(Ca(2+)-Mg2+)ATPase in Schistosoma mansoni: evidence for heterogeneity and resistance to praziquantel

Functional characterization of the Ca2+-ATPase SMA1 from Schistosoma mansoni

Schistosoma mansoni is a parasite that causes bilharzia, a neglected tropical disease affecting hundreds of millions of people each year worldwide. In 2012, S. mansoni had been identified as the only invertebrate possessing two SERCA-type Ca2+-ATPases, SMA1 and SMA2. However, our analysis of recent genomic data shows that the presence of two SERCA pumps is rather frequent in parasitic flatworms. To understand the reasons of this redundancy in S. mansoni, we compared SMA1 and SMA2 at different levels. In terms of sequence and organization, the genes SMA1 and SMA2 are similar, suggesting that they might be the result of a duplication event. At the protein level, SMA1 and SMA2 only slightly differ in length and in the sequence of the nucleotide-binding domain. To get functional information on SMA1, we produced it in an active form in Saccharomyces cerevisiae, as previously done for SMA2. Using phosphorylation assays from ATP, we demonstrated that like SMA2, SMA1 bound calcium in a cooperative mode with an apparent affinity in the micromolar range. We also showed that SMA1 and SMA2 had close sensitivities to cyclopiazonic acid but different sensitivities to thapsigargin, two specific inhibitors of SERCA pumps. On the basis of transcriptomic data available in GeneDB, we hypothesize that SMA1 is a housekeeping Ca2+-ATPase, whereas SMA2 might be required in particular striated-like muscles like those present the tail of the cercariae, the infecting form of the parasite.

Role of calcium influx through voltage-operated calcium channels and of calcium mobilization in the physiology of Schistosoma mansoni muscle contractions

We tested the hypothesis that voltage-operated Ca2+ channels mediate an extracellular Ca2+ influx in muscle fibres from the human parasite Schistosoma mansoni and, along with Ca2+ mobilization from the sarcoplasmic reticulum, contribute to muscle contraction. Indeed, whole-cell voltage clamp revealed voltage-gated inward currents carried by divalent ions with a peak current elicited by steps to +20 mV (from a holding potential of -70 mV). Depolarization of the fibres by elevated extracellular K+ elicited contractions that were completely dependent on extracellular Ca2+ and inhibited by nicardipine (half inhibition at 4.1 microM). However these contractions were not very sensitive to other classical blockers of voltage-gated Ca2+ channels, indicating that the schistosome muscle channels have an atypical pharmacology when compared to their mammalian counterparts. Futhermore, the contraction induced by 5 mM caffeine was inhibited after depletion of the sarcoplasmic reticulum either with thapsigargin (10 microM) or ryanodine (10 microM). These data suggest that voltage-operated Ca2+ channels do contribute to S. mansoni contraction as does the mobilization of stored Ca2+, despite the small volume of sarcoplasmic reticulum in schistosome smooth muscles.

Schistosomiasis--an unusual cause of ureteral obstruction: a case history and perspective

A male, 32 years of age, presented with dysuria and abdominal pain, but no gross hematuria. He emigrated three years earlier from Somalia, East Africa, and was currently employed as a poultry processor in a rural Wisconsin community. The patient denied any trauma, sexual activity, or family history of significant illness. Abdominal and genitourinary exams were normal with negative tests for gonococcus and chlamydia. Urinalysis demonstrated microhematuria. A urogram and retrograde pyelogram revealed a mildly dilated right ureter down to the ureterovesical junction. Cystoscopy showed punctate white lesions on the bladder urothelium. Ureteroscopy was used to biopsy abnormal tissue in the distal ureter and bladder. Biopsy tissue demonstrated deposits of Schistosoma haematobium eggs. No ova were seen in collected urine specimens. The patient was successfully treated with praziquantel and will be monitored for sequelae of the disease. Schistosomiasis (Bilharziasis) can be expected to be seen with increasing frequency in the United States with the continuing influx of immigrants and refugees, as well as the return of travelers and soldiers from endemic areas. While no intermediate snail host exists for the transmission of Schistosoma sp. in the United States, the continued importation of exotic animals including snails from Africa, as well as the ability of schistosomes to shift host species warrants concern. Additionally, increasing disease associated with non-human bird schistosomes of the same genus seen in the midwestern United States is occurring throughout Europe. One should be aware that praziquantel may not always be available or effective in the treatment of schistosomiasis. It behooves the practicing clinician to remain updated on the status of this widespread zoonosis.

Evidence against rapid emergence of praziquantel resistance in Schistosoma haematobium, Kenya

We examined the long-term efficacy of praziquantel against Schistosoma haematobium, the causative agent of urinary schistosomiasis, during a school-based treatment program in the Msambweni area of Coast Province, Kenya, where the disease is highly endemic. Our results, derived from treating 4,031 of 7,641 children from 1984 to 1993, indicate substantial year-to- year variation in drug efficacy. However, the pattern of this variation was not consistent with primary or progressive emergence of praziquantel resistance. Mathematical modeling indicated that, at current treatment rates, praziquantel resistance will likely take 10 or more years to emerge.