alberta, and growing numbers of immune suppressed individuals in the human population may lead to increasing recognition of AE in North America.
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Affiliation(s)
- Stan Houston
- University of Alberta, Edmonton, Canada;,Address correspondence to Stan Houston, University of Alberta, 1-124 Clinical Sciences Bldg., 11350 83 Ave., Edmonton T6G 2G3, Canada. E-mail:
| | - Sara Belga
- University of Alberta, Edmonton, Canada;,University of British Columbia, Vancouver, Canada
| | | | | | | | | | - Gavin Low
- University of Alberta, Edmonton, Canada
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17
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Tamarozzi F, Silva R, Fittipaldo VA, Buonfrate D, Gottstein B, Siles-Lucas M. Serology for the diagnosis of human hepatic cystic echinococcosis and its relation with cyst staging: A systematic review of the literature with meta-analysis. PLoS Negl Trop Dis 2021; 15:e0009370. [PMID: 33909640 PMCID: PMC8081258 DOI: 10.1371/journal.pntd.0009370] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 04/07/2021] [Indexed: 01/13/2023] Open
Abstract
Background The diagnosis of cystic echinococcosis (CE) is primarily based on imaging, while serology should be applied when imaging is inconclusive. CE cyst stage has been reported among the most important factors influencing the outcome of serodiagnosis. We performed a systematic review and meta-analysis of the relation between cyst stage of hepatic CE and diagnostic sensitivity of serological tests, to evaluate whether their relation is a consistent finding and provide guidance for the interpretation of results of serological tests. Methodology/Principal findings MEDLINE, EMBASE, CENTRAL, and Lilacs databases were searched on December 1st 2019. Original studies published after 2003 (year of publication of the CE cyst classification), reporting sensitivity of serological tests applied to the diagnosis of human hepatic CE, as diagnosed and staged by imaging, were included. The quality of studies was assessed using the Newcastle-Ottawa Scale. Data from 14 studies were included in the meta-analysis. Summary estimates of sensitivities and 95% confidence intervals were obtained using random effects meta-analysis. Overall, test sensitivity was highest in the presence of CE2 and CE3 (CE3a and/or CE3b), and lowest in the presence of CE5 and CE4 cysts. ELISA, ICT and WB showed the highest sensitivities, while IHA performed worst. Conclusions/Significance The results of our study confirm the presence of a clear and consistent relation between cyst stage and serological tests results. Limitations of evidence included the heterogeneity of the antigenic preparations used, which prevented to determine whether the relation between cyst stage and sensitivity was influenced by the type of antigenic preparation, the paucity of studies testing the same panel of sera with different assays, and the lack of studies assessing the performance of the same assay in both field and hospital-based settings. Our results indicate the absolute need to consider cyst staging when evaluating serological results of patients with hepatic CE. Cystic echinococcosis is a neglected zoonosis induced by the development of parasitic cysts in intermediate hosts, including humans, mostly in the liver. The diagnosis of CE is based on imaging. As CE cysts may assume different aspects (stages), the range of differential diagnoses is broad, from harmless simple cysts to neoplasms. Serological assays for the detection of serum antibodies are applied when imaging is inconclusive, but their performance depend on a number of factors, among which cyst stage has been reported as important. If this was a robust finding, it would be absolutely required to interpret serological findings in the light of CE cyst staging. The results of our systematic review and meta-analysis of the relation between cyst stage of hepatic CE and diagnostic sensitivity of serological tests confirmed that such relation is clear and consistent, and indicate the absolute need to consider cyst staging when evaluating serology results of patients with hepatic CE.
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Affiliation(s)
- Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
- * E-mail:
| | - Ronaldo Silva
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Veronica Andrea Fittipaldo
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Dora Buonfrate
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Bruno Gottstein
- Institute of Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), Salamanca, Spain
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18
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Polish LB, Pritt B, Barth TFE, Gottstein B, O’Connell EM, Gibson PC. First European Haplotype of Echinococcus multilocularis Identified in the United States: An Emerging Disease? Clin Infect Dis 2021; 72:1117-1123. [PMID: 32198510 PMCID: PMC8028098 DOI: 10.1093/cid/ciaa245] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 03/16/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Echinococcus multilocularis is one of the most severe and lethal parasitic diseases of humans, most often reported in Europe and Asia. Only 1 previous case has been documented in the contiguous United States from Minnesota in 1977. European haplotypes have been identified in carnivores and domestic dogs as well as recently in patients in western and central Canada. METHODS We used immunohistochemical testing with the monoclonal antibody Em2G11 and a species-specific enzyme-linked immunosorbent assay affinity-purified antigen Em2, as well as COX1 gene sequencing. RESULTS Using pathology, immunohistochemical staining, specific immunodiagnostic testing, and COX1 gene sequencing, we were able to definitively identify E. multilocularis as the causative agent of our patient's liver and lung lesions, which clustered most closely with the European haplotype. CONCLUSIONS We have identified the first case of a European haplotype E. multilocularis in the United States and the first case of this parasitic infection east of the Mississippi River. Given the identification of this haplotype in Canada, this appears to be an emerging infectious disease in North America.
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Affiliation(s)
- Louis B Polish
- Division of Infectious Diseases, University of Vermont Larner College of Medicine, Burlington, Vermont, USA
| | - Bobbi Pritt
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Bruno Gottstein
- Institute of Infectious Diseases, University of Bern, Bern, Switzerland
| | - Elise M O’Connell
- Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Pamela C Gibson
- Department of Pathology and Laboratory Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont, USA
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19
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Salah EB, Barrera C, Mosbahi S, Gottstein B, Siles-Lucas M, Belhassen S, Nouri A, Babba H, Millon L, Sakly W. Promising proteins detected by Western blot from Echinococcus granulosus protoscoleces for predicting early post-surgical outcomes in CE-affected Tunisian children. Parasit Vectors 2021; 14:180. [PMID: 33781311 PMCID: PMC8008569 DOI: 10.1186/s13071-021-04679-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/11/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Cystic echinococcosis (CE) affects predominantly young patients in highly endemic areas. Improved serological methods are needed for the follow-up of CE cases, especially given the high rates of post-surgical relapse that require detection as soon as possible. METHODS We designed a study to investigate the value of antigenic proteins extracted from Echinococcus granulosus (E. granulosus) protoscoleces, and of recombinant B2t and 2B2t proteins, for assessing the efficacy of surgical treatment carried out on CE-affected children. This study was performed on 278 plasma samples collected from 59 Tunisian children surgically treated for CE and monitored for 3 years post-surgery. The patients were classified according to post-surgical outcomes into a "non-relapsed" (NRCE) and a "relapsed" (RCE) group. We performed in-house ELISAs to measure anti-B2t and anti-2B2t IgG and immunoblotting for the detection of IgG against SDS-PAGE-resolved E. granulosus protoscoleces-specific antigens. The Wilcoxon test was applied to assess anti-B2t and anti-2B2t IgG levels. We applied the Cochran Q test to compare the distribution of immunoblotting antigenic bands between 1-month and 1-year post-surgery. RESULTS The probability of being "relapse-free" when a decrease in antibody titers occurred between 1 month and 1 year post-surgery was 81% and 75%, respectively, for anti-B2t and anti-2B2t IgG. We identified five protoscolex protein bands of 20, 26/27, 30, 40 and 46 kDa as highly immunoreactive by immunoblot for both RCE and NRCE patients at 1 month post-surgery, and significantly lower immunoreactivity after 1 year (p < 10-4) for NRCE compared to RCE patients. The proteins at 26/27 and 40 kDa displayed the best performance in predicting the outcome, with an 84% probability of being relapse-free when the reactivity against the 40 kDa antigen, the doublet at 26/27 kDa, or both was absent or disappeared between 1 month and 1 year post-surgery, and a 93% probability of being relapsed when both bands remained reactive or increased in intensity between the two time points. CONCLUSIONS The B2t protein could be useful for the prediction of CE early post-surgical outcomes. The proteins of E. granulosus protoscoleces, especially the doublet P26/27 and P40, could be promising predictive biomarkers for the post-surgical follow-up of CE cases as well.
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Affiliation(s)
- Eya Ben Salah
- Département de Biologie Clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale Et Moléculaire, LR12ES08, Université de Monastir, 1 Rue Avicenne, 5000, Monastir, Tunisie
| | - Coralie Barrera
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, Besançon, France
| | - Sana Mosbahi
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Medical School , Monastir, Tunisia
| | - Bruno Gottstein
- Institute for Infectious Diseases, Faculty of Medicine, University of Bern, 3001, Bern, Switzerland
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales Y Agrobiología de Salamanca (IRNASA-CSIC), 37008, Salamanca, España
| | - Samia Belhassen
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Medical School , Monastir, Tunisia
| | - Abdellatif Nouri
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Medical School , Monastir, Tunisia
| | - Hamouda Babba
- Département de Biologie Clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale Et Moléculaire, LR12ES08, Université de Monastir, 1 Rue Avicenne, 5000, Monastir, Tunisie
| | - Laurence Millon
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, Besançon, France
| | - Wahiba Sakly
- Département de Biologie Clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale Et Moléculaire, LR12ES08, Université de Monastir, 1 Rue Avicenne, 5000, Monastir, Tunisie.
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20
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Bellanger AP, Wang J, Gbaguidi-Haore H, Barrera C, Bresson-Hadni S, Zlobec I, Lachenmayer A, Richou C, Turco C, Gottstein B, Millon L, Beldi G. Investigating new serological and tissue markers for the follow-up of patients operated for alveolar echinococcosis. Parasite Immunol 2021; 43:e12827. [PMID: 33655559 DOI: 10.1111/pim.12827] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/11/2021] [Accepted: 02/26/2021] [Indexed: 01/17/2023]
Abstract
AIMS Alveolar echinococcosis (AE) is characterized by a chronically progressing hepatic injury caused by Echinococcus multilocularis. Surgery presently remains the best curative option. Currently, biological predictive features derived from the resected specimens are not suitable to assess surgery efficacy. The present study was designed to investigate whether a selection of markers measured on the resected specimens exhibits predictive features related to parasite viability, or to a total elimination of the parasite, in addition to serological markers. METHODS AND RESULTS In a collaboration between two centres, one in France (Besançon), and one in Switzerland (Bern), samples from 40 AE patients were analysed by microarray and serology techniques, individually. Paired serum samples before and after surgery were obtained for 26 patients. In the sera, a significant decrease in PD-L1 levels was observed after surgery, in addition to anti-Em18 levels. In the liver tissue, low levels of Cluster of Differentiation (CD)-3 were correlated with the absence of serum anti-Em18 after surgery. CONCLUSION This study showed PD-L1 is promising as a potential serological marker and further confirmed the performance of anti-Em18 serology. Further studies on a larger cohort are needed to confirm the utility of performing systematically microarray on resected liver tissue.
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Affiliation(s)
- Anne-Pauline Bellanger
- Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France.,Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,National Reference Center for Echinococcosis, University Hospital of Besancon, Besançon, France
| | - Junhua Wang
- Faculty of Medicine, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | | | - Coralie Barrera
- Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,National Reference Center for Echinococcosis, University Hospital of Besancon, Besançon, France
| | - Solange Bresson-Hadni
- Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France.,National Reference Center for Echinococcosis, University Hospital of Besancon, Besançon, France
| | - Inti Zlobec
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Anja Lachenmayer
- Visceral Surgery Department, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Carine Richou
- National Reference Center for Echinococcosis, University Hospital of Besancon, Besançon, France.,Hepatology Department, University Hospital Jean Minjoz, Besancon, France
| | - Celia Turco
- Digestive Surgical Oncology Department, Liver transplantation Unit, University Hospital Jean Minjoz, Besancon, France
| | - Bruno Gottstein
- Faculty of Medicine, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Laurence Millon
- Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France.,Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,National Reference Center for Echinococcosis, University Hospital of Besancon, Besançon, France
| | - Guido Beldi
- Visceral Surgery Department, Inselspital, University Hospital of Bern, Bern, Switzerland
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21
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Ben Salah E, Sakly W, Barrera C, Mosbahi S, Bellanger AP, Farhani R, Ksia A, Gottstein B, Nouri A, Babba H, Millon L. Soluble programmed death-1 (sPD-1) as predictor of early surgical outcomes of paediatric cystic echinococcosis. Parasite Immunol 2020; 43:e12809. [PMID: 33207012 DOI: 10.1111/pim.12809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022]
Abstract
AIMS Following treatment, cystic echinococcosis (CE) exhibits a relatively high relapse rate. Here, we evaluated the value of soluble programmed death-1 (sPD-1), sPD-1 ligand (sPD-L1) and anti-recP29 antibody concentrations, as predictors of early surgical treatment outcomes in young CE-affected patients. METHODS AND RESULTS This prospective study included 59 Tunisian children (177 plasmas), where CE was surgically treated and monitored for 3 post-operative years. Based on CE post-surgical development, patients were clustered into a 'No relapsed' CE (NRCE; n = 39) and a 'Relapsed' CE (RCE; n = 20) group. Plasma levels of sPD-1, sPD-L1 and anti-recP29 IgG were measured using ELISA. In the NRCE group, sPD-1, sPD-L1 and anti-recP29 IgG concentrations were significantly lower at D365 than at D30. By contrast, in the RCE group, no significant difference was observed between D0, D30 and D365. When considering individual variations, the probability to be 'relapse-free' was 67% and 73% when anti-recP29 IgG and sPD-L1 level, respectively, decreased between D30 and D365. The probability to be 'relapse-free' was 86% when the sPD-1 level decreased between D30 and D365 (P = .003; chi-square test). CONCLUSION sPD-1 may be a useful biomaker for the early evaluation of surgical procedure efficacy in paediatric CE cases.
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Affiliation(s)
- Eya Ben Salah
- Departement de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire, LR12ES08, Université de Monastir, Monastir, Tunisia
| | - Wahiba Sakly
- Departement de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire, LR12ES08, Université de Monastir, Monastir, Tunisia
| | - Coralie Barrera
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France
| | - Sana Mosbahi
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Anne-Pauline Bellanger
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France
| | - Rabeb Farhani
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Amine Ksia
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Bruno Gottstein
- Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Abdellatif Nouri
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Hamouda Babba
- Departement de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire, LR12ES08, Université de Monastir, Monastir, Tunisia
| | - Laurence Millon
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France
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22
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Wang J, Marreros N, Rufener R, Hemphill A, Gottstein B, Lundström-Stadelmann B. Short communication: Efficacy of albendazole in Echinococcus multilocularis-infected mice depends on the functional immunity of the host. Exp Parasitol 2020; 219:108013. [PMID: 33010287 DOI: 10.1016/j.exppara.2020.108013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/08/2020] [Accepted: 09/29/2020] [Indexed: 01/10/2023]
Abstract
Alveolar echinococcosis (AE) is a deadly parasitic disease that requires lifelong treatment with albendazole. Development of host immunity is pivotal with regard to the clinical outcome of AE, but its influence on conventional albendazole treatment is unknown. Using T-cell deficient athymic nude mice, we demonstrated that functional immunity is required for albendazole to be efficacious against murine AE. These results call for attention given the increasing number of immunocompromised patients with AE.
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Affiliation(s)
- Junhua Wang
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Berne, Längassstrasse 122, 3012, Berne, Switzerland; Institute for Infectious Diseases, Faculty of Medicine, University of Berne, Friedbühlstrasse 51, 3010, Berne, Switzerland
| | - Nelson Marreros
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Berne, Längassstrasse 122, 3012, Berne, Switzerland
| | - Reto Rufener
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Berne, Längassstrasse 122, 3012, Berne, Switzerland
| | - Andrew Hemphill
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Berne, Längassstrasse 122, 3012, Berne, Switzerland
| | - Bruno Gottstein
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Berne, Längassstrasse 122, 3012, Berne, Switzerland; Institute for Infectious Diseases, Faculty of Medicine, University of Berne, Friedbühlstrasse 51, 3010, Berne, Switzerland
| | - Britta Lundström-Stadelmann
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Berne, Längassstrasse 122, 3012, Berne, Switzerland.
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Maksimov P, Bergmann H, Wassermann M, Romig T, Gottstein B, Casulli A, Conraths FJ. Species Detection within the Echinococcus granulosus sensu lato Complex by Novel Probe-Based Real-Time PCRs. Pathogens 2020; 9:pathogens9100791. [PMID: 32993077 PMCID: PMC7599986 DOI: 10.3390/pathogens9100791] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/18/2020] [Accepted: 09/23/2020] [Indexed: 12/02/2022] Open
Abstract
Infections with eggs of Echinococcus granulosus sensu lato (s.l.) can cause cystic echinococcosis in intermediate host animals and humans. Upon ingestion of viable eggs, oncospheres hatch from the eggs and subsequently develop into fluid-filled larval cysts, most frequently in the liver or the lungs. The slowly growing cysts progressively interfere with organ function. The risk of infection is determined by the host range of the parasite, its pathogenicity and other epidemiologically relevant parameters, which differ significantly among the five species within the E. granulosus s.l. complex. It is therefore essential to diagnose the correct species within E. granulosus s.l. to help understand specific disease epidemiology and to facilitate effective implementation of control measures. For this purpose, simple, fast and cost-effective typing techniques are needed. We developed quantitative real-time polymerase chain reactions (qPCRs) to target polymorphic regions in the mitochondrial genome of E. granulosus s.l. In a single-step typing approach, we distinguished E. granulosus s.l. members in four epidemiologically relevant subgroups. These were E. granulosus sensu stricto, E. equinus, E. ortleppi and the E. canadensis cluster. The technique also allowed identification and differentiation of these species from other Echinococcus or Taenia taxa for samples isolated from cysts or faeces.
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Affiliation(s)
- Pavlo Maksimov
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, National Reference Centre for Echinococcosis, 17493 Greifswald-Insel Riems, Germany; (H.B.); (F.J.C.)
- Correspondence:
| | - Hannes Bergmann
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, National Reference Centre for Echinococcosis, 17493 Greifswald-Insel Riems, Germany; (H.B.); (F.J.C.)
| | - Marion Wassermann
- Parasitology Unit, University of Hohenheim, Emil-Wolff-Str. 34, 70599 Stuttgart, Germany; (M.W.); (T.R.)
| | - Thomas Romig
- Parasitology Unit, University of Hohenheim, Emil-Wolff-Str. 34, 70599 Stuttgart, Germany; (M.W.); (T.R.)
| | - Bruno Gottstein
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Bern, 3012 Bern, Switzerland;
| | - Adriano Casulli
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy;
- European Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Franz J. Conraths
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, National Reference Centre for Echinococcosis, 17493 Greifswald-Insel Riems, Germany; (H.B.); (F.J.C.)
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Meyer A, Olias P, Schüpbach G, Henzi M, Barmettler T, Hentrich B, Gottstein B, Frey CF. Combined cross-sectional and case-control study on Echinococcus multilocularis infection in pigs in Switzerland. Vet Parasitol 2020; 277S:100031. [PMID: 32984810 PMCID: PMC7491148 DOI: 10.1016/j.vpoa.2020.100031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/02/2020] [Accepted: 09/05/2020] [Indexed: 12/26/2022]
Abstract
Minimal prevalence for Echinococcus multilocularis infection in Swiss domestic pigs was established. Minimal prevalence was 0.008% for fattening pigs and 0.11% for breeding pigs, respectively. All but one metacestode were degenerated; no protoscoleces were detected in histopathology. Main risk factors were foxes or other animals in the barns, no hygiene barrier, outdoor feeding and grass feeding. No geographical clusters of higher infection with E. multilocularis were evident.
The canid tapeworm Echinococcus multilocularis causes alveolar echinococcosis (AE) in humans and other intermediate hosts. Depending on the permissiveness of the intermediate host, the larval form of E. multilocularis (metacestode) may be either fertile, e.g. in rodents, and thus supporting the life cycle of the parasite, or infertile, e.g. in pigs, and thus interrupting the life cycle. Pigs have been shown to act as aberrant hosts for the metacestode and consequently develop liver lesions but represent a dead-end for the parasite. Routine liver inspection at slaughter provided the basis for a large-scale surveillance study on E. multilocularis infection in pigs. The aim of this combined cross-sectional and case-control study was to estimate the minimal prevalence of E. multilocularis in pigs in Switzerland, to find factors associated with infection, and to assess potential regional clusters of infection. During the 12-month-study period, approximately 85% of all pigs slaughtered in Switzerland were assessed. In total, 450 pig livers with macroscopic lesions suggestive of E. multilocularis infection were analysed. Of those, 200 samples were positive by E. multilocularis-PCR. Thus, the overall minimal prevalence detected by molecular means was 0.009% in all slaughter pigs (200 of 2'143'996), 0.008% in finishing pigs (177 of 2'123'542), and 0.11% in breeding pigs (22 of 20'454). Histology revealed the unique presence of a laminated layer in 105 cases, and an additional germinal layer detected in a single case. Protoscoleces could not be observed in any of the lesions. Factors positively associated with infection were "foxes seen in the pig shed", "foxes on premises", "presence of other animals in the shed", "absence of a hygiene barrier", "outdoor feeding", "feeding grass", "lack of rodent control", "not having own dogs on the farm" and "infrequent deworming of sows". Infection was present in all regions sampled and was representative of the important pig rearing areas of Switzerland, without evidence of any obvious geographical cluster. Conclusively, our study provided further evidence of widespread environmental contamination with E. multilocularis eggs in Switzerland. Furthermore, the absence of protoscoleces in any of the lesions supported the concept that pigs act only as a dead-end host and thus do not contribute to the life cycle of the parasite. Factors associated with E. multilocularis infection were in-line with parasite biology, and many can be addressed by increasing hygiene and management standards.
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Affiliation(s)
- Anika Meyer
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Switzerland
| | - Philipp Olias
- Institute of Animal Pathology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Switzerland
| | - Gertraud Schüpbach
- Veterinary Public Health Institute, Department of Clinical Research and Veterinary Public Health, Vetsuisse Faculty, University of Bern, Switzerland
| | - Martin Henzi
- Service de la sécurité alimentaire et des affaires vétérinaires SAAV, Inspectorat des viandes et abattoirs, Contrôle des viandes - Division Porcs, Courtepin, Switzerland
| | | | - Brigitte Hentrich
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Switzerland
| | - Bruno Gottstein
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Switzerland
| | - Caroline F Frey
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Switzerland.
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Wang J, von Gunten S, Beldi G, Grandgirard D, Leib SL, Gottstein B. Digest the Sugar, Kill the Parasite: A New Experimental Concept in Treating Alveolar Echinococcosis. Pharmacology 2020; 106:3-8. [PMID: 32739918 DOI: 10.1159/000509355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/11/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The E. multilocularis laminated layer (LL) is a heavily glycosylated parasitic structure that plays an important role in protecting the larval stage (metacestode) of this parasite from physiological and immunological host reactions. We elaborated an experimental design with the idea to modify the (glycan) surface of the LL by a targeted digestion. This should allow the host defense to more easily recognize and attack (or kill) the parasite by immune-mediated effects. METHODS Experimentally, E. multilocularis (clone H95) metacestodes were cultured in vitro with or without addition of α1-3,4,6-galactosidase or β1-3-galactosidase in the medium. Morphological changes were subsequently measured by microscopy at different time points. Parasites were then recovered at day 5 and reinjected into mice for assessing their viability and infectious status. For finally recovered parasites, the respective load was assessed ex vivo by wet weight measurement, and host-related PD1 and IL-10 levels were determined as the key immunoregulators by using flow cytometry. RESULTS Our experiments demonstrated that the parasite vesicular structure can be directly destroyed by adding galactosidases into the in vitro culture system, resulting in the fact that the parasite metacestode vesicles could not anymore infect and develop in mice after this glycan digestion. Moreover, when compared to the mice inoculated with E. multilocularis metacestode without galactosidases, PD1 expression was upregulated in CD4+ Teffs from mice inoculated with E. multilocularis metacestode pretreated with β1-3-galactosidase, with a lower IL-10 secretion from CD4+ Teffs; there was no difference of PD1 and IL-10 expression levels regarding CD4+ Teff from mice inoculated with E. multilocularis metacestode pretreated with α1-3,4,6-galac-tosidase. DISCUSSION We raised our hypothesis that this "aborting" effect may be linked to an altered PD1 and IL-10 response fine-tuning between immunopathology and immune protection. These findings justify a continuation of these experiments upon therapeutical in vivo administration of the enzymes.
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Affiliation(s)
- Junhua Wang
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland, .,Institute of Parasitology, University of Bern, Bern, Switzerland,
| | | | - Guido Beldi
- Department of Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland
| | - Denis Grandgirard
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Stephen L Leib
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Bruno Gottstein
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
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Vuitton DA, McManus DP, Rogan MT, Romig T, Gottstein B, Naidich A, Tuxun T, Wen H, Menezes da Silva A. International consensus on terminology to be used in the field of echinococcoses. ACTA ACUST UNITED AC 2020; 27:41. [PMID: 32500855 PMCID: PMC7273836 DOI: 10.1051/parasite/2020024] [Citation(s) in RCA: 131] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 04/07/2020] [Indexed: 12/13/2022]
Abstract
Echinococcoses require the involvement of specialists from nearly all disciplines; standardization of the terminology used in the field is thus crucial. To harmonize echinococcosis terminology on sound scientific and linguistic grounds, the World Association of Echinococcosis launched a Formal Consensus process. Under the coordination of a Steering and Writing Group (SWG), a Consultation and Rating Group (CRG) had the main missions of (1) providing input on the list of terms drafted by the SWG, taking into account the available literature and the participants’ experience; and (2) providing independent rating on all debated terms submitted to vote. The mission of the Reading and Review Group (RRG) was to give an opinion about the recommendation paper in terms of readability, acceptability and applicability. The main achievements of this process were: (1) an update of the current nomenclature of Echinococcus spp.; (2) an agreement on three names of diseases due to Echinococcus spp.: Cystic Echinococcosis (CE), Alveolar Echinococcosis (AE) and Neotropical Echinococcosis (NE), and the exclusion of all other names; (3) an agreement on the restricted use of the adjective “hydatid” to refer to the cyst and fluid due to E. granulosus sensu lato; and (4) an agreement on a standardized description of the surgical operations for CE, according to the “Approach, cyst Opening, Resection, and Completeness” (AORC) framework. In addition, 95 “approved” and 60 “rejected” terms were listed. The recommendations provided in this paper will be applicable to scientific publications in English and communication with professionals. They will be used for translation into other languages spoken in endemic countries.
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Affiliation(s)
- Dominique A Vuitton
- National French Reference Centre for Echinococcosis, University Bourgogne Franche-Comté and University Hospital, FR-25030 Besançon, France
| | - Donald P McManus
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, AU-4006 Brisbane, Queensland, Australia
| | - Michael T Rogan
- Department of Biology and School of Environment & Life Sciences, University of Salford, GB-M5 4WT Manchester, United Kingdom
| | - Thomas Romig
- Department of Parasitology, Hohenheim University, DE-70599 Stuttgart, Germany
| | - Bruno Gottstein
- Institute of Parasitology, School of Medicine and Veterinary Medicine, University of Bern, CH-3012 Bern, Switzerland
| | - Ariel Naidich
- Department of Parasitology, National Institute of Infectious Diseases, ANLIS "Dr. Carlos G. Malbrán", AR-1281 Buenos Aires, Argentina
| | - Tuerhongjiang Tuxun
- WHO Collaborating Centre for Prevention and Care Management of Echinococcosis and State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, CN-830011 Urumqi, PR China
| | - Hao Wen
- WHO Collaborating Centre for Prevention and Care Management of Echinococcosis and State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, CN-830011 Urumqi, PR China
| | - Antonio Menezes da Silva
- Past-President of the World Association of Echinococcosis, President of the College of General Surgery of the Portuguese Medical Association, PT-1649-028 Lisbon, Portugal
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Boubaker G, Strempel S, Hemphill A, Müller N, Wang J, Gottstein B, Spiliotis M. Regulation of hepatic microRNAs in response to early stage Echinococcus multilocularis egg infection in C57BL/6 mice. PLoS Negl Trop Dis 2020; 14:e0007640. [PMID: 32442168 PMCID: PMC7244097 DOI: 10.1371/journal.pntd.0007640] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 03/05/2020] [Indexed: 12/15/2022] Open
Abstract
We present a comprehensive analysis of the hepatic miRNA transcriptome at one month post-infection of experimental primary alveolar echinococcosis (AE), a parasitic infection caused upon ingestion of E. multilocularis eggs. Liver tissues were collected from infected and non-infected C57BL/6 mice, then small RNA libraries were prepared for next-generation sequencing (NGS). We conducted a Stem-loop RT-qPCR for validation of most dysregulated miRNAs. In infected mice, the expression levels of 28 miRNAs were significantly altered. Of these, 9 were up-regulated (fold change (FC) ≥ 1.5) and 19 were down-regulated (FC ≤ 0.66) as compared to the non-infected controls. In infected livers, mmu-miR-148a-3p and mmu-miR-101b-3p were 8- and 6-fold down-regulated, respectively, and the expression of mmu-miR-22-3p was reduced by 50%, compared to non-infected liver tissue. Conversely, significantly higher hepatic levels were noted for Mus musculus (mmu)-miR-21a-5p (FC = 2.3) and mmu-miR-122-5p (FC = 1.8). In addition, the relative mRNA expression levels of five genes (vegfa, mtor, hif1-α, fasn and acsl1) that were identified as targets of down-regulated miRNAs were significantly enhanced. All the five genes exhibited a higher expression level in livers of E. multilocularis infected mice compared to non-infected mice. Finally, we studied the issue related to functionally mature arm selection preference (5p and/or 3p) from the miRNA precursor and showed that 9 pre-miRNAs exhibited different arm selection preferences in normal versus infected liver tissues. In conclusion, this study provides first evidence that miRNAs are regulated early in primary murine AE. Our findings raise intriguing questions such as (i) how E. multilocularis affects hepatic miRNA expression;(ii) what are the alterations in miRNA expression patterns in more advanced AE-stages; and (iii) which hepatic cellular, metabolic and/or immunologic processes are modulated through altered miRNAs in AE. Thus, further research on the regulation of miRNAs during AE is needed, since miRNAs constitute an attractive potential option for development of novel therapeutic approaches against AE. Various infectious diseases in humans have been associated with altered expression patterns of microRNAs (miRNAs), a class of small non-coding RNAs involved in negative regulation of gene expression. Herein, we revealed that significant alteration of miRNAs expression occurred in murine liver subsequently to experimental infection with E. multilocularis eggs when compared to non-infected controls. At the early stage of murine AE, hepatic miRNAs were mainly down-regulated. Respective target genes of the most extensively down-regulated miRNAs were involved in angiogenesis and fatty acid synthesis. Furthermore, we found higher mRNA levels of three angiogenic and two lipogenic genes in E. multilocularis infected livers compared to non-infected controls. Angiogenesis and fatty acid biosynthesis may be beneficial for development of the E. multilocularis metacestodes. In fact the formation of new blood vessels in the periparasitic area may ensure that parasites are supplied with oxygen and nutrients and get rid of waste products. Additionally, E. multilocularis is not able to undertake de novo fatty acid synthesis, thus lipids must be scavenged from its host. More research on the regulation of the hepatic miRNA transcriptome at more advanced stages of AE is needed.
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Affiliation(s)
- Ghalia Boubaker
- Department of Infectious Diseases and Pathobiology, Institute of Parasitology, University of Bern, Bern, Switzerland
- Department of Clinical Biology B, Laboratory of Parasitology and Mycology, University of Monastir, Monastir, Tunisia
- * E-mail: (GB); (BG)
| | | | - Andrew Hemphill
- Department of Infectious Diseases and Pathobiology, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Norbert Müller
- Department of Infectious Diseases and Pathobiology, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Junhua Wang
- Department of Infectious Diseases and Pathobiology, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Bruno Gottstein
- Department of Infectious Diseases and Pathobiology, Institute of Parasitology, University of Bern, Bern, Switzerland
- Institute of Infectious Diseases, Faculty of Medicine, University of Berne, Berne, Switzerland
- * E-mail: (GB); (BG)
| | - Markus Spiliotis
- Department of Infectious Diseases and Pathobiology, Institute of Parasitology, University of Bern, Bern, Switzerland
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Knapp J, Gottstein B, Bretagne S, Bart JM, Umhang G, Richou C, Bresson-Hadni S, Millon L. Genotyping Echinococcus multilocularis in Human Alveolar Echinococcosis Patients: An EmsB Microsatellite Analysis. Pathogens 2020; 9:pathogens9040282. [PMID: 32295095 PMCID: PMC7238142 DOI: 10.3390/pathogens9040282] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 12/19/2022] Open
Abstract
For clinical epidemiology specialists, connecting the genetic diversity of Echinococcusmultilocularis to sources of infection or particular sites has become somewhat of a holy grail. It is very difficult to trace the infection history of alveolar echinococcosis (AE) patients as there may be an incubation period of five to 15 years before reliable diagnosis. Moreover, the variability of parasitic manifestations in human patients raises the possibility of genetically different isolates of E. multilocularis having different levels of pathogenicity. Thus, the exposure of human patients to different strains or genotypes circulating in geographically different environments may lead to different disease outcomes. Molecular tools, such as the microsatellite marker EmsB, were required to investigate these aspects. This genetic marker was previously tested on a collection of 1211 European field samples predominantly of animal origin, referenced on a publicly available database. In this study, we investigated a panel of 66 metacestode samples (between 1981 and 2019) recovered surgically from 63 patients diagnosed with alveolar echinococcosis originating from four European countries (France, Switzerland, Germany, Belgium). In this study, we identified nine EmsB profiles, five of which were found in patients located in the same areas of France and Switzerland. One profile was detected on both sides of the French-Swiss border, whereas most patients from non-endemic regions clustered together in another profile. EmsB profiles appeared to remain stable over time because similar profiles were detected in patients who underwent surgery recently and patients who underwent surgery some time ago. This study sheds light on possible pathways of contamination in humans, including proximity contamination in some cases, and the dominant contamination profiles in Europe, particularly for extrahepatic lesions.
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Affiliation(s)
- Jenny Knapp
- UMR CNRS 6249 Laboratoire Chrono-environnement, Université Franche-Comté, 16 Route de Gray, 25030 Besançon, France; (S.B.-H.); (L.M.)
- Department of Parasitology-Mycology, National Reference Centre for Echinococcoses, University Hospital of Besançon, 25030 Besançon, France
- Correspondence: ; Tel.: +33-370-632-106
| | - Bruno Gottstein
- Institute for Infectious Diseases, Faculty of Medicine, University of Berne, 3001 Berne, Switzerland;
| | - Stéphane Bretagne
- Parasitology-Mycology Laboratory, Lariboisière-Saint Louis-Fernand Widal Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, 75475 Paris, France;
| | - Jean-Mathieu Bart
- UMR INTERTRYP, IRD/CIRAD, University of Montpellier, 34398 Montpellier, France;
| | - Gérald Umhang
- ANSES, Nancy Laboratory for Rabies and Wildlife, Wildlife Surveillance and Eco-Epidemiology Unit, Technopôle Agricole et Vétérinaire, B.P. 40009, 54220 Malzéville, France;
| | - Carine Richou
- Department of Hepatology, University Hospital of Besançon, 25000 Besançon, France;
| | - Solange Bresson-Hadni
- UMR CNRS 6249 Laboratoire Chrono-environnement, Université Franche-Comté, 16 Route de Gray, 25030 Besançon, France; (S.B.-H.); (L.M.)
- Department of Parasitology-Mycology, National Reference Centre for Echinococcoses, University Hospital of Besançon, 25030 Besançon, France
| | - Laurence Millon
- UMR CNRS 6249 Laboratoire Chrono-environnement, Université Franche-Comté, 16 Route de Gray, 25030 Besançon, France; (S.B.-H.); (L.M.)
- Department of Parasitology-Mycology, National Reference Centre for Echinococcoses, University Hospital of Besançon, 25030 Besançon, France
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Barkati S, Gottstein B, Mu Ller N, Sheitoyan-Pesant C, Metrakos P, Chen T, Garceau R, Libman MD, Ndao M, Yansouni CP. First Human Case of Metacestode Infection Caused by Versteria sp. in a Kidney Transplant Recipient. Clin Infect Dis 2020; 68:680-683. [PMID: 30212859 DOI: 10.1093/cid/ciy602] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 07/25/2018] [Indexed: 11/13/2022] Open
Abstract
Cestodes are emerging agents of severe opportunistic infections among immunocompromised patients. We describe the first case of human infection, with the recently-proposed genus Versteria causing an invasive, tumor-like hepatic infection with regional and distant extension in a 53-year-old female kidney transplant recipient from Atlantic Canada.
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Affiliation(s)
- Sapha Barkati
- J.D. MacLean Centre for Tropical Diseases at McGill University.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Bruno Gottstein
- Institute of Parasitology, Vertsuisse Faculty and Faculty of Medicine, University of Bern, Switzerland
| | - Norbert Mu Ller
- Institute of Parasitology, Vertsuisse Faculty and Faculty of Medicine, University of Bern, Switzerland
| | | | - Peter Metrakos
- McGill University Health Centre, Montreal, Quebec, Canada
| | - Tianyan Chen
- McGill University Health Centre, Montreal, Quebec, Canada
| | - Richard Garceau
- Centre Hospitalier Universitaire Dr-Georges-L.-Dumont, Moncton, New-Brunswick
| | - Michael D Libman
- J.D. MacLean Centre for Tropical Diseases at McGill University.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Momar Ndao
- J.D. MacLean Centre for Tropical Diseases at McGill University.,National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Cedric P Yansouni
- J.D. MacLean Centre for Tropical Diseases at McGill University.,McGill University Health Centre, Montreal, Quebec, Canada
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Dąbrowska J, Keller I, Karamon J, Kochanowski M, Gottstein B, Cencek T, Frey CF, Müller N. Whole genome sequencing of a feline strain of Tritrichomonas foetus reveals massive genetic differences to bovine and porcine isolates. Int J Parasitol 2020; 50:227-233. [PMID: 32109482 DOI: 10.1016/j.ijpara.2019.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 01/14/2023]
Abstract
Tritrichomonas foetus is a protozoan parasite that colonizes the reproductive tract of cattle as well as the gastrointestinal tract of cats. Bovine tritrichomonosis is a sexually transmitted disease whereas feline tritrichomonosis is thought to be transmitted by the fecal-oral route. Furthermore, T. foetus is known as an essentially apathogenic commensal located in the nasal cavity of pigs. Transmission of T. foetus between the different hosts has to be considered a realistic scenario that may have important implications for the epidemiology of infections and disease. In our study, we generated whole genome sequencing (WGS) data from bovine, feline and porcine T. foetus strains to investigate the genetic (dis)similarities among these diverse strains. As a reference, we used a previously released draft assembly from a bovine T. foetus strain K isolated from an infected bull in Brazil. In particular, we identified single nucleotide polymorphisms (SNPs) and the insertion-deletion (indel) variations within the genomes of the different strains. Interestingly, only a low degree of polymorphism (68 SNPs and indels) was found between the bovine and the porcine strains in terms of variants with a predicted impact of moderate or high and where one species is homozygous for one allele and the other homozygous for the other allele. Conversely, however, a 964 times higher number of such differences was detected by comparing the feline with either the bovine (65,569) or the porcine (65,615) strain. These data clearly indicated a close phylogenetic relationship between bovine and porcine T. foetus but a remarkable genetic distinctness of these two strains from the feline strain. The latter observation was confirmed by PCR-based sequencing of 20 in silico-selected indel markers and five in silico-selected SNP markers that uniformly demonstrated a relatively distant phylogenetic relationship of three independent feline T. foetus isolates in comparison to the bovine and porcine strains investigated. In summary, our comparative genome sequencing approach provided further insights into the genetic diversity of T. foetus in relation to the different host origins of the parasite. Furthermore, our study identified a large number of SNP- and indel-containing sequences that may be useful molecular markers for future epidemiological studies aimed at the elucidation of the transmission patterns of T. foetus within different host species.
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Affiliation(s)
- Joanna Dąbrowska
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Partyzantów Avenue 57, 24-100 Puławy, Poland
| | - Irene Keller
- Department for BioMedical Research and Swiss Institute of Bioinformatics, University of Bern, Baltzerstrasse 6, 3012 Bern, Switzerland
| | - Jacek Karamon
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Partyzantów Avenue 57, 24-100 Puławy, Poland
| | - Maciej Kochanowski
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Partyzantów Avenue 57, 24-100 Puławy, Poland
| | - Bruno Gottstein
- Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3010 Bern, Switzerland
| | - Tomasz Cencek
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Partyzantów Avenue 57, 24-100 Puławy, Poland
| | - Caroline F Frey
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, 3012 Bern, Switzerland
| | - Norbert Müller
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, 3012 Bern, Switzerland.
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Campero LM, Schott F, Gottstein B, Deplazes P, Sidler X, Basso W. Detection of antibodies to Toxoplasma gondii in oral fluid from pigs. Int J Parasitol 2019; 50:349-355. [PMID: 31866312 DOI: 10.1016/j.ijpara.2019.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/04/2019] [Accepted: 11/07/2019] [Indexed: 11/19/2022]
Abstract
Toxoplasma gondii-infected pigs play a major role as a source of infection for humans and detection of high-risk herds is essential to implement control measures at the farm level. The aim of this study was to determine whether oral fluid (OF) could be used as a matrix to detect antibodies against T. gondii in infected pigs by immunoblot (IB). For this, OF from experimentally inoculated sows (n = 8) (serial samples) and naturally exposed group-housed fatteners (n = 42 groups, one sample/group) were analysed for IgG and IgA against T. gondii-SAG1 antigen by IB. Simultaneously, each animal was serologically tested for anti-T. gondii IgG by ELISA. Specific IgG was detected in the sera of all inoculated sows from 2 to 3 weeks post inoculation (pi) and in 3.4 to 92% of the pigs in 13 out of 42 groups. Experimentally inoculated sows showed positive OF-IB results for IgA (100%) and IgG (87.5%) at 1.5 weeks pi and continued yielding positive results for IgA (87.5-75%) and IgG (50%) until 4 weeks pi; however, from 8 weeks pi the frequency of detection of both isotypes was lower, despite constantly positive IgG values in serum-ELISA. Interestingly, consecutive daily samplings for 4 days at 13 and 30 weeks pi showed inconsistent results for some sows, showing that the antibody concentration in OF is prone to timely variations. Pooled OF from groups with 91 and 92% of seropositive pigs yielded positive IB results for IgG and IgA. Fattener groups with ≤13% of seropositive pigs gave negative IB results to both isotypes. Our results showed that antibodies to T. gondii can be detected in OF from infected pigs, and that IgA seems to be a more adequate target than IgG. Although OF does not seem to be a robust matrix to assess the serological status for T. gondii in individual animals, this diagnostic approach represents an interesting non-invasive, low-cost and animal welfare friendly option as a screening method at the farm level to determine high exposure to T. gondii in the herd.
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Affiliation(s)
- Lucía María Campero
- Institute of Parasitology, Vetsuisse-Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland; Immunoparasitology Laboratory, Faculty of Veterinary Sciences, National University of La Plata, 60 and 118 s/n, 1900 La Plata, Argentina; National Scientific and Technical Research Council (CONICET), Godoy Cruz, 2290, C1033AAJ Buenos Aires, Argentina
| | - Franziska Schott
- Department of Farm Animals, Division of Swine Medicine, Vetsuisse-Faculty, University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland
| | - Bruno Gottstein
- Institute of Parasitology, Vetsuisse-Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland
| | - Peter Deplazes
- Institute of Parasitology, Vetsuisse-Faculty, University of Zurich, Winterthurerstrasse 266a, CH-8057 Zurich, Switzerland
| | - Xaver Sidler
- Department of Farm Animals, Division of Swine Medicine, Vetsuisse-Faculty, University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland
| | - Walter Basso
- Institute of Parasitology, Vetsuisse-Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland; Department of Farm Animals, Division of Swine Medicine, Vetsuisse-Faculty, University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland; Institute of Parasitology, Vetsuisse-Faculty, University of Zurich, Winterthurerstrasse 266a, CH-8057 Zurich, Switzerland.
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Abstract
Background Fasciola hepatica is a foodborne trematode present worldwide. Definitive hosts are mostly ruminants such as cattle and sheep, as well as humans. In Switzerland, Fasciola infection in humans is rare. Unfortunately, many patients are likely to undergo multiple unnecessary investigations before the parasite is suspected and fascioliasis diagnosed, especially if symptoms are unspecific. Methods Retrospective analysis of all patients diagnosed with Fasciola hepatica at the University Hospital of Bern between 2005 and 2018. Diagnosis was positive if a positive serology and/or eggs in stool samples correlated with clinical presentation (symptoms and/or imaging). Patients were excluded if serology was weakly positive and another diagnosis more likely. Personal data, laboratory results, imaging, proposed treatment and outcome were collected from patient files. Results Sixty patients had a positive serology during this time period. Forty-seven of them had a more plausible alternative diagnosis and were not included in the study, leaving 13 patients for analyses; 46.2% (6/13) were male, mean age was 45.8 years old (range, 17-80 years old). Four patients (4/13, 30.8%) were asymptomatic, nine (9/13, 69.2%) presented with symptoms ranging from right upper quadrant abdominal pain (44.4%) and generalized pruritus (33.3%) to weight loss and night sweats (33.3%). The mean duration of symptoms until correct diagnosis was 8.9 months (range, 1-48 months). Five patients (5/13, 38.5%) had documented eosinophilia, four (4/13, 30.8%) elevated liver enzymes and seven (7/13, 53.8%) elevated cholestasis parameters. Mean antibody level on serology was 88 AU/mL (range, 3-134 AU/mL). Ultrasound was used most frequently (7/13, 53.8%), followed by magnetic resonance imaging (4/13, 30.8%), computed tomography and endoscopic retrograde cholangiopancreatography (3/13, 23.1%). The most common findings were bile duct dilatation, followed by hepatic lesions. Treatment consisted of Triclabendazole 10 mg/Kg. One patient needed a second treatment course for persistent disease. There were no recurrences. Conclusions With a low incidence of Fasciola hepatica in Switzerland, correct diagnosis is often substantially delayed. Raising awareness among Swiss physicians is paramount, and a higher level of suspicion necessary when confronted with unspecific symptoms or liver imaging, thus avoiding a long delay in diagnosis, as well as unnecessary tests.
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Affiliation(s)
- Stéphanie Perrodin
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Laura Walti
- Department of Infectious Diseases, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Bruno Gottstein
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Corina Kim-Fuchs
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Daniel Candinas
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Vanessa Banz
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
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Pinard C, Cuq B, Gibson T, Brisson B, Plattner B, Lillie B, Bienzle D, Brouwer E, Gottstein B, Peregrine A. Alveolar echinococcosis in an Ontario dog resembling an hepatic abscess. Can Vet J 2019; 60:1099-1103. [PMID: 31597996 PMCID: PMC6741825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A boxer dog was evaluated because of lethargy, vomiting, and abdominal pain. Ultrasonography revealed multiple cystic structures in the abdomen. Exploratory laparotomy revealed 3 well-encapsulated hepatic masses and abdominal effusion with suppurative inflammation. Collectively, these findings suggested the hepatic masses were most likely abscesses. However, histologic examination of the hepatic masses revealed multi-cystic structures, consistent with alveolar echinococcosis. The diagnosis was confirmed by DNA sequencing. The dog was treated with daily albendazole, but within a few weeks exhibited adverse side effects. After 6 months, the dog's condition deteriorated, and it was euthanized.
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Affiliation(s)
- Christopher Pinard
- Department of Clinical Studies (Pinard, Gibson, Brisson), Department of Pathobiology (Cuq, Plattner, Lillie, Bienzle, Brouwer, Peregrine), University of Guelph, Guelph, Ontario N1G 2W1; Institut für Parasitologie, Universität Bern, Bern, Switzerland (Gottstein)
| | - Benoît Cuq
- Department of Clinical Studies (Pinard, Gibson, Brisson), Department of Pathobiology (Cuq, Plattner, Lillie, Bienzle, Brouwer, Peregrine), University of Guelph, Guelph, Ontario N1G 2W1; Institut für Parasitologie, Universität Bern, Bern, Switzerland (Gottstein)
| | - Thomas Gibson
- Department of Clinical Studies (Pinard, Gibson, Brisson), Department of Pathobiology (Cuq, Plattner, Lillie, Bienzle, Brouwer, Peregrine), University of Guelph, Guelph, Ontario N1G 2W1; Institut für Parasitologie, Universität Bern, Bern, Switzerland (Gottstein)
| | - Brigitte Brisson
- Department of Clinical Studies (Pinard, Gibson, Brisson), Department of Pathobiology (Cuq, Plattner, Lillie, Bienzle, Brouwer, Peregrine), University of Guelph, Guelph, Ontario N1G 2W1; Institut für Parasitologie, Universität Bern, Bern, Switzerland (Gottstein)
| | - Brandon Plattner
- Department of Clinical Studies (Pinard, Gibson, Brisson), Department of Pathobiology (Cuq, Plattner, Lillie, Bienzle, Brouwer, Peregrine), University of Guelph, Guelph, Ontario N1G 2W1; Institut für Parasitologie, Universität Bern, Bern, Switzerland (Gottstein)
| | - Brandon Lillie
- Department of Clinical Studies (Pinard, Gibson, Brisson), Department of Pathobiology (Cuq, Plattner, Lillie, Bienzle, Brouwer, Peregrine), University of Guelph, Guelph, Ontario N1G 2W1; Institut für Parasitologie, Universität Bern, Bern, Switzerland (Gottstein)
| | - Dorothee Bienzle
- Department of Clinical Studies (Pinard, Gibson, Brisson), Department of Pathobiology (Cuq, Plattner, Lillie, Bienzle, Brouwer, Peregrine), University of Guelph, Guelph, Ontario N1G 2W1; Institut für Parasitologie, Universität Bern, Bern, Switzerland (Gottstein)
| | - Emily Brouwer
- Department of Clinical Studies (Pinard, Gibson, Brisson), Department of Pathobiology (Cuq, Plattner, Lillie, Bienzle, Brouwer, Peregrine), University of Guelph, Guelph, Ontario N1G 2W1; Institut für Parasitologie, Universität Bern, Bern, Switzerland (Gottstein)
| | - Bruno Gottstein
- Department of Clinical Studies (Pinard, Gibson, Brisson), Department of Pathobiology (Cuq, Plattner, Lillie, Bienzle, Brouwer, Peregrine), University of Guelph, Guelph, Ontario N1G 2W1; Institut für Parasitologie, Universität Bern, Bern, Switzerland (Gottstein)
| | - Andrew Peregrine
- Department of Clinical Studies (Pinard, Gibson, Brisson), Department of Pathobiology (Cuq, Plattner, Lillie, Bienzle, Brouwer, Peregrine), University of Guelph, Guelph, Ontario N1G 2W1; Institut für Parasitologie, Universität Bern, Bern, Switzerland (Gottstein)
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Pires H, Martins M, Matos AC, Cardoso L, Monteiro F, Roque N, Nunes T, Gottstein B, Cortes H. Geospatial analysis applied to seroepidemiological survey of canine leishmaniosis in east-central Portugal. Vet Parasitol 2019; 274:108930. [PMID: 31586700 DOI: 10.1016/j.vetpar.2019.108930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 09/20/2019] [Accepted: 09/21/2019] [Indexed: 10/25/2022]
Abstract
Despite the high prevalence of canine Leishmania infantum infection in Portugal, significant differences associated with different risk factors can be found between geographically contiguous areas. In this study, a geographical area within the central region of Portugal (municipalities of Proença-a-Nova, Mação and Vila de Rei) was investigated. An epidemiological survey involved the analysis by an indirect enzyme-linked immunosorbent assay of serum samples collected during the anti-rabies vaccination campaign from 282 dogs. Geospatial analysis showed the distribution of geospatial prevalence of leishmaniosis and has delimited two areas (clusters) with a statistically significant higher risk of seropositivity in dogs (p = 0.003 and p = 0.027, for clusters 1 and 2, respectively). The highest seroprevalence (56.0%; CI: 41.2-70.0) was found in Vila de Rei. Five land occupation types showed a possible influence on the geographic distribution of seropositivity, with statistically significant differences between seropositive and seronegative dogs. Land occupied by temporary irrigated crops (p = 0.026), olive groves (p = 0.013), complex cultural systems and parcelling (p = 0.021), open forests, logging and new plantations (p = 0.043) and watercourses (p = 0.012) influenced the geographical distribution of canine Leishmania infection. Seropositive dogs had a greater average area of occupied land (i.e. open forests, logging and new plantations) than the seronegative ones (3.1439 km2 versus 2.5650 km2, respectively; p = 0.043).
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Affiliation(s)
- Humberto Pires
- Polytechnic Institute of Castelo Branco, School of Agriculture, Castelo Branco, Portugal
| | - Manuel Martins
- Polytechnic Institute of Castelo Branco, School of Agriculture, Castelo Branco, Portugal; QRural - Quality of Life in the Rural World - Research Unit, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
| | - Ana Cristina Matos
- Polytechnic Institute of Castelo Branco, School of Agriculture, Castelo Branco, Portugal; QRural - Quality of Life in the Rural World - Research Unit, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal; CERNAS - Research Center for Natural Resources, Environment and Society, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal.
| | - Luís Cardoso
- CECAV - Animal and Veterinary Research Centre, Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal
| | | | - Natália Roque
- Polytechnic Institute of Castelo Branco, School of Agriculture, Castelo Branco, Portugal; QRural - Quality of Life in the Rural World - Research Unit, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
| | - Telmo Nunes
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisboa, Portugal
| | - Bruno Gottstein
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Helder Cortes
- Institute of Mediterranean Agricultural and Environmental Sciences (ICAAM). University of Évora, Núcleo da Mitra, Évora, Portugal
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Dąbrowska J, Karamon J, Kochanowski M, Gottstein B, Cencek T, Frey CF, Müller N. Development and comparative evaluation of different LAMP and PCR assays for coprological diagnosis of feline tritrichomonosis. Vet Parasitol 2019; 273:17-23. [PMID: 31442888 DOI: 10.1016/j.vetpar.2019.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 11/16/2022]
Abstract
The protozoan parasite Tritrichomonas foetus may cause severe diarrhea in cats all over the world. In order to evaluate the methodology in coprological molecular diagnosis of feline tritrichomonosis, we compared previously published ("old") and newly developed ("novel") loop-mediated isothermal amplification (LAMP) (targeted to the T. foetus β-tubulin and the elf1α 1 gene, respectively) as well as an old conventional and an old and novel real-time PCR (all targeted to overlapping regions of T. foetus rDNA) assays regarding their diagnostic sensitivities and specificities. Here, the novel real-time PCR yielded the best methodical performance in that a sensitivity with a detection limit of <0.1 trophozoites (corresponding to ca.<0.13 trophozoites per mg feces) and a maximal specificity for diagnosis of Tritrichomonas spp. was achieved. The other test systems exhibited either an approximately 10-times lower sensitivity (<1 trophozoite corresponding to ca.<1.3 trophozoites per mg feces) (conventional PCR and both LAMP assays) or a lower specificity (old real-time PCR). Conversely, the diagnostic performance assessed with clinical fecal samples from cats demonstrated identical sensitivities (8 of 20 samples tested were positive) for the novel PCR and both LAMP assays. Diagnostic sensitivities were significantly higher than those found for the old real-time (5 positive samples) and conventional PCR (6 positive samples), respectively. Accordingly, our data suggested the novel PCR and both LAMP assays to be well suited molecular tools for direct (i.e. without including an in vitro cultivation step) coprological diagnosis of tritrichomonosis in cats. Interestingly, relative high (novel LAMP, 7 positive samples) to at least moderate (old LAMP, 6 positive samples and 1 sample with equivocal score) diagnostic sensitivities were also achieved by testing clinical samples upon simple visual inspection of colorimetric changes during the LAMP amplification reactions. Accordingly, both LAMP assays may serve as practical molecular tools to perform epidemiological studies on feline (and bovine as well as porcine) tritrichomonosis under simple laboratory conditions.
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Affiliation(s)
- Joanna Dąbrowska
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Partyzantów Avenue 57, 24-100, Puławy, Poland
| | - Jacek Karamon
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Partyzantów Avenue 57, 24-100, Puławy, Poland
| | - Maciej Kochanowski
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Partyzantów Avenue 57, 24-100, Puławy, Poland
| | - Bruno Gottstein
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, 3012, Bern, Switzerland
| | - Tomasz Cencek
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Partyzantów Avenue 57, 24-100, Puławy, Poland
| | - Caroline F Frey
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, 3012, Bern, Switzerland
| | - Norbert Müller
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, 3012, Bern, Switzerland.
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Massolo A, Klein C, Kowalewska-Grochowska K, Belga S, MacDonald C, Vaughan S, Girgis S, Giunchi D, Bramer SA, Santa MA, Grant DM, Mori K, Duignan P, Slater O, Gottstein B, Müller N, Houston S. European Echinococcus multilocularis Identified in Patients in Canada. N Engl J Med 2019; 381:384-385. [PMID: 31340100 DOI: 10.1056/nejmc1814975] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | | | | | - Sara Belga
- University of Alberta, Edmonton, AB, Canada
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Lachenmayer A, Gebbers D, Gottstein B, Candinas D, Beldi G. Elevated incidence of alveolar echinococcosis in immunocompromised patients. Food Waterborne Parasitol 2019; 16:e00060. [PMID: 32095630 PMCID: PMC7034048 DOI: 10.1016/j.fawpar.2019.e00060] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/21/2019] [Accepted: 05/21/2019] [Indexed: 02/06/2023] Open
Abstract
Introduction Recent experimental data has revealed that the course of alveolar echinococcosis (AE) depends on adaptive immunity. For this study, we aimed to analyze the incidence and outcome of AE in immunocompromised humans. Material and methods Retrospective analysis of 131 patients with a median age of 54 years treated for AE between 1971 and 2017 at a Swiss tertiary referral Centre. Fifty-two percent were females and 65 patients (50%) were diagnosed incidentally. Fourteen patients (16%) were operated on laparoscopically. Overall, median follow-up was 48 months. Results New diagnoses have increased fourfold in immunocompetent and tenfold in immunocompromised patients in the past decade (p ≤ 0.005). Forty-one patients (31.3%) had co-existing or previous immunosuppressive conditions including 16 malignancies (36%), 11 auto-immune diseases or immunosuppressive therapies (31%), 5 infectious diseases (11%), 4 chronic asthma conditions (9%), 2 previous transplantations (4%) and 4 other immunocompromising conditions (9%). Serum levels of anti-Em18, −Em2 and -EgHF antibodies were neither associated with immunocompetence at diagnosis nor during follow-up, but significantly decreased after treatment with benzimidazole (n = 43) or surgery (n = 88) in all patients. Adjuvant therapy for ≥1 year (p = 0.007) with benzimidazole and resection status (R0) (p = 0.002) were both correlated with recurrence-free survival. Survival at 5 and 10 years after surgery was 97% and 94%, respectively, and after conservative treatment 91% and 73%, respectively. Curative surgery (p = 0.014) and immunocompetence (p = 0.048) correlated significantly with overall survival. Conclusion The incidence of human AE has increased over the last 2 decades with surgical interventions resulting in excellent outcomes. We have observed an association of immunosuppressive conditions with both incidence and survival of AE eventually justifying the implementation of a screening program for patients at risk in endemic regions. Alveolar echinococcosis incidence increased significantly in Switzerland. Immunosuppression may lead to an increased susceptibility for the disease. Coexisting immunosuppressive conditions lead to worse survival of AE. Adjuvant treatment with benzimidazole increases recurrence-free survival. Resections with sufficient safety margin improve recurrence-free survival.
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Affiliation(s)
- A Lachenmayer
- Department of Visceral Surgery and Medicine, University Hospital Bern, University of Bern, Bern, Switzerland
| | - D Gebbers
- Department of Visceral Surgery and Medicine, University Hospital Bern, University of Bern, Bern, Switzerland
| | - B Gottstein
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggass-Strasse 122, 3012, Bern, Switzerland
| | - D Candinas
- Department of Visceral Surgery and Medicine, University Hospital Bern, University of Bern, Bern, Switzerland
| | - G Beldi
- Department of Visceral Surgery and Medicine, University Hospital Bern, University of Bern, Bern, Switzerland
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Gottstein B, Lachenmayer A, Beldi G, Wang J, Merkle B, Vu XL, Kurath U, Müller N. Diagnostic and follow-up performance of serological tests for different forms/courses of alveolar echinococcosis. Food Waterborne Parasitol 2019; 16:e00055. [PMID: 32095626 PMCID: PMC7034017 DOI: 10.1016/j.fawpar.2019.e00055] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 02/07/2023] Open
Abstract
Diagnosis of alveolar echinococcosis (AE) is predominantly based on imaging procedures combined with immunodiagnostic testing. In the present study, we retrospectively analyzed the performance of four serological tests (EgHF-ELISA, Em2-ELISA, recEm18-ELISA and Em-Immunoblotting) for initial diagnosis and subsequent monitoring of AE patients. Overall, 101 AE patients were included, grouped according to treatment options and immune status as follows: (A) curative surgical treatment (n = 45 patients), (B) non-radical or palliative surgical treatment (n = 11), (C) benzimidazoles only (n = 20), (D) immunocompromised with radical surgical treatment (n = 11), (E) immunocompromised with benzimidazoles only (n = 4), and finally a group of 10 AE patients (F) that were considered to present so-called “abortive” lesions. Initial (i.e. pretreatment) ELISA-based diagnosis for patients in groups A to E revealed overall diagnostic sensitivities of 95% for EgHF, 86% for Em2, and 80% for recEm18, respectively. Comparatively, the diagnostic sensitivity of Em-Immunoblotting was higher with an overall value of 98%. In group F, only Em-Immunoblotting had an excellent diagnostic sensitivity (100%), whereas the ELISAs had poor sensitivities of 30% (EgHF- and Em2-ELISA) or even 0% (recEm18-ELISA). Serological monitoring of AE patients showed a clear association between a curative development of disease (induced either by surgery or benzimidazole medication) and a negativization in the ELISAs. This effect was most pronounced for the recEm18-ELISA, where 56% negativized following diagnosis/treatment, as compared to 36% for the EgHF-ELISA, and 37% for the Em2-ELISA, respectively. After radical surgery, the mean time until negativization in the recEm18-ELISA was 2.4 years (SD 1.6). This was significantly shorter than the mean 3.9 years (SD 2.5) in those AE patients with non-radical, palliative surgery or ABZ treatment who were able to negativize during the study period (p = 0.048). Conclusively, Em-Immunoblotting appears as the most sensitive test to diagnose active as well as inactive (“abortive”) AE-cases. The inclusion of the ELISAs completes the initial diagnostic picture and offers valuable additional information. Conversely, recEm18-ELISA appears as the currently best serological tool to monitor a regressive and putatively curative course of AE in treated patients. EgHF-ELISA plus Em-Immunoblotting results in most sensitive initial AE serodiagnosis. Em2- and recEm18-ELISA allow differentiation between AE and CE. recEm18-ELISA is currently the best monitoring test for assessing curative course of AE. Presumably inactive (“abortive”) AE cases were all positive by Em-Immunoblotting.
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Key Words
- ABZ, Albendazole
- AE, Alveolar echinococcosis
- CE, Cystic echinococcosis
- Diagnosis
- ELISA
- ELISA, Enzyme-linked immunosorbent assay
- Echinococcus multilocularis
- EgHF, Echinococcus granulosus hydatid fluid
- Em, Echinococcus multilocularis
- EmVF, Echinococcus multilocularis vesicular fluid
- FDG-PET/CT, fluorodeoxyglucose Positron Emission Tomography/Computed Tomography
- Follow-up serology
- Immunoblotting
- MRI, Magnetic Resonance Imaging
- US, Ultrasonography
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Affiliation(s)
- Bruno Gottstein
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
- Institute for Infectious Diseases, Medical Faculty, University of Bern, Bern, Switzerland
- Corresponding author at: Institute for Infectious Diseases, Medical Faculty, University of Bern, Bern, Switzerland.
| | - Anja Lachenmayer
- Department of Visceral Surgery and Medicine, Visceral Surgery, Inselspital University Hospital Bern and University Bern, Bern, Switzerland
| | - Guido Beldi
- Department of Visceral Surgery and Medicine, Visceral Surgery, Inselspital University Hospital Bern and University Bern, Bern, Switzerland
| | - Junhua Wang
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Bernadette Merkle
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Xuan Lan Vu
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Ursula Kurath
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Norbert Müller
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Kochanowski M, González-Muñoz M, Gómez-Morales MÁ, Gottstein B, Dąbrowska J, Różycki M, Cencek T, Müller N, Boubaker G. Comparative analysis of excretory-secretory antigens of Anisakis simplex, Pseudoterranova decipiens and Contracaecum osculatum regarding their applicability for specific serodiagnosis of human anisakidosis based on IgG-ELISA. Exp Parasitol 2018; 197:9-15. [PMID: 30584924 DOI: 10.1016/j.exppara.2018.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/22/2018] [Accepted: 12/20/2018] [Indexed: 11/25/2022]
Abstract
Serodiagnosis of human anisakidosis is presently hampered by the current lack of standardised serological assays that allow sensitive and specific detection of Anisakidae-specific antibodies in human patients. In the present study, we comparatively evaluated the diagnostic value (by IgG-ELISA) of excretory-secretory antigens (ESAgs) of Anisakis simplex, Pseudoterranova decipiens and Contracaecum osculatum, representing the most frequently found genera responsible for human infection. In addition, we tested also a mix of the three ES preparations (Mix-ESAgs) as well as two recombinant allergens of A. simplex, rAni s 1 and rAni s 7. ES antigen from C. osculatum yielded the best diagnostic performance in IgG-ELISA-based serodiagnosis of the Spanish anisakidosis patients investigated in this study (relative serodiagnostic sensitivity 100%; specificity 89%) as compared to A. simplex ES-antigen (93% versus 57%) and P. decipiens (67% versus 93%) or a mix of the three ES antigens (100% versus 44%), respectively. Cross-reactions of C. osculatum ES antigen with serum-antibodies from patients suffering from other helminth infections were rare and were exclusively found with few sera from toxocariasis, ascariasis, and filariasis patients. The two recombinant allergens rAni s 1 and rAni s 7 did not prove sufficiently sensitive and specific in order to justify a further evaluation of these antigens regarding their suitability in IgG-ELISA-based serodiagnosis of human anisakidosis. In conclusion, the C. osculatum-ESAg-ELISA remains as key candidate to be further assessed for the serodiagnosis of symptomatic anisakidosis in different endemic regions.
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Affiliation(s)
- Maciej Kochanowski
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Partyzantów Avenue 57, 24-100, Puławy, Poland
| | | | | | - Bruno Gottstein
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggass-Strasse 122, 3012, Bern, Switzerland
| | - Joanna Dąbrowska
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Partyzantów Avenue 57, 24-100, Puławy, Poland
| | - Mirosław Różycki
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Partyzantów Avenue 57, 24-100, Puławy, Poland
| | - Tomasz Cencek
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Partyzantów Avenue 57, 24-100, Puławy, Poland
| | - Norbert Müller
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggass-Strasse 122, 3012, Bern, Switzerland.
| | - Ghalia Boubaker
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggass-Strasse 122, 3012, Bern, Switzerland
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Basso W, Grandt LM, Magnenat AL, Gottstein B, Campos M. Strongyloides stercoralis infection in imported and local dogs in Switzerland: from clinics to molecular genetics. Parasitol Res 2018; 118:255-266. [PMID: 30552576 DOI: 10.1007/s00436-018-6173-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 12/03/2018] [Indexed: 11/29/2022]
Abstract
Strongyloides stercoralis is a worldwide-distributed intestinal nematode affecting mainly humans and dogs. Canine strongyloidosis is generally characterised by diarrhoea, malabsorption and bronchopneumonia, and may be fatal in cases of impaired immunity. In recent years, molecular and epidemiological studies suggested that host-adapted populations of S. stercoralis with different zoonotic potential may exist. Clinical and subclinical cases of S. stercoralis infection have been increasingly diagnosed in imported (France, Belgium, Bulgaria) and locally born dogs in Switzerland, showing that this parasite is currently circulating in Europe. Three of these clinical cases will be described here. All three dogs presented severe disease, characterised by harsh diarrhoea, dehydration, vomiting, respiratory and/or neurologic signs, and needed intensive care and hospitalisation. One of these dogs was related to a Swiss breeding kennel, in which the infection was subsequently diagnosed in several other dogs. Faeces were analysed by three coproscopical methods including (i) the Baermann technique, which consistently identified the typical S. stercoralis first-stage larvae in both clinical and subclinical infections, (ii) the sedimentation-zinc chloride flotation and (iii) sodium acetate-acetic acid-formalin concentration (SAFC) methods, which allowed the additional identification of parasitic females and/or eggs in two of the clinical cases. Interestingly, S. stercoralis isolated from all three independent clinical cases exhibited an identical genetic background on the nuclear 18S rDNA (fragment involving hypervariable regions I and IV) and the mitochondrial cytochrome oxidase subunit I (cox1) loci, similar to that of zoonotic isolates from other geographical regions, and not to that of dog-adapted variants. Due to the clinical relevance and zoonotic potential of this parasite, the awareness of both diagnosticians and clinicians is strongly required.
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Affiliation(s)
- Walter Basso
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
| | - Lisa-Maria Grandt
- Small Animal Clinic, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Anne-Laure Magnenat
- Small Animal Clinic, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Bruno Gottstein
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Miguel Campos
- Small Animal Clinic, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Wang J, Jebbawi F, Bellanger AP, Beldi G, Millon L, Gottstein B. Cover Image. Parasite Immunol 2018. [DOI: 10.1111/pim.12486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wang J, Jebbawi F, Bellanger AP, Beldi G, Millon L, Gottstein B. Immunotherapy of alveolar echinococcosis via PD-1/PD-L1 immune checkpoint blockade in mice. Parasite Immunol 2018; 40:e12596. [PMID: 30315719 PMCID: PMC6587932 DOI: 10.1111/pim.12596] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 09/04/2018] [Accepted: 10/08/2018] [Indexed: 01/01/2023]
Abstract
The growth potential of the tumour‐like Echinococcus multilocularis metacestode (causing alveolar echinococcosis, AE) is directly dependent upon the nature/function of the periparasitic adaptive host immune‐mediated processes. PD‐1/PD‐L1 pathway (programmed cell death 1), which inhibits lymphocytic proliferation in tumour development, is over‐expressed at the chronic stage of AE. We tested the impact of a PD‐1/PD‐L1 pathway blockade on the outcome of both chronic AE (intraperitoneal metacestode inoculation, secondary AE and SAE) and acute AE (peroral egg infection, primary AE and PAE). To assess the parasite proliferation potential, we measured parasite mass weight for SAE and liver lesion number for PAE. In both models, the parasite load was significantly decreased in response to anti‐PD‐L1 antibody treatment. In SAE, anti‐PDL1 administration was associated with increased Th1 response parameters and decreased Treg responses, while in PAE anti‐PDL1 administration was associated with fewer lesions in the liver and decreased Treg/Th2 responses. Our findings highly suggested that a PD‐1/PD‐L1 pathway blockade triggered the host immune responses in favour of an immune‐mediated control of E. multilocularis proliferation. Based on this, future studies that combine PD‐1/PD‐L1 blockade with a parasitostatic albendazole medication may yield in a putatively curative therapeutic approach to control alveolar echinococcosis.
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Affiliation(s)
- Junhua Wang
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Fadi Jebbawi
- Department of Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Anne-Pauline Bellanger
- Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France
| | - Guido Beldi
- Department of Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Laurence Millon
- Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France
| | - Bruno Gottstein
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
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Wang J, Goepfert C, Mueller N, Piersigilli A, Lin R, Wen H, Vuitton DA, Vuitton L, Mueller C, Gottstein B. Larval Echinococcus multilocularis infection reduces dextran sulphate sodium-induced colitis in mice by attenuating T helper type 1/type 17-mediated immune reactions. Immunology 2017; 154:76-88. [PMID: 29121394 PMCID: PMC5904711 DOI: 10.1111/imm.12860] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 10/27/2017] [Accepted: 10/29/2017] [Indexed: 12/13/2022] Open
Abstract
The tumour‐like growth of larval Echinococcus multilocularis tissue (causing alveolar echinococcosis, AE) is directly linked to the nature/orientation of the periparasitic host immune‐mediated processes. Parasite‐mediated immune suppression is a hallmark triggering infection outcome in both chronic human and murine AE. So far, little is known about secondary systemic immune effects of this pathogen on other concomitant diseases, e.g. endogenous gut inflammation. We examined the influence of E. multilocularis infection on murine dextran sodium sulphate (DSS) ‐induced colitis. At 3 months after E. multilocularis infection (chronic stage), the mice were challenged with 3% DSS in the drinking water for 5 days plus subsequently with tap water (alone) for another 4 days. After necropsy, fixed tissues/organs were sectioned and stained with haematoxylin & eosin for assessing inflammatory reactions. Cytokine levels were measured by flow cytometry and quantitative RT‐PCR. Colitis severity was assessed (by board‐certified veterinary pathologists) regarding (i) colon length, (ii) weight loss and (iii) a semi‐quantitative score of morphological changes. The histopathological analysis of the colon showed a significant reduction of DSS‐induced gut inflammation by concomitant E. multilocularis infection, which correlated with down‐regulation of T helper type 1 (Th1)/Th17 T‐cell responses in the colon tissue. Echinococcus multilocularis infection markedly reduced the severity of DSS‐induced gut inflammation upon down‐regulation of Th1/Th17 cytokine expression and attenuation of CD11b+ cell activation. In conclusion, E. multilocularis infection remarkably reduces DSS‐induced colitis in mice by attenuating Th1/Th17‐mediated immune reactions.
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Affiliation(s)
- Junhua Wang
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland.,State Key Laboratory Incubation Base of Xinjiang Major Diseases Research (2010DS890294) and Xinjiang Key Laboratory of Echinococcosis, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Christine Goepfert
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Animal Pathology, COMPATH, University of Bern, Bern, Switzerland
| | - Norbert Mueller
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Alessandra Piersigilli
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Animal Pathology, COMPATH, University of Bern, Bern, Switzerland
| | - Renyong Lin
- State Key Laboratory Incubation Base of Xinjiang Major Diseases Research (2010DS890294) and Xinjiang Key Laboratory of Echinococcosis, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Hao Wen
- State Key Laboratory Incubation Base of Xinjiang Major Diseases Research (2010DS890294) and Xinjiang Key Laboratory of Echinococcosis, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Dominique A Vuitton
- WHO-Collaborating Centre on Prevention and Treatment of Human Echinococcosis and French National Reference Centre on Alveolar Echinococcosis, University of Franche-Comté and University Hospital, Besançon, France
| | - Lucine Vuitton
- WHO-Collaborating Centre on Prevention and Treatment of Human Echinococcosis and French National Reference Centre on Alveolar Echinococcosis, University of Franche-Comté and University Hospital, Besançon, France.,Gastroenterology and Digestive Endoscopy, University Hospital, Besançon, France
| | - Christoph Mueller
- Institute of Pathology, Medical Faculty, University of Bern, Bern, Switzerland
| | - Bruno Gottstein
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
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Knapp J, Damy S, Brillaud J, Tissot JD, Navion J, Mélior R, Afonso E, Hormaz V, Gottstein B, Umhang G, Casulli A, Dadeau F, Millon L, Raoul F. EWET: Data collection and interface for the genetic analysis of Echinococcus multilocularis based on EmsB microsatellite. PLoS One 2017; 12:e0183849. [PMID: 28972978 PMCID: PMC5626424 DOI: 10.1371/journal.pone.0183849] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/12/2017] [Indexed: 11/19/2022] Open
Abstract
Evolution and dispersion history on Earth of organisms can best be studied through biological markers in molecular epidemiological studies. The biological diversity of the cestode Echinococcus multilocularis was investigated in different cladistic approaches. First the morphological aspects were explored in connection with its ecology. More recently, molecular aspects were investigated to better understand the nature of the variations observed among isolates. The study of the tandemly repeated multilocus microsatellite EmsB allowed us to attain a high genetic diversity level where other classic markers have failed. Since 2006, EmsB data have been collected on specimens from various endemic foci of the parasite in Europe (in historic and newly endemic areas), Asia (China, Japan and Kyrgyzstan), and North America (Canada and Alaska). Biological data on the isolates and metadata were also recorded (e.g. host, geographical location, EmsB analysis, citation in the literature). In order to make available the data set of 1,166 isolates from classic and aberrant domestic and wild animal hosts (larval lesions and adult worms) and from human origin, an open web access interface, developed in PHP, and connected to a PostgreSQL database, was developed in the EmsB Website for the Echinococcus Typing (EWET) project. It allows researchers to access data collection, perform genetic analyses online (e.g. defining the genetic distance between their own samples and the samples in the database), consult distribution maps of EmsB profiles, and record and share their new EmsB genotyping data. In order to standardize the EmsB analyses performed in the different laboratories throughout the world, a calibrator was developed. The final aim of this project was to gather and arrange available data to permit to better understand the dispersion and transmission patterns of the parasite among definitive and intermediate hosts, in order to organize control strategies on the ground.
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Affiliation(s)
- Jenny Knapp
- Laboratoire Chrono-environnement UMR CNRS 6249, University Bourgogne Franche-Comté, Besançon, France
- * E-mail:
| | - Sylvie Damy
- Laboratoire Chrono-environnement UMR CNRS 6249, University Bourgogne Franche-Comté, Besançon, France
| | - Jonathan Brillaud
- Laboratoire Chrono-environnement UMR CNRS 6249, University Bourgogne Franche-Comté, Besançon, France
| | - Jean-Daniel Tissot
- Laboratoire Chrono-environnement UMR CNRS 6249, University Bourgogne Franche-Comté, Besançon, France
| | - Jérémy Navion
- Laboratoire Chrono-environnement UMR CNRS 6249, University Bourgogne Franche-Comté, Besançon, France
| | - Raphael Mélior
- UMS 3245 OSU THETA Bourgogne Franche-Comté, Observatory of Besançon, Besançon, France
| | - Eve Afonso
- Laboratoire Chrono-environnement UMR CNRS 6249, University Bourgogne Franche-Comté, Besançon, France
| | - Vanessa Hormaz
- Anses Nancy laboratory for Rabies and Wildlife, National Reference Laboratory for Echinococcus spp., Wildlife Surveillance and Eco-epidemiology unit, Technopole Agricole et Vétérinaire, Malzéville, France
| | | | - Gérald Umhang
- Anses Nancy laboratory for Rabies and Wildlife, National Reference Laboratory for Echinococcus spp., Wildlife Surveillance and Eco-epidemiology unit, Technopole Agricole et Vétérinaire, Malzéville, France
| | - Adriano Casulli
- WHO Collaborating Centre for the epidemiology, detection and control of cystic and alveolar echinococcosis, Istituto Superiore di Sanità, Rome, Italy
- European Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy
| | - Frédéric Dadeau
- University Bourgogne Franche-Comté FEMTO-ST Institute/CNRS, Besançon, France
| | - Laurence Millon
- Laboratoire Chrono-environnement UMR CNRS 6249, University Bourgogne Franche-Comté, Besançon, France
| | - Francis Raoul
- Laboratoire Chrono-environnement UMR CNRS 6249, University Bourgogne Franche-Comté, Besançon, France
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Frey CF, Marreros N, Renneker S, Schmidt L, Sager H, Hentrich B, Milesi S, Gottstein B. Dogs as victims of their own worms: Serodiagnosis of canine alveolar echinococcosis. Parasit Vectors 2017; 10:422. [PMID: 28915832 PMCID: PMC5602927 DOI: 10.1186/s13071-017-2369-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 09/08/2017] [Indexed: 12/30/2022] Open
Abstract
Background Besides acting as definitive hosts for Echinococcus multilocularis, dogs can become infected by the larval form of this parasite and thereby develop life-threatening alveolar echinococcosis (AE). Although AE is a zoonotic disease, most therapeutic and diagnostic approaches have been developed for human patients. In dogs, AE is typically diagnosed in the advanced stage of the disease when the parasitic mass has already caused abdominal distension. At that stage, complete resection of the parasitic mass is often impossible, leaving a guarded prognosis for the affected dogs. For humans, sensitive and specific diagnostic protocols relying on serology have been validated and are now widely used. In contrast, sensitive and specific laboratory diagnostic tools that would enable early diagnosis of canine AE are still lacking. The aim of the current study was to establish a serological protocol specifically adapted to dogs. Methods We tested several native and recombinant antigens (EmVF, Em2, recEm95, recEm18) in in-house ELISA, an in-house Western blot (WB), as well as a commercially available WB developed for serodiagnosing human AE (Anti-Echinococcus EUROLINE-WB®), using a panel of known status dog sera. Results RecEm95-antigen was revealed to be the most promising antigen for use in ELISA, demonstrating 100% (95% CI: 72–100%) sensitivity and 100% (95% CI: 93–100%) specificity in our study. The in-house WB using EmVF antigen performed as well as the recEm95-ELISA. The commercial WB also correctly identified all infected dogs, coupled with a specificity of 98% (95% CI: 91–100%). Conclusion The recEm95-ELISA alone or in combination with either the in-house WB or the Anti-Echinococcus EUROLINE-WB® (IgG) with a minor modification should be considered as the best current approach for the serological diagnosis of dogs infected with the larval stage of E. multilocularis. However, larger studies with a focus on potentially cross-reacting sera should be undertaken to verify these findings.
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Affiliation(s)
- C F Frey
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Länggassstrasse 122, CH-3001, Bern, Switzerland. .,Canadian Food Inspection Agency, Centre for Food-borne and Animal Parasitology, 116 Veterinary Road, Saskatoon, S7N 2R3, Canada.
| | - N Marreros
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Länggassstrasse 122, CH-3001, Bern, Switzerland
| | - S Renneker
- EUROIMMUN AG, Seekamp 31, 23560, Luebeck, Germany
| | - L Schmidt
- EUROIMMUN AG, Seekamp 31, 23560, Luebeck, Germany
| | - H Sager
- Elanco Animal Health, Schwarzwaldallee 215, CH-4058, Basel, Switzerland
| | - B Hentrich
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Länggassstrasse 122, CH-3001, Bern, Switzerland
| | - S Milesi
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Länggassstrasse 122, CH-3001, Bern, Switzerland
| | - B Gottstein
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Länggassstrasse 122, CH-3001, Bern, Switzerland
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Valot B, Rognon B, Prenel A, Baraquin A, Knapp J, Anelli M, Richou C, Bresson-Hadni S, Grenouillet F, Wang J, Vuitton DA, Gottstein B, Millon L. Screening of antigenic vesicular fluid proteins of Echinococcus multilocularis as potential viability biomarkers to monitor drug response in alveolar echinococcosis patients. Proteomics Clin Appl 2017; 11. [PMID: 28697272 DOI: 10.1002/prca.201700010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 06/29/2017] [Accepted: 07/07/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE The only drugs available to treat alveolar echinococcosis (AE) are mostly parasitostatic and in many cases prescribed for life. Decision criteria for discontinuation rely on the absence of parasitic viability. The aim of the present study is to search for candidate proteins that may exhibit good potential as biomarkers for viability. EXPERIMENTAL DESIGN Sixteen serum samples (five healthy controls, 11 patients with AE), are used. AE-patients are classified into three groups "Cured" (n = 2), "ABZ-responders" (n = 4) and "ABZ-nonresponders" (n = 5). Immunoreactive proteins from vesicular fluid (VF) are identified and quantified by LC-MS/MS analysis after immunoprecipitation (IP) using all 16 serum samples. RESULTS Shotgun analysis of VF lead to the identification of 107 E. multilocularis proteins. Comparative proteomics reveal nine proteins more abundant in IP eluates from ABZ-nonresponder patients (cathepsin b, prosaposin a preprotein, actin modulator protein, fucosidase alpha L1 tissue, gluthatione-S-tranferase, beta galactosidase, elongation factor 2, H17g protein tegumental antigen, and NiemannPick C2 protein). CONCLUSIONS AND CLINICAL RELEVANCE Detection of antibodies against these proteins by ELISA could be helpful to monitor the course of alveolar echinococcosis under albendazole (ABZ) treatment.
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Affiliation(s)
- Benoît Valot
- UMR/CNRS 6249 Chrono-Environnement, University of Franche-Comté, Besançon, France
| | - Bénédicte Rognon
- UMR/CNRS 6249 Chrono-Environnement, University of Franche-Comté, Besançon, France.,Parasitology-Mycology Department, University Hospital of Besançon, Besançon, France
| | - Anais Prenel
- UMR/CNRS 6249 Chrono-Environnement, University of Franche-Comté, Besançon, France
| | - Alice Baraquin
- UMR/CNRS 6249 Chrono-Environnement, University of Franche-Comté, Besançon, France
| | - Jenny Knapp
- UMR/CNRS 6249 Chrono-Environnement, University of Franche-Comté, Besançon, France.,Parasitology-Mycology Department, University Hospital of Besançon, Besançon, France
| | - Mathilde Anelli
- UMR/CNRS 6249 Chrono-Environnement, University of Franche-Comté, Besançon, France
| | - Carine Richou
- WHO Collaborating Centre for Prevention and Treatment of Echinococcosis, and French National Reference Centre for Alveolar Echinococcosis, University Hospital of Besançon, Besançon, France.,Hepatology Department, University Hospital of Besançon, Besançon, France
| | - Solange Bresson-Hadni
- Parasitology-Mycology Department, University Hospital of Besançon, Besançon, France.,WHO Collaborating Centre for Prevention and Treatment of Echinococcosis, and French National Reference Centre for Alveolar Echinococcosis, University Hospital of Besançon, Besançon, France
| | - Frederic Grenouillet
- UMR/CNRS 6249 Chrono-Environnement, University of Franche-Comté, Besançon, France.,Parasitology-Mycology Department, University Hospital of Besançon, Besançon, France
| | - Junhua Wang
- Vetsuisse Faculty, Institute of Parasitology, University of Berne, Berne, Switzerland
| | - Dominique Angèle Vuitton
- WHO Collaborating Centre for Prevention and Treatment of Echinococcosis, and French National Reference Centre for Alveolar Echinococcosis, University Hospital of Besançon, Besançon, France
| | - Bruno Gottstein
- Vetsuisse Faculty, Institute of Parasitology, University of Berne, Berne, Switzerland
| | - Laurence Millon
- UMR/CNRS 6249 Chrono-Environnement, University of Franche-Comté, Besançon, France.,Parasitology-Mycology Department, University Hospital of Besançon, Besançon, France
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Meinel TR, Gottstein B, Geib V, Keel MJ, Biral R, Mohaupt M, Brügger J. Vertebral alveolar echinococcosis-a case report, systematic analysis, and review of the literature. Lancet Infect Dis 2017; 18:e87-e98. [PMID: 28807628 DOI: 10.1016/s1473-3099(17)30335-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 04/13/2017] [Accepted: 05/11/2017] [Indexed: 01/03/2023]
Abstract
Alveolar echinococcosis caused by Echinococcus multilocularis is an infrequent zoonosis with a high degree of disability, morbidity, and mortality, especially in disease clusters of the northern hemisphere. The diagnosis is complicated by extended incubation time, diverse clinical manifestations, and mimicking of differential diagnoses. The primary organ affected is the liver, but extrahepatic disease is possible, with vertebral involvement in only a few dozen cases described worldwide. Although vertebral alveolar echinococcosis seems to be rare, it might be under diagnosed, and it might be seen more often as the number of people with immunocompromised conditions increases. Recognition of this syndrome is crucial, because advances in medical and surgical management strategies since the introduction of benzimidazole in 1976 have controlled and relieved symptoms in most cases. In this Grand Round, we present the case of a 75-year-old woman who was referred for biopsy of a lumbar lesion 3 months after she was diagnosed with chronic myeloid leukaemia. The diagnosis of hepatic alveolar echinococcosis with metastasis to the lumbar spine and paravertebral region as well as the brain was confirmed by biopsy, PCR, and serology. The patient was given albendazole and referred for palliative surgery with the aim of pain control. Clinical features of the case are presented and discussed in the context of the literature. This case and review illustrate the complexity of extrahepatic alveolar echinococcosis manifestations and the necessity of an interdisciplinary approach.
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Affiliation(s)
| | - Bruno Gottstein
- Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Vanessa Geib
- Department of Internal Medicine, Sonnenhofspital, Bern, Switzerland
| | - Marius Johann Keel
- Department of Orthopedic Surgery, Bern University Hospital, Inselspital, Bern, Switzerland; Trauma Center Hirslanden, Clinic Hirslanden, Zurich, Switzerland
| | | | - Markus Mohaupt
- Department of Internal Medicine, Sonnenhofspital, Bern, Switzerland
| | - Jan Brügger
- Department of Internal Medicine, Sonnenhofspital, Bern, Switzerland.
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Wang J, Müller S, Lin R, Siffert M, Vuitton DA, Wen H, Gottstein B. Depletion of FoxP3 + Tregs improves control of larval Echinococcus multilocularis infection by promoting co-stimulation and Th1/17 immunity. Immun Inflamm Dis 2017. [PMID: 28621034 PMCID: PMC5691311 DOI: 10.1002/iid3.181] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction The growth potential of the tumor‐like Echinococcus multilocularis metacestode (causing alveolar echinococcosis, AE) is directly linked to the nature/function of the periparasitic host immune‐mediated processes. Previous studies had shown that regulatory T cells (Tregs) become gradually up‐regulated in the course of both chronic human and murine AE. Thus we now tackled the role of FoxP3+ Tregs and FoxP3+‐Treg‐regulated immune response in contributing to the control of this helminthic infection. Methods The infection outcome in E. multilocularis‐infected DEREG mice was measured upon determining parasite load (wet weight of parasitic metacestode tissue). Flow cytometry and qRT‐PCR were used to assess Treg, Th17‐, Th1‐, Th2‐type immune responses and antigen presenting cell activation. Results We showed that E. multilocularis‐infected DEREG‐mice treated with DT (as compared to infected control DEREG‐mice without DT application) exhibited a significantly lower parasite load, associated with a persisting capacity of co‐stimulation, and an increased Th1/Th17‐polarization. Conclusions FoxP3+ Tregs appear as one of the key players in immune regulatory processes favoring (i) metacestode survival by inhibiting the maturation potential of co‐stimulatory activity and (ii) T cell exhaustion (suppressing Th1/Th17‐type immune responses). We showed as well that prospectively, targeting FoxP3+ Tregs could be an option to develop an immunotherapy against AE.
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Affiliation(s)
- Junhua Wang
- Vetsuisse Faculty, Department of Infectious Diseases and Pathobiology, Institute of Parasitology, University of Bern, Bern, Switzerland.,State Key Lab Incubation Base of Xinjiang Major Diseases Research (2010DS890294) and Xinjiang Key Laboratory of Echinococcosis, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Stephan Müller
- FACSLab, c/o Institute of Pathology, University of Bern, Bern, Switzerland
| | - Renyong Lin
- State Key Lab Incubation Base of Xinjiang Major Diseases Research (2010DS890294) and Xinjiang Key Laboratory of Echinococcosis, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Myriam Siffert
- Vetsuisse Faculty, Department of Infectious Diseases and Pathobiology, Central Animal Facilities, University of Bern, Bern, Switzerland
| | - Dominique A Vuitton
- WHO-Collaborating Centre on Prevention and Treatment of Human Echinococcosis and French National Reference Centre on Alveolar Echinococcosis, University of Franche-Comté and University Hospital, Besançon, France
| | - Hao Wen
- State Key Lab Incubation Base of Xinjiang Major Diseases Research (2010DS890294) and Xinjiang Key Laboratory of Echinococcosis, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Bruno Gottstein
- Vetsuisse Faculty, Department of Infectious Diseases and Pathobiology, Institute of Parasitology, University of Bern, Bern, Switzerland
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Marinova I, Spiliotis M, Wang J, Muhtarov M, Chaligiannis I, Sotiraki S, Rainova I, Gottstein B, Boubaker G. Molecular characterization of Echinococcus granulosus isolates from Bulgarian human cystic echinococcosis patients. Parasitol Res 2017; 116:1043-1054. [PMID: 28110440 DOI: 10.1007/s00436-017-5386-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 01/16/2017] [Indexed: 02/03/2023]
Abstract
Although cystic echinococcosis (CE) is highly endemic in Bulgaria, there is still scarce information about species and/or genotypes of the Echinococcus granulosus complex that infect humans. Our study tackled the genetic diversity of E. granulosus complex in a cohort of 30 Bulgarian CE patients. Ten animal E. granulosus isolates from neighboring Greece were additionally included. Specimens were comparatively analyzed for partial sequences of five mitochondrial (mt) (cox I, nad I, rrnS, rrnL, and atp6) and three nuclear (nc) genes (act II, hbx 2, and ef-1α) using a PCR-sequencing approach. All 30 Bulgarian isolates were identified as E. granulosus sensu stricto (s.s.) and were showing identical sequences for each of the three examined partial nc gene markers. Based upon concatenated sequences from partial mtDNA markers, we detected 10 haplotypes: 6 haplotypes (H1-H6) clustering with E. granulosus s.s. (G1) and 4 haplotypes (H9-H13) grouping with E. granulosus s.s. (G3), with H1 and H10 being the most frequent in Bulgarian patients. The haplotypes H1, H4, and H11 were also present in Greek hydatid cyst samples of animal origin. In conclusion, E. granulosus s.s. (G1 and G3 genotypes) is the only causative agent found so far to cause human CE in Bulgaria. However, further studies including larger sample sizes and other additional geographic regions in Bulgaria will have to be performed to confirm our results.
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Affiliation(s)
- Irina Marinova
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Bern, 3012, Bern, Switzerland.,Department of Parasitology and Tropical Medicine, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Markus Spiliotis
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Bern, 3012, Bern, Switzerland
| | - Junhua Wang
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Bern, 3012, Bern, Switzerland
| | - Marin Muhtarov
- Department of Parasitology and Tropical Medicine, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria.,Multi-Profile Hospital for Active Treatment "Kardzhali", Gastroenterology Ward, Kardzhali, Bulgaria
| | - Ilias Chaligiannis
- Hellenic Agricultural Organisation-Demeter, Veterinary Research Institute, Thessaloniki, Greece
| | - Smaro Sotiraki
- Hellenic Agricultural Organisation-Demeter, Veterinary Research Institute, Thessaloniki, Greece
| | - Iskra Rainova
- Department of Parasitology and Tropical Medicine, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Bruno Gottstein
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Bern, 3012, Bern, Switzerland.
| | - Ghalia Boubaker
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Bern, 3012, Bern, Switzerland.,Department of Clinical Biology B, Laboratory of Medical and Molecular Parasitology-Mycology (LR12ES08), Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
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50
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Abrahamian FM, Aldape MJ, Aldasoro E, Allen UD, Al-Sum H, Anadkat MJ, Anders K, Angelakis E, Angus BJ, Antoniadou A, Arena F, Arends JE, Arribas JR, Artenstein AW, Atherton JC, Aucott JN, Aw TC, Babcock HM, Bailey R, Bailey TC, Banks AZ, Barillo DJ, Barrette EP, Bauer MP, Bayston R, Beard CB, Beardsley J, Beeching NJ, Bégué RE, Beldi G, Benson CA, Berbari EF, Berenger JM, Berger C, Bernardino JI, Bille J, Billioux AC, Bitnun A, Blair I, Blanche S, Bleck TP, Bleeker-Rovers CP, Bleijenberg G, Bloch KC, Blum J, Blumberg EA, Bonomo RA, Bonten MJ, Bourayou R, Bouza E, Brandt KA, Bretelle F, Brisse S, Britton WJ, Brook I, Brouwer MC, Browne SK, Bryant AE, Bühler S, Bulger EM, Buller RML, Burke LA, Burri C, Butler MW, Calandra T, Calfee DP, Calvo-Cano A, Cameron DW, Carcillo JA, Carson G, Chambers ST, Charrel RN, Nguyen VCV, Chevaliez S, Chiller TM, Christaki E, Chung KK, Clifford DB, Clumeck N, Cohen J, Collinge J, Conlon CP, Conrad C, Cooke FJ, Cope JR, Corey GR, Cross JH, Cunha BA, Cunha CB, D'Journo B, Daikos GL, Daniels JM, Davidson RN, Day NP, De Cock KM, de Silva TI, de Vries HJ, de Wit S, Delaloye J, Denning DW, Dennis DT, Dhanireddy S, Dielubanza EJ, Diemert DJ, Doganay M, Doherty T, Dolecek C, Dondorp AM, Douglas A, Drancourt M, Dubourg G, Dudley MN, Durand G, Eckhardt BJ, Efstratiou A, Ekkelenkamp MB, Eranki A, Erdem H, Escota GV, Evans HL, Eziefula AC, Fenollar F, Fenwick A, Fierer J, Finch RG, Fleckenstein JM, Forstner C, Foschi F, Fournier PE, French MA, Gage KL, Garcia LS, Gascon J, Gastañaduy AS, Gautret P, Geisler WM, Ghanem KG, Giani T, Giannella M, Gilliam BL, Gilliet M, Glaser CA, Glupczynski Y, Gnann JW, Goldstein EJ, Gottstein B, Gouriet F, Gravitt PE, Green MD, Green ST, Groll AH, Gulick RM, Gupta A, Habib G, Harbarth S, Harris M, Hayden FG, Hetem DJ, Hill PC, Hirschel B, Hodowanec AC, Hoffart L, Hoffmann C, Holland SM, Horby PW, Horne DJ, Hraiech S, Hull MW, Huttner A, Ingram RJ, Islam J, Ison MG, James SH, Jenkins C, Jenkins SG, Jensen JS, Johnston C, Jones TB, Jordan SJ, Julian KG, Kato Y, Kauffman CA, Kaye KS, Keane MP, Keeney J, Kelly P, Kent SJ, Kern WV, Keynan Y, Kim AA, Koné-Paut I, Kosmidis C, Kroes AC, Kroon FP, Ksiazek TG, Kuhlmann FM, Kuijper EJ, Kwon JH, Kyei GB, Lacombe K, Lagacé-Wiens P, Lagier JC, Lamagni T, Landraud L, Lanternier F, LaPlante KL, Lawn SD, Lawrence SJ, Leblebicioglu H, Lee N, Leggett JE, Lehours P, Levy PY, Leyh RG, Lillis RA, Limmathurotsakul D, Lin J, Lindquist HA, Lipsky BA, Liscynesky C, Looney D, Lortholary O, Lowy FD, Luft BJ, Mackowiak PA, MacPherson PA, Maghraoui-Slim V, Mallon PW, Mangino JE, Manuel O, Marchetti O, Marks KM, Marr KA, Marrazzo J, Marschall J, Martin DH, Matonti F, Matulewicz RS, Mayer KH, McCulloh RJ, McGready R, Mdodo R, Mead S, Mégraud F, Meintjes G, Metcalf SC, Michaels MG, Migliori GB, Miles MA, Miller A, Mimiaga MJ, Mingeot-Leclercq MP, Misch EA, Mitreva M, Montaner JS, Moore CB, Muñoz P, Muñoz J, Murray CK, Musso D, Mutengo M, Mutizwa MM, Naber KG, Natarajan P, Neme S, Newton PN, Nichols RA, Nicolle LE, Nosten F, Notarangelo LD, Nutman TB, Nyirjesy P, O'Connell PR, Opal SM, Ormerod LP, Osmon DR, Pankert MB, Pantaleo G, Papazian L, Parente DM, Parola P, Parsaei S, Pascual MA, Patel R, Patrozou E, Pawlotsky JM, Peacock SJ, Pechère JC, Pelegrin I, Peters BS, Peters EJ, Petersen JM, Petersen LR, Petraitis V, Pham LL, Picado A, Pilatz A, Pilmis B, Pinazo MJ, Pletz MW, Pogue JM, Polgreen EL, Polgreen PM, Posfay-Barbe KM, Powderly WG, Presti R, Prod'hom G, Puolakkainen M, Quinn TC, Raoult D, Razonable RR, Read RC, Redfield RR, Rentenaar RJ, Reynolds SJ, Ribi C, Richardson MD, Ritter ML, Roch A, Rockstroh JK, Rojek A, Romero JR, Rooijakkers SH, Rosenbluth D, Rosenzweig SD, Rossolini GM, Rubinstein E, Ryan G, Safren SA, Sahasrabuddhe VV, Saikku PA, Sajadi MM, Salvaggio MR, Santos CA, Satlin MJ, Schaeffer AJ, Schimmer C, Schooley RT, Schumacher RF, Sha BE, Shapiro DS, Sheehan G, Shlaes DM, Shoham S, Simmons CP, Simon DW, Simon MS, Simonsen KA, Slack MP, Smith TT, Sobel JD, Souli M, Sridhar S, Steckelberg JM, Stevens DL, Strah H, Sturm AW, Sungkanuparph S, Tabrizi SJ, Tacconelli E, Tan CS, Taplitz RA, Thomas G, Thomas LD, Thuny F, Thwaites G, Tissot F, Tønjum T, Torriani FJ, Toso C, Tulkens PM, Tunkel AR, Turner CE, Ustianowski AP, van Bambeke F, van Crevel R, van de Beek D, van Delden C, van der Eerden MM, van der Meer JW, van der Poll T, van Ingen J, van Putten J, Vaudaux BP, Vermund SH, Viscidi RP, Visvanathan K, Visvesvara GS, von Seidlein L, Wagenlehner FM, Wald A, Walsh TJ, Warhurst DC, Warnock DW, Warrell DA, Warrell MJ, Warris A, Watkins RR, Weatherall DJ, Weber R, Weidner W, White JR, White PJ, Whitehorn J, Whitley RJ, Whitty CJ, Wiersinga WJ, Wilcox MH, Williams TN, Wilson CC, Wilson ME, Wisplinghoff H, Wood R, Wunderink RG, Wyles D, Yang ZT, Yoder JS, Zaidi NA, Zimmer AJ, Zuckerman JN, Zumla A. List of Contributors. Infect Dis (Lond) 2017. [DOI: 10.1016/b978-0-7020-6285-8.00234-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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