Pathogenesis of congenital infection with Schistosoma japonicum in pigs

A case of chronic schistosomiasis in a Dongola stallion (Equus ferus caballus Linnaeus, 1758) from Nigeria

Schistosomiasis is a worldwide snail-borne parasitic infestation of man and animals with acute or chronic phases having devastating sequelae. The present case report focused on post-mortem examination of a cachexic Dongola stallion (Equus ferus caballus Linnaeus, 1758) in Abuja, Nigeria, that failed to respond to treatment. Typical dense collagenous granulomatous lesions with marked inflammatory responses and fibrosis occurred in the liver and several visceral organs of the horse along with other lesions indicative of systemic collapse. Special Ziehl-Neelsen and Periodic Acid-Schiff staining as well as microbial culture returned negative results to rule out acid-fast bacilli, fungal, and other bacterial involvement. In addition, the presence of a yellowish-brown eggshell within fibrosing granulomatous lesions led to the diagnosis of chronic schistosomiasis. Prolonged malnutrition under harsh and changing increment weather conditions with lack of medical care following the infection might have predisposed the horse to the recorded systemic collapse in the present case. The dearth of information on the ante-mortem evaluation of acute equine schistosomiasis cases notwithstanding, the observed lesions/cellular changes reinforced  associated multi-organ damages and systemic collapse in chronic cases. Our findings highlighted the pathological presentations and prognosis of chronic schistosomiasis and its triggers, especially in endemic areas, and in horses that often do not present obvious clinical manifestations.

Maternal schistosomiasis: a growing concern in sub-Saharan Africa

Schistosomiasis remains one of the most important tropical parasitic infections threatening millions of lives in endemic areas. Cases of infections due to Schistosoma spp, the diecious digenetic trematodes have been on the increase over the last decades. While considerable efforts have been made to reduce infections and morbidities in most endemic areas, these efforts seem to be tailored only towards a specific group (school-based resources). This bias towards school children in epidemiological studies has also been observed in various research efforts in sub-Saharan Africa, thus making it difficult to produce a reliable estimate of the extent of infection in other strata of the population at risk. In recent times, attention has been drawn to Schistosoma spp infections in infants and preschool children, while studies on epidemiology of maternal schistosomiasis still suffer neglect. Considering the potential morbidity of Schistosoma infections on the mothers, fetuses, and neonates, as evidenced in some animal models and human case studies, more attention is solicited in all areas of observational studies and clinical trials, for maternal schistosomiasis with the aim of providing relevant data and information for effective management of the disease during pregnancy.

Schistosoma japonicum: susceptibility of neonate mice born to infected and noninfected mothers following subsequent challenge

This study was to investigate the differences between neonate mice born to Schistosoma japonicum-infected mothers and those born to noninfected mothers in subsequent challenge. The intensity of infection (evidenced by worm burden and liver egg burden) and liver immunopathology (number and size of liver granulomas) were significantly reduced in neonates from infected mothers (I.M.) compared with neonates from noninfected mothers (N.M.). Anti-soluble worm antigen of S. japonicum (SWA) IgG could be detected in sera of neonates from I.M. (N.N./I.M.) at 1 week after delivery, remained a plateau for 2 weeks and gradually decreased until 8 weeks of age. Parasite-specific IgM was not detected in sera from N.N./I.M. at any time after delivery. At 6 weeks after infection, the level of anti-SWA IgG in infected neonates from I.M. (I.N./I.M.) was significantly higher than that of infected neonates from N.M. (I.N./N.M.). In addition, production of IFN-γ, IL-12 and TGF-β by cultured splenocytes from I.N./I.M. was significantly increased, while the level of IL-4 was significantly decreased when compared to those from I.N./N.M.. These data demonstrate that congenital exposure to schistosomiasis japonica may render neonatal mice born to I.M. less susceptible to subsequent challenge and result in down-regulation of both infection intensity and immunopathology.

Towards improved diagnosis of zoonotic trematode infections in Southeast Asia

Humans in Southeast Asia are at risk for at least 70 species of food-borne and water-borne trematodes, including blood flukes, intestinal flukes, liver flukes and lung flukes, which are shared with a great variety of animals. Co-infection with several other zoonotic trematodes is pervasive, and hence differential diagnosis represents a major challenge. Many zoonotic trematodes are commonly overlooked, leading to unreliable prevalence data, underappreciation of their veterinary and public health burden and impact, and general neglect with respect to treatment and control. Additionally, many eggs are indistinguishable by microscopy. For example, failure to address this diagnostic dilemma has resulted in overestimation of Clonorchis sinensis prevalence and underestimation of minute intestinal flukes. Test insensitivity is becoming a problem of prime interest as surveillance is gaining in importance and various control programmes now regularly register progress. Hence, the likelihood of underestimating the true burden of disease is growing in well-controlled areas when the faecal egg excretion among infected individuals approaches zero. While antibody testing has ultimate sensitivity, its use as a test of cure remains contentious. On the other hand, employing faecal egg detection as the diagnostic 'gold' standard makes many positive antibody test results (incorrectly) appear false. Polymerase chain reaction (PCR)-based diagnostics could solve this dilemma, but more experience is needed and costs must be brought down to permit large-scale use of this approach. The future development of virtual microscopy to be used for diagnosis of parasitic infections in the field could make ordinary microscopy obsolete by electronically capturing specimens at point-of-contact in remote areas.

Hepatic changes in congenital Schistosoma japonicum infections in pigs

The inflammatory response in liver tissue from piglets congenitally infected with Schistosoma japonicum was examined at two different timepoints after infection. The piglets, which were the offspring of three sows infected with 9000 S. japonicum cercariae in the 10th week of gestation, were allocated into two groups (n=9 and 17) killed 5 or 11 weeks after birth, respectively. All piglets developed a low level infection,with no significant difference between the groups. Inflammatory lesions in the liver consisted mainly of granulomas in portal areas, often obliterating the portal veins, and frequently with central eggs or egg remnants. The granulomatous reaction consisted of epithelioid cells and occasional giant cells surrounded by layers of lymphocytes, eosinophils, plasma cells, and various amounts of collagen and fibroblasts. Mild to moderate infiltration of portal and septal connective tissue with eosinophils and lymphocytes was common, but the connective tissue was generally not increased. At the two timepoints, slight differences were observed in the numbers of eosinophils and lymphocytes in the granulomas and in the size of the granulomatous reaction. The same pattern of immunohistochemical labelling was seen in both groups. CD79alpha(+) B cells were scarce except in granuloma-associated lymphoid follicles;the majority of lymphocytes in granulomas and at other sites were CD3epsilon(+) T cells. The granulomatous reaction in the livers of piglets to schistosoma eggs from prenatal S. japonicum infection was similar to that seen in postnatal infection. Signs of immunomodulation of granulomas between the two timepoints of infection were not demonstrable.

Schistosomiasis and pregnancy

Currently, schistosomes infect approximately 40 million women of child-bearing age, yet little is known about schistosome-associated morbidity in pregnant women and their offspring. Animal models indicate a deleterious effect of schistosome infection on maternal, fetal and neonatal outcomes. Case reports have documented maternal infection in association with poor birth outcomes, and two observational studies indicate that maternal schistosome infection might be associated with decreased birth weight. Rigorously identifying and quantifying the impact of schistosome infection on pregnancy outcomes with well-designed observational and treatment studies are crucial for improving birth outcomes in schistosome-endemic areas. In addition, studies that address the safety of praziquantel during pregnancy could lead to further adoption of the recent informal recommendation by the World Health Organization to treat schistosome-infected pregnant and lactating women.

Cytokine mRNA profiles in pigs exposed prenatally and postnatally to Schistosoma japonicum

The pig is a natural host for Schistosoma japonicum and a useful animal model of human infection. The aim of the present study was to assess the differences between the cytokine profiles in prenatally or postnatally S. japonicum exposed pigs. Seven prenatally exposed pigs, 7 postnatally exposed pigs and 4 uninfected control pigs were compared 27 weeks post exposure. Variables included worm burdens, tissue egg counts, liver pathology and mRNA levels of IL-2, IL-4, IL-10, IL-12, TNF-alpha, TGF-beta1 and IFN-gamma in the liver and the caecum, assessed by RT-PCR. Infection intensity and level of septal fibrosis were significantly higher in the postnatal group compared to the prenatal group (P < 0.05). A significant increase of IL-4 (P < 0.01), IL-10 (P < 0.01), IL-12 (P < 0.01) and TNF-alpha (P < 0.05) mRNA level was also observed in the caecum of prenatally infected animals compared to the control group (P < 0.01). The prenatal group showed higher levels of TGF-beta1 in the liver compared with the postnatally infected group (P< 0.05) and the control group (P< 0.01). This suppressive immune response correlated with previously reported low hepatic pathogenesis in prenatally exposed pigs.

Immunity to schistosomiasis in animals: an update

The present paper reviews the available literature on the development of immunity to animal Schistosoma infections. The majority of the studies on animal schistosomiasis were performed in cattle and pigs and only Schistosoma mattheei, S. bovis and S. japonicum received particular attention, mainly because of their recognized veterinary significance or zoonotic aspect. Although it is an accepted fact that acquired resistance to Schistosoma is of major importance in the regulation of infection intensity in the field, almost nothing is yet known of either the nature of the antigens or of the immune mechanisms involved. The recent studies on immunity development focus in particular on the occurrence of maternal to foetal transfer of immunological substances related to animal Schistosoma infections and possible effects of these transfers on the immunity development of the foetus/newborn. Since congenital infections for Schistosoma species other than S. japonicum are extremely rare, the most plausible route for foetal contact is the transplacental or postnatal transfer of immunological substances. Prenatal transfers of specific antibodies and antigens via placental lesions and postnatal transfers via the colostrum were observed in cattle and pigs, and subsequent modifications of the immune response of the newborn were observed. Placental lesions induced by Schistosoma eggs could allow other pathogens to cross the placenta.

The effect of colostrum on pigs pre-natally or post-natally exposed toSchistosoma japonicum

Pre-natal infection ofSchistosoma japonicumin pigs may prove to be a useful model in shedding light on human pre-natal schistosomiasis. This study describes the effects of immune colostrum on worm burdens, tissue egg counts, liver pathology and crude worm or egg antigen-specific IgG and IgA responses, in groups of pigs pre-natally, pre-natally+post-natally or post-natally exposed toS. japonicum. Results suggest that pre-natal exposure and immune colostrum did not affect the establishment of a post-natal challenge infection. However, immune colostrum seemed to increase the levels of septal fibrosis in pre-natally exposed pigs. These findings indicate that further investigations will prove valuable, elucidating the influence of the parasitological and immunological status of the sow, on pre-natally exposed pigs, and on the ability of these pigs to develop resistance againstS. japonicumlater in life.

PRENATAL SCHISTOSOMA JAPONICUM INFECTION IN PIGLETS: EFFECT OF REPEATED EXPOSURE OF THE DAMS ON TREATMENT EFFICACY AND SUSCEPTIBILITY TO CHALLENGE INFECTIONS

This study elucidated the fate of prenatal infections in piglets born by dams repeatedly infected before and during pregnancy with Schistosoma japonicum. Independent variables included repeated infections of the dams and treatment or challenge infection (or both) of the prenatally exposed piglets. Dependant variables were worm counts, fecal and tissue egg counts, weight gain, and gross pathological observations. Fifteen female piglets (the dams) were included, of which 6 received repeated infections with S. japonicum during 6 mo. All dams were inseminated and 10 wk pregnant; 12 of the dams were infected with S. japonicum, of which 6 had been repeatedly infected. Three dams remained uninfected. Eight weeks after delivery, the prenatally exposed piglets (the offspring) were grouped, and 6 of the 12 groups were treated with praziquantel. Four weeks after treatment, 5 groups of piglets were infected with S. japonicum. Groups of piglets were killed either 12 or 22 wk after delivery. Repeated infections of the dam did not prevent establishment of a congenital infection in the pig fetuses. Piglets born with a congenital infection were not resistant to a S. japonicum challenge infection given 12 wk after birth. Neither did praziquantel effectively cure the piglets nor did treatment of the prenatally infected piglets prevent establishment of a challenge infection given 4 wk after treatment. Results of the present study indicate that prenatal exposure, independently of the dam's infection status, may change the host response to challenge infections and treatment after birth.