Evaluation of Dirofilaria immitis excretory/secretory products for seroepidemiological studies on human dirofilariosis

The usefulness of excretory/secretory (E/S) products of adult Dirofilaria immitis for the diagnosis of human dirofilariosis was evaluated in 97 human sera using an ELISA and a Western Blot analysis with E/S antigens. Results of the ELISA analysis show that in healthy individuals from an endemic area seropositivity is high (22%). Immuno Blot analysis shows that the reaction pattern with E/S antigens differentiates healthy seropositives, which recognize a 43 kDa band, from patients with pulmonary dirofilariosis, which specifically recognize bands between 22-28 kDa.

Diethylcarbamazine-induced Dirofilaria immitis larval death, as indicated by immunoglobulin E concentration, in dogs with concurrent Ancylostoma caninum infection

Immunoglobulin E is produced in response to parasitic nematodes that undergo blood and tissue migrations. Results of our previous studies indicated that IgE and IgG respond to Dirofilaria immitis in experimentally infected dogs. To determine the association between treatment with the larvicide, diethylcarbamazine (DEC), and antibody responses and to examine the potential influence of infection with a nonfilarid intestinal nematode on isotype-specific immune responses, we monitored, by use of isotype-specific ELISA, separate IgE and IgG responses against D immitis in 4 groups (A-D) of 8 dogs experimentally coinfected with D immitis and Ancylostoma caninum. All dogs were monitored from 2 weeks before inoculation with D immitis, through postinoculation (PI) week 20. Group-B dogs received a daily regimen of 6.6 mg of DEC/kg of body weight. Group-C dogs received 4.95 mg of oxibendazole/kg daily. Group-D dogs received DEC and oxibendazole, equivalent to the daily doses given to dogs of groups B and C. All dogs given oxibendazole had no A caninum at necropsy. Of the groups receiving DEC, 3 group-B dogs each had 1 to 2 D immitis at necropsy. When results of chronologic IgE determination for all groups were statistically compared, only groups B and C had significant (P = 0.0148 and P < 0.00005, respectively) increases in IgE values. Group-C dogs had the highest IgE values from PI week 10 until the end of the study, whereas IgG values were statistically identical to those of group-A dogs.(ABSTRACT TRUNCATED AT 250 WORDS)

An ultrastructural study on the early cellular response to Dirofilaria immitis (Nematoda) in the Malpighian tubules of Aedes aegypti (refractory strains)

Dirofilaria immitis living in Aedes aegypti refractory strains were studied in relation to ultrastructural events in primary cells of Malpighian tubules and to defense mechanisms activated by host-cells. When the microfilaria reaches the Malpighian cells, its intracellular development is blocked by defense mechanisms activated by the host, resulting in lysis of the outermost cuticle of the parasite without melanin involvement. Ultrastructural evidence suggests that lysis is brought about by Malpighian cell products.

Immunoblotting analysis of somatic components of Dirofilaria immitis

SDS-PAGE analysis of Dirofilaria immitis extracts demonstrated the complexicity of protein components of microfilariae, similar to that of adult male and female worms. Immunoblotting analysis using sera from microfilaremic and amicrofilaremic dogs with D. immitis infection suggest that antigenic components in the low molecular weight region may be related to the anti-microfilarial mechanism of the host.

Clinical prophylactic activity of melarsomine dihydrochloride (RM 340) against Dirofilaria immitis in heartworm-naive beagles exposed to natural infection in three southeastern states

Melarsomine dihydrochloride (RM 340), a drug being developed as an adulticide for treatment of heartworm (Dirofilaria immitis) infection in dogs, was safe and highly effective as a clinical prophylactic agent against naturally acquired infections using Strategic and Tactical Treatment Programs. The Strategic Program involved treatment every 4 months (three series of treatments per year), disregarding the mosquito season (MS), to clear the existing infection at each treatment. The Tactical Program consisted of two series of treatments per year, 4 months apart, with the first one given about the middle of the MS (August) and the second one given after the end of the MS (December). Melarsomine was administered as two i.m. injections (lumbar muscles) of 2.2 mg kg-1 given 3 h apart. A total of 90 heartworm-naive beagles and a number of microfilaremic 'seed' dogs were used. Three similar experiments (30 beagles per experiment) were conducted at selected areas (Georgia, Florida, Louisiana) known to be enzootic for heartworm. At each site, 30 beagles were allocated to six groups of five dogs each, and four of these groups were placed outdoors in April of 1988. Two groups (control and treated) were exposed for 12 months, and the treated group was given melarsomine at 4, 8, and 12 months after exposure was started (Strategic Program). Another group was exposed for 8 months and treated with melarsomine at 4 and 8 months (Tactical Program). One group of tracer (sentinel) beagles was exposed from April to August 1988, one group from August to December 1988, and another from December 1988 to April 1989. April-August and August-December tracers served as controls for the tactically treated dogs. After exposure, all dogs were held indoors for 5 months before necropsy. Blood was collected at 4-5 month intervals and examined for microfilariae (MF) and adult heartworm antigen (enzyme-linked immunosorbent assay, ELISA). Treatment by the Strategic Program was 99% effective, with only one of the total of 15 treated dogs harboring any worms (a single female) at necropsy. Thirteen of the 14 control dogs (93%) exposed for 12 months became infected, with average worm recoveries of 6.8, 5.4, and 25.2 (range 1-45) for the Georgia, Florida, and Louisiana sites, respectively. All of the 13 heartworm-infected control dogs were antigen-positive, and 12 of these were also MF-positive, while none of the strategically treated dogs was either antigen- or MF-positive at necropsy. Tactical treatment of the total of 14 dogs twice per year was 100% effective.(ABSTRACT TRUNCATED AT 400 WORDS)

Evaluation of a 22 kDa Dirofilaria immitis antigen for the immunodiagnosis of human pulmonary dirofilariosis

Human pulmonary dirofilariosis usually appears as a solitary pulmonary nodule. A 22 kDa antigen from Dirofilaria immitis adult worms specifically recognized by three sera from individuals diagnosed with pulmonary dirofilariosis was identified by enzyme-linked-immunoelectrotransfer blot. This antigen was purified by elution from acrylamide gels and evaluated in enzyme-linked immunoassay using sera from 92 patients with pulmonary dirofilariosis and other pulmonary and parasitic diseases. Its use in the diagnosis of human pulmonary dirofilariosis should be considered.

Expression of an Onchocerca volvulus Ov33 homolog in Dirofilaria immitis: potential in immunodiagnosis of heartworm infection

In this study, the expression of an Onchocerca volvulus Ov33 homolog was demonstrated in Dirofilaria immitis. Rabbit antiserum raised against a recombinant fusion protein of O. volvulus, MBP/OvD 5B (Ov33), was found to react with a 31-33 kDa glycoprotein (DiT33) of adult worms of D. immitis. An antibody response to MBP/OvD 5B was observed in dogs, as early as 11 weeks post infection with infective larvae of D. immitis, and in dogs with occult infection. Cats both experimentally and naturally infected with D. immitis also reacted strongly with the recombinant antigen. In contrast, sera from dogs receiving chemically-abbreviated infection or from animals harbouring a variety of other helminths failed to react. These data suggest that antibody responses generated by DiT33 may have potential in immunodiagnosis of heartworm infection in cats and dogs.

Purified excretory-secretory component of filarial parasite enhances Fc epsilon RII/CD23 expression on human splenic B and T cells and IgE synthesis while potentiating T-helper type 2-related cytokine generation from T cells

The CD23-bearing cells are known to be involved in multiple biological activities, including IgE synthesis and IgE-dependent cytotoxicity to parasites. The factors that regulate interleukin-4 (IL-4)-induced IgE synthesis in helminthic infection were analysed by using an excretory-secretory component (ESC) of Dirofilaria immitis (DI). Human splenic B and T cells significantly enhanced the expression of low-affinity Fc receptors for IgE (Fc epsilon RII/CD23) by stimulation with ESC, either acting alone or in synergy with IL-4. On B cells, ESC potentiated the CD23 expression in synergy with IL-4, whereas ESC alone was unable to modulate CD23 expression. In contrast, ESC directly induced CD23 expression on T cells by acting alone and no further enhancement was observed in the presence of IL-4. Furthermore, IL-4-induced IgE synthesis by splenic mononuclear cells (SMNC) was greatly enhanced in the presence of ESC. Of particular interest, T cells primed by ESC significantly produced a set of cytokines including IL-3, IL-4, IL-5 and IL-6. Inasmuch, IL-4-induced IgE synthesis in helminthic infection may be selectively modulated by parasite protein(s) acting on the generation of T-helper type 2 (Th2)-related cytokines.

[Human dirofilariasis: identification of a 44kD antigen recognized by IgM against Dirofilaria immitis]

BACKGROUND

Dirofilaria immitis is a nematode parasite of canids that, in endemic areas, can infect humans. The use of adult somatic antigens for the diagnosis of human dirofilariasis has the disadvantage of a low sensibility because of cross-reactivity with other helminths, specially with IgM antibodies. We describe in this work proteins of the adult somatic antigenic complex that are specifically recognized by human IgM.

METHODS

Human sera with different characteristics were analyzed by an enzyme-linked immunosorbent assay (ELISA) for the detection of anti-D. immitis IgM seropositive individuals. Moreover, an enzyme-linked immuno-electro-transfer blot (EITB) was performed for the detection of polypeptides that specifically react with IgM anti-D. immitis.

RESULTS

EITB analysis shows that 2 proteins of 44 and 18 kD are recognized by IgM in human sera from an endemic area with a high antibody titer against D. immitis measured by ELISA. Sera from a non-endemic area and from patients suffering from other parasitic and non-parasitic diseases did not recognize these antigens.

CONCLUSIONS

We believe that the 44 kD protein could be a good marker of recent D. immitis infection.

An analysis of the humoral immune response of dogs following vaccination with irradiated infective larvae of Dirofilaria immitis

In this study, dogs were immunized with irradiated L3 larvae of Dirofilaria immitis. Following challenge with non-irradiated L3, vaccinated dogs had an average of 71% fewer adult worms compared to non-vaccinated animals. A comparative analysis of eosinophil and antibody responses of these two groups of dogs is presented. Vaccinated dogs preferentially recognized several larval (14, 20, 30, 34, 39 kDa), adult worm (20 kDa) and microfilarial (36, 38, 71, 84 kDa) antigens. To characterize these antigens, the extent of glycosylation was assessed. The data suggest that an earlier response to these antigens may be important in the protection induced in dogs by administration of irradiated L3 of D. immitis.

Decision analysis in the evaluation of diagnostic tests

Decision analysis was used to evaluate the clinical usefulness of 2 diagnostic tests: one for canine heartworm disease and the other for bovine traumatic reticulo-peritonitis. Several clinically relevant measures of test performance are introduced, including expected utility, risk profile, testing band, threshold analysis, and the relative cost of misdiagnosis. One of the principal benefits of decision analysis of diagnostic tests is that the technique can be used to determine how changes in underlying assumptions will affect clinical decisions. If clinicians can identify and assign values to relevant variables, then decision analysis can provide clinically meaningful guidelines for interpreting the results of diagnostic tests. To take advantage of these techniques, clinicians must become comfortable with quantitative expressions for test performance, risk, and prognosis.

Molecular cloning and characterization of a novel neutrophil chemotactic factor from a filarial parasite

To compare the molecular structure of a parasite-derived neutrophil chemotactic factor (NCF) with host-derived NCFs or other NCFs, molecular cloning of cDNA encoding NCF derived from Dirofilaria immitis adult worm (DiNCF) was performed. A D. immitis cDNA library was screened with an antibody to DiNCF, and one DiNCF cDNA clone (pD-4) was isolated. A fusion protein of pD-4 and gene 10 protein showed significant neutrophil chemotactic activity whereas gene 10 protein itself showed marginal neutrophil chemotactic activity. The total nucleotide sequence analysis revealed that pD-4 was 994 bp long with a 432 bp open leading frame encoding a 143 residue protein. The NH2-terminal amino acid sequence of the natural DiNCF and the deduced amino acid sequence from the cDNA showed that the mature functional protein was comprised of 112 amino acids. Although the deduced amino acid sequence of this protein did not show overall homology to host-derived NCFs or other known proteins, it contained a similar sequence (Met-Phe-Lys) to the known chemotactic peptides. The possibility of the functional epitope of DiNCF is discussed.

The effect of prostaglandin inhibition on the development of pulmonary pathology associated with dead Dirofilaria immitis

Flunixin meglumine was used to examine the effect of prostaglandin inhibition on the pathogenesis of Dirofilaria immitis in the pulmonary arteries of dogs. Immunopathological reactions to dead filariae were monitored by light and transmission electron microscopy and serology. Lung lesions in prostaglandin-inhibited dogs exposed to dead filariae were enhanced compared to control dogs. This was associated with the persistence of parasitic antigen in lung tissue and in the blood. Serology demonstrated that after insertion of D. immitis in treated dogs, antibody levels did not change, while immune complex and antigen levels increased. These results indicate that prostaglandin may have a protective effect on the way the lung reacts to dead D. immitis, and that altered dynamics of the antigen processing may well contribute to the associated lung lesions.

Anti-Dirofilaria immitis IgE: seroepidemiology and seasonal variation in an exposed human population

The seroprevalence of seasonal variation of human anti-Dirofilaria immitis IgE levels were studied in an area where specific IgM and IgG had been previously investigated. An antibody capture ELISA assay was used to detect specific IgE. The IgE seroprevalence observed in the whole population was 12.6%. No specific IgE was detected in atopic individuals or in sera from people suffering other helminthiases. The distribution of the IgE anti-D. immitis seroprevalence by age groups did not show differences. Females had significantly higher levels than males. This isotype of immunoglobulin peaks in July, decreasing sharply in October, and persisting at a level similar to that of a non exposed population during the rest of the year. No specific IgE were detected in subjects with pulmonary alterations related to the parasite, suggesting a possible relationship between the clinico-radiological status and the type of immunoglobulin synthesized in subjects infected by D. immitis.

Immunodiagnosis of human dirofilariasis in Puerto Rico

A seroepidemiologic study was carried out in humans inhabiting southeastern Puerto Rico, the area on this island with highest prevalence of canine heartworm, to detect the presence of antibodies to Dirofilaria immitis. Three hundred serum samples were analyzed by enzyme-linked immunosorbent assay (ELISA) using somatic antigens of the adult worm. Serum samples from eight patients were positive for anti-dirofilarial IgG. These patients had a mean age of 54 years. Although the study population had a female: male of 2.5:1, six out of the eight positive sera were from males. The minimum prevalence of human dirofilariasis was conservatively estimated to be 2.66%. After Western blot analysis of positive sera, four polypeptide markers with M(r) values of 15, 33, 42, and 69 kD were selected as potential immunologic markers for this human infection. Three of them (15, 33, and 69 kD) were specifically reactive only with ELISA-positive sera. The 42-kD polypeptide reacted strongly with ELISA-positive sera, although it reacted weakly with some of the ELISA-negative controls. The 15-, 33-, and 69-kD polypeptides were recognized by positive sera in several combinations, but only those sera with the highest ELISA optical density values reacted with all three polypeptides.

Vaccination with recombinant filarial paramyosin induces partial immunity to Brugia malayi infection in jirds

Vaccination with irradiated infective larvae induces partial protective immunity to infection with the filarial nematode Brugia malayi in jirds. Prior studies have shown that such immunization stimulates a much stronger antibody response to recombinant and native filarial paramyosin than that seen after normal infection. To determine whether vaccination with recombinant paramyosin could induce protective immunity to larval challenge, jirds were immunized with either B. malayi paramyosin and maltose binding protein (BM5-MBP) (fusion protein of B. malayi paramyosin and maltose-binding protein), MBP alone, or recombinant Dirofilaria immitis paramyosin. Animals were challenged with 100 infective larvae s.c. 8 wk after the second immunization. Necropsies were performed 16 wk after challenge. Vaccination with BM5-MBP induced significant protective immunity; adult worm recoveries, worm lengths, and blood microfilaria counts were reduced in the BM5-MBP group relative to the MBP control group. The reductions in adult worm recoveries (43%) and female worm lengths (10%) were statistically significant (p < 0.05). Interestingly, protective immunity was not induced by immunization with D. immitis paramyosin. Additional studies are needed to identify mechanisms involved in protective immunity induced by BM5-MBP and to understand the differential activity of the two closely related recombinant paramyosin proteins in this model.

Immunohistological observations on pulmonary tissues from dogs infected with Dirofilaria immitis

Pulmonary tissues from non-infected dogs, naturally Dirofilaria immitis-infected dogs and experimentally infected puppies, selectively necropsied after infection, were assessed using peroxidase-antiperoxidase (PAP) staining technology. Sequential sections of pulmonary tissue were PAP stained with anti-fresh D. immitis serum, anti-paraffin processed D. immitis serum, anti-dog immunoglobulin (IgG, IgG Fc, IgM) sera and anti-dog complement (C3) serum, and examined for antibody, complement and for D. immitis antigen. The extent of alveolar septal thickening was positively correlated with infection status. Cellular infiltration was most evident surrounding obstructed areas where D. immitis were in situ. Antigenic material (microfilariae, eggs, fragmented filariae) labelled by PAP was identified in the pulmonary arteries, alveolar capillaries and alveolar septa. Deposits of complement and IgG, presumably associated with immune complex formation, were also observed in some of the infected dogs. Identification of antigen, antibodies and complement associated with alveolar septal pathology suggested that immune mechanisms were active in its development.

Dirofilaria immitis: detection of parasite-specific antigen by monoclonal antibodies in glomerulonephritis in infected dogs

For the identification of circulating parasite antigens associated with immune-complex glomerulonephritis in dogs infected with Dirofilaria immitis, monoclonal antibodies (mAbs) were generated against adult worms. A total of 11 mAbs were selected for cloning because of their high productivity and their lack of cross-reactivity with Toxocara canis in indirect immunofluorescence tests. The ability of mAbs to detect circulating antigens was examined using an antigen-capture enzyme-linked immunosorbent assay. Of the 11 mAbs, only NAK-1, an IgG2a mAb, was capable of detecting circulating antigens in 75% of infected dogs. However, this mAb was highly species-specific in its detection of circulating antigens, since sera from dogs infected with other nematode parasites were negative. Furthermore, the mAb detected antigens at the same glomerular sites in which IgG and/or C3 were deposited. The antigen deposits were observed along capillaries and/or in mesangial cells. The epitope recognized by this mAb is probably a carbohydrate, as it remained stable for 1 h at 100 degrees C and was sensitive to periodate treatment. Two bands of 62 and 26 kDa, respectively, were detected on Western blots by the mAb when sera from dogs infected with D. immitis were subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis and transblotted.

The effect of ketoconazole on pulmonary pathology associated with dead Dirofilaria immitis

The involvement of thromboxane and lipoxygenase in the regulation of pulmonary lesions and immune responses was investigated in dogs given ketoconazole and exposed to dead adult Dirofiliara immitis. Immunopathological reactions to the dead filariae were monitored by light and transmission electron microscopy and serology. When compared with control tissues, ketoconazole administration enhanced the level of pulmonary haemorrhage and early parenchymal fibrosis associated with dead adult filariae. Ultrastructurally, alveolar capillaries were filled with erythrocyte aggregations and proteinaceous material. These results suggested that an intact thromboxane and lipoxygenase pathway within the arachidonic acid system is necessary to minimize the effect of dead D. immitis in this pulmonary artery model.

Further evidence that the genes controlling susceptibility of Aedes aegypti to filarial parasites function independently

Comparisons were made of in vivo labeled polypeptides from Aedes aegypti strains refractory to either Brugia malayi or Dirofilaria immitis. There does not seem to be a generalized "anti-parasite" polypeptide response that mosquitoes refractory to filarial worm infection produce following bloodfeeding. Instead, it seems that any response produced by these mosquitoes is localized to the tissue in which the filarial parasite develops.

Immunoglobulin E recognition of Dirofilaria immitis antigens is more specific than immunoglobulin G

The chronological development of the serum IgE and IgG response to microfilaria, third and fourth stage larvae, and male and female adult Dirofilaria immitis was examined by enzyme-linked immunosorbent assay (ELISA) and enzyme-linked immunoelectrotransfer blot (EITB). Dirofilaria immitis-specific IgE and IgG levels peaked 16-18 weeks post-infection after increasing in response to the fourth larval molt. Specific IgG levels plateaued after patency, while IgE continued to decline. The use of ammonium sulfate cut sera showed there was no quenching or blocking of IgE binding by IgG in the ELISA and EITB methods used in this study. IgE-specific EITB showed 30-49 bands for the five respective extracts that were identified by M(r) or relative mobility. Eighty-five to 100 bands were visualized by IgG-specific EITB for the same five extracts. The isotype-specific ELISA and EITB were shown to be closely related by significant correlations (P < 0.0001) between S/N ratios and the number of bands found on blots. The isotype-specific EITB bands non-specifically recognized were greater in size than 21 kDa for IgG and 45 kDa for IgE. Recognition of bands changed over time with some bands being recognized only by prepatent sera. Ten antigen bands of seven M(r) were consistently and specifically recognized by IgE in the five-stage extracts by sera from prepatent and patent infections; only one such M(r) at 13.9 kDa, was described for IgG. A potentially diagnostic 31.9 kDa antigen band was identified on the IgE-specific EITB of D. immitis female extract and was shown to be recognized by IgE in sera from all infected dogs at all time points examined from 2 weeks until 1 year post-inoculation. Overall, IgE reactivity was more specific for D. immitis infections than IgG reactivity.

Immunodiagnosis of human dirofilariasis by enzyme-linked immunosorbent assay using recombinant DNA-derived fusion protein

An enzyme-linked immunosorbent assay (ELISA) using antigenic beta-galactosidase-Dirofilaria immitis recombinant fusion protein (FP) obtained by the recombinant DNA technique provided a useful diagnostic tool for human dirofilariasis. D. immitis-infected human sera reacted strongly with FP that was immobilized with anti-beta-galactosidase monoclonal antibody on microplates. However, the FP did not react with sera from patients with other filariasis. In detection of anti-D. immitis IgG antibody. ELISA using FP was highly sensitive and specific compared to that using crude somatic antigen.

Molecular characterization of a Dirofilaria immitis cDNA encoding a highly immunoreactive antigen

Dirofilaria immitis, a filarial nematode, is the causative agent of canine and feline heartworm disease. Previous research has demonstrated that immunity to D. immitis can be induced in dogs by repeated chemical abbreviation of infections while the parasite is a fourth-stage larva. Sera obtained from dogs immunized in this manner has been effective in passively transferring larval killing and stunting. These immune sera, by comparison to nonimmune sera from infected cohorts, recognize a number of unique D. immitis antigens, some of which are larval specific. In this study immune dog sera were used to screen a D. immitis larval cDNA expression library. Three overlapping cDNA clones, Di22, Di18 and Di16, were obtained that encode a portion of a large molecule, greater than 150 kDa, that is composed of multiples of a 399-bp repeat. This protein when immunoblotted with antibody against a recombinant expressed Di22 fusion protein is found in larval as well as adult extracts and excretory-secretory products, and is seen as a series of ascending subunits, each approximately 15 kDa larger than the previous one. This antigen is highly immunogenic, as evidenced by the strong reactivity of the recombinant expressed Di22 fusion protein with sera from immune dogs, microfilaremic dogs and infected amicrofilaremic dogs. While the function of this antigen is unknown it has significant sequence similarity with an allergen found in Ascaris.

Cloning of a cuticular antigen that contains multiple tandem repeats from the filarial parasite Dirofilaria immitis

An unusual antigen composed of tandemly repeated protein units was cloned from the filarial parasite Dirofilaria immitis. The antigen was initially identified by screening a lambda gt11 cDNA library with serum from dogs immunized with irradiated D. immitis third-stage larvae. DNA sequence analysis of the cDNA clone, Di5, revealed a continuous open reading frame composed of two 399-base-pair repeats arranged in tandem. Southern blot analysis of genomic D. immitis DNA showed that the gene coding for Di5 is composed of a tandem array of 25-50 copies of this same 399-base-pair repeat. Antiserum raised against recombinant Di5 protein detected a protein "ladder," from about 14 to greater than 200 kDa with steps approximately 15 kDa apart, on immunoblots of D. immitis extract. Metabolic labeling of adult parasites with [35S]methionine showed that Di5 is synthesized as a large precursor that is subsequently cleaved to produce the ladder-like array. These results suggest that the characteristic ladder is created by proteolytic cleavage of the precursor at the same site in each monomer. The Di5 antigen was localized to the cuticle and hypodermis of adult D. immitis by immunoelectron microscopy. Both male and female parasites were found to release Di5 when cultured in vitro. DNA hybridization analysis demonstrated that Di5 is a member of a gene family present in many filarial parasites that infect both animal and human populations.

Are transient pulmonary solitary nodules a common event in human dirofilariosis?

Infection by Dirofilaria immitis is a rare cause of solitary pulmonary nodule. We describe the second case of transitory pulmonary nodule found by us in the course of a case-finding study, the third one reported in the literature. The detection of cases of transient pulmonary dirofilariotic nodules suggests that human infection is more prevalent than usually thought, and that this kind of manifestation is frequent in human dirofilariosis. Greater awareness is warranted in endemic areas.

Identification of Dirofilaria immitis larval antigens with immunoprophylactic potential using sera from immune dogs

Previous research has demonstrated that dogs that received chemically abbreviated Dirofilaria immitis larval infections were significantly immune to challenge infections. Sera from those immune animals have been effective in passively transferring larval killing and stunting. In the present study, sera from immune and control animals were used to screen various Ag subsets for unique Ag. Through Western blot analysis of larval extracts and excretory-secretory products, and immunoprecipitation of metabolically labeled proteins and larval surface Ag, it was determined that as many as 12 molecules were uniquely recognized by protective immune sera. A 39-kDa molecule was present in both soluble lysates of third- and fourth-stage larvae and larval excretory-secretory products; it was recognized by each of the immune dogs and by none of the infected or uninfected control animals. The 39-kDa molecule appeared to be absent from adults and microfilariae of the parasite. In addition to the unique recognition by immune dog sera, larval stage specificity of this molecule suggests that it may be useful as a vaccine candidate.

Stage-specific expression of a developmentally regulated gene in Dirofilaria immitis

A previously reported cDNA clone encoding 34 kDa antigenic polypeptide of Dirofilaria immitis (lambda cD34) was studied to elucidate the mechanism of stage-specific gene expression. The 34 kDa polypeptide was a larva-specific antigen and the mRNA was detectable in microfilariae but not in adult worms and eggs. The lambda cD34 gene was not sex linked and was contained in the genome of D. immitis at each stage. The stage-specific expression of the developmentally regulated gene in D. immitis may be controlled primarily at the mRNA level.

Identification of Dirofilaria immitis-infected dogs with a coagglutination assay

The presence of Dirofilaria immitis excretory-secretory (ES) products was detected in the urine of infected dogs using a coagglutination assay. Urine samples from 30 naturally infected dogs were positive. Seventeen of them were microfilaremic, whereas 13 had become amicrofilaremic after receiving 2 courses of diethylcarbamazine. Urine samples from 20 dogs infected with other parasites, Dipetalonema reconditum (7), Toxocara canis (5), and Ancylostoma caninum (8), and urine samples from 20 healthy dogs were negative. The assay detected 200 ng/ml or more of ES products. This assay is simple, easy to perform with minimum training, and requires no equipment. Therefore it should be useful to detect canine filariasis under field conditions.

The humoral response in natural Dirofilaria immitis infections in dogs

Plasma samples from dogs with infections of Dirofilaria immitis were assessed using ELISA and Western blotting techniques. These results were then assessed in relation to age and sex of the host, and to the numbers of microfilariae and adult filariae. Dogs with microfilariae tended to have lower levels of infection. In infected dogs, mean ELISA titres increased directly with the degree of infection. Dogs that were either young or mildly infected, showed a preferential antibody reactivity to antigens in the high molecular weight regions of the immunoblots. With increasing age and/or the extent of infection, an antibody response to antigens in the low molecular weight regions was apparent.

Seasonal changes in the levels of anti-Dirofilaria immitis antibodies in an exposed human population

A prospective follow-up study to define seasonal changes in the level of anti-Dirofilaria immitis antibodies in an exposed human population in Western Spain was conducted. Specific antibodies were detected using an enzymelinked immunosorbent assay (ELISA). Ig M antibodies predominated in Summer, during maximal vector activity, while Ig G rose to a maximum in Winter. The sole risk factor associated with higher optical densities in the ELISA proved to be age, indicating that repeated exposure to the parasite is the rule. It is concluded that, for serodiagnosis the endemic or non-endemic nature of the geographical area and the season of the year should be considered to define the basal level of positivity, and that as well as Ig G, Ig M should always be determined.

Aedes aegypti: characterization of hemocyte polypeptide synthesis during wound healing and immune response to inoculated microfilariae

Hemocytes from adult, female Aedes aegypti, intrathoracically inoculated with microfilariae (mf) of the nematode Dirofilaria immitis, were compared to saline-inoculated and uninoculated controls using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), 125I-labeling, and wheat germ agglutinin (WGA) binding techniques. Activation of wound healing and/or melanotic encapsulation responses by the inoculation of saline or mf into the host hemocoel induced alterations in the hemocyte activity of these mosquitoes. Protein assays of whole hemocyte lysates revealed that hemocytes from saline- and mf-inoculated mosquitoes had higher protein concentrations than uninoculated controls. Many polypeptides were seen within all three hemocytes preparations when stained with silver nitrate, but there was an overall increase in protein synthesis in hemocytes from inoculated mosquitoes. In addition, a 200-kDa polypeptide was uniquely expressed in hemocytes from inoculated mosquitoes. There were several prominent surface proteins labeled with 125I, and several of these increased dramatically in intensity during wound healing and/or a melanotic encapsulation response. Similar results were seen in two-dimensional separations. A set of basic polypeptides comigrated with an acidic polypeptide resulting in a surface protein of approximately 80-90 kDa that increased in inoculated mosquitoes. Hemocytes from inoculated mosquitoes exhibited a group of three acidic polypeptides, whereas hemocytes from uninoculated mosquitoes exhibited only one of these protein fragments. Three surface polypeptides bound 125I-labeled WGA, and binding of WGA to hemocyte surface polypeptides was successfully inhibited by the incubation of cells with the lectin and its competing sugar.

Dirofilaria immitis in cats from inner Sydney

Two hundred feral cats from the inner suburbs of Sydney were examined post mortem for adult Dirofilaria immitis and circulating microfilariae, and 101 of these cats were tested for heartworm antigens by an ELISA. Only 2 cats (1%) had adult heartworms, the blood sample from another cat contained a single microfilaria. The blood of a further three cats contained small amounts of D immitis antigen. Although D immitis occurs in cats in Sydney, the prevalence is not high enough to warrant prophylactic treatment.

Prevalence of circulating heartworm antigen in dogs in northeastern Colorado

Heartworm antigenemia was evaluated and found to be negative in 1010 dogs in Northeastern Colorado that were examined at the Colorado State University Veterinary Teaching Hospital. The estimated prevalence of canine heartworm for the native Northeastern Colorado population was determined to be 0.3% and is similar to the prevalence reported 10 years ago in the same area. We conclude there has not been an increase in prevalence of heartworm in the last 10 years; because of the low prevalence, there is no need for routine testing or testing and prophylaxis in the study area at this time.

Serological survey for heartworm (Dirofilaria immitis) in dogs in Washington

The serologic prevalence of Dirofilaria immitis infection in 601 dogs in Washington was investigated in 1989-1990. Blood samples for serum were obtained from dogs approximately 2 yr of age or older in humane society shelters (n = 392) or veterinary clinics (n = 209). Serum samples were tested for heartworm infection using an enzyme-linked immunosorbent assay antigen test. Three (0.5%) dogs were positive for D. immitis infection, all of which were born and lived several years in states other than Washington. Heartworms have not been detected during the last 9 yr in the 1,203 dogs examined at the Washington Animal Disease Diagnostic Laboratory, Pullman, Washington. Consequently, the likelihood of indigenous heartworm infections in dogs in Washington remains low at this time.

Immunoblot analysis of Dirofilaria immitis recognized by infected humans

To help to develop better diagnostic tests for zoonotic pulmonary dirofilariasis, seven patients with histologically confirmed pulmonary dirofilariasis were evaluated using the immunoblot technique. Six patients exhibited a response to the excretory-secretory (AS) antigen proteins with molecular weights of 20-19.5, 17.5-17 and 14 derived from Dirofilaria immitis adult works. However, when adult worm extracts were used as the antigen, there was no qualitative difference in antigen recognition between the Dirofilaria patients, other patients with non-filarial parasitic infections or with lung cancer or tuberculosis, and normal individuals. All the sera, not only those of the Dirofilaria patients but also those of the non-filarial patients and the controls, strongly cross-reacted with the 18-kDa ES antigen. These findings suggest that the ES antigen of D. immitis provides a more sensitive antigen than does the adult somatic antigen; but the ES antigen and the adult somatic antigen have a common antigenic band at 18 kDa.

Immunological treatment of cough occurring in dogs with dirofilariosis

A persistent, spasmic and productive cough known as filarial cough often occurs in dogs with dirofilariosis, and has been considered to be the consequence of an allergic response to Dirofilaria immitis. Twenty-one dogs with filarial cough were subcutaneously injected with worm antigen (200 micrograms of protein concentration) extracted from adult D. immitis once a day for 5 days. These injections were effective for 17 (81%) of the dogs, resulting in a complete cure for 7 dogs and marked improvement for 10 dogs.

Molecular cloning of the cDNA encoding an immunodominant antigen of Dirofilaria immitis

An immunodominant antigen of Dirofilaria immitis was studied using recombinant DNA techniques. The mRNA from D. immitis adult female worms was translated in vitro and a major 34 kDa antigenic polypeptide product was demonstrated by immunoprecipitation. cDNA was synthesized from mRNA and a lambda gt11 expression library was constructed and immunoscreened with dirofilariasis positive serum. A positive clone containing a nearly full length cDNA was isolated. The cDNA was 2415 bp in length and consisted of a single open reading frame followed by a long 3' non-coding region of 1446 bp. The open reading frame of 969 bp encoded a polypeptide of 322 amino acids with a molecular weight of 34,400. A cDNA fusion protein synthesized by bacteria (Escherichia coli JM109) using the expression vector pGEMEX-1 was identified as an immunodominant antigen by absorption experiments and had no cross-reactivity with sera from patients with other filarial species.

A seroepidemiologic survey of human dirofilariosis in Western Spain

The objective of this work is to define the prevalence of IgM and IgG antibodies against Dirofilaria immitis in an exposed human population. 395 individuals attending primary care facilities in an area endemic with canine dirofilariasis were studied, as well as 100 non exposed individuals. An ELISA method was used for the detection of IgG and IgM antidirofilarial antibodies. Sera were preadsorbed with antigens of Toxocara canis, Ascaris suum, Echinoccocus granulosus and Fasciola hepatica to prevent cross reactions. Global seroprevalence was 9.3%. IgG antibodies were observed in the oldest sector of the population, while IgM antibodies were found only in its youngest half. No sex differences were observed. This result show that dirofilariasis is common in humans from endemic areas. Repeated contacts with the parasite are common and begin at a young age.

Passive transfer of protective immunity to larval Dirofilaria immitis from dogs to BALB/c mice

Protective immunity to larval Dirofilaria immitis has been demonstrated in both the natural host, the dog, and in an experimental host, the mouse. In the present study, sera were collected and pooled from dogs that had been shown to have protective immunity to larval D. immitis. The pooled serum was inoculated into normal BALB/cByJ mice that then were challenged with third-stage larvae (L3) implanted in diffusion chambers. Two weeks postchallenge no significant difference was seen in either parasite survival or growth. Three weeks postchallenge, there was a significant decrease in parasite survival in mice receiving serum from immune dogs. Living larvae recovered at 3 wk postchallenge were significantly shorter than cohorts recovered from control mice. Antibody responses to L3 and forth-stage larvae (L4) surface antigens, to L3 and L4 aqueous soluble antigens, and to an excretory-secretory antigen fraction were measured. Only antibody responses to L3 surface antigens were elevated in the immune serum as compared to controls, thus suggesting a possible role for antibodies with specificity for surface antigens in protective immunity.

Onchocerca volvulus, O. gutturosa, Brugia malayi, and Dirofilaria immitis: a comparative study of the immunochemical properties of cuticular proteins from filarial parasites

We compared the chemical and immunological properties of cuticular collagens from four species of filarial nematodes, Onchocerca volvulus, O. gutturosa, Brugia malayi, and Dirofilaria immitis. The electrophoretic mobility of the major polypeptides extracted from adult worms is characteristic for each species studied. Cuticular collagens from adult worms and infective larvae differ in their susceptibility to proteases that cleave vertebrate collagens and to collagenases prepared from different developmental stages of filarial parasites. The overall amino acid composition of filarial collagens resembles that of vertebrate interstitial collagens and differs from that reported for collagens from free-living or intestinal nematodes. However, cuticular proteins of the four filarial species studied significantly differed in amino acid composition and in their reactivity with antisera to interstitial and basement membrane collagens of vertebrates.

Induction of Fc epsilon RII/CD23 on human T cells by excretory and secretory antigen of Dirofilaria immitis

We investigated the capacity of excretory and secretory antigen (ES) derived from living filarial worms in the induction of CD23 expression on human peripheral blood T cells by using flow cytometry. ES (10 micrograms/ml) significantly induced the expression of CD23 on human T cells. Moreover, increased CD23 expression was completely abolished by preincubation with specific antibody to ES. The results suggest that ES might play a certain role in IgE antibody production by induction of CD23 expression on T cells.

Immunoperoxidase staining characteristics of Dirofilaria immitis in the dog

The immunoperoxidase staining characteristics of Dirofilaria immitis and pulmonary tissues from infected dogs were studied by using the following sera: anti-fresh D immitis, anti-processed D immitis, anti-dog IgG, anti-dog IgG Fc, anti-dog IgM and anti-dog C3. Marked staining was observed using anti-fresh D immitis serum. Body cavity fluid and cuticle were strongly stained and hypodermis, muscle, lateral cord, testis, vas deferens, ovary, oviduct and uterus were moderately stained. Oesophagus and intestine were mildly stained. Degenerate worms were stained by all antisera. The intact and cut surfaces of microfilariae and eggs and sperm present in filariae were stained, but not their internal contents. Circulating and stored immotile microfilariae did not stain. Excreted eggs, presumed to be unfertilized and, or, degenerate, stained positively. Immunoperoxidase staining of routinely processed histological samples provides a means of assessing D immitis antigen.

Ultrastructural localization of Dirofilaria immitis antigen in canine lung tissue using the protein A-gold labelling technique

Dirofilaria immitis antigens were demonstrated in the pulmonary tissues of dogs, with natural and experimental infection (D. immitis) in dogs using an immunostaining colloidal gold technique. Electron microscopy of thin sections treated with anti-heartworm serum revealed antigen deposition within the pulmonary microvasculatur and perivascular areas.

B cell responses to paramyosin. Isotypic analysis and epitope mapping of filarial paramyosin in patients with onchocerciasis

To examine the fine specificity of the human immune response to filarial paramyosin, the antigenicity of an expressed rcDNA (2.55 kb) of Dirofilaria immitis paramyosin was detailed by ELISA. Using sera from patients infected with Onchocerca volvulus, we analyzed both the entire paramyosin molecule and six subcloned fragments for their IgG, IgG subclasses, and IgE responses. Patients from both Guatemala (64% positive) and Ghana (100% positive) reacted to paramyosin with specific IgG levels above normal controls. Although there was no anti-paramyosin subclass restriction common to all patients, the IgG3 response in the Ghananians was significantly greater than that of Guatemalans (p less than 0.001). IgE anti-paramyosin responses showed positive correlations with IgG2 (p less than 0.001), IgG4 (p less than 0.002), and IgG1 (p less than 0.04) responses. Epitope mapping using the IgG response to the six subclones demonstrated preferential recognition of the amino terminal end of the molecule (nucleotides 1 to 360). IgG2 reactivity was clearly localized to the most amino-terminal 120 amino acids, and the IgG4 antibodies recognized amino acids immediately adjacent to this fragment. These studies examining the fine specificity of anti-filarial immune reactions should provide a method for understanding how parasites either evade or induce host immune responses.

Dirofilaria immitis: effect on hemolymph polypeptide synthesis in Aedes aegypti during melanotic encapsulation reactions against microfilariae

[35S]Methionine-labeled hemolymph polypeptides from adult, female Aedes aegypti Liverpool strain mosquitoes inoculated with the microfilariae of the filarial nematode Dirofilaria immitis were compared with those from saline-inoculated and uninoculated controls by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) followed by fluorography. SDS-PAGE analysis of cell-free hemolymph collected via perfusion at 6, 12, 24, 48, 72, and 96 hr postinoculation (PI) detected the enhanced expression of an 84-kDa polypeptide. This polypeptide, expressed constitutively in the hemolymph of all three groups of mosquitoes, increased considerably in inoculated mosquitoes as time progressed as compared with uninoculated controls. Moreover, the 84-kDa polypeptide was expressed at higher levels in D. immitis-inoculated mosquitoes than in saline-inoculated controls. This stimulation of de novo biosynthesis of the 84-kDa polypeptide in inoculated mosquitoes may play a role in the immune response of mosquitoes. Since it is likely that the wound healing response in insects involves many of the same chemical processes as occur in melanotic encapsulation reactions of mosquitoes against filarial worms, the preferential expression of the 84-kDa polypeptide in saline-inoculated mosquitoes seen in this study may reflect a wound healing response. The greater increase in synthesis of this protein in D. immitis-inoculated mosquitoes may reflect production of melanotic material required for parasite destruction as well as for wound healing.

Antigenic identification of excretory-secretory products of adult Dirofilaria immitis

Excretory-secretory (ES) products collected from adult Dirofilaria immitis cultured in vitro were analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting. ES products of male (M-ES) and female (F-ES) worms were separated into 16 and 21 bands by SDS-PAGE with Coomassie blue and silver staining, respectively. The antigenic bands were then analyzed by immunoblotting, using pooled sera from dogs that had naturally contracted D. immitis. Sera from dogs with microfilaremic infection showed 7 bands in M-ES and 10 bands in F-ES, while those from dogs with occult infection revealed 3 bands in M-ES and 10 bands in F-ES. Among these bands, those of 14, 18, 21, 22, 29, and 32 kilodaltons (Kd) were common to M-ES and F-ES, those of 39 and 44 Kd were specific to M-ES, and those of 20, 38, 43, 53, 63, 90, 110, 125 and 136 Kd were specific to F-ES.

Evaluation of heartworm immunodiagnostic tests

In this report, the use of appropriate statistical methods for the evaluation of heartworm immunodiagnostic tests is discussed. The evaluation of these tests is complicated by factors causing variation in sensitivity, specificity, accuracy, and predictive values of positive and negative test results. The primary sources of inconsistency are variation in the prevalence of heartworm infection among populations of dogs and the sensitivity of immunodiagnostic tests to various categories of heartworm infections (ie, patent, immune-mediated occult, unisex occult, and immature occult). Sample size (ie, number of dogs tested) affects the confidence limit values of sensitivity and specificity. At least 100 dogs should be used in each testing group (infected and uninfected) to generate values of sensitivity or specificity within reasonably narrow confidence limits. Use of more than 200 dogs in each testing group contributes little to further narrowing of confidence limits. The selection of appropriate statistical tests for comparison of tests or comparison of the sensitivity or specificity of a single diagnostic test to various categories of heartworm infections is critical. The McNemar paired chi 2 test is appropriate for comparison of diagnostic tests, but it must be done by use of duplicate sera from each animal. A chi 2 test of independence, or, in the case of a small sample size, the Fisher exact test, is appropriate for comparing the sensitivity or specificity of a single diagnostic test to various categories of heartworm infection.

Onchocerca volvulus: molecular cloning, primary structure, and expression of a microfilarial surface-associated antigen

Although the filarial nematode parasite Onchocerca volvulus is an important human pathogen in large areas of Africa and Latin America, little is known of the molecular interactions that govern the clinical status of patients with this chronic, debilitating disease. As a step toward defining the parasite molecules important to the immunobiology of host-parasite interactions, we have identified and cloned a major surface-associated antigen expressed by O. volvulus microfilariae. Radiolabeling experiments demonstrated that O. volvulus microfilariae have a limited repertoire of peptides at the surface. Prominent among these labeled peptides is an 18-kDa component. Immunological cross-reactivity between a surface-associated component of Dirofilaria immitis microfilariae and the 18-kDa surface-associated molecule from O. volvulus was exploited in a strategy to clone this potentially important O. volvulus microfilarial antigen. The cross-reacting antibodies were used to immunoscreen O. volvulus cDNA expression libraries. One clone, M2f.e, contained an open reading frame of 495 bp encoding an 18.1-kDa protein (OVMS18). Antibodies produced against the expression product of M2f.e recognized an 18-kDa component in extracts of O. volvulus microfilariae and bound to the surface of intact O. volvulus and D. immitis microfilariae. Southern blot analyses showed that M2f.e-like sequences are present in the genomic DNA of a number of filarial nematode species, but not in DNAs from nonfilarial nematode species.

Histopathological and immunopathological evaluation of filarial glomerulonephritis in Dirofilaria immitis infected dogs

Filarial glomerulonephritis was studied using Dirofilaria immitis infected dogs. Of 34 infected dogs examined, 15 dogs (44.1%) had histopathological lesions in the kidney. These lesions included an increased number of mesangial cells and increased thickness of the matrix, the infiltration of the small round and plasma cells into the interstitium and thickening of the basement membrane. Deposits of IgG were demonstrated in the infected dogs, whereas C3 deposits were found in all dogs. Combined immunoglobulin and complement deposits were not always found in the dogs with histopathological lesions. The mean concentration (expressed as absorbance) of circulating immune complexes (CIC) was 0.675 +/- 0.517 in infected dogs, and 0.132 +/- 0.092 in uninfected dogs. Although there was significant difference in the level of CIC between infected and uninfected dogs (P less than 0.001), 11 dogs (32.4%) in infected group were negative. Otherwise, the CIC levels were correlated to the adult worm burden (r = 0.848; P less than 0.001) but not to the number of circulating microfilariae (mf) (r = 0.398; P less than 0.05). Transfer of mf to 7 naive dogs was performed to clarify the role of mf in the pathogenesis of filariasis. Antibodies to crude mf antigen became detectable two weeks after the transfer. Neither pathologic findings nor deposits of IgG and C3 in the kidney were found in dogs examined 20 days or 70 days after transfer. There was no evidence that histopathological lesions were induced by live mf, suggesting that adult worm burdens may be more closely related to filarial nephropathy.