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Mohanty MC, Desai M, Mohammad A, Aggarwal A, Govindaraj G, Bhattad S, Lashkari HP, Rajasekhar L, Verma H, Kumar A, Sawant U, Varose SY, Taur P, Yadav RM, Tatkare M, Fernandes M, Bargir U, Majumdar S, Edavazhippurath A, Rangarajan J, Manthri R, Madkaikar MR. Assessment of Enterovirus Excretion and Identification of VDPVs in Patients with Primary Immunodeficiency in India: Outcome of ICMR-WHO Collaborative Study Phase-I. Vaccines (Basel) 2023; 11:1211. [PMID: 37515027 PMCID: PMC10383878 DOI: 10.3390/vaccines11071211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 07/30/2023] Open
Abstract
The emergence of vaccine-derived polioviruses (VDPVs) in patients with Primary Immunodeficiency (PID) is a threat to the polio-eradication program. In a first of its kind pilot study for successful screening and identification of VDPV excretion among patients with PID in India, enteroviruses were assessed in stool specimens of 154 PID patients across India in a period of two years. A total of 21.42% of patients were tested positive for enteroviruses, 2.59% tested positive for polioviruses (PV), whereas 18.83% of patients were positive for non-polio enteroviruses (NPEV). A male child of 3 years and 6 months of age diagnosed with Hyper IgM syndrome was detected positive for type1 VDPV (iVDPV1) with 1.6% nucleotide divergence from the parent Sabin strain. E21 (19.4%), E14 (9%), E11 (9%), E16 (7.5%), and CVA2 (7.5%) were the five most frequently observed NPEV types in PID patients. Patients with combined immunodeficiency were at a higher risk for enterovirus infection as compared to antibody deficiency. The high susceptibility of PID patients to enterovirus infection emphasizes the need for enhanced surveillance of these patients until the use of OPV is stopped. The expansion of PID surveillance and integration with a national program will facilitate early detection and follow-up of iVDPV excretion to mitigate the risk for iVDPV spread.
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Affiliation(s)
| | - Mukesh Desai
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Mumbai 400012, India
| | - Ahmad Mohammad
- World Health Organization, Country Office, New Delhi 110011, India
| | - Amita Aggarwal
- Department of Clinical Immunology & Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
| | - Geeta Govindaraj
- Department of Pediatrics, Government Medical College, Kozhikode 673008, India
| | - Sagar Bhattad
- Department of Pediatrics, Aster CMI Hospital, Bangalore 560092, India
| | | | - Liza Rajasekhar
- Department of Clinical Immunology and Rheumatology, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India
| | - Harish Verma
- World Health Organization, CH-1211 Geneva, Switzerland
| | - Arun Kumar
- World Health Organization, Country Office, New Delhi 110011, India
| | - Unnati Sawant
- Mumbai Unit, ICMR-National Institute of Virology (ICMR-NIV), Mumbai 400012, India
| | | | - Prasad Taur
- Department of Immunology, Bai Jerbai Wadia Hospital for Children, Mumbai 400012, India
| | - Reetika Malik Yadav
- ICMR-National Institute of Immunohaematology (ICMR-NIIH), Mumbai 400012, India
| | - Manogat Tatkare
- Mumbai Unit, ICMR-National Institute of Virology (ICMR-NIV), Mumbai 400012, India
| | - Mevis Fernandes
- Mumbai Unit, ICMR-National Institute of Virology (ICMR-NIV), Mumbai 400012, India
| | - Umair Bargir
- ICMR-National Institute of Immunohaematology (ICMR-NIIH), Mumbai 400012, India
| | - Sanjukta Majumdar
- Department of Clinical Immunology & Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
| | | | - Jyoti Rangarajan
- Department of Pediatrics, Aster CMI Hospital, Bangalore 560092, India
| | - Ramesh Manthri
- Department of Clinical Immunology and Rheumatology, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India
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Mohanty MC, Mohammad A, Verma H, Kumar A, Madkaikar MR, Desai M, Varose SY, Sawant U, Yadav RM, Taur P, Kathuria R, Tatkare M, Murhekar M, Haldar P, Abraham P. Poliovirus surveillance in patients with primary immunodeficiencies, India. Bull World Health Organ 2023; 101:346-354. [PMID: 37131936 PMCID: PMC10140681 DOI: 10.2471/blt.22.289066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Individuals with primary immunodeficiencies who are infected with vaccine-derived polioviruses may continue to shed poliovirus for months and go undetected by surveillance programmes of acute flaccid paralysis. These patients therefore pose a risk of initiating poliovirus outbreaks that jeopardize efforts towards global polio eradication. To identify these individuals, we designed a study protocol for the establishment of a network for surveillance of immunodeficiency-related vaccine-derived poliovirus in India. In the first step we identified recognized centres in India that could diagnose and enrol patients with primary immunodeficiency disorder into the study. Stool sample collection from study sites, culture, isolation, characterization of enteroviruses and reporting to study sites was carried out at the National Institute of Virology Mumbai Unit, as per the WHO national polio surveillance project protocol. In the first phase of the study from January 2020 to December 2021, we implemented the protocol at seven study sites at different medical institutes to determine the proportion of poliovirus infections in primary immunodeficiency disorder patients of India. We later expanded the study by including an additional 14 medical institutes across the country in the second phase running from January 2022 to December 2023. We believe this study protocol will help other countries to initiate immunodeficiency-related vaccine-derived poliovirus surveillance to identify and follow up patients who are long-term excretors of vaccine-derived poliovirus. Integration of immunodeficiency-related poliovirus surveillance with acute flaccid paralysis surveillance of the existing poliovirus network will enhance continuous screening of patients with primary immunodeficiency disorder in the future.
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Affiliation(s)
- Madhu Chhanda Mohanty
- National Institute of Virology Mumbai Unit, Indian Council of Medical Research, Haffkine Institute Campus, Acharya Donde Marg, Parel, Mumbai-400012, India
| | - Ahmad Mohammad
- World Health Organization Country Office, New Delhi, India
| | - Harish Verma
- Polio Eradication, World Health Organization, Geneva, Switzerland
| | - Arun Kumar
- World Health Organization Country Office, New Delhi, India
| | | | - Mukesh Desai
- Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Swapnil Yashwant Varose
- National Institute of Virology Mumbai Unit, Indian Council of Medical Research, Haffkine Institute Campus, Acharya Donde Marg, Parel, Mumbai-400012, India
| | - Unnati Sawant
- National Institute of Virology Mumbai Unit, Indian Council of Medical Research, Haffkine Institute Campus, Acharya Donde Marg, Parel, Mumbai-400012, India
| | - Reetika Malik Yadav
- National Institute of Immunohaematology, Indian Council of Medical Research, Mumbai, India
| | - Prasad Taur
- Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | | | - Manogat Tatkare
- National Institute of Virology Mumbai Unit, Indian Council of Medical Research, Haffkine Institute Campus, Acharya Donde Marg, Parel, Mumbai-400012, India
| | - Megh Murhekar
- National Institute of Virology Mumbai Unit, Indian Council of Medical Research, Haffkine Institute Campus, Acharya Donde Marg, Parel, Mumbai-400012, India
| | | | - Priya Abraham
- National Institute of Virology, Indian Council of Medical Research, Pune, India
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Mohanty MC, Taur PD, Sawant UP, Yadav RM, Potdar V. Prolonged Fecal Shedding of SARS-CoV-2 in Asymptomatic Children with Inborn Errors of Immunity. J Clin Immunol 2021; 41:1748-1753. [PMID: 34528161 PMCID: PMC8443305 DOI: 10.1007/s10875-021-01132-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/31/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Madhu Chhanda Mohanty
- ICMR-National Institute of Virology, Mumbai Unit, Indian Council of Medical Research, Haffkine Institute Campus, Acharya Donde Marg, Parel, Mumbai, 400012, India.
| | - Prasad D Taur
- Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India
| | - Unnati Prashant Sawant
- ICMR-National Institute of Virology, Mumbai Unit, Indian Council of Medical Research, Haffkine Institute Campus, Acharya Donde Marg, Parel, Mumbai, 400012, India
| | | | - Varsha Potdar
- ICMR-National Institute of Virology, National Influenza Center (NIC), Pune, India
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Mohanty MC, Varose SY, Saxena VK. Susceptibility and cytokine responses of human neuronal cells to multiple circulating EV-A71 genotypes in India. Sci Rep 2021; 11:17751. [PMID: 34493781 PMCID: PMC8423732 DOI: 10.1038/s41598-021-97166-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/23/2021] [Indexed: 11/26/2022] Open
Abstract
Enterovirus-A71 (EV-A71) associated Hand, foot and mouth disease (HFMD) is a highly contagious viral infection affecting children in Asia–Pacific region and has become a major threat to public health. Although several EV-A71 genotypes (C, D, and G) were isolated in India in recent years, no recognizable outbreak of EV-A71 caused HFMD, Acute Flaccid paralysis (AFP) or encephalitis have been reported so far. It is essential to study the pathogenicity or cell tropism of these Indian isolates in order to understand their tendency to cause disease. We investigated the susceptibility and cytokine responses of indigenous EV-A71 genotypes (D and G) isolated from cases of AFP and genotype C viruses isolated from cases of HFMD and encephalitis, in human cells in-vitro. Although all three EV-A71 genotypes could infect and replicate in human muscle and neuronal cells, the genotype D virus showed a delayed response in human neuronal cells. Quantification of cytokine secretion in response to these isolates followed by confirmation with gene expression assays in human neuronal cells revealed significantly higher secretion of pro-inflammatory cytokines TNF-α IL-8, IL-6, IP-10 (p < 0.001) in G genotype infected cells as compared to pathogenic C genotypes whereas the genotype D virus could not induce any of the inflammatory cytokines. These findings will help to better understand the host response to indigenous EV-A71 genotypes for management of future EV-A71 outbreaks in India, if any.
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Affiliation(s)
- Madhu Chhanda Mohanty
- ICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Haffkine Institute Campus, Acharya Donde Marg, Parel, Mumbai, 400012, India.
| | - Swapnil Yashavant Varose
- ICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Haffkine Institute Campus, Acharya Donde Marg, Parel, Mumbai, 400012, India
| | - Vinay Kumar Saxena
- ICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Haffkine Institute Campus, Acharya Donde Marg, Parel, Mumbai, 400012, India
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Mohanty MC, Varose SY, Sawant UP, Fernandes MM. Expression of innate immune response genes in upper airway samples of SARS-CoV-2 infected patients: A preliminary study. Indian J Med Res 2021; 153:677-683. [PMID: 34528526 PMCID: PMC8555587 DOI: 10.4103/ijmr.ijmr_131_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background & objectives Upper respiratory mucosa is the entryway for SARS-CoV-2, and cells at this site form the first line of resistance against the pathogens. Innate immune response at this point is crucial for managing the replication and early stage symptoms of virus infection. This study was aimed to evaluate the expression of pattern recognition receptors and cytokines in upper airway cells of SARS-CoV-2 infected patients. Methods Forty seven nasopharyngeal swab (NPS) specimens from 25 SARS-CoV-2 infected patients and 22 SARS-CoV-2 negative individuals were investigated for expression of toll-like receptors (TLRs), melanoma differentiation-associated protein 5 (MDA5), NOD-like receptors family pyrin domain containing 3 (NLRP3), angiotensin-converting enzyme 2 (ACE2), interleukin (IL) - 6, tumour necrosis factor alpha (TNFα) and type-1 interferons (IFNs) by real time reverse transcription polymerase chain reaction. Results Increased expression of TLR2, MDA5 and ACE2 was detected in SARS-CoV-2 infected patients in comparison with controls. MDA5 expression was significantly higher in asymptomatic and mildly symptomatic SARS-CoV-2 positive patients than the patients with severe symptoms. The asymptomatic group showed significant induction of type 1 IFNs than the symptomatic group. Non-specific induction of TLR7 could be observed in nasopharyngeal (NP) cells irrespective of symptoms and SARS-CoV-2 positivity. Interpretation & conclusions The findings suggest that increased MDA5 in NP cells of asymptomatic SARS-CoV-2 positive patients may subsequently induce type 1 IFNs to protect the individuals from further clinical severity of SARS-CoV-2 infection. A future prospective study in NPS of larger cohort needs to be performed to confirm our findings.
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Affiliation(s)
- Madhu Chhanda Mohanty
- ICMR-National Institute of Virology, Mumbai Unit, Indian Council of Medical Research, Haffkine Institute Campus, Mumbai, Maharashtra, India
| | - Swapnil Yashwant Varose
- ICMR-National Institute of Virology, Mumbai Unit, Indian Council of Medical Research, Haffkine Institute Campus, Mumbai, Maharashtra, India
| | - Unnati Prashant Sawant
- ICMR-National Institute of Virology, Mumbai Unit, Indian Council of Medical Research, Haffkine Institute Campus, Mumbai, Maharashtra, India
| | - Mevis Minin Fernandes
- ICMR-National Institute of Virology, Mumbai Unit, Indian Council of Medical Research, Haffkine Institute Campus, Mumbai, Maharashtra, India
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Mohanty MC, Madkaikar MR, Desai M, Aluri J, Varose SY, Taur P, Sharma DK, Nalavade UP, Rane SV, Gupta M, Shabarish S, Dalvi A, Deshpande JM. Natural Clearance of Prolonged VDPV Infection in a Child With Primary Immunodeficiency Disorder. Front Immunol 2019; 10:1567. [PMID: 31396204 PMCID: PMC6663979 DOI: 10.3389/fimmu.2019.01567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 06/24/2019] [Indexed: 12/21/2022] Open
Abstract
The emergence of immunodeficiency-associated vaccine-derived polioviruses (iVDPV) from children with primary immunodeficiency disorders poses a threat to the eradication program. Herein, we report a patient with severe combined immunodeficiency (SCID), identified as a prolonged serotype 3 iVDPV (iVDPV3) excreter with 13 VDPV3 isolates and a maximum of 10.33% nucleotide divergence, who abruptly cleared infection after a period of 2 years. Occurrence of an episode of norovirus diarrhea associated with increased activated oligoclonal cytotoxic T cells, inverse CD4:CD8 ratio, significantly elevated pro-inflammatory cytokines, and subsequent clearance of the poliovirus suggests a possible link between inflammatory diarrheal illness and clearance of iVDPV. Our findings suggest that in the absence of B cells and sufficiently activated T/NK cells, macrophages and other T cells may produce auto-inflammatory conditions by TLR/RLR ligands expressed by previous/ongoing bacterial or viral infections to clear VDPV infection. The study highlights the need to screen all the patients with combined immunodeficiency for poliovirus excretion and intermittent follow-up of their immune parameters if found positive, in order to manage the risk of iVDPV excretion in the polio eradication endgame strategy.
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Affiliation(s)
- Madhu Chhanda Mohanty
- ICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Mumbai, India
| | - Manisha Ranjan Madkaikar
- ICMR-National Institute of Immunohaematology, Indian Council of Medical Research, KEM Hospital, Mumbai, India
| | - Mukesh Desai
- Bai Jer Bai Wadia Childrens Hospital, Mumbai, India
| | - Jahnavi Aluri
- ICMR-National Institute of Immunohaematology, Indian Council of Medical Research, KEM Hospital, Mumbai, India
| | - Swapnil Yashwant Varose
- ICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Mumbai, India
| | - Prasad Taur
- Bai Jer Bai Wadia Childrens Hospital, Mumbai, India
| | - Deepa Kailash Sharma
- ICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Mumbai, India
| | - Uma Prajwal Nalavade
- ICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Mumbai, India
| | - Sneha Vijay Rane
- ICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Mumbai, India
| | - Maya Gupta
- ICMR-National Institute of Immunohaematology, Indian Council of Medical Research, KEM Hospital, Mumbai, India
| | - Snehal Shabarish
- ICMR-National Institute of Immunohaematology, Indian Council of Medical Research, KEM Hospital, Mumbai, India
| | - Aparna Dalvi
- ICMR-National Institute of Immunohaematology, Indian Council of Medical Research, KEM Hospital, Mumbai, India
| | - Jagadish Mohanrao Deshpande
- ICMR-National Institute of Virology, Mumbai Unit, Formerly Enterovirus Research Centre, Indian Council of Medical Research, Mumbai, India
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Mohanty MC, Madkaikar MR, Desai M, Taur P, Nalavade UP, Sharma DK, Gupta M, Dalvi A, Shabrish S, Kulkarni M, Aluri J, Deshpande JM. Poliovirus Excretion in Children with Primary Immunodeficiency Disorders, India. Emerg Infect Dis 2018; 23:1664-1670. [PMID: 28930011 PMCID: PMC5621533 DOI: 10.3201/eid2310.170724] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Prolonged excretion of poliovirus can occur in immunodeficient patients who receive oral polio vaccine, which may lead to propagation of highly divergent vaccine-derived polioviruses (VDPVs), posing a concern for global polio eradication. This study aimed to estimate the proportion of primary immunodeficient children with enterovirus infection and to identify the long-term polio/nonpolio enterovirus excreters in a tertiary care unit in Mumbai, India. During September 2014–April 2017, 151 patients received diagnoses of primary immunodeficiency (PID). We isolated 8 enteroviruses (3 polioviruses and 5 nonpolio enteroviruses) in cell culture of 105 fecal samples collected from 42 patients. Only 1 patient with severe combined immunodeficiency was identified as a long-term VDPV3 excreter (for 2 years after identification of infection). Our results show that the risk of enterovirus excretion among children in India with PID is low; however, systematic screening is necessary to identify long-term poliovirus excreters until the use of oral polio vaccine is stopped.
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Ravindran B, Satapathy AK, Sahoo PK, Mohanty MC. Protective immunity in human lymphatic filariasis: problems and prospects. Med Microbiol Immunol 2003; 192:41-6. [PMID: 12592562 DOI: 10.1007/s00430-002-0157-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2002] [Indexed: 10/25/2022]
Abstract
Human filariasis caused by lymphatic dwelling nematodes, affecting 120 million persons worldwide, is a major public health problem. Efforts towards development of vaccines for such large tissue-dwelling nematodes depends significantly on identification and demonstration of protective immunity in the exposed population. Immunological studies conducted in human filariasis so far are essentially attempts to establish a correlation of the immune response phenotypes with presence or absence of filarial infections/disease in the host, and the cause-effect relationship between the observed immune responses in the host and protective immunity continues to be conjectural. This short review attempts to clarify the functional definition of protective immunity, problems associated with identification of putatively immune subjects in endemic areas, role of antibodies reactive to surface of microfilariae and larvae stages of filarial parasites and importance of undertaking immunological investigations on a longitudinal basis in different cohorts of subjects presenting with one or the features of infection and/or disease for more accurate delineation of protective immunity in human filariasis.
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Affiliation(s)
- Balachandran Ravindran
- Division of Immunology, Regional Medical Research Centre (Indian Council of Medical Research), Bhubaneswar 7510123, India.
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Abstract
Meriones unguiculatus commonly known as gerbils are widely used as animal models for a variety of parasitic infections such as Brugia malayi, Entamoeba histolytica, Giardia duodenalis, Toxoplasma gondi, Helicobacter pylori, Strongyloides stercoralis and Echinococcus multilocularis. Groups of BALB/c mice, gerbils and XID mice were studied for antibody responses to T-independent antigens. Gerbils were found to be significantly deficient in eliciting antibodies to both dextran and phosphorylcholine (PC) in comparison to BALB/c mice. The antibody response of gerbils to T-independent antigens was found to be similar to the response observed in Bruton's tyrosine kinase (Btk) deficient XID mice, which are known to be poor responders to T-independent antigens. Similar to XID mice, normal gerbil sera were found to be deficient in naturally occurring antibodies to single stranded DNA (SS-DNA), lipopolysaccharide (LPS) and phospholipids. This raises the possibility of a deficiency of CD5+ B-lymphocytes (also known as B-1 cells) in gerbils, since deficiency of this sub-population of B-lymphocytes has been attributed to the absence of such naturally occurring antibodies in XID mice. These results indicate the need to study immunogenicity of parasite T-independent antigens and their relationship to protective immunity in parasitic infections in gerbils.
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Affiliation(s)
- Madhu Chhanda Mohanty
- Division of Applied Immunology, Regional Medical Research Centre, ICMR, Chandrasekharpur, Orissa 751 016, Bhubaneswar, India
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Sahoo PK, Babu Geddam JJ, Satapathy AK, Mohanty MC, Das BK, Acharya AS, Mishra N, Ravindran B. Bancroftian filariasis: a 13-year follow-up study of asymptomatic microfilariae carriers and endemic normals in Orissa, India. Parasitology 2002; 124:191-201. [PMID: 11862995 DOI: 10.1017/s0031182001001007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The natural history of human filarial infections leading to development of disease has been a subject of intense debate. The models proposed so far have largely been based on cross-sectional data on microfilariae (Mf) and disease prevalence in filariasis endemic areas. In an attempt to study the parasitological and clinical consequences of filarial infection in Beldal (Orissa, India), an area endemic for Bancroftian filariasis, cohorts of 59 asymptomatic Mf carriers (AS) and 187 asymptomatic and amicrofilaraemic subjects or 'endemic normals' ('EN'), were followed-up and a fraction (73% and 46% respectively) re-examined after 13 years to monitor (a) Mf prevalence, (b) Mf density, (c) circulating filarial antigen (CFA) and (d) chronic disease manifestations. The Mf prevalence and density were also monitored in Mf carriers after 1 and 4 years. Both Mf prevalence and density decreased progressively in the cohort of Mf carriers over a period of 13 years in Beldal. Only 37% of them continued to be microfilaraemic and the Mf density in these subjects was only 10% of the original level. However, loss of circulating Mf in this cohort did not result in loss of CFA and 95% remained CFA positive regardless of Mf status. About 23% of males in the 'EN' cohort developed hydrocoele while only 5.7% of male Mf carriers, who were not treated with DEC, had developed hydrocoele after 13 years. A cohort of Mf carriers in another area, Jatni, was also examined after 10 years to study the parasitological and clinical outcome. In this area, about 59% of the Mf carriers continued to be microfilaraemic after 10 years. These results reveal that in Mf carriers adult filarial worms persist for several years and that loss of circulating Mf with or without chemotherapy with DEC (single 12-day course) does not influence adult worm survival. The findings have been discussed in the context of 'static' and 'dynamic' models describing the relationship between infection and disease in human filariasis.
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Affiliation(s)
- P K Sahoo
- Division of Immunology, Regional Medical Research Centre, ICMR, Bhubaneswar, Orissa, India
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Abstract
Studies on immune responses to parasites have been undertaken in filariasis with a view to understand protective immunity, pathogenesis of the disease process and mechanisms of immune deviation. However none of the investigations conducted so far on antibody responses have addressed the issue of immunogenicity of filarial carbohydrate antigens in human lymphatic filariasis. In this communication we report details on relative protein and carbohydrate contents of various developmental stages of filarial parasites and antibody responses to filarial proteins (Fil.Pro) and carbohydrates (Fil.Cho) in different clinical spectrum of human bancroftian filariasis. As expected, antibodies of IgM and IgG2 subclass recognized primarily Fil.Cho while IgG4 filarial antibodies recognized exclusively Fil.Pro. Reactivity of IgG3 to Fil.Cho was similar to that of IgG2 while IgG1 more readily recognized Fil.Pro than Fil.Cho. The IgG2 and IgG3 antibodies to Fil.Cho were found to be significantly more in patients with chronic filarial disease and in endemic normals when compared with microfilariae (mf) carriers while IgG4 antibodies to Fil.Pro were significantly more in mf carriers. The dichotomy in reactivity of filarial IgG2, IgG3 and IgG4 was dependent on active filarial infection as indicated by presence of circulating filarial antigen (CFA). Individuals with CFA were found to possess significantly more IgG4 to Fil.Pro than those without CFA while IgG2 and IgG3 levels to Fil.Cho was significantly more in CFA negative subjects when compared to those with CFA. Although IgG1 reacted more readily with Fil.Pro, unlike IgG4, their levels were significantly more in CFA negative subjects when compared to those with active filarial infection. Absorption of sera with phosphorylcholine (PC) resulted in no significant loss of reactivity to Fil.Cho indicating that most of the anticarbohydrate antibodies were recognizing non-PC determinants in human filariasis. Elevated levels of IgG2 and IgG3 antibodies to Fil.Cho in individuals free of filarial infection indicate a possible role for carbohydrate antigens in induction of protective immunity in human filariasis.
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Affiliation(s)
- M C Mohanty
- Division of Immunology, Regional Medical Research Centre, ICMR, Bhubaneswar, India
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Satapathy AK, Sahoo PK, Babu Geddam JJ, Mohanty MC, Ravindran B. Human Bancroftian filariasis: loss of patent microfilaraemia is not associated with production of antibodies to microfilarial sheath. Parasite Immunol 2001; 23:163-7. [PMID: 11240907 DOI: 10.1046/j.1365-3024.2001.00367.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Antisheath antibodies have been incriminated in elimination of circulating microfilariae in human filariasis since a very significant inverse association has been consistently demonstrated between the two parameters. An attempt was made in the present study to seek empirical proof for the above proposal. Two cohorts of 43 and 73 microfilariae (mf) carriers were examined after 13 and 10 years, respectively, for mf as well as antisheath antibodies. The first cohort was also examined for the presence of circulating filarial antigen (CFA). Of the 43 mf carriers examined after 13 years, 62.8% were free of circulating mf although only 3.7% of them had demonstrable antisheath antibodies. Approximately 93% of this cohort (with or without current microfilaraemia) tested positive for CFA after 13 years indicating continued presence of adult filarial worms in the host after loss of mf in circulation. When the second cohort of 73 mf carriers were examined after 10 years, 30 were found to be amicrofilaraemic and only 6.66% of them had demonstrable antisheath antibodies. We conclude that, in human Bancroftian filariasis, elimination of circulating microfilariae may not be mediated by antibodies to microfilarial sheath.
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Affiliation(s)
- A K Satapathy
- Division of Immunology, Regional Medical Research Centre, ICMR, Bhubaneswar, India
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Mohanty MC, Sahoo PK, Satapathy AK, Ravindran B. Setaria digitata infections in cattle: parasite load, microfilaraemia status and relationship to immune response. J Helminthol 2000; 74:343-7. [PMID: 11138024 DOI: 10.1017/s0022149x00000500] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A total of 110 cattle were examined in an area endemic for Bancroftian filariasis for the prevalence of infection of the bovine filarial parasite Setaria digitata. About 12.5% of cattle were found to harbour both adult worms in the peritoneum and microfilariae (mf) in circulation; 70% of the cattle were amicrofilaraemic but with an adult worm infection. A third group of cattle (16.5%) was free of detectable mf and adult worms. The presence of adult worms and/or mf did not influence the antibody levels to any of the four antigen preparations of S. digitata. However, there was a significant inverse relationship between the presence of antibodies to microfilarial sheaths and the absence of circulating mf as shown by the immunoperoxidase assay. Cattle immunoglobulin containing high titres of anti-sheath antibodies cleared circulating microfilariae very effectively in Mastomys coucha thus demonstrating the protective nature of anti-sheath antibodies in eliminating circulating microfilariae in vivo.
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Affiliation(s)
- M C Mohanty
- Division of Immunology, Regional Medical Research Centre (ICMR), Chandrasekharpur, Bhubaneswar 751 016, Orissa, India
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Sahoo PK, Geddam JJ, Satapathy AK, Mohanty MC, Ravindran B. Bancroftian filariasis: prevalence of antigenaemia and endemic normals in Orissa, India. Trans R Soc Trop Med Hyg 2000; 94:515-7. [PMID: 11132379 DOI: 10.1016/s0035-9203(00)90070-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- P K Sahoo
- Division of Immunology, Regional Medical Research Centre, ICMR, Bhubaneswar 751016, India
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