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Zhang C, Huang H, Guo B. Idiopathic mesenteric phlebosclerosis occurring in a patient with liver cirrhosis: A case report. Medicine (Baltimore) 2024; 103:e37608. [PMID: 38489674 PMCID: PMC10939688 DOI: 10.1097/md.0000000000037608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Idiopathic mesenteric phlebosclerosis (IMP) is a rare gastrointestinal disease with unclear etiology and pathogenesis. IMP occurring in a patient with liver cirrhosis is more scarcely reported than independent IMP. In this study, we reported a case of IMP occurring in a patient with liver cirrhosis, so as to provide a reference for understanding liver cirrhosis with IMP. METHOD A 63-year-old man with liver cirrhosis was admitted in the hospital's department of infectious disease because of fatigue and constipation for 1 month. The patient had an irregular medical history of antivirus drug and Chinese herbal medicine intake because of the hepatitis B virus infection. No other abnormalities were found in the functions of the liver, coagulation, renal, or complete blood count. Fecal occult blood tests were all positive in 5 detections. Contrast-enhanced computed tomography revealed liver cirrhosis and showed thickening of the wall of the right hemicolon and multiple calcifications of the mesenteric veins. Mesenteric vein computed tomography venography displayed diffuse colon mural thickening of the right colon and tortuous linear calcification line in the right colic veins. Colonoscopy revealed a purple-blue, swollen, rough, and vanished vascular texture mucosa. He was finically diagnosed as liver cirrhosis with IMP by a series of examinations during hospitalization. RESULTS His symptoms of fatigue and constipation subsided after conservative treatment and withdraw from Chinese herbal medicine. The patient experienced no obvious discomfort during the follow-up period. CONCLUSION A comprehensive medical diagnosis is necessary for the discovery of IMP, especially IMP with liver cirrhosis. Liver cirrhosis maybe play a key role in the development of IMP. The regulatory mechanism of liver cirrhosis contributing to IMP needs to be further studied based on more clinical cases.
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Affiliation(s)
- Congjie Zhang
- Department of Dermatology, Center for Plastic and Reconstructive Surgery, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Haijun Huang
- Department of Infectious Diseases, Center for General Practice Medicine, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Beibei Guo
- Department of Gastroenterology, Center for General Practice Medicine, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou Zhejiang, China
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Li X, Weth O, Haimann M, Möscheid MF, Huber TS, Grevelding CG. Rhodopsin orphan GPCR20 interacts with neuropeptides and directs growth, sexual differentiation, and egg production in female Schistosoma mansoni. Microbiol Spectr 2024; 12:e0219323. [PMID: 38047698 PMCID: PMC10783048 DOI: 10.1128/spectrum.02193-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/17/2023] [Indexed: 12/05/2023] Open
Abstract
IMPORTANCE Schistosomes cause schistosomiasis, one of the neglected tropical diseases as defined by the WHO. For decades, the treatment of schistosomiasis relies on a single drug, praziquantel. Due to its wide use, there is justified fear of resistance against this drug, and a vaccine is not available. Besides its biological relevance in signal transduction processes, the class of G protein-coupled receptors (GPCRs) is also well suited for drug design. Against this background, we characterized one GPCR of Schistosoma mansoni, SmGPCR20, at the molecular and functional level. We identified two potential neuropeptides (NPPs) as ligands, SmNPP26 and SmNPP40, and unraveled their roles, in combination with SmGPCR20, in neuronal processes controlling egg production, oogenesis, and growth of S. mansoni females. Since eggs are closely associated with the pathogenesis of schistosomiasis, our results contribute to the understanding of processes leading to egg production in schistosomes, which is under the control of pairing in this exceptional parasite.
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Affiliation(s)
- Xuesong Li
- Institute for Parasitology, BFS, Justus Liebig University Giessen, Giessen, Germany
| | - Oliver Weth
- Institute for Parasitology, BFS, Justus Liebig University Giessen, Giessen, Germany
| | - Martin Haimann
- Institute for Parasitology, BFS, Justus Liebig University Giessen, Giessen, Germany
| | - Max F. Möscheid
- Institute for Parasitology, BFS, Justus Liebig University Giessen, Giessen, Germany
| | - Theresa S. Huber
- Institute for Parasitology, BFS, Justus Liebig University Giessen, Giessen, Germany
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Pan W, Guo J, Li J, Su J, Zhang X, Liu J, Xu C, Hou Y. Presence of schistosome eggs in lymph node predict unfavorable prognosis in schistosomal colorectal cancer. Eur J Cancer Prev 2023; 32:566-574. [PMID: 37200090 PMCID: PMC10538618 DOI: 10.1097/cej.0000000000000811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/10/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the prognostic significance of schistosome eggs' location in schistosomal colorectal cancer (SCRC). METHODS 172 cases of SCRC were retrospectively analyzed. Patient clinicopathological parameters and survival rates were analyzed. RESULTS There were 102 males and 70 females, the median age was 71 years (range, 44-91). All patients were followed, and the median time was 50.1 months (range, 1.0-79.7). There were 87 patients with PS1 (presence site 1, eggs deposited in the mucosa) and 85 patients with PS2 (presence site 2, eggs deposited in the muscularis propria or throughout the full thickness of the intestinal wall), 159 patients presented with eggs in cutting edge and 83 patients presented with eggs in lymph node (LN). Hepatic schistosomiasis was found in 27.3% of patients by imaging modalities and correlated to patients with PS2 ( P < 0.001) and LNs' eggs ( P < 0.001). Survival analyses showed that in stage III SCRC, eggs' presence in LN associated with worse DFS ( P = 0.004) or marginally worse OS ( P = 0.056), patients with PS2 had shorter OS ( P = 0.044). Multivariate analyses revealed hepatic schistosomiasis was an independent prognostic factor for DFS and OS in stage III SCRC ( P = 0.001, 0.002, respectively). In adjusted multivariate analysis, eggs' presence in LN was an independent prognostic factor for DFS in stage III SCRC ( P = 0.006). CONCLUSIONS In stage III SCRC, eggs' presence in LN could predict poor prognosis and hepatic schistosomiasis was an independently unfavorable prognosis factor.
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Affiliation(s)
- Weiyu Pan
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Jiaojiao Guo
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Jiali Li
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Jieakesu Su
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Xiaolei Zhang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Jia Liu
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Chen Xu
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Yingyong Hou
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
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Li S, Sun X, Li T, Shi Y, Xu B, Deng Y, Wang S. A novel proteomic-based model for predicting colorectal cancer with Schistosoma japonicum co-infection by integrated bioinformatics analysis and machine learning. BMC Med Genomics 2023; 16:269. [PMID: 37904220 PMCID: PMC10614356 DOI: 10.1186/s12920-023-01711-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/23/2023] [Indexed: 11/01/2023] Open
Abstract
Schistosoma japonicum infection is an important public health problem and the S. japonicum infection is associated with a variety of diseases, including colorectal cancer. We collected the paraffin samples of CRC patients with or without S. japonicum infection according to standard procedures. Data-Independent Acquisition was used to identify differentially expressed proteins (DEPs), protein-protein interaction (PPI) network construction, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional enrichment analysis and machine learning algorithms (least absolute shrinkage and selection operator (LASSO) regression) were used to identify candidate genes for diagnosing CRC with S. japonicum infection. To assess the diagnostic value, the nomogram and receiver operating characteristic (ROC) curve were developed. A total of 115 DEPs were screened, the DEPs that were discovered were mostly related with biological process in generation of precursor metabolites and energy,energy derivation by oxidation of organic compounds, carboxylic acid metabolic process, oxoacid metabolic process, cellular respiration aerobic respiration according to the analyses. Enrichment analysis showed that these compounds might regulate oxidoreductase activity, transporter activity, transmembrane transporter activity, ion transmembrane transporter activity and inorganic molecular entity transmembrane transporter activity. Following the development of PPI network and LASSO, 13 genes (hsd17b4, h2ac4, hla-c, pc, epx, rpia, tor1aip1, mindy1, dpysl5, nucks1, cnot2, ndufa13 and dnm3) were filtered, and 3 candidate hub genes were chosen for nomogram building and diagnostic value evaluation after machine learning. The nomogram and all 3 candidate hub genes (hsd17b4, rpia and cnot2) had high diagnostic values (area under the curve is 0.9556). The results of our study indicate that the combination of hsd17b4, rpia, and cnot2 may become a predictive model for the occurrence of CRC in combination with S. japonicum infection. This study also provides new clues for the mechanism research of S. japonicum infection and CRC.
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Affiliation(s)
- Shan Li
- Precision Preventive Medicine Laboratory of Basic Medical School, Jiujiang University, Jiujiang, 332005, China.
| | - Xuguang Sun
- Art School, Jiujiang University, Jiujiang, 332005, China
| | - Ting Li
- Affiliated Hospital of Jiujiang University, Jiujiang, 332005, China
| | - Yanqing Shi
- Affiliated Hospital of Jiujiang University, Jiujiang, 332005, China
| | - Binjie Xu
- Precision Preventive Medicine Laboratory of Basic Medical School, Jiujiang University, Jiujiang, 332005, China
| | - Yuyong Deng
- Precision Preventive Medicine Laboratory of Basic Medical School, Jiujiang University, Jiujiang, 332005, China
| | - Sifan Wang
- Precision Preventive Medicine Laboratory of Basic Medical School, Jiujiang University, Jiujiang, 332005, China
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Luo C, Wang Y, Su Q, Zhu J, Tang S, Bergquist R, Zhang Z, Hu Y. Mapping schistosomiasis risk in Southeast Asia: a systematic review and geospatial analysis. Int J Epidemiol 2023; 52:1137-1149. [PMID: 36478466 DOI: 10.1093/ije/dyac227] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 12/01/2022] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Schistosomiasis is a water-borne parasitic disease estimated to have infected >140 million people globally in 2019, mostly in sub-Saharan Africa. Within the goal of eliminating schistosomiasis as a public health problem by 2030 in the World Health Organization (WHO) Roadmap for neglected tropical diseases, other regions cannot be neglected. Empirical estimates of the disease burden in Southeast Asia largely remain unavailable. METHODS We undertook a systematic review to identify empirical survey data on schistosomiasis prevalence in Southeast Asia using the Web of Science, ScienceDirect, PubMed and the Global Atlas of Helminth Infections, from inception to 5 February 2021. We then conducted advanced Bayesian geostatistical analysis to assess the geographical distribution of infection risk at a high spatial resolution (5 × 5 km) using the prevalence, number of infected individuals and doses needed for preventive chemotherapy. RESULTS We identified 494 Schistosoma japonicum surveys in the Philippines and Indonesia, and 285 in Cambodia and Laos for S. mekongi. The latest estimates suggest that 225 [95% credible interval (CrI): 168-285] thousand in the endemic areas of Southeast Asian population were infected in 2018. The highest prevalence of schistosomiasis was 3.86% (95% CrI: 3.40-4.31) in Laos whereas the lowest was 0.29% in Cambodia (95% CrI: 0.22-0.36). The estimated number of praziquantel doses needed per year was 1.99 million (95% CrI: 1.92-2.03 million) for the entire population in endemic areas of Southeast Asia. CONCLUSIONS The burden of schistosomiasis remains far from the WHO goal and our estimates highlighted areas to target with strengthened interventions against schistosomiasis.
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Affiliation(s)
- Can Luo
- Department of Environmental Science, Changsha Environmental Protection Vocational Technical College, Changsha, China
| | - Yan Wang
- Beijing Research Institute of Smart Water, Beijing, China
| | - Qing Su
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China
| | - Jie Zhu
- Department of Environmental Science, Changsha Environmental Protection Vocational Technical College, Changsha, China
| | - Shijing Tang
- Department of Environmental Science, Changsha Environmental Protection Vocational Technical College, Changsha, China
| | | | - Zhijie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China
| | - Yi Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China
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Li X, Weth O, Haeberlein S, Grevelding CG. Molecular characterization of Sm tdc-1 and Sm ddc-1 discloses roles as male-competence factors for the sexual maturation of Schistosoma mansoni females. Front Cell Infect Microbiol 2023; 13:1173557. [PMID: 37305409 PMCID: PMC10252128 DOI: 10.3389/fcimb.2023.1173557] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/27/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Schistosomes are the only mammalian flatworms that have evolved separate sexes. A key question of schistosome research is the male-dependent sexual maturation of the female since a constant pairing contact with a male is required for the onset of gonad development in the female. Although this phenomenon is long known, only recently a first peptide-based pheromone of males was identified that contributes to the control of female sexual development. Beyond this, our understanding of the molecular principles inducing the substantial developmental changes in a paired female is still rudimentary. Objectives Previous transcriptomic studies have consistently pointed to neuronal genes being differentially expressed and upregulated in paired males. These genes included Smp_135230 and Smp_171580, both annotated as aromatic-L-amino-acid decarboxylases (DOPA decarboxylases). Here, we characterized both genes and investigated their roles in male-female interaction of S. mansoni. Methodologies/findings Sequence analyses indicated that Smp_135230 represents an L-tyrosine decarboxylase (Smtdc-1), whereas Smp_171580 represents a DOPA decarboxylase (Smddc-1). By qRT-PCR, we confirmed the male-specific and pairing-dependent expression of both genes with a significant bias toward paired males. RNA-interference experiments showed a strong influence of each gene on gonad differentiation in paired females, which was enhanced by double knockdown. Accordingly, egg production was significantly reduced. By confocal laser scanning microscopy, a failure of oocyte maturation was found in paired knockdown females. Whole-mount in situ hybridization patterns exhibited the tissue-specific occurrence of both genes in particular cells at the ventral surface of the male, the gynecophoral canal, which represents the physical interface of both genders. These cells probably belong to the predicted neuronal cluster 2 of S. mansoni. Conclusion Our results suggest that Smtdc-1 and Smddc-2 are male-competence factors that are expressed in neuronal cells at the contact zone between the genders as a response of pairing to subsequently control processes of female sexual maturation.
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Evolution of tetraspanin antigens in the zoonotic Asian blood fluke Schistosoma japonicum. Parasit Vectors 2023; 16:97. [PMID: 36918965 PMCID: PMC10012309 DOI: 10.1186/s13071-023-05706-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/17/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Despite successful control efforts in China over the past 60 years, zoonotic schistosomiasis caused by Schistosoma japonicum remains a threat with transmission ongoing and the risk of localised resurgences prompting calls for a novel integrated control strategy, with an anti-schistosome vaccine as a core element. Anti-schistosome vaccine development and immunisation attempts in non-human mammalian host species, intended to interrupt transmission, and utilising various antigen targets, have yielded mixed success, with some studies highlighting variation in schistosome antigen coding genes (ACGs) as possible confounders of vaccine efficacy. Thus, robust selection of target ACGs, including assessment of their genetic diversity and antigenic variability, is paramount. Tetraspanins (TSPs), a family of tegument-surface antigens in schistosomes, interact directly with the host's immune system and are promising vaccine candidates. Here, for the first time to our knowledge, diversity in S. japonicum TSPs (SjTSPs) and the impact of diversifying selection and sequence variation on immunogenicity in these protiens were evaluated. METHODS SjTSP sequences, representing parasite populations from seven provinces across China, were gathered by baiting published short-read NGS data and were analysed using in silico methods to measure sequence variation and selection pressures and predict the impact of selection on variation in antigen protein structure, function and antigenic propensity. RESULTS Here, 27 SjTSPs were identified across three subfamilies, highlighting the diversity of TSPs in S. japonicum. Considerable variation was demonstrated for several SjTSPs between geographical regions/provinces, revealing that episodic, diversifying positive selection pressures promote amino acid variation/variability in the large extracellular loop (LEL) domain of certain SjTSPs. Accumulating polymorphisms in the LEL domain of SjTSP-2, -8 and -23 led to altered structural, functional and antibody binding characteristics, which are predicted to impact antibody recognition and possibly blunt the host's ability to respond to infection. Such changes, therefore, appear to represent a mechanism utilised by S. japonicum to evade the host's immune system. CONCLUSION Whilst the genetic and antigenic geographic variability observed amongst certain SjTSPs could present challenges to vaccine development, here we demonstrate conservation amongst SjTSP-1, -13 and -14, revealing their likely improved utility as efficacious vaccine candidates. Importantly, our data highlight that robust evaluation of vaccine target variability in natural parasite populations should be a prerequisite for anti-schistosome vaccine development.
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von Bülow V, Gindner S, Baier A, Hehr L, Buss N, Russ L, Wrobel S, Wirth V, Tabatabai K, Quack T, Haeberlein S, Kadesch P, Gerbig S, Wiedemann KR, Spengler B, Mehl A, Morlock G, Schramm G, Pons-Kühnemann J, Falcone FH, Wilson RA, Bankov K, Wild P, Grevelding CG, Roeb E, Roderfeld M. Metabolic reprogramming of hepatocytes by Schistosoma mansoni eggs. JHEP Rep 2022; 5:100625. [PMID: 36590323 PMCID: PMC9800334 DOI: 10.1016/j.jhepr.2022.100625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/13/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022] Open
Abstract
Background & Aims Schistosomiasis is a parasitic infection which affects more than 200 million people globally. Schistosome eggs, but not the adult worms, are mainly responsible for schistosomiasis-specific morbidity in the liver. It is unclear if S. mansoni eggs consume host metabolites, and how this compromises the host parenchyma. Methods Metabolic reprogramming was analyzed by matrix-assisted laser desorption/ionization mass spectrometry imaging, liquid chromatography with high-resolution mass spectrometry, metabolite quantification, confocal laser scanning microscopy, live cell imaging, quantitative real-time PCR, western blotting, assessment of DNA damage, and immunohistology in hamster models and functional experiments in human cell lines. Major results were validated in human biopsies. Results The infection with S. mansoni provokes hepatic exhaustion of neutral lipids and glycogen. Furthermore, the distribution of distinct lipid species and the regulation of rate-limiting metabolic enzymes is disrupted in the liver of S. mansoni infected animals. Notably, eggs mobilize, incorporate, and store host lipids, while the associated metabolic reprogramming causes oxidative stress-induced DNA damage in hepatocytes. Administration of reactive oxygen species scavengers ameliorates these deleterious effects. Conclusions Our findings indicate that S. mansoni eggs completely reprogram lipid and carbohydrate metabolism via soluble factors, which results in oxidative stress-induced cell damage in the host parenchyma. Impact and implications The authors demonstrate that soluble egg products of the parasite S. mansoni induce hepatocellular reprogramming, causing metabolic exhaustion and a strong redox imbalance. Notably, eggs mobilize, incorporate, and store host lipids, while the metabolic reprogramming causes oxidative stress-induced DNA damage in hepatocytes, independent of the host's immune response. S. mansoni eggs take advantage of the host environment through metabolic reprogramming of hepatocytes and enterocytes. By inducing DNA damage, this neglected tropical disease might promote hepatocellular damage and thus influence international health efforts.
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Key Words
- DMPE, dimethyl-phosphatidylethanolamine
- DNA damage
- GS, glycogen synthase
- GSH, reduced L-glutathione
- HCC, hepatocellular carcinoma
- Lipid
- MALDI-MSI, matrix assisted laser desorption/ionization mass spectrometry imaging
- MDA, malondialdehyde
- OA, oleic acid
- Oxidative stress
- PAS, periodic acid-Schiff
- PC, phosphatidylcholine
- PDH, pyruvate dehydrogenase
- PE, phosphatidylethanolamine
- PLIN2, perilipin 2
- Parasite
- ROS, reactive oxygen species
- S. japonicum, Schistosoma japonicum
- S. mansoni, Schistosoma mansoni
- SEA, soluble egg antigens
- Schistosomiasis
- TG, triglyceride
- bs, bisex
- flOA, fluorescently labelled OA
- hRF, retention factor ∗ 100
- ms, monosex
- ni, non-infected
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Affiliation(s)
- Verena von Bülow
- Department of Gastroenterology, Justus Liebig University, Klinikstr. 33, 35392 Giessen, Germany
| | - Sarah Gindner
- Department of Gastroenterology, Justus Liebig University, Klinikstr. 33, 35392 Giessen, Germany
| | - Anne Baier
- Department of Gastroenterology, Justus Liebig University, Klinikstr. 33, 35392 Giessen, Germany
| | - Laura Hehr
- Department of Gastroenterology, Justus Liebig University, Klinikstr. 33, 35392 Giessen, Germany
| | - Nicola Buss
- Department of Gastroenterology, Justus Liebig University, Klinikstr. 33, 35392 Giessen, Germany
| | - Lena Russ
- Department of Gastroenterology, Justus Liebig University, Klinikstr. 33, 35392 Giessen, Germany
| | - Sarah Wrobel
- Department of Gastroenterology, Justus Liebig University, Klinikstr. 33, 35392 Giessen, Germany
| | - Victoria Wirth
- Department of Gastroenterology, Justus Liebig University, Klinikstr. 33, 35392 Giessen, Germany
| | - Kuscha Tabatabai
- Department of Gastroenterology, Justus Liebig University, Klinikstr. 33, 35392 Giessen, Germany
| | - Thomas Quack
- Institute of Parasitology, BFS, Justus Liebig University, Schubertstr. 81, 35392 Giessen, Germany
| | - Simone Haeberlein
- Institute of Parasitology, BFS, Justus Liebig University, Schubertstr. 81, 35392 Giessen, Germany
| | - Patrik Kadesch
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University, Heinrich-Buff-Ring 17, 35392 Giessen, Germany
| | - Stefanie Gerbig
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University, Heinrich-Buff-Ring 17, 35392 Giessen, Germany
| | - Katja R. Wiedemann
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University, Heinrich-Buff-Ring 17, 35392 Giessen, Germany
| | - Bernhard Spengler
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University, Heinrich-Buff-Ring 17, 35392 Giessen, Germany
| | - Annabel Mehl
- Institute of Nutritional Science, Food Science Department, and Interdisciplinary Research Center (iFZ), Justus Liebig University Giessen, Heinrich-Buff-Ring 26-32, 35392 Giessen, Germany
| | - Gertrud Morlock
- Institute of Nutritional Science, Food Science Department, and Interdisciplinary Research Center (iFZ), Justus Liebig University Giessen, Heinrich-Buff-Ring 26-32, 35392 Giessen, Germany
| | - Gabriele Schramm
- Experimental Pneumology, Priority Research Area Asthma & Allergy, Research Center Borstel, Parkallee 1-40, 23845 Borstel, Germany
| | - Jörn Pons-Kühnemann
- Institute of Medical Informatics, Justus Liebig University, Rudolf-Buchheim-Str. 6. 35392 Giessen, Germany
| | - Franco H. Falcone
- Institute of Parasitology, BFS, Justus Liebig University, Schubertstr. 81, 35392 Giessen, Germany
| | - R. Alan Wilson
- York Biomedical Research Institute, Department of Biology, University of York, York YO10 5DD, UK
| | - Katrin Bankov
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Peter Wild
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Christoph G. Grevelding
- Institute of Parasitology, BFS, Justus Liebig University, Schubertstr. 81, 35392 Giessen, Germany
| | - Elke Roeb
- Department of Gastroenterology, Justus Liebig University, Klinikstr. 33, 35392 Giessen, Germany
| | - Martin Roderfeld
- Department of Gastroenterology, Justus Liebig University, Klinikstr. 33, 35392 Giessen, Germany,Corresponding author. Address: Department of Gastroenterology, Justus Liebig University Giessen, Gaffkystr. 11, 35392 Giessen, Germany. Tel.: +49 641 99 42527, fax: +49 641 99 42333.
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Nyangulu W, Sadimba C, Nyirenda J, Twaibu G, Kamwendo J, Chawawa K, Masano A, Chilinda E, Kayuni S, Muula AS, Maleta K. The prevalence of Schistosoma mansoni infection among adults with chronic non-communicable diseases in Malawi. Trop Med Health 2022; 50:56. [PMID: 35986382 PMCID: PMC9389769 DOI: 10.1186/s41182-022-00450-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background Schistosomiasis is a parasitic infectious disease caused by flatworms of the Schistosoma genus. The global burden of schistosomiasis is high. In Malawi, schistosomiasis is among the top 20 causes of outpatient department visits in health facilities. Schistosomiasis is among the most important but neglected causes of non-communicable diseases (NCD) peculiar to tropical endemic settings. While much is known about the contribution of S. haematobium to the NCD burden in Malawi, the role of S. mansoni remains largely unknown.
Methods We conducted a cross-sectional study at Mangochi District Hospital. Adults over 18 years diagnosed with NCDs (n = 414), admitted or attending weekly outpatient clinics were recruited between August 2021 and February 2022. Data were collected on sociodemographic characteristics, medical history, body weight, blood pressure, and fasting blood glucose. Stool and midstream urine were collected for Kato–Katz (KK) microscopy and urine point of care-circulating cathodic antigen (POC-CCA) tests, respectively. We computed prevalence of S. mansoni as number of positive KK and CCA tests, each divided by total submitted samples. Univariate and multivariable logistic regression were done to evaluate risk factors of NCDs and association between S. mansoni infection and NCDs. Results We recruited 414 participants, mean age 57 years (SD 16), 67% of whom were female. Prevalence of S. mansoni based on urine CCA was 15% (95% CI: 11–19) and 0% on KK microscopy. Hypertension was the most common condition with a prevalence of 85% (95% CI: 81–89), followed by diabetes mellitus with a prevalence of 42% (95% CI: 37–46) and heart disease with a prevalence of 3% (95% CI: 2–5). S. mansoni infection was not significantly associated with hypertension (OR: 1.2, 95% CI: 0.5–3.1), diabetes (OR: 0.6, 95% CI: 0.3–1.10) or heart disease (OR: 2.0, 95% CI: 0.4–10). Conclusions We observed moderate prevalence of S. mansoni infection among adults in the study per WHO classification of endemicity. This is within the range observed in children in Mangochi from 10 to 56.7%. Supplementary Information The online version contains supplementary material available at 10.1186/s41182-022-00450-3.
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10
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Rennar GA, Gallinger TL, Mäder P, Lange-Grünweller K, Haeberlein S, Grünweller A, Grevelding CG, Schlitzer M. Disulfiram and dithiocarbamate analogues demonstrate promising antischistosomal effects. Eur J Med Chem 2022; 242:114641. [PMID: 36027862 DOI: 10.1016/j.ejmech.2022.114641] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/14/2022] [Accepted: 07/27/2022] [Indexed: 11/03/2022]
Abstract
Schistosomiasis is a neglected tropical disease with more than 200 million new infections per year. It is caused by parasites of the genus Schistosoma and can lead to death if left untreated. Currently, only two drugs are available to combat schistosomiasis: praziquantel and, to a limited extent, oxamniquine. However, the intensive use of these two drugs leads to an increased probability of the emergence of resistance. Thus, the search for new active substances and their targeted development are mandatory. In this study the substance class of "dithiocarbamates" and their potential as antischistosomal agents is highlighted. These compounds are derived from the basic structure of the human aldehyde dehydrogenase inhibitor disulfiram (tetraethylthiuram disulfide, DSF) and its metabolites. Our compounds revealed promising activity (in vitro) against adults of Schistosoma mansoni, such as the reduction of egg production, pairing stability, vitality, and motility. Moreover, tegument damage as well as gut dilatations or even the death of the parasite were observed. We performed detailed structure-activity relationship studies on both sides of the dithiocarbamate core leading to a library of approximately 300 derivatives (116 derivatives shown here). Starting with 100 μm we improved antischistosomal activity down to 25 μm by substitution of the single bonded sulfur atom for example with different benzyl moieties and integration of the two residues on the nitrogen atom into a cyclic structure like piperazine. Its derivatization at the 4-nitrogen with a sulfonyl group or an acyl group led to the most active derivatives of this study which were active at 10 μm. In light of this SAR study, we identified 17 derivatives that significantly reduced motility and induced several other phenotypes at 25 μm, and importantly five of them have antischistosomal activity also at 10 μm. These derivatives were found to be non-cytotoxic in two human cell lines at 100 μm. Therefore, dithiocarbamates seem to be interesting new candidates for further antischistosomal drug development.
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Affiliation(s)
- Georg A Rennar
- Department of Pharmaceutical Chemistry, Philipps-Universität Marburg, Marbacher, Weg 6, 35032, Marburg, Germany
| | - Tom L Gallinger
- Department of Pharmaceutical Chemistry, Philipps-Universität Marburg, Marbacher, Weg 6, 35032, Marburg, Germany
| | - Patrick Mäder
- Department of Pharmaceutical Chemistry, Philipps-Universität Marburg, Marbacher, Weg 6, 35032, Marburg, Germany
| | - Kerstin Lange-Grünweller
- Department of Pharmaceutical Chemistry, Philipps-Universität Marburg, Marbacher, Weg 6, 35032, Marburg, Germany
| | - Simone Haeberlein
- BFS, Institute of Parasitology, Justus-Liebig-Universität Gießen, Schubertstraße 81, 35392, Gießen, Germany
| | - Arnold Grünweller
- Department of Pharmaceutical Chemistry, Philipps-Universität Marburg, Marbacher, Weg 6, 35032, Marburg, Germany
| | - Christoph G Grevelding
- BFS, Institute of Parasitology, Justus-Liebig-Universität Gießen, Schubertstraße 81, 35392, Gießen, Germany.
| | - Martin Schlitzer
- Department of Pharmaceutical Chemistry, Philipps-Universität Marburg, Marbacher, Weg 6, 35032, Marburg, Germany.
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11
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Santos JC, Pereira CLD, Domingues ALC, Lopes EP. Noninvasive diagnosis of periportal fibrosis in schistosomiasis mansoni: A comprehensive review. World J Hepatol 2022; 14:696-707. [PMID: 35646262 PMCID: PMC9099109 DOI: 10.4254/wjh.v14.i4.696] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/14/2021] [Accepted: 03/14/2022] [Indexed: 02/06/2023] Open
Abstract
Schistosomiasis mansoni is a neglected disease and key public health problem, mainly due to its high prevalence, the scarcity of public policies, and the severity of some clinical forms. Periportal fibrosis (PPF) is the commonest complication of chronic schistosomiasis mansoni and its diagnosis requires different techniques. Even though wedge biopsy of the liver is considered the gold standard, it is not justified in non-surgical patients, and percutaneous liver biopsy may be informative but does not have sufficient sensitivity. Noninvasive PPF tests mostly include biological (serum biomarkers or combined scores) or physical assessments (imaging assessment of fibrosis pattern or tissue stiffness). Moreover, imaging techniques, such as ultrasound, computed tomography, magnetic resonance imaging, and elastography are applied not only to support the diagnosis of schistosomiasis, but also to assess and detect signs of portal hypertension and organ damage due to chronic schistosomiasis. A combination between a comprehensive history and physical examination with biomarkers for liver fibrosis and imaging methods seems to offer the best approach for evaluating these patients. In addition, understanding their strengths and limitations will allow a more accurate interpretation in the clinical context and can lead to greater accuracy in estimating the degree of fibrosis in patients with Schistosomiasis mansoni (S. mansoni) infection. This review will discuss the different noninvasive methods that are currently available for the evaluation of PPF in S. mansoni infection, and their application, advantages, and limitations in clinical practice.
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Affiliation(s)
- Joelma Carvalho Santos
- Postgraduate Program in Tropical Medicine, Center of Health Sciences, Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil
| | - Caroline Louise Diniz Pereira
- Postgraduate Program in Tropical Medicine, Center of Health Sciences, Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil
| | - Ana Lúcia Coutinho Domingues
- Postgraduate Program in Tropical Medicine, Center of Health Sciences, Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil
- Gastroenterology Division, Department of Internal Medicine of Center of Health Sciences, Hospital das Clínicas - Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil
| | - Edmundo Pessoa Lopes
- Postgraduate Program in Tropical Medicine, Center of Health Sciences, Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil
- Gastroenterology Division, Department of Internal Medicine of Center of Health Sciences, Hospital das Clínicas - Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil.
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12
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Zhou M, Xue C, Wu Z, Wu X, Li M. Genome-Wide Association Study Identifies New Risk Loci for Progression of Schistosomiasis Among the Chinese Population. Front Cell Infect Microbiol 2022; 12:871545. [PMID: 35493725 PMCID: PMC9039613 DOI: 10.3389/fcimb.2022.871545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
Schistosoma japonicum infections, which lead to local inflammatory responses to schistosome eggs trapped in host tissues, can result in long-term, severe complications. The development of schistosomiasis may result from a complex interaction between the pathogenic, environmental, and host genetic components. Notably, the genetic factors that influence the development of schistosomiasis complications are poorly understood. Here we performed a genome-wide association study on multiple schistosomiasis-related phenotypes of 637 unrelated schistosomiasis patients in the Chinese population. Among three indicators of liver damage, we identified two novel, genome-wide significant single-nucleotide polymorphisms (SNPs) rs34486793 (P = 1.415 × 10-8) and rs2008259 (P = 6.78 × 10-8) at locus 14q32.2 as well as a gene, PMEPA1, at 20q13.31 (index rs62205791, P = 6.52 × 10-7). These were significantly associated with serum levels of hyaluronic acid (HA). In addition, RASIP1 and MAMSTR at 19q13.33 (index rs62132778, P = 1.72 × 10-7) were significantly associated with serum levels of aspartate aminotransferase (AST), and TPM1 at 15q22.2 (index rs12442303, P = 4.39 × 10-7) was significantly associated with serum levels of albumin. In schistosomiasis clinical signs, ITIH4 at 3p21.1 (index rs2239548) was associated with portal vein diameter (PVD) class, an indicator of portal hypertension, and OGDHL at 10q11.23 (index rs1258172) was related to ascites grade. We also detected an increased expression of these six genes in livers of mice with severe schistosomiasis. Summary data-based Mendelian randomization analyses indicated that ITIH4, PMEPA1 and MAMSTR were pleiotropically associated with PVD class, HA and AST, respectively.
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Affiliation(s)
- Miao Zhou
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
- Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-Sen University, Guangzhou, China
- Provincial Engineering Technology Research Center for Biological Vector Control, Sun Yat-sen University, Guangzhou, China
| | - Chao Xue
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Zhongdao Wu
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
- Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-Sen University, Guangzhou, China
- Provincial Engineering Technology Research Center for Biological Vector Control, Sun Yat-sen University, Guangzhou, China
| | - Xiaoying Wu
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- School of Public Health, Fudan University, Shanghai, China
- *Correspondence: Xiaoying Wu, ; Miaoxin Li,
| | - Miaoxin Li
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
- Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-Sen University, Guangzhou, China
- Center for Precision Medicine, Sun Yat-Sen University, Guangzhou, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: Xiaoying Wu, ; Miaoxin Li,
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de L Paula LA, Santos MFC, Pagotti MC, Veneziani RCS, Bastos JK, Caffrey CR, Ambrósio SR, Magalhães LG. Brazilian green propolis reduces worm burden and hepatic granuloma formation in a Schistosoma mansoni experimental murine model. Parasitol Res 2022; 121:775-780. [PMID: 35048211 DOI: 10.1007/s00436-021-07408-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/08/2021] [Indexed: 11/27/2022]
Abstract
Characterized as an acute and chronic parasitic disease, schistosomiasis mansoni has as its central pathology the formation of hepatic granulomas in response to the parasite's eggs trapped in the host's liver. In recent years, research on propolis has grown; however, there is little anthelmintic work on this bee product. In the propolis scenario, Brazilian ones receive attention, with green and red propolis standing out. This study aims to evaluate in vivo the standardized extract of Brazilian green propolis (Pex) against Schistosoma mansoni. The in vivo antiparasitic activity of Pex was conducted in female BALB/c mice infected with S. mansoni and of the three groups treated with Pex (300 mg/kg); G2 (35th to 42nd dpi) reduced the total worm burden by 55.32%, followed by G3 (42nd to 49th dpi) and G4 (49th to 56th dpi), with about 46%. Furthermore, G2 significantly reduced the total egg load in the ileum (59.33%) and showed an increase in the dead eggs. Similarly, histological analysis of the livers showed a significant reduction in the number and diameter of the granulomas. Based on these results, there is an interesting schistosomicidal activity of Pex and its potential against the formation of hepatic granulomas, paving the way for more detailed studies of propolis in the animal model of schistosomiasis mansoni.
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Affiliation(s)
- Lucas A de L Paula
- Research Group on Natural Products, Center for Research in Sciences and Technology, University of Franca, Avenida Dr. Armando Salles de Oliveira, 201, SP, CEP 14404-600, Franca, Brazil
| | - Mário F C Santos
- Research Group on Natural Products, Center for Research in Sciences and Technology, University of Franca, Avenida Dr. Armando Salles de Oliveira, 201, SP, CEP 14404-600, Franca, Brazil
| | - Mariana C Pagotti
- Research Group on Natural Products, Center for Research in Sciences and Technology, University of Franca, Avenida Dr. Armando Salles de Oliveira, 201, SP, CEP 14404-600, Franca, Brazil
| | - Rodrigo C S Veneziani
- Research Group on Natural Products, Center for Research in Sciences and Technology, University of Franca, Avenida Dr. Armando Salles de Oliveira, 201, SP, CEP 14404-600, Franca, Brazil
| | - Jairo K Bastos
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, CEP 14.040-903, Ribeirão Preto, SP, Brazil
| | - Conor R Caffrey
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Sérgio R Ambrósio
- Research Group on Natural Products, Center for Research in Sciences and Technology, University of Franca, Avenida Dr. Armando Salles de Oliveira, 201, SP, CEP 14404-600, Franca, Brazil.
| | - Lizandra G Magalhães
- Research Group on Natural Products, Center for Research in Sciences and Technology, University of Franca, Avenida Dr. Armando Salles de Oliveira, 201, SP, CEP 14404-600, Franca, Brazil.
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Stitz M, Chaparro C, Lu Z, Olzog VJ, Weinberg CE, Blom J, Goesmann A, Grunau C, Grevelding CG. Satellite-Like W-Elements: Repetitive, Transcribed, and Putative Mobile Genetic Factors with Potential Roles for Biology and Evolution of Schistosoma mansoni. Genome Biol Evol 2021; 13:6361599. [PMID: 34469545 PMCID: PMC8490949 DOI: 10.1093/gbe/evab204] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2021] [Indexed: 12/17/2022] Open
Abstract
A large portion of animal and plant genomes consists of noncoding DNA. This part includes tandemly repeated sequences and gained attention because it offers exciting insights into genome biology. We investigated satellite-DNA elements of the platyhelminth Schistosoma mansoni, a parasite with remarkable biological features. Schistosoma mansoni lives in the vasculature of humans causing schistosomiasis, a disease of worldwide importance. Schistosomes are the only trematodes that have evolved separate sexes, and the sexual maturation of the female depends on constant pairing with the male. The schistosome karyotype comprises eight chromosome pairs, males are homogametic (ZZ) and females are heterogametic (ZW). Part of the repetitive DNA of S. mansoni are W-elements (WEs), originally discovered as female-specific satellite DNAs in the heterochromatic block of the W-chromosome. Based on new genome and transcriptome data, we performed a reanalysis of the W-element families (WEFs). Besides a new classification of 19 WEFs, we provide first evidence for stage-, sex-, pairing-, gonad-, and strain-specific/preferential transcription of WEs as well as their mobile nature, deduced from autosomal copies of full-length and partial WEs. Structural analyses suggested roles as sources of noncoding RNA-like hammerhead ribozymes, for which we obtained functional evidence. Finally, the variable WEF occurrence in different schistosome species revealed remarkable divergence. From these results, we propose that WEs potentially exert enduring influence on the biology of S. mansoni. Their variable occurrence in different strains, isolates, and species suggests that schistosome WEs may represent genetic factors taking effect on variability and evolution of the family Schistosomatidae.
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Affiliation(s)
- Maria Stitz
- Institute of Parasitology, BFS, Justus Liebig University Giessen, Giessen, Germany
| | - Cristian Chaparro
- IHPE, CNRS, IFREMER, UPVD, University Montpellier, Perpignan, France
| | - Zhigang Lu
- Institute of Parasitology, BFS, Justus Liebig University Giessen, Giessen, Germany
| | | | | | - Jochen Blom
- Bioinformatics and Systems Biology, Justus Liebig University Giessen, Germany
| | - Alexander Goesmann
- Bioinformatics and Systems Biology, Justus Liebig University Giessen, Germany
| | - Christoph Grunau
- IHPE, CNRS, IFREMER, UPVD, University Montpellier, Perpignan, France
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15
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Peter Ventura AM, Haeberlein S, Konopka L, Obermann W, Grünweller A, Grevelding CG, Schlitzer M. Synthesis and antischistosomal activity of linker- and thiophene-modified biaryl alkyl carboxylic acid derivatives. Arch Pharm (Weinheim) 2021; 354:e2100259. [PMID: 34523746 DOI: 10.1002/ardp.202100259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 01/22/2023]
Abstract
Schistosomiasis is a neglected tropical disease caused by blood flukes of the genus Schistosoma and causes severe morbidity in infected patients. In 2018, 290.8 million people required treatment, and 200,000 deaths are reported per year. Treatment of this disease depends on a single drug, praziquantel (PZQ). However, in the past few years, reduced sensitivity of the parasites toward PZQ has been reported. Therefore, there is an urgent need for new drugs against this disease. In the past few years, we have focused on a new substance class called biaryl alkyl carboxylic acid derivatives, which showed promising antischistosomal activity in vitro. Structure-activity relationship (SAR) studies of the carboxylic acid moiety led to three promising carboxylic amides (morpholine, thiomorpholine, and methyl sulfonyl piperazine) with an antischistosomal activity down to 10 µM (morpholine derivative) and no cytotoxicity up to 100 µM. Here, we show our continued work on this substance class. We investigated, in extended SAR studies, whether modification of the linker and the thiophene ring could improve the antischistosomal activity. We found that the exchange of the alkyl linker by a pentadienyl or benzyl linker was tolerated and led to similar antischistosomal effects, whereas the exchange of the thiophene ring was not tolerated. Our data suggest that the thiophene ring is important for the antischistosomal activity of this compound class.
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Affiliation(s)
| | - Simone Haeberlein
- BFS, Institute of Parasitology, Justus Liebig University Giessen, Giessen, Germany
| | - Leonie Konopka
- Institute of Pharmaceutical Chemistry, Philipps University Marburg, Marburg, Germany
| | - Wiebke Obermann
- Institute of Pharmaceutical Chemistry, Philipps University Marburg, Marburg, Germany
| | - Arnold Grünweller
- Institute of Pharmaceutical Chemistry, Philipps University Marburg, Marburg, Germany
| | | | - Martin Schlitzer
- Institute of Pharmaceutical Chemistry, Philipps University Marburg, Marburg, Germany
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Shousha HI, Abdelaziz AO, Nabeel MM, Omran DA, Abdelmaksoud AH, Elbaz TM, Salah A, Harb STE, Hosny KA, Osman A, Atef M, Gaber A, Zayed NA, Yosry AA, Leithy R. Schistosoma mansoni infection and the occurrence, characteristics, and survival of patients with hepatocellular carcinoma: an observational study over a decade. Pathog Glob Health 2021; 116:119-127. [PMID: 34494507 DOI: 10.1080/20477724.2021.1975081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Schistosoma mansoni infection (SMI) is suspected to be directly and indirectly involved in hepato-carcinogenesis. This study evaluated the association of a previous SMI with hepatocellular carcinoma (HCC) development, patients, tumor characteristics, treatment outcomes, and survival. This observational study included patients with HCC with and without previous SMI who presented to the multidisciplinary HCC clinic, Kasr-Alainy hospital (November 2009 to December 2019). It also included 313 patients with liver cirrhosis without HCC. Clinical and laboratory features of the patients (complete blood count, liver/renal functions , alpha-fetoprotein, and hepatitis B/C status), tumor characteristics (Triphasic CT and/or dynamic MRI), liver stiffness (transient elastography), HCC treatment outcome, and overall survival were studied. This study included 1446 patients with HCC; 688(47.6%) composed group-1, defined by patients having a history of SMI, and 758(52.4%) were in group-2 and without history of SMI. Male sex, smoking, diabetes mellitus, splenomegaly, deteriorated performance status, synthetic liver functions, and platelet count were significantly higher in group-1. The groups did not differ with regard to liver stiffness, tumor characteristics, or the occurrence of post-HCC treatment hepatic decompensation or recurrence. HCC treatment response was better in group-2. Group-1 showed lower sustained virological response to hepatitis C direct-acting antivirals (DAAs) compared with group-2 (60% versus 84.3%, respectively, P = 0.027). Prior SMI was associated with HCC (adjusted odds ratio = 1.589, 95% confidence interval = 1.187-2.127), and it was concluded that it increases the risk of HCC. In addition, it significantly affects the performance status, laboratory characteristics, response to DAAs, and overall survival.
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Affiliation(s)
- Hend Ibrahim Shousha
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ashraf Omar Abdelaziz
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Mahmoud Nabeel
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dalia Abdelhamid Omran
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Hosni Abdelmaksoud
- Diagnostic and Interventional Radiology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Tamer Mahmoud Elbaz
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman Salah
- General Surgery Department, Liver Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Karim Adel Hosny
- General Surgery Department, Liver Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman Osman
- General Surgery Department, Liver Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mira Atef
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Abdelazez Gaber
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Naglaa Ali Zayed
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman Abdelhady Yosry
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rania Leithy
- Endemic Medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Alsayegh HA, AlAlwan MQ, Siddiqui F, AlAlwan QM, Alamer H. Atypical Presentation of Acute Appendicitis with Schistosomiasis. Cureus 2021; 13:e15144. [PMID: 34164244 PMCID: PMC8214657 DOI: 10.7759/cureus.15144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Schistosomiasis is a parasitic infection that is induced by different species of Schistosoma. The infection can manifest with a variety of different pathologies depending on the involved system and causative species. Schistosoma-induced appendicitis is rare in developed countries. We discuss a case of a middle-aged female who was diagnosed with acute appendicitis and underwent appendectomy. Upon histopathological examination of the resected appendix, Schistosoma infestation was identified as the underlying cause.
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Affiliation(s)
| | | | | | | | - Haidar Alamer
- Department of Emergency Medicine, King Fahad Hospital, Hofuf, SAU
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18
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Mokosch AS, Gerbig S, Grevelding CG, Haeberlein S, Spengler B. High-resolution AP-SMALDI MSI as a tool for drug imaging in Schistosoma mansoni. Anal Bioanal Chem 2021; 413:2755-2766. [PMID: 33723627 PMCID: PMC8007518 DOI: 10.1007/s00216-021-03230-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/31/2020] [Accepted: 02/09/2021] [Indexed: 12/21/2022]
Abstract
Schistosoma mansoni is a parasitic flatworm causing schistosomiasis, an infectious disease affecting several hundred million people worldwide. Schistosomes live dioeciously, and upon pairing with the male, the female starts massive egg production, which causes pathology. Praziquantel (PZQ) is the only drug used, but it has an inherent risk of resistance development. Therefore, alternatives are needed. In the context of drug repurposing, the cancer drug imatinib was tested, showing high efficacy against S. mansoni in vitro. Besides the gonads, imatinib mainly affected the integrity of the intestine in males and females. In this study, we investigated the potential uptake and distribution of imatinib in adult schistosomes including its distribution kinetics. To this end, we applied for the first time atmospheric-pressure scanning microprobe matrix-assisted laser desorption/ionization mass spectrometry imaging (AP-SMALDI MSI) for drug imaging in paired S. mansoni. Our results indicate that imatinib was present in the esophagus and intestine of the male as early as 20 min after in vitro exposure, suggesting an oral uptake route. After one hour, the drug was also found inside the paired female. The detection of the main metabolite, N-desmethyl imatinib, indicated metabolization of the drug. Additionally, a marker signal for the female ovary was successfully applied to facilitate further conclusions regarding organ tropism of imatinib. Our results demonstrate that AP-SMALDI MSI is a useful method to study the uptake, tissue distribution, and metabolization of imatinib in S. mansoni. The results suggest using AP-SMALDI MSI also for investigating other antiparasitic compounds and their metabolites in schistosomes and other parasites. ![]()
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Affiliation(s)
- Annika S Mokosch
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University Giessen, 35392, Giessen, Germany
| | - Stefanie Gerbig
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University Giessen, 35392, Giessen, Germany
| | - Christoph G Grevelding
- Institute of Parasitology, BFS, Justus Liebig University Giessen, 35392, Giessen, Germany
| | - Simone Haeberlein
- Institute of Parasitology, BFS, Justus Liebig University Giessen, 35392, Giessen, Germany
| | - Bernhard Spengler
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University Giessen, 35392, Giessen, Germany.
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19
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Mughal MN, Grevelding CG, Haeberlein S. First insights into the autophagy machinery of adult Schistosoma mansoni. Int J Parasitol 2021; 51:571-585. [PMID: 33713647 DOI: 10.1016/j.ijpara.2020.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/29/2020] [Accepted: 11/30/2020] [Indexed: 11/17/2022]
Abstract
Schistosomiasis is a disease of global importance caused by parasitic flatworms, schistosomes, which cause pathogenicity through eggs laid by the female worm inside the host's blood vessels. Maintenance of cellular homeostasis is crucial for parasites, as for other organisms, and is quite likely important for schistosome reproduction and vitality. We hypothesize a role for autophagy in these processes, an evolutionarily conserved and essential cellular degradation pathway. Here, for the first known time, we shed light on the autophagy machinery and its involvement in pairing-dependent processes, vitality and reproduction of Schistosoma mansoni. We identified autophagy genes by in silico analyses and determined the influence of in vitro culture on the transcriptional expression in male and female worms using quantitative real-time PCR. Among the identified autophagy genes were Beclin, Ambra1, Vps34, DRAM, DAP1, and LC3B, of which some showed a sex-dependent expression. Specifically, the death-associated protein DAP1 was significantly more highly expressed in females compared with males, while for the damage-regulated autophagy modulator DRAM it was the opposite. Furthermore, in-vitro culture significantly changed the transcript expression level of DAP1 in female worms. Next, worms were treated with an autophagy inducer (rapamycin) or inhibitors (bafilomycin A1, wortmannin and spautin-1) to evaluate effects on autophagy protein expression, worm vitality, and reproduction. The conversion of the key autophagy protein LC3B, a marker for autophagic activity, was increased by rapamycin and blocked by bafilomycin. All inhibitors affected worm fitness, egg production, and negatively affected the morphology of gonads and intestine. In summary, autophagy genes in S. mansoni show an interesting sex-dependent expression pattern and manipulation of autophagy in S. mansoni by inhibitors induced detrimental effects, which encourages subsequent studies to identify antischistosomal targets within the autophagy machinery.
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Affiliation(s)
- Mudassar N Mughal
- Institute of Parasitology, Biomedical Research Center Seltersberg (BFS), Justus Liebig University Giessen, Schubertstr. 81, D-35392 Giessen, Germany
| | - Christoph G Grevelding
- Institute of Parasitology, Biomedical Research Center Seltersberg (BFS), Justus Liebig University Giessen, Schubertstr. 81, D-35392 Giessen, Germany
| | - Simone Haeberlein
- Institute of Parasitology, Biomedical Research Center Seltersberg (BFS), Justus Liebig University Giessen, Schubertstr. 81, D-35392 Giessen, Germany.
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20
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Maternal schistosomiasis impairs offspring Interleukin-4 production and B cell expansion. PLoS Pathog 2021; 17:e1009260. [PMID: 33524040 PMCID: PMC7877777 DOI: 10.1371/journal.ppat.1009260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 02/11/2021] [Accepted: 12/28/2020] [Indexed: 12/13/2022] Open
Abstract
Epidemiological studies have identified a correlation between maternal helminth infections and reduced immunity to some early childhood vaccinations, but the cellular basis for this is poorly understood. Here, we investigated the effects of maternal Schistosoma mansoni infection on steady-state offspring immunity, as well as immunity induced by a commercial tetanus/diphtheria vaccine using a dual IL-4 reporter mouse model of maternal schistosomiasis. We demonstrate that offspring born to S. mansoni infected mothers have reduced circulating plasma cells and peripheral lymph node follicular dendritic cells at steady state. These reductions correlate with reduced production of IL-4 by iNKT cells, the cellular source of IL-4 in the peripheral lymph node during early life. These defects in follicular dendritic cells and IL-4 production were maintained long-term with reduced secretion of IL-4 in the germinal center and reduced generation of TFH, memory B, and memory T cells in response to immunization with tetanus/diphtheria. Using single-cell RNASeq following tetanus/diphtheria immunization of offspring, we identified a defect in cell-cycle and cell-proliferation pathways in addition to a reduction in Ebf-1, a key B-cell transcription factor, in the majority of follicular B cells. These reductions are dependent on the presence of egg antigens in the mother, as offspring born to single-sex infected mothers do not have these transcriptional defects. These data indicate that maternal schistosomiasis leads to long-term defects in antigen-induced cellular immunity, and for the first time provide key mechanistic insight into the factors regulating reduced immunity in offspring born to S. mansoni infected mothers. Maternal helminth infections are a global public health concern and correlate with altered infant immune responses to some childhood immunizations, but a mechanistic understanding of how maternal helminth infection alters the cellular immune responses of offspring is lacking. Here we establish a model of maternal Schistosoma mansoni infection in dual IL-4 reporter mice. We find that offspring born to mothers infected with S. mansoni have impaired production of IL-4 during homeostasis, and following immunization with a Tetanus-Diphtheria vaccine. We identified that iNKT cells are the dominant source of IL-4 during early life homeostasis, and that diminished IL-4 production was associated with both reduced B cell and follicular dendritic cell responses. These defects were maintained long-term, affecting memory B and T cell responses. Single-cell RNASeq analysis of immunized offspring identified egg antigen-dependent reductions in B-cell cell cycle and proliferation-related genes. These data reveal that maternal infection leads to long-lasting defects in the cellular responses to heterologous antigens and provide vital insight into the influence of maternal infection on offspring immunity.
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21
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Schistosoma mansoni eggs induce Wnt/β-catenin signaling and activate the protooncogene c-Jun in human and hamster colon. Sci Rep 2020; 10:22373. [PMID: 33361772 PMCID: PMC7758332 DOI: 10.1038/s41598-020-79450-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/08/2020] [Indexed: 12/15/2022] Open
Abstract
Schistosomiasis (bilharzia) is a neglected tropical disease caused by parasitic flatworms of the genus Schistosoma, with considerable morbidity in parts of the Middle East, South America, Southeast Asia, in sub-Saharan Africa, and particularly also in Europe. The WHO describes an increasing global health burden with more than 290 million people threatened by the disease and a potential to spread into regions with temperate climates like Corsica, France. The aim of our study was to investigate the influence of S. mansoni infection on colorectal carcinogenic signaling pathways in vivo and in vitro. S. mansoni infection, soluble egg antigens (SEA) and the Interleukin-4-inducing principle from S. mansoni eggs induce Wnt/β-catenin signaling and the protooncogene c-Jun as well as downstream factor Cyclin D1 and markers for DNA-damage, such as Parp1 and γH2a.x in enterocytes. The presence of these characteristic hallmarks of colorectal carcinogenesis was confirmed in colon biopsies from S. mansoni-infected patients demonstrating the clinical relevance of our findings. For the first time it was shown that S. mansoni SEA may be involved in the induction of colorectal carcinoma-associated signaling pathways.
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22
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Sibomana JP, Campeche A, Carvalho-Filho RJ, Correa RA, Duani H, Pacheco Guimaraes V, Hilton JF, Kassa B, Kumar R, Lee MH, Loureiro CMC, Mazimba S, Mickael C, Oliveira RKF, Ota-Arakaki JS, Rezende CF, Silva LCS, Sinkala E, Ahmed HY, Graham BB. Schistosomiasis Pulmonary Arterial Hypertension. Front Immunol 2020; 11:608883. [PMID: 33362796 PMCID: PMC7758287 DOI: 10.3389/fimmu.2020.608883] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/03/2020] [Indexed: 12/18/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) is a disease of the lung blood vessels that results in right heart failure. PAH is thought to occur in about 5% to 10% of patients with hepatosplenic schistosomiasis, particularly due to S. mansoni. The lung blood vessel injury may result from a combination of embolization of eggs through portocaval shunts into the lungs causing localized Type 2 inflammatory response and vessel remodeling, triggering of autonomous pathology that becomes independent of the antigen, and high cardiac output as seen in portopulmonary hypertension. The condition is likely underdiagnosed as there is little systematic screening, and risk factors for developing PAH are not known. Screening is done by echocardiography, and formal diagnosis requires invasive right heart catheterization. Patients with Schistosoma-associated PAH show reduced functional capacity and can be treated with pulmonary vasodilators, which improves symptoms and may improve survival. There are animal models of this disease that might help in understanding disease pathogenesis and identify novel targets to screen and treatment. Pathogenic mechanisms include Type 2 immunity and activation and signaling in the TGF-β pathway. There are still major uncertainties regarding Schistosoma-associated PAH development, course and treatment.
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Affiliation(s)
- Jean Pierre Sibomana
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Tikur Anbessa Specialized Hospital, College of Health Sciences, University of Addis Ababa, Addis Ababa, Ethiopia
- Department of Medicine, Butare University Teaching Hospital, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Aloma Campeche
- Division of Gastroenterology, Department of Medicine, Santa Casa Hospital, Salvador, Bahia, Brazil
| | - Roberto J. Carvalho-Filho
- Division of Gastroenterology, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Ricardo Amorim Correa
- Internal Medicine/Pulmonary Division, Medical School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Helena Duani
- Internal Medicine/Infectious Diseases Division, Medical School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Virginia Pacheco Guimaraes
- Pulmonary Department, Hospital Júlia Kubistchek, Fundação Hospitalar of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Joan F. Hilton
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
| | - Biruk Kassa
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Rahul Kumar
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Michael H. Lee
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | | | - Sula Mazimba
- Division of Cardiology, Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Claudia Mickael
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Rudolf K. F. Oliveira
- Division of Respiratory Diseases, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Jaquelina S. Ota-Arakaki
- Division of Respiratory Diseases, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Camila Farnese Rezende
- Pulmonary Medicine, Hospital das Clinicas, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luciana C. S. Silva
- Internal Medicine Department, Medical School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Edford Sinkala
- Hepatology Clinic, Department of Medicine, University of Zambia Teaching Hospital, Lusaka, Zambia
| | - Hanan Yusuf Ahmed
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Tikur Anbessa Specialized Hospital, College of Health Sciences, University of Addis Ababa, Addis Ababa, Ethiopia
| | - Brian B. Graham
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
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23
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Unraveling the Role of Leptin in Liver Function and Its Relationship with Liver Diseases. Int J Mol Sci 2020; 21:ijms21249368. [PMID: 33316927 PMCID: PMC7764544 DOI: 10.3390/ijms21249368] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/19/2020] [Accepted: 12/04/2020] [Indexed: 02/06/2023] Open
Abstract
Since its discovery twenty-five years ago, the fat-derived hormone leptin has provided a revolutionary framework for studying the physiological role of adipose tissue as an endocrine organ. Leptin exerts pleiotropic effects on many metabolic pathways and is tightly connected with the liver, the major player in systemic metabolism. As a consequence, understanding the metabolic and hormonal interplay between the liver and adipose tissue could provide us with new therapeutic targets for some chronic liver diseases, an increasing problem worldwide. In this review, we assess relevant literature regarding the main metabolic effects of leptin on the liver, by direct regulation or through the central nervous system (CNS). We draw special attention to the contribution of leptin to the non-alcoholic fatty liver disease (NAFLD) pathogenesis and its progression to more advanced stages of the disease as non-alcoholic steatohepatitis (NASH). Likewise, we describe the contribution of leptin to the liver regeneration process after partial hepatectomy, the mainstay of treatment for certain hepatic malignant tumors.
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24
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Wang L, Wu X, Li X, Zheng X, Wang F, Qi Z, Huang M, Zou Y. Imported Schistosomiasis: A New Public Health Challenge for China. Front Med (Lausanne) 2020; 7:553487. [PMID: 33195303 PMCID: PMC7642816 DOI: 10.3389/fmed.2020.553487] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/18/2020] [Indexed: 12/18/2022] Open
Abstract
Significantly increased imported schistosomiasis cases have been reported in China as the economy grows. The aim of this study is to review and summarize the current status, clinical features, and transmission risk of imported infections of Schistosoma mansoni and Schistosoma haematobium in China. A retrospective study was performed to review all information regarding the imported cases of schistosomiasis collected from published literature and the database of the National Notifiable Disease Report System from 1979 to 2019. The characterization of epidemiological and clinical features was analyzed. A total of 355 cases of imported schistosomiasis have been reported in 15 provinces (autonomous regions, municipalities) in China since 1979, including 78 cases of infection with S. mansoni (21.97%), 262 cases with S. haematobium (73.80%), and 15 cases with unidentified Schistosoma species. Eosinophilia was the most common sign of the infection with S. mansoni (91.03%). The parasitological findings were confirmed in 89.74% (70/78) of cases infected with S. mansoni and 32.06% (84/262) of cases infected with S. haematobium. There was no imported case of infection of Schistosoma japonicum, Schistosoma intercalatum, or Schistosoma mekongi reported in China during this period. Praziquantel is the best therapeutic drug for curing imported schistosomiasis. In addition, Biomphalaria straminea, the intermediate host of S. mansoni, has already been found in Guangdong province in south China. There is a rising risk that the existence of the intermediate host B. straminea and the imported cases of S. mansoni infection could cause the spread of the infections and make these endemic. Thus, better understanding of the clinical features and the transmission pattern of these Schistosoma infections would assist Chinese physicians in the diagnosis and treatment of these imported schistosomiasis cases.
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Affiliation(s)
- Lei Wang
- Emergency and Critical Care Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Tropical Medicine, Beijing, China.,Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, China
| | - Xiaoying Wu
- Department of Gastroenterology, 3rd Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoli Li
- Emergency and Critical Care Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Tropical Medicine, Beijing, China.,Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, China
| | - Xiaoyan Zheng
- Emergency and Critical Care Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Tropical Medicine, Beijing, China.,Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, China
| | - Fei Wang
- Emergency and Critical Care Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Tropical Medicine, Beijing, China.,Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, China
| | - Zhiqun Qi
- Emergency and Critical Care Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Tropical Medicine, Beijing, China.,Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, China
| | - Minjun Huang
- Emergency and Critical Care Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Tropical Medicine, Beijing, China.,Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, China
| | - Yang Zou
- Emergency and Critical Care Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Tropical Medicine, Beijing, China.,Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases, Beijing, China
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25
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Roderfeld M, Padem S, Lichtenberger J, Quack T, Weiskirchen R, Longerich T, Schramm G, Churin Y, Irungbam K, Tschuschner A, Windhorst A, Grevelding CG, Roeb E. Schistosoma mansoni Egg-Secreted Antigens Activate Hepatocellular Carcinoma-Associated Transcription Factors c-Jun and STAT3 in Hamster and Human Hepatocytes. Hepatology 2020; 72:626-641. [PMID: 30053321 PMCID: PMC7496692 DOI: 10.1002/hep.30192] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 07/23/2018] [Indexed: 12/16/2022]
Abstract
Clinical data have provided evidence that schistosomiasis can promote hepatocellular carcinogenesis. c-Jun and STAT3 are critical regulators of liver cancer development and progression. The aim of the present study was to investigate the hepatocellular activation of c-Jun and STAT3 by Schistosoma mansoni infection. Expression and function of c-Jun and STAT3 as well as proliferation and DNA repair were analyzed by western blotting, electrophoretic mobility-shift assay, and immunohistochemistry in liver of S. mansoni-infected hamsters, Huh7 cells, primary hepatocytes, and human liver biopsies. Hepatocellular activation of c-Jun was demonstrated by nuclear translocation of c-Jun, enhanced phosphorylation (Ser73), and AP-1/DNA-binding in response to S. mansoni infection. Nuclear c-Jun staining pattern around lodged eggs without ambient immune reaction, and directionally from granuloma to the central veins, suggested that substances released from schistosome eggs were responsible for the observed effects. In addition, hepatocytes with c-Jun activation show cell activation and DNA double-strand breaks. These findings from the hamster model were confirmed by analyses of human biopsies from patients with schistosomiasis. Cell culture experiments finally demonstrated that activation of c-Jun and STAT3 as well as DNA repair were induced by an extract from schistosome eggs (soluble egg antigens) and culture supernatants of live schistosome egg (egg-conditioned medium), and in particular by IPSE/alpha-1, the major component secreted by live schistosome eggs. The permanent activation of hepatocellular carcinoma-associated proto-oncogenes such as c-Jun and associated transcription factors including STAT3 by substances released from tissue-trapped schistosome eggs may be important factors contributing to the development of liver cancer in S. mansoni-infected patients. Therefore, identification and therapeutic targeting of the underlying pathways is a useful strategy to prevent schistosomiasis-associated carcinogenesis.
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Affiliation(s)
- Martin Roderfeld
- Department of GastroenterologyJustus‐Liebig‐UniversityGiessenGermany
| | - Sevinc Padem
- Department of GastroenterologyJustus‐Liebig‐UniversityGiessenGermany
| | | | - Thomas Quack
- Institute of ParasitologyBFS, Justus‐Liebig‐UniversityGiessenGermany
| | - Ralf Weiskirchen
- Institute of Molecular Pathobiochemistry, Experimental Gene Therapy and Clinical ChemistryRWTH University Hospital AachenAachenGermany
| | - Thomas Longerich
- Translational Gastrointestinal Pathology, Institute of PathologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Gabriele Schramm
- Experimental Pneumology, Priority Research Area Asthma & AllergyResearch Center BorstelParkallee, BorstelGermany
| | - Yuri Churin
- Department of GastroenterologyJustus‐Liebig‐UniversityGiessenGermany
| | - Karuna Irungbam
- Department of GastroenterologyJustus‐Liebig‐UniversityGiessenGermany
| | | | - Anita Windhorst
- Institute for Medical InformaticsJustus‐Liebig‐UniversityGiessenGermany
| | | | - Elke Roeb
- Department of GastroenterologyJustus‐Liebig‐UniversityGiessenGermany
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26
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Bexkens ML, van Gestel RA, van Breukelen B, Urbanus RT, Brouwers JF, Nieuwland R, Tielens AGM, van Hellemond JJ. Schistosoma mansoni infection affects the proteome and lipidome of circulating extracellular vesicles in the host. Mol Biochem Parasitol 2020; 238:111296. [PMID: 32603736 DOI: 10.1016/j.molbiopara.2020.111296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 06/19/2020] [Accepted: 06/25/2020] [Indexed: 12/19/2022]
Abstract
Eggs, schistosomula and adult Schistosoma worms are known to release extracellular vesicles (EV) during in vitro incubations and these EVs are postulated to affect the host responses. So far only those EVs released during in vitro incubations of schistosomes have been studied and it is unknown whether in blood of infected hosts the schistosomal EVs can be detected amidst all the circulating EVs of the host itself. In this study we analyzed the protein as well as the phospholipid composition of EVs circulating in blood plasma of S. mansoni infected hamsters and compared those with the EVs circulating in blood of non-infected hamsters. Although neither proteins nor lipids specific for schistosomes could be detected in the circulating EVs of the infected hamsters, the infection with schistosomes had a marked effect on the circulating EVs of the host, as the protein as well as the lipid composition of EVs circulating in infected hamsters were different from the EVs of uninfected hamsters. The observed changes in the EV lipid and protein content suggest that more EVs are released by the diseased liver, the affected erythrocytes and activated immune cells.
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Affiliation(s)
- Michiel L Bexkens
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Renske A van Gestel
- Biomolecular Mass Spectrometry & Proteomics, Utrecht Institute for Pharmaceutical Sciences and Bijvoet Center for Biomolecular Research, Utrecht University, Utrecht, the Netherlands
| | - Bas van Breukelen
- Biomolecular Mass Spectrometry & Proteomics, Utrecht Institute for Pharmaceutical Sciences and Bijvoet Center for Biomolecular Research, Utrecht University, Utrecht, the Netherlands
| | - Rolf T Urbanus
- Department of Clinical Chemistry and Haematology, Center for Circulatory Health, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Jos F Brouwers
- Department of Biochemistry and Cell Biology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Rienk Nieuwland
- Laboratory of Experimental Clinical Chemistry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Vesicle Observation Centre, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Aloysius G M Tielens
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Biochemistry and Cell Biology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Jaap J van Hellemond
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.
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27
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Huang Y, Lu J, Xu Y, Xiong C, Tong D, Hu N, Yang H. Xiaochaihu decorction relieves liver fibrosis caused by Schistosoma japonicum infection via the HSP47/TGF-β pathway. Parasit Vectors 2020; 13:254. [PMID: 32410640 PMCID: PMC7227055 DOI: 10.1186/s13071-020-04121-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 05/06/2020] [Indexed: 12/11/2022] Open
Abstract
Background Hepatic fibrosis caused by chronic infection with Schistosoma japonica remains a serious public health problem in the world. Symptoms include inflammation, liver granuloma and fibrosis, whilst treatment options are still limited. This study aims to investigate whether and how traditional Chinese medicine Xiaochaihu decoction (XCH) could mitigate liver fibrosis caused by S. japonicum infection. Methods BALB/c mice were infected with S. japonicum cercariae and treated with XCH for 16 weeks. Liver pathological changes were assessed by H&E and Masson staining. NIH3T3 and Raw264.7 cells were treated with S. japonicum egg antigens with or without XCH treatment. Quantitative real-time PCR, western blot, immunfluorescence and ELISA were performed to determine the changes of levels of fibrogenic markers. Results XCH protected mouse liver from injuries and fibrosis caused by S. japonicum infection and considerably reduced egg burden in a dose-dependent manner. Infection with S. japonicum caused elevation of serum ALT, AST, ALP, HA and PIIINP levels and reduction of ALB and GLOB levels, which was markedly suppressed by XCH. The upregulation of TGF-β1, Hsp47, α-SMA, Col1A1 and Col3A1 in S. japonicum-infected mouse liver was also significantly inhibited by XCH. Schistosoma japonicum egg antigens promoted the expression of Hsp47, TGF-β1, Timp-1, α-SMA, Col1A1 and Col3A1 in NIH3T3 cells, and TGF-β1, CTGF, IL-13, IL-17 and IL-6 in Raw264.7 cells, which was inhibited by XCH, LY2157299 and shRNA-Hsp47. Conclusions These results demonstrated that the hepatic protective effects of Xiaochaihu decoction were mediated by HSP47/TGF-β axis.![]()
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Affiliation(s)
- Yuzheng Huang
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, 117 Meiyuan Yangxiang, Wuxi, 214064, Jiangsu, China. .,Public Health Research Center, Jiangnan University, Wuxi, 214122, Jiangsu Province, China. .,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
| | - Jin Lu
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, 117 Meiyuan Yangxiang, Wuxi, 214064, Jiangsu, China.,Public Health Research Center, Jiangnan University, Wuxi, 214122, Jiangsu Province, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Yongliang Xu
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, 117 Meiyuan Yangxiang, Wuxi, 214064, Jiangsu, China.,Public Health Research Center, Jiangnan University, Wuxi, 214122, Jiangsu Province, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Chunrong Xiong
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, 117 Meiyuan Yangxiang, Wuxi, 214064, Jiangsu, China.,Public Health Research Center, Jiangnan University, Wuxi, 214122, Jiangsu Province, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Deshen Tong
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, 117 Meiyuan Yangxiang, Wuxi, 214064, Jiangsu, China.,Public Health Research Center, Jiangnan University, Wuxi, 214122, Jiangsu Province, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Nannan Hu
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, 117 Meiyuan Yangxiang, Wuxi, 214064, Jiangsu, China.,Public Health Research Center, Jiangnan University, Wuxi, 214122, Jiangsu Province, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Haitao Yang
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, 117 Meiyuan Yangxiang, Wuxi, 214064, Jiangsu, China. .,Public Health Research Center, Jiangnan University, Wuxi, 214122, Jiangsu Province, China. .,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
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Zhang LJ, Mwanakasale V, Xu J, Sun LP, Yin XM, Zhang JF, Hu MC, Si WM, Zhou XN. Diagnostic performance of two specific schistosoma japonicum immunological tests for screening schistosoma haematobium in school children in Zambia. Acta Trop 2020; 202:105285. [PMID: 31786108 DOI: 10.1016/j.actatropica.2019.105285] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 11/22/2019] [Accepted: 11/27/2019] [Indexed: 12/27/2022]
Abstract
Dipstick Dye Immunoassay (DDIA) and Indirect Haemagglutination Assay (IHA), are two commercially available kits which have been widely used for screening Schistosoma japonicum in P.R. China. Whether they can be used for screening of Schistosoma haematobium are not clear. In order to evaluate the diagnostic efficiency of DDIA and IHA for screening Schistosoma haematobium, serum samples were collected from pupils in endemic areas in Zambia, Southern Africa, and tested by DDIA and IHA by single-blind manner. Meanwhile, the pupils were microscopically examined by infection with Schistosoma and soil-transmitted helminths, visually observed for parasite eggs. Of the enrolled 148 pupils, 61% tested positive for S. haematobium infection, while 31% and 36% of pupils were infected with hookworm and Ascaris respectively. Regarding the parasitological tests as reference standard, for the diagnosis of S. haematobium infection, IHA performed higher sensitivity (74%, 95% CI: 65%-83%) than that of DDIA (60%, 95%CI: 49%-70%). The sensitivities of IHA and DDIA are significant higher in 10-14 years old students than those of 7-9 years old group. The specificity of DDIA and IHA were 61% (95%CI: 49%-74%) and 72% (95%CI: 60%-84%), respectively. The co-infection with STHs decreased the specificity of DDIA but had no impact on that of IHA. Our study indicated that IHA has more potential as an alternative diagnostic tool for identifying schistosomiasis haematobium but need further improvement.
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Affiliation(s)
- Li-Juan Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, PR China; WHO Collaborating Center for Tropical Diseases, Shanghai, PR China; National Center for International Research on Tropical Diseases, Shanghai, PR China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, PR China
| | | | - Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, PR China; WHO Collaborating Center for Tropical Diseases, Shanghai, PR China; National Center for International Research on Tropical Diseases, Shanghai, PR China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, PR China.
| | - Le-Ping Sun
- Institute for Schistosomiasis Control, Wuxi, Jiangsu, PR China
| | - Xiao-Mei Yin
- Institute for Schistosomiasis Control, Hefei, Anhui, PR China
| | - Jian-Feng Zhang
- Institute for Schistosomiasis Control, Wuxi, Jiangsu, PR China
| | - Ming-Chuang Hu
- Institute for Schistosomiasis Control, Hefei, Anhui, PR China
| | - Wu-Min Si
- Institute for Schistosomiasis Control, Hefei, Anhui, PR China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, PR China; WHO Collaborating Center for Tropical Diseases, Shanghai, PR China; National Center for International Research on Tropical Diseases, Shanghai, PR China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, PR China.
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29
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Clinical and Preclinical Imaging of Hepatosplenic Schistosomiasis. Trends Parasitol 2019; 36:206-226. [PMID: 31864895 DOI: 10.1016/j.pt.2019.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/22/2019] [Accepted: 11/30/2019] [Indexed: 12/12/2022]
Abstract
Schistosomiasis, a neglected tropical disease, is a major cause of chronic morbidity and disability, and premature death. The hepatosplenic form of schistosomiasis is characterized by hepatosplenomegaly, liver fibrosis, portal hypertension, and esophageal varices, whose rupture may cause bleeding and death. We review currently available abdominal imaging modalities and describe their basic principles, strengths, weaknesses, and usefulness in the assessment of hepatosplenic schistosomiasis (HSS). Advanced imaging methods are presented that could be of interest for hepatosplenic schistosomiasis evaluation by yielding morphological, functional, and molecular parameters of disease progression. We also provide a comprehensive view of preclinical imaging studies and current research objectives such as parasite visualization in hosts, follow-up of the host's immune response, and development of noninvasive quantitative methods for liver fibrosis assessment.
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30
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Peter Ventura AM, Haeberlein S, Lange-Grünweller K, Grünweller A, Hartmann RK, Grevelding CG, Schlitzer M. Development of Biarylalkyl Carboxylic Acid Amides with Improved Anti-schistosomal Activity. ChemMedChem 2019; 14:1856-1862. [PMID: 31454168 PMCID: PMC7687077 DOI: 10.1002/cmdc.201900423] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/09/2019] [Indexed: 12/14/2022]
Abstract
The parasitic disease schistosomiasis is the cause of more than 200 000 human deaths per year. Although the disease is treatable, there is one major shortcoming: praziquantel has been the only drug used to combat these parasites since 1977. The risk of the emergence of resistant schistosomes is known to be increasing, as a reduced sensitivity of these parasites toward praziquantel has been observed. We developed a new class of substances, which are derived from inhibitors of human aldose reductase, and which showed promising activity against Schistosoma mansoni couples in vitro. Further optimisation of the compounds led to an increase in anti‐schistosomal activity with observed phenotypes such as reduced egg production, vitality, and motility as well as tegumental damage and gut dilatation. Here, we performed structure–activity relationship studies on the carboxylic acid moiety of biarylalkyl carboxylic acids. Out of 82 carboxylic acid amides, we identified 10 compounds that are active against S. mansoni at 25 μm. The best five compounds showed an anti‐schistosomal activity up to 10 μm and induced severe phenotypes. Cytotoxicity tests in human cell lines showed that two derivatives had no cytotoxicity at 50 or 100 μm. These compounds are promising candidates for further optimisation toward the new anti‐schistosomal agents.
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Affiliation(s)
- Alejandra M Peter Ventura
- Department of Pharmaceutical Chemistry, Philipps Universität Marburg, Marbacher Weg 6, 35032, Marburg, Germany
| | - Simone Haeberlein
- BFS, Institute of Parasitology, Justus-Liebig-Universität Gießen, Schubertstrasse 81, 35392, Gießen, Germany
| | - Kerstin Lange-Grünweller
- Department of Pharmaceutical Chemistry, Philipps Universität Marburg, Marbacher Weg 6, 35032, Marburg, Germany
| | - Arnold Grünweller
- Department of Pharmaceutical Chemistry, Philipps Universität Marburg, Marbacher Weg 6, 35032, Marburg, Germany
| | - Roland K Hartmann
- Department of Pharmaceutical Chemistry, Philipps Universität Marburg, Marbacher Weg 6, 35032, Marburg, Germany
| | - Christoph G Grevelding
- BFS, Institute of Parasitology, Justus-Liebig-Universität Gießen, Schubertstrasse 81, 35392, Gießen, Germany
| | - Martin Schlitzer
- Department of Pharmaceutical Chemistry, Philipps Universität Marburg, Marbacher Weg 6, 35032, Marburg, Germany
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31
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Abstract
Over the past 20 years, RNAS+ has been generating research results from highly collaborative projects meant to promote and advance understanding in various aspects of schistosomiasis. Epidemiological studies in endemic countries like the Philippines, the People's Republic of China (PR China), the Lao People's Democratic Republic (Lao PDR) and Cambodia clarified the role of reservoir hosts in transmission and the use of spatio-temporal methods such as remote sensing and geographical information systems (GIS) in surveillance of schistosomiasis. Morbidity studies proposed factors that might influence development of fibrosis, anaemia and malnutrition in schistosomiasis. Immune responses in schistosomiasis continue to be an interesting focus in research to explain possible development of resistance with age. Results of evaluation of candidate vaccine molecules are also presented. New diagnostics are continually being developed in response to the call for more sensitive and field applicable techniques that will be used for surveillance in areas nearing elimination of the disease. Several studies presented here show the insufficiency of mass drug administration (MDA) with praziquantel in eliminating the disease. Emphasis is given to an integrated control approach that can be accomplished through intensive and extensive intersectoral collaboration.
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32
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Leonardo L, Bergquist R, Olveda R, Satrija F, Sripa B, Sayasone S, Khieu V, Willingham AL, Utzinger J, Zhou XN. From country control programmes to translational research. ADVANCES IN PARASITOLOGY 2019; 105:69-93. [PMID: 31530396 DOI: 10.1016/bs.apar.2019.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
From the time it was conceptualized in 1998 to the present, RNAS+ has largely concentrated on research that will generate results to facilitate control, prevention and elimination of its target diseases. Diagnostics has remained an active field of research in order to develop tools that are appropriate for each stage from the first efforts until attempts to block transmission. For example, with regard to schistosomiasis, chemotherapy has excellent impact on morbidity, while better diagnostics and vaccine research have been promoted to complement the other components of the control programme. The need for surveillance in areas where the prevalence has been brought down to very low levels necessitated development of spatio-temporal tools and ecological models based on geographical information systems (GIS) to produce risk and distribution maps for monitoring and evaluation of programme success. New knowledge and experiences in management of the diseases contribute to the formulation of new schemes in management and treatment. Ways of drawing attention to the disease, such as determining disability weights for use in computation of burden of disease, updating epidemiological profile and unravelling new aspects of the disease provide bases for modifying the operation of control programmes as we move forward. Programme evaluation based on reports of actual implementation of activities brought to the fore problems related to the distribution of chemotherapy as well as social, cultural and behavioural aspects of endemic communities. Importantly, this highlighted the necessity of adapting control activities to specific situations of the endemic areas. New models evolving from reviews of this kind and success stories, such us the elimination of lymphatic filariasis (LF) in PR China and Cambodia are presented.
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Affiliation(s)
- Lydia Leonardo
- Institute of Biology, College of Science, University of the Philippines Diliman and University of the East Ramon Magsaysay Graduate School, Quezon City, Philippines
| | | | - Remigio Olveda
- Asian Tropical Foundation, Filinvest Corporate City, Research Institute for Tropical Medicine Compound, Muntinlupa, Philippines
| | - Fadjar Satrija
- Bogor Agricultural University (IPB), JL. Agatis, Kampus IPB, Bogor, Indonesia
| | - Banchob Sripa
- Department of Pathology, Khon Kaen University, Khon Kaen, Thailand
| | - Somphou Sayasone
- Lao Tropical and Public Health Institute, Vientianne, Lao People's Democratic Republic
| | - Virak Khieu
- National Helminth Control Program, National Center for Parasitology, Entomology and Malaria Control Ministry of Health, Phnom Penh, Cambodia
| | - Arve Lee Willingham
- One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, West Indies
| | - Juerg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases, China; National Center for International Research on Tropical Diseases, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, China, Shanghai, China.
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33
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Lu Z, Spänig S, Weth O, Grevelding CG. Males, the Wrongly Neglected Partners of the Biologically Unprecedented Male-Female Interaction of Schistosomes. Front Genet 2019; 10:796. [PMID: 31552097 PMCID: PMC6743411 DOI: 10.3389/fgene.2019.00796] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/30/2019] [Indexed: 01/18/2023] Open
Abstract
Schistosomes are the only platyhelminths that have evolved separate sexes, and they exhibit a unique reproductive biology because the female’s sexual maturation depends on a constant pairing contact with the male. In the female, pairing leads to gonad differentiation, which is associated with substantial morphological changes, and controls among others the expression of gonad-associated genes. In the male, no morphological changes have been observed after pairing, although first data indicated an effect of pairing on gene transcription. Comprehensive transcriptomic approaches have revealed an unexpected high number of genes that are differentially transcribed in the male after pairing. Their identities suggest roles for the male that are not restricted to feeding and enhanced muscular power to transport paired female and, as assumed before, to induce its sexual maturation by one “magic” factor. Instead, a more complex picture emerges in which both partners live in a reciprocal sender-recipient relationship that not only affects the gonads of both genders but may also involve tactile stimuli, transforming growth factor β signaling, nutritional parts, and neuronal processes, including neuropeptides and G protein-coupled receptor signaling. This review provides a summary of transcriptomics including an overview of genes expressed in a pairing-dependent manner in schistosome males. This may stimulate further research in understanding the role of the male as the recipient of the female’s signals upon pairing, the male’s “capacitation,” and its subsequent competence as a sender of information. The latter process finally transforms a sexually immature, autonomous female without completely developed gonads into a sexually mature, partially non-autonomous female with fully differentiated gonads and enormous egg production capacity.
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Affiliation(s)
- Zhigang Lu
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom.,Insitute for Parasitology, BFS, Justus Liebig University Giessen, Giessen, Germany
| | - Sebastian Spänig
- Department of Mathematics & Computer Science, University of Marburg, Marburg, Germany
| | - Oliver Weth
- Insitute for Parasitology, BFS, Justus Liebig University Giessen, Giessen, Germany
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34
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Haeberlein S, Angrisano A, Quack T, Lu Z, Kellershohn J, Blohm A, Grevelding CG, Hahnel SR. Identification of a new panel of reference genes to study pairing-dependent gene expression in Schistosoma mansoni. Int J Parasitol 2019; 49:615-624. [PMID: 31136746 DOI: 10.1016/j.ijpara.2019.01.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 12/18/2022]
Abstract
Facilitated by the Schistosoma mansoni genome project, multiple transcriptomic studies were performed over the last decade to elucidate gene expression patterns among different developmental stages of the complex schistosome life cycle. While these analyses enable the identification of candidate genes with key functions in schistosome biology, a diverse molecular tool set is needed that allows comprehensive functional characterization at the single gene level. This includes the availability of reliable reference genes to confirm changes in the transcription of genes of interest over different biological samples and experimental conditions. In particular, the investigation of one key aspect of schistosome biology, the pairing-dependent gene expression in females and males, requires knowledge on reference genes that are expressed independently of both pairing and of in vitro culture effects. Therefore, the present study focused on the identification of quantitative reverse transcription (qRT)-PCR reference genes suitable for the investigation of pairing-dependent gene expression in the S. mansoni male. The "pipeline" we present here is based on qRT-PCR analyses of high biological replication combined with three different statistical analysis tools, BestKeeper, geNorm, and NormFinder. Our approach resulted in a statistically robust ranking of 15 selected reference genes with respect to their transcription stability between pairing-unexperienced and -experienced males. We further tested the top seven candidate genes for their transcription stability during invitro culture of adult S. mansoni. Of these, the two most suitable reference genes were used to investigate the influence of the pairing contact on the transcription of genes of interest, comprising a tyrosine decarboxylase gene Smtdc1, an ebony ortholog Smebony, and the follistatin ortholog Smfst in S. mansoni males. Performing pairing, separation and re-pairing experiments with adult S. mansoni in vitro, our results indicate for the first time that pairing can act as a molecular on/off-switch of specific genes to strictly control their expression in schistosome males.
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Affiliation(s)
- Simone Haeberlein
- Institute of Parasitology, BFS, Justus-Liebig-University, Giessen, Germany
| | | | - Thomas Quack
- Institute of Parasitology, BFS, Justus-Liebig-University, Giessen, Germany
| | - Zhigang Lu
- Institute of Parasitology, BFS, Justus-Liebig-University, Giessen, Germany; Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom
| | - Josina Kellershohn
- Institute of Parasitology, BFS, Justus-Liebig-University, Giessen, Germany
| | - Ariane Blohm
- Institute of Parasitology, BFS, Justus-Liebig-University, Giessen, Germany
| | | | - Steffen R Hahnel
- Institute of Parasitology, BFS, Justus-Liebig-University, Giessen, Germany.
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35
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Coakley G, Wright MD, Borger JG. Schistosoma mansoni-Derived Lipids in Extracellular Vesicles: Potential Agonists for Eosinophillic Tissue Repair. Front Immunol 2019; 10:1010. [PMID: 31134080 PMCID: PMC6514238 DOI: 10.3389/fimmu.2019.01010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 04/23/2019] [Indexed: 01/09/2023] Open
Affiliation(s)
- Gillian Coakley
- Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Mark D Wright
- Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Jessica G Borger
- Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, VIC, Australia
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36
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Jejunal Ulcer Caused by Schistosoma japonicum. Case Rep Gastrointest Med 2019; 2019:8356438. [PMID: 31049231 PMCID: PMC6462326 DOI: 10.1155/2019/8356438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 02/03/2019] [Accepted: 03/13/2019] [Indexed: 11/22/2022] Open
Abstract
Intestinal schistosomiasis can be caused by the trematodes Schistosoma japonicum that mainly exists in East Asia or the S. mansoni in Africa and South America. The adult worms of S. japonicum live in the mesenteric veins and excrete eggs that circulate to the liver and colon; the eggs migrate through the intestinal wall and pass out with the stool. Here, we report a case of jejunal ulcer caused by the infection of Schistosoma japonicum. A 63-year-old woman from Wuhan, China, was admitted with left quadrant abdominal pain and weight loss for more than 6 months. The patient's computerized tomography reported cirrhotic liver changes, jejunal wall edema, and narrowed lumen; the upper enteroscopy corroborated these findings with the presence of several jejunal ulcers and edema. The pathology report showed chronic inflammation with ulcerative changes and S. japonicum eggs deposition. Schistosomiasis is one of the neglected tropical diseases that affect the poorest. Although a great improvement has been made to control it, there is a lot of work that remains to be fulfilled.
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37
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Nepal P, Ojili V, Songmen S, Batchala P, Kumar D, Nagar AM. Multisystem imaging review of human schistosomiasis: characteristic imaging findings. Clin Imaging 2019; 54:163-171. [DOI: 10.1016/j.clinimag.2019.01.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/07/2019] [Accepted: 01/15/2019] [Indexed: 12/14/2022]
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38
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Zhao X, Gu K, Zeng Q, Gao L, Cheng D. Diagnostic Value of SjR2 Gene in Colonic Tissue from Schistosoma Japonicum Infected Hosts. Med Sci Monit 2019; 25:427-435. [PMID: 30641544 PMCID: PMC6342060 DOI: 10.12659/msm.912997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The prevalence and intensity of schistosomiasis infection in China has decreased markedly in recent years. Therefore, more accurate methods are critically needed to ensure further control of low-intensity schistosomiasis infection. For chronic schistosomiasis patients, the detection of schistosome eggs in colorectal mucosa tissues is commonly used. This work aimed to explore differences in sensitivity of the Schistosoma japonicum (S. japonicum) retrotransposon (SjR2) gene in colon tissue from S. japonicum infected hosts and to develop an ideal method for genetic diagnosis of low-intensity schistosomiasis. MATERIAL AND METHODS Serum and colon samples were collected from mice at different time points, either post-infection (PI) or post-treatment (PT). Colorectal biopsy specimens from outpatients with schistosomiasis were collected. All samples from mice and patients, including serum as well as colon tissue containing eggs and tissue containing no eggs, were examined using the polymerase chain reaction technique. RESULTS The results showed that the SjR2 gene could be detected in all colon tissue containing at least one egg, except for when the egg was completely degraded. The positive rate of gene detection in serum was low. The results from egg-free colon tissue from around the eggs were more consistent with the actual parasitism in vivo. CONCLUSIONS The results indicate that detection of the gene in colon tissue located within a 0.5 cm distance from the eggs would be a practical and ideal method for genetic diagnosis of schistosomiasis. After the colorectal biopsy, this method can be a sensitive assisted examination to the clinical diagnosis of low-intensity schistosomiasis infection.
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Affiliation(s)
- Xu Zhao
- Department of Parasitology, Xiangya School of Medicine, Central South University (CSU), Changsha, Hunan, China (mainland)
| | - Kongzhen Gu
- Faculty of Laboratory Medicine, Xiangya School of Medicine, Central South University (CSU), Changsha, Hunan, China (mainland)
| | - Qingren Zeng
- Department of Parasitology, Xiangya School of Medicine, Central South University (CSU), Changsha, Hunan, China (mainland)
| | - Lu Gao
- Department of Parasitology, Xiangya School of Medicine, Central South University (CSU), Changsha, Hunan, China (mainland)
| | - Da Cheng
- Department of Parasitology, Xiangya School of Medicine, Central South University (CSU), Changsha, Hunan, China (mainland)
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39
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Melo AGSD, Irmão JJDM, Jeraldo VDLS, Melo CM. Schistosomiasis mansoni in families of fishing workers of endemic area of Alagoas. ESCOLA ANNA NERY 2018. [DOI: 10.1590/2177-9465-ean-2018-0150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Abstract Objective: To analyze the epidemiological and clinical aspects involved in the transmission and manifestation of schistosomiasis in a community of fishermen from the endemic area of Alagoas. Methods: Epidemiological, transversal, prospective, descriptive, quantitative study. The coproparasitological survey included 275 family units of fish workers and the epidemiological and clinical ones, those with a positive diagnosis for S. mansoni. Results: The prevalence of schistosomiasis was 13.9% (fishermen), 2.1% (shellfish) and 2.1% (family members). The occurrence of the infection varied according to gender, age, ethnicity and socioeconomic status. Exposure occurred near the home. Autochthonous and predominant low parasite burden, intestinal clinical presentation, abdominal pain and diarrhea were observed. There were no nutritional and pressure changes associated with parasitosis. Adherence to drug therapy and use of the schistosomicidal drug was feared. Conclusion: Fish workers are at high risk for contracting the disease with clinical hepatointestinal manifestation, which requires more intense health actions.
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40
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Mäder P, Rennar GA, Ventura AMP, Grevelding CG, Schlitzer M. Chemotherapy for Fighting Schistosomiasis: Past, Present and Future. ChemMedChem 2018; 13:2374-2389. [DOI: 10.1002/cmdc.201800572] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Indexed: 01/22/2023]
Affiliation(s)
- Patrick Mäder
- Department of Pharmaceutical Chemistry; Philipps-Universität Marburg; Marbacher Weg 6 35032 Marburg Germany
| | - Georg A. Rennar
- Department of Pharmaceutical Chemistry; Philipps-Universität Marburg; Marbacher Weg 6 35032 Marburg Germany
| | - Alejandra M. Peter Ventura
- Department of Pharmaceutical Chemistry; Philipps-Universität Marburg; Marbacher Weg 6 35032 Marburg Germany
| | - Christoph G. Grevelding
- Institute of Parasitology, BFS; Justus-Liebig-Universität Gießen; Schubertstraße 81 35392 Gießen Germany
| | - Martin Schlitzer
- Department of Pharmaceutical Chemistry; Philipps-Universität Marburg; Marbacher Weg 6 35032 Marburg Germany
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41
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Abstract
Schistosomiasis (bilharzia) is a neglected tropical disease caused by parasitic flatworms (blood flukes) of the genus Schistosoma, with considerable morbidity in parts of the Middle East, South America, Southeast Asia and, particularly, in sub-Saharan Africa. Infective larvae grow in an intermediate host (fresh-water snails) before penetrating the skin of the definitive human host. Mature adult worms reside in the mesenteric (Schistosoma mansoni and Schistosoma japonicum) or pelvic (Schistosoma haematobium) veins, where female worms lay eggs, which are secreted in stool or urine. Eggs trapped in the surrounding tissues and organs, such as the liver and bladder, cause inflammatory immune responses (including granulomas) that result in intestinal, hepato-splenic or urogenital disease. Diagnosis requires the detection of eggs in excreta or worm antigens in the serum, and sensitive, rapid, point-of-care tests for populations living in endemic areas are needed. The anti-schistosomal drug praziquantel is safe and efficacious against adult worms of all the six Schistosoma spp. infecting humans; however, it does not prevent reinfection and the emergence of drug resistance is a concern. Schistosomiasis elimination will require a multifaceted approach, including: treatment; snail control; information, education and communication; improved water, sanitation and hygiene; accurate diagnostics; and surveillance-response systems that are readily tailored to social-ecological settings.
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Affiliation(s)
- Donald P McManus
- Immunology Department, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia.
| | - David W Dunne
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Moussa Sacko
- Department of Diagnostic and Biomedical Research, Institut National de Recherche en Santé Publique, Bamako, Mali
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Birgitte J Vennervald
- Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Shanghai, People's Republic of China
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42
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Schistosoma egg-induced liver pathology resolution by Sm-p80-based schistosomiasis vaccine in baboons. Pathology 2018; 50:442-449. [PMID: 29739616 DOI: 10.1016/j.pathol.2018.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 12/22/2017] [Accepted: 01/11/2018] [Indexed: 01/20/2023]
Abstract
Schistosomiasis remains a serious chronic debilitating hepato-intestinal disease. Current control measures based on mass drug administration are inadequate due to sustained re-infection rates, low treatment coverage and emergence of drug resistance. Hence, there is an urgent need for a schistosomiasis vaccine for disease control. In this study, we assessed the anti-pathology efficacy of Schistosoma mansoni large subunit of calpain (Sm-p80)-based vaccine against schistosomiasis caused by infections with Schistosoma mansoni in baboons. We also evaluated the disease transmission-blocking potential of Sm-p80 vaccine. Immunisations with Sm-p80-based vaccine resulted in significant reduction of hepatic egg load in vaccinated baboons (67.7% reduction, p = 0.0032) when compared to the control animals, indicative of reduction in pathology. There was also a significant reduction in sizes of egg-induced granulomas in baboons immunised with Sm-p80 vaccine compared to their control counterparts. Egg hatching rate analysis revealed an overall 85.6% reduction (p = 0.0018) in vaccinated animals compared to the controls, highlighting the potential role of Sm-p80 vaccine in disease transmission. The findings on anti-pathology efficacy and transmission-blocking potential presented in this study have formed the basis for a large-scale double-blinded baboon experiment that is currently underway.
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Gouveia MJ, Brindley PJ, Gärtner F, Costa JMCD, Vale N. Drug Repurposing for Schistosomiasis: Combinations of Drugs or Biomolecules. Pharmaceuticals (Basel) 2018; 11:E15. [PMID: 29401734 PMCID: PMC5874711 DOI: 10.3390/ph11010015] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/19/2018] [Accepted: 01/31/2018] [Indexed: 12/17/2022] Open
Abstract
Schistosomiasis is a major neglected tropical disease. Control of schistosomiasis currently relies on a single drug, praziquantel, and despite its efficacy against the all schistosome species that parasitize humans, it displays some problematic drawbacks and alone is ineffective in counteracting adverse pathologies associated with infection. Moreover, due to the development of the potential emergence of PZQ-resistant strains, the search for additional or alternative antischistosomal drugs have become a public health priority. The current drug discovery for schistosomiasis has been slow and uninspiring. By contrast, repurposing of existing approved drugs may offer a safe, rapid and cost-effective alternative. Combined treatment with PZQ and other drugs with different mode of action, i.e., antimalarials, shows promise results. In addition, a combination of anthelminthic drugs with antioxidant might be advantageous for modulating oxidative processes associated with schistosomiasis. Herein, we review studies dealing with combination therapies that involve PZQ and other anthelminthic drugs and/or antioxidant agents in treatment of schistosomiasis. Whereas PZQ combined with antioxidant agents might or might not interfere with anthelminthic efficacy, combinations may nonetheless ameliorate tissue damage and infection-associated complications. In fact, alone or combine with other drugs, antioxidants might be a valuable adjuvant to reduce morbidity and mortality of schistosomiasis. Therefore, attempting new combinations of anthelmintic drugs with other biomolecules such as antioxidants provides new avenues for discovery of alternatives to PZQ.
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Affiliation(s)
- Maria João Gouveia
- UCBIO/REQUIMTE, Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo, 228, 4050-313 Porto, Portugal.
- Center for the Study of Animal Science, ICETA, University of Porto, Praça Gomes Teixeira, Apartado 55142, 4031-401 Porto, Portugal.
- Department of Molecular Pathology and Immunology, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal.
| | - Paul J Brindley
- Department of Microbiology, Immunology & Tropical Medicine, and Research Center for Neglected Diseases of Poverty, School of Medicine & Health Sciences, George Washington University, Washington, DC 20037, USA.
| | - Fátima Gärtner
- Department of Molecular Pathology and Immunology, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal.
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Júlio Amaral de Carvalho, 45, 4200-135 Porto, Portugal.
- Institute of Investigation and Innovation in Health (i3s), Rua Alfredo Allen, 4200-135 Porto, Portugal.
| | - José M Correia da Costa
- Center for the Study of Animal Science, ICETA, University of Porto, Praça Gomes Teixeira, Apartado 55142, 4031-401 Porto, Portugal.
- Department of Infectious Diseases, INSA-National Health Institute Dr. Ricardo Jorge, Rua Alexandre Herculano 321, 4000-055 Porto, Portugal.
| | - Nuno Vale
- UCBIO/REQUIMTE, Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo, 228, 4050-313 Porto, Portugal.
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Hahnel S, Wheeler N, Lu Z, Wangwiwatsin A, McVeigh P, Maule A, Berriman M, Day T, Ribeiro P, Grevelding CG. Tissue-specific transcriptome analyses provide new insights into GPCR signalling in adult Schistosoma mansoni. PLoS Pathog 2018; 14:e1006718. [PMID: 29346437 PMCID: PMC5773224 DOI: 10.1371/journal.ppat.1006718] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Schistosomes are blood-dwelling trematodes with global impact on human and animal health. Because medical treatment is currently based on a single drug, praziquantel, there is urgent need for the development of alternative control strategies. The Schistosoma mansoni genome project provides a platform to study and connect the genetic repertoire of schistosomes to specific biological functions essential for successful parasitism. G protein-coupled receptors (GPCRs) form the largest superfamily of transmembrane receptors throughout the Eumetazoan phyla, including platyhelminths. Due to their involvement in diverse biological processes, their pharmacological importance, and proven druggability, GPCRs are promising targets for new anthelmintics. However, to identify candidate receptors, a more detailed understanding of the roles of GPCR signalling in schistosome biology is essential. An updated phylogenetic analysis of the S. mansoni GPCR genome (GPCRome) is presented, facilitated by updated genome data that allowed a more precise annotation of GPCRs. Additionally, we review the current knowledge on GPCR signalling in this parasite and provide new insights into the potential roles of GPCRs in schistosome reproduction based on the findings of a recent tissue-specific transcriptomic study in paired and unpaired S. mansoni. According to the current analysis, GPCRs contribute to gonad-specific functions but also to nongonad, pairing-dependent processes. The latter may regulate gonad-unrelated functions during the multifaceted male-female interaction. Finally, we compare the schistosome GPCRome to that of another parasitic trematode, Fasciola, and discuss the importance of GPCRs to basic and applied research. Phylogenetic analyses display GPCR diversity in free-living and parasitic platyhelminths and suggest diverse functions in schistosomes. Although their roles need to be substantiated by functional studies in the future, the data support the selection of GPCR candidates for basic and applied studies, invigorating the exploitation of this important receptor class for drug discovery against schistosomes but also other trematodes.
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Affiliation(s)
- Steffen Hahnel
- Institute of Parasitology, BFS, Justus Liebig University, Giessen, Germany
- Department of Molecular Biosciences, Northwestern University, Evanston, Illinois, United States of America
| | - Nic Wheeler
- Department of Biomedical Sciences, Iowa State University, Ames, Iowa, United States of America
| | - Zhigang Lu
- Institute of Parasitology, BFS, Justus Liebig University, Giessen, Germany
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom
| | - Arporn Wangwiwatsin
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom
| | - Paul McVeigh
- The Institute for Global Food Security, School of Biological Sciences, Queen’s University, Belfast, United Kingdom
| | - Aaron Maule
- The Institute for Global Food Security, School of Biological Sciences, Queen’s University, Belfast, United Kingdom
| | - Matthew Berriman
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom
| | - Timothy Day
- Department of Biomedical Sciences, Iowa State University, Ames, Iowa, United States of America
| | - Paula Ribeiro
- Institute of Parasitology, McGill University, Montreal, Canada
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Siqueira LDP, Fontes DAF, Aguilera CSB, Timóteo TRR, Ângelos MA, Silva LCPBB, de Melo CG, Rolim LA, da Silva RMF, Neto PJR. Schistosomiasis: Drugs used and treatment strategies. Acta Trop 2017; 176:179-187. [PMID: 28803725 DOI: 10.1016/j.actatropica.2017.08.002] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 07/29/2017] [Accepted: 08/02/2017] [Indexed: 11/18/2022]
Abstract
Neglected tropical diseases (NTDs) affect millions of people in different geographic regions, especially the poorest and most vulnerable. Currently NTDs are prevalent in 149 countries, seventeen of these neglected tropical parasitic diseases are classified as endemic. One of the most important of these diseases is schistosomiasis, also known as bilharzia, a disease caused by the genus Schistosoma. It presents several species, such as Schistosoma haematobium, Schistosoma japonicum and Schistosoma mansoni, the latter being responsible for parasitosis in Brazil. Contamination occurs through exposure to contaminated water in the endemic region. This parasitosis is characterized by being initially asymptomatic, but it is able to evolve into more severe clinical forms, potentially causing death. Globally, more than 200 million people are infected with one of three Schistosome species, including an estimated 40 million women of reproductive age. In Brazil, about 12 million children require preventive chemotherapy with anthelmintic. However, according to the World Health Organization (WHO), only about 15% of the at-risk children receive regular treatment. The lack of investment by the pharmaceutical industry for the development and/or improvement of new pharmaceutical forms, mainly aimed at the pediatric public, is a great challenge. Currently, the main forms of treatment used for schistosomiasis are praziquantel (PZQ) and oxaminiquine (OXA). PZQ is the drug of choice because it presents as a high-spectrum anthelmintic, used in the treatment of all known species of schistosomiasis and some species of cestodes and trematodes. OXA, however, is not active against the three Schistosome species. This work presents a literature review regarding schistosomiasis. It addresses points such as available treatments, the role of the pharmaceutical industry against neglected diseases, and perspectives for treatment.
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Affiliation(s)
- Lidiany da Paixão Siqueira
- Laboratório de Tecnologia dos Medicamentos, Universidade Federal de Pernambuco, Avenida Professor Artur de Sá, CEP 50740-521, Recife, Pernambuco, Brazil
| | - Danilo Augusto Ferreira Fontes
- Laboratório de Tecnologia dos Medicamentos, Universidade Federal de Pernambuco, Avenida Professor Artur de Sá, CEP 50740-521, Recife, Pernambuco, Brazil
| | - Cindy Siqueira Britto Aguilera
- Laboratório de Tecnologia dos Medicamentos, Universidade Federal de Pernambuco, Avenida Professor Artur de Sá, CEP 50740-521, Recife, Pernambuco, Brazil
| | - Taysa Renata Ribeiro Timóteo
- Laboratório de Tecnologia dos Medicamentos, Universidade Federal de Pernambuco, Avenida Professor Artur de Sá, CEP 50740-521, Recife, Pernambuco, Brazil
| | - Matheus Alves Ângelos
- Laboratório de Tecnologia dos Medicamentos, Universidade Federal de Pernambuco, Avenida Professor Artur de Sá, CEP 50740-521, Recife, Pernambuco, Brazil
| | - Laysa Creusa Paes Barreto Barros Silva
- Laboratório de Tecnologia dos Medicamentos, Universidade Federal de Pernambuco, Avenida Professor Artur de Sá, CEP 50740-521, Recife, Pernambuco, Brazil
| | - Camila Gomes de Melo
- Laboratório de Tecnologia dos Medicamentos, Universidade Federal de Pernambuco, Avenida Professor Artur de Sá, CEP 50740-521, Recife, Pernambuco, Brazil
| | - Larissa Araújo Rolim
- Central de Análise de Fármacos, Medicamentos e Alimentos da Universidade Federal do Vale do São Francisco, Avenida José de Sá Maniçoba, CEP 56304-917, Petrolina, Pernambuco, Brazil
| | - Rosali Maria Ferreira da Silva
- Laboratório de Tecnologia dos Medicamentos, Universidade Federal de Pernambuco, Avenida Professor Artur de Sá, CEP 50740-521, Recife, Pernambuco, Brazil
| | - Pedro José Rolim Neto
- Laboratório de Tecnologia dos Medicamentos, Universidade Federal de Pernambuco, Avenida Professor Artur de Sá, CEP 50740-521, Recife, Pernambuco, Brazil.
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Briley SM, Jasti S, McCracken JM, Hornick JE, Fegley B, Pritchard MT, Duncan FE. Reproductive age-associated fibrosis in the stroma of the mammalian ovary. Reproduction 2017; 152:245-260. [PMID: 27491879 DOI: 10.1530/rep-16-0129] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 06/29/2016] [Indexed: 12/13/2022]
Abstract
Under normal physiological conditions, tissue remodeling in response to injury leads to tissue regeneration without permanent damage. However, if homeostasis between synthesis and degradation of extracellular matrix (ECM) components is altered, fibrosis - or the excess accumulation of ECM - can disrupt tissue architecture and function. Several organs, including the heart, lung and kidney, exhibit age-associated fibrosis. Here we investigated whether fibrosis underlies aging in the ovary - an organ that ages chronologically before other organs. We used Picrosirius Red (PSR), a connective tissue stain specific for collagen I and III fibers, to evaluate ovarian fibrosis. Using bright-field, epifluorescence, confocal and polarized light microscopy, we validated the specific staining of highly ordered PSR-stained fibers in the ovary. We next examined ovarian PSR staining in two mouse strains (CD1 and CB6F1) across an aging continuum and found that PSR staining was minimal in ovaries from reproductively young adult animals, increased in distinct foci in animals of mid-to-advanced reproductive age, and was prominent throughout the stroma of the oldest animals. Consistent with fibrosis, there was a reproductive age-associated increase in ovarian hydroxyproline content. We also observed a unique population of multinucleated macrophage giant cells, which are associated with chronic inflammation, within the ovarian stroma exclusively in reproductively old mice. In fact, several genes central to inflammation had significantly higher levels of expression in ovaries from reproductively old mice relative to young mice. These results establish fibrosis as an early hallmark of the aging ovarian stroma, and this altered microenvironment may contribute to the age-associated decline in gamete quality.
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Affiliation(s)
- Shawn M Briley
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS 66160
| | - Susmita Jasti
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS 66160
| | - Jennifer M McCracken
- Department of Pharmacology, Toxicology, and Therapeutics, University of Kansas Medical Center, Kansas City, KS, 66160
| | - Jessica E Hornick
- Biological Imaging Facility, Northwestern University, Evanston, IL 60208
| | - Barbara Fegley
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS 66160.,Electron Microscopy Research Laboratory, University of Kansas Medical Center, Kansas City, KS 66160
| | - Michele T Pritchard
- Department of Pharmacology, Toxicology, and Therapeutics, University of Kansas Medical Center, Kansas City, KS, 66160
| | - Francesca E Duncan
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS 66160
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Han Q, Jia B, Hong Y, Cao X, Zhai Q, Lu K, Li H, Zhu C, Fu Z, Shi Y, Lin J. Suppression of VAMP2 Alters Morphology of the Tegument and Affects Glucose uptake, Development and Reproduction of Schistosoma japonicum. Sci Rep 2017; 7:5212. [PMID: 28701752 PMCID: PMC5507895 DOI: 10.1038/s41598-017-05602-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 05/31/2017] [Indexed: 01/17/2023] Open
Abstract
Schistosomiasis caused by schsitosomes is a serious global public health concern. The tegument that surrounds the worm is critical to the schistosomes survival. The tegument apical membrane undergoes a continuous process of rupture and repair owing to membranous vacuoles fusing with the plasma membrane. Vesicle-associated membrane protein 2 (VAMP2), a member of soluble N-ethylmaleimide sensitive factor attachment protein receptor (SNAREs) is required for membrane fusion. Here, we used RNA interference (RNAi) to knock down the expression of VAMP2 of Schistosoma japonicum (SjVAMP2), and both real-time PCR and western blot analysis confirmed the suppression of this molecule, as well as the suppression of the transcript levels of schistosome glucose transporters (SGTP1 and SGTP4), and insulin receptors (SjIR1 and SjIR2). SjVAMP2-suppressed worms exhibited a lower viability, and phenotypic alterations were also observed in the tegument. Moreover, the glucose consumption of SjVAMP2-suppressed worms decreased significantly in 4 and 6 days, respectively, as well as a significant reduction in egg production. We also observed a significant reduction in worm burden and hepatic eggs burden in two independent RNAi experiment in vivo, and minor pathological changes in mice treated with SjVAMP2 specific small interfering (si)RNA. These findings reveal that SjVAMP2 may play important roles in the maintenance of tegument, glucose uptake, worm development and egg production in schistosomes.
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Affiliation(s)
- Qian Han
- Ministry of Agriculture, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, People's Republic of China
| | - Bingguang Jia
- Ministry of Agriculture, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, People's Republic of China
| | - Yang Hong
- Ministry of Agriculture, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, People's Republic of China
| | - Xiaodan Cao
- Ministry of Agriculture, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, People's Republic of China
| | - Qi Zhai
- Ministry of Agriculture, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, People's Republic of China
| | - Ke Lu
- Ministry of Agriculture, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, People's Republic of China
| | - Hao Li
- Ministry of Agriculture, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, People's Republic of China
| | - Chuangang Zhu
- Ministry of Agriculture, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, People's Republic of China
| | - Zhiqiang Fu
- Ministry of Agriculture, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, People's Republic of China
| | - Yonghong Shi
- Ministry of Agriculture, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, People's Republic of China
| | - Jiaojiao Lin
- Ministry of Agriculture, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, People's Republic of China. .,Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, China.
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Development of monoclonal antibodies against Sj29 and its possible application for schistosomiasis diagnosis. Int J Infect Dis 2017; 61:74-78. [PMID: 28412409 DOI: 10.1016/j.ijid.2017.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 04/04/2017] [Accepted: 04/05/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Timely Schistosoma japonicum detection improves outcomes in schistosomiasis. Here, we established a double antibody sandwich ELISA to detect Schistosoma japonicum. METHODS Sj29 polyclonal and monoclonal antibodies were developed and identified. A Sj29 double antibody sandwich ELISA was evaluated. RESULTS Assay sensitivity for detecting Schistosoma japonicum circulating antigen Sj29 was 76.7% (23/30), 54.5% (18/33) and 50.0% (18/36) in patients with acute, chronic and advanced schistosomiasis. No false positives or cross-reactivity was observed in healthy controls or patients with clonorchiasis, paragonimiasis, or ancylostomiasis, respectively. By contrast, false positives (5.7%) and cross-reactivity (6.5%-10%) were detected using an AWA-ELISA. The circulating antigen positive rates decreased significantly faster than that of the antibody detection after 6 months treatment (22.2%, 4/18 and 88.9%, 16/18). Chi-Square Tests revealed that Sj29 sandwich ELISA had lower sensitivity than AWA indirect ELISA in the detection of S. japonicum infected patients (p<0.05). Although our assay detection specificity in patients infected with other parasites or healthy controls appeared higher, the difference between the assays was insignificant. However, our assay showed significantly better results in monitoring praziquantel therapeutic effects (p=0.001), with antigen-positive rates decreasing significantly faster than antibody detection rates after 6 months of treatment (22.2%, 4/18 versus 88.9%, 16/18). CONCLUSIONS Sj29 double antibody sandwich ELISA was established. The specificity of this method for detecting healthy sera was 100%. Meanwhile, Sj29 sandwich ELISA may have a potential diagnostic capability to distinguish current from past infections and assess drug treatment responses.
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Gelmedin V, Morel M, Hahnel S, Cailliau K, Dissous C, Grevelding CG. Evidence for Integrin - Venus Kinase Receptor 1 Alliance in the Ovary of Schistosoma mansoni Females Controlling Cell Survival. PLoS Pathog 2017; 13:e1006147. [PMID: 28114363 PMCID: PMC5289644 DOI: 10.1371/journal.ppat.1006147] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 02/02/2017] [Accepted: 12/21/2016] [Indexed: 12/21/2022] Open
Abstract
In metazoan integrin signaling is an important process of mediating extracellular and intracellular communication processes. This can be achieved by cooperation of integrins with growth factor receptors (GFRs). Schistosoma mansoni is a helminth parasite inducing schistosomiasis, an infectious disease of worldwide significance for humans and animals. First studies on schistosome integrins revealed their role in reproductive processes, being involved in spermatogenesis and oogenesis. With respect to the roles of eggs for maintaining the parasite´s life cycle and for inducing the pathology of schistosomiasis, elucidating reproductive processes is of high importance. Here we studied the interaction of the integrin receptor Smβ-Int1 with the venus kinase receptor SmVKR1 in S. mansoni. To this end we cloned and characterized SmILK, SmPINCH, and SmNck2, three putative bridging molecules for their role in mediating Smβ-Int1/SmVKR1 cooperation. Phylogenetic analyses showed that these molecules form clusters that are specific for parasitic platyhelminths as it was shown for integrins before. Transcripts of all genes colocalized in the ovary. In Xenopus oocytes germinal vesicle breakdown (GVBD) was only induced if all members were simultaneously expressed. Coimmunoprecipitation results suggest that a Smβ-Int1-SmILK-SmPINCH-SmNck2-SmVKR1 complex can be formed leading to the phosphorylation and activation of SmVKR1. These results indicate that SmVKR1 can be activated in a ligand-independent manner by receptor-complex interaction. RNAi and inhibitor studies to knock-down SmILK as a representative complex member concurrently revealed effects on the extracellular matrix surrounding the ovary and oocyte localization within the ovary, oocyte survival, and egg production. By TUNEL assays, confocal laser scanning microscopy (CLSM), Caspase-3 assay, and transcript profiling of the pro-apoptotic BCL-2 family members BAK/BAX we obtained first evidence for roles of this signaling complex in mediating cell death in immature and primary oocytes. These results suggest that the Smβ-Int1/SmVKR1 signaling complex is important for differentiation and survival in oocytes of paired schistosomes. Parasites of the genus Schistosoma cause schistosomiasis, a life-threatening infectious disease for humans and animals worldwide. Among the remarkable biological features of schistosomes is the differentiation of the female gonads which is controlled by pairing with the male and a prerequisite for egg production. Eggs, however, are not only important for the maintenance of the life-cycle; they also cause the pathological consequences of schistosomiasis. Part of the eggs gets trapped in host tissues such as liver and spleen and trigger inflammatory processes, finally leading to liver cirrhosis. Research activities of the last decade have indicated that different families of cellular and receptor-type kinases but also integrins contribute to the control of mitogenic activity and differentiation the female goands. In this context an unusual class of receptor tyrosine kinases (RTKs) has been identified, the venus kinase receptors (SmVKRs). By biochemical and molecular approaches we demonstrate that SmVKR1 activation can be achieved by cooperation with a signaling complex consisting of the beta integrin receptor Smβ-Int1 and the bridging molecules SmILK, SmPINCH, SmNck2. Besides unravelling a novel way of SmVKR1 activation, we provide evidence that this complex controls the differentiation status of oocytes by regulating cell death-associated processes.
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Affiliation(s)
- Verena Gelmedin
- Institute for Parasitology, Justus-Liebig-University, Giessen, Germany
| | - Marion Morel
- CIIL – Center for Infection and Immunity of Lille Inserm U1019 - CNRS UMR 8204, University Lille, Lille, France
| | - Steffen Hahnel
- Institute for Parasitology, Justus-Liebig-University, Giessen, Germany
| | - Katia Cailliau
- UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, CNRS UMR 8576, University Lille, Lille, France
| | - Colette Dissous
- CIIL – Center for Infection and Immunity of Lille Inserm U1019 - CNRS UMR 8204, University Lille, Lille, France
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Olveda DU, Inobaya MT, McManus DP, Olveda RM, Vinluan ML, Ng SK, Harn DA, Li Y, Guevarra JR, Lam AK, Ross AG. Biennial versus annual treatment for schistosomiasis and its impact on liver morbidity. Int J Infect Dis 2017; 54:145-149. [DOI: 10.1016/j.ijid.2016.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 09/22/2016] [Accepted: 10/03/2016] [Indexed: 12/30/2022] Open
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