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Intestinal mast cell response and mucosal defence against Strongyloides venezuelensis in interleukin-3-hyporesponsive mice.

Recently several inbred strains of mice were found to be hyporesponsive to Interleukin (IL)-3 because of a 5-bp deletion in the intron 7 of the gene that encodes IL-3 receptor alpha subunit (IL-3R alpha). Due to this mutation, mast cells were not generated in vitro from bone marrow cells of these mice under the presence of IL-3. Intestinal mucosal mast cells, of which growth/differentiation is dependent on IL-3, are important effector cells in immune-mediated expulsion of intestinal nematodes, Stronglyoides spp. In the present study, therefore, we examined intestinal mast cell response and mucosal defence against Strongyloides venezuelensis in IL-3-hyporesponsive C58/J and A/J mice. After subcutaneous inoculation with 10,000 infective larvae, C58/J and IL-3-responsive C57BL/6 mice showed identical kinetic patterns of daily faecal egg output and intestinal mast cell response. When these mice were infected with 3000 L3 and, five weeks later, they were challenged by intraduodenal implantation of 800 S. venezuelensis adult worms, the timing of logarithmic decline of faecal egg count as well as intestinal mastocytosis was delayed for two days in C58/J mice. Kinetics of intestinal mastocytosis and faecal egg excretion after a primary and challenge infection in A/J mice, another IL-3-hyporesponsive strain, were identical with those seen in C58/J mice. These results suggest that intestinal mast cell response and mucosal defence against S. venezuelensis of the mutant mice were almost completely compensated in vivo. Possible mechanisms of induction of intestinal mast cell response in IL-3R alpha-defective mice are discussed.

Animals↗

Protective mechanisms against the intestinal nematode Strongyloides venezuelensis in Schistosoma japonicum-infected mice.

Mice infected with Schistosoma japonicum were resistant to the intestinal nematode, Strongyloides venezuelensis. The numbers of adult S. venezuelensis recovered from mice were significantly decreased when infections were given from 6 weeks after S. japonicum infection. Larval recovery from the lungs showed that significant numbers of subcutaneously inoculated S. venezuelensis larvae were eliminated by 3 days in S. japonicum-infected mice (P < 0.0001), while histology revealed that this was associated with massive eosinophilic infiltration in the lungs. In addition, adult S. venezuelensis worms implanted in the duodenum of S. japonicum-infected mice could not establish in the intestine. This failure was associated with mucosal mastocytosis. Activation of eosinophils and intestinal mast cells was correlated with elevated expression of mRNA for interleukin (IL)-3, IL-4, and IL-5 in S. japonicum-infected mice. Sera from S. japonicum-infected mice recognized S. venezuelensis larva antigens as strongly as those from S. venezuelensis-infected mice, although transfer of sera from S. japonicum-infected mice to normal recipient mice did not protect them from S. venezuelensis challenge infection. It was concluded that the mechanisms for larval killing and adult worm expulsion of S. venezuelensis in S. japonicum-infected mice were identical to those seen in infections with S. venezuelensis only.

Animals↗

Natural resistance of 129/SvJ mice to Strongyloides venezuelensis infection.

The susceptibility of 129/SvJ mice to infection with Strongyloides venezuelensis was compared with that of C57BL/6 mice. After a primary infection, daily egg output in faeces (EPG) from 129/SvJ mice was lower and terminated earlier than that from C57BL/6 mice. Adult worm recovery from the small intestine of 129/SvJ mice on day 7 was also lower than that of C57BL/6 mice. When the numbers of larvae recovered from the lungs were examined on days 2, 3 and 4 after a primary infection, they were comparable between the two strains. On the other hand, when an equal number of larvae recovered from the lungs of each strain on day 3 were implanted orally into homologous strain mice, the magnitude of EPG and the number of adult worms in the small intestine on day 5 after implantation were significantly lower in 129/SvJ than in C57BL/6 mice. The number of mucosal mast cells in the jejunum was not significantly different between 129/SvJ and C57BL/6 naive mice. Total chondroitin sulphate concentration in the gut washings obtained from naive mice was significantly higher in 129/SvJ (11.34 +/- 9.48) than in C57BL/6 mice (1.09 +/- 0.77, P < 0.05). These results indicate that the natural resistance of 129SvJ mice to S. venezuelensis infection is expressed at the intestine, probably due to higher concentration of chondroitin sulphate, which prevents establishment of S. venezuelensis.

Animals↗

Strongyloides stercoralis infestation associated with septicemia due to intestinal transmural migration of bacteria.

Strongyloides stercoralis infestation is common in the tropics and is usually asymptomatic. Patients with immunocompromised states may develop hyperinfection and fulminant disease. It has been suggested that bacteria accompany S. stercoralis during its passage across the bowel wall, resulting in systemic sepsis. Herein is a report on a 30-year-old man with S. stercoralis infestation and small bowel bacterial overgrowth presenting as malabsorption syndrome. He developed extensive duodenojejunal ulceration, septicemia and fatal hypokalemia. Blood and jejunal fluid grew Escherichia coli with the same antibiotic sensitivity patterns. This supports the hypothesis of migration of bacteria from the intestinal lumen as a cause of septicemia in patients with fulminant S. stercoralis infestation.

Adult↗

Strongyloides hyperinfection in a patient with sarcoidosis.

A 51-year-old-woman presented with chronic eosinophilia, a diffuse interstitial lung pattern on CT and splenomegaly with hypodense lesions. A diagnosis of sarcoidosis was determined from a lung biopsy. Hyperinfection with strongyloides following treatment with systemic steroids explains the presence of eosinophilia and splenic involvement.

Animals↗

[Mechanism of hyocorticosteronemia action of Strongyloides ratti in the rat].

In order to explain the hypocorticosteronemia which establishes itself in rats with Strongyloides ratti parasites, we are proceeding with a functional exploration of the hypothalamo-hypophyso-corticosurrenal axis in experimentally infested rodents. The adreno-cortico-tropic-hormone test (A.C.T.H.), stress to ether and the Lysin-8-Vasopressin and Metopirone tests lead to concordant results: -- the hypothalamo-pituitary-corticosurrenal present a functional integrity which allows it to react normally to direct stimulation or to feed-back; -- the deficiency seems to relate to the hypothalamic secretion of the cortico-releasing factor; -- the cause would stem from an inhibition of the nervous mechanism which regulates this neurosecretion.

Adrenal Cortex Hormones↗

[Interactions of 2 associated parasitoses in the rat: Plasmodium berghei and Strongyloides ratti].

When Plasmodium berghei and Strongyloides ratti are associated, each one of these parasites can modify development of the other one. This repercussion is subordinated to the respective periods of contamination and strength of influential parasitism. It lies in an inhibition of Protozoosis or intensification of helminthiasis. When severe, palustral infection releases two hypercosticosteronemy phases; the more important one is situated at the peak of the parasitemia. These hypercorticosteronemiae reactions to a severe malaria enable the interpretation of the variations of an associateds trongyloïdiasis. They may be regarded as one of the inducer elements of immunological depression which takes place in the course of malaria in rodents.

Animals↗

[The role of inflammation in the spontaneous elimination of Strongyloides ratti infestation].

In order to assess the role of inflammation and its components in spontaneous cure of Strongyloides ratti infestation, rats were treated with non-steroid anti-inflammatory agents (indometacin; sodium salicylate) or with antagonists of certain mediators (dexchlorpheniramin; cyproheptadin, promethazin). Results were compared with those obtained in similar treatments of rats infested by other Nematoda which also give rise to spontaneous cure: especially Trichinella spiralis, and Nippostrongylus brasiliensis. Coordinating the various findings made it possible to devise a pattern accounting for the chain of reactions that lead to rejection of the parasite.

Animals↗

Cloning and expression of isocitrate lyase from human round worm Strongyloides stercoralis.

A full length cDNA (1463 bp) encoding isocitrate lyase (EC 4.1.3.1) of Strongyloides stercoralis is described. The nucleotide sequence of this insert identified a cDNA coding for the isocitrate lyase. The conceptually translated amino acid sequence of the open reading frame for S. stercoralis isocitrate lyase encodes a 450 amino acid residue protein with an apparent molecular weight of 50 kDa and a predicted pl of 6.39. The sequence is 69% A/T, reflecting a characteristic A/T codon bias of S. stercoralis. The amino acid sequence of S. stercoralis isocitrate lyase is compared with bifunctional glyoxylate cycle protein of Caenorhabditis elegans and isocitrate lyases from Chlamydomonas reinhardtii and Myxococcus xanthus. The full length cDNA of S. stercoralis was expressed in pRSET vector and bacteriophage T7 promoter based expression system. S. stercoralis lyase recombinant protein, purified via immobilized metal affinity chromatography, showed a molecular mass of 50 kDa on polyacrylamide gels. The role of isocitrate lyase in the glyoxylate cycle and energy metabolism of S. stercoralis is also discussed.

Amino Acid Sequence↗

Isolation of a cDNA encoding an IgG immunoreactive antigen (zinc finger protein) of Strongyloides stercoralis.

A full length cDNA encoding an IgG immunoreactive antigen of Strongyloides stercoralis is described. A clone containing 1,328 bp insert was selected following screening of S. stercoralis cDNA library with an IgG fraction obtained from a pool of 78 S. stercoralis positive human sera samples. The nucleotide sequence of the 1,328 bp insert was found to be 70.5% A/T, reflecting a characteristic A/T codon bias of S. stercoralis. The nucleotide sequence of this insert identified a cDNA coding for a zinc finger protein. The conceptually translated amino acid sequence of the open reading frame for the IgG immunoreactive antigen of S. stercoralis encodes a 211 amino acid residue protein with an apparent molecular weight of 22.8 kDa and a predicted isoelectric point of 8.71. The diagnostic potential of this IgG immunoreactive antigen of S. stercoralis is also discussed.

Amino Acid Sequence↗

The risk of Strongyloides stercoralis transmission from patients with disseminated strongyloidiasis to the medical staff.

To assess the risk of Strongyloides stercoralis transmission from two patients with disseminated strongyloidiasis to medical staff who had been in close contact with the patients, blood and stool specimens were obtained from medical staff two to three months after close contact with the patients. Antibodies to S. stercoralis were determined in blood. Stool specimens were tested for parasites with three different procedures.Forty-one medical staff were included. Culture and stool examination were negative in all subjects. Serology was negative in all subjects but one who had a borderline titer without signs or symptoms of strongyloidiasis. No evidence of transmission of S. stercoralis from patients with disseminated strongyloidiasis to medical staff was found.

Aged↗

Cutaneous Strongyloides stercoralis infection: an unusual presentation.

Strongyloides stercoralis is a widespread, soil-transmitted, intestinal nematode common in tropical and subtropical countries. The parasite is unique in its capability to carry out its entire life cycle inside the human body. Human beings contract strongyloidiasis by penetration of filariform larvae into the skin or mucous membrane after contact with contaminated soil. The larvae travel by the venous systems to the lungs, then ascend the bronchi to the trachea, where the larvae are coughed up by the human host, subsequently swallowed, and attain their habitat in the small intestine. Chronic strongyloidiasis acquired in endemic areas may last decades and gives rise to various dermatologic lesions, the most characteristic of which is larva currens, a serpiginous, creeping urticarial eruption. In disseminated strongyloidiasis, the characteristic skin lesions are widespread petechiae and purpura. We present a case of disseminated strongyloidiasis with an unusual manifestation mimicking a drug rash and review the dermatologic manifestations of strongyloidiasis infestation.

Aged↗

Effects of recombinant bovine interferon gamma on Strongyloides papillosus infection in calves.

The effects of interferon (IFN) gamma on the course of infection with Strongyloides papillosus in calves were investigated. Calves (N = 7 each) were inoculated with recombinant bovine IFNy or control solution daily from day 0 to day 15 following S. papillosus infection. Treatment with IFN-gamma induced an increase in faecal egg output in the peak stage of infection. The IFNgamma-treated animals harboured more worms, especially more immature worms, in the small intestine than control animals at necropsy on day 17, with no decreases in intestinal mucosal mast cells. Both animal groups had similar small numbers of intestinal worms at necropsy on day 26. All control animals developed peripheral blood eosinophilia on day 7, while five of seven IFN-gamma-treated animals did not. Serum alpha1-acid glycoprotein concentrations increased on day 7 in both animal groups, with higher values in control animals than in IFNgamma-treated animals. Control animals mounted a predominant IgG1 response to S. papillosus from day 10, while IFNgamma-treated animals did from day 22. These data suggested that IFNgamma inhibited some host protective responses to S. papillosus migrating larvae, resulting in an improvement of worm survival after a period when protective responses should be activated during the early stage of infection. The effects of IFNgamma on intestinal worm expulsion should be confirmed by further experiments.

Animals↗

Host genetic factors do not account for variation in parasite loads in Strongyloides fuelleborni kellyi.

Previous work in Papua New Guinea has shown considerable variation in egg counts between different people infected with Strongyloides fuelleborni kellyi, although individual egg loads remained relatively constant over a 14-month period. Possible explanations include genetic predisposition, a surprising longevity of the worms, or external auto-infection. We have now analysed the pedigrees of 177 individuals for whom egg counts were available, and find no evidence for polygenic inheritance of factors related to egg counts. The use of genetic models postulating the segregation of a single unknown susceptibility gene did not enable us, using the data available, to distinguish between this hypothesis and environmental determination of egg counts; nor did we find any association between egg load and the class 1 HLA genotype of the host.

Animals↗

A case of Strongyloides stercoralis and mesenteric tuberculous infection with acute abdominal pain in an HIV-positive patient.

We describe an HIV-positive female patient who had acute abdominal pain as the initial presentation of Strongyloides stercoralis infection. The diagnosis was established by identifying rhabditiform larvae in stool. She also had intra-abdominal tuberculosis without intestinal perforation. To our knowledge, this is the first reported case of such a presentation.

Adult↗

IL-18 with IL-2 protects against Strongyloides venezuelensis infection by activating mucosal mast cell-dependent type 2 innate immunity.

C57BL/6 (B6) and B6 background STAT6(-/-) mice pretreated with IL-18 plus IL-2 showed prominent intestinal mastocytosis and rapidly expelled implanted adult worms of the gastrointestinal nematode Strongyloides venezuelensis. In contrast, identically pretreated mast cell-deficient W/W(v) mice failed to do so. Thus, activated mucosal mast cells (MMC) are crucial for parasite expulsion. B6 mice infected with S. venezuelensis third-stage larvae (L3) completed parasite expulsion by day 12 after infection, whereas IL-18(-/-) or IL-18Ralpha(-/-) B6 mice exhibited marked impairment in parasite expulsion, suggesting a substantial contribution of IL-18-dependent MMC activation to parasite expulsion. Compared with IL-18(-/-) or IL-18Ralpha(-/-) mice, S. venezuelensis L3-infected STAT6(-/-) mice have poorly activated MMC and sustained infection; although their IL-18 production is normal. Neutralization of IL-18 and IL-2 further reduces expulsion in infected STAT6(-/-) mice. These results suggest that collaboration between IL-18-dependent and Th2 cell-dependent mastocytosis is important for prompt parasite expulsion.

Animals↗

Diagnosis of Strongyloides stercoralis infection.

Strongyloides stercoralis infects 30 million people in 70 countries. Infection usually results in asymptomatic chronic disease of the gut, which can remain undetected for decades. However, in patients receiving long-term corticosteroid therapy, hyperinfection can occur, resulting in high mortality rates (up to 87%). Strongyloidiasis is difficult to diagnose because the parasite load is low and the larval output is irregular. Results of a single stool examination by use of conventional techniques fail to detect larvae in up to 70% of cases. Several immunodiagnostic assays have been found ineffective in detecting disseminated infections and show extensive cross-reactivity with hookworms, filariae, and schistosomes. Although it is important to detect latent S. stercoralis infections before administering chemotherapy or before the onset of immunosuppression in patients at risk, a specific and sensitive diagnostic test is lacking. This review describes the clinical manifestations of strongyloidiasis, as well as various diagnostic tests and treatment strategies.

Animals↗