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W E Secor

Publications and source records attributed to W E Secor.

36 records · Page 2Linked to original sources

Studies on schistosomiasis in western Kenya: II. Efficacy of praziquantel for treatment of schistosomiasis in persons coinfected with human immunodeficiency virus-1.

Praziquantel is the drug of choice for schistosomiasis chemotherapy. Although the exact mechanism of how praziquantel kills schistosomes remains poorly understood, the immune response of the host is an important factor in drug efficacy. It is thus possible that disease states of humans that lead to immunodeficiencies, such as infection with human immunodeficiency virus-1 (HIV-1), may render praziquantel less effective in treating schistosomiasis. To test this hypothesis, persons with high levels of Schistosoma mansoni infection who were or were not also infected with HIV-1 were treated with a standard regimen of praziquantel and monitored by quantitative fecal examination and plasma circulating cathodic antigen. Both groups responded to praziquantel therapy equally and individuals with low percentages (< 20%) of CD4+ T cells did not differ from individuals with higher CD4 cell percentages. These data demonstrate that persons with HIV-1 infection can be treated effectively for schistosomiasis with praziquantel.

Animals↗

Immunoregulatory idiotypes stimulate T helper 1 cytokine responses in experimental Schistosoma mansoni infections.

Inbred male CBA/J mice with chronic Schistosoma mansoni infections develop two distinct syndromes. Hypersplenomegaly syndrome (HSS) demonstrates pathologic similarities to the hepatosplenic form of chronic human schistosomiasis, and moderate splenomegaly syndrome (MSS) resembles the asymptomatic intestinal form. Immunoaffinity-purified Abs against S. mansoni soluble egg Ags (SEA) from infected patients' sera differ idiotypically according to the donor's clinical form of the disease. We now show that immunoaffinity-purified anti-SEA Abs (Id) from MSS or HSS mice parallel idiotypic preparations of the analogous human clinical form by their differential ability to stimulate the proliferation of anti-Id T cells. MSS Id preparations stimulate spleen cells from either MSS or HSS animals. In contrast, HSS Id does not stimulate spleen cells from either group. In an anti-SEA ELISA, MSS and HSS Id preparations contained comparable levels of IgM and IgG1. However, the MSS Id preparation had higher levels of SEA-specific IgG2a and IgG2b than did HSS Id. The Ig isotypes of these Id preparations suggested differences in cytokine expression patterns. Studies of the cytokine profiles of the spleen cells responding to anti-SEA Id preparations demonstrated that while Id preparations from acutely infected mice stimulate IL-4 and IL-10 production, Id preparations from chronic MSS mice stimulate IFN-gamma production. HSS Id did not stimulate the production of any of these cytokines. The possibility that distinct immunoregulatory environments may contribute to the development of MSS and HSS correlates with earlier hypotheses that hepatosplenic pathology results at least in part from a lack of development or expression of appropriate regulatory Ids.

Adjuvants, Immunologic↗

B-1 cell (CD5+B220+) outgrowth in murine schistosomiasis is genetically restricted and is largely due to activation by polylactosamine sugars.

Previously, we demonstrated that lacto-N-fucopentaose III, a sugar found on egg Ags of Schistosoma mansoni, stimulated splenic B cells from parasite-infected mice to proliferate and produce IL-10 and PGE2. The major source of B cell IL-10 is the B-1 subset (CD5+B220+). Thus we examined whether levels of peritoneal exudate B-1 cells changed as a consequence of infection. In CBA/J, BALB/c, and C3H/HeJ mice, we observed significant increases in B-1 cells at 2 to 4 wk postinfection, declining to baseline by 6 to 8 wk. In contrast, the percentage of B-1 cells remained unchanged in C57BL/6 and BALB/c X.id mice after infection. B-1 cells were not observed in the spleens of infected mice; however, coincident with peritoneal B-1 cell decline, splenic CD23+B220+ cells increased from 11% to 30%. Peritoneal B-1 cells could also be expanded by injection of soluble egg Ag, but not by its deglycosylated form, suggesting a role for carbohydrates in B-1 recruitment. In addition, these cells secreted in vitro large amounts of IL-10 in response to lacto-N-fucopentaose III. Further, this sugar induced B-1 cell outgrowth in CBA/J and C3H/HeJ mice, but not in C57BL/6 mice. Thus, early activation of polylactosamine-reactive, IL-10-producing peritoneal B-1 and splenic B cells may be related to early dominance of the Th2-type CD4+ T cell subset. The degree to which this occurs may in part explain differences in the degree of granulomatous pathology reported among various strains of mouse.

Amino Sugars↗

Schistosoma mansoni: susceptibility differences between male and female mice can be mediated by testosterone during early infection.

In murine Schistosoma mansoni infections, fewer adult worms develop in male than in female mice infected with the same number of cercariae. To evaluate a potential role for testosterone in this phenomenon, testosterone levels were manipulated in groups of CBA/J mice that were then infected and monitored for survival rates, worm burdens, organomegaly, and egg production. By 16 weeks of infection, more than 80% of mice in groups with low levels of testosterone (untreated females, castrated males, or carrier-treated castrates) were dead, while less than 40% of those in groups with high levels of testosterone (sham-castrated males, testosterone-treated castrates, or testosterone-treated female mice) succumbed to infection. The mean number of worms recovered from mice in the low testosterone level groups was comparable among groups, and significantly greater than that from those in high-testosterone-level groups. The degree of organomegaly observed correlated strongly with worm burden, but the number of hepatic eggs per female worm did not differ significantly between groups. When male mice were castrated or sham-castrated 5 weeks after S. mansoni infection, no significant differences in host survival occurred. Furthermore, female mice treated with testosterone demonstrated reduced worm burdens if the testosterone was given 10 days prior to infection but not if the testosterone was given 10 days or 5 weeks after infection. Thus, the host sex bias observed in parallel-infected male and female mice appears to be related to the presence of male gonadal tissue or testosterone early in infection, during the development of immature schistosomules.

Animals↗

IL-10 deficit correlates with chronic, hypersplenomegaly syndrome in male CBA/J mice infected with Schistosoma mansoni.

Twenty weeks after moderate level infections with Schistosoma mansoni, approximately 20% of male CBA/J mice develop hypersplenomegaly syndrome (HSS) while the rest present with moderate splenomegaly syndrome (MSS). HSS and MSS mice differ pathophysiologically (degree of splenomegaly, anaemia, ascites, periportal fibrosis, portal hypertension) and immunologically with regard to antibodies (idiotypic expression, isotype levels) to schistosome soluble egg antigens (SEA), and spleen cell phenotypic profiles. This study compared in vitro proliferative responses and IL-2, IFN gamma, IL-4, and IL-10 production by spleen cells from uninfected mice and mice with acute (8 wk), MSS or HSS schistosomiasis mansoni, upon exposure to anti-CD3 epsilon or SEA, Spleen cells from uninfected mice produce Il-2 to anti-CD3 epsilon but exposure of cells from all three groups of infected mice to anti-CD3 epsilon or SEA led to only very low levels of supernatant IL-2. Anti-CD3 epsilon- or SEA-stimulated production of IFN gamma or Il-4, and anti-CD3 epsilon-stimulated production of IL-10, displayed similar patterns: highest cytokine production by cells from mice with acute infections and lower levels of production that did not differ between the two chronic groups. In contrast, while SEA-stimulated IL-10 production was again highest with cells from mice with acute infections, spleen cells from mice with MSS produced significantly more IL-10 than did those from mice with HSS. This association of low levels of antigen-induced IL-10 with severe pathology is consistent with the theory that IL-10 plays a role in the immunoregulation that occurs in chronic schistosomiasis.

Animals↗

Studies on schistosomiasis in western Kenya: I. Evidence for immune-facilitated excretion of schistosome eggs from patients with Schistosoma mansoni and human immunodeficiency virus coinfections.

Persons employed as vehicle washers in the town of Kisumu, Kenya are exposed for several hours each day to water in Lake Victoria that contains Schistosoma mansoni-infected Biomphalaria pherifferi snails. This results in a focus of high endemicity for schistosomiasis and these persons have very high concentrations of eggs in their feces (mean +/- SD = 1,469 +/- 1,581 eggs per gram [EPG] of feces). Fecal egg counts, but not circulating cathodic antigen (CCA) levels, in these schistosomiasis patients differed strikingly based on the patient's seropositivity for human immunodeficiency virus (HIV). Patients who were infected with S. mansoni and were seropositive for HIV had similar levels of CCA but excreted fewer eggs (643 +/- 622 EPG; n = 16) than individuals who were not seropositive for HIV infection (1,891 +/- 1,779 EPG; n = 37) (P = 0.009). Egg excretion ratios (EPG/CCA) of the seronegative group were also significantly higher than those of the seropositive group. Those in the seropositive group showed a significant correlative relationship between egg excretion ratios and CD4+ lymphocyte percentages. These observations are compatible with the hypothesis that schistosome eggs exit the human host through the requisite facilitation of functional immune responses, and that the efficacy of this process decreases in schistosomiasis patients co-infected with HIV as their peripheral blood CD4- cell levels decrease.

Adult↗

Immunopathogenesis and immunoregulation in schistosomiasis. Distinct chronic pathologic syndromes in CBA/J mice.

Inbred CBA/J mice with chronic (20-week) Schistosoma mansoni infections demonstrate two distinct syndromes. Hypersplenomegaly syndrome (HSS), characterized by a massive spleen, liver fibrosis, ascites, and anemia, resembles hepatosplenic human schistosomiasis, complete with portal hypertension and shunting. Moderate splenomegaly (MSS) syndrome, with less severe pathology, parallels most chronic human infections. Phenotypic analyses of spleen cells for CD44, CD62L, CD45RB, Ia, and CD25 indicate that HSS mice have more activated and memory CD4+ T cells than do MSS mice. HSS animals also have more B cells that highly express B7-2. Anti-CD3 stimulated spleen cells from 8-week or chronically infected mice produce IL-4 and IL-10 in a manner that appears not to involve the CD28/B7-2 costimulation pathway. By contrast IFN-gamma production is augmented in the presence of anti-CD28 and decreased in the presence of anti-B7-2. Infected mice make very little IL-2 to anti-CD3, even with added anti-CD28. As cytokines affect resultant B-cell responses and HSS and MSS mice display distinctive isotypes, differential regulatory or anergy hypotheses may best explain MSS/HSS differences.

Animals↗

Schistosoma mansoni: relationship of tumor necrosis factor-alpha to morbidity and collagen deposition in chronic experimental infection.

Chronic (20-week) Schistosoma mansoni infections in male CBA/J mice present as one of two pathophysiologic forms: severe hypersplenomegaly syndrome (HSS) or a less severe, moderate splenomegaly syndrome (MSS). HSS mice are cachectic (including anemia and hypertriglyceridemia) and exhibit high levels of periportal and perioval fibrosis. Because tumor necrosis factor-alpha (TNF-alpha) is associated with the symptoms of cachexia, we measured TNF-alpha protein and mRNA levels in the livers of infected and uninfected animals. TNF-alpha levels in liver homogenates from mice with acute infections (8-week) were high (mean +/- SEM; 41.0 +/- 1.6 ng/g tissue) and remained high in livers of HSS mice (41.8 +/- 3.0 ng/g tissue) while TNF-alpha levels in liver homogenates of MSS mice were significantly lower (27.9 +/- 2.0 ng/g tissue). Similarly, hepatic TNF-alpha mRNA levels from HSS mice were two- to threefold higher than those from MSS mice. Hydroxyproline levels in these animals were determined as a measure of collagen deposition and fibrosis and showed increased overall levels in the livers of HSS animals. To investigate the progression of HSS development, hematocrit and serum triglyceride levels were followed over a 20-week period after infection. In mice that developed HSS, hematocrit levels decreased significantly and progressively from Weeks 10 through 20. These same animals showed significant increases in serum triglycerides compared to 8-week-infected mice or the mice which developed MSS over the same time period. These results suggest that failure to downregulate hepatic production of TNF-alpha correlates with, and may contribute to, the development of liver fibrosis and HSS in experimental schistosomiasis.

Acute Disease↗

Association of hepatosplenic schistosomiasis with HLA-DQB1*0201.

Major histocompatibility class II alleles of 351 persons living in an area endemic for Schistosoma mansoni in northeastern Brazil were characterized at three loci (DRB1, DQA1, and DQB1). Contingency analyses were used to compare allele frequencies with high egg excretion, proliferative response to schistosome soluble egg antigens (SEA), and occurrence of severe, biopsy-confirmed hepatosplenic disease. There were no associations of HLA-DR or DQ with egg excretion. Patients positive for DRB1*01, DQA1*0101, or DQB1*0501 were less likely to respond to SEA than was the overall study population. However, using stringent Bonferroni correction (multiplying P values by the number of alleles tested; P x 35), none of these associations with SEA responsiveness remained significant. Hepatosplenic disease was less likely in patients positive for DRB1*11 and was more likely in patients positive for DRB1*07 or DQB1*0201. However, only the DQB1*0201 association remained significant (odds ratio = 3.72; P < .005) following Bonferroni correction.

Adolescent↗

In vitro effect of tinidazole and furazolidone on metronidazole-resistant Trichomonas vaginalis.

Trichomonas vaginalis is a common sexually transmitted protozoan parasite. Although often considered simply a nuisance infection, T. vaginalis has been implicated in premature rupture of placental membranes and increases in the risk of acquiring human immunodeficiency virus. Metronidazole, a 5-nitroimidazole, is currently the drug of choice to treat T. vaginalis infection. Because some patients have severe reactions to metronidazole and others are infected with metronidazole-resistant T. vaginalis, we were prompted to investigate alternative therapies. Tinidazole, another 5-nitroimidazole used in other countries to treat T. vaginalis infections, and furazolidone, a nitrofuran presently used to treat giardiasis and infections with some anaerobic enteric bacteria, were investigated for effectiveness against 9 metronidazole-susceptible and 12 metronidazole-resistant T. vaginalis patient isolates. The in vitro aerobic and anaerobic minimum lethal concentrations (MLC) and the time for drug efficacy were determined. Tinidazole killed the metronidazole-susceptible isolates at a low MLC but was effective against only 4 of the 12 metronidazole-resistant isolates. In contrast, furazolidone was effective at a low MLC for all isolates. When tinidazole was effective, it required > 6 h to kill trichomonads. However, furazolidone killed both metronidazole-susceptible and resistant trichomonads within 2 to 3 h of exposure. These data suggest that furazolidone may be a good candidate for treating metronidazole-resistant trichomoniasis and that further investigation of this drug is warranted.

Animals↗

Specific antibody patterns of Wistar rats inoculated with third stage larvae of Anisakis simplex.

Levels of excretory-secretory (ES)-specific antibody were measured in Wistar rats inoculated with 1, 5, or 20 third stage larvae (L3) of Anisakis simplex. Primary inoculation induced ES-specific IgM and IgG titers, paralleling inoculum size. Secondary inoculations resulted in an IgM and IgG titer augmentation in 1 or 5 larvae-inoculated animals to levels comparable to those of animals inoculated with 20 larvae, but titers in high inoculum animals did not increase upon secondary inoculation. Primary inoculation induced low ES-specific IgE antibody titers. However, secondary inoculation produced a different pattern than with IgM or IgG titers. Instead of titers equivalent to animals receiving more larvae, rats receiving 1 larva developed higher IgE titers than rats receiving larger inoculums. IgE titers of single larvae-inoculated rats peaked at 3-5 days after secondary inoculation but disappeared by day 14. The time course of IgE production is therefore consistent with duration of the infection. As the natural infection typically involves few larvae, monitoring ES-specific IgE may be a useful diagnostic tool for human intestinal anisakiasis.

Animals↗

Elevated innate peripheral blood eosinophilia fails to augment irradiated cercarial vaccine-induced resistance to Schistosoma mansoni in IL-5 transgenic mice.

Numerous factors contribute to host resistance to infection with Schistosoma mansoni. Although several studies have investigated the eosinophil as an effector cell of protective responses, its true role remains unclear. In vitro, human, but not mouse, eosinophils can kill schistosomula. Studies on schistosome infection susceptibility in naive or vaccinated eosinophil-deficient mice have yielded conflicting results. Using the gamma-irradiated cercariae (irr-cerc) model, we vaccinated interleukin (IL)-5 transgenic mice in parallel with background-matched controls (C3H/HeN) to examine whether innate eosinophilia contributes to increased protection from a challenge infection. In our laboratory, mean peripheral blood eosinophil (PBE) levels in IL-5 transgenic mice were 21,000 mm3, whereas in naive C3H/HeN mice this value was 240 mm3. In 3 separate experiments, both groups of vaccinated mice showed significant resistance to challenge infection. However, there was no significant difference in the percent worm reduction between transgenic IL-5 C3H mice (mean % protection = 44.3; range = 42-45%) and the control C3H/HeN mice (mean % protection = 51.7; range = 41-64%). Our findings indicate that high levels of innate PBE due to constitutive production of IL-5 do not augment irr-cerc-stimulated immunity.

Animals↗

Soluble intercellular adhesion molecules in human schistosomiasis: correlations with disease severity and decreased responsiveness to egg antigens.

Granuloma formation, the principal pathologic consequence of infection with Schistosoma mansoni, is a complex process involving intricate cell-cell interactions in which intercellular adhesion molecules are likely to participate. To examine this possibility, sera of schistosomiasis patients in various clinical groups were assayed for the presence of soluble intercellular adhesion molecule 1 (sICAM-1) and soluble E-selectin (sE-selectin). Comparisons were made between groups with different infection intensities (as predicted by fecal egg count) as well as between groups with severe (hepatosplenic) or milder (intestinal) pathology. All groups had elevated levels of sICAM-1 compared with controls. Also, patients in the high egg-excreting and hepatosplenic groups had significantly higher levels of serum sICAM-1 than patients in the low-egg-excreting and intestinal groups, respectively. The levels of sE-selectin were significantly elevated in the sera of all patients except those in the hepatosplenic group compared with controls. Patients in the intestinal group had significantly higher levels of sE-selectin in their sera than did hepatosplenic group patients, but serum sE-selectin levels of high- and low-egg-excreting patients were comparable. A striking finding of this study was the inverse correlation observed between sICAM-1 levels and peripheral blood mononuclear cell responses to schistosome soluble egg antigens (SEA) but not with responses to other schistosome antigens, purified protein derivative, or mitogen. Because ICAM-1 can perform a costimulatory function in antigen-presenting cell-T cell interactions, it is possible that shedding of ICAM-1 in the granuloma microenvironment interrupts proper costimulation, leading to unresponsive SEA-specific T cells. In this way, sICAM-1 could be one factor contributing to the observed modulation of cellular responses to SEA in chronic human schistosomiasis.

Adolescent↗

Failure of schistosomiasis to significantly decrease testosterone levels in Brazilian men.

Schistosomes can decrease the reproductive potential or castrate both invertebrate (snail) hosts as well as vertebrate (mouse, rat, and hamster) hosts. To determine if host castration occurs in human males, we examined testosterone levels in the sera of 38 Brazilian males, 16-35 years of age, who had Schistosoma mansoni infections. We found that individuals with intestinal schistosomiasis exhibited serum testosterone levels similar to those of noninfected controls. Four subjects with severe hepatosplenic disease also exhibited testosterone levels within the normal range. We did observe a negative correlation between parasite load (as predicted by fecal egg count) and testosterone levels but could not dissociate this relationship from the effect of age on either parameter. Therefore, in contrast to rodent models, host castration does not appear to be a usual side effect of human schistosomiasis.

Adolescent↗

Eosinophils and immune mechanisms. VI. The synergistic combination of granulocyte-macrophage colony-stimulating factor and IL-5 accounts for eosinophil-stimulation promoter activity in Schistosoma mansoni-infected mice.

Eosinophil stimulation promoter (ESP) is a lymphokine activity that stimulates eosinophil migration and is produced by mitogen or specific Ag stimulation of spleen cells from mice infected with Schistosoma mansoni. It is also produced by intact, schistosome egg-induced granulomas isolated from the livers of such mice without additional antigenic exposure. The production of ESP activity is decreased during chronic infection in a time course coordinate with granuloma modulation. Characterization of ESP was pursued to determine its relationship to other cytokines and to identify factors that may play a role in granuloma formation and modulation. Chromatographic separations, assays of recombinant cytokines, and cytokine-specific immunodepletions were used in the characterization. ESP+ supernatant fluids contain both granulocyte-macrophage CSF and IL-5. The removal of both granulocyte-macrophage CSF and IL-5 is required to eliminate ESP activity, and together they act synergistically to constitute ESP.

Animals↗

Mucosal cytokine and antigen-specific responses to Cryptosporidium parvum in IL-12p40 KO mice.

Studies of cellular immune responses to Cryptosporidium parvum have been limited in part by lack of suitable animal models. IL-12p40(-/-)mice are susceptible to initial infection with C. parvum but recover within 2 weeks, rendering the animals resistant to reinfection. Because the host responses that determine duration and severity of primary infection are not yet understood, we studied the cellular immune response to primary infection with C. parvum in IL-12p40(-/-)mice and also explored possible mechanisms for this response. Female IL-12p40(-/-)mice were inoculated with 10,000 oocysts. Uninfected age-matched mice served as controls. At different time intervals following exposure to oocysts, mice were sacrificed and their intestine, spleen, and mesenteric lymph node tissues were harvested. Cellular immune responses to C. parvum were characterized. Infection of IL-12p40(-/-)mice induced changes in the gene expression of the cytokines IFN-gamma, IL-4, IL-15, IL-18, TNF-alpha and TGF-beta during primary infection. There was also a significant increase in total numbers of lymphocytes and CD19/CD62L-expressing cells in mesenteric lymph nodes. These MLN cells exhibited increased antigen-specific proliferation and cytokine production (IL-6 and IFN-gamma) levels when stimulated in vitro. These observations delineate the cellular immune responses during acute C. parvum infection of the IL-12p40(-/-)mouse model.

Animals↗

Immunology of human schistosomiasis: off the beaten path.

Reviews of the immunology of human schistosomiasis generally address the host's protective responses against infection or the factors associated with development of severe pathology. However, there is a growing recognition that the high number of patients expressing moderate morbidity, rather than the few patients with severe morbidity, accounts for the greatest public health impact of schistosomiasis. Therefore, other aspects of the host immune response that have received relatively little attention may actually provide pivotal answers in our understanding and management of the morbidity associated with human schistosomiasis. This review highlights lines of investigation that focus on how immune responses to schistosomiasis may affect schistosomiasis-associated anaemia, alter susceptibility or disease progression during co-infections, and influence effective execution of mass treatment programmes.

Anemia↗