Adult schistosomes have an epithelial bacterial population distinct from the surrounding mammalian host blood

Background

Schistosomiasis is a neglected tropical parasitic and chronic disease affecting hundreds of millions of people. Adult schistosomes reside in the blood stream of the definitive mammalian host. These helminth parasites possess two epithelial surfaces, the tegument and the gastrodermis, both of which interact with the host during immune evasion and in nutrient uptake.

Methods

Female ARC Swiss mice (4–6 weeks old) were infected percutaneously with Schistosoma japonicum cercariae freshly shed from Oncomelania hupensis quadrasi snails (Philippines strain). Fluorescent in situ hybridisation (FISH) was performed by using fresh adult S. japonicum perfused from those infected mice. Adult S. japonicum worms were processed to isolate the tegument from the carcass containing the gastrodermis; blood and bile were collected individually from infected and uninfected mice. Total DNA extracted from all those samples were used for microbiome profiling.

Results

FISH and microbiome profiling showed the presence of bacterial populations on two epithelial surfaces of adult worms, suggesting they were distinct not only from the host blood but also from each other. Whereas microbial diversity was reduced overall in the parasite epithelial tissues when compared with that of host blood, specific bacterial taxa, including Anoxybacillus and Escherichia, were elevated on the tegument. Minimal differences were evident in the microbiome of host blood during an active infection, compared with that of control uninfected blood. However, sampling of bile from infected animals identified some differences compared with controls, including elevated levels of Limnohabitans, Clostridium and Curvibacter.

Conclusions

Using FISH and microbial profiling, we were able to demonstrate, for the first time, that bacteria are presented on the epithelial surfaces of adult schistosomes. These schistosome surface-associated bacteria, which are distinct from the host blood microenvironment, should be considered as a new and important component of the host-schistosome interaction. The importance of individual bacterial species in relation to schistosome parasitism needs further elucidation.

[Endemic situation of schistosomiasis in national surveillance sites of Jiangsu Province from 2011 to 2018]

OBJECTIVE

To analyze and investigate the changing trend of the endemic situation of schistosomiasis in national surveillance sites of Jiangsu Province from 2011 to 2018, so as to provide scientific evidence for formulating strategies for schistosomiasis control.

METHODS

From 2011 to 2014, the national schistosomiasis surveillance sites were set in seven schistosomiasis endemic counties (cities, districts) across Jiangsu Province as according to the National Schistosomiasis Surveillance Scheme (2011 version), and from 2015 to 2018, the national surveillance sites were assigned in all 64 counties (cities, districts) endemic for schistosomiasis in Jiangsu Province according to the National Schistosomiasis Surveillance Scheme (2014 version). Schistosoma japonicum infections in local populations, mobile populations and livestock, and snail status were monitored in the national schistosomiasis surveillance sites of Jiangsu Province from 2011 to 2018, and the monitoring data were statistically analyzed.

RESULTS

The sero-prevalence of S. japonicum infections was 1.50% to 4.61% among local populations in the national schistosomiasis surveillance sites of Jiangsu Province from 2011 to 2018, and a higher sero-prevalence was seen in men than in women, with the sero-positives predominantly detected in local populations at ages of over 50 years. The positive rate of stool examinations was 0 to 0.14% among sero-positive local populations in the national schistosomiasis surveillance sites of Jiangsu Province from 2011 to 2018, and no acute case was found in local populations during the study period. The sero-prevalence of S. japonicum infections was 0.46% to 15.97% among mobile populations in the national schistosomiasis surveillance sites of Jiangsu Province from 2011 to 2018, and no egg-positives were identified. A total of 1 453 livestock were tested in the national schistosomiasis surveillance sites of Jiangsu Province from 2011 to 2018, and no S. japonicum infections were detected. During the period from 2011 through 2018, snail survey was conducted in an area of 216 million m² in the national schistosomiasis surveillance sites of Jiangsu Province, and 1 291.01 hm² snail habitats were identified, with snail densities ranging from 0.01 to 0.47 snails/0.1 m²; however, no S. japonicum infections were identified in snails.

CONCLUSIONS

The overall endemic situation of schistosomiasis appears a tendency towards a decline in Jiangsu Province, and S. japonicum infection remains at a low level in both humans and livestock. No S. japonicum infection has been identified in local populations in Jiangsu Province since 2012. In the future, monitoring and management of imported sources of S. japonicum infections should be intensified in Jiangsu Province, and the capability building of passive surveillance of schistosomiasis should be improved in sentinel hospitals in national schistosomiasis surveillance sites of Jiangsu Province. In addition, the examination of schistosomiasis should be strengthened in mobile populations in Jiangsu Province, a sensitive and effective surveillance-response system for schistosomiasis is urgently needed.

Gene Expression in Developmental Stages of Schistosoma japonicum Provides Further Insight into the Importance of the Schistosome Insulin-Like Peptide

We showed previously that the Schistosoma japonicum insulin-like peptide (SjILP) binds the worm insulin receptors, thereby, activating the parasite’s insulin pathway and emphasizing its important role in regulating uptake of glucose, a nutrient essential for parasite survival. Here we show that SjILP is differentially expressed in the schistosome life cycle and is especially highly transcribed in eggs, miracidia, and adult female worms. RNA inference was employed to knockdown SjILP in adults in vitro, with suppression confirmed by significantly reduced protein production, declined adenosine diphosphate levels, and reduction in glucose consumption. Immunolocalization showed that SjILP is located to lateral gland cells of mature intra-ovular miracidia in the schistosome egg, and is distributed on the ciliated epithelium and internal cell masses of newly transformed miracidia. In schistosomula, SjILP is present on the tegument in two antero-lateral points, indicating highly polarized expression during cercarial transformation. Analysis of serum from S. japonicum-infected mice by ELISA using a recombinant form of SjILP as an antigen revealed IgG immunoreactivity to this molecule at 7 weeks post-infection indicating it is likely secreted from mature eggs into the host circulation. These findings provide further insights on ILP function in schistosomes and its essential roles in parasite survival and growth in different development stages.

Circulating miRNAs as footprints for liver fibrosis grading in schistosomiasis

BACKGROUND

Chronic infection with Schistosoma japonicum or S. mansoni results in hepatic fibrosis of the human host. Staging fibrosis is crucial for the prognosis and to determine the rapid need of treatment in patients with schistosomiasis.

METHODS

To establish whether there is a correlation between circulating microRNA (miRNA) level and fibrosis progression in schistosomiasis, ten miRNAs were selected to assess their potential in grading schistosomiasis liver fibrosis. This was done firstly in two mouse strains (C57BL/6 and BALB/c) to determine the temporal expression profiles in serum over the course of S. japonicum infection, and then within a cohort of 163 schistosomiasis japonica patients with different grades of liver fibrosis.

FINDING

Four miRNAs (miR-150-5p, let-7a-5p, let-7d-5p and miR-146a-5p) were able to distinguish patients with mild versus severe fibrosis. The level of serum miR-150-5p showed the most promising potential for grading hepatic fibrosis in schistosomiasis. The diagnostic performance of miR-150-5p in discriminating mild from severe fibrosis is comparable with that of the ELF test and serum HA level. In addition, the serum levels of the four miRNAs rebounded in infected C57BL/6 mice, after 6 months post treatment, following the regression of liver fibrosis, thereby providing further support for the utility of these miRNAs in grading schistosomal hepatic fibrosis.

INTERPRETATION

Circulating miRNAs can be a supplementary tool for assessing hepatic fibrosis in human schistosomiasis. FUND: National Health and Medical Research Council (NHMRC) of Australia (APP1102926, APP1037304 and APP1098244).

Serological Prevalence of Schistosoma japonicum in Mobile Populations in Previously Endemic but Now Non-Endemic Regions of China: A Systematic Review and Meta-Analysis

BACKGROUND

Schistosomiasis japonica has been resurging in certain areas of China where its transmission was previously well controlled or interrupted. Several factors may be contributing to this, including mobile populations, which if infected, may spread the disease. A wide range of estimates have been published for S. japonicum infections in mobile populations, and a synthesis of these data will elucidate the relative risk presented from these groups.

METHODS

A literature search for publications up to Oct 31, 2014 on S. japonicum infection in mobile populations in previously endemic but now non-endemic regions was conducted using four bibliographic databases: China National Knowledge Infrastructure, WanFang, VIP Chinese Journal Databases, and PubMed. A meta-analysis was conducted by pooling one arm binary data with MetaAnalyst Beta 3.13. The protocol is available on PROSPERO (No. CRD42013005967).

RESULTS

A total of 41 studies in Chinese met the inclusion criteria, covering seven provinces of China. The time of post-interruption surveillance ranged from the first year to the 31st year. After employing a random-effects model, from 1992 to 2013 the pooled seroprevalence ranged from 0.9% (95% CI: 0.5-1.6%) in 2003 to 2.3% (95% CI: 1.5-3.4) in 1995; from the first year after the disease had been interrupted to the 31st year, the pooled seroprevalence ranged from 0.6% (95% CI: 0.2-2.1%) in the 27th year to 4.0% (95%CI: 1.3-11.3%) in the second year. The pooled seroprevalence in mobile populations each year was significantly lower than among the residents of endemic regions, whilst four papers reported a lower level of infection in the mobile populations than in the local residents out of only 13 papers which included this data.

CONCLUSIONS

The re-emergence of S. japonicum in areas which had previously interrupted transmission might be due to other factors, although risk from re-introduction from mobile populations could not be excluded.

[Effect of Schistosoma japonicum infection on serum lipid status in mice]

OBJECTIVE

To investigate the effect of Schistosoma japonicum infection on lipid status in mouse serum.

METHODS

Twenty-four ICR mice were randomly divided into two groups, fed a high fat diet (HFD) or a normal diet (ND). On the 28th day, 6 mice from each group were infected with double sex cercariae of S. japonicum via abdominal skin (150 cercariae/mouse). At 42 days post-infection, the mice were sacrificed and the sera were collected. Other 36 ICR mice were randomly divided into three groups fed on normal diet. Mice in the first group were infected with S. japonicum single-sex cercariae via abdominal skin (150 cercariae/mouse) and sacrificed on Day 42. Mice in the second group were intraperitoneally injected with 10,000 S. japonicum eggs and serum samples were collected at Day 4 and Day 7. Mice in the third group were intraperitoneally injected with soluble egg antigen (SEA) every day for 6 days [1 mg/(mice x d)] and serum was collected at Day 7. Mice from control group were fed a high fat diet or a normal diet without infection. Serum levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), and low density lipoprotein (LDL) were measured.

RESULTS

Compared with the uninfected controls, the serum levels of TC, TG, HDL, and LDL decreased significantly in double-sex cercariae infected-mice fed on a high fat diet or a normal diet (P < 0.05). In HFD group, serum TC[(1.45 +/- 0.31) mmol/L], TG [(0.17 +/- 0.06)mmol/L], HDL [(1.11 +/- 0.26) mmol/L] and LDL [(0.44 +/- 0.15)mmol/L] levels in mice infected with double-sex cercariae were lower than that of uninfected mice [(7.86 +/- 0.07)mmol/L, (0.23 +/- 0.07) mmol/L, (4.96 +/- 0.81) mmol/L, (3.93 +/- 0.29) mmol/L] (P < 0.05) . In ND group, serum TC [(1.03 +/- 0.08) mmol/L] , TG [(0.17 +/- 0.03) mmol/L], HDL [(0.84 +/- 0.02) mmol/L], and LDL [(0.09 +/- 0.02) mmol/L] levels in mice infected with double-sex cercariae were lower than that of uninfected mice [(1.85 +/- 0.05) mmol/L, (0.90 +/- 0.14) mmol/L (1.38 +/- 0.18) mmol/L, (0.15 +/- 0.01) mmol/L, respectively] (P < 0.05) . The mice serum lipid indices had no obvious change after single-sex cercariae or egg injection (P > 0.05). Serum TC [(1.07 +/- 0.15) mmol/L], TG [(1.06 +/- 0.15) mmol/L], HDL [(0.71 +/- 0.14) mmol/L], and LDL [(0.05 +/- 0.04) mmol/L] levels in SEA injected mice were lower than that of the control group [(1.81 +/- 0.06) mmol/L, (2.15 +/- 0.13) mmol/L, (1.160.15) mmol/L, (0.16 +/- 0.03) mmol/L] (P < 0.05).

CONCLUSION

Schistosoma japonicum infection can decrease serum lipid concentrations in the mouse host.

[Correlation between acute schistosomiasis japonica and serum interleukin-33 levels]

OBJECTIVE

To study the function of interleukin-33 (IL-33) in the development of human acute schistosomiasis japonica by determining the serum IL-33 levels in acute schistosomiasis japonica patients.

METHODS

Four patients with acute schistosomiasis japonica were recruited from schistosomiasis endemic lake areas, and 15 controls were recruited outside the schistosomiasis endemic areas. The demographic data and venous blood were collected from all the subjects. The serum IL-33 levels of all the subjects were tested by using enzyme-linked immunosorbent assay. All the results were statistically analyzed with Stata 10.0 software.

RESULTS

The serum IL-33 levels of the patients with acute schistosomiasis japonica [517.33 (334.65, 1 056.88) pg/ml] were significantly higher than those of the controls [1.66(1.66, 6.35) pg/ml] (Z = -3.207, P = 0.001). The correlation coefficients between serum IL-33 levels and numbers of eosinophils, serum IL-33 levels and duration of infection were both 0.8 (P = 0.2).

CONCLUSIONS

The serum IL-33 level is significantly elevated in the patients with acute schistosomiasis japonica, indicating that IL-33 may play a pro-inflammatory role in the acute stage of schistosomiasis japonica and participate in initiating the Th2 type immune responses between 7 and 9 weeks after the infection.

[Surveillance and forecast of schistosomiasis transmission in Chaohu Lake area in Anhui Province, 2008-2010]

OBJECTIVE

To understand the dynamic changes of the potential prevalent factors of schistosomiasis in Chaohu Lake area so as to provide forecast information on the outbreak of schistosomiasis in the area.

METHODS

From 2008 to 2010, fixed and mobile surveillance sites in potential endemic areas of Juchao District in Chaohu City, which was located in the southeast side of Chaohu Lake, were selected, and the schistosomiasis infection situation of local people, mobile population and livestock were investigated by immunological assays and/or stool examinations. The distribution of Oncomelania snails was surveyed in risk areas and suspicious areas, the spreading patterns of Oncomelania snails were observed in rivers that directly connected with the Yangtze River, and the Oncomelania snails were raised in the cages on the beaches of Chaohu Lake and a control area, and their survival and reproduction capacity was observed.

RESULTS

In 2008, a total of 301 local people were screened by IHA, and there were no positives. From 2008 to 2010, a total of 321, 362 and 306 mobile population were examined by IHA, respectively, and the positive rate of antibody were 3.74%, 4.97% and 2.94%, respectively. The antibody positives were tested by stool examinations, and the positive rates were 66.67%, 50% and 55.56%, respectively. A total of 91 local livestock and 92 livestock from endemic areas were examined respectively by the miracidium hatching method, and there were no positives. A total of 97.8 hm2 risk areas and 193.62 hm2 suspicious areas in the potential endemic area were surveyed respectively, but no Oncomelania snails were found. The investigation results on snail spreading patterns indicated that snails could spread into Chaohu Lake by adsorbing on floating debris. The field study revealed that Oncomelania snails could survive and reproduce in the Lake.

CONCLUSIONS

The imported infectious sources of schistosomiasis have been found in Chaohu Lake area, and the higher possibility of imported Oncomelania snails spreading into the Lake and surviving and reproducing in the lake is predicted. Therefore, effective measures should be taken to decrease the risks of schistosomiasis transmission in the potential endemic area.

[Risk factors of schistosomiasis transmission in marshland and lake regions in midstream of Yangtze River]

OBJECTIVE

To study the risk factors of schistosomiasis related to household economic condition and individual behavior in marshland and lake regions, so as to provide evidences for schistosomiasis control.

METHODS

Six villages were sampled with the stratified cluster sampling method, 2 339 villagers from 1 247 households were surveyed by a questionnaire and meanwhile their sera were assayed for schistosomiasis by IHA. The Logistic regression was used to analyze the relationship between the results of serological examinations and risk factors.

RESULTS

The Logistic regression model fitted well (R2 = 0.598 4) and it indicated that there existed a regressive relationship between the antibody positive rate and the endemic situation of village, family economic status, age, education level and infection history of schistosomiasis.

CONCLUSION

Suitable measures should be made in according to the local economic situation, endemic type and population to control the transmission of schistosomiasis effectively.

[Diagnostic efficiency of Indirect Hemagglutination Assay Kit for antibody detection of schistosomiasis japonica]

OBJECTIVE

To evaluate the clinical diagnostic efficiency of Indirect Hemagglutination Assay Kit (IHA kit) for antibody detection of schistosomiasis japonica.

METHODS

Schistosomiasis examinations by parasitological method were conducted in the schistosomiasis endemic areas in Jiangxi, Anhui and Hubei provinces, respectively. A total of 371 serum samples of schistosomiasis patients and 761 serum samples of non-patients without history of schistosome infection and infested water contact were collected. All the sera were detected by using IHA Kit. The diagnostic efficiency indicators of the kit, including sensitivity, specificity, positive predicted value, negative predicted value etc. were calculated.

RESULTS

The sensitivity and specificity of the kit were 95.1% (95% confidence interval was between 92.9% and 97.3%) and 97.8% (95% confidence interval was between 96.8% and 98.8%), respectively; the positive and negative predicted values were 95.4% and 97.6%, respectively. No statistically significant difference was found in the prevalence of IHA positive detecting by the kit among the groups with different EPG levels (< or = 40, 41-100, > 100). Also, no significant difference was observed in sensitivity and specificity among the different age groups.

CONCLUSIONS

The IHA kit shows a relative high efficiency for diagnosis and can be used for mass screening of schistosomiasis in field sites.

[Evaluation of early diagnostic value of 6 antigens from Schistosoma japonicum in mice]

OBJECTIVE

To find out the candidate antigen for immunoreagent, which could be used to diagnose Schistosoma japonicum infection early in mice.

METHODS

The mice were infected with cereariae of S. japonicum Chinese mainland strain. The sera of mice before and after infection at different time were collected. The recombinant fusion protein (GST-HD) of the large hydrophilic domain (HD) of 23 kDa membrane protein of S. japonicum with the Glutathione-S-transferase (GST) of S. japonicum, soluble eggs antigen (SEA), TSP2 hydrophilic domain of S. japonicum (TSP2HD), IL4-inducing principle of S. mansoni eggs (IPSE), fusion protein GST-SjMP10 (SjMP-10), and recombinant S. japonicum (Chinese strain) signaling protein 14-3-3 (Sj14-3-3) were used as diagnostic antigens, the specific IgG and IgM antibodies were measured respectively by enzyme linked immunosorbent assay (ELISA). The antigens with the value of diagnosing schistosomiasis early were screened by analyzing the changes of the levels of specific IgG (or IgM) antibodies and the positive rates of specific antibodies in the sera of mice before and post infection at different time. Moreover, the antigen's value of early diagnosis was further validated by Immunoblot.

RESULTS

On the 18th, 21st and 28th day post infection, the positive rates of specific antibody IgM against GST-HD were 60%, 70% and 100%, respectively; the positive rates of specific antibody IgG against GST-HD were 40%, 60% and 90%, respectively. The positive rates of antibody IgM against SEA were 50%, 60% and 90%, respectively; the positive rates of antibody IgG against SEA were 20%, 50% and 70%, respectively. The positive rates of IgM against TSP2HD were 30%, 40% and 50%, respectively; the rates of IgG against TSP2HD were 20%, 30% and 70%, respectively. The positive rates of IgM against IPSE were 20%, 30% and 50%, respectively; the positive rates of IgG against IPSE were 20%, 30% and 60%, respectively. The positive rates of IgM against SjMP-10 were 10%, 20% and 20%, respectively; the rates of IgG against SjMP-10 were 10%, 20% and 30%, respectively. The positive rates of IgM against Sj14-3-3 were 0, 10% and 20%, respectively; the rates of IgG against Sj14-3-3 were 0, 10% and 30%, respectively. The sensitivities of GST-HD and SEA for diagnosing schistosome infection early in mice were significantly higher than those of Sj14-3-3, IPSE, TSP, and MP-10. The sensitivity of IgM was higher than that of IgG. In Western blotting, the about 73 kDa protein band of SEA was recognized by sera of mice one week post infection and showed stronger reaction as the infected time went on. Moreover, the bands (33 kDa) of GST-HD were earliest recognized by the mouse sera on the 10th day post-infection, the bands showed strong reaction with the mouse sera of 5-week post-infection.

CONCLUSIONS

The GST-HD fusion protein and the protein of which molecular weight is about 73 kDa of SEA have the early diagnostic value for schistosomiasis, and the sensitivity of Immunoblot is higher than that of ELISA.

[Detection of urine antibodies to Schistosoma japonicum by magnetic particle affinity immunoassay]

OBJECTIVE

To explore a non-invasive method for detection of urine antibodies to Schistosoma japonicum.

METHODS

The urine antibodies to S. japonicum were detected by magnetic particle affinity immunoassay (MPAIA) in 158 cases of schistosomiasis japonica and 100 health persons, and their serum antibodies to S. japonicum were also detected at the same time.

RESULTS

The sample of urine by MPAIA was 10 microl original urine without any special treatment. The positive rate of urine and serum were 48.10% (76/158)and 88.61% (140/158), respectively. There was difference between the performance of two methods (chi2 = 60.24, P < 0.05). However, both of their specificity were 100% (100/100).

CONCLUSION

MPAIA is viable for detection of urine antibodies to S. japonicum, but its sensitivity should be improved.

[Cloning, expression and stage-specific analysis of Schistosoma japonicum P7 antigen and evaluation of its value in early diagnosis]

OBJECTIVE

To clone and express Schistosoma japonicum P7 antigen (GenBank accession No. EU121231), analyze stage-specific transcription and expression of the antigen, and evaluate its value in early diagnosis.

METHODS

The positive clone (P7) screened from schistosomula cDNA library was amplified by PCR. The PCR product was subcloned into prokaryotic expression vector pET28a. The recombinant plasmids were identified by restrictive enzymes digestion. The positive recombinant plasmids were transformed into E. coli BL21 (DE3), induced by IPG for expression and purified. The diagnostic value of P7 recombinant protein was evaluated by Western blotting analysis. RT-PCR and Western blotting were used to investigate the differential transcription and expression of P7 during the developmental stages. The specific antibodies against P7 recombinant protein in the sera of S. japonicum-infected rabbits at 14 d postinfection, sera of schistosomiasis (28 cases), clonorchiasis (30 cases) and paragonimiasis (20 cases) patients, and sera of healthy people (30 cases) were detected by ELISA, respectively.

RESULTS

The expression vector of p7/pET28a was established and the P7 recombinant protein (about Mr 20 100) was expressed in E. coli. Western blotting analysis showed that the recombinant protein was specifically recognized by immunized rabbit sera, and sera from mice on the 14th day post infection, but was not recognized by the sera of mice at 42 d post-infection. P7 mRNA was detected in cercariae, schistosomula and adult worms, while the protein was only found in schistosomula. The positive rate of rabbit sera collected at 14 d post-infection was 83.3% (15/18). The sensitivity and specificity of ELISA for diagnosis of schistosomiasis japonica were 75.0% (21/28) and 93.8% (75/80), respectively. And the P7 protein showed cross reaction with sera of clonorchiasis and paragonimiasis patients with positive rates of 6.7% (2/30) and 5.0% (1/20), respectively.

CONCLUSION

P7 antigen might be a potential candidate for early diagnosis of schistosomiasis.

[Antibody responses to leucine aminopeptidase in Schistosoma japonicum infection]

OBJECTIVE

To investigate the antibody response to leucine aminopeptidase in the different stages of Schistosoma japonicum infection.

METHODS

The expression product of SjLAP was identified by Western blot and further purified by using nickel column. The IgG levels in the response to SjLAP in murine and porcine sera were detected by ELISA at different time points after the infection of S. japonicum.

RESULTS

SjLAP expressed by E. coli was recognized by anti-his monoclonal antibody and S. japonicum-infected mice sera by Western blot. The results of ELISA showed that IgG responses to SjLAP rose gradually and reached the peak at 4 weeks post-infection for pigs (P1) and 6 weeks post-infection for mice (P2). With the appearance of a large number of eggs in the tissue, SjLAP-specific IgG levels were significantly down-regulated ( P1 = 0. 0004, P2 = 0. 0001).

CONCLUSION

SjLAP originated from the adult worm might become a potential target for early diagnosis of schistosomiasis japonica.

[Application of F-ELISA for immunodiagnosis of schistosomiasis japonica]

OBJECTIVE

To optimize the experimental conditions of fast enzyme-linked immunosorbent assay (F-ELISA) and evaluate its performance for immunodiagnosis of schistosomiasis japonica.

METHODS

HRP-SPA was used at different concentrations in the assay to determine the best HRP-SPA concentration by comparing the detection accuracy. The working conditions of F-ELISA were optimized by examining the ratio of absorbance values of positive and negative controls with different incubation time of serum samples and HRP-SPA. To evaluate the performance of F-ELISA in diagnosis of schistosomiasis, the detection accuracy of F-ELISA was compared with routine ELISA and dipstick dye immunoassay (DDIA) by testing serum samples from both healthy subjects and those clinically diagnosed with schistosomiasis and clonorchiasis in parallel.

RESULTS

In F-ELISA, the best working concentration of HRP-SPA was 1:2 000 while the optimized incubation condition for serum samples and HRP-SPA was 60 min at 37 degrees C. Using F-ELISA, we identified 93.8% to be schistosomiasis positive among chronic schistosomiasis subjects, 4% within the clonorchiasis group, and a false positive rate of 1.5% in healthy individuals. This diagnostic accuracy for F-ELISA was similar to routine ELISA and DDIA.

CONCLUSIONS

F-ELISA combines the 2-steps of routine ELISA into a single step making the assay process faster and simpler without sacrificing the diagnostic accuracy. With further investigations, F-ELISA as an easy and practical method is promising to be applied for schistosomiasis diagnosis in the field.

[Detection of specific IgG in the sera of patients with chronic schistosomiasis japonica by dot-ELISA with the recombinant Sj26-Sj32 fusion protein]

OBJECTIVE

To study the diagnostic value of the Dot ELISA with rSj26-Sj32 fusion protein for chronic schistosomiasis japonica.

METHODS

rSj26-Sj32 fusion protein and SjAWA were used to establish the HRP-IgG-Dot-ELISA. Serum samples from patients with chronic schistosomiasis japonica (40 cases), clonorchiasis sinensis (21 cases), paragonimiasis westermani(13 cases), alveolar echinococcosis (10 cases), cystic echinococcosis(9 cases), hepatitis B(20 cases), pulmonary tuberculosis (20 cases) and healthy persons (43 cases) were examined.

RESULTS

Sensitivity and specificity were respectively 92.5% (37/40) and 95.4% (41/43) for rSj26-Sj32-Dot-ELISA and 95.0% (38/40) and 93.0% (40/43) for SjAWA-Dot-ELISA, and there was no significant difference between two antigens (P > 0.05). There were different cross reactions to the sera of patients with clonorchiasis sinensis, paragonimiasis westermani or alveolar echinococcosis, but no cross reaction to the sera of patients with cystic echinococcosis, hepatitis B or pulmonary tuberculosis. The positive and negative predictive value and efficiency of diagnosis of rSj26-Sj32-Dot-ELISA for chronic schistosomiasis japonica were 84.1% (37/44), 97.7% (129/132), and 94.3% (166/176), respectively, and those of SjAWA-Dot-ELISA were 77.6% (38/49), 98.4% (125/127), and 92.6% (163/176), respectively. There was no significant difference between the two methods (P > 0.05).

CONCLUSION

rSi26-Si32 fusion protein can be applied to immunodiagnosis for chronic schistosomiasis japonica.

Preparation and preliminary application of colloidal carbon dipstick for schistosomiasis japonica

OBJECTIVE

To develop a rapid and simple immunoassay to detect antibodies in the sera of patients infect Schistosoma japonicum (S. japonicum).

METHODS

Soluble egg antigen (SEA) of S. japonicum conjugated with colloidal carbon in advance was used to react with the antibodies in the sera of patients with schistosomiasis. Then the carbon-antigen-antibody complex would be captured by SEA which had been absorbed on the nitrocellulose membrane and a gray band was shown.

RESULTS

A total of 137 sera samples from S. japonicum epidemic area were tested, and the consistency, sensitivity, and specificity of colloidal carbon dipstick assay were 98.54%, 98.99%, and 97.37%, respectively, compared with the IHA method. The gray scale of bands on the dipstick was curvilinear to serum titer which revealed that the assay could be used semi-quantitatively in serum analysis.

CONCLUSION

Colloidal carbon dipstick assay is not only rapid and simple, but also sensitive and specific for the detection of serum antibodies of schistosomiasis japonica. It will be a practical immunological assay for the diagnosis of schistosomiasis in the field testing.

[Cloning, expression and identification of membrane protein Tetraspanin 2-A of Schistosoma japonicum]

OBJECTIVE

To clone and express a membrane protein (Tetraspanin 2) gene of Schistosoma japonicum (SjTsp2).

METHODS

A pair of primers was designed to amplify the SjTsp2 gene which was subcloned into prokaryotic plasmid pET28a(+). The recombinant plasmid was transformed into E. coli BL21(D3) and followed by expression of the protein induced by IPTG. The protein was purified by affinity chromatography and used to immunize BALB/c mice. Dilution of antibody against SjTsp2 was determined by ELISA. The protein was also identified by Western blotting.

RESULTS

Big loop of SjTsp2-A, 228 bp, was amplified in vitro by PCR. Its deduced amino sequence shared 52% similarity with SmTsp2. The soluble recombinant SjTsp2-A was expressed in the experiment and high dilution antibody against the recombinant (1:32,000 in maximum) was produced in immunized mice. SjTsp2-A reacted positively with sera of acute and chronic schistosomiasis patients but not with sera from healthy persons by Western blotting.

CONCLUSION

SjTsp2 has been expressed and shows certain antigenicity.

[Effect of IgG3 antibody purified from sera of Microtus fortis against Schistosoma japonicum]

IgG3 antibody reaction to soluble antigens prepared from schistosomula (SSA), adult worms (SAWA) and eggs (SEA) in laboratory-bred Microtus fortis (Mf), BALB/c mice and Kunming (Km) mice challenged by cercariae of Schistosoma japonicum was detected by indirect ELISA. The effect of purified IgG3 antibody on in vitro killing schistosomula and protecting mice from infection of S. japonicum was evaluated. The IgG3 antibody level in Mf against SSA and SAWA increased significantly by 79.6 percent and 49.6 percent after the fourth week of challenge infection, but no significant increase in BALB/c mice. Purified IgG3 antibody from laboratory-bred Mf and wild Mf effectively killed schistosomula, and that of the wild Mf induced higher worm-reduction rate. The death rate of schistosomula due to IgG3 antibody purified from sera of laboratory-bred Mf and wild Mf was 2.35 and 5.88 times as high as that of Km mice respectively. The results suggest that IgG3 antibody from Microtus fortis may play an important role in immunity against S. japonicum.

Spatial risk profiling of Schistosoma japonicum in Eryuan county, Yunnan province, China

Bayesian spatial risk profiling holds promise to enhance our understanding of the epidemiology of parasitic diseases, and to target interventions in a cost-effective manner. Here, we present findings from a study using Bayesian variogram models to map and predict the seroprevalence of Schistosoma japonicum in Eryuan county, Yunnan province, China, including risk factor analysis. Questionnaire and serological data were obtained through a cross-sectional survey carried out in 35 randomly selected villages with 3,220 people enrolled. Remotely-sensed environmental data were derived from publicly available databases. Bivariate and non-spatial Bayesian multiple logistic regression models were used to identify associations between the local seroprevalence and demographic (i.e. age and sex), environmental (i.e. location of village, altitude, slope, land surface temperature and normalized difference vegetation index) and socio-economic factors. In the spatially-explicit Bayesian model, S. japonicum seroprevalence was significantly associated with sex, age and the location of the village. Males, those aged below 10 years and inhabitants of villages situated on steep slopes (inclination =20 degrees ) or on less precipitous slopes of >5 degrees above 2,150 m were at lower risk of seroconversion than their respective counterparts. Our final prediction model revealed an elevated risk for seroconversion in the plains of the eastern parts of Eryuan county. In conclusion, the prediction map can be utilized for spatial targeting of schistosomiasis control interventions in Eryuan county. Moreover, S. japonicum seroprevalence studies might offer a convenient means to assess the infection pressure experienced by local communities, and to improve risk profiling in areas where the prevalence and infection intensities have come down following repeated rounds of praziquantel administration.

[Development and identification of the multiple B cell epitope antigens of Schistosoma japonicum]

OBJECTIVE

To develop multiple B cell epitope antigens of Schistosoma japonicum and evaluate their antigenicity.

METHODS

Bioinformatics software BioSun was used to predict B cell epitopes from Sj22.6, Sj14-3-3 and Sj26. The predicted epitopes P2, P6 and P7 were ligated to construct P2-P6-P7 and P6-P2-P7 multiepitope in random order, a 6 amino acid linker inserted between epitopes. Recombinant plasmids containing the two multiepitopes identified by enzyme digestion and sequencing were transformed into E. coli BL21. The expressed recombinant fusion proteins of E. coli BL21 induced with IPTG were purified with Ni2+ chelating HiTrap HP column. Their antigenicity was evaluated with Western-blotting.

RESULT

The two multiple B cell epitopes P2-P6-P7 and P6-P2-P7 were successfully cloned into pET-32c(+) plasmid and fusion proteins were expressed. SDS-PAGE showed a single band and both of the recombinant fusion proteins were with Mr 20 400. The two proteins reacted with the sera of schistosomiasis patients but not with that of healthy people.

CONCLUSION

Two multiple B cell epitope antigens were developed with potential diagnosis value.

Field comparison of immunodiagnostic and parasitological techniques for the detection of Schistosomiasis japonica in the People's Republic of China

A total of 1,811 individuals from two villages located in the areas of China endemic for Schistosoma japonicum were analyzed by the Kato-Katz parasitologic examination, indirect hemagglutination assay (IHA), and enzyme-linked immunosorbent assay (ELISA). Statistical analysis of the results showed the kappa indices ranged from 0.106 to 0.234 between IHA and the stool examination and ranged from 0.037 to 0.134 between ELISA and the fecal examination. The sensitivity value of the IHA was 83.7% in Village A and 92.3% in Village B; the specificity value of the IHA was 55.8% in Village A and 67.3% in Village B. The sensitivity value of the ELISA was 88.4% in Village A and 96.2% in Village B; the specificity value of the ELISA was 38.4% in both Village A and Village B. A search for a good diagnostic test that can be applied in field situations in China should be given high priority.

[Potential risks for transmission of schistosomiasis caused by mobile population in Shanghai]

OBJECTIVE

To understand the potential risk for schistosomiasis transmission caused by introduction of infection source from mobile population in Shanghai.

METHODS

Field investigation was conducted in the suburb of Shanghai City by screening the mobile population living in Shanghai for more than 1 month and over 1 years old in a procedure of interviewing, serum indirect hemagglutination (IHA) test, and then fecal examination to detect the eggs with nylon sedimentation approach for those IHA positives.

RESULTS

Among 2,931 mobile people investigated, 1,575 were male (53.74%) and 1356 were female(46.26%); 138 out of 2931 were positive in IHA test (4.71%). 1938 (66.12%) out of 2 931 came from Schistosoma japonicum-endemic provinces and its positive rate in mobile population (5.99%) was significantly higher than those from the transmission-interrupted provinces (2.6%) (chi2=10.28, P<0.01), and those from non-endemic provinces (1.68%) (chi2=12.86, P<0.01). The 138 IHA positives all showed negative in fecal examination. In accordance with the serum positive rate and egg-infection rate in the national reporting system in 2004, it was estimated that there would be about 13 356 and 1 699 potential serum positive cases respectively from endemic area and transmission controlled area, and about 2,168 and 255 egg-positive cases from the two kind areas respectively, majority of the cases were from Anhui Province.

CONCLUSION

Schistosomiasis transmission risks potentially exist in Shanghai suburb due to the introduction of infected mobile people from other endemic provinces, and a surveillance system and quick response are needed for the possible re-emergence of the disease.

[Secreted expression of signaling protein 14-3-3 of Schistosoma japonicum in Pichia pastoris system with primary evaluation on its antigenicity]

OBJECTIVE

To express signaling protein Sj14-3-3 in Pichia pastoris and compare its antigenicity with prokaryotic expression one.

METHODS

Sj14-3-3 gene was amplified from pET28a-Sj14-3-3 recombinant plasmid, cloned into vector pMD18-T followed by sequencing. The Sj14-3-3 gene was subcloned into the expression vector pPICZalpha-B and transformed into Pichia pastoris X-33 by electroporation. The transformants were identified by sequencing. Three transformants with high copies were obtained when selected under zeocin, and expression was induced with methanol. The culture supernatant was collected and tested by SDS-PAGE and Western blotting. The specificity and sensitivity of eukaryotic expression rSj14-3-3 in Pichia pastoris were compared with that from prokaryotic expression by detecting sera of patients with schistosomiasis by indirect ELISA.

RESULTS

The Sj14-3-3 gene was integrated into Pichia pastoris, and the gene of interest detected by PCR was with 1 300 bp. After induction by methanol, the Sj14-3-3 gene was expressed and secreted into the medium. The molecular weight of the recombinant protein was determined as about Mr 35 000 by SDS-PAGE. Western blotting showed that the protein has a high specificity against mouse-anti-Sjl4-3-3 monoclonal antibody. The recombinant protein had a promising immune reactivity. Indirect ELISA showed that by using eukaryotic expression rSj14-3-3 in Pichia pastoris, the positive rate in 36 cases of acute schistosomiasis was 81%, with no cross-reactivity in 12 cases of Clonorchis sinensis, 9.3% cross-reactivity in 32 cases of normal sera. While using prokaryotic expression rSj14-3-3 in E.coli, the positive rate in 36 cases of acute schistosomiasis was 88.9%, with 16.7% cross-reactivity in 12 cases of Clonorchis sinensis, 12.5% cross-reactivity in 32 cases of normal sera. There was no statistically significant difference of the results (P>0.05).

CONCLUSION

The recombinant protein Sj14-3-3 of eukaryotic expression in Pichia pastoris has been successfully harvested and shows a promising immunological potential.

[DNA vaccine encoding SjIR3 induces partial immune protection against Schistosoma japonicum in mice]

OBJECTIVE

To detect the protection in mice induced by DNA vaccine encoding SjIR3 against Schistosoma japonicum (Sj).

METHODS

Sj1R3 was amplified by PCR with specific primers and linked to T vector. The reconstructed plasmid was digested by Xho I and BamH I. The target segments were collected and inserted into pcDNA3.0 to construct DNA vaccine SjIR3/pC. Fifty-four female mice were divided into 3 groups: groups A and B received normal saline and pcDNA3.0 respectively as controls, and group C was immunized with SjIR3/pC. All the mice were injected three times with an interval of two weeks. Sera were collected before each inoculation and before challenge infection. Six mice from each group were sacrificed 2 weeks after the final inoculation and spleen cells were collected. Serum IgG was detected by ELISA and the proliferation activity of spleen T lymphocytes induced by ConA or rSjIR3 was detected by MTT assay. The remaining mice were infected by (40+/-1) Sj cercariae per mouse 2 weeks after the final inoculation. Forty-five days later, mice were sacrificed and perfused, numbers of adult worms and of eggs in liver tissue were counted.

RESULTS

ELISA showed no significant change of serum IgG level in groups A and B, but considerable increase in group C (0.78+/-0.05) (P<0.01). The proliferation activity of spleen T lymphocytes increased with the induction of ConA or recombinant protein rSjIR3 after the final inoculation. The A570 was 0.57+/-0.02 and 0.68+/-0.01 respectively, showing a significant difference in comparison to the groups A and B (P<0.01). The worm reduction rate and the egg reduction rate in group C were 29.42% and 36.56% respectively.

CONCLUSION

DNA vaccine encoding SjIR3 induces humoral and cell-mediated immune response, and shows partial immune protection against Schistosoma japonicum.

Rapid, Simple, and Sensitive Immunoagglutination Assay with SiO2 Particles and Quartz Crystal Microbalance for Quantifying Schistosoma japonicum Antibodies

Background: The resurgence of the parasitic disease schistosomiasis calls for more efficient diagnostic tests. We developed a rapid, simple, portable, and sensitive immunoagglutination assay that uses SiO2 particles and quartz crystal microbalance (QCM) for quantifying Schistosoma japonicum (Sj) antibodies (SjAb).

Methods: We prepared submicrometer-sized silica particles derivatized with Sj antigens as replacements for traditional latex microspheres to specifically agglutinate in the presence of SjAb targets, and we used the QCM monitor to measure the resulting frequency shifts. We optimized the assay medium by adding poly(ethylene glycol) (PEG) as a response accelerator of immunoagglutination. To minimize or eliminate any nonspecific agglutination or adsorption interferences, we conducted appropriate sealing procedures separately for silica particles and the QCM probe.

Results: The measured frequency changes were linearly related to the SjAb concentrations in infected rabbit serum. The PEG-assisted immunoagglutination system was quantitatively sensitive to SjAb concentrations ranging from ∼0.70 to 32.31 mg/L, with a detection limit of ∼0.46 mg/L. The obtained linear regression equation was: y = 43.61 x + 80.44 (r = 0.9872). Several serum specimens were evaluated with the developed QCM immunoassay and the results were compared with ELISA, validating the feasibility of practical applications.

Conclusions: This novel immunoagglutination-based QCM detection format is rapid, simple to use, and more portable than conventional diagnostic immunoassays, thus offering a promising alternative tool that can be used for point-of-care clinical diagnosis of schistosomiasis, particularly in epidemic situations.

[Protective immunity induced by recombinant Schistosoma japonicum thioredoxin in mice]

OBJECTIVE

To investigate the protective immunity of the recombinant thioredoxin of Schistosoma japonicum(reSjcTrx)in mice.

METHODS

Thirty 6-week old female C57BL/6 mice were randomly divided into 3 groups with 10 each: reSjcTrx with Montanide ISA720 adjuvant, adjuvant control, and infection control. Mice were vaccinated subcutaneously at week 0, 2, 4 with reSjcTrx emulsified in Montanide ISA720 adjuvant. The mice in adjuvant group was injected three times with Montanide ISA720 and saline only. Mice in infection control group were given no injection. Three weeks after final injection, each mouse was challenged with 30 +/- 1 cercariae of S. japonicum (Chinese strain). At the week six after challenge, all mice were sacrificed and perfused. The number of recovered worms and eggs from liver tissue of mice were counted. Sera were collected from mice before immunization, before challenge and before killing. The anti-SjcTrx antibodies in sera were detected with ELISA.

RESULTS

ELISA showed a high level of specific IgG antibodies in mice immunized with the reSjcTrx. The worm reduction rate and egg reduction rate of reSjcTrx immunization group were 22.8% and 29.5% respectively, significantly higher than those of the control groups (P < 0.05). SDS-PAGE and Western blotting revealed that the molecular weight of expressed protein was around Mr 14 000 and could be recognized by sera from rabbit infected with S. japonicum and from mice immunized with reSjcTrx.

CONCLUSION

The reSjcTrx induces certain protective immunity against schistosomiasis japonica in mice.

[Antibody detection in sera of patients with Schistosomiasis japonica by dot immunogold filtration assay]

Serum antibody of schistosomiasis patients was detected by dot immunogold filtration method (DIGFA) in laboratory and field, and F-ELISA was used as control. The results showed that there was no significant difference between these two assays in sensitivity and specificity (P > 0.05), with a high coincidence. DIGFA is easy to operate and may deserve a wide application in the diagnosis of schistosomiasis.

Oligonucleotide microarray analysis of strain- and gender-associated gene expression in the human blood fluke, Schistosoma japonicum

Schistosomiasis is a chronic and debilitating disease caused by blood flukes (digenetic trematodes) of the genus Schistosoma. Schistosomiasis japonica, a zoonosis caused by Schistosoma japonicum, is endemic to the Philippines and China. We utilised a 22,575 feature custom oligonucleotide DNA microarray designed from public domain databases of schistosome-expressed sequence tags to explore differential gene expression between the Philippine (SJP) and Chinese (SJC) strains of S. japonicum, and between male and female S. japonicum. We found that 593, 664 and 426 probes were differentially expressed between the two geographical strains when we compared mix sexed adults, male worms and female worms. Additionally, the study revealed that 1163 male- and 1016 female-associated probes were differentially expressed in SJP whereas 1047 male- and 897 female-associated probes were differentially expressed in SJC. The study greatly expands previously published data of strain and gender-associated differential expression in S. japonicum. Further, these new data provide a stepping stone for understanding the complexities of the biology, sexual differentiation, maturation, and development of human schistosomes, signaling new approaches for identifying novel intervention and diagnostic targets against schistosomiasis.

Comparison of the role of dendritic cells and macrophages in inducing protective immunity against Schistosoma japonicum

OBJECTIVE

To compare a potential role of dendritic cells (DCs) and macrophages in inducing protective immunity against infection with Schistosoma japonicum.

METHODS

DCs and macrophages were pulsed in vitro with soluble egg antigen (SEA) of S. japonicum. BALB/c mice were injected three times with DCs or macrophages, either antigen-pulsed or not, and challenged with 40 +/- 2 cercariae of S. japonicum per mouse. Worms were collected 42 days later by portal perfusion of the mice and egg number of liver was calculated. To evaluate whether protective immunity had been induced by preparations of DCs or macrophages, the worm burden and fertility (eggs per female per mouse liver) were compared between the groups of mice. The antibody level against SEA was detected by ELISA.

RESULTS

With respect to mice injected with untreated cells, numbers of worms and eggs per female worms were significantly reduced in the groups of mice having received pulsed DCs (26. 3% and 37.9%, respectively), or pulsed macrophages (22.0% and 30.7%). Untreated DCs and macrophages induced no significant effects. The antibody level against SEA rose in sera of all groups of mice up to 42 days after the challenge, but most pronounced in those immunized with pulsed DCs, although this was not significantly different from other groups.

CONCLUSION

The results suggest that the protective immunity against S. japonicum might be induced by DCs to a higher extent than by macrophages after in vitro pulsing with egg antigen.

Schistosomiasis japonica, anemia, and iron status in children, adolescents, and young adults in Leyte, Philippines 1

BACKGROUND

Observational and interventional evidence supports a relation between human schistosomiasis and anemia; however, the exact causal mechanisms remain unclear. Eggs translocating across the intestinal or bladder wall may result in extracorporeal blood loss with subsequent iron deficiency. Alternatively, anemia may result from cytokine-mediated dyserythropoiesis, as seen in anemia of inflammation.

OBJECTIVES

By evaluating the cross-sectional relation between the intensity of Schistosoma japonicum infection, hemoglobin concentration, and iron status in 7-30-y-old persons from S. japonicum-endemic rice-farming villages in the province of Leyte, Philippines, we assessed the relative contribution of iron deficiency and anemia of inflammation to schistosomiasis-associated anemia.

DESIGN

We enrolled 627 S. japonicum-infected and 111 S. japonicum-uninfected persons. We obtained stool samples to quantify S. japonicum infection and venous blood samples for hemograms and measures of iron status and inflammation.

RESULTS

Intensity of S. japonicum infection was independently associated with hemoglobin (beta = -0.24; 95% CI: -0.31, -0.17). Persons with high-intensity infection had a greater risk of iron deficiency anemia (adjusted prevalence odds ratio: 6.6; 95% CI: 2.9, 14.7), but there was no evidence of this relation in low-intensity infections. In contrast, anemia without iron deficiency was prevalent across all intensities (adjusted prevalence odds ratio: 3.8; 95% CI: 1.5, 9.5).

CONCLUSIONS

Storage iron deficiency is a major contributor to anemia in high-intensity S. japonicum infection. A high prevalence of anemia without iron deficiency, exclusion of other mechanisms of anemia, and the evidence of low bioavailable iron suggest that anemia of inflammation contributes to S. japonicum-associated anemia at all infection intensities.

Determination of serum levels of YKL-40 and hyaluronic acid in patients with hepatic fibrosis due to schistosomiasis japonica and appraisal of their clinical value

The objectives of this study were (i) to evaluate the serum levels of human cartilage glycoprotein 39 (YKL-40) and hyaluronic acid (HA) in people infected with Schistosoma japonicum, and (ii) to determine their clinical value. A total of 563 people were subjected to ultrasonography, and 60 patients were identified with either mild (n=30) or severe (n=30) hepatic fibrosis. In addition, 28 healthy subjects were included as controls. Blood sera of these 88 people were examined with regard to the levels of YKL-40 and HA. The former was measured by enzyme-linked immunosorbent assay, and serum HA was determined by a commercially available radioimmunoassay method. On the basis of the ultrasonographic investigations, HA levels in normal, mild, and severe cases of hepatic fibrosis were 83.0+/-35.7, 216.1+/-77.9 and 212.6+/-80.9 microg/ml, respectively. When the same sera were tested for YKL-40, 49.0+/-10.4, 92.3+/-18.5 and 172.1+/-35.9 microg/ml, respectively, were recorded in the three groups. Thus, the serum levels of YKL-40 are not only increased in patients infected with S. japonicum but they are also correlated with the stage of hepatic fibrosis. In conclusion, it appears that YKL-40 is more sensitive than HA in measuring the degree of hepatic fibrosis due to schistosomiasis, which warrants further investigation.

Nutritional status and serum cytokine profiles in children, adolescents, and young adults with Schistosoma japonicum-associated hepatic fibrosis, in Leyte, Philippines

In a cross-sectional study of 641 Schistosoma japonicum-infected individuals in Leyte, Philippines, who were 7-30 years old, we determined the grade of hepatic fibrosis (HF) by ultrasound and used anthropometric measurements and hemoglobin levels to assess nutritional status. Serum levels of interleukin (IL)-1, IL-6, and IL-10; tumor-necrosis factor (TNF)-alpha; soluble TNF- alpha receptor I; and C-reactive protein (CRP) were measured to examine the association between these markers of inflammation and HF grade. HF was present in 8.9% of the cohort; the majority of cases were mild (grade I), and severe (grade II or grade III) cases occurred only in male individuals. Compared with individuals without HF, those with severe HF--and, to a lesser degree, those with mild HF--had a significantly lower body-mass index (BMI) and BMI z-score, a higher prevalence of anemia, and a higher level of CRP and were more likely to produce IL-6; furthermore, those with severe HF had a significantly higher level of IL-1, compared with those either without HF or with mild HF. These findings suggest that even mild HF is associated with nutritional morbidity and underscore the importance of early recognition and treatment. In addition, our data are consistent with the hypothesis that, by systemically increasing the levels of the proinflammatory cytokines IL-1 and IL-6, HF causes undernutrition and anemia.

Expression, purification, and human antibody response to a 67 kDa vaccine candidate for schistosomiasis japonica

Schistosomiasis remains a leading cause of morbidity and mortality in the developing tropical world, and vaccines to prevent these infections remain a scientific and public health priority. Sj67 is a 67 kDa Schistosoma japonicum surface membrane protein homologous to a family of actin-binding proteins. Sj67 is recognized by a mouse monoclonal antibody (mAb 6) that confers resistance to challenge infection in passive transfer experiments. These data support Sj67 as a potential vaccine candidate for schistosomiasis japonica. In the present study, we report the ligation-independent cloning of a cDNA encoding thioredoxin/elastin-like polypeptide (ELP)/rSj67 into a pET-32 Xa/LIC vector. Soluble recombinant fusion protein (Thio-ELP-rSj67) was expressed and purified using anion-exchange and size exclusion chromatography. rSj67 was cleaved from the Thio-ELP fusion partner by digestion with Factor Xa protease and purified using hydroxyapatite column chromatography. Endotoxin was reduced by absorption to a polymyxin support. Purified rSj67 had a molecular weight of 67 kDa and N-terminal sequencing confirmed that the first five amino acids of the recombinant protein matched the predicted sequence for the Sj67 gene. In Western blot analysis, rSj67 was recognized by the Sj67 specific mAb 6 antibody. IgG antibodies in sera from schistosomiasis infected volunteers living in an endemic area of the Philippines (n = 13) recognized rSj67 with 4.7-fold greater median fluorescence compared to uninfected North American controls (n = 5) (p < 0.009). Together, these data confirm the expression and purification of recombinant Sj67 and its immuno-reactivity with sera from S. japonicum infected humans.

Comparative study on rapid dot-immunogold staining and two immunogold silver staining assays for diagnosing schistosomiasis japonica

A fast, specific, sensitive, convenient, and economical rapid-dot-immunogold staining (R-Dot-IGS) assay was used to detect serum antibodies in patients infected with Schistosoma japonicum. The soluble egg antigen of Schistosoma japonicum was added onto microspore membrane. After pre-reacting and blocking, the serum to be detected and sheep anti-human IgG labeled with chloroauric acid were added sequentially. The assay took 15 minutes. For comparison, the dot-immunogold silver staining (Dot-IGSS) and rapid micro-volume Dot-IGSS (RM-Dot-IGSS) assay were also performed. The positive rate to detect the serum of schistosomiasis japonica by the R-Dot-IGS, Dot-IGSS and RM-Dot-IGSS assay was 98%, 98% and 100%, respectively. Samples from 50 healthy controls, 10 cases of clonorchiasis, and 10 cases of paragonimiasis showed negative reactions except for one case of clonorchiasis with RM-Dot-IGSS assay. Compared with Dot-IGSS and RM-Dot-IGSS, R-Dot-IGS assay has similar sensitivity and specificity, but the latter is quicker, simpler, and cheaper. Therefore, R-Dot-IGS is strongly recommended for rapid diagnosis of schistosomiasis japonica both in epidemiological study and in the clinic.

[The clinical significance of interferon-gamma and its receptor in patients with schistosomiasis]

OBJECTIVE

To study the expression of interferon-gamma (IFN-gamma) and type I interferon-y receptor (IFN-gammaRI) in the chronic and advanced patients of schistosomiasis japonica, and to discuss its clinical relationship with hepatic fibrosis. Methods IFN-yR1 in the peripheral blood lymphocytes was detected by ELISA, and the hyaluronic acid (HA) , collagen type IV (C-IV), procollagen type III (PC III), laminin (LN) were detected by radio-immunoassay (RIA) in schistosomiasis patients. The level of IFN-y, IFN-gammaR1 and serum markers of hepatic fibrosis were observed, and the relationship with each other was analyzed by statistical method.

RESULTS

There was no difference in the expression of IFN-gamma and IFN-gammaR1 between the patients with chronic schistosomiasis and the normal group (P > 0. 05 ), the IFN-gammaR1 in advanced cases without splenectomy was low (P <0. 05) , but IFN-y was high (P < 0. 01). The two indicators in the advanced schistosomiasis patients with splenectomy returned to normal. There was no corresponding relationship between the two indicators and HA, C-IV, PC III, LN with a r value of 0. 19, 0.20, 0. 14, and 0.21 respectively.

CONCLUSION

There is a corresponding relationship between IFN-gamma and IFN-gammaR1; the expression of IFN-gammaR1 is related to the course of schistosomiasis, and the relationship with hepatic fibrosis needs further study.

IFN-gamma is associated with risk of Schistosoma japonicum infection in China

Before the start of the schistosomiasis transmission season, 129 villagers resident on a Schistosoma japonicum-endemic island in Poyang Lake, Jiangxi Province, 64 of whom were stool-positive for S. japonicum eggs by the Kato method and 65 negative, were treated with praziquantel. Forty-five days later the 93 subjects who presented for follow-up were all stool-negative. Blood samples were collected from all 93 individuals. S. japonicum soluble worm antigen (SWAP) and soluble egg antigen (SEA) stimulated IL-4, IL-5 and IFN-gamma production in whole-blood cultures were measured by ELISA. All the subjects were interviewed nine times during the subsequent transmission season to estimate the intensity of their contact with potentially infective snail habitats, and the subjects were all re-screened for S. japonicum by the Kato method at the end of the transmission season. Fourteen subjects were found to be infected at that time. There was some indication that the risk of infection might be associated with gender (with females being at higher risk) and with the intensity of water contact, and there was evidence that levels of SEA-induced IFN-gamma production were associated with reduced risk of infection.

A historical view of schistosomiasis japonica in the Chikugo river basin. What can we learn from autopsy?

Three hundred and forty-nine autopsy cases of schistosomiasis japonica were divided into two groups, based on the pathomorphology. Frequent regressive hepatic lesions such as active schistosomal lesion and destruction of limiting plates characterized the first group. The second group showed reparative hepatic lesions such as regeneration of the collapsed parenchyma, newly formed limiting plates and subsequent narrowing and disappearance of fibrous septa. Complications of liver cirrhosis and hepatocellular carcinoma related to viral hepatitis B and/or C also increased. Clonorchiasis was consistently found in both groups.

Immunoblot analysis of Schistosoma japonicum egg antigens with sera from patients with acute and chronic schistosomiasis japonica

Humoral immune responses of IgG, IgM, IgA, IgE and IgG subclass antibodies to Schistosoma japonicum egg antigens were determined by immunoblotting with serum samples from individuals in China with acute (n=24) or chronic (n=35) schistosomiasis. In general, IgM, IgA, and IgE in sera from acute patients exhibited strong binding to antigens but binding was much weaker in chronic cases. Reaction of IgG4 of chronic cases was stronger than that of IgG4 of acute cases. The recognition profile of each antibody isotype in sera was analyzed for 11 major antigen molecules (antigens with apparent molecular weights of 82, 76, 61, 57, 53, 46, 40, 32, 27, 10 and less than 6.5 kDa). Except for the 10 kDa molecule, they were well-recognized by IgA and IgE in sera of acute cases. In other combinations of antibody class and clinical phase, recognition patterns against these molecules differed among individuals. Notably, the 10 kDa molecule was specifically recognized by total IgG and IgG4 in sera from most of the chronic patients, but in sera from only one acute case. This result suggests that the 10 kDa molecule is one of the major target antigens of IgG4 and may be useful as a marker antigen to characterize the clinical phases of S. japonicum infection.

Effect of Schistosoma japonicum infection on serum testosterone levels in mice

OBJECTIVE

To determine the effect of Schistosoma japonicum infection on the testoterone level in the sera from male C57BL/6 mice.

METHODS

Radioimmunoassay was used to examine testosterone levels in sera of 9 male mice experimentally infected with Schistosoma japonicum.

RESULTS

The serum testosterone levels reduced significantly in all experimentally infected animals 45 days after infection, as compared with the uninfected controls.

CONCLUSION

Infection with Schistosoma japonicum decreases testosterone levels in the mouse host.

Identification of a novel eosinophil chemotactic cytokine (ECF-L) as a chitinase family protein

A novel eosinophil chemotactic cytokine (ECF-L) was purified from the culture supernatant of splenocytes of mice by a combination of anion-exchange chromatography, Procion red-agarose affinity chromatography, size exclusion high performance liquid chromatography (HPLC), and reverse phase HPLC. The NH(2)-terminal amino acid sequence was determined by direct protein sequencing. An ECF-L cDNA clone of 1,506 nucleotides was isolated from a cDNA library, and the nucleotide sequence predicted a mature protein of 397 amino acids. A recombinant ECF-L showed a level of eosinophil chemotactic activity comparable with that of natural ECF-L, and the activity was inhibited by a monoclonal antibody to ECF-L. ECF-L also attracted T lymphocytes and bone marrow polymorphonuclear leukocytes in vitro, whereas it caused selective extravasation of eosinophils in vivo. ECF-L mRNA was highly expressed in spleen, bone marrow, lung, and heart. A comprehensive GenBank data base search revealed that ECF-L is a chitinase family protein. ECF-L retains those amino acids highly conserved among chitinase family proteins, but Asp and Glu residues essential for the proton donation in hydrolysis were replaced by Asn and Gln, respectively. Although ECF-L contains a consensus CXC sequence near the NH(2) terminus akin to chemokine family proteins, the rest of ECF-L shows poor homology with chemokines.

The role of TGF-beta 1 in mice hepatic fibrosis by Schistosomiasis Japonica

To investigate the role of transforming growth factor-beta 1 (TGF-beta 1) in mice with hepatic fibrosis caused by Schistosomiasis Japonica, ELISA, VG staining and multimedia color hieroglyph quantitative analysis were used to study the change of the serum TGF-beta 1, liver collagen fiber and reticular fiber in mice. The level of serum TGF-beta 1 in experimental group was significantly higher than that in control group (P < 0.01 or P < 0.05) 8, 10, 12 weeks after infected by schistosomiasis. After infection, the level of liver collagen fiber and reticular fiber, and that of TGF-beta 1 increased over time (P < 0.01 or P < 0.05). In mice infected by Schistosomiasis Japonica, the level of TGF-beta 1 increased with prolongation of infection time, and with the increase of liver collagen fiber and reticular fiber. TGF beta 1 plays an important role of immunomodulation in hepatic fibrosis formation caused by Schistosomiasis Japonica.

Human antibody isotype responses to Schistosoma japonicum egg antigen

Schistosoma japonicum-infected subjects from Hubei province of China were investigated to determine the class and subclass of the antibody response to soluble egg antigen (SEA), using an enzyme-linked immunosorbent assay. The subjects were 50 acute and 55 chronic cases. In acute cases, the mean OD values for IgA, IgE and IgG3 were very high, while the positive ratios of IgA and IgE were only 78% and 74%, respectively. The positive ratios of IgG, IgM, IgG1, IgG3 and IgG4 were all above 90%. In chronic cases, the mean OD values for IgG, IgG3 and IgG4 were very high, and the positivity rates of IgG, IgG1, IgG3 and IgG4 were all above 90%. Comparing the two study groups, the mean OD values of IgM, IgA, IgE were higher in acute cases than those of chronic cases (p < 0.0001), while the mean OD values of IgG, IgG4 were higher in chronic cases than in acute cases (p < 0.05). The mean OD values of IgG3 in both groups were high and those of IgG2 in both groups were low.

Differential antigen-stimulated proliferation of human mononuclear cells by recombinant Schistosoma japonicum antigens in a Chinese population

Peripheral blood mononuclear cells (PBMC) from 117 individuals living on two islands in an area (Dongting Lake) endemic for schistosomiasis japonica in China, and 15 control individuals from a non-endemic area of China, were assessed for antigen-stimulated proliferation against five recombinant Schistosoma japonicum antigens of recognized interest in the development of immunity to schistosomiasis. Two recombinant antigens, paramyosin and 28-kD glutathione-S-transferase, stimulated cellular proliferation (stimulation index > or = 3.0) in 38.5% and 42.5% of subjects, respectively, a level similar to that induced by a soluble whole parasite extract (51.3%). In contrast, three other recombinant antigens tested--a fatty acid binding protein, 22-kD tegumental membrane-associated antigen, and glyceraldehyde-3-phosphate dehydrogenase--stimulated PBMC proliferation in only 3-8% of subjects. Moreover, we also identified a positive association between the degree of exposure, and cellular proliferation following stimulation with recombinant paramyosin or whole parasite extract. Highly significant differences in antigen-stimulated proliferation were also observed between the two islands, Niangashan and Qingshan. The whole parasite extract stimulated proliferation in 90% of subjects from Niangashan island compared with only 42.1% of subjects from Qingshan island (chi2 = 16.88, P = 0.00004), while glutathione-S-transferase stimulated proliferation in 77.3% of subjects from Niangashan island compared with only 34.7% of subjects from Qingshan island (chi2 = 13.09, P = 0.003). A similar, but not significant, trend was observed for paramyosin and the fatty-acid binding protein. The identification of differential cellular proliferative responses to specific schistosome antigens within an infected human population may have important practical implications for vaccine development against schistosomiasis japonica.

Proton nuclear magnetic resonance detects leucine, 2,3-butanediol, and a prominent increase in the level of choline in the sera from patients chronically infected with schistosomiasis japonica

1H-NMR spectroscopy with 'Hahn' spin-echo pulse sequence has been employed to investigate the metabolic profiles of sera of chronic patients with schistosomiasis japonica, and compared with those of healthy volunteers and former patients who had been treated successfully. 1H-NMR clearly detected 2,3-butanediol and leucine, and markedly elevated levels of choline in sera from the chronic patients. Profiles of the sera from former patients were essentially similar to those from healthy volunteers, except that ketone bodies (3-hydroxybutyrate and acetone) were detectable in sera from 58% of the former patients but not in those of the normal controls patients.

Schistosoma japonicum and Trichuris suis infections in pigs fed diets with high and low protein

The aim of the study was to measure the impact of Schistosoma japonicum and Trichuris suis infections in young growing pigs fed low- or high-protein diets. Thirty-two pigs. 6-10 weeks old, were randomly allocated to 2 groups receiving either a high- or a low-protein diet. After 11 weeks half of the pigs from each group were infected with 1500 S. japonicum cercariae and 4000 T. suis eggs. The weight of the pigs was measured throughout the study, and blood and faecal samples were collected every second week from the time of infection. At the time of infection the low-protein pigs had significantly lower mean body weights, haemoglobin and albumin levels compared with the high-protein pigs, and this pattern continued throughout the study. The serum albumin concentration was further significantly reduced in the infected low-protein pigs compared to the non-infected low-protein pigs. Significantly more S. japonicum worms as well as faecal and tissue eggs were found in the low-protein pigs compared with the high-protein pigs. No differences between the 2 diet groups were observed in T. suis establishment rates or faecal egg excretion. We conclude that this low-protein diet increased the establishment rates of S. japonicum, favoured larger deposits of S. japonicum eggs in the liver and faecal egg excretion, reduced weight gains and caused anaemia and hypoalbuminaemia in young growing pigs as compared with a high-protein diet.

The serological differentiation of acute and chronic schistosomiasis japonica using IgA antibody to egg antigen

Two groups of Schistosoma japonicum infected patients (acute and chronic) and non-infected individuals were studied using IgA antibody to egg antigen (SEA) and IgG and IgM antibodies to keyhole limpet haemocyanin (KLH). The means and standard deviation of the optical density in ELISA of acute, chronic and negative groups for IgA anti-SEA were 583 +/- 124.7, 98.2 +/- 78.8 and 82.2 +/- 39.3, respectively. There was a statistically significance between acute patients and chronic patients (P < 0.01). The means and standard deviation of IgG and IgM antibodies to KLH were 501.5 +/- 150.6, 113.0 +/- 79.1, 28.8 +/- 56.3 and 413.6 +/- 148.5, 70.2 +/- 14.8, 65.3 +/- 45.3, respectively. The detection results of IgA to SEA compared with the IgG and IgM to KLH did not demonstrate a significant difference (P < 0.01). The sensitivities of IgA to SEA and IgG and IgM antibodies to KLH for the detection of acute infection were 95.24%, 90.48% and 85.71%, respectively. Therefore, this study showed that the detection of IgA to SEA is also a useful new method for the serological differentiation of acute and chronic schistosomiasis japonica in humans.

Schistosomiasis japonica and childhood nutritional status in northeastern Leyte, the Philippines: a randomized trial of praziquantel versus placebo

The hypothesis that infection with Schistosoma japonicum causes decreased nutritional status was studied in a randomized trial among 170 males and females, mean (SD) age 11.4 (3.5) years, residing in an endemic region of northeastern Leyte, Philippines. The S. japonicum-infected children were randomized to receive praziquantel or placebo and followed-up six months after randomization. Stature, weight, triceps, subscapular, and calf skinfold thicknesses and their sum, and hemoglobin level were measured at baseline and follow-up. Schistosoma japonicum eggs were detected in Kato-Katz stool smears and the intensity of infection was assessed by quantitative egg count. Intensities of hookworm, ascaris, and trichuris infections were also measured. The six-month levels of the anthropometric measures and hemoglobin were adjusted for age and their baseline levels and then compared between the praziquantel and placebo groups. Treatment interactions were also analyzed by sex. Baseline anthropometric and hemoglobin levels and parasite infection intensities were the same in the two groups. At six months, the praziquantel group had significantly higher hemoglobin levels (P < 0.001) and sum of skinfolds (P < 0.001) than the placebo group. Males had a significantly greater increase in hemoglobin levels with treatment than did females. The hemoglobin increase was not due to changes in hookworm intensity. The results show that schistosomiasis japonica caused decreased nutritional status in children and probably is partly responsible for the malnutrition and reduction in growth for age described in prior cross-sectional studies.

Circulating antigens in schistosomiasis: detection of 31/32-kDa proteins in sera from patients infected with Schistosoma japonicum, S. mansoni, S. haematobium, or S. intercalatum

A sandwich enzyme-linked immunosorbent assay (ELISA) was developed to detect 31/32-kDa schistosome proteins as circulating antigens in sera from schistosomiasis patients. A monoclonal antibody was used as a capture antibody and rabbit antiserum raised against purified 31/32-kDa proteins was the detecting antibody. Positive results were obtained with patients infected with Schistosoma japonicum (88%; n = 69), S. mansoni (80%; n = 56), S. haematobium (100%; n = 40), or S. intercalatum (94%; n = 65). Sera from uninfected Chinese and African individuals and from Chinese patients with trichinosis, cysticercosis, or paragonimiasis did not react in the assay. This ELISA appears to be valuable in diagnosing infections by all major human schistosome species.

Experimental studies on early treatment of schistosomal infection with artemether

An early treatment with artemether given in appropriate regimens was tested in mice, rabbits and dogs for prevention purposes. Artemether was administered intragastrically (ig) to the hosts on day 7 after infection with Schistosoma japonicum cercariae at a single dose, and the same dose of artemether was repeated every 1 or 2 weeks for 2-4 times. As a result, most of the female worms were killed before their oviposition with female worm reduction rates of 90-100%, resulting in protection of the host from damage induced by schistosome eggs. When rabbits were treated ig with artemether 10 mg kg-1 on day 7 after infection, followed by repeated dosing every week for 4 times, some parameters related to acute schistosomiasis, such as temperature, eosinophil count and eggs in the feces were negative, and low specific antigen and antibody levels in serum were seen. Further study showed that the appropriate regimens of Artemether were also effective in early treatment of reinfection with cercariae. When rabbits infected with 48-52 cercariae once every other day for 5 times were treated ig with artemether 15 mg kg-1, followed by repeated dosing every 1 or 2 week for 2- 3 times, the female worm reduction rates were 92.1-98.4%. Histopathological examination of the livers showed that the above-mentioned early treatment with Artemether exhibited a promising protective effect on dogs and rabbits. The major features included normal appearance of the liver resembling those of uninfected dogs and rabbits; few or no dispersed miliary egg tubercles appeared on the surface of the liver; the structure of the hepatic lobules was normal with normal arrangement of the liver bundles; few or no eggs appeared in the portal vein area and there was apparent diminution of total egg granuloma, comprising inflammatory, fibrous or scarred egg granuloma. On the basis of above-mentioned results, early treatment with Artemether could be recommended for field trial for controlling acute schistosomiasis, reducing infection rate and intensity of infection.