In vivo treatment with IL-17A attenuates hydatid cyst growth and liver fibrogenesis in an experimental model of echinococcosis

We aimed to assess the effect of exogenous Interleukin (IL)-17A in experimental model of echinococcosis. Swiss mice were inoculated intra-peritoneally with viable protoscoleces (PSCs). Then, IL-17A was administered at 100, 125 or 150 pg/mL two weeks after cystic echinococcosis (CE) induction. Cyst development and hepatic damage were macroscopically and histologically analyzed. We observed that in vivo IL-17A treatment at 100, 125, and 150 pg/mL, reduced metacestode growth by 72.3%, 93.8%, and 96.9%, respectively. Interestingly an amelioration of liver architecture was noted at 125 pg/mL without toxic effect. In this context, we showed less fibrosis reaction and reduced expression of iNOS, TNF-α, NF-κb and CD68 in hepatic parenchyma of treated mice by 125 pg/mL of IL-17A. Collectively, our results indicate an antihydatic effect and immunoprotective properties of IL-17A and suggest its potential therapeutic value against Echinococcus granulosus infection.

Ecology and Life Cycle Patterns of Echinococcus Species

The genus Echinococcus is composed of eight generally recognized species and one genotypic cluster (Echinococcus canadensis cluster) that may in future be resolved into one to three species. For each species, we review existing information on transmission routes and life cycles in different geographical contexts and - where available - include basic biological information of parasites and hosts (e.g., susceptibility of host species). While some Echinococcus spp. are transmitted in life cycles that involve predominantly domestic animals (e.g., dog - livestock cycles), others are wildlife parasites that do or do not interact with domestic transmission. In many cases, life cycle patterns of the same parasite species differ according to geography. Simple life cycles contrast with transmission patterns that are highly complex, involving multihost systems that may include both domestic and wild mammals. Wildlife transmission may be primary or secondary, i.e., resulting from spillovers from domestic animals. For most of the species and regions, existing information does not yet permit a conclusive description of transmission systems. Such data, however, would be highly relevant, e.g., for anticipation of geographical changes of the presence and frequency of these parasites in a warming world, or for initiating evidence-based control strategies.

Biology and Systematics of Echinococcus

The biology of Echinococcus, the causative agent of echinococcosis (hydatid disease) is reviewed with emphasis on the developmental biology of the adult and metacestode stages of the parasite. Major advances include determining the origin, structure and functional activities of the laminated layer and its relationship with the germinal layer; and the isolation, in vitro establishment and characterization of the multipotential germinal cells. Future challenges are to identify the mechanisms that provide Echinococcus with its unique developmental plasticity and the nature of activities at the parasite-host interface, particularly in the definitive host. The revised taxonomy of Echinococcus is presented and the solid nomenclature it provides will be essential in understanding the epidemiology of echinococcosis.

Report: Evaluation of the scolicidal effects of Nectaroscordum tripedale extract and its acute toxicity in mice model

Current scolicidal agents, which have been used for inactivation of protoscoleces during hydatid cyst surgery are associated with adverse side effects. This study aims to evaluate the in vitro scolicidal effects of Nectaroscordum tripedale L. leave extract against protoscoleces of hydatid cysts and its acute toxicity in mice model. Various concentrations of the extract (12.5-100 mg/mL) were used for 5 to 30 min. Viability of protoscoleces was confirmed using eosin exclusion test (0.1% eosin staining). In addition, the acute toxicity of N. tripedale extract was determined for 2 days in mice model. The results showed that the N. tripedale extract at the concentration of 100 mg/mL after 5 min of exposure killed 100% protoscoleces. Similarly, the mean of mortality rate of protoscoleces after 10 min of exposure to concentration of 50 mg/mL was 100%. The LD₅₀ values of intraperitoneal injection of the N. tripedale extract was 3.36 g/kg body wt. and the maximum nonfatal doses were 2.98 g/kg body wt. The results showed the potential of N. tripedale extract as a natural source for the production of new scolicidal agent for use in hydatid cyst surgery.

Validation of suitable reference genes for expression normalization in Echinococcus spp. larval stages

In recent years, a significant amount of sequence data (both genomic and transcriptomic) for Echinococcus spp. has been published, thereby facilitating the analysis of genes expressed during a specific stage or involved in parasite development. To perform a suitable gene expression quantification analysis, the use of validated reference genes is strongly recommended. Thus, the aim of this work was to identify suitable reference genes to allow reliable expression normalization for genes of interest in Echinococcus granulosus sensu stricto (s.s.) (G1) and Echinococcus ortleppi upon induction of the early pre-adult development. Untreated protoscoleces (PS) and pepsin-treated protoscoleces (PSP) from E. granulosus s.s. (G1) and E. ortleppi metacestode were used. The gene expression stability of eleven candidate reference genes (βTUB, NDUFV2, RPL13, TBP, CYP-1, RPII, EF-1α, βACT-1, GAPDH, ETIF4A-III and MAPK3) was assessed using geNorm, Normfinder, and RefFinder. Our qPCR data showed a good correlation with the recently published RNA-seq data. Regarding expression stability, EF-1α and TBP were the most stable genes for both species. Interestingly, βACT-1 (the most commonly used reference gene), and GAPDH and ETIF4A-III (previously identified as housekeeping genes) did not behave stably in our assay conditions. We propose the use of EF-1α as a reference gene for studies involving gene expression analysis in both PS and PSP experimental conditions for E. granulosus s.s. and E. ortleppi. To demonstrate its applicability, EF-1α was used as a normalizer gene in the relative quantification of transcripts from genes coding for antigen B subunits. The same EF-1α reference gene may be used in studies with other Echinococcus sensu lato species. This report validates suitable reference genes for species of class Cestoda, phylum Platyhelminthes, thus providing a foundation for further validation in other epidemiologically important cestode species, such as those from the Taenia genus.

Echinococcosis: historical landmarks and progress in research and control

Although hydatid cysts were recognised and described in ancient times, in both livestock and humans, it was not until the 17th Century that their biological nature began to be understood. The past 50 years have seen a veritable revolution in knowledge and technology applicable to the biology of the cestodes and the diseases they cause. The parasites that form hydatid cysts belong to the genus Echinococcus, which is now recognized as a complex of closely related cestode parasites adapted to a variety of host-assemblages linked by predator-prey relationships. Synanthropic transmission in dogs and domestic livestock greatly increases the possibilities of zoonotic transmission, and the highest prevalences of Echinococcus infection in humans therefore occur in populations engaged in livestock rearing in which domestic dogs have access to the viscera of the livestock that serve as intermediate hosts. The application of modern scientific technology over the last few decades has not only revealed the diversity of host-parasite relationships within the genus Echinococcus but also led to greatly improved technology for the diagnosis and treatment of the echinococcoses in humans and lower animals. Although control programmes have led to marked reductions in transmission in certain geographical and socio-political settings, transmission and the resultant diseases continue unabated throughout most of the parasites' world-wide distribution.

Hepatic hydatid cyst presenting as cutaneous abscess

Hydatidosis is a parasitic zoonotic echinococcal infection that affects both humans and other mammals. These diseases are common worldwide but particularly common in sheep and cattle farming regions. Anaphylaxis mediated by IgE is a serious complication of surgery or trauma which necessitates more aware of its clinical features, diagnosis and management. It is important to make a preoperative diagnosis based on the typical image findings, so that particular precaution can be taken not to rupture the lesion. A woman presented with a right upper quadrant cutaneous abscess. USG reveals multiple cystic lesions in the liver arranged in cartwheel appearance, CT disclosed a cystic lesions having daughter cysts, marginal calcifications, marginal enhancement and contiguous abdominal wall abscess, which led to a diagnosis of complicated hepatic hydatid cysts with abdominal wall abscess formation. FNAC showed scolices surrounded by chronic inflammatory cells. Abdominal wall abscess may be a presentation of hydatid liver disease.

[Application of in vitro cultivation technique for metacestodes in study of Echinococcus spp]

With the development of the in vitro cultivation of Echinococcus metacestodes, the technique is widely applied in research areas such as the pathogenic biological characteristics and the mechanism of infection and pathopoiesis of echinococcus, and development of novel therapeutic agents against echinococcosis. These will help futher understand the disease and its control. This paper reviews the application of the in vitro cultivation technique of Echinococcus spp.

[Development of a new hydrocarbon extract from the medicinal raw material of Circassian walnut (Juglans regia) and study of its antiparasitic activity]

The authors developed a technology for preparing a hydrocarbon extract from the medicinal raw material of Circassian walnut (Juglans regia), including its green fruits, green leaves, and fresh roots. To prepare the preparation, they obtained for the first time a new extragent called petroleum Russia that was found to contain more than hundred chemical compounds by chromatography mass spectrometry. The new agent was named irillen. Experiments on albino mice and albino rats established that the new agent was low toxic. The lethal doses of irillen were calculated: LD50 was 16377 +/- 457.5 mg/kg; LD16 = 12986.4 mg/kg; LD84 was 18976.6 mg/kg for albino mice; LD50 was 16998.0 +/- 535.4 mg/kg; LD16 = 12875.3 mg/ kg; LD84 = 18583.4 mg/kg for albino rats. The irillen prepared by the authors should be referred to as a low toxic and practically nontoxic agent (Toxicity Class IV and V). Irillen has a broad spectrum of antiparasitic activity. It is effective in treating toxocariasis in dogs, larval alveolar echinococcosis, ascaridiasis, and eimeriasis in chickens, and siphachiasis.

Production of experimental hydatid cyst in the eye, peritoneum and liver of BALB/c mice

As the main treatment for this infection is surgery, the surgery team personnel are at the risk of the protoscoleces released from the hydatid cysts (HC) of patients. The first goal of this study was to determine the probability of the production of ocular HC in mice due to the fluid of the aspirated protoscoleces from the sheep liver with HC. The second goal of this study was to produce HC in the peritoneum and liver, in order to gather more information for future studies on hepatic and peritoneal HC treatment procedures. For the first goal of this study, different concentrations of protoscoleces were prepared and injected into the eyes of 60 mice. After 20 weeks, 10 of the 60 mice of this group died. The remaining 50 mice were examined by a surgeon under the anesthesia. There weren't any symptoms of HC in the eyes and around it. For the second goal, 39 new mice were separated into three sub groups and 0.5 ml of protoscolex solution was injected intraperitoneally. After 20 weeks, they were anesthetized and their peritoneum, intestines and liver were examined. HC was seen in the peritoneum and liver of 6 mice.

Echinococcus, Giardia and Cryptosporidium: observational studies challenging accepted dogma

The development of in vitro culture systems that allow the maintenance, and support the development of Echinococcus, Giardia and Cryptosporidium in the laboratory have had a significant impact on their biology and taxonomy and the epidemiology of infections they cause. This short retrospective review demonstrates how radical shifts in our understanding have occurred as a result of being able to grow these organisms in culture, and how molecular tools have helped in the interpretation of such research that often reflects the observations of earlier workers.

Hydatidosis of slaughtered animals in Bahir Dar Abattoir, Northwestern Ethiopia

The study was conducted from May 2005 to December 2006 in Bahir Dar Abattoir to assess the current status of hydatidosis in cattle and sheep. Hydatid cyst count and characterization were conducted based on routine meat inspection. Of the total 420 cattle and 340 sheep slaughtered in Bahir Dar Abattoir 143 (34.05%) and 36 (10.6%) animals were found harboring hydatid cysts respectively. Thorough meat inspection in the abattoir revealed that 202 and 54 visceral organs were found harboring one or more hydatid cysts in cattle and sheep respectively. Differences in prevalence rates between the two species of animals were highly significant (P < 0.001). The infection of the lung, liver, kidney, spleen and heart were found to be 57.9% , 36.6% , 3% , 1.5% , 1% in cattle and 50%, 48.1% and 1.9% in sheep respectively. From the total of 864 in cattle and 138 in sheep hydatid cysts counted 315 (36.4%), 268 (31.0%), 65 (7.5%), 216 (25.0%) in cattle and 92 (66.7%), 20 (14.5%), 1 (0.7%), 25 (18.1%) in sheep were found to be small, medium, large and calcified cysts respectively and 484 (56.0%), 164 (18.9%), 216 (25%) in cattle and 35 (25.4%), 78 (56.5%), 25 (18.1%) in sheep were sterile, fertile and calcified cysts respectively. Viability rates of 62.2% in cattle and 78.2% in sheep were observed. The rate of cyst calcification was higher in the liver than in the lung while fertility rate was higher among the cysts of the lung for both cattle and sheep.

Prevention and control of cystic echinococcosis

Human cystic echinococcosis (hydatid disease) continues to be a substantial cause of morbidity and mortality in many parts of the world. Elimination is difficult to obtain and it is estimated that, using current control options, achieving such a goal will take around 20 years of sustained efforts. Since the introduction of current (and past) hydatid control campaigns, there have been clear technological improvements made in the diagnosis and treatment of human and animal cystic echinococcosis, the diagnosis of canine echinococcosis, and the genetic characterisation of strains and vaccination against Echinococcus granulosus in animals. Incorporation of these new measures could increase the efficiency of hydatid control programmes, potentially reducing the time required to achieve effective prevention of disease transmission to as little as 5-10 years.

Alveolar Echinococcus species from Vulpes corsac in Hulunbeier, Inner Mongolia, China, and differential development of the metacestodes in experimental rodents

Adults of alveolar Echinococcus species with different uterine structures were collected from Vulpes corsac in the Hulunbeier Pasture of Northeastern China in 2001. They were Echinococcus multilocularis Leuckart, 1863 (type No. 3, similar to E. m. multilocularis), with vaselike uterus; Echinococcus cf. sibiricensis Rausch et Schiller, 1954 (type No. 1), with pyriform uterus; and Echinococcus sp. (type No. 2) with spherical uterus at segment top. The metacestode development in rodents also differed among those 3 parasites. In the case of E. multilocularis (type No. 3), many germinal cells grew on the inner surface of early cysts, most of which metastasized into host tissue to form brood vesicles or from the germinal cell layer on the inner surface of the vesicle wall. Cells also had an appearance of proliferating by means of alveolar buds from alveolar tissue that developed outward to form new alveolar foci. In Echinococcus cf. sibiricensis (type No. 1), the formation of alveolar vesicles was due to the metastasizing of germinal tissue into host tissue; protoscoleces grew in the center of alveolar vesicles. In type No. 2 (Echinococcus sp.), the formation of the alveolar vesicle was by multiplication of germinal cell layers on the inner surface of alveolar cysts; protoscoleces grew from the germinal cell layer and mesh in the vesicles. On the basis of uterine structure and on differences in development of metacestodes in experimental rodents, we propose that the 3 types of Echinococcus represent 3 independent species: E. multilocularis, Echinococcus sibiricensis, and Echinococcus sp. (type No. 2-as yet under study).

Hydatid cysts: does every picture tell a story?

Ultrasound imaging is an effective aid to the detection of abdominal cystic echinococcosis. Recently, the images produced have provided more information than just a diagnosis. Different cyst morphologies have been classified into types, and such classifications can be considered to represent a natural history of cyst development. Understanding how cyst structures alter with time is crucial to evaluating the effectiveness of different treatment regimes and to understanding natural degeneration of cysts that can occur. However, the developmental events seen in ultrasound need to be matched more closely to immunological and cellular events if we are to have a fuller appreciation of disease progression and regression. At a community level, the relative proportions of cyst types could also provide epidemiological information on disease transmission.

Echinococcus shiquicus, a new species from the Qinghai–Tibet plateau region of China: Discovery and epidemiological implications

In Shiqu County of the Qinghai-Tibet plateau, many wild and domestic mammals are involved in the transmission cycles of Echinococcus spp. Echinococcus multilocularis and Echinococcus granulosus genotype G1 (sheep strain) are sympatrically distributed in the plateau. In 1995, we identified a unique strobilate stage of Echinococcus from the Tibetan fox, Vulpes ferrilata, but considered it to be a variant of E. multilocularis. Subsequent molecular genetic studies revealed that a hydatid cyst from the plateau pika, Ochotona curzoniae, had unique mitochondrial DNA sequences which are dissimilar to any published sequences of Echinococcus. The same sequences were subsequently found in adult worms from Tibetan foxes. Morphological, genetic and ecological features of the cestode led us to designate a new species Echinococcus shiquicus. E. shiquicus has been found at other areas surveyed on the plateau; however, no infections in humans caused by E. shiquicus have been yet identified.

The molecular mechanisms of larval cestode development: first steps into an unknown world

Several hundred million years ago, the free-living ancestors of all extant helminth parasites decided to colonize entirely new habitats, the bodies of other metazoan animals. As a consequence of the resulting adaptation processes, they evolved highly complex life-cycles in which many developmental transitions were initiated and controlled by host-derived signals. Understanding the molecular basis of the original developmental mechanisms, and the modifications that occurred during co-evolution with the host, is not only fundamental to our understanding of parasitism but also highly relevant for the design of anti-parasitic drugs and vaccines. In the past several years, molecular investigations on parasitic nematode and trematode development have made considerable progress and, supported by respective genome sequencing projects and emerging methods of genetic manipulation, will be a flourishing field in the years to come. We consider it time that corresponding studies are also pushed for the third large group of parasitic helminths, the cestodes. Here, we review the first experimental steps into that area, which have been undertaken recently. We report on cestode genomics, the identification of signaling factors associated with larval development, and the establishment as well as improvement of in vitro cultivation systems by which cestode life-cycles can be studied in the laboratory.

Methods for assessing the burden of parasitic zoonoses: echinococcosis and cysticercosis

Cysticercosis and echinococcosis cause illness and productivity losses in human and agricultural animal populations. Recent studies suggest that these diseases have large societal impacts on endemic areas. Estimates of burden provide essential, evidence-based data for conducting cost-benefit and cost-utility analyses that will secure political will, and financial and technical resources. To evaluate the burden, the monetary and non-monetary impacts of these zoonoses on human health, agriculture and society must be considered comprehensively. In this article, we review the framework used to assess the burden of cysticercosis and echinococcosis, and the data needed to estimate the extent of the problem for societies.

Immunobiology of cystic echinococcosis

The present report focuses on the ability of cystic echinoccocosis metacestode to survive for a long time, despite host immunity, by developing avoidance strategies. The tactics believed to come into play, ranging from intrinsic parasitic factors to host-related mechanisms, are briefly discussed and the importance of studies on experimental models is highlighted particularly in relation to furthering the theoretical understanding of the dynamic equilibrium between host and parasite, and to the feasibility of practical approaches in controlling the disease by artificial manipulation of the immunoregulatory mechanisms.

Characterization of excretory-secretory products from protoscoleces of Echinococcus granulosus and evaluation of their potential for immunodiagnosis of human cystic echinococcosis

This study describes, for the first time, the characterization of excretory-secretory antigens (ES-Ag) from Echinococcus granulosus protoscoleces, evaluating their usefulness in the immunodiagnosis of human cystic echinococcosis. ES-Ag were obtained from the first 50 h maintenance of protoscoleces in vitro. This preparation contained over 20 major protein components which could be distinguished by 1-dimensional SDS-PAGE with apparent masses between 9 and 300 kDa. The culture of of protoscoleces from liver produced a greater variety of excretory-secretory protein components than those from lung. Determination of enzymatic activities of secreted proteins revealed the presence of phosphatases, lipases and glucosidases, but no proteases. These findings were compared to those obtained from somatic extracts of protoscoleces and hydatid cyst fluid products. Immunochemical characterization was performed by immunoblotting with sera from individuals infected by cystic echinococcosis (n = 15), non-hydatidic parasitoses (n = 19), various liver diseases (n = 24), lung neoplasia (n = 16), and healthy donors (n = 18). Antigens with apparent masses of 89, 74, 47/50, 32, and 20 kDa showed specificity for immunodiagnosis of human hydatidosis. The 89 and 74 kDa components corresponded to antigens not yet described in E. granulosus, whereas proteins of 41-43 kDa and 91-95 kDa were recognized by the majority of the non-hydatid sera studied.

In vitro effects of nitazoxanide on Echinococcus granulosus protoscoleces and metacestodes

OBJECTIVES

Infection of humans and domestic ruminants with the larval stage (metacestode) of Echinococcus granulosus results in cystic echinococcosis (CE). The metacestode causes a space-occupying lesion in visceral organs, most commonly in the liver. Benzimidazole carbamate derivatives, such as mebendazole and albendazole, are currently used for chemotherapeutic treatment of CE. In human patients, benzimidazoles have to be applied in high doses for extended periods of time, and adverse side effects are frequently observed. In order to evaluate alternative treatment options, the in vitro efficacy of nitazoxanide, a broad-spectrum drug used against intestinal parasites and bacteria, was investigated.

METHODS

Freshly isolated E. granulosus protoscoleces were subjected to nitazoxanide treatment (1, 5 and 10 microg/mL), and the effects on parasite viability were monitored by Trypan Blue staining and scanning electron microscopy. Protoscolex cultures were maintained further, until metacestode development took place. Metacestodes were then subjected to nitazoxanide treatment (10 microg/mL), and corresponding effects were visualized by scanning and transmission electron microscopy.

RESULTS

Dose-dependent protoscolex death within a few days of nitazoxanide treatment was observed. Subsequent in vitro culture of drug-treated protoscoleces confirmed the non-viability of parasites, while further cultivation of non-treated protoscoleces for a period of at least 3 months resulted in stage conversion and the formation of small metacestodes 3-4 mm in diameter. Nitazoxanide had a deleterious effect on these metacestodes, which was comparable to that of albendazole.

CONCLUSIONS

Our study indicates a potential for nitazoxanide as an alternative treatment option against CE.

Echinococcus granulosus: oncosphere-specific transcription of genes encoding a host-protective antigen

A recombinant antigen vaccine has been developed which is effective in preventing the hydatid parasite, Echinococcus granulosus from infecting its animal intermediate hosts. The vaccine antigen, designated EG95, is expressed by a cDNA cloned from E. granulosus oncosphere mRNA. The gene encoding EG95 belongs to a small gene family where six of the members are transcribed in the oncosphere. Conditions were established which allowed specific RT-PCR amplification of mRNA for each gene family member and these conditions were applied to determine transcription patterns for each gene family member in gravid adult worms, oncospheres, and protoscoleces. The four eg95 gene family members which encode an identical EG95 protein, were transcribed only in the oncosphere. In contrast, two gene family members that encode variant EG95 proteins did not have transcription patterns confined to the oncosphere. These findings suggest a common biological role for four genes in the gene family and a separate role for the other, more variant gene family members.