Study on Centrocestus armatus in Korea. II. Recovery rate, growth and development of worms in albino rats

Infections with Centrocestus armatus Metacercariae in Fishes from Water Systems of Major Rivers in Republic of Korea

The infection status of Centrocestus armatus metacercariae (CaMc) was broadly surveyed in freshwater fishes from major river systems in the Republic of Korea (Korea) during 2008–2017. A total of 14,977 fishes was caught and examined by the artificial digestion method. CaMc were detected in 3,818 (97.1%) (2,114 Z. platypus: 96.1% and 1,704 Z. temminckii: 98.4%) out of 3,932 Zacco spp. examined and their density was 1,867 (2,109 in Z. platypus and 1,567 in Z. temminckii) per fish infected. The prevalences with CaMc were high, 93.7–100%, in Zacco spp. from all surveyed areas. However, their densities were more or less different by the surveyed areas and fish species. They were most high in Nakdong-gang in Gyeongsangnam-do (4,201 in average), and followed by Geum-gang (2,343), Nakdong-gang in Gyeongsangbuk-do (1,623), Han-gang (1,564), Tamjin-gang and Yeongsan-gang (1,540), streams in the east coast (1,028), Seomjin-gang (488) and Mangyeong-gang (170). In another species of rasborinid fish, Opsariichthys uncirostris amurensis, CaMc were detected in 222 (74.8%) out of 297 ones examined and their density was 278 (1–4,480) per fish infected. CaMc were also detected in total 41 fish species except for the rasborinid fish, Z. platypus, Z. temminckii and O. uncirostris amurensis. Conclusively, it was confirmed that among the 3 species of rasborinid fish, Z. platypus and Z. temminckii are highly prevalent and O. uncirostris amurensis is moderately prevalent with CaMc. Additionally, we could know that variety of fish species act as the second intermediate hosts of C. armatus in Korea.

Fishborne zoonotic heterophyid infections: An update

Fishborne heterophyid trematodes infecting humans are at least 29 species worldwide and belong to 13 genera. Its global burden is much more than 7 million infected people. They include Metagonimus (M. yokogawai, M. takahashii, M. miyatai, M. minutus, and M. katsuradai), Heterophyes (H. heterophyes, H. nocens, H. dispar, and H. aequalis), Haplorchis (H. taichui, H. pumilio, H. yokogawai, and H. vanissimus), Pygidiopsis (P. summa and P. genata), Heterophyopsis (H. continua), Stellantchasmus (S. falcatus), Centrocestus (C. formosanus, C. armatus, C. cuspidatus, and C. kurokawai), Stictodora (S. fuscata and S. lari), Procerovum (P. varium and P. calderoni), Acanthotrema (A. felis), Apophallus (A. donicus), Ascocotyle (A. longa), and Cryptocotyle (C. lingua). Human infections are scattered around the world but the major endemic areas are located in Southeast Asia. The source of human infection is ingestion of raw or improperly cooked fish. The pathogenicity, host-parasite relationships, and clinical manifestations in each species infection are poorly understood; these should be elucidated particularly in immunocompromised hosts. Problems exist in the differential diagnosis of these parasitic infections because of close morphological similarity of eggs in feces and unavailability of alternative methods such as serology. Molecular diagnostic techniques are promising but they are still at an infant stage. Praziquantel has been proved to be highly effective against most of the patients infected with heterophyid flukes. Epidemiological surveys and detection of human infections are required for better understanding of the geographical distribution and global burden of each heterophyid species. In this review, the most updated knowledge on the morphology, biology, epidemiology, pathogenesis and pathology, immunology, clinical manifestations, diagnosis and treatment, and prevention and control of fishborne zoonotic heterophyid infections is provided.

Optimization of an experimental model for the recovery of adult Haplorchis pumilio (Heterophyidae: Digenea)

Recent studies in Vietnam and other Asian countries have shown that fish-borne zoonotic intestinal trematodes (FZT) occur very frequently in humans. The dominant intestinal FZT in Vietnamese fish are species of Haplorchis, in particular H. pumilio. However, basic studies on the biology and pathology of adult H. pumilio are difficult because of the lack of a standardized experimental animal model. The objective of this study was to establish and optimize such an animal-infection model for H. pumilio. Using metacercariae isolated from naturally infected fish, experiments were conducted to identify a suitable experimental animal host species, as well as the optimum metacercariae infection dose, and to determine the post-infection interval for patency. In a series of experiments, mice (Mus musculus) and chickens (Gallus gallus dom.) were infected with different numbers of metacercariae, and worm recoveries were made at varying intervals post-infection (PI). Based on the mean number of adult flukes recovered/number of metacercariae inoculated and the percent of hosts infected, mice were significantly more susceptible to infection than were chickens. The proportion of metacercariae developing to the adult stage increased with dose size. The peak worm recovery (geometric mean) was found to be day 7, although not all recovered flukes were gravid until day 9 PI. These results describe a mouse infection model with good predictability for intestinal flukes, such as H. pumilio, results which could facilitate investigations on important biological and pathological aspects of intestinal fluke infections.

Haplorchis taichui: worm recovery rate and immune responses in infected rats (Rattus norvegicus)

Worm recovery rate, mucosal mast cells (MMCs), eosinophils and serum IgE concentration in rats were investigated after orally feeding 300 Haplorchis taichui metacercariae to male rats. The duodenal, jejunal and ileal tissue sections were stained with 1% alcian blue and 0.5% safranin-O for MMC count. Eosinophil count and the serum IgE concentration assay were measured from cardiac puncture blood. The average worm recovery rates were 20.00%, 13.00%, 0.67%, 1.67% and 0.00% on day 3, 7, 14, 21 and 28 post-infection (PI), respectively. The number of MMCs in the infected rats were significantly higher than in the controls (P<0.01), reaching a peak on day 21 PI. They decreased thereafter, with the decline in worm recovery. Eosinophil count and Serum IgE concentration were also increased but not significantly higher than the controls. However, they showed a positive relationship to worm recovery. It could be concluded from the results that MMCs, eosinophils and IgE may play an important role in the expulsion of H. taichui from rat intestine. However, the mechanism by which the MMC result in the helminth expulsion still need to be understood, and it is recommended that other cells such as goblet cells be studied further.

Development of Centrocestus armatus in different final hosts

In this study, Centrocestus armatus metacercariae were fed orally to hamsters, albino rats, mice, and chicks. Animals were sacrificed and dissected at 1, 3, 5, 7, and 14 days post-infection to determine the development and recovery rate of worms. Results indicated that the average worm recovery rate in hamsters was 25% on the first day post-infection and recovery continued until the 14th day with a gradual decrease in the percentage. Worms were also recovered from mice and albino rats from the first until the third day post-infection, but no worms were recovered thereafter. In chicks, worms were not observed on first day but recovery was positive at 12 h post-infection. Among the four animal hosts, feces from hamsters were the only ones positive for eggs; these were initially observed from the third day and recovery continued until 14 days post-infection. In our study, hamsters are the animal model most suitable for the study of C. armatus when compared to rats, mice, and chicks.

Growth and development of Massaliatrema misgurni (Trematoda: Heterophyidae) in mice and its metacercarial morphology

The morphology of metacercariae of Massaliatrema misgurni Ohyama et al. (Ohyama et al., Parasitol Int 2001; 50; 267-71) was described, and their infectivity, egg output, growth and development in mice until day 35 post infection (PI) were studied. Metacercarial cysts from loaches imported from China to Japan were 199-349 microm in diameter and consisted of a very thick translucent outer layer and a refractile inner layer. Excysted metacercariae basically had the shape of miniature adults, and a pair of pre-developed testes but no other genital organs were recognized. The worm recovery rate from mice was 36.7-51.7% during days 3-7 PI, and decreased remarkably to 2.5 and 1.7% at days 28 and 35 PI. The prepatent period was 3-4 days, and the egg output quickly increased and sustained high levels at days 5-7 PI, then decreased suddenly at day 8 PI, and continued at a low level until day 28 PI. The size of the body and inner organs such as the oral sucker, pharynx, acetabulum, testes, ovary and seminal receptacle quickly increased until day 3 PI, and sustained at a plateau level until day 21 PI except testes which gradually decreased until 21 PI. The number of the uterine eggs increased with a short time lag compared to other genital organs and sustained a plateau level until day 21 PI. Compared with other Heterophyidae species, M. misgurni was characterized by the remarkably fast growth and development.

Food-borne intestinal trematode infections in the Republic of Korea

A total of 19 species of food-borne intestinal trematodes have been reported in humans in the Republic of Korea. They include 12 species of the Heterophyidae, Metagonimus yokogawai, M. takahashii, M. miyatai, Heterophyes nocens, H. heterophyes (imported), H. dispar (imported), Heterophyopsis continua, Pygidiopsis summa, Stellantchasmus falcatus, Centrocestus armatus, Stictodora fuscata, and S. lari; four species of the Echinostomatidae, Echinostoma hortense, E. cinetorchis, Echinochasmus japonicus, and Acanthoparyphium tyosenense; and one species each of the Neodiplostomidae, Neodiplostomum seoulense, Plagiorchiidae, Plagiorchis muris, and Gymnophallidae, Gymnophalloides seoi. Fresh water fish harbor the metacercarial stage of M. yokogawai, M. takahashii, M. miyatai, C. armatus, E. hortense, E. cinetorchis, E. japonicus, or P. muris. Brackish water fish serve as the second intermediate hosts for H. nocens, H. continua, P. summa, S. falcatus, S. fuscata, and S. lari. Brackish water bivalves are the source of infection with A. tyosenense. Tadpoles and frogs are the second intermediate hosts for N. seoulense, but the major source of human infection is the grass snake Rhabdophis tigrina, a paratenic host. The metacercariae of G. seoi are observed in oysters. The natural definitive hosts are, in most cases, mammals such as rats, cats and dogs. However, several species (C. armatus, S. lari, E. japonicus, A. tyosenense, and G. seoi) have birds as natural definitive hosts. Host-parasite relationships, pathogenesis and pathology, immunity, clinical aspects, differential diagnosis, treatment, prevention and control of these intestinal trematodes are briefly discussed.

Surface ultrastructure of juvenile and adult stages of Centrocestus armatus

Centrocestus armatus (Trematoda: Heterophyidae) develops rapidly and produces eggs at 3 days postinfection in albino rats. Excysted metacercariae are pear-shaped and concave ventrally, with 42-44 peg-like circumoral spines. The entire body surface is densely covered with scale-like serrated spines. On juveniles, serration of the tegumental spines is greatest in the middle of the ventral and dorsal surfaces, and decreases anteriorly and posteriorly. Ciliated sensory papillae are concentrated around the oral sucker. Several nonciliated sensory papillae (type II papillae) occur equidistantly on the acetabulum and are arranged in a linear symmetry on the dorsal surface. On adults, the serration of the tegumental spines decreases to 14-17 tips on the ventrolateral surface. The high density of tegumental spines on posterior half of the body and the distribution of type II papillae on dorsal surface are considered to be characteristic of C. armatus.

Intestinal pathologic findings at early stage infection by Centrocestus armatus in albino rats

This study was performed to observe intestinal pathology in early infection by Centrocestus armatus. The flukes were in the lowermost part of the intervillous space of the duodenum and jejunum from 1 day to 7 days postinfection (PI). The stroma of villi around the young fluke was edematous and infiltrated by inflammatory cells such as lymphocytes, plasma cells and eosinophils. The crypt became mildly hyperplastic and villi were moderately atrophied at 4 days PI. The intestinal lesion produced was confined to the areas around the fluke. The pathologic findings were not significantly different between 1,000 and 5,000 metacercariae infection groups. It is suggested that the lesion should be produced by mechanical destruction of the fluke on the enteroepithelial cells.

Recovery rate, growth and development of Heterophyopsis continua in experimental chicks

The growth and developmental pattern of H. continua was observed after experimental infection of their metacercariae to chicks. The recovery rate of worms from the chicks at 1 to 28 days post-infection (PI) was 12.8% in average. The rate remained fairly high for early 4 days of infection but decreased thereafter rapidly till 28 days PI. Most of the flukes, 91.9%, were recovered from the ileum of the chicks. In metacercariae, genital organs such as the ovary, testes, seminal vesicle, seminal receptacle and genital sucker were recognizable. At one day PI Mehlis' gland appeared, and at 2 days follicular vitellaria were observed. At 3 days PI, eggs were formed in the uterine tubule and increased in number as the worm grew old. The worms reached 2,990 microns in length and 525 microns in width at 28 days PI. Genital organs developed rapidly in early stages of infection but slowly thereafter to 28 days PI, whereas non-genital organs developed steadily through the infection period. It was proved by this experiment that chicks should be a moderately suitable final host of H. continua.

[Study on Centrocestus armatus in Korea. I. Infection status of Zacco platypus and Z. temminckii with the metacercariae of C. armatus]

This study was performed to observe the infection rate and infection intensity of fresh water fish such as pale chub (Z. platypus) and dark chub (Z. temminckii) with the metacercariae of C. armatus. The fish were caught in several rivers and streams from June to September, 1988 and examined by artificial digestion technique. Total 370 fish were caught at 19 rivers. The metacercarial (C. armatus) infection rate and average burden in Z. platypus were 86.8% and 224, and those in Z. temminckii were 78.5% and 131. The infection rate and burden per fish were 73.4% and 32 in the fish caught from the Han river, and 88.0% and 44 from the Youngsan river. All fish caught from the Keum and the Tamjin river were infected and their mean metacercarial density was 45 and 59 respectively. The infection rate and density in fish caught from the Seomjin and Nagdong rivers were 100% and 119, and 81.0% and 348 respectively. From this study, it is confirmed that C. armatus is widely distributed along 5 major rivers in Korea.