Differential diagnosis of eosinophilic meningitis

Meningitis - infection o f the meninges - can be attributed to a variety o f agents, including bacteria, protozoa and some helminths. In helminth infections, but rarely in protozoal infections, eosinophilia is a common sign. Thus eosinophilic meningitis (EOM) is typically associated with certain helminth infections in which nervous system involvement occurs. Among the most important of these are ongiostrongyliosis, gnathostomiasis, porogonimiasis and cysticercosis (see Fig. 1). Here, Nibha Jaroonvesoma discusses the key distinctions between such infections.     

A new species of Polystomoides ward, 1917 (Monogenea: polystomatidae) from freshwater chelonians (Testudines: chelidae) in Brazil

This report describes the first occurrence of Polystomoides brasiliensis n. sp. (Monogenea: Polystomatidae), a new monogenean species in the buccal and pharyngeal cavities of the freshwater turtles in Brazil. Live monogeneans were collected from Hydromedusa maximiliani and Phrynops geoffroanus at the Mariano Procópio Museum's lake, in Juiz de Fora, Minas Gerais, Brazil. Polystomoides brasiliensis differs from all other species of this genus in having 8-9 genital spines, except for Polystomoides uruguayensis, which has 8-10 genital spines. However, the new species differs morphometrically from P. uruguayensis in the greater size of the outer and inner hamuli, as well as having a testis that is proportionally greater than the pharynx and oral sucker. The current study is the first report of monogeneans in chelonians of Brazil, and the first record of helminths in H. maximiliani.     

Host influences on reproduction and establishment of mouse-adapted Nippostrongylus brasiliensis (Nematoda)

Various influences of the host altered the establishment and reproduction of mouse-adapted Nippostrongylus brasiliensis. Establishment and egg production were greater in mature male than in female mice. Worm fecundity increased similarly in both sexes of mice prior to 41 days of host age. Male mice at 62 days of age or older harbored more N. brasiliensis than did females, but the number of nematodes was similar in younger hosts of both sexes. Crowding of male mice significantly increased the establishment of helminths, but not the production of eggs by N. brasiliensis. Pregnancy of the host significantly increased both establishment of and reproduction by N. brasiliensis. Ligation of the bile duct of the mouse reduced both establishment and fecundity of the nematode after subcutaneous or surgical infection with larvae and adults, respectively.     

Heydenius araneus n.sp. (Nematoda: Mermithidae), a parasite of a fossil spider, with an examination of helminths from extant spiders (Arachnida: Araneae)

Abstract. A mermithid, a parasite of a spider (Araneae: Thomisidae) in Baltic amber (40 mya), is described as Heydenius araneus n.sp. (Nematoda: Mermithidae) and represents the first fossil record of a nematode parasite of an arachnid. After a critical examination of reports of naturally occurring helminths of extant spiders, I conclude that although mermithid parasitism is well established in this host group, previous reports of hairworm parasites of spiders are "nomina dubia," putative records, or refer to mermithid nematodes.     

Effect of selected anthelmintics on three common helminths in the brown pelican (Pelecanus occidentalis)

The effect of selected anthelmintics (albendazole, fenbendazole, piperazine dihydrochloride and clorsulon) against three major helminths (Contracaecum multipapillatum, Mesostephanus appendiculatoides, and Phagicola longus) were studied in 29 brown pelicans (Pelecanus occidentalis). Albendazole and fenbendazole were highly effective against all three parasites. Clorsulon had moderate effect against M. appendiculatoides and poor effect against C. multipapillatum and P. longus. Piperazine dihydrochloride had no effect against these helminths.     

Helminth mediated modulation of Type 1 diabetes (T1D)

Type 1 diabetes is increasing dramatically in incidence in the developed world. While there may be several reasons for this, improved sanitation and public health measures have altered our interactions with certain infectious agents such as helminths. There is increasing interest in the use of helminths or their products to alleviate inflammatory or allergic conditions. Using rodent models of diabetes, it has been possible to explore the therapeutic potential of both live infections as well as helminth-derived products on the development of autoimmunity. This review provides an overview of the findings from animal models and additionally explores the potential for translation to the clinic.     

Impregnated bednets and the dose-severity relationship in malaria

The finding that insecticide-impregnated bednets decrease symptomatic malaria and death more than infection has been interpreted as providing evidence that dose influences seventy o f disease in malaria. The complications o f this argument in areas where much o f the population has a background parasitaemia have already been considered. In this article, Judith Glynn, Jo Lines and David Bradley explore whether or not the results of impregnated bednet trials can help to determine the existence of a dose-severity relationship for malaria.     

Helminths and protozoans of aquatic organisms as bioindicators of chemical pollution

There is no doubt that the aquatic environments receive large quantities of chemicals as consequence of human activities and that those substances have a detrimental effect on human health. Despite the obvious need for effective disposal of these substances, we need to understand and prevent the outcome of harmful environmental exposures. Thus, we need biomarkers and bioindicators to advance our understanding to these harmful exposures and their biological effects. In the last three decades a large number of publications has suggested that aquatic organisms and their parasites (mainly helminths and ciliate protozoans) are useful bioindicators of chemical pollution. However, the main weakness of this approach is that after exposure the population size of these parasites can increase or decrease without a consistent pattern. I suggest that this is in part due to the lack of focus on the correct spatial or temporal scales at which the environment is acting over our study object. Thus, I propose to use spatially explicit (= georeferenced) data for determining whether there is spatial structure in our study area. Spatial structure is the tendency of nearby samples to have attribute values more similar than those farther apart. These attributes are shaped by environmental variables acting at specific spatial and temporal scales. Thus, I suggest to consider these tools for determining the correct spatial or temporal scales of study, but also to record pollutant concentrations, bioindicators, biomarkers and parasites at individual host level. Combining this information with long-term monitoring programs is likely to improve our understanding of the effects of chemical pollutants over the aquatic environments.     

Intermediary metabolism of Trypanosoma cruzi

In this article, Julio Urbino discusses the characteristics o f the intermediary metabolism of Trypanosoma cruzi (the causative agent of Chagas disease), which are responsible for the unusual capacity of this parasite to use carbohydrates or amino acids as carbon and energy sources without drastic changes in its catabolic enzyme levels(1-3). Many, but not all, o f the metabolic capabilities of this organism are shared with Leishmania and the procyclic form o f the African trypanosomes, and the reviewer presents a metabolic model which is also consistent with the information available on these other parasites(2,4).     

Dangerous liaisons: how helminths manipulate the intestinal epithelium

Intestinal helminths remain highly pervasive throughout the animal kingdom by modulating multiple aspects of the host immune response. The intestinal epithelium functions as a physical barrier as well as a sentinel innate immune tissue with the ability to sense and respond to infectious agents. Although helminths form intimate interactions with the epithelium, comprehensive knowledge about host–helminth interactions at this dynamic interface is lacking. In addition, little is known about the ability of helminths to directly shape the fate of this barrier tissue. Here, we review the diverse pathways by which helminths regulate the epithelium and highlight the emerging field of direct helminth regulation of intestinal stem cell (ISC) fate and function.     

Helminth Collection and Identification from Wildlife

Wild animals are commonly parasitized by a wide range of helminths. The four major types of helminths are "roundworms" (nematodes), "thorny-headed worms" (acanthocephalans), "flukes" (trematodes), and "tapeworms" (cestodes). The optimum method for collecting helminths is to examine a host that has been dead less than 4-6 hr since most helminths will still be alive. A thorough necropsy should be conducted and all major organs examined. Organs are washed over a 106 μm sieve under running water and contents examined under a stereo microscope. All helminths are counted and a representative number are fixed (either in 70% ethanol, 10% buffered formalin, or alcohol-formalin-acetic acid). For species identification, helminths are either cleared in lactophenol (nematodes and small acanthocephalans) or stained (trematodes, cestodes, and large acanthocephalans) using Harris'' hematoxylin or Semichon''s carmine. Helminths are keyed to species by examining different structures (e.g. male spicules in nematodes or the rostellum in cestodes). The protocols outlined here can be applied to any vertebrate animal. They require some expertise on recognizing the different organs and being able to differentiate helminths from other tissue debris or gut contents. Collection, preservation, and staining are straightforward techniques that require minimal equipment and reagents. Taxonomic identification, especially to species, can be very time consuming and might require the submission of specimens to an expert or DNA analysis.     

Helminthic host defense peptides: using the parasite to defend the host

Parasitic helminths are destined to share niches with a variety of microbiota that inevitably influence their interaction with the host. To modulate the microbiome for their benefit and defend against pathogenic isolates, helminths have developed host defense peptides (HDPs) and proteins as integral elements of their immunity. These often exert a relatively nonspecific membranolytic activity toward bacteria, sometimes with limited or no toxicity toward host cells. With a few exceptions, such as nematode cecropin-like peptides and antibacterial factors (ABFs), helminthic HDPs are largely underexplored. This review scrutinizes current knowledge on the repertoire of such peptides in helminths and promotes their research as potential leads for an anti-infective solution to the burgeoning problem of antibiotic resistance.     

Translatability of helminth therapy in inflammatory bowel diseases

Modern hygienic lifestyles are associated with the emergence of inflammatory bowel disease (IBD) which now afflicts millions of people in highly-developed countries. Meticulous hygiene interrupts conduits of transmission required for ubiquitous exposure to parasitic worms (helminths). We proposed that loss of exposure to helminths permits development of IBD. Early clinical trials suggested that exposure to helminths such as Trichuris suis or Necator americanus can improve IBD. Over the last several years, processes to “medicinalize” T. suis have been developed and use of this helminth is now being studied in large multi-center clinical trials. Concurrently, we and others have identified some of the immune regulatory mechanisms elicited by helminth exposure that suppress inappropriate intestinal inflammation. These efforts could soon result in new therapies for patients with IBD.     

Host sharing and host manipulation by larval helminths in shore crabs: cooperation or conflict?

Larval helminths of different species that share the same intermediate host and are transmitted by predation to the same definitive host may cooperate in their attempts to manipulate the behaviour of the intermediate host, while at the same time having conflicts of interests over the use of host resources. A few studies have indicated that intermediate hosts harbouring larval helminths have altered concentrations of neurotransmitters in their nervous system, and thus measuring levels of neurotransmitters in host brains could serve to assess the respective and combined effect of different helminth species on host behaviour. Here, we investigate potential cooperation and conflict among three helminths in two species of crab intermediate hosts. The acanthocephalan Profilicollis spp., the trematode Maritrema sp. and an acuariid nematode, all use Macrophthalmus hirtipes (Ocypodidae) as intermediate host, whereas Profilicollis and Maritrema also use Hemigrapsus crenulatus (Grapsidae). All three helminths mature inside gulls or other shore birds. There was a significant decrease in the mean volume of Profilicollis cystacanths as the intensity of infection by this parasite increased in H. crenulatus, the only host in which this was investigated; however, there was no measurable effect of other helminth species on the size of acanthocephalans, suggesting no interspecific conflict over resource use within crabs. There was, in contrast, evidence of a positive interspecific association between the two most common helminth species: numbers of Profilicollis and Maritrema were positively correlated among crabs, independently of crab size, in M. hirtipes but not H. crenulatus. More importantly, we found that the total number of larval helminths per crab correlated significantly, and negatively, with concentrations of serotonin in crab brains, again only in M. hirtipes; numbers of each parasite species separately did not covary in either crab species with serotonin or dopamine, the other neurotransmitter investigated in this study. The relationship with serotonin appears due mainly to numbers of Profilicollis and Maritrema and not to nematodes. This is the first demonstration of a potentially synergistic manipulation of host behaviour by different helminth species, one that appears host-specific; our results also point toward the neurobiological mechanism underlying this phenomenon.     

The economics of schistosomiasis chemotherapy

The optimal choice o f chemotherapy regime arises in the design o f every schistosomiasis control programme. This choice is o f particular contemporary interest for two reasons. At one extreme the development of effective single-dose oral drugs such as praziquantel and oxamniquine makes mass chemotherapy a practical option. At the other extreme there has been a revival o f advocacy for some form o f selective treatment. But all developing countries that contemplate schistosomiasis control face severe budget constraints, requiring careful analysis o f the economics o f chemotherapy. In this article, Nick Prescott presents a generalized framework For resource allocation in schistosomiasis chemotherapy, demonstrating that the optimal choice o f chemotherapy regime depends critically on the level of budget constraint, the unit costs o f screening and treatment, and rates o f compliance with screening and chemotherapy-all factors which are usually neglected in the choice o f control strategy.     

Dissecting desaturation: plants prove advantageous

Fatty acid desaturases play important roles in controlling the physical properties o f membranes and in the synthesis of signal molecules such as prostaglandins and pheromones. Most desaturases are membrane proteins that have been recalcitrant to characterization by conventional biochemical methods. Only one enzyme o f this class has been characterized from animals or fungi. In this context, plants have proved to be useful sources of experimental materials. Substantial progress has been made in characterizing and manipulating nine classes of desaturases that control the fatty acid composition o f both plant membranes and plant storage lipids, which account for approximately -30% of the calories in the human diet.     

ELISAs for parasitologists: or lies, damned lies and ELISAs

The introduction in 1971, by Engvoll and Perlmann, of enzyme labels in immunoassays represented a significant technical advance. Their enzyme-linked immunosorbent assay (ELISA) proved to be as sensitive as radioimmunoossoys but safer to use. Since then, ELISAs have been widely used in the assay o f anti-bodies and antigens. In this article, Pradhib Venkateson and Derek Wokelin focus on some o f the problems associated with ELISAs when applied to parasitic infections, which can modify antibody responses, by immunosuppression or polyclonal activation. The article also considers optimization, which is an essential step in the establishment o f on ELISA.     

Pharmacology of ivermectin

Ivermectin is a semi-synthetic macrocyclic lactone (Fig. I) active in single low doses against many parasites - particularly nematodes and arthropods. It has been registered for animal health use since early 1985, and was earlier this year approved for human use by the French Directorate o f Pharmacy and Drugs. Of particular interest is ivermectin's potential as a micro filaricide for treatment o f onchocerciasis. Clinical trials leave little doubt about the potential o f ivermectin as a therapeutic tool for symptomatic relief from the effects o f infection with Onchocerca volvulus, and the drug is also recognized to have potential in reducing transmission o f the parasite. The manufacturers (Merck, Sharp and Dohme) recently arranged to provide the drug free o f charge to the WHO for mass trials against onchocerciasis in 12 African and Central American countries. In this article we focus on the pharmacological properties o f ivermectin, with a brief consideration of its absorption, fate, excretion and side-effects, and a discussion o f its micro filaricidal action.     

Diversity in parasitic helminths of Australasian marsupials and monotremes: a molecular perspective

Marsupials and monotremes are a prominent part of the mammalian fauna in Australia, and harbour an extremely diverse and highly distinctive array of helminth parasites. Their study has been relatively neglected, likely because they have no direct, adverse socioeconomic impact. As the body plans of helminths generally are very simple and morphological characterisation likely underestimates true diversity, molecular tools have been employed to assess genetic diversity. Using biochemical and/or molecular methods, recent studies show extensive diversity in helminths of marsupials, with cryptic species being commonly encountered. The purpose of this article is to review current knowledge about the diversity of parasitic helminths of marsupials and monotremes, to raise questions as to whether current molecular data can be used to estimate diversity, what mechanisms lead to such diversity, to critically appraise the molecular tools that have been employed thus far to explore diversity and to discuss the directions which might be taken in the future employing improved techniques.     

Structural differences between human proteins and aero- and microbial allergens define allergenicity

The current paradigm suggests that structural homology of allergenic proteins to microbial (particularly helminths) or human proteins underlie their allergenic nature. To examine systematically the structural relationships among allergens and proteins of pathogens (helminths, protozoans, fungi and bacteria) as they relate to allergenicity, we compared the amino acid sequence of 499 molecularly-defined allergens with the predicted proteomes of fifteen known pathogens, including Th2 inducing helminths and Th1-inducing protozoans, and humans using a variety of bioinformatic tools. Allergenicity was assessed based on IgE prevalences using publicly accessible databases and the literature. We found multiple homologues of common allergens among proteins of helminths, protozoans, fungi and humans, but not of bacteria. In contrast, 187 allergens showed no homology with any of the microbial genera studied. Interestingly, allergens without homologues or those with limited levels of sequence conservation were the most allergenic displaying high IgE prevalences in the allergic population. There was an inverse relationship between allergenicity and amino acid conservation levels with either parasite, including helminth, or human proteins. Our results suggest that allergenicity may be associated with the relative "uniqueness" of an antigen, i.e. immunogenicity, while similarity would lead to immunological tolerance.