An in vitro larval motility assay characterizes anthelmintic efficacy against Crenosoma vulpis, Angiostrongylus vasorum, and Aelurostrongylus abstrusus

OBJECTIVE

This study determined the in vitro efficacy of 6 common anthelmintics (eprinomectin, ivermectin, milbemycin oxime, moxidectin, selamectin, and fenbendazole) on motility (viability) of infectious third-stage larvae (L3) of Crenosoma vulpis, Angiostrongylus vasorum, and Aelurostrongylus abstrusus, which are important causes of canine and feline cardiopulmonary disease.

SAMPLES

First-stage larvae (L1) from C vulpis, An vasorum, and Ae abstrusus.

PROCEDURES

Naïve Limax maximus slugs were fed 1,000 to 2,000 L1 and held at 16 °C for at least 4 weeks to produce live L3. Approximately 50 to 100 L3/well were subsequently incubated in culture media alone or media containing 6 separate test anthelmintics at 4 concentrations, to bracket expected in vivo drug plasma levels in anthelmintic-treated dogs and cats. Drug effects on L3 motility (viability) were analyzed by multilevel logistic models, generating dose-response relationships. Experiments were completed 1-9/2019.

RESULTS

Drug concentration estimates corresponding to a 50% larval mortality rate identified that C vulpis was the most sensitive species to the anthelmintics tested. Ae abstrusus was most susceptible to moxidectin and selamectin, while An vasorum was insusceptible to all anthelmintics tested, except for selamectin at high drug concentrations.

CLINICAL RELEVANCE

The in vitro anthelmintic response to antiparasitic agents may guide and improve disease therapy and prevention. Considering the observed lack of efficacy against L3, monthly anthelmintic treatment for protection against An vasorum infection in dogs would primarily rely on the anthelmintic's adulticidal activity. Maximal preventive control for An vasorum would, therefore, require at least 1 treatment administered a minimum of 1 week after the end of the transmission season.

Abdominal angiostrongyliasis in the Americas: fifty years since the discovery of a new metastrongylid species, Angiostrongylus costaricensis

Angiostrongylus costaricensis is a zoonotic parasitic nematode described for the first time in 1971 by Pedro Morera and Rodolfo Céspedes in Costa Rica. This parasite causes an infection known as abdominal angiostrongyliasis, affecting mainly school-aged children and young adults. Infection with A. costaricensis has been associated with a myriad of rodent and mollusk species in the Americas and the Caribbean, as its natural hosts and reservoirs. In this commemorative review, we highlight the extensive research collected through a 50-year journey, which includes ecological, pathological, and molecular studies on A. costaricensis and its implicated disease. We also identify major knowledge gaps in its evolutionary history, the ecological role of imported and invasive mollusk species, and immune response. We propose that the advent of -omics analyses will allow us to gather novel information regarding A. costaricensis biology and infection dynamics, as well as to promote the design of much-needed sensitive and specific diagnostic tools.

Quantitative proteomics analysis of Angiostrongylus vasorum-induced alterations in dog serum sheds light on the pathogenesis of canine angiostrongylosis

Blood contains hundreds of proteins, reflecting ongoing cellular processes and immune reactions. Infections with the blood-dwelling cardiopulmonary nematode Angiostrongylus vasorum in dogs manifest with a broad spectrum of clinical signs including respiratory distress, bleeding diathesis and neurological signs, and are associated with a perturbed blood protein profile in dogs. However, current knowledge does not completely explain the observed pathologies induced by A. vasorum infections, including bleeding disorders. Using sera from experimentally infected dogs, dog serum proteome was analysed by quantitative mass spectrometry methods over several time points before and after inoculation. Following computational analysis, we identified 139 up- and downregulated proteins after infection (log2 ratio cut-off ≥ 1.0; q-value ≤ 0.05). Among upregulated proteins were chitinase 3-like 1 and pulmonary surfactant-associated protein B (log2 fold-changes ≥ 5). Pathway enrichment revealed the complement (especially the lectin pathway) and coagulation cascades as significantly affected upon analysis of downregulated proteins. Among them were mannan-binding lectin serine peptidases, ficolin, and coagulation factor XIII-B. These results bring new elements towards understanding the underlying pathomechanisms of bleeding diatheses observed in some A. vasorum-infected dogs.

Use of a commercial serologic test for Angiostrongylus vasorum for the detection of A. chabaudi in wildcats and A. daskalovi in badgers

Three species of the genus Angiostrongylus are known to infect European carnivores: A. vasorum (mainly in canids but also in other carnivores), A. chabaudi (in felids) and A. daskalovi (in mustelids). A. vasorum is responsible for clinically severe disease in domestic dogs, most commonly diagnosed based on fecal examination and serological detection of circulating antigens. Considering the poorly known host range and the challenging larval differentiation in the feces between the three species of Angiostrongylus infecting European carnivores, our aim was to evaluate the cross-reactivity of A. chabaudi and A. daskalovi with A. vasorum using a commercial serologic test developed for domestic dogs. Badgers (Meles meles) (n=10) and wildcats (Felis silvestris) (n=8) were examined between 2015 and 2016 by full parasitological necropsy with subsequent morphological and molecular identification of nematodes and by serology, using IDEXX Angio Detect™ tests. Five out of the ten badgers and two out of the eight wildcats were harboring nematodes in the pulmonary arteries. All nematodes were identified morphologically as A. daskalovi in badgers and A. chabaudi in wildcats, respectively. Serological examination of the plasma samples revealed the positivity of the same animals as found in necropsy. None of the animals negative at necropsy was positive at serology. The 100% correlation between the necropsy results and the serologic positivity to IDEXX Angio Detect™ in badgers infected with A. daskalovi and wildcats infected with A. chabaudi suggest that these rapid tests are able to identify circulating antigens of all species of Angiostrongylus found in European carnivores: A. vasorum, A. daskalovi and A. chabaudi. The possibility for future in-clinic use of this test in domestic cats should be further investigated.

New host, geographic records, and histopathologic studies of Angiostrongylus spp (Nematoda: Angiostrongylidae) in rodents from Argentina with updated summary of records from rodent hosts and host specificity assessment

To date, 21 species of the genus Angiostrongylus (Nematoda: Angiostrongylidae) have been reported around the world, 15 of which are parasites of rodents. In this study, new host, geographic records, and histopathologic studies of Angiostrongylus spp in sigmodontine rodents from Argentina, with an updated summary of records from rodent hosts and host specificity assessment, are provided. Records of Angiostrongylus costaricensis from Akodon montensis and Angiostrongylus morerai from six new hosts and geographical localities in Argentina are reported. The gross and histopathologic changes in the lungs of the host species due to angiostrongylosis are described. Published records of the genus Angiostrongylus from rodents and patterns of host specificity are presented. Individual Angiostrongylus species parasitise between one-19 different host species. The most frequent values of the specificity index (STD) were between 1-5.97. The elevated number of host species (n = 7) of A. morerai with a STD = 1.86 is a reflection of multiple systematic studies of parasites from sigmodontine rodents in the area of Cuenca del Plata, Argentina, showing that an increase in sampling effort can result in new findings. The combination of low host specificity and a wide geographic distribution of Angiostrongylus spp indicates a troubling epidemiological scenario although, as yet, no human cases have been reported.

Survival of first stage larvae (L1) of Angiostrongylus vasorum under various conditions of temperature and humidity

This experiment has been conducted to evaluate the viability of Angiostrongylus vasorum L1 under different conditions of temperature and humidity. In order to assess the viability, fox faecal pellets containing first stage larvae (L1) were exposed to relative humidity (RH) 95% and 75%, and to different temperatures (5°C, 18°C) and at fluctuating conditions ranging from -5°C to +5°C. Moreover, larval viability under outdoor conditions in April was also observed. Survival of the larvae was strongly influenced by temperature; however, humidity did not show any significant influence on viability. In controlled condition, 100% of the larvae were found motile and active; whereas, around 14% and 19% of the larvae kept at 5°C remained viable at RH 95% and RH 75%, respectively after 78 h. All of the larvae kept at 18°C died after 66 h. In outdoor condition, larval survivability reduced to 18% after 66 h, and in fluctuation temperature viable larvae were observed in both control and experimental conditions (15%) after 78 h.

Abdominal angiostrongyliasis in rodent experimental infection: evidence for systemic circulation of first stage larvae

Eggs of Angiostrongylus costaricensis embrionate and hatch in the course of their migration in the intestinal wall, and first stage larvae (L1) are released in feces. Aiming to investigate the possible systemic circulation of L1, we inoculated mice and, four weeks later, examined their peritoneal cavities and several organs for the presence of L1. A total of 65 larvae were found in extra-intestinal organs (kidney, heart, spleen, liver, lungs). No larvae were found in blood or in the peritoneal cavity. 320 and 578 L1 were found in intestinal wall and intestinal contents, respectively. The experiment was repeated and it confirmed that the metastrongylid larvae found in several organs were larval stages of A. costaricensis. Ten Oligoryzomis sp. rodents, a natural host for A. costaricensis, were also infected and in three animals L1 could be recovered from several organs as well as from bronchoalveolar lavage (BAL) in one of them. These data indicate that systemic circulation and bronchial elimination of L1 may represent an alternative route for release of L1 of A. costaricensis into the environment for transmission to the intermediate host.

Expansion of Achatina fulica in Brazil and potential increased risk for angiostrongyliasis

The explosive introduction of the snail Achatina fulica in Brazil illustrates the current concern with global changes favouring dissemination of infectious diseases. The mollusc is an important host for Angiostrongylus cantonensis, which occurs in Asia and the Pacific Islands and is a causative agent for eosinophilic meningoencephalitis. In the Americas there is another metastrongylid worm, An. costaricensis, that causes abdominal disease and may also be transmitted by Ac. fulica. Although both infections may occur in focal outbreaks and with low morbidity, very severe complicated clinical courses pose a challenge for diagnosis and treatment. Data on abdominal angiostrongyliasis are briefly reviewed.

Low susceptibility of Achatina fulica from Brazil to infection with Angiostrongylus costaricensis and A. cantonensis

Introduction of Achatina fulica in Brazil has led to serious concerns about its role as vector for metaIylid worms: AngioIylus costaricensis and A. cantonensis. Experimental infection with both parasites was performed to evaluate the potential risk for their transmission by the giant African snail. Groups of 5 animals, both wild and bred at captivity were exposed at different inocula: 1, 5, and 10 x 10(3) L1 of A. costaricensis and A. cantonensis. In all groups, few snails got infected and parasitic burden was low. Two different ways of infection were tested: ingestion produced higher numbers of L3 than the inoculation through an artificial hole in the shell. We also report the parasitological examination of 6 batches of wild A. fulica from Florianópolis, state of Santa Catarina, Brazil: only 1 out of 244 animals were infected with metaIylid larvae. Taken together these data indicate that the giant African snail occurring in Southern Brazil is not a permissive host for both AngioIylus species and does not represent a significant risk for transmission of these parasites.

Effect of Angiostrongylus vasorum infection on Biomphalaria tenagophila susceptibility to Schistosoma mansoni

Concomitant infection with different parasites may be a helpful laboratorial strategy leading to the better understanding of the mechanisms used by the internal defense system (IDS) of Gastropoda to deal with helminth infection, such as Schistosoma mansoni. This work reports the effect of co-infection of Angiostrongylus vasorum and S. mansoni in hemocyte activity and in the outcome of infection. The simultaneous infection resulted in an increase of snail susceptibility to S. mansoni. In contrast, snails infected with both parasites, 15 days apart, did not show differences in the susceptibility compared to a single parasite infection. The increased susceptibility was measured by the significantly higher number of migrating sporocysts, higher percentage of snails shedding cercariae, higher number of cercariae shed and higher mortality in the experimental group that were simultaneously infected with A. vasorum and S. mansoni, when compared to snails infected only with S. mansoni. Snails simultaneously infected with A. vasorum and S. mansoni showed lower hemocyte activation during the first few days of infection, compared to activation induced only by A. vasorum infection. Between 5 and 15 days post-infection (dpi), granulocyte number and nitric oxide (NO) contents of simultaneously infected snails were lower than the S. mansoni-infected snails. Based on the results, we suggest that differences in the level of hemocyte response could explain the increased S. mansoni susceptibility observed in snails simultaneously infected with both parasites. However, when S. mansoni infection occurred after A. vasorum larvae are completely encapsulated, the response against S. mansoni was not altered, and therefore there were no differences in the susceptibility level.

Behavior of Angiostrongylus costaricensis in planorbids

Some terrestrial mollusks are natural hosts of Angiostrongylus costaricensis. In the laboratory, this nematode can be maintained in certain planorbids, which are aquatic mollusks and intermediate hosts of Schistosoma mansoni. Mollusks can be infected with Angiostrongylus costaricensis by ingestion of or active penetration by the first-stage larvae. In this work we assessed the ability of Biomphalaria glabrata to attract first-stage larvae of A. costaricensis. Movement of the nematode larvae towards the mollusks was observed after 15 min, 30 min and 1 h. B. glabrata did not attract the first-stage larvae of A. costaricensis in any of the three intervals. The susceptibility of two populations of Biomphalaria tenagophila to infection by A. costaricensis was also determined. One population was genetically selected for the susceptibility to S. mansoni while the other was not. Third-stage larvae were recovered from the snails 30 days after exposure of the two populations to 120 first-stage larvae. All the mollusks were infected. However, a significantly higher number of third-stage larvae were recovered in mollusks not genetically selected.

The first record of Aelurostrongylus abstrusus (Angistrongylidae: Nematoda) in Eurasian lynx (Lynx lynx L.) from Poland based on fecal analysis

MATERIAL

Thirty eight fecal samples of Eurasian Lynx (Lynx lynx L.) collected in Białowieza Primeval Forest (E Poland) in years 2001-2004 were analysed.

RESULTS

The presence of Aelurostrongylus abstrusus (L1) larvae was evidenced by use of decantation and flotation methods. The general prevalence of the infection recorded during the study was 21.1%, whereas mean intensity was 11,5 (1-33 larvae per sample). To our knowledge, this is the first case of Aelurostrongylus abstrusus recorded in Euroasian lynx from Poland.

Angiostrongylus costaricensis: complete redescription of the migratory pathways based on experimental Sigmodon hispidus infection

Angiostrongylus costaricensis lives in the cecal and mesenteric arteries of its vertebrate hosts, and causes an inflammatory disease in humans. To investigate unknown aspects of the abdominal angiostrogyliasis pathogenesis, infected Sigmodon hispidus were sequentially studied in different times of infection. The study revealed that L3 goes alternatively through two migratory courses during its development into an adult worm: lymphatic/venous-arterial and venous portal pathways. The former is considered the principal one, because it is used by most of the larvae. Like other metastrongylides, A. costaricensis passes over the pulmonary circulation to migrate from the lymphatic system to the arterial circulation, where they circulate during some days before reaching their definitive habitat. The oviposition by mature females began on 15th day. Eggs and L1 were detected mainly in the intestine and stomach, surrounded by inflammatory reaction constituted by macrophages, monocytes, and eosinophils. They were also spread to the lungs, mesenteric lymph nodes, pancreas, spleen, and kidneys. The larvae (L1) exhibited the centripetal capacity to invade the lymphatic and venous vessels of the intestine and mesentery. Adult worms that developed in the venous intrahepatic pathway migrated downstream to reach the mesenteric veins and laid eggs that embolized in the portal hepatic vessels.

In vitro maintenance of Angiostrongylus costaricensis does not provide physiological conditions for egg laying

Fifteen pairs (male/female) of Angiostrongylus costaricensis were kept in vitro in Waymouth medium for three days to evaluate the amount and duration of egg laying. At 24, 48 and 72 hours, the mean egg counts were 321, 24 and 4 eggs/10 microliters, respectively. Most of the eggs were eliminated within the first 24 hours, suggesting they are expelled under non-physiological conditions. These results indicate that in vitro conditions are not appropriate for drug trials of egg-laying inhibitors for treatment of abdominal angiostrongylosis.

Angiostrongylus costaricensis and experimental infection of Sarasinula marginata II: elimination routes

Angiostrongylus costaricensis intermediate hosts are terrestrial mollusks mostly belonging to the Veronicellidae family. In the present investigation we focused on the mechanisms of larval expulsion from Sarasinula marginata infected with A. costaricensis. Twenty-five mollusks were individually infected with 5000 L1 and sacrificed at 30 min and 1, 2, 4, 6, and 8 h post-infection and at days 1, 2, 4, 5, 6, 8, 10, 11, 12, 14, 15, 16, 20, 21, 22, 25, 26, 28, and 30 post-infection; the mollusks were then fixed and stained. Diverse organs involved throughout the course of the migratory routes of larvae from oral penetration on were specified and the mechanisms of larval access to the fibromuscular layer through the kidney, rectum, and vascular system were defined. The elimination of L3, derived from oral and/or cutaneous infections, appears to depend on granulomas located close to the excretory ducts of mucous cells.

Angiostrongylus costaricensis infection in C57BL/6 mice: MHC-II deficiency results in increased larval elimination but unaltered mortality

During experimental Angiostrongylus costaricensis infections in several inbred mouse strains, genetic factors as well as different cytokine secretion patterns have recently been shown to play a role in the outcome of infection in terms of morbidity and mortality, e.g. BALB/c mice show a high and C57BL/6 mice a low mortality during the acute phase of infection. In this study, C57BL/6 MHC-II knockout mice infected with A. costaricensis did not show increased mortality during the acute phase of infection when compared with wild-type mice. Furthermore, MHC-II knockout mice showed a strongly diminished parasite-specific humoral and cellular immune response, which can be explained by the nearly complete lack of CD4+ T cells in the periphery. This defect in MHC-II genes, the lack of CD4+ T cells, and the resulting cellular and humoral unresponsiveness resulted in a three times higher output of first-stage larvae in feces compared with wild-type animals. The results indicate that during experimental A. costaricensis infection a parasite-specific immune response, directed via MHC-II molecules and CD4+ T cells, is not essential for the survival of C57BL/6 mice during the acute phase of infection, whereas the elimination of first-stage larvae seems to be regulated by a MHC-II- and CD4+ T-cell-dependent mechanism.

Chromosomal mapping of host susceptibility loci to Angiostrongylus costaricensis nematode infection in mice

Angiostrongylus costaricensis is a nematode found mainly as a rodent parasite. Laboratory mice were experimentally infected with this parasite. It is known that there is great variability in mortality among inbred mouse strains after infection with this nematode. The survival rate at 5 weeks after infection of A/J mice was 90.5%, whereas that of SM/J mice was only 33.3%, with severe anemia and decreased body weight about 3 weeks after infection. To identify host susceptibility genes for infection with this nematode, we undertook chromosomal mapping by a whole-genome scanning approach in (A/JxSM/J)F2 mice. We mapped a host susceptibility locus (here designated Acsns, for Angiostrongylus costaricensis nematode susceptibility locus) to the telomeric portion of Chromosome 19 (peak LOD=4.35). We also identified two loci on Chr 13 and Chr 17 that have epistatic effects on host survival. This is the first report on host susceptibility loci for helminth infection mapped by whole-genome scanning.

Dogs may be a reservoir host for Angiostrongylus costaricensis

Angiostrongylus costaricensis is a parasitic nematode of wild rodents. Several other vertebrate species including man may become infected by ingestion of the third stage larvae produced by the intermediate hosts, usually slugs from the family Veronicellidae. There is a report of the diagnosis of abdominal angiostrongyliasis in Canis familiaris with lesions resembling those found in human disease. As a preliminar evaluation of the adequacy of a canine model for pathogenetic studies, a dog was inoculated with 75 L3 of A. costaricensis. Infection was established and fist stage larvae were found in feces up to 88 days post infection, sometimes in very large numbers (9.5 x 10(4) L1/g). No clinical manifestations or significant lesions were detected. These are indications that dog may play a role as a reservoir host for A. costaricensis.

The effect of temperature on mobility of Angiostrongylus costaricensis third stage larvae

Third stage larvae (L3) from Angiostrongylus costaricensis were incubated in water at room temperature and at 5 degrees C and their mobility was assessed daily for 17 days. Viability was associated with the mobility and position of the L3, and it was confirmed by inoculation per os in albino mice. The number of actively moving L3 sharply decreased within 3 to 4 days, but there were some infective L3 at end of observation. A mathematical model estimated 80 days as the time required to reduce the probability of infective larvae to zero. This data does not support the proposition of refrigerating vegetables and raw food as an isolated procedure for prophylaxis of human abdominal angiostrongylosis infection.

Penetration sites and migratory routes of Angiostrongylus costaricensis in the experimental intermediate host (Sarasinula marginata)

The intermediate hosts of Angiostrongylus costaricensis are terrestrian molluscs, mostly of the family Veronicellidae. The present work aimed at clarifying more accurately the sites of penetration and the migratory routes of A. costaricensis in the tissue slugs and at verifying the pattern of the perilarval reaction at different times of infection. Slugs were individually infected with 5,000 L1, and killed from 30 min to 30 days after infection. From 30 min up to 2 hr after infection, L1 were found within the lumen of different segments of the digestive tube having their number diminished in more advanced times after exposition until complete disappearance. After 30 min of exposition, percutaneous infection occurred, simultaneously to oral infection. Perilarval reaction was observed from 2 hr of infection around larvae in fibromuscular layer, appearing later (after 6 hr) around larvae located in the viscera. A pre-granulomatous reaction was characterized by gradative concentration of amebocytes around larvae, evolving two well-organized granulomas. In this work we confirmed the simultaneous occurrence of oral and percutaneous infections. Perilarval reaction, when very well developed, defined typical granulomatous structure, including epithelioid cell transformation. The infection also caused a systemic mobilization of amebocytes and provoked amebocyte-endothelium interactions.

Angiostrongylus costaricensis and the intermediate hosts: observations on elimination of L3 in the mucus and inoculation of L1 through the tegument of mollucs

Human accidental infection with Angiostrongylus costaricensis may result in abdominal disease of varied severity. Slugs from the Veronicellidae family are the main intermediate hosts for this parasitic nematode of rodents. Phyllocaulis variegatus, Phyllocaulis soleiformis and Phyllocaulis boraceiensis were experimentally infected to describe the kinetics of L3 elimination in the mucus secretions of those veronicelid species. A maximum of 2 L3/g/day was found in the mucus, while the number of L3 isolated from the fibromuscular tissues varied from 14 to 448. Productive infection was established by inoculations in the hyponotum or in the body cavity, through the tegument. Intra-cavity injection is a less complex procedure and permits a better control of inocula. A preliminary trial to titrate the infective dosis for P. variegatus indicated that inocula should range between 1000 and 5000 L1. The data also confirmed the importance of P. variegatus as an intermediate host of A. costaricensis.

Angiostrongylus vasorum infection in foxes (Vulpes vulpes) in Cornwall

A post mortem examination on a young fox which had been observed to be clinically ill revealed a severe infection with Angiostrongylus vasorum. A further 11 foxes were examined and four were infected with the parasite; three of these also had advanced lesions of sarcoptic mange. The cases all occurred outside the previously defined focus of endemic infection for dogs in Cornwall and they appear to be the first recorded cases of A vasorum in foxes in the United Kingdom.

Evidences against a significant role of Mus musculus as natural host for Angiostrongylus costaricensis

Wild rodents have been described as the most important hosts for Angiostrongylus costaricensis in Central America and southern Brazil. Sinantropic rodents apparently do not play a significant role as natural hosts. A search for natural infection failed to document worms in 14 mice captured in the house of a patient with diagnosis of abdominal angiostrongylosis and experimental infection of a "wild" Mus musculus strain and groups of albino swiss mice were carried out. Mortality was not significantly different and varied from 42% to 80% for Swiss mice and from 26% to 80% for "wild" mice. The high mortality of a "wild" M. musculus infected with A. costaricensis was very similar to what is observed with most laboratory mice strains. These data may be taken as indications that M. musculus is not a well adapted host for A. costaricensis, although susceptibility was apparently higher with "wild" populations of M. musculus as compared to Swiss strain.

Comparative infectivity and survival of first-stage larvae of Angiostrongylus cantonensis and Angiostrongylus malaysiensis

Angiostrongylus malaysiensis was isolated from wild rats Rattus norvegicus in a seaport area of Kitakyushu City, Kyushu, Japan in 1990. The infectivity and survival capacities of first-stage larvae of A. malaysiensis and Angiostrongylus cantonensis were compared under various conditions. Infectivity of first-stage larvae of the former in Biomphalaria glabrata was much lower than that of the latter. In an exposure at various pHs, and with various proteases and tissue homogenates of B. glabrata, the survival of first-stage larvae of A. malaysiensis was also lower than that of A. cantonensis. This lower survival was compared to that of A. cantonensis in response to desiccation of rat feces and high water temperature. First-stage larvae of A. malaysiensis thus appear to be influenced by conditions in the host's feces, specifically temperature and desiccation, and also show a greater sensitivity to pH and component proteases in the snail body than A. cantonensis.

Canine angiostrongylosis: a review

Angiostrongylus vasorum has been recognised as a cause of respiratory and circulatory distress among dogs in southwestern France for more than a decade, and the nematode now appears to be of increasing importance in the British Isles and Denmark. The aim of this review is to give a concise account of present knowledge of this intriguing parasitosis.

[Human angiostrongyliasis caused by Angiostrongylus costaricensis]

Angiostrongylus costaricensis was discovered by Morera and Céspedes in 1971, in a man suffering from an abdominal syndrome. Upon surgery, worms were observed in the cranial mesenteric artery. These worms were assigned to the metastrongylid strongyles and to the genus Angiostrongylus, which was already known, in man medicine, by the species A. cantonensis, the causative agent of an eosinophilic meningitis. Morera's parasite was named Angiostrongylus costaricensis from the place where it was described. A costaricensis is a dixenic parasite, the definitive hosts (D.H.) of which are the cotton-rat (Sigmodon hispidus) and some other rodents. Experimentally, carnivora (Nasua spp: procyonidae) and monkeys (Saguinus mystax: hapalidae) are receptive, same as dogs. The intermediary hosts (I.H.) are slugs belonging to the Veronicellidae family (order gymnophila), mainly Vaginulus plebeius. In the D.H., the parasite produces eggs that hatch into first stage larvae (L1), which are expelled with faeces, eaten by slugs and become infective third stage larvae (L3). L3 are then expelled through mucoïd secretions of the slug and pollute soil and vegetables. D.H. and man get infected with consuming polluted vegetables or even the infected slugs themselves. L3 migrate through lymphatic system and arrive inside the mesenteric artery, where they become adults. In man, the worm can reach this adult egg-laying stage, but larvae are trapped inside granulomas in the intestinal wall and cannot evolve. So, man is a dead-lock for A. costaricensis. Angiostrongylosis costaricensis is an illustration of an hemi-zoonosis (the parasite cannot go back from man to animals) of the biological pattern.

On the diversity of mollusc intermediate hosts of Angiostrongylus costaricensis Morera & Cespedes, 1971 in southern Brazil

Veronicellid slugs are considered the most important intermediate hosts of Angiostrongylus costaricensis, an intra-arterial nematode of rodents. Studies undertaken in three localities in southern Brazil led to identification of molluscs other than veronicellid slugs as hosts of A. costaricensis: Limax maximus, Limax flavus and Bradybaena similaris. These data indicate a low host specificity of larval stages of A. costaricensis, as it has been reported to other congeneric species.

Experimental infection routes of Angiostrongylus cantonensis in mice

Stomach intubation is the most common method used in the experimental infection of animals with Angiostrongylus cantonensis. In order to compare the effectiveness of other possible transmission methods, groups of BALB/c mice were given infective third-stage larvae of A. cantonensis by different routes including intraperitoneal or subcutaneous injections, and penetration of anal mucosa, vaginal mucosa, conjunctival mucosa, lacerated skin, unabraded skin, foot pad and tail skin, while stomach intubation was used as control. Recovery of fifth-stage larvae was higher in mice inoculated with third-stage larvae subcutaneously. Successful infections were established through all experimental transmission routes except tail skin penetration. This study suggests that oral infection may not be the only route for the transmission of human angiostrongyliasis, and subcutaneous infection may be a better method for experimental infection.

Abdominal angiostrongyliasis in Nicaragua: a clinico-pathological study on a series of 12 cases reports

A retrospective study was done to determine the presence of abdominal angiostrongyliasis in Nicaragua. Twelve cases of this parasitic disease were found among 48 visceral specimens: small intestine, liver and testes. The patients with intestinal lesions presented symptoms of an acute abdomen, and in some instances, a tumor-like mass was palpated in the lower right quadrant. A thickening of the intestinal wall accompanied by necrosis and perforation were the most important macroscopic findings. One patient with hepatic localisation of Angiostrongylus costaricencis displayed a clinical picture of visceral larva migrans-like syndrome. The chief laboratory findings were leukocytosis and eosinophilia. The histopathological examination showed granulomas and heavy eosinophilic infiltration around the eggs and larvae of A. costaricencis. Also, an adult worm was seen in one biopsy.

Effects of infection with Angiostrongylus cantonensis on the circulating haemocyte population and the haematopoietic organ of the host snail M-line Biomphalaria glabrata

The number of circulating haemocytes, the size of the haematopoietic organ, and the size of haemocyte capsules around the parasite were studied in M-line Biomphalaria glabrata snails exposed to 100 or 400 first-stage larvae of Angiostrongylus cantonensis. The number of haemocytes in exposed snails increased significantly at 1 day post-exposure, decreased to control value, and then increased again. The decrease in number of circulating haemocytes is probably due to the removal of cells from the circulation to participate in encapsulation of larvae. The majority of circulating haemocytes in M-line B. glabrata are fully-spread granulocytes, which increase significantly in number in snails following exposure to A. cantonensis larvae. However, populations of partially-spread granulocytes, round cells, hyalinocytes and miscellaneous haemocytes were relatively constant. The size of capsules around the parasite increased during the 42-day interval of the experiment. The haematopoietic organ increased in size in response to infection.

Phyllocaulis variegatus--an intermediate host of Angiostrongylus costaricensis in south Brazil

Molluscs collected in five localities in the State of Rio Grande do Sul (Brazil) were digested and examined. The infected slugs were identified as Phyllocaulis variegatus and the larvae found were inoculated per os into mice. After 50 days, worms with the caracteristics of Angiostrongylus costaricensis were recovered from the mesenteric arterial system. The results establish the role of P. variegatus as intermediate host of A. costaricensis in south Brazil, where many cases of abdominal angiostrongyliasis have been diagnosed.

Motility and drug susceptibility of Angiostrongylus cantonensis developing from gamma-irradiated first-stage larvae

The effects of neuropharmacological agents on the motility of irradiated and non-irradiated Angiostrongylus cantonensis adult females were studied. GABA induced complete paralysis in non-irradiated and 5,000 R-irradiated worms, but caused only slight paralysis on 10,000 R-irradiated worms. The paralytic effect of GABA was antagonised by picrotoxin. The reason for low susceptibility of heavily irradiated worms to GABA is not known. There was no difference in susceptibility of non-irradiated and irradiated worms to other neuropharmacological agents including eserine, phenylephrine and dibenamine.

Observations on the transmission of Angiostrongylus cantonensis from snail to rodent

A survey of Angiostrongylus cantonensis was carried out to investigate the mode of transmission from mollusc to rat in a fixed study area of Yoron Island from 1979 to 1982. Rattus rattus was found to be infected with a small number of worms in spite of heavy infection with third-stage larvae in Achatina fulica and an abundance of this snail in the area. Natural infection and/or susceptibility with A. cantonensis were confirmed in three small snail species. Bradybaena circulus, Fruticicola despecta and Luchuena reticulata. Young A. fulica was found to be infected with fewer third-stage larvae than mature A. fulica. It was concluded that molluscs which were infected with a small number of third-stage larvae of A. cantonensis play an important role in maintaining the life cycle of A. cantonensis. The percentage of rat stomachs containing mollusc tissue was relatively low, and the incidence and infection was low in rats. Infection with A. cantonensis did not occur very often in R. rattus in nature.

Studies on growth and distribution of Angiostrongylus cantonensis larvae in Ampullarium canaliculatus

The intramolluscan development of Angiostrongylus cantonensis larvae in Ampullarium canaliculatus, a fresh-water migrant snail which multiplies in tremendous rate in Taiwan, was followed for 28 consecutive days in this study. The snails were infected with first stage larvae of A. cantonensis and groups of three snails were sacrificed daily to study various larval stages in different organs. A. cantonensis larvae were found in all snails examined. During the first four days, they were obtained only from the digestive tract. Mouth is thus suggested as the primary route of natural infection. The first molt was observed on the fifth day of infection, and the second molt, the 12th day. Molting occurred in almost all kinds of organs examined. Studies on tissue tropism showed that the predilection site of A. cantonensis in this freshwater snail was headfoot region. Relatively few larvae were found in visceral organs including liver, heart, and ovary. Most parasites, 62.1%, recovered on the 28th day of infection were third-stage larvae.

Late development and fertility of adult worms derived from gamma-irradiated first-stage larvae of Angiostrongylus cantonensis

Effects of gamma ray irradiation on the first-stage larvae of Angiostrongylus cantonensis were studied. Compared to the non-treated controls, infection of rats with third-stage larvae which developed from irradiated first-stage larvae resulted in reduced recovery rates of adults. There was also a change in the male-female adult worm ratio and a reduction in larval output per female in relation to increasing irradiation dosage. Morphological changes in the adults were noted.

Coagulation abnormalities associated with acute Angiostrongylus vasorum infection in dogs

Ten dogs were experimentally infected with 150 3rd-stage larvae of the lungworm Angiostrongylus vasorum (Baillet, 1866). Blood samples obtained once a week for 5 weeks after infection was induced were examined for coagulation alterations. Thrombocytopenia developed in infected dogs before and after parasitic patency, which occurred 6 weeks after infection was induced. Prolongation of activated partial thromboplastin time and thrombocytopenia initially were associated with periods of larval migration and, later, at patency, with pulmonary egg embolism and hatching of 1st-stage larvae in the lung. Decreased factor-V activity, significantly shortened values for the prothrombin time, and increased factor-VIII activity were evident during postpatent periods of parasitic infection. Significant changes were not found in factors-XII and -IX activities throughout the course of infection. Coagulation abnormalities were attributed to excessive intravascular coagulation. Immature adults and first stages of the parasite seemed to have initiated the coagulopathy in the prepatent phase of infection, with subsequent coagulation abnormalities occurring at the time of patency.

First report of Angiostrongylus cantonensis in Puerto Rico

From January to April 1984, 63 Rattus rattus and 40 R. norvegicus were trapped in northeastern Puerto Rico and examined for Angiostrongylus cantonensis adults. Nineteen (47.5%) of the R. norvegicus and 10 (15.9%) of the R. rattus were infected, giving an overall infection rate of 28.2%. Four species of terrestrial snails and one species of brown slug were examined for A. cantonensis larvae. Two snail species, Subulina octona and Aquebana belutina, were found infected with third stage larvae of A. cantonensis. These larvae were harvested and inoculated per os into adult white mice. Immature adult worms were found in the brain tissue of all mice inoculated. This is the first report in the rat and snail populations of Puerto Rico.

Effects of diethylcarbamazine on the motility of Angiostrongylus cantonensis and Dirofilaria immitis

Effects of piperazine derivatives, especially of diethylcarbamazine (DEC) on adult Angiostrongylus cantonensis and Dirofilaria immitis were examined. Piperazine (3 X 10(-5)-10(-4) M) paralyzed A. cantonensis and the action was antagonized by picrotoxin. 1,1-dimethyl-4-phenylpiperazinium iodide (DMPP) (10(-5)-10(-4) M) caused contraction but little effect was produced by strychnine. An inhibitory effect on untreated preparations was caused by lower concentrations (3 X 10(-6)-10(-5) M) of diethylcarbamazine citrate (DEC) and also on the preparations contracted by eserine. A stimulatory effect was also seen when higher concentrations (10(-4)-3 X 10(-4) M) of this drug were applied to both preparations. The inhibitory action of DEC was antagonized by gabergic antagonists such as picrotoxin and bicuculline, but not by alpha-adrenergic antagonists like dibenamine and phentolamine. When the worm preparation was paralyzed by strychnine or hexylresorcinol (inhibitors of the release of acetylcholine in this worm), the stimulatory effect of DEC was blocked, but pyrantel (a nicotinic cholinergic agonist) contracted the paralyzed preparation. However, the effect of DEC on D. immitis (10(-7)-3 X 10(-4) M) was inhibitory, and this action was also antagonized by picrotoxin. These results suggest that the DEC inhibitory and stimulatory action is through the gabergic and cholinergic mechanisms in adult A. cantonensis and D. immitis.

Eosinophil responses of permissive and nonpermissive hosts to the young adult worms of Angiostrongylus cantonensis

Blood and bone marrow eosinophilia was assessed in nonpermissive (guinea pigs) and permissive (rats) hosts following the pulmonary arterial transfers of live or dead young adult worms of Angiostrongylus cantonensis. Guinea pigs showed a marked eosinophilic response to live worms but only a slight response to dead worms. Neither IgE nor haemagglutinating antibodies correlated with the induction of this eosinophilia. In contrast, the rat responded to neither form of the young adult worm. When the guinea pig and the rat were injected with whole worm extract (WWE) of the young adult worms either by an osmotic mini-pump connected to the jugular vein or by intermittent intravenous injections, the former animal showed blood eosinophilia but the latter failed to do so. Guinea pigs also developed blood eosinophilia after continuous exposure to the excretory and secretory products of the young adult worms, administered by the mini-pump. Eosinophil responses to WWE could be induced both in athymic CD-1 (ICR) nude mice and in its heterozygous litter mates, suggesting that T cell-independent mechanism(s) could be involved in the induction of blood eosinophilia in the nonpermissive, mouse host. These data clearly indicate that the eosinophilia-inducing factor(s) and the mechanism of eosinophilia are different in permissive and nonpermissive hosts.

Parasite density and the fecundity of Angiostrongylus cantonensis in rats

The larval output of Angiostrongylus cantonensis at different initial densities in rats was examined throughout the reproductive life-span of the worms using a modified dilution technique. With an initial density of 2 worms the mean duration of larval output was 414.2 days. The output was at a level above 50000 larvae/female/day from 15 to 45 weeks after infection. The mean total output was 18.9 X 10(6) larvae/female. The larval output/female decreased with an increase in the worm burden and also with the passage of time after infection. The longevity of host rats also decreased with increasing worm density and many of the heavily infected rats died early during infection. These results suggest that worm density has an effect on the fecundity of this parasite, and that the effects may be due to fibrous changes in host lung tissue but not changes in the physiology of the worms. It is also suggested that density-dependent effects on fecundity play a role in the population dynamics of both the parasite and host as regulatory mechanisms in the field.

Angiostrongylus cantonensis: paralysis due to avermectin B1a and ivermectin

Paralysis due to avermectin B1a and ivermectin of Angiostrongylus cantonensis was compared to that of phenylephrine (an alpha-adrenergic agonist) and strychnine (a cholinergic inhibitor). The paralyzing action of ivermectin (2.5 X 10(-9) g/ml) was inhibited by the single, simultaneous addition of picrotoxin (3 X 10(-5) M), whereas the effect of the drug (2.5 X 10(-7) g/ml) was reversed only when picrotoxin was given with cholinergic spasmogens such as pyrantel and eserine. Bicuculline (3 X 10(-5) M) had a similar antagonistic effect for picrotoxin, but bicuculline was less effective. The paralyzing action of avermectin B1a (3.6 X 10(-14) M, 3.0 X 10(-14) g/ml) was antagonized only when picrotoxin was given with cholinergic spasmogens such as pyrantel, eserine, and N-methylcytisine (N-MC), or alpha-adrenergic antagonists such as phentolamine and dibenamine. On the other hand, the paralyzing action of strychnine (3 X 10(-6) M) or phenylephrine (3 X 10(-5) M) was relatively uninfluenced by picrotoxin, but was antagonized by pyrantel and N-MC or dibenamine. These results suggest that a gabergic mechanism is involved in the paralyzing action of ivermectin, as well as avermectin B1a, in A. cantonensis.

Studies on chemotherapy of parasitic helminths (XVIII). Mechanism of spastically paralyzing action of pyrantel in Angiostrongylus cantonensis

Pyrantel tartrate caused spastic paralysis through stimulating nicotinic cholinoceptors in Angiostrongylus cantonensis.

Studies on the cryopreservation of eggs of Angiostrongylus cantonensis

The possibility of cryopreserving the eggs of Angiostrongylus cantonensis collected from the uterus of female worms was investigated. Eggs were cultured in NCTC 109 medium containing 50% rat serum, and various growth stages, from one-cell eggs to embryonated eggs, were used in this study. As a cryoprotective agent, dimethylsulphoxide (Me2SO) was added to the medium at a final concentration of 1 M. Eggs suspended in 0.2 ml of the medium at 37 degrees C were cooled to 0 degrees C at a rate of 1 degree C min-1, then an equal volume of 2M-Me2SO solution was added. After equilibration for 15 min, the freezing procedures were started. In the freezing procedures, the effectiveness of (i) a seeding process, (ii) different cooling and warming rates and (iii) the relationship between the growth stages of the eggs and their tolerance to freezing at -20 degrees C were investigated. It was found the highest level of survival could be obtained with 32-cell eggs cooled at a rate of 0.3 degrees C min-1 or more slowly with seeding at -4 degrees C and warming at a rate of 5 degrees C min-1. Survival was influenced more by cooling rate than by warming rate. Using these optimum conditions, the survival of eggs was then investigated following cooling to various temperatures. While more than 50% of eggs were found to survive cooling to -30 degrees C, extremely low survival was noted from lower temperatures.

First record of Angiostrongylus costaricensis Morera and Céspedes, 1971 in Ecuador

Third-stage metastrongyle larvae were recovered from slugs (Vaginulus sp.) collected in Santa Lucia, Ecuador, a town about 40 miles north of Guayaquil. Some of the larvae were inoculated into laboratory-bred cotton rats and adults of Angiostrongylus costaricensis were later recovered. This is the first report of this parasite in Ecuador.