Nutritional aspects of Ascaris infection in young protein-deficient pigs

Modulation of the porcine intestinal microbiota in the course of Ascaris suum infection

Background

The porcine roundworm Ascaris suum impairs feed conversion and weight gain, but its effects on intestinal microbiota remain largely unexplored.

Methods

Modulation of the intestinal microbiota was assessed in pigs that were infected once with 10,000 A. suum eggs and pigs that received a trickle infection (1000 eggs/day over 10 days), compared with a non-infected control group. Six pigs each were sacrificed per group at days 21, 35 and 49 post-infection (p.i.). Faecal samples taken weekly until slaughter and ingesta samples from different intestinal compartments were subjected to next-generation sequencing of the bacterial 16S rRNA gene.

Results

The results revealed marked differences between the single- and the trickle-infected group. Single infection caused a remarkable but transient decrease in microbial diversity in the caecum, which was not observed in the trickle-infected group. However, an increase in short-chain fatty acid-producing genera in the caecum on day 21 p.i., which shifted to a decrease on day 35 p.i., was common to both groups, possibly related to changes in excretory–secretory products following the parasite’s final moult. Faecal microbial interaction networks were more similar between the single-infected and control group than the trickle-infected group. In addition, a lower degree of similarity over time indicated that A. suum trickle infection prevented microbiota stabilization.

Conclusions

These different patterns may have important implications regarding the comparability of experimental infections with natural scenarios characterized by continuous exposure, and should be confirmed by further studies.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13071-022-05535-w.

Changes in porcine nutrient transport physiology in response to Ascaris suum infection

Background

The roundworm Ascaris suum is one of the parasites with the greatest economic impact on pig farming. In this context, lower weight gain is hypothesized to be due to decreased nutrient absorption. This study aims at characterizing the effects of A. suum infection on intestinal nutrient transport processes and potential molecular mechanisms.

Methods

Three groups of six piglets each were infected orally (10,000 embryonated A. suum eggs) in a single dose (“single infection”). Another three groups were infected orally (1000 embryonated eggs) for 10 consecutive days (“trickle infection”). Animals were necropsied 21, 35 and 49 days post-infection (dpi). Three groups served as respective controls. The Ussing chamber technique was applied for the functional characterization of small intestinal tissues [short-circuit currents (I_sc) as induced by glucose, alanine and peptides; ³H-glucose net flux rates; tissue conductance (G_t)]. Transcription and expression levels of relevant cytokines and nutrient transporters were evaluated (qPCR/western blot).

Results

Peptide- and alanine-induced changes in I_sc were significantly decreased in the jejunum and ileum of the trickle-infected group at 49 dpi and in the ileum of the single-infected group at 49 dpi. No significant differences regarding glucose transport were observed between the Ascaris-infected groups and the control group in Ussing chamber experiments. Transcription levels of the glucose and peptide transporters as well as of selected transcription factors (transcription of signal transducer and activator of transcription 6 [STAT6] and hypoxia-inducible factor 1-alpha [Hif-1α]) were significantly increased in response to both infection types after some periods. The transcription of interleukins 4 and 13 varied between decrease and increase regarding the respective time points, as did the protein expression of glucose transporters. The expression of the peptide transporter PepT1 was significantly decreased in the ileal single-infected group at 35 dpi. Hif-1α was significantly increased in the ileal tissue from the single-infected group at 21 dpi and in the trickle-infected group at 35 dpi. The expression levels of Na⁺/K⁺-ATPase and ASCT1 remained unaffected.

Conclusions

In contrast to the current hypothesis, these results indicate that the nutrient deprivation induced by A. suum cannot be explained by transcriptional or expression changes alone and requires further studies.

Graphical abstract

Prevalence and Risk Factors of Intestinal Parasite Infections in Greek Swine Farrow-To-Finish Farms

Intestinal parasites, helminths, and protozoa challenge health and welfare of pigs and deteriorate the sustainability of swine farms leading to monetary losses. A multicentric survey was conducted for approximately one year. Overall, 1150 fecal samples were collected from eight intensive farms in Greece at regular intervals and examined by flotation and Ziehl-Neelsen techniques. Age, season, and time of last recorded antiparasitic treatment were assessed as possible risk factors using binary regression models. The overall prevalence of intestinal parasitism in pigs was 44.7%. The most frequently detected parasites in the studied population were the protozoa Balantidium coli (37.8%), followed by Entamoeba spp. (8.3%), Cystoisospora suis (6.0%), and the nematodes Ascaris suum (3.7%), Trichuris suis (2.5%), and Oesophagostomum spp. (1.4%). Distribution of intestinal parasites in different age groups was as expected. In autumn, the prevalence of Balantidium coli infection enhanced whereas the prevalence of Entamoeba spp. and Cystoisospora suis infections increased in spring. Time of last recorded antiparasitic treatment influenced Balantidium coli and Trichuris suis infection levels. Our results demonstrated that swine intestinal parasitism in intensive farms of Greece seems to be relatively common and highlighted the importance of proper laboratory examinations, as well as the need for tailored made control programs.

Soil-Transmitted Helminthiasis and Vitamin A Deficiency: Two Problems, One Policy

Vitamin A deficiency (VAD) and soil-transmitted helminthiasis (STH) represent two widely prevalent and often overlapping global health problems. Approximately 75% of countries with moderate or severe VAD are coendemic for STH. We reviewed the literature on the complex relationship between STH and VAD. Treatment for STH significantly increases provitamin A (e.g., β-carotene) levels but is associated with minimal increases in preformed vitamin A (retinol). Interpretation of the data is complicated by variations in STH infection intensity and limitations of vitamin A biomarkers. Despite these challenges, increased coordination of STH and VAD interventions represents an important public health opportunity.

Protein-energy malnutrition: a risk factor for various ailments

The wheel of industrialization that spun throughout the last century resulted in urbanization coupled with modifications in lifestyles and dietary habits. However, the communities living in developing economies are facing many problems related to their diet and health. Amongst, the prevalence of nutritional problems especially protein-energy malnutrition (PEM) and micronutrients deficiencies are the rising issues. Moreover, the immunity or susceptibility to infect-parasitic diseases is also directly linked with the nutritional status of the host. Likewise, disease-related malnutrition that includes an inflammatory component is commonly observed in clinical practice thus affecting the quality of life. The PEM is treatable but early detection is a key for its appropriate management. However, controlling the menace of PEM requires an aggressive partnership between the physician and the dietitian. This review mainly attempts to describe the pathophysiology, prevalence and consequences of PEM and aims to highlight the importance of this clinical syndrome and the recent growth in our understanding of the processes behind its development. Some management strategies/remedies to overcome PEM are also the limelight of the article. In the nutshell, early recognition, prompt management, and robust follow up are critical for best outcomes in preventing and treating PEM.

An unexpected life in nutrition

In this biographical article, I describe the evolution of my career in nutrition from an early period as an animal nutritionist interested in amino acid metabolism and genetic variation in nutrient requirements to an involvement in human nutrition and international public health. The career changes were in some respects a mirror of the evolution of nutritional science in my lifetime. I spent my entire career at Cornell University in what I think of as three distinct phases. As a researcher and teacher in the Poultry Science Department, I was able to do research in animal nutrition and witness the rapid industrialization of the production of poultry meat and eggs, helped by the findings of the era of nutrient discovery in nutritional science. Later I had the opportunity to lead the reorganization of human nutrition at Cornell during a period when research in nutritional science turned away from identifying new nutrients and became increasingly concerned with the roles of diet and chronic disease. During this period my research focus evolved as I became interested in aspects of international nutrition problems, particularly the influence of parasitic infections on child health and nutrition. I also became involved nationally in nutrition issues through participation in organizations such as the National Nutrition Consortium, the Food and Nutrition Board, and National Institutes of Health study sections at a time of great ferment in nutrition about the relationship of dietary patterns to health. Finally, I became provost of Cornell University and involved in the administration of a major research university. I describe my career in the context of my origins and early education springing from life on a sustainable family farm in rural Illinois.

Ascaris and ascariasis

Ascaris lumbricoides and Ascaris suum are widespread parasitic nematodes of humans and pigs respectively. Recent prevalence data suggests that approximately 1.2 billion people are infected. Adult worms exhibit an overdispersed frequency distribution in their hosts and individuals harbouring heavy burdens display associated morbidity. In this review, we describe the parasite, its distribution and measures undertaken to control infection.

Parasitism and production in farm animals

The impact of internal and external parasitism on productivity of farm animals is considered for cattle, sheep, pigs and poultry. The parasitic challenge experienced and the outcome of that challenge is a dynamic one in which environment, management practices, including housing or grazing management, nutritional status, the host's ability to develop effective immunity and the speed with which this can occur, play a significant role. Much of our assessment of the impact of infection comes from pathophysiological and nutritional studies with contrived infestations. A common feature of all infestations is reduced efficiency of food utilization through reduction in food intake, though in some cases increases in nutrient requirement are induced as a result of damage to or loss of host tissue. Assessment of the impact on productivity in the field is technically very difficult and must take account of fluctuating challenge, determined by environmental and management decisions, and the manager's objectives for the performance of a particular category of livestock. This review attempts to integrate the assessment of losses in productivity based on pathophysiological studies with those based on protection of groups of livestock in production systems by regular pesticide use. Throughout the review the limitations inherent in both approaches and in our knowledge of how parasites impair productivity of the host are emphasised.

Mucosal surface lesions in young protein-deficient pigs infected with Ascaris suum (Nematoda)

The morphology of the mucosal surface of samples from the small intestine of young protein-deficient pigs was examined by scanning electron microscopy. Three pigs had been infected with Ascaris suum for at least 58 days while 1 had remained uninfected; all pigs were housed and maintained under the same conditions, at the same time. The tissue samples collected at post mortem examination from pigs which contained A. suum showed varying degrees of villous atrophy and fusion. In addition, unusual small craters and as yet unidentified objects were observed at the surfaces of the enterocytes of Ascaris-infected pigs. These changes in mucosal morphology were not seen in the tissue taken from the uninfected pig. The possible association between the mucosal lesions and lactose maldigestion in young, protein-deficient pigs infeceted with A. suum is discussed.

Addendum

The effect of two types of diet on populations of Ascaris suum and Oesophagostomum dentatum in experimentally infected pigs Parasitology (1995), 111, 395–402

Part of the reference list that was omitted from p. 402 appears below.

The nutritional physiology of Trichoplusia ni parasitized by the insect parasite, Hyposoter exiguae, and the effects of parallel-feeding

Host nutrition plays a major role in the nutritional physiology of Trichoplusia ni parasitized by the hymenopterous insect parasite, Hyposoter exiguae. Severely reduced growth rate characterized the host association throughout the 4th developmental stadium. This effect of parasitization, however, was indirect and growth depression of parasitized larvae was entirely accounted for by the accompanying decreased rate of food consumption. Parallel-fed larvae, that is, unparasitized larvae feeding on nutrients at the same rate as observed in ad libitum-fed parasitized individuals, displayed lower rates of growth than parasitized larvae and the latter had higher rates of assimilation. Parasitization, therefore, directly resulted in an increased rate of assimilation over that observed in uninfected insects after accounting for the effects of altered food consumption. Similarly, differences in the pattern of response to decreased dietary protein levels between parasitized and unparasitized insects could be explained on the basis of differences in their rates of food consumption

Immunohistochemical distribution of antigens in liver of infected and immunized pigs with Ascaris suum

In the present work, we carry out an immunopathological study of the swine ascariosis, under different conditions (control, infection and immunization). Twenty-one Iberian pigs were used and divided in seven groups. Groups 1 and 2 were the uninfected and challenged controls, respectively. Groups 3 and 4 were weakly infected with increasing doses of Ascaris suum eggs and treated with pyrantel (Group 4). Groups 5-7 were immunized with 14, 42 and 97 kDa proteins from the parasite, respectively. Groups 2-7 were challenged with 10,000 infective eggs 7 days before the sacrifice. The focal parasitic granulomata with eosinophils and lymphocytes were the main histopathological lesions in the liver of reinfected pigs, while more marked cellular infiltrate and abundant connective tissue were seen in the livers of immunized animals. There were important deposits of antigens in the livers of immunized and infected pigs. Antigens were mainly located in the connective tissue, with positive staining detection of the somatic larvae antigen, the body wall from the adult worms and the 14-, 42- and 97-kDa proteins. However, cholangiols, biliary ducts and macrophages presented an immunohistochemical positive stain against excretory-secretory and somatic antigens from the larvae and the body fluid antigen from the adult parasite. The detection of A. suum antigens in the liver of infected pigs improves the diagnosis of swine ascariosis. It may be possible to apply these procedures for diagnosis of human ascariosis in liver biopsies since A. suum from swine have been previously used as a substitute for the study of the human parasite Ascaris lumbricoides.

Nutritional impact of intestinal helminthiasis during the human life cycle

Poor people in developing countries endure the burden of disease caused by four common species of soil-transmitted nematode that inhabit the gastrointestinal tract. Disease accompanying these infections is manifested mainly as nutritional disturbance, with the differing infections having their deleterious effects at different phases during the human life cycle. Reduced food intake, impaired digestion, malabsorption, and poor growth rate are frequently observed in children suffering from ascariasis and trichuriasis. Poor iron status and iron deficiency anemia are the hallmarks of hookworm disease. The course and outcome of pregnancy, growth, and development during childhood and the extent of worker productivity are diminished during hookworm disease. Less is known about the impact of these infections in children under 2 years of age. The severity of disease caused by soil-transmitted nematodes has consistently been found to depend on the number of worms present per person. Cost-effective measures based on highly efficacious anthelminthic drugs are now available to reduce and control disease caused by these infections.

The range and biological activity of FMRFamide-related peptides and classical neurotransmitters in nematodes

Nematodes include both major parasites of humans, livestock and plants in addition to free-living species such as Caenorhabditis elegans. The nematode nervous system (especially in C. elegans) is exceptionally well defined in terms of the number, location and projections of the small number of neurons in the nervous system and their integration into circuits involved in regulatory behaviours vital to their survival. This review will summarize what is known about the biological activity of neurotransmitters in nematodes: the biosynthetic pathways and genes involved, their receptors, inactivation mechanisms and secondary messenger signalling systems. It will cover the 'classical' transmitters, such as acetylcholine (ACh), GABA, glutamate, serotonin, dopamine, octopamine, noradrenaline and nitric oxide. The localization of peptides throughout the nematode nervous system is summarized, in addition to the isolation of nematode neuropeptides by both traditional biochemical techniques and more modern genetic means. The major contribution of the completion of the C. elegans genome-sequencing program is highlighted throughout. Efforts to unravel neurotransmitter action in various physiological actions such as locomotion, feeding and reproduction are detailed as well as the various inactivation mechanisms for the current complement of nematode transmitters.

Helminth surveillance as a prerequisite for anthelmintic treatment in intensive sow herds

Helminth prevalences in pigs in intensive production systems are often very low due to housing and management factors, and the present study was carried out to examine whether routine anthelmintic treatment in such herds can be replaced by coprological surveillance of the helminth status combined with anthelmintic treatment when necessary. After an initial examination, 25 out of 28 large herds of Danish sows (> or = 50 sows, production of fatteners) were found to have such light helminth infections that routine deworming could be replaced experimentally by coprological examination every 6 months of 10 weaners (10-12 weeks old), 10 fatteners (5-6 months old), 10 dry sows and 10 lactating sows. This coprological surveillance continued in 21 herds of the selected 25 herds for a 3-year period, while it was stopped immediately in one herd due to increasing Ascaris suum prevalences, and ceased after one year in three herds due to other reasons. A. suum was found in all but one of the 25 herds. The most heavily infected age group was the sows, in which the A. suum prevalence was consistently low in approximately half of the herds, while it increased slowly or rapidly in the other half. When this happened, treatment of the breeding stock was recommended which resulted in low prevalences for varying periods of time. Few farmers neglected the recommendations for some time or for all 3 years, which resulted in consistently high prevalences in the sows (e.g. 40-60%). The fatteners were in general more lightly infected with A. suum than the sows, and in approximately 3/4 of the herds the prevalence remained at a low level, while it fluctuated in the remaining herds. No weaners were ever found to excrete eggs, most likely due to unfavourable conditions for egg development in the farrowing pens. Throughout the study Oesophagostomum sp. eggs were found sporadically in the sows of two herds, and in a third herd, Oesophagostomum sp. was introduced after 2 years, probably due to close contact with a neighbour herd. Oesophagostomum sp. was not found in the remaining herds. Eggs of Trichuris sp. were found sporadically. In conclusion, it is recommended that veterinarian advisers evaluate the production systems before suggesting an anthelmintic routine. If helminth infections may be controlled by intensive management and housing alone, coprological surveillance combined with anthelmintic treatment when necessary may replace routine use of anthelmintics. If the surveillance reveals that the infection levels continue to be low unnecessary medication is avoided, and if the infection levels increase, the coprological data obtained can be used to optimize the anthelmintic strategy.

Improvements in appetite and growth in helminth-infected schoolboys three and seven weeks after a single dose of pyrantel pamoate

Appetite and growth were studied in primary schoolboys (6-10 years) infected with Ascaris lumbricoides (86%) and Trichuris trichiura (100%) who received a single dose of pyrantel pamoate (which has little or no effect on Trichuris trichiura) or a placebo. Boys were examined, allocated at random by descending Ascaris egg count to pyrantel (PR, n = 36) or placebo (PL, n = 36) groups, treated, and re-examined 3 and 7 weeks later. The 2 groups did not differ significantly before treatment in helminth infections, appetite, or growth. Three and 7 weeks after treatment, the PR group exhibited significantly greater increases than did the PL group in weight (0.2 kg and 0.4 kg more, respectively) and percentage weight-for-age (0.6% and 1.7% points more, respectively). Appetite increased significantly in the PR group at 3 and 7 weeks (P < 0.0005 and P < 0.01, respectively) but not in the PL group. The prevalence and intensity of A. lumbricoides infection were greatly reduced in the PR group at 3 and 7 weeks (both P < 0.0001) but not in the PL group. We conclude that treatment with pyrantel pamoate may improve appetite and growth in school children in areas where A. lumbricoides infections and poor growth are highly prevalent.

A possible influence of diet composition on the establishment of nematodes in the pig

Two groups of 20 pigs weighing approx. 26 kg were offered either ground barley plus protein supplement (GBP) or commercial pelleted feed (CPF), two diets consisting of nearly the same amounts of carbohydrates, proteins and micronutrients. All pigs were experimentally infected with 600 infective Ascaris suum eggs and 6000 infective Oesophagostomum spp. larvae and followed coprologically for approx. 12 weeks post infection, whereafter they were slaughtered. The number of Oesophagostomum spp. and A. suum eggs was significantly higher in the GBP-fed pigs compared with the CPF-fed pigs (P < 0.0001). The mean worm burden of adult Oesophagostomum spp. was higher in the GBP-pigs than in the CPF-pigs (P < 0.05), while the mean worm burden of adult A. suum in the two groups was not significantly different. The results indicate that two diets, both fulfilling the requirements of modern pig raising, may result in different establishment rates of natural adult gastrointestinal helminths in swine.

The impact of gastrointestinal parasites on protein-energy malnutrition in man

There is no doubt that at high intensity of infection, intestinal parasites can cause severe illness and the death of their hosts. Even with the high prevalence of these infections, however, such severe cases are rare and the norm is for low to moderate numbers of parasites which cause few if any overt symptoms. Nevertheless, it has been argued that by causing subtle reductions in appetite, absorption, digestion and acute-phase status and increasing intestinal nutrient losses, these low-level but long-term infections could be responsible for the persistent, poor nutritional status of so many children in Third World communities. Although geographically, high parasite prevalence occurs in conjunction with high levels of protein-energy malnutrition, attempts to establish a cause and effect relationship have had very limited success with many investigators being unable to demonstrate any detrimental consequence of infection. The unimpressive results might be explained to some extent by the unusual features of helminth infections such as rapid reinfection, the overdisperse distribution pattern and the uncertainty of a host inflammatory response, but they also suggest that A. lumbricoides (on which most studies have concentrated) may be of little nutritional importance. It seems likely that the more invasive parasites, e.g. the hookworms, S. stercoralis, T. trichiura and perhaps G. lamblia may have a greater impact and clearly more studies are required here. Safe, cheap and effective anthelmintics are now available and, on the grounds of disease prevention, there is a case for their nationwide use. However, from the available evidence, it would be unwise to expect that such programmes would make a significant impact on the nutritional status of children in Third World communities.

Pathways to the impairment of human nutritional status by gastrointestinal pathogens

Gastrointestinal pathogens are of three varieties, those that can, and often do, take the life of the host, those that infect transiently and rarely are life-threatening, and those (parasites) that establish a relatively prolonged residence or colonization of the host's alimentary tract. In the case of the second form, if infections are recurrent, both catabolic effects during the episode and failure to digest foods and/or absorb nutrients results. Similarly, catabolic wastage through activation of the acute phase response, and interference with the host's acquisition of nutrients by maldigestion, malabsorption, intestinal losses and competition with the parasite burden can impair growth and nutrition with helminthic infections. Growth and nutrition with respect to all of the macronutrients and virtually all of the micronutrients have been documented to be adversely affected by gastrointestinal pathogens. For its burgeoning importance as a worldwide health problem, both with the HIV virus as a direct intestinal pathogen and with the opportunistic gut infections occurring in the immunocompromised host, AIDS represents the emerging context of the impairment of nutritional status by intestinal pathogens.

Human nutrition needs and parasitic infections

The series of articles that follow in this volume deals with specific aspects of how parasites might influence nutrient utilization by their human hosts. To put these aspects of parasitic disease in context, this contribution is intended to provide an overview of human nutritional needs and to introduce concepts of how nutritional consequences of parasitic infection might be viewed. Although parasitic diseases are often considered to be those caused by protozoa and helminths, the principles considered here can be applied to any infectious agent, including bacteria and viruses.

Ascariasis and childhood malnutrition

The present review will examine epidemiological perspectives and be confined mainly to the results of those field studies published since 1975 in order to provide concrete scientific evidence of the effect of ascariasis on childhood malnutrition, particularly on growth. The field studies were done in many developing countries from Africa, Asia and Latin America, using cross-sectional and intervention studies in which anthelmintics were employed, with different dosing frequency and follow-up periods ranging from 33 days to 2 years. In general, a better nutritional status in terms of growth, lactose tolerance, vitamins A and C, and albumin levels were observed among Ascaris-free or treated than among Ascaris-infected or untreated children even in cross-sectional or non-randomized studies. More importantly, the improvement in weight or height after chemotherapeutic treatment was found to be significant particularly in those randomized controlled studies with an initially high prevalence of ascariasis and malnutrition, a low prevalence of other intestinal parasites, repetitive and regular treatments of children with tetramisole, levamisole or pyrantel, within a period of 12 or 24 months. Reasons for failures to detect improved growth in some studies are provided. This review strongly indicates that A. lumbricoides infection definitely retards childhood growth.

Protein content of CBA/Ca mouse diet: relationship with host antibody responses and the population dynamics of Trichuris muris (Nematoda) in repeated infection

The influence of host dietary protein on acquired immunity and intestinal helminth population dynamics during repeated infection was studied using the mouse-Trichuris muris experimental model. CBA/Ca mice fed a 2% (by mass) protein diet ad libitum maintained body weight during the experiment, but when fed diets containing either 4% or 16% (by mass) protein gained weight steadily. Infection with T. muris did not affect the growth of the latter mice but significantly reduced the growth of animals fed on the 2% protein diet. When repeatedly infected with either 5 or 50 eggs every 10 days, the mice fed the 2% or 4% protein diet accumulated adults in proportion to infection dose. The results show that this is due to both the establishment of larvae at each repeated infection and the survival of established adults. In contrast, very few worms were recovered from animals fed the 16% protein diet, principally as a result of the development of strong acquired immunity to reinfection. T. muris egg output/mouse increased with infection dose in animals fed the low protein diets, but no parasite eggs were detected in the faeces of hosts fed the 16% protein diet. Mouse antibody responses to adult worm excretory/secretory antigen were time- and infection dose-dependent in all 3 dietary groups. The major finding was that the specific antibody response was more intense, both quantitatively (serum OD levels) and qualitatively (antigen recognition by IgG1), in mice fed the low protein diets, even though they remained susceptible to infection. This study shows that host dietary protein deficiency, even at levels irrelevant to normal growth, can markedly potentiate the transmission of T. muris via alterations in host resistance. The high levels of antibody in susceptible animals suggest that this defect in resistance is unlikely to be due to nutrient deficiency-associated defects in humoral immunity.

Response to repeated inoculations with Ascaris suum eggs in pigs during the fattening period. I. Studies on worm population kinetics

This experimental study on pigs was designed to simulate natural, long-term exposure to Ascaris suum under modern management conditions. Parasite kinetics were followed in pigs receiving A. suum eggs as repeated trickle inoculations at two dose levels beginning at a body weight of 25 kg until their slaughter at 90 kg (baconers). In pigs inoculated twice weekly with 500 eggs, there was an initial marked rise in the numbers of hepatic milk spots, but as early as around week 6 after the start of inoculations and until week 16, at which time the last pigs were slaughtered, the numbers of spots diminished drastically. In pigs receiving only 25 eggs twice weekly, low and moderately fluctuating numbers of spots were seen throughout the experiment. Larvae recoverable from the livers and lungs were observed mainly during the beginning of the experiment. Before patency, immature intestinal worms were found in moderate numbers that showed a rough positive correlation with the dose levels, but at the time at which adult worms started to appear, immature parasites could practically no longer be found. In all, only 10 of 40 pigs harbored adults, and 4 of these 10 pigs harbored 80% of the total worm population. The results show that acquired dose-dependent host responses to A. suum play an important role in regulating the worm population along the migratory route of the parasite and that the final burden of worms in the small intestine is dose-dependent and highly variable.

Interaction between Ascaris suum and Pasteurella multocida in the lungs of mice

In an experiment including 8 groups of 15 mice, the effect of migrating Ascaris suum larvae in the lungs on the establishment and pathogenicity of aerosol exposure to Pasteurella multocida was investigated. Following aerosol exposure to P. multocida, mice with migrating A. suum in their lungs developed more severe pneumonia and septicaemia than did parasite-free mice. The parasite-induced effect on bacterial pathogenicity was more marked for a non-toxin-producing P. multocida as compared with a toxin-producing strain of P. multocida, possibly due to the higher spontaneous pathogenicity of the non-toxigenic strain of P. multocida. The present results should encourage controlled experiments on possible interactions between A. suum and various airborne microbial infections in pigs.

A controlled chemotherapeutic intervention trial on the relationship between Ascaris lumbricoides infection and malnutrition in children

A 2-year investigation, consisting of a controlled, non-blind, 3-monthly chemotherapeutic intervention trial, based on transmission dynamics of Ascaris lumbricoides infection, was undertaken to prove or refute the role of A. lumbricoides as a contributor to childhood malnutrition. The study involved 1206 children aged 2-12 years in 21 villages in Myanmar [Burma] starting in August 1984. The intervention and non-intervention villages were comparable regarding almost all the important baseline variables, including prevalences of Ascaris infection (80.8 vs 83.0%) and of malnutrition of grade 2 and above for height-for-age (58.4 vs 55.8%) and for weight-for-age (48.2 vs 47.8%). The intensity of Ascaris infection was related to the degree of malnutrition. A significant increment of height gain was found, starting after the 6th month, and of weight gain after the 24th month, of the study among the treated 2-10 years old children when compared with the non-treated ones. By the end of 24 months, the height and weight gains per child were 0.65 cm and 0.93 kg respectively. Lesser increments in height-for-age and weight-for-age were also observed after successive treatments among the treated children with initially higher mean worm burdens. The findings are discussed in the context of causal relationship between ascariasis and malnutrition in children.

Effects of multiple dose infections with Ascaris suum on blood gastrointestinal hormone levels in pigs

Ten consecutive daily doses of infective Ascaris suum eggs were administered to pigs in two experiments and the levels of gastrointestinal hormones in their blood were measured. The piglets in each experiment were divided into low-dose (LDI) and high-dose (HDI) infections and control groups. Infected pigs had lower feed consumption, lower weight gains, and lower feed efficiency than control pigs. Serum gastrin levels in infected pigs were significantly lower than the controls from Days 7 to 17 post first inoculation (PFI), and so were their serum glucagon levels from Days 12 to 24 PFI. Serum insulin levels in infected animals were sometimes lower than those in controls. These differences were usually more intense in the LDI pigs than in HDI pigs. The plasma cholecystokinin (CCK) levels in the LDI group were significantly higher than those in controls from Day 10 PFI to the end of the experiment, while the CCK levels in the HDI group did not differ significantly from the controls. Increased plasma CCK levels could be a satiety factor in A. suum infection since the time of occurrence of high levels of CCK matched the period of reduced feed consumption.

Serum levels of gastrin, insulin and glucagon as possible factors of anorexia in pigs infected once with Ascaris suum

In order to determine possible mediators for development of anorexia in pigs infected with Ascaris suum, serum levels of gastrin, insulin and glucagon were measured. After a single high oral dose of 100,000-200,000 embryonated eggs the serum levels of gastrin and insulin in the infected pigs did not significantly differ from those in controls. Serum glucagon levels in the infected groups, however, were lower than those in controls and the difference was more evident 24 days postinoculation and later.

Effect of Strongyloides ratti on small bowel function in normal and immunosuppressed host rats

Although Strongyloides stercoralis is a common parasite, little is known about its effect on intestinal function. Published clinical studies are difficult to evaluate and compare because of the inability to differentiate the effects of the parasite load from that of various other coexisting features such as bacterial overgrowth, multiparasitism, malnutrition, or tropical sprue. Using a rat model where these problems do not occur, we found that Strongyloides ratti did not inhibit intestinal function in the healthy rat. In fact, in normal rats S. ratti appeared to increase ileal sucrase activity. In contrast, in the methylprednisolone-treated rat, S. ratti produced a decrease in lactase and sucrase activity and an increase in alkaline phosphatase activity. S. ratti had no effect on 3-O-methylglucose uptake or D-xylose absorption in either group. These results suggest that S. ratti has little effect on small bowel function in a healthy rat but can cause minor alterations in intestinal function in an immunosuppressed, methylprednisolone-treated, malnourished host. These results are also consistent with clinical observations seen with S. stercoralis in humans and with another nematode, Ascaris suus, in the pig model.

Intestinal helminthiases in relation to the socioeconomic environment of Panamanian children

A cross-sectional investigation was made into ascariasis and nutritional status in Panamanian preschool children from October 1983 to July 1984. Within this framework, an analysis was undertaken of possible relationships between a range of intestinal helminthiases and the socioeconomic status of the participants. Attention was paid to caregiver's education, parental occupation, family earnings, quality of housing and sanitation in the assessment of socioeconomic status. On this basis, strong associations were established between the socioeconomic status of the children and infection with Ascaris lumbricoides, Trichuris trichiura and hookworm. In general, the prevalence of single and multiple helminth infections was significantly higher in children living in housing made of wood or bamboo than in those living in housing made of concrete blocks. The same pattern applied to levels of sanitation. Ascaris lumbricoides occurred more frequently in children of mothers with the least formal education and in children living in relatively crowded conditions. Evidence was also obtained to indicate that the intensity of the intestinal helminth infections was greater in the children from the poorer environment. Since children from poorer socioeconomic conditions might be more exposed to infective stages than those from a better environment, the possible role of socioeconomic factors in contributing to the predisposition of some individuals to harbour large worm burdens of intestinal helminths was briefly discussed.

Contributions of ascariasis to poor nutritional status in children from Chiriqui Province, Republic of Panama

Relationships between ascariasis and lactose digestion and between ascariasis and food transit time from mouth to caecum were investigated in young children from Chiriqui Province, Republic of Panama. The breath hydrogen method was used in both studies. Ascaris-infected children showed a significantly poorer degree of lactose digestion following a test oral load than uninfected children. Recovery of the capacity of the children to digest lactose was still not fully complete for at least 3 weeks following anthelmintic treatment. On average, the mouth-to-caecum transit time was similar in infected and uninfected children, but among the Ascaris-infected children the transit time tended to be shorter in relation to the intensity of infection. Evidence from a cross-sectional survey indicated that ascariasis was significantly associated with reduced plasma vitamin A and carotenoid concentrations. This relationship remained after controlling for a range of socio-economic variables. Ascaris-infected children were frequently found to have lower haematocrits and blood haemoglobin concentrations than uninfected children, but these relationships could not be attributed to ascariasis alone.

Pathophysiology of parasitic infections

Parasites can have a wide range of pathophysiological effects on the host. This review describes those associated with some parasites of major importance in man and animals. Haemoprotozoan diseases such as trypanosomiasis and malaria are primarily associated with anaemia. Such anaemias have a complex aetiology involving various mechanisms responsible for red cell destruction as well as possible defects in red cell production. In addition to these haematological effects these diseases are associated with marked disturbances in heart function and the nervous, immune and urinary systems. The other major groups of parasitic diseases are those associated with the gastrointestinal tract. The most advanced studies have been conducted on the pathophysiology of gastrointestinal nematode parasites of sheep and have revealed significant effects on feed intake, gastrointestinal function, and protein and energy metabolism. Similar studies have yet to be conducted in other hosts and parasitic diseases. There is also a need to examine in greater detail the factors which can modulate pathophysiological responses by the host to parasitic infections.

Nutritional aspects of infection

Current knowledge is examined about the means whereby ascariasis, hookworm disease, strongyloidiasis and trichuriasis may contribute to the aetiology of human malnutrition. Results from experiments with related parasites in the laboratory have demonstrated the role of gastrointestinal helminthiases in animal malnutrition. Some evidence shows that in children, infection with the intestinal stages of Ascaris lumbricoides is associated with reduced growth rate, disturbed nitrogen balance, malabsorption of vitamin A, abnormal fat digestion, lactose maldigestion and an increased intestinal transit time. The main impact of hookworm infection is its relationship with iron-deficiency anaemia which may have effects at the community level as regards work and productivity in adults and learning and school performance in children. More research is needed to extend knowledge of the nutritional impact of ascariasis and hookworm disease in order to establish their public health significance. Research is needed also to identify the range of nutritional effects on man that occur as a result of trichuriasis and strongyloidiasis. The significance of less prevalent and more localized gastrointestinal helminthiases should not be ignored.

Chronic ascariasis and malnutrition

Malnutrition is the most widespread ill of mankind. Its global distribution coincides indistinguishably with that of the common roundworm. Ascaris lumbricoides is common - infecting about one-quarter of the world's population. Acute clinical ascariasis sometimes requires hospital treatment, but chronic infections contribute to long-term malnutrition. This alone should justify greater expenditure on the treatment and control of Ascaris.

Food intake and body weight changes in mice infected with metacestodes of Taenia crassiceps

General nutritional effects on female CFLP mice harbouring larval Taenia crassiceps were investigated using groups of mice fed ad libitum on purified diets containing 2%, 4%, 8% and 16% (w/w) protein respectively. When uninfected and infected mice were compared over an experimental period of 20 weeks, it was established that a significantly higher proportion of uninfected mice survived the course of the experiment than infected mice. There was no evidence of the presence of the parasites having any effect on the overall food intake of the mice. Infected mice, however, were found to be significantly heavier, on a fresh weight basis, than their uninfected partners, but the pattern was reversed when the dry weights of mouse carcasses were compared following the removal of parasites. In general, more parasite tissue was recovered from mice feeding on the higher protein diets (8% and 16%).

Methods to evaluate nutritional and economic implications of Ascaris infection

Ascaris infection has important economic implications for human populations, due to its negative effects on growth of undernourished children and its less common role in causing intestinal obstruction. The deleterious effects of Ascaris infection on growth of undernourished children have been demonstrated in studies conducted in India, Kenya and Tanzania; deworming has resulted in improved weight gains of 20-35% compared with uninfected children. However other studies in Ethiopia, Bangladesh and Guatemala have not found statistically significant improvements in growth of children after treatment for Ascaris infection, most likely due to inadequacies in choice of population, sample size, experimental design, data analysis and/or relative failure of drug treatment. Field studies which attempt to measure the magnitude of growth deficits due to Ascaris must take the following into account: (1) rapidly growing preschool age children from communities with a high prevalence of protein-energy malnutrition are the most important group to study. (2) A longitudinal design, preferably using randomly allocated treatment and placebo groups, is highly desirable. (3) A sufficient period of time for growth improvement must be allowed between the beginning of the intervention and final measurements. (4) The sample sizes necessary to test hypotheses adequately should be calculated in advance. (5) The drug chosen for treatment of Ascaris should produce high cure rates and reinfection rates should be determined. Possible effects of the drug on other diseases prevalent in the population should be considered in the data analysis. (6) Evaluation of worm loads are very important in interpretation of results. (7) The data analysis must be appropriate for the individual study and must be designed to consider confounding factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Biochemical and physiological effects of metazoan endoparasites on their host species

1. The integrative nature of the parasite-host association was discussed, specifically with regard to the metabolic effects of parasitization as well as the physiological manifestation of infection in relation to the host's nutritional physiology. Endocrine interactions were also considered. 2. Relationships involving parasitic insects, including members of the orders Diptera, Hymenoptera and Strepsiptera, parasitic helminths, including members of the phyla Acanthocephala and Nematoda and the classes Cestoidea and Trematoda of the Platyhelminthes, as well as parasitic crustaceans in association with their invertebrate and/or vertebrate, intermediate, paratenic as well as definitive hosts were considered. 3. A broad conceptual or "topic" approach to understanding symbiotic relationships was emphasized. De-emphasis of descriptive categorization and the use of benefit/harm as criteria characterizing parasitic relationships was suggested. 4. The hypothetical concept of host regulation was briefly examined and the use of anthropometric descriptors such as "beneficial" and "harmonious" in parasitology discussed.