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PubMed2002

Reduction in the prevalence and intensity of hookworm infections after praziquantel treatment for schistosomiasis infection.

Praziquantel exhibits activity against all major human schistosome parasites and has become the cornerstone for treatment and morbidity control of schistosomiasis. Praziquantel is also active against a wide range of trematodes, human and veterinary cestodes and displays cysticidal effects. To the best of our knowledge anthelminthic properties have never been documented. Here, we report a study among 96 schoolchildren from an area highly endemic for Schistosoma mansoni and hookworm infection, and place particular emphasis on the effect of praziquantel on the prevalence and intensity of hookworm infections. Stool specimens were screened over several consecutive days prior and 4 weeks after systematic administration of praziquantel. We found a significant reduction in the prevalence of hookworm infection from 75.0 to 40.6% (odds ratio (OR)=0.21; 95% confidence interval (CI): 0.11-0.40). Infection intensities, expressed by geometric mean egg counts of all children, were also reduced significantly from 10.7 to 2.0 eggs per gram stool (paired t-test=7.78, P<0.001). If these findings are confirmed in other epidemiological settings - following a similarly sensitive diagnostic approach - they might become of considerable relevance. In areas where both schistosome and hookworm coexist, and praziquantel is being recommended for schistosomiasis control, large-scale application of this drug might also reduce the burden of hookworms.

Adolescent↗
PubMed2003

Altered T helper responses in CD40 and interleukin-12 deficient mice reveal a critical role for Th1 responses in eliminating the helminth parasite Taenia crassiceps.

A key feature of helminth infections is the induction of strong Th2-biased immune responses in their hosts. We have previously found that Th2-like responses mediate susceptibility to the helminth parasite Taenia crassiceps, probably by inhibiting Th1 responses required for the development of protective immunity against this parasite. Here we show that mice lacking interleukin-12p35 (IL-12p35-/-) following T. crassiceps infection, failed to mount a Th1 response, but developed a strong Th2-type response, produced higher levels of IgG1, IgE, interleukin-4, interleukin-5 as well as interleukin-13 than wild-type mice, and became highly susceptible to the larval stage of this cestode. In contrast, similarly-infected CD40 deficient BALB/c mice (CD40-/-) displayed impairment of both Th1 and Th2-type responses associated with low levels of interferon-gamma as well as IgE, interleukin-4, interleukin-5 and interleukin-13, but efficiently controlled T. crassiceps infection. Together, these findings suggest a detrimental role for Th2-biased responses during the larval stage of T. crassiceps infection. Furthermore, they also suggest a pivotal role for CD40 in developing Th2-type responses.

Animals↗
PubMed2003

Population genetic structure of Taenia solium from Madagascar and Mexico: implications for clinical profile diversity and immunological technology.

Taenia solium is a cestode parasitic of humans and pigs that strongly impacts on public health in developing countries. Its larvae (cysticercus) lodge in the brain, causing neurocysticercosis, and in other tissues, like skeletal muscle and subcutaneous space, causing extraneuronal cysticercosis. Prevalences of these two clinical manifestations vary greatly among continents. Also, neurocysticercosis may be clinically heterogeneous, ranging from asymptomatic forms to severely incapacitating and even fatal presentation. Further, vaccine design and diagnosis technology have met with difficulties in sensitivity, specificity and reproducibility. Parasite diversity underlying clinical heterogeneity and technological difficulties is little explored. Here, T. solium genetic population structure and diversity was studied by way of random amplified polymorphic DNA in individual cysticerci collected from pigs in Madagascar and two regions in Mexico. The amplification profiles of T. solium were also compared with those of the murine cysticercus Taenia crassiceps (ORF strain). We show significant genetic differentiation between Madagascar and Mexico and between regions in Mexico, but less so between cysticerci from different localities in Mexico and none between cysticerci from different tissues from the same pig. We also found restricted genetic variability within populations and gene flow was estimated to be low between populations. Thus, genetic differentiation of T. solium suggests that different evolutionary paths have been taken and provides support for its involvement in the differential tissue distribution of cysticerci and varying degrees of severity of the disease. It may also explain difficulties in the development of vaccines and tools for immunodiagnosis.

Animals↗
PubMed2003

Identification and characterisation of two distinct Smad proteins from the fox-tapeworm Echinococcus multilocularis.

Members of the transforming growth factor-beta (TGF-beta) family of cytokines and their corresponding receptors regulate cellular key processes such as proliferation and differentiation, and could be involved in communication mechanisms between parasitic helminths and their hosts. A pivotal role in intracellular TGF-beta signalling is played by Smad factors which directly transmit incoming signals from the cell surface receptors to the nucleus. In this study, we have identified and characterised two novel members of the Smad family, EmSmadA and EmSmadB, which are expressed by the human parasite Echinococcus multilocularis. Based on amino acid sequence comparisons, both echinococcal Smad homologues could be classified as members of the R-Smad subfamily. EmSmadB showed a typical domain structure consisting of conserved MH1 and MH2 domains separated by a proline-rich linker region. EmSmadA, on the other hand, lacked an MH1 region and merely contained an MH2 domain, a feature which has so far not been described for R-Smads. Based on the structures of the corresponding chromosomal loci and on sequence features of the conserved L3 loop regions, EmSmadA and EmSmadB are most likely involved in the transmission of TGF-beta- and bone morphogenetic protein (BMP) signals, respectively. Yeast two-hybrid analyses revealed that both Echinococcus Smads are capable of homo- and heterodimer formations. However, while the formation of homodimers for EmSmadB required previous activation of the protein at the C-terminal SSVS motif, EmSmadA homodimers were already formed in the basal state of the factor. Upon expression of the Echinococcus Smads in human cells, EmSmadA, but not EmSmadB, was phosphorylated by the human TGF-beta type I receptor. Furthermore, both factors functionally interacted with human BMP receptors. By reverse transcriptase-PCR experiments, the encoding genes, emsmadA and emsmadB, were shown to be expressed in the larval stages metacestode and protoscolex during an infection of the intermediate host. Taken together, our data suggest an involvement of EmSmadA and EmSmadB in echinococcal developmental processes during natural infections and provide a solid basis for further investigations on TGF-beta signalling mechanisms in cestodes.

Amino Acid Sequence↗
PubMed1997

Nutritional adaptations to parasitism within the platyhelminthes.

Some of the most significant alterations to the basic turbellarian plan are evident in the adaptations that relate to the acquisition of food by parasitic flatworms, reflecting the most potent of selection pressures in initiating and maintaining the host-parasite association. Nutritionally, ectoparasitic monogeneans show most correspondence with the predatory turbellarians, with certain monopisthocotylean members feeding by means of a protrusible pharynx and extracorporeal digestion, as skin-browsers of fish, with extensive intracellular digestion involving lysosomal enzymes in a well-differentiated gut. The more sheltered vascularised gill chamber of fish provides many polyopisthocotylean monogeneans with a totally renewable and more comprehensive diet in the form of blood, but haematophagy has necessitated a number of digestive adaptations, not least in resolving the problem of intracellular accumulations of haematin pigment. Haematophagy is the predominant feeding strategy of digeneans, but in contrast to monogeneans digestion of blood is largely extracellular; in schistosomes digestion is rapid, involving a battery of cathepsin-like cysteine proteinases and aminopeptidases. The external surfaces of all parasitic flatworms depart from turbellarian character and are composed of a multifunctional syncytial tegument, which is permeable to a variety of small organic solutes, some crossing by passive diffusion, others via facilitated or active mediated transport. The relative roles of the tegument and gut in trematode nutrition are difficult to assess, but can be related to the nature of the microhabitat within the host. Cestodes are highly adapted intestinal parasites bereft of any vestige of gut, and their tegument has become elaborated into a sophisticated and highly efficient digestive-absorptive layer, rivalling the vertebrate mucosa in its ability to gain kinetic advantage in the selective uptake of nutrient at the host-parasite interface. The patterns of energy metabolism in adult flatworm parasites are generally anaerobic and based on glycogen, with abbreviated metabolic pathways and the loss of biosynthetic capacities.

Animal Nutritional Physiological Phenomena↗
PubMed1997

Coproantigen detection in dogs experimentally and naturally infected with Echinococcus granulosus by a monoclonal antibody-based enzyme-linked immunosorbent assay.

A sandwich ELISA for the detection of Echinococcus granulosus coproantigen in formalin and heat-treated faecal supernatants of dogs was developed. The assay used affinity-purified polyclonal antibodies obtained from rabbits hyperimmunised with E. granulosus excretory/secretory antigens and biotinylated monoclonal antibody EmA9 produced against adult E. multilocularis somatic extract. The test was sensitive to 7 ng and 2.3 ng of E. granulosus protein and carbohydrate/ml of faecal supernatant, respectively. Thirteen helminth-free dogs were infected with different amounts of E. granulosus protoscoleces and the presence of coproantigen was monitored during the prepatent period until day 35 post-infection, when they were necropsied. Faecal antigen levels started to rise above the normal range between days 10 and 20 post-infection, and typically peaked at the end of the experiment. All the dogs, bearing from 3 to 67,700 worms, showed positive values in the ELISA during the prepatent period. One dog experimentally infected with Taenia hydatigena metacestode and harbouring three worms, tested positive only after the prepatent period at day 52. The test was applied to 98 stray dogs. The ELISA detected all of four dogs naturally infected with E. granulosus, two dogs with patent infections of T. hydatigena and two dogs with no cestode infections, showing a sensitivity of 100% and a specificity of 96%.

Animals↗
PubMed1998

Relative concentrations of heavy metals in the parasites Ascaris suum (Nematoda) and Fasciola hepatica (Digenea) and their respective porcine and bovine definitive hosts.

The concentrations of lead and cadmium determined by electrothermal atomic absorption spectrometry were significantly higher in the liver and kidney, respectively, of pigs than in their intestinal nematode parasites Ascaris suum. There was no clear pattern in the distribution of lead within the ascarids, but cadmium concentrations were highest in the intestine. A parallel investigation of cattle naturally infected with the liver fluke, Fasciola hepatica, revealed interesting differences. Although the cadmium content of F. hepatica was considerably lower than that in the tissues of cattle, the concentration of lead in the digenean was on average 172, 53 and 115 times higher than in the muscle, kidney and liver of the host. Furthermore, there was a significant positive correlation between the weight of individual F. hepatica and their lead burden. The lack of appreciable heavy-metal accumulation in A. suum is consistent with results for the nematode Anguillicola crassus in fish. However, although lead concentrations in the liver fluke F. hepatica were considerably elevated above host tissue levels, the degree of heavy-metal accumulation was relatively low when compared to that of acanthocephalans and cestodes of fish.

Animals↗
PubMed1998

The phylogenetic position of Udonella (Platyhelminthes).

Phylogenetic analysis of molecular data from complete 18S rRNA and partial 28S rRNA genes, of a variety of platyhelminths, places the enigmatic Udonella caligorum firmly as a monopisthocotylean monogenean. Both maximum parsimony and a modified distance measure, operating under a maximum likelihood model, gave identical solutions for each data set. These data further support morphological evidence from ultrastructural studies indicating the neodermatan affinities of Udonella, namely shared features in sensory receptors, surface tegument, sperm structure and spermiogenesis. The molecular data reject the class Udonellidea and the placement of udonellids as sister-group to the Neodermata. As shown previously with molecular data, the monogeneans appear as a paraphyletic assemblage comprising strongly monophyletic Monopisthocotylea and Polyopisthocotylea. Their relationships with the trematodes and cestodes are not resolved with 28S rDNA or 18S rDNA alone.

Animals↗
PubMed1998

Ultrastructure of spermiogenesis of Dipylidium caninum (Cestoda, Cyclophyllidea, Dipylidiidae), an intestinal parasite of Canis familiaris.

We describe for the first time the ultrastructure of spermiogenesis of a representative of the family Dipylidiidae, Dipylidium caninum. Spermiogenesis begins with the formation of a differentiation zone. This conical area presents two centrioles with associated striated roots. One of the centrioles develops a flagellum and posteriorly a proximodistal fusion is produced between the axoneme and a median cytoplasmic process. In a final stage of spermiogenesis a condensation of electron-dense material between cortical microtubules is observed in the anterior part of the differentiation zone. This is the origin of the crest-like body that appears at the end of spermiogenesis. The presence of striated roots associated with centrioles constitutes the first report of these structures in the spermiogenesis of a cyclophyllidean cestode.

Animals↗
PubMed1998

Dideoxy fingerprinting: application to the genotyping of Echinococcus.

Dideoxy fingerprinting is an efficient method for the detection of sequence variation in PCR-amplified DNA segments. It is a hybrid between single-strand conformation polymorphism and dideoxy sequencing, employing only one dideoxynucleotide in the sequencing reaction. Herein, we report the application of dideoxy fingerprinting to genetically type cestodes of the genus Echinococcus, utilising the mitochondrial cytochrome c oxidase subunit I as the gene sequence for analysis. All of the seven genotypes (G1, G4, G6, G8, O, V and M2) examined could be readily differentiated from one another by their characteristic and reproducible dideoxy fingerprinting profiles. Only subtle variation in profiles was detected among some of the eight isolates representing genotype G1, and no variation was detected between two samples of genotype G4 and of genotype M2. The capacity of dideoxy fingerprinting to detect all nucleotide variations over 150-250bp fragments indicates that it should be possible to distinguish among all of the genotypes of Echinococcus thus far described. Although employed herein to display sequence variation in the cytochrome c oxidase subunit I of Echinococcus, dideoxy fingerprinting could be used for the high-resolution analysis of nucleotide variations in other parasite genes, without the need for DNA sequencing. This has important implications for studying the genetic structure of parasite populations.

Animals↗
PubMed1999

Cysteine conjugate beta-lyase activity in three species of parasitic helminth.

Living organisms employ a variety of metabolic pathways when detoxifying xenobiotic compounds, including the formation of cysteine S-conjugates via glutathione conjugation. However, cysteine conjugate beta-lyase (CCBL) catalysed beta-cleavage, of certain cysteine conjugates, is known to cause cytotoxicity. This study represents the first investigation into the expression of CCBL and other associated enzymes in helminth species. A survey of the three major groups of parasitic helminths [cestodes (Moniezia expansa), digeneans (Fasciola hepatica) and nematodes (Necator americanus, Heligmosomoides polygyrus)] has been made. The presence of CCBL enzymes within Moniezia expansa, Necator americanus and Heligmosomoides polygyrus has been established. Each species was screened for gamma-glutamyl transpeptidase activity and transaminase activity towards L-aspartate, L-alanine, L-albizziin and L-phenylalanine. Aspartate and alanine aminotransferase activity were detected in all four species tested. Gamma-glutamyl transpeptidase activity was only detected in Moniezia expansa and Necator americanus.

Alanine↗
PubMed1999

Molecular systematic analysis of the order Proteocephalidea (Eucestoda) based on mitochondrial and nuclear rDNA sequences.

Two ribosomal DNA sequences were used to infer phylogenetic relationships among the Eucestoda order Proteocephalidea. A 437 bp portion of the 16S mitochondrial and a 1149 bp 5' portion of the nuclear large sub-unit rRNA molecule were sequenced for 53 proteocephalidean cestodes (representing nine subfamilies and 22 genera) and for one outgroup species. Parsimony and distance-based analyses of the two databases, alone and combined, failed to support the monophyly of the two traditionally accepted families, of numerous subfamilies (with the exception of the Rudolphielliinae and Othinoscolescinae which were validated in our analysis) and of various genera, including the genus Nomimoscolex (Woodland), Ophiotaenia (La Rue) as well as the type genus Proteocephalus (Weinland). Palaearctic Proteocephalus species nevertheless constituted a well-defined clade. The two genes globally yielded compatible results; however, the nuclear ribosomal gene provided a better resolution of relations among Proteocephalidea.

Animals↗
PubMed2000

High molecular mass glycans are major structural elements associated with the laminated layer of in vitro cultivated Echinococcus multilocularis metacestodes.

The laminated layer of the larval stage (metacestode) of the cestode parasite Echinococcus multilocularis is composed largely of carbohydrates, which form a tight microfibrillar meshwork around the entire metacestode. Since this laminated layer is the only parasite structure which is in constant contact with host immune and non-immune cells, and appears largely resistant to physiological and immunological reactions of the host, it most likely carries out important functions with regard to host-parasite interactions. In infected hosts, the metacestode is usually concentrically covered by host connective tissue cells and large amounts of collagen, causing a dense scar-like fibrosis, and it is likely that host-derived components are incorporated into the laminated layer at the host-parasite interface. Therefore, in order to obtain information on the molecular composition of this structure, we used parasite larvae which were generated through in vitro cultivation and thus were largely devoid of interfering host components. Lectin fluorescence on section-labelling of metacestodes embedded in LR-White suggested that the laminated layer is largely composed of N-acetyl-beta-D-galactosaminyl, and alpha- and beta-D-galactosyl residues, as well as of the core structure of O-linked carbohydrate chains, N-acetylgalactosamine-beta-1.3-galactose, while N-linked glycopeptides and alpha-D-mannosyl residues and/or glucosyl residues were found mainly within the germinal layer, and within the cellular mass and the surface of developing protoscoleces. Lectin-gold EM confirmed these findings. The laminated layer was isolated from in vitro cultivated metacestodes by urea extraction, and the ultrastructure of the purified laminated layer was assessed comparatively with respect to the laminated layer of intact parasites. The glycan composition was determined using SDS-PAGE and lectin blotting. This work has laid the basis for a more detailed dissection of the molecular composition of the laminated layer.

Animals↗
PubMed1997

Renal echinococcosis: clinical study of 34 cases.

PURPOSE: Hydatid disease, a cyclo-zoonotic parasitic infestation caused by the larval stage of the cestode Echinococcus granulosus, is prevalent worldwide. We reviewed the clinical findings of a large series of renal hydatidosis treated in an endemic area with special emphasis on diagnostic pitfalls. MATERIALS AND METHODS: A retrospective 15-year review in a rural area of central Spain (600,000 population), with a global incidence of hydatidosis of 10 new cases per 100,000 population per year, revealed 34 with renal echinococcosis treated surgically (3 to 4% of officially confirmed cases of hydatidosis). Clinical, radiological and laboratory data were analyzed. RESULTS: Renal hydatid disease mimicked other diseases. The combination of clinical history, imaging studies, and serological and urine investigation yielded a reliable pretreatment diagnosis in only 50% of cases and a presumptive diagnosis in 71%. Among imaging studies computerized tomography was the most valuable diagnostic examination. Moderate eosinophilia was found in half of the cases, while a third had scoleces in the urine. A diagnostic and therapeutic algorithm is presented. CONCLUSIONS: Preoperative diagnosis of renal hydatid disease is difficult even in an endemic zone. Imaging studies are suggestive but usually inconclusive, and the differential diagnosis with a renal tumor or complicated cyst may not be made without surgery. Renal sparing surgery is possible in a significant proportion of cases, particularly when preoperative diagnosis has been considered. Significant surgical morbidity can be expected, and the risk of anaphylaxis and hydatid seeding, although low, should not be overlooked.

Adolescent↗
PubMed1998

Bacterial and parasitic cholangitis.

Bacterial cholangitis is a clinically defined syndrome caused by the regurgitation of infected bile into the circulation. The pathogenic mechanism is unclear, and systemic sepsis may not occur. Prerequisite conditions are the presence of microorganisms in the bile and increased biliary pressure. Bacteria that commonly cause cholangitis are Escherichia coli, Klebsiella, Enterococcus, Enterobacter, Pseudomonas, and anaerobes. Although most infections are polymicrobial, this situation may not always prevail. Successful treatment depends on relieving biliary obstruction and administering antibiotics effective against bacteria in the circulation and the bile. The causes of biliary obstruction that predispose to bacterial cholangitis are myriad. Common conditions include biliary stones and benign strictures. In many parts of the world, biliary parasites are an important factor. Biliary parasites cause necrosis, inflammation, fibrosis, strictures, and cholangiectasis of the bile ducts by several mechanisms: (1) as a direct result of the irritating chemical composition of the parasite, parasitic secretions, or eggs; (2) physical obstruction of the bile ducts; (3) induction of formation of biliary stones; and (4) introduction of bacteria into the biliary system during migration from the duodenum. Therefore, bacterial cholangitis has an important and frequently dominant role in the pathogenesis and clinical course of biliary disease due to these parasitic infestations. Common biliary parasites include the nematode Ascaris lumbricoides, the trematodes Opisthorchis viverrini and felineus, Clonorchis sinensis, and Fasciola hepatica, and the cestodes Echinococcus granulosus and multilocularis. The epidemiologic, pathologic, and clinical manifestations of these parasitic infestations are reviewed.

Cholangitis↗
PubMed2002

Differential diagnosis of Taenia saginata and Taenia solium infections: from DNA probes to polymerase chain reaction.

The objective of this work was the rapid and easy differential diagnosis of Taenia saginata and T. solium. First, a T. saginata size-selected genomic deoxyribonucleic acid (gDNA) library was constructed in the vector lambda gt10 using the 2-4 kb fraction from the parasite DNA digested with EcoR1, under 'star' conditions. After differential screening of the library and hybridization analysis with DNA from T. saginata, T. solium, T. taeniaeformis, T. crassiceps, and Echinococcus granulosus (bovine, porcine, and human), 2 recombinant phages were selected. They were designated HDP1 and HDP2. HDP1 reacted specifically with T. saginata DNA, and HDP2 recognized DNA from both T. saginata and T. solium. The 2 DNA probes were then sequenced and further characterized. HDP1 was a repetitive sequence with a 53 bp monomeric unit repeated 24 times in direct tandem along the 1272 bp fragment, while the 3954 bp HDP2 was not a repetitive sequence. Using the sequencing data, oligonucleotides were designed and used in a polymerase chain reaction (PCR). The 2 selected oligonucleotides from probe HDP1 (PTs4F1 and PTs4R1) specifically amplified gDNA from T. saginata, but not T. solium or other related cestodes, with a sensitivity of < 10 pg of T. saginata gDNA, about the quantity of DNA in one taeniid egg. The 3 oligonucleotides selected from the HDP2 sequence (PTs7S35F1, PTs7S35F2, and PTs7S35R1) allowed the differential amplification of gDNA from T. saginata, T. solium and E. granulosus in a multiplex PCR, again with a sensitivity of < 10 pg. These diagnostic tools have immediate application in the differential diagnosis of T. solium and T. saginata in humans and in the diagnosis of dubious cysts in the slaughterhouse. We also hope to apply them to epidemiological surveys of, for example, soil and water in endemic areas.

Animals↗
PubMed1982

Cysticercosis of the fallopian tube: histology and microanalysis.

The authors identified a degenerated, focally calcified cestode larva (cysticercus) in the fallopian tube of a 50-year-old woman with endometriosis. The physiologic reaction to the larva was minimal, with some focal granulomatous salpingitis. No other focus of infection was detected. The differential diagnosis included trophoblastic tissue, foreign material, and parasites. Scanning electron microscopy and x-ray microanalysis of the organism revealed concentration of iodine in the subcuticular connective tissue of the larva and confirmed the calcium phosphate composition of the calcareous corpuscles. The presumed source of the iodine was the continued exposure of the larva to an environment rich in iodide secreted by the epithelium of the fallopian tube.

Cysticercosis↗
PubMed2006

Control of cystic echinococcosis/hydatidosis: 1863-2002.

Echinococcosis/hydatidosis, caused by Echinococcus granulosus, is a chronic and debilitating zoonotic larval cestode infection in humans, which is principally transmitted between dogs and domestic livestock, particularly sheep. Human hydatid disease occurs in almost all pastoral communities and rangeland areas of the underdeveloped and developed world. Control programmes against hydatidosis have been implemented in several endemic countries, states, provinces, districts or regions to reduce or eliminate cystic echinococcosis (CE) as a public health problem. This review assesses the impact of 13 of the hydatid control programmes implemented, since the first was introduced in Iceland in 1863. Five island-based control programmes (Iceland, New Zealand, Tasmania, Falklands and Cyprus) resulted, over various intervention periods (from <15 to >50 years), in successful control of transmission as evidenced by major reduction in incidence rates of human CE, and prevalence levels in sheep and dogs. By 2002, two countries, Iceland and New Zealand, and one island-state, Tasmania, had already declared that hydatid disease had been eliminated from their territories. Other hydatid programmes implemented in South America (Argentina, Chile, Uruguay), in Europe (mid-Wales, Sardinia) and in East Africa (northwest Kenya), showed varying degrees of success, but some were considered as having failed. Reasons for the eventual success of certain hydatid control programmes and the problems encountered in others are analysed and discussed, and recommendations for likely optimal approaches considered. The application of new control tools, including use of a hydatid vaccine, are also considered.

Animals↗