A mathematical model for the transmission of Schistosoma japonicum in consideration of seasonal water level fluctuations of Poyang Lake in Jiangxi,China

BackgroundPoyang Lake, the largest fresh water lake in China, is the major transmission site of Schistosoma japonicum in China. Epidemics of schistosomiasis japonica have threatened the health of residents and stunted social–economic development there.ObjectiveThis article aims at evaluating the effect of various control measures against schistosomiasis: selective mass treatment (ST), targeted mass treatment (TT), mass treatment for animal reservoirs (MT), and health education (HE), on reduction of the prevalence through simulations based on a mathematical model.MethodsWe proposed a mathematical model, which is a system of ordinary differential equations for the transmission of S. japonicum among humans, bovines, and snails. The model takes into account the seasonal variation of the water level of Poyang Lake that is caused by the backflow of the Yangtze River and inflow from five small rivers, which influences the transmission of S. japonicum. For the purpose of dealing with the age-specific prevalence and intensity of infection, the human population was classified into four age categories in the model. We carried out several simulations resulting from the execution of ST and TT for elementary school children (E Sch), and combinations of ST, MT, and HE.ResultsThe simulations indicated that all of the control measures only for humans had a trend of revival after interruption, and a combination of ST and MT has a significant effect on reducing human infection. Although TT and HE had a significant effect on the prevalence in the E Sch group, it had little effect on the overall human population.ConclusionThe simulations indicate that measures targeted to bovines such as chemotherapy besides humans will be vital to eliminate the transmission of S. japonicum in the Poyang Lake region. Moreover, it is desirable to improve health education for fishermen and herdsmen.     

Comparative Phylogenetic Studies on Schistosoma japonicum and Its Snail Intermediate Host Oncomelania hupensis: Origins,Dispersal and Coevolution

Background

Schistosoma japonicum causes major public health problems in China and the Philippines; this parasite, which is transmitted by freshwater snails of the species Oncomelania hupensis, causes the disease intestinal schistosomiasis in humans and cattle. Researchers working on Schistosoma in Africa have described the relationship between the parasites and their snail intermediate hosts as coevolved or even as an evolutionary arms race. In the present study this hypothesis of coevolution is evaluated for S. japonicum and O. hupensis. The origins and radiation of the snails and the parasite across China, and the taxonomic validity of the sub-species of O. hupensis, are also assessed.

Methodology/Principal Findings

The findings provide no evidence for coevolution between S. japonicum and O. hupensis, and the phylogeographical analysis suggests a heterochronous radiation of the parasites and snails in response to different palaeogeographical and climatic triggers. The results are consistent with a hypothesis of East to West colonisation of China by Oncomelania with a re-invasion of Japan by O. hupensis from China. The Taiwan population of S. japonicum appears to be recently established in comparison with mainland Chinese populations.

Conclusions/Significance

The snail and parasite populations of the western mountain region of China (Yunnan and Sichuan) appear to have been isolated from Southeast Asian populations since the Pleistocene; this has implications for road and rail links being constructed in the region, which will breach biogeographical barriers between China and Southeast Asia. The results also have implications for the spread of S. japonicum. In the absence of coevolution, the parasite may more readily colonise new snail populations to which it is not locally adapted, or even new intermediate host species; this can facilitate its dispersal into new areas. Additional work is required to assess further the risk of spread of S. japonicum.     

Distinct Genetic Diversity of Oncomelania hupensis,Intermediate Host of Schistosoma japonicum in Mainland China as Revealed by ITS Sequences

Background

Oncomelania hupensis is the unique intermediate host of Schistosoma japonicum, which causes schistosomiasis endemic in the Far East, and especially in mainland China. O. hupensis largely determines the parasite''s geographical range. How O. hupensis''s genetic diversity is distributed geographically in mainland China has never been well examined with DNA sequence data.

Methodology/Principal Findings

In this study we investigate the genetic variation among O. hupensis from different geographical origins using the combined complete internal transcribed spacer 1 (ITS1) and ITS2 regions of nuclear ribosomal DNA. 165 O. hupensis isolates were obtained in 29 localities from 7 provinces across mainland China: lake/marshland and hill regions in Anhui, Hubei, Hunan, Jiangxi and Jiangsu provinces, located along the middle and lower reaches of Yangtze River, and mountainous regions in Sichuan and Yunnan provinces. Phylogenetic and haplotype network analyses showed distinct genetic diversity and no shared haplotypes between populations from lake/marshland regions of the middle and lower reaches of the Yangtze River and populations from mountainous regions of Sichuan and Yunnan provinces. The genetic distance between these two groups is up to 0.81 based on Fst, and branch time was estimated as 2–6 Ma. As revealed in the phylogenetic tree, snails from Sichuan and Yunnan provinces were also clustered separately. Geographical separation appears to be an important factor accounting for the diversification of the two groups of O. hupensis in mainland China, and probably for the separate clades between snails from Sichuan and Yunnan provinces. In lake/marshland and hill regions along the middle and lower reaches of the Yangtze River, three clades were identified in the phylogenetic tree, but without any obvious clustering of snails from different provinces.

Conclusions

O. hupensis in mainland China may have considerable genetic diversity, and a more complex population structure than expected. It will be of significant importance to consider the genetic diversity of O. hupensis when assessing co-evolutionary interactions with S. japonicum.     

Susceptibility of Oncomelania hupensis formosana recombinants and hybrids with Oncomelania hupensis nosophora to infection with Schistosoma japonicum

Chiu J.-K., Ong S.-J., Yu J.-C., Kao C.-Y. and Iuima T. 1981. Susceptibility of Oncomelania hupensis formosana recombinants and hybrids with Oncomelania hupensis nosophora to infection with Schistosoma japonicum. International Journal for Parasitology11: 391–397. Three generations of Oncomelania hupensis formosana recombinants were produced by mating the Kaohsiung race with the Ilan and Changhua races of the snails. F₂ and F₃ recombinants were produced by back-crossing F₁ and F₂ with Kaohsiung O. h. formosana. Subsequently, susceptibility of recombinants to infection with the original strain of Schistosoma japonicum, Ilan or Changhua strain, was investigated. Results indicated that susceptibility of recombinants declined steadily generation by generation. Marked decline of infectivity was observed for Kaohsiung-Ilan recombinants as compared with Kaohsiung-Changhua recombinants. For example, the overall infection rate of Kaohsiung-Ilan F₁ recombinants was 7.3 % with a 51.4 % of control snails. The same figures for F₂ were 4.2 and 52.6%, and 1 and 40.3 % for F₃. On the other hand, the overall infection rate of Kaohsiung-Changhua F₁ recombinants was 21.9% with a 46.9% of control snails; and 11.9 and 50.3 % for F₂; and 7.6 and 33.2% for F₃. The F₃ hybrids of Oncomelania hupensis nosophora from Japan and O. h. formosana from Kaohsiung and Ilan were also produced, and susceptibility with the Japanese strain of S. japonicum was studied. A highly significant decline of susceptibility was observed among hybrids (4.4%) in contrast with control snails (85.6 %).Feasibility of applying O. h. formosana in biological control of S. japonicum was discussed. One must determine in the laboratory, prior to application, which race of O. h. formosana should be used depending on the Oncomelania snails of an endemic area. For S. japonicum prevalent in Yamanashi, Japan, the Ilan race of O. h. formosana was found to be better choice than the Kaohsiung race of the snails.     

Diversification of Schistosoma japonicum in Mainland China revealed by mitochondrial DNA

Background

Schistosoma japonicum still causes severe parasitic disease in mainland China, but mainly in areas along the Yangtze River. However, the genetic diversity in populations of S. japonicum has not been well understood across its geographical distribution, and such data may provide insights into the epidemiology and possible control strategies for schistosomiasis.

Methodology/Principal Findings

In this study infected Oncomelania snails were collected from areas in the middle and lower (ML) reaches of the Yangtze River, including Hubei, Hunan, Anhui, Jiangxi and Jiangsu provinces, and in the upper reaches of the river, including Sichuan and Yunnan provinces in southwest (SW) China. The adult parasites obtained from experimentally infected mice using isolated cercariae were sequenced individually for several fragments of mitochondrial regions, including Cytb-ND4L-ND4, 16S-12S and ND1. Populations in the ML reaches exhibited a relatively high level of diversity in nucleotides and haplotypes, whereas a low level was observed for populations in the SW, using either each single fragment or the combined sequence of the three fragments. Pairwise analyses of F-statistics (Fst) revealed a significant genetic difference between populations in the ML reaches and those in the SW, with limited gene flow and no shared haplotypes in between. It is rather obvious that genetic diversity in the populations of S. japonicum was significantly correlated with the geographical distance, and the geographical separation/isolation was considered to be the major factor accounting for the observed difference between populations in the ML reaches and those in the SW in China.

Conclusions

S. japonicum in mainland China exhibits a high degree of genetic diversity, with a similar pattern of genetic diversity as observed in the intermediate host snails in the same region in China.     

Evaluation of mammalian and intermediate host surveillance methods for detecting schistosomiasis reemergence in southwest China

Background

Schistosomiasis has reemerged in China, threatening schistosomiasis elimination efforts. Surveillance methods that can identify locations where schistosomiasis has reemerged are needed to prevent the further spread of infections.

Methods and Principal Findings

We tested humans, cows, water buffalo and the intermediate host snail, Oncomelania hupensis, for Schistosoma japonicum infection, assessed snail densities and extracted regional surveillance records in areas where schistosomiasis reemerged in Sichuan province. We then evaluated the ability of surveillance methods to identify villages where human infections were present. Human infections were detected in 35 of the 53 villages surveyed (infection prevalence: 0 to 43%), including 17 of 28 villages with no prior evidence of reemergence. Bovine infections were detected in 23 villages (infection prevalence: 0 to 65%) and snail infections in one village. Two common surveillance methods, acute schistosomiasis case reports and surveys for S. japonicum-infected snails, grossly underestimated the number of villages where human infections were present (sensitivity 1% and 3%, respectively). Screening bovines for S. japonicum and surveys for the presence of O. hupensis had modest sensitivity (59% and 69% respectively) and specificity (67% and 44%, respectively). Older adults and bovine owners were at elevated risk of infection. Testing only these high-risk human populations yielded sensitivities of 77% and 71%, respectively.

Conclusions

Human and bovine schistosomiasis were widespread in regions where schistosomiasis had reemerged but acute schistosomiasis and S. japonicum-infected snails were rare and, therefore, poor surveillance targets. Until more efficient, sensitive surveillance strategies are developed, direct, targeted parasitological testing of high-risk human populations should be considered to monitor for schistosomiasis reemergence.     

驴源兽疫链球菌的分离鉴定及多位点序列分型分析

【目的】本研究采集了新疆地区驴腺疫病料,从样品中分离鉴定可疑病原菌并对其进行基因水平的分型与进化分析。【方法】对采集的新疆地区某驴场驴腺疫病驴颌下淋巴结拭子进行细菌分离培养,对2个分离株(HT111、HT321)进行染色、培养、生化试验、药敏试验,对其16S rRNA及SeM基因进行测序和进化分析,并通过PCR扩增7个管家基因,利用多位点序列分型(MLST)方法鉴定其分子分型。【结果】2个分离株均属马链球菌兽疫亚种,其中HT111对测试的13种抗生素中的3种(青霉素、克拉霉素和四环素)耐药,HT321对8种抗生素(阿莫西林、头孢呋辛、头孢噻呋、青霉素、克拉霉素、克林霉素、土霉素和四环素)耐药。序列分型发现了一种新的ST型为ST420 (HT321),分离株HT111为ST179型。【结论】本研究在新疆地区首次分离了驴源马链球菌兽疫亚种,并鉴定出一个新的ST型(ST420),为驴腺疫的流行病学提供了参考数据。     

Differential susceptibility of male and female Oncomelania hupensis quadrasi infected with Schistosoma japonicum

Laboratory-reared male and female Oncomelania hupensis quadrasi were exposed to infection with Schistosoma japonicum. In three of four trials, infection rates in female snails (30.5–68.0%) were higher than in males (8.6–28.6%). Higher cercarial production in females may be accounted for by male-female size difference, and presumably by the availability of more nutrients in females as a result of ovarian tissue breakdown. Male and female snails were individually exposed to 20 miracidia, fixed 3–72 h post-exposure and serially sectioned to check for encapsulated and nonencapsulated primary sporocysts (ps). In 23 female (65.2%) and 12 male (39.3%) snails, ps were all unencapsulated. Six male snails (17.6%) showed 100% ps encapsulation. Among the 12 females and 16 males with both negative and positive host-tissue response, encapsulated ps in females varied from 7.1 to 50.0% and 20.0 to 71.4% in males. Distribution of encapsulated and non-encapsulated ps in both sexes suggests that males are more resistant to infection by their encapsulation reaction. Whether resistance in O. h. quadrasi to S. japonicum is genetically determined warrants further study.     

Three Gorges Dam: Impact of Water Level Changes on the Density of Schistosome-Transmitting Snail Oncomelania hupensis in Dongting Lake Area,China

BackgroundSchistosomiasis remains an important public health issue in China and worldwide. Oncomelania hupensis is the unique intermediate host of schistosoma japonicum, and its change influences the distribution of S. japonica. The Three Gorges Dam (TGD) has substantially changed the ecology and environment in the Dongting Lake region. This study investigated the impact of water level and elevation on the survival and habitat of the snails.MethodsData were collected for 16 bottomlands around 4 hydrological stations, which included water, density of living snails (form the Anxiang Station for Schistosomiasis Control) and elevation (from Google Earth). Based on the elevation, sixteen bottomlands were divided into 3 groups. ARIMA models were built to predict the density of living snails in different elevation areas.ResultsBefore closure of TGD, 7 out of 9 years had a water level beyond the warning level at least once at Anxiang hydrological station, compared with only 3 out of 10 years after closure of TGD. There were two severe droughts that happened in 2006 and 2011, with much fewer number of flooding per year compared with other study years. Overall, there was a correlation between water level changing and density of living snails variation in all the elevations areas. The density of living snails in all elevations areas was decreasing after the TGD was built. The relationship between number of flooding per year and the density of living snails was more pronounced in the medium and high elevation areas; the density of living snails kept decreasing from 2003 to 2014. In low elevation area however, the density of living snails decreased after 2003 first and turned to increase after 2011. Our ARIMA prediction models indicated that the snails would not disappear in the Dongting Lake region in the next 7 years. In the low elevation area, the density of living snails would increase slightly, and then stabilize after the year 2017. In the medium elevation region, the change of the density of living snails would be more obvious and would increase till the year 2020. In the high elevation area, the density of living snails would remain stable after the year 2015.ConclusionThe TGD influenced water levels and reduced the risk of flooding and the density of living snails in the study region. Based on our prediction models, the density of living snails in all elevations tends to be stabilized. Control of S. japonica would continue to be an important task in the study area in the coming decade.     

Etude experimentale de l' effet du groupement sur la ponte d' Helix aspersa Müller / Experimental study of the effect of population density on egg-laying by the snail Helix aspersa Müller

Summary

The reproductive cycle of Helix aspersa raised under our experimental conditions starts six months after birth.

The experimental grouping of snails influences three aspects of their reproductive activity

1. The rate of egg-laying has been calculated not only in relation to the total number of animals (N1), but also to the number of individuals weighing 8 g or more (N2), and the number of ‘full-grown’ snails.

2. The sexual precocity of the snails is inversely related to the density of the population.

3. The period of reproduction is longer when the density of the population is low.

As with growth, a high density of population has unfavourable mass-effect consequences as regards the proportion of laying snails and the number of layings per animal.     

Vaccine potential of hemocyanin from Oncomelania hupensis against Schistosoma japonicum

Hemocyanin, a giant oxygen transport protein which is usually found in many arthropods and mollusks was isolated and purified from Oncomelania hupensis. In this study, we showed that Oncomelania hupensis hemocyanin (OhH) shared carbohydrate epitopes with different developmental stages of Schistosoma japonicum (Cercaria, Schistosomulum, Adult worm and Egg) and exhibited serological cross-reaction with these stages of S. japonicum immune sera, which had a potential for use in diagnostic and therapeutic studies of schistosomasis. OhH was used as a vaccine in combination with Freund's adjuvant to evaluate the induction of immune responses and protection against S. japonicum infection in mice. Mice immunized with OhH induced a Th1 type of immune responses. Strong protection against S. japonicum were observed in adult worm and egg burdens after 42 days post-challenge, which showed a significant worm reduction of 52.5% and egg reduction of 69.2% compared to the control groups, respectively. These results indicated that OhH was a potential candidate to compose an anti-schistosome vaccine.     

Spatio-temporal Transmission and Environmental Determinants of Schistosomiasis Japonica in Anhui Province,China

Background

Schistosomiasis japonica still remains of public health and economic significance in China, especially in the lake and marshland areas along the Yangtze River Basin, where the control of transmission has proven difficult. In the study, we investigated spatio-temporal variations of S. japonicum infection risk in Anhui Province and assessed the associations of the disease with key environmental factors with the aim of understanding the mechanism of the disease and seeking clues to effective and sustainable schistosomiasis control.

Methodology/Principal Findings

Infection data of schistosomiasis from annual conventional surveys were obtained at the village level in Anhui Province, China, from 2000 to 2010 and used in combination with environmental data. The spatio-temporal kriging model was used to assess how these environmental factors affected the spatio-temporal pattern of schistosomiasis risk. Our results suggested that seasonal variation of the normalized difference vegetation index (NDVI), seasonal variation of land surface temperature at daytime (LSTD), and distance to the Yangtze River were negatively significantly associated with risk of schistosomiasis. Predictive maps showed that schistosomiasis prevalence remained at a low level and schistosomiasis risk mainly evolved along the Yangtze River. Schistosomiasis risk also followed a focal spatial pattern, fluctuating temporally with a peak (the largest spatial extent) in 2005 and then contracting gradually but with a scattered distribution until 2010.

Conclusion

The fitted spatio-temporal kriging model can capture variations of schistosomiasis risk over space and time. Combined with techniques of geographic information system (GIS) and remote sensing (RS), this approach facilitates and enriches risk modeling of schistosomiasis, which in turn helps to identify prior areas for effective and sustainable control of schistosomiasis in Anhui Province and perhaps elsewhere in China.     

Immunization of mice with cells from juvenile worms of <Emphasis Type="Italic">Schistosoma japonicum</Emphasis> provides immunoprotection against schistosomiasis

To validate the protective efficacy against schistosomiasis by immunization with cells from juvenile Schistosoma japonicum in a murine model and to analyze possible factors related to protection, in this study, two independent repeated vaccination trials were performed. After three subcutaneous vaccinations, in trial one, in the absence of adjuvant, primary juvenile worm cells (pJCs) from S. japonicum induced remarkable average reductions in worm burden (54.3%), liver eggs per gram (LEPG) load (59.8%) as well as egg granulomas size (66.5%) compared to PBS control group (P<0.01), which were significantly higher than those elicited by fractions of juvenile worm cells (JCFs) or fractions of juvenile worms (JWFs) (P<0.05). Non-cell components of worms (WNCs) showed no significant protection. In trial two, compared to PBS control group, significant protective effect was also observed for cultured juvenile worm cells (cJCs) from S. japonicum with 58.4% worm reduction and 68.1% LEPG reduction (P<0.01). However, cultured adult worms cells (cACs) showed significantly higher worm burden (P<0.05) and egg burden (P<0.01) when compared to cJCs. Immunological analysis of trial two revealed that cJCs engendered a Th1-biased mixed Th1/Th2 type of immune response while cACs elicited a Th2-type response. Our data indicated that immunization with both primary and cultured cells from S. japonicum juvenile worms provided high immunoprotection, for which the physical character of immunogens, stage-specific parasite and the type of immune response induced might be responsible, suggesting that vaccination with whole cells from S. japonicum larvae is a promising approach to produce protective immunity against schistosomiasis.     

血吸虫病感染特征及其免疫病理机制的研究进展

血吸虫病是由血吸虫病裂体吸虫属血吸虫引起的一种寄生虫病,分布范围广,广泛分布在热带及亚热带的贫困偏远地区,其在公共卫生方面的重要性仅次于疟疾,该病已经造成了大量的残疾和死亡。据世界卫生组织(WHO)血吸虫病专家委员会1984年统计,全球感染血吸虫人口已达2亿。血吸虫种类繁多,寄生于人体的有6类,其中埃及血吸虫、曼氏血吸虫和日本血吸虫是主要的致病种类。血吸虫卵是血吸虫病的主要致病因子,寄生于宿主组织中的虫卵使宿主发生免疫病理反应,导致泌尿生殖系统(埃及血吸虫)炎症和梗阻性疾病、肠道疾病、肝脾炎症和肝纤维化(曼氏血吸虫和日本血吸虫)的发生。没有得到有效控制的早期血吸虫病发展到晚期,可引起包括上消化道出血、肝性脑病(日本血吸虫和曼氏血吸虫)、膀胱鳞状细胞癌(埃及血吸虫)和不孕不育症在内的严重并发症,主要对血吸虫病流行病学、临床表现、临床分期、并发症、致病机制及其免疫病理机制作一综述。     

Pedometer-determined physical activity levels of healthy children and children with Down’s syndrome

Purpose: Children with Down’s syndrome (DS) are considered sedentary and less engaged in recommended physical activity (PA) levels. This study compared the PA levels between children with DS and healthy children in Saudi Arabia.

Methods: The study included 85 children divided into two groups. The DS group comprised 37 children with DS aged 8–12?years recruited from the Down Syndrome Charitable Association and Al-Nahda Schools for DS. The healthy group comprised 41 healthy children aged 8–12?years recruited from regular schools in the same region. PA levels were measured over 7?days using a pedometer.

Results: The healthy group was more active than the DS group (p?p?p?Conclusions: The DS group had a high body mass index and physical inactivity compared with the second group. Obesity and physical inactivity among Saudi Arabian children with and without DS are major health concerns. Therefore, concerted efforts are needed to combat childhood obesity, promote PA, improve patient quality of life, and reduce the sedentary lifestyle among Saudi children and adolescents.     

Comparative Analyses of Codon and Amino Acid Usage in Symbiotic Island and Core Genome in Nitrogen-Fixing Symbiotic Bacterium Bradyrhizobium japonicum

Abstract

Genes involved in the symbiotic interactions between the nitrogen-fixing endosymbiont Bradyrhizobium japonicum, and its leguminous host are mostly clustered in a symbiotic island (SI), acquired by the bacterium through a process of horizontal transfer. A comparative analysis of the codon and amino acid usage in core and SI genes/proteins of B. japonicum has been carried out in the present study. The mutational bias, translational selection, and gene length are found to be the major sources of variation in synonymous codon usage in the core genome as well as in SI, the strength of translational selection being higher in core genes than in SI. In core proteins, hydrophobicity is the main source of variation in amino acid usage, expressivity and aromaticity being the second and third important sources. But in SI proteins, aromaticity is the chief source of variation, followed by expressivity and hydrophobicity. In SI proteins, both the mean molecular weight and mean aromaticity of individual proteins exhibit significant positive correlation with gene expressivity, which violate the cost-minimization hypothesis. Investigation of nucleotide substitution patterns in B. japonicum and Mesorhizobium loti orthologous genes reveals that both synonymous and non-synonymous sites of highly expressed genes are more conserved than their lowly expressed counterparts and this conservation is more pronounced in the genes present in core genome than in SI.     

Molecular cloning and expression of a Schistosoma japonicum tegumental membrane-associated antigen from Japanese strain

Diagnosis and vaccine development form the major focus in creating strategies for the control of schistosomiasis. In this study, we established an IgG1 mouse monoclonal antibody (MoAb), SJA111, which strongly reacted with 23–25-kDa Schistosoma japonicum tegumental-associated membrane proteins, but not with eight other parasitic antigens. A λgt 11 cDNA library from the Japanese strain of the Schistosoma japonicum adult worm was screened with SJA111 as a probe. A single positive clone was isolated and the nucleotide sequence of the isolated cDNA was determined. The cDNA clone consisted of 844 bp, and the coding region contained 576 bp which was translated to a 22.6-kDa protein. This region showed 99.0% and 99.3% significant homology with those of the Chinese and Philippine strains of Schistosoma japonicum, respectively. The deduced amino acid sequence of the protein was identical to that of the Philippine strain and only one residue differed from that of the Chinese strain. The recombinant form of the tegumental protein was expressed in Escherichia coli and purified by a combination of ion exchange and affinity chromatography, and the purified protein was found to react with the sera of patients infected with Schistosoma japonicum. This result suggests that this antigen may be useful in the immunodiagnosis of schistosomiasis as well as in the development of an effective vaccine.     

NTproBNP and ST2 as predictors for all-cause and cardiovascular mortality in elderly patients with symptoms suggestive for heart failure

Background: A new biomarker, suppression of tumorigenicity 2 (ST2) has been introduced as a marker for fibrosis and hypertrophy. Its clinical value in comparison with N-terminal pro-hormone of brain natriuretic peptide /Amino-terminal pro-B-type natriuretic peptide (NTproBNP) in predicting mortality in elderly patients with symptoms of heart failure (HF) is still unclear.

Aim: To evaluate the prognostic value for all-cause- and cardiovascular mortality of ST2 or NTproBNP and the combination of these biomarkers.

Patients and methods: One hundred seventy patients patients with clinical symptoms of HF (77 (45%) were with verified HF) were recruited from one selected primary health care center (PHC) in Sweden and echocardiography was performed in all patients. Blood samples were obtained from 159 patients and stored frozen at –70?°C. NTproBNP was analyzed at a central core laboratory using a clinically available immunoassay.ST2 was analyzed with Critical Diagnostics Presage ST2 ELISA immunoassay.

Results: We studied 159 patients (mean age 77?±?8.3?years, 70% women). During ten years of follow up 78 patients had died, out of which 50 deaths were for cardiovascular reasons. Continuous NTproBNP and ST2 were both significantly associated with all-cause mortality (1.0001; 1.00001–1.0002, p?=?0.04 and 1.03; 1.003–1.06, p?=?0.03), NTproBNP but not ST2 remained significant for cardiovascular mortality after adjustments (1.0001; 1.00001–1.0002, p?=?0.03 and 1.01; 0.77–1.06, p?=?0.53), respectively. NTproBNP above median (>328?ng/L) compared to below median was significantly associated with all-cause mortality(HR: 4.0; CI :2.46–6.61; p?p?Conclusion: In elderly patients with symptoms of heart failure ST2 was not superior to NTproBNP to predict all cause or cardiovascular mortality. Furthermore, it is unclear if the combination of ST2 and NTproBNP will improve long-term prognostication beyond what is achieved by NTproBNP alone.     

Phylogenetic relationships between Lymnaeidae in relation to infection with Fasciola sp. in Hokkaido,Japan

ABSTRACT

In this paper, lymnaeid snails collected from 107 localities in Hokkaido, Japan were examined for infection by Fasciola larvae. DNA sequences from the snails were analysed phylogenetically based on their mitochondrial cytochrome c oxidase (COI) gene. Based on shell morphology, the snails were identified as Galba truncatula, Radix auricularia, and Austropeplea ollula and were divided into distinct clades in the COI tree. No Fasciola larvae were detected in any of the collected snails. The 58 haplotypes of Galba truncatula which were found in Hokkaido included five detected previously in snails infected with Fasciola larvae, and constituted a closely related haplogroup (Gt-c1), suggesting that Gt-c1 snails would be susceptible to Fasciola sp. The Gt14 haplotype snails were considered to be Lymnaea schirazensis, an intermediate host of F. hepatica. The COI haplotypes of A. ollula belonged to a single clade, and were considered conspecific, whereas those of R. auricularia constituted three genetically distinct haplogroups, each of which was possibly a distinct species. This study suggests that morphologically-identified lymnaeid snails possibly include additional species. Further study of these snails is required to clarify their susceptibility to Fasciola sp.