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Nateros F, Saenz E, Saavedra H, Gonzales I, Pretell EJ, Perez E, Castillo Y, Bustos JA, Garcia HH. Older Age in Subarachnoid Neurocysticercosis Reflects a Long Prepatent Period. Am J Trop Med Hyg 2023; 108:1188-1191. [PMID: 37127275 PMCID: PMC10540123 DOI: 10.4269/ajtmh.22-0791] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/07/2023] [Indexed: 05/03/2023] Open
Abstract
Patients with subarachnoid neurocysticercosis (NCC) are usually older than those with parenchymal disease. Whether this difference reflects a prolonged presymptomatic period or a delay in diagnosis is not clear. From 408 eligible patients, we retrospectively compared the age at symptom onset in 140 patients diagnosed with parenchymal (pure viable or pure calcified) and subarachnoid NCC who had a confirmatory image available not more than 2 years after the beginning of symptoms. Patients with mixed (parenchymal and subarachnoid) NCC or those with parenchymal cysts at different stages (viable and/or degenerating and/or calcified) were not included. After controlling by sex and residence in rural endemic regions, the mean age at symptom onset in patients with subarachnoid disease was 13.69 years older than those with viable parenchymal disease. A long incubation period is a major contributing factor to older age at presentation in subarachnoid NCC, independent of delayed diagnosis or access to care.
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Affiliation(s)
- Fernando Nateros
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Edith Saenz
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Herbert Saavedra
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Isidro Gonzales
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Unidad de Investigación, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | | | - Erika Perez
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Yesenia Castillo
- Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Javier A. Bustos
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hector H. Garcia
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - for the Cysticercosis Working Group in Peru
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
- Centro Básico de Investigación en Exámenes Auxiliares en Parasitosis del Sistema Nervioso Central, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Unidad de Investigación, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Hospital Nacional Alberto Sabogal, Callao, Peru
- Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Peru
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Pizzitutti F, Bonnet G, Gonzales-Gustavson E, Gabriël S, Pan WK, Pray IW, Gonzalez AE, Garcia HH, O’Neal SE. Non-local validated parametrization of an agent-based model of local-scale Taenia solium transmission in North-West Peru. PLoS One 2022; 17:e0275247. [PMID: 36166462 PMCID: PMC9514638 DOI: 10.1371/journal.pone.0275247] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 09/13/2022] [Indexed: 12/01/2022] Open
Abstract
The pork tapeworm, Taenia solium, is the cause of a preventable zoonotic disease, cysticercosis, affecting both pigs and humans. Continued endemic transmission of T. solium is a major contributor of epilepsy and other neurologic morbidity, and the source of important economic losses, in many rural areas of developing countries. Simulation modelling can play an important role in aiding the design and evaluation of strategies to control or even eliminate transmission of the parasite. In this paper, we present a new agent based model of local-scale T. solium transmission and a new, non-local, approach to the model calibration to fit model outputs to observed human taeniasis and pig cysticercosis prevalence simultaneously for several endemic villages. The model fully describes all relevant aspects of T. solium transmission, including the processes of pig and human infection, the spatial distribution of human and pig populations, the production of pork for human consumption, and the movement of humans and pigs in and out in several endemic villages of the northwest of Peru. Despite the high level of uncertainty associated with the empirical measurements of epidemiological data associated with T. solium, the non-local calibrated model parametrization reproduces the observed prevalences with an acceptable precision. It does so not only for the villages used to calibrate the model, but also for villages not included in the calibration process. This important finding demonstrates that the model, including its calibrated parametrization, can be successfully transferred within an endemic region. This will enable future studies to inform the design and optimization of T. solium control interventions in villages where the calibration may be prevented by the limited amount of empirical data, expanding the possible applications to a wider range of settings compared to previous models.
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Affiliation(s)
| | - Gabrielle Bonnet
- Centre for the Mathematical Modelling of Infectious Diseases (CMMID), London School of Hygiene & Tropical Diseases, London, United Kingdom
| | - Eloy Gonzales-Gustavson
- Tropical and Highlands Veterinary Research Institute, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Ghent University, Ghent, Belgium
| | - William K. Pan
- Nicholas School of Environment Durham, Duke University, Durham, NC, United States of America
- Duke Global Health Institute, Durham, Duke University, Durham, NC, United States of America
| | - Ian W. Pray
- School of Public Health, Oregon Health and Science University Portland State University, Portland, OR, United States of America
| | - Armando E. Gonzalez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Hector H. Garcia
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima Peru
- Cysticercosis Unit, National Institute of Neurological Sciences, Lima, Peru
| | - Seth E. O’Neal
- School of Public Health, Oregon Health and Science University Portland State University, Portland, OR, United States of America
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima Peru
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Bonnet G, Pizzitutti F, Gonzales-Gustavson EA, Gabriël S, Pan WK, Garcia HH, Bustos JA, Vilchez P, O’Neal SE. CystiHuman: A model of human neurocysticercosis. PLoS Comput Biol 2022; 18:e1010118. [PMID: 35587497 PMCID: PMC9159625 DOI: 10.1371/journal.pcbi.1010118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 06/01/2022] [Accepted: 04/19/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The Taenia solium tapeworm is responsible for cysticercosis, a neglected tropical disease presenting as larvae in the body of a host following taenia egg ingestion. Neurocysticercosis (NCC), the name of the disease when it affects the human central nervous system, is a major cause of epilepsy in developing countries, and can also cause intracranial hypertension, hydrocephalus and death. Simulation models can help identify the most cost-effective interventions before their implementation. Modelling NCC should enable the comparison of a broad range of interventions, from treatment of human taeniasis (presence of an adult taenia worm in the human intestine) to NCC mitigation. It also allows a focus on the actual impact of the disease, rather than using proxies as is the case for other models. METHODS This agent-based model is the first model that simulates human NCC and associated pathologies. It uses the output of another model, CystiAgent, which simulates the evolution of pig cysticercosis and human taeniasis, adding human and cyst agents, including a model of cyst location and stage, human symptoms, and treatment. CystiHuman also accounts for delays in the appearance of NCC-related symptoms. It comprises three modules detailing cyst development, seizure probability and timing, and intracranial hypertension/hydrocephalus, respectively. It has been implemented in Java MASON and calibrated in three endemic villages in Peru, then applied to another village (Rica Playa) to compare simulation results with field data in that village. RESULTS AND DISCUSSION Despite limitations in available field data, parameter values found through calibration are plausible and simulated outcomes in Rica Playa are close to actual values for NCC prevalence and the way it increases with age and cases with single lesions. Initial simulations further suggest that short-term interventions followed by a rapid increase in taeniasis prevalence back to original levels may have limited impacts on NCC prevalence.
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Affiliation(s)
- Gabrielle Bonnet
- Independent Consultant for the School of Public Health, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Francesco Pizzitutti
- Independent Consultant for the School of Public Health, Oregon Health & Science University, Portland, Oregon, United States of America
| | | | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Ghent University, Gent, Belgium
| | - William K. Pan
- Nicholas School of Environment and Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Hector H. Garcia
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
- Cysticercosis Unit, National Institute of Neurological Sciences, Lima, Peru
| | - Javier A. Bustos
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Percy Vilchez
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Seth E. O’Neal
- Center for Global Health Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Public Health, Oregon Health & Science University and Portland State University, Portland, Oregon, United States of America
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Sánchez SS, Bustos JA, Del Brutto OH, Herrera G, dos Santos AC, Javier Pretell E, Gonzales I, Saavedra H, Garcia HH. Hippocampal Atrophy/Sclerosis Is Associated with Old, Calcified Parenchymal Brain Neurocysticercosis, But Not with More Recent, Viable Infections. Am J Trop Med Hyg 2022; 106:215-218. [PMID: 34695784 PMCID: PMC8733520 DOI: 10.4269/ajtmh.21-0392] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 09/02/2021] [Indexed: 01/03/2023] Open
Abstract
Magnetic resonance images from 197 patients with calcified neurocysticercosis (NCC), 38 with viable NCC and 197 NCC-free healthy rural villagers were evaluated to compare the frequency of hippocampal atrophy/sclerosis (HAS) across these populations. Scheltens' medial temporal atrophy scale was used for hippocampal rating. The median age of the 432 study participants was 46 years (interquartile range, 29-62 years), and 58% were women. Hippocampal atrophy/sclerosis was disclosed in 26.9% patients with calcified NCC, compared with 7.9% in patients with viable NCC and 8.1% in healthy rural villagers. After adjusting for age, gender, and history of epilepsy, hippocampal atrophy/sclerosis was more frequent in patients with calcified NCC than in those with viable cysts (RR, 3.60; 95% CI, 1.18- 0.99; P = 0.025) and healthy rural villagers (RR, 3.43; 95% CI, 1.94-6.06; P < 0.001), suggesting that hippocampal damage develops late in the course of this parasitic disease.
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Affiliation(s)
- Sofía S. Sánchez
- Center for Global Health, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Javier A. Bustos
- Center for Global Health, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru;,Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Oscar H. Del Brutto
- School of Medicine, Universidad Espíritu Santo–Ecuador, Samborondón, Ecuador;,Address correspondence to Oscar H. Del Brutto, Urbanización Toscana, Apt 3H, Km 4.5 vía Puntilla-Samborondón, 092301, Samborondón, Ecuador. E-mail:
| | - Genaro Herrera
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Antonio Carlos dos Santos
- Centro de Cirurgia de Epilepsia, Faculdade de Medicina, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - E. Javier Pretell
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru;,Department of Neurology, Hospital Alberto Sabogal, Callao, Peru
| | - Isidro Gonzales
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Herbert Saavedra
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Héctor H. Garcia
- Center for Global Health, Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru;,Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
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Carmen-Orozco RP, Dávila-Villacorta DG, Delgado-Kamiche AD, Celiz RH, Trompeter G, Sutherland G, Gavídia C, Garcia HH, Gilman RH, Verástegui MR. Changes in inflammatory gene expression in brain tissue adjacent and distant to a viable cyst in a rat model for neurocysticercosis. PLoS Negl Trop Dis 2021; 15:e0009295. [PMID: 33905419 PMCID: PMC8104410 DOI: 10.1371/journal.pntd.0009295] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 05/07/2021] [Accepted: 03/07/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The parasite Taenia solium causes neurocysticercosis (NCC) in humans and is a common cause of adult-onset epilepsy in the developing world. Hippocampal atrophy, which occurs far from the cyst, is an emerging new complication of NCC. Evaluation of molecular pathways in brain regions close to and distant from the cyst could offer insight into this pathology. METHODS Rats were inoculated intracranially with T. solium oncospheres. After 4 months, RNA was extracted from brain tissue samples in rats with NCC and uninfected controls, and cDNA was generated. Expression of 38 genes related to different molecular pathways involved in the inflammatory response and healing was assessed by RT-PCR array. RESULTS Inflammatory cytokines IFN-γ, TNF-α, and IL-1, together with TGF-β and ARG-1, were overexpressed in tissue close to the parasite compared to non-infected tissue. Genes for IL-1A, CSF-1, FN-1, COL-3A1, and MMP-2 were overexpressed in contralateral tissue compared to non-infected tissue. CONCLUSIONS The viable cysticerci in the rat model for NCC is characterized by increased expression of genes associated with a proinflammatory response and fibrosis-related proteins, which may mediate the chronic state of infection. These pathways appear to influence regions far from the cyst, which may explain the emerging association between NCC and hippocampal atrophy.
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Affiliation(s)
- Rogger P. Carmen-Orozco
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú
- Cellular and Molecular Medicine Program, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Danitza G. Dávila-Villacorta
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Ana D. Delgado-Kamiche
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Rensson H. Celiz
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Grace Trompeter
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States of America
| | - Graham Sutherland
- Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Cesar Gavídia
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Hector H. Garcia
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Perú
| | - Robert H. Gilman
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú
- Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland, United States of America
- Asociación Benéfica PRISMA, Lima, Perú
| | - Manuela R. Verástegui
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú
- * E-mail:
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McCleery E, Allen SE, Moyano LM, Gamboa R, Vilchez P, Muro C, Castillo Y, Dorny P, Garcia HH, O’Neal SE. Population Screening for Urine Antigens to Detect Asymptomatic Subarachnoid Neurocysticercosis: A Pilot Study in Northern Peru. Am J Trop Med Hyg 2020; 103:1125-1128. [PMID: 32602434 PMCID: PMC7470589 DOI: 10.4269/ajtmh.20-0196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/20/2020] [Indexed: 11/07/2022] Open
Abstract
Subarachnoid neurocysticercosis (SANCC) is a severe and progressive brain infection with Taenia solium. We performed a pilot study of noninvasive screening for SANCC in two endemic villages in northern Peru using a urine antigen screen followed by brain magnetic resonance imaging for participants with elevated levels of antigen. Among the 978 participants screened, we identified eight individuals with SANCC, many of whom were asymptomatic. This represents a minimum prevalence of 0.8% of SANCC, a level higher than expected based on prior studies, and a positive predictive value of 62% for our novel urine screening test. Future studies should confirm whether early detection and management improve clinical outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | - Pierre Dorny
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Hector H. Garcia
- Centro de Salud Global, Tumbes, Peru
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Seth E. O’Neal
- Oregon Health & Science University, Portland, Oregon
- Centro de Salud Global, Tumbes, Peru
- Portland State University, Portland, Oregon
| | - for the Cysticercosis Working Group in Peru
- University of California Davis, Sacramento, California
- Oregon Health & Science University, Portland, Oregon
- Centro de Salud Global, Tumbes, Peru
- Universidad Peruana Cayetano Heredia, Lima, Peru
- Institute of Tropical Medicine, Antwerp, Belgium
- Portland State University, Portland, Oregon
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Palma S, Chile N, Carmen-Orozco RP, Trompeter G, Fishbeck K, Cooper V, Rapoport L, Bernal-Teran EG, Condori BJ, Gilman RH, Verastegui MR. In vitro model of postoncosphere development, and in vivo infection abilities of Taenia solium and Taenia saginata. PLoS Negl Trop Dis 2019; 13:e0007261. [PMID: 30870421 PMCID: PMC6435196 DOI: 10.1371/journal.pntd.0007261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 03/26/2019] [Accepted: 02/25/2019] [Indexed: 12/29/2022] Open
Abstract
Taenia solium is known to cause human cysticercosis while T. saginata does not. Comparative in vitro and in vivo studies on the oncosphere and the postoncospheral (PO) forms of T. solium and T. saginata may help to elucidate why cysticercosis can occur from one and not the other. The aim of this study was to use in vitro culture assays and in vivo models to study the differences in the development of the T. solium and T. saginata oncosphere. Furthermore, this study aimed to evaluate the expression of cytokines and metalloproteinases (MMPs) in human peripheral blood mononuclear cells (PBMCs), which were stimulated by these oncospheres and PO antigens. T. solium and T. saginata activated oncospheres (AO) were cultured in INT-407 and HCT-8 intestinal cells for 180 days. The T. solium began to die while the T. saginata grew for 180 days and developed to cysticerci in INT-407 cells. Rats were inoculated intracranially with AO and PO forms of either T. saginata or T. solium. Rats infected with T. solium AO and PO forms developed neurocysticercosis (NCC), while those infected with the T. saginata did not. Human PMBCs were stimulated with antigens of AO and PO forms of both species, and the production of cytokines and metalloproteinases (MMPs) was measured. The T. solium AO antigen stimulated a higher production of IL-4, IL-5, IL-13, IFN-γ, and IL-2 cytokines compared to T. saginata AO. In the PO form, the T. saginata PO antigen increased the production of IL-4, IL-5, IL-13, IFN-γ, IL-1β, IL-6, IL-10, TNF-α and IL-12 cytokines compared to T. solium, suggesting that this global immune response stimulated by different forms could permit survival or destruction of the parasite depending of their life-cycle stage. Regarding MMPs, T. solium AO antigen stimulated a higher production of MMP-9 compared to T. saginata AO antigen, which may be responsible for altering the permeability of intestinal cells and facilitating breakdown of the blood-brain barrier during the process of invasion of host tissue. Taenia solium and Taenia saginata are two parasites that cause the tissue infection cysticercosis in their intermediate hosts, pigs and cows, respectively. One major difference between them is that T. solium can also cause neurocysticercosis in the human brain, while T. saginata cannot. Neurocysticercosis is thought to be the major cause of adult-onset seizures in developing countries. It is not well understood why only T. solium can survive in human tissue; however, the host inflammatory response likely plays an important role. The authors found that human immune cells stimulated with T. solium in the early stages of the parasite life cycle produced a more robust cytokine response than T. saginata. However, in the mature stage, which occurs once T. solium reaches the brain, T. solium antigens stimulated a lower inflammatory response compared to T. saginata, suggesting the parasite is able to manipulate the host immune response in some way to evade destruction. These findings may support the differences in growth observed by the authors when rat brains were inoculated with either parasite species. This study provides new insights into the different ways T. solium and T. saginata activate the immune response to survive and develop within the host.
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Affiliation(s)
- Sandra Palma
- Infectious Diseases Research Laboratory, Department of Cellular and Molecular Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Nancy Chile
- Infectious Diseases Research Laboratory, Department of Cellular and Molecular Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rogger P. Carmen-Orozco
- Infectious Diseases Research Laboratory, Department of Cellular and Molecular Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Grace Trompeter
- Department of International Health, Bloomberg School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Kayla Fishbeck
- Department of International Health, Bloomberg School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Virginia Cooper
- Department of International Health, Bloomberg School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Laura Rapoport
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, United States of America
| | - Edson G. Bernal-Teran
- Infectious Diseases Research Laboratory, Department of Cellular and Molecular Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Beth J. Condori
- Infectious Diseases Research Laboratory, Department of Cellular and Molecular Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert H. Gilman
- Department of International Health, Bloomberg School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Manuela R. Verastegui
- Infectious Diseases Research Laboratory, Department of Cellular and Molecular Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
- * E-mail:
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Fernandez L, Gamboa R, Vilchez P, Pray I, Beam M, Garvey B, Spencer A, Atto R, Muro C, Moyano LM, Garcia HH, O’Neal SE. Evaluating Urban Taeniasis as a Threat to Cysticercosis Elimination in Northern Peru. Am J Trop Med Hyg 2019; 100:140-142. [PMID: 30457096 PMCID: PMC6335904 DOI: 10.4269/ajtmh.18-0767] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 10/15/2018] [Indexed: 11/07/2022] Open
Abstract
Reintroduction of Taenia solium into a region in Peru where it had been eliminated prompted evaluation of the possibility of reintroduction from an urban reservoir of taeniasis. In a cross-sectional study of an adjacent urban area, we found low prevalence of taeniasis (4/1,621; 0.25%), suggesting minimal risk of parasite reintroduction into rural areas through this route.
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Affiliation(s)
- Lauralee Fernandez
- Oregon Health & Science University, Portland, Oregon
- Portland State University, Portland, Oregon
| | | | | | - Ian Pray
- Oregon Health & Science University, Portland, Oregon
- Portland State University, Portland, Oregon
| | - Michelle Beam
- Oregon Health & Science University, Portland, Oregon
| | - Brian Garvey
- Oregon Health & Science University, Portland, Oregon
| | - Angela Spencer
- Oregon Health & Science University, Portland, Oregon
- Portland State University, Portland, Oregon
| | - Ruth Atto
- Centro de Salud Global, Tumbes, Tumbes, Peru
| | | | | | - Hector H. Garcia
- Centro de Salud Global, Tumbes, Tumbes, Peru
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Seth E. O’Neal
- Oregon Health & Science University, Portland, Oregon
- Portland State University, Portland, Oregon
- Centro de Salud Global, Tumbes, Tumbes, Peru
| | - for the Cysticercosis Working Group in Peru
- Oregon Health & Science University, Portland, Oregon
- Portland State University, Portland, Oregon
- Centro de Salud Global, Tumbes, Tumbes, Peru
- Universidad Peruana Cayetano Heredia, Lima, Peru
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Cangalaya C, Bustos JA, Calcina J, Vargas-Calla A, Mamani J, Suarez D, Arroyo G, Gonzalez AE, Chacaltana J, Guerra-Giraldez C, Mahanty S, Nash TE, García HH. Radiological evolution of porcine neurocysticercosis after combined antiparasitic treatment with praziquantel and albendazole. PLoS Negl Trop Dis 2017; 11:e0005624. [PMID: 28575043 PMCID: PMC5470720 DOI: 10.1371/journal.pntd.0005624] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 06/14/2017] [Accepted: 05/04/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The onset of anthelmintic treatment of neurocysticercosis (NCC) provokes an acute immune response of the host, which in human cases is associated with exacerbation of neurological symptoms. This inflammation can occur at the first days of therapy. So, changes in the brain cysts appearance may be detected by medical imaging. We evaluated radiological changes in the appearance of brain cysts (enhancement and size) on days two and five after the onset of antiparasitic treatment using naturally infected pigs as a model for human NCC. METHODS AND RESULTS Contrast T1-weighted magnetic resonance imaging with gadolinium was performed before and after antiparasitic treatment. Eight NCC-infected pigs were treated with praziquantel plus albendazole and euthanized two (n = 4) and five (n = 4) days after treatment; another group of four infected pigs served as untreated controls. For each lesion, gadolinium enhancement intensity (GEI) and cyst volume were measured at baseline and after antiparasitic treatment. Volume and GEI quantification ratios (post/pre-treatment measures) were used to appraise the effect of treatment. Cysts from untreated pigs showed little variations between their basal and post treatment measures. At days 2 and 5 there were significant increases in GEI ratio compared with the untreated group (1.32 and 1.47 vs 1.01, p = 0.021 and p = 0.021). Cyst volume ratios were significantly lower at days 2 and 5 compared with the untreated group (0.60 and 0.22 vs 0.95, p = 0.04 and p = 0.02). Cysts with lower cyst volume ratios showed more marked post-treatment inflammation, loss of vesicular fluid and cyst wall wrinkling. CONCLUSION/SIGNIFICANCE A significant and drastic reduction of cyst size and increased pericystic enhancement occur in the initial days after antiparasitic treatment as an effect of acute perilesional immune response. These significant changes showed that early anthelmintic efficacy (day two) can be detected using magnetic resonance imaging.
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Affiliation(s)
- Carla Cangalaya
- Laboratorio de Inmunopatología en Neurocisticercosis, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Peru
- * E-mail:
| | - Javier A. Bustos
- Unidad de Cisticercosis, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Juan Calcina
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Ana Vargas-Calla
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Javier Mamani
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Diego Suarez
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Gianfranco Arroyo
- Unidad de Cisticercosis, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Armando E. Gonzalez
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Juan Chacaltana
- Departamento de Diagnóstico por imágenes, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Cristina Guerra-Giraldez
- Laboratorio de Inmunopatología en Neurocisticercosis, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Siddhartha Mahanty
- Laboratorio de Inmunopatología en Neurocisticercosis, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Theodore E. Nash
- Laboratorio de Inmunopatología en Neurocisticercosis, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Héctor H. García
- Unidad de Cisticercosis, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
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Watts NS, Pajuelo M, Clark T, Loader MCI, Verastegui MR, Sterling C, Friedland JS, Garcia HH, Gilman RH. Taenia solium infection in Peru: a collaboration between Peace Corps Volunteers and researchers in a community based study. PLoS One 2014; 9:e113239. [PMID: 25469506 PMCID: PMC4254459 DOI: 10.1371/journal.pone.0113239] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 09/22/2014] [Indexed: 11/26/2022] Open
Abstract
Background Neurocysticercosis is a leading cause of seizures and epilepsy in most of the world, and it occurs when Taenia solium larval cysts infect the central nervous system. T. solium tapeworm infection is endemic in much of Peru, but there are scarce data on the prevalence in many rural highland communities where it is likely to be hyper-endemic. Peace Corps Volunteers live and work in these communities; however, to our knowledge, they have not been used to facilitate public health research. Materials and Methods We utilized Peace Corps Volunteers to estimate the prevalence of T. solium tapeworm infection in seven rural communities in northern Peru. A convenience non-random sampling frame was used. Peace Corps Volunteers facilitated the collection of stool samples (N = 2,328), which were analyzed by sedimentation and microscopy. Niclosamide treatment and purgation preceded species identification, which was done by PCR-REA. Results Taenia sp. egg-positive stool samples were found in three of the seven communities we surveyed. The overall prevalence of Taenia sp. egg positivity was 2.1% (49/2,328) (95% CI = 1.6–2.8%) with prevalence up to 4.3% (42/977) (95% CI = 3.1–5.8%) by community. All 34 of the specimens tested by PCR-REA were T. solium. The overall prevalence of T. solium tapeworm infection was 1.5% (34/2,328) (95% CI = 1.0–2.0%). Prevalence up to 2.9% (28/977) (95% CI = 1.9–4.1%) by community was observed. Conclusion/Significance This study recorded high T. solium tapeworm prevalence, and identified hyper-endemic rural communities. It demonstrates that synergy between researchers and Peace Corps Volunteers can be an effective means to conducting large-scale, community-based studies in remote areas of Peru.
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Affiliation(s)
- Nathaniel S. Watts
- Department of Epidemiology, Boston University School of Public Health, Boston, United States of America
- * E-mail:
| | - Monica Pajuelo
- Unit of Bioinformatics and Molecular Biology, School of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Taryn Clark
- Weill Cornell Medical College, New York, United States of America
| | - Maria-Cristina I. Loader
- Infectious Diseases & Immunity and the Wellcome Trust-Imperial Centre for Global Health, Imperial College London, London, England, United Kingdom
| | - Manuela R. Verastegui
- Department of Microbiology, School of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Charles Sterling
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, United States of America
| | - Jon S. Friedland
- Infectious Diseases & Immunity and the Wellcome Trust-Imperial Centre for Global Health, Imperial College London, London, England, United Kingdom
| | - Hector H. Garcia
- Department of Microbiology, School of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert H. Gilman
- Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura (AB PRISMA), Lima, Peru
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States of America
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