Daniel G. Colley

Resistance to reinfection with Schistosoma mansoni in occupationally exposed adults and effect of HIV-1 co-infection on susceptibility to schistosomiasis: a longitudinal study.

BACKGROUNDnPrevious studies have reported age-dependent development of resistance to reinfection by schistosomes and identified immunological correlates of this resistance. However, whether resistance exists that is independent of age effects has been questioned. We did a longitudinal investigation of reinfection by Schistosoma mansoni in an adult population with high occupational exposure.nnnMETHODSnWe monitored a cohort of 96 male car washers working along the shores of Lake Victoria, Kenya during 349.7 person-years for frequency of water contact and infection with S mansoni. Patients were treated with praziquantel upon study entry and after reinfection with S mansoni. Bivariate analyses and a multivariate proportional hazards model were used to assess the effects of water contact, previous infections, and HIV-1 on S mansoni reinfection rates.nnnFINDINGSn13 car washers did not get reinfected or only became reinfected after an extended time (91 weeks). 47 initially had a short time to reinfection (15 weeks) but on subsequent treatments showed increased time to reinfection (29-38 weeks). 36 consistently displayed short times to reinfection (<15 weeks) despite multiple reinfection and treatment cycles. Decreased CD4 T-cell counts in HIV-1-positive individuals corresponded to increased susceptibility to S mansoni reinfection.nnnINTERPRETATIONnAdults similarly exposed to schistosomiasis are either resistant to reinfection; susceptible, but develop resistance to reinfection after multiple treatments; or remain susceptible to reinfection. Thus, immunological resistance to reinfection with S mansoni exists or can develop independent of age effects. The consequence of HIV-1 co-infection suggests that CD4 T cells contribute to this resistance.

Interferon-γ production by peripheral blood mononuclear cells from residents of an area endemic for Schistosoma mansoni

During human schistosomiasis host responses to antigens of various parasite life-cycle stages may contribute to whether the severe, hepatosplenic state develops or the patient remains relatively asymptomatic throughout infection, and may play a role in resistance. This study evaluated production of interferon gamma (IFN-gamma) in vitro by schistosome antigen-stimulated peripheral blood mononuclear cells (PBMCs) from asymptomatic patients, and by PBMCs from apparently uninfected, untreated persons living in areas endemic for Schistosoma mansoni (endemic normals). IFN-gamma production parallels PBMC proliferation in that schistosomal egg antigens stimulate patent patients cells poorly, but strongly stimulate PBMCs from endemic normals. This is proportionally true for antigens from adult worms and cercariae. Although asymptomatic patent patients cells produced little or no IFN-gamma in response to the 3 schistosomal antigenic extracts, their PBMCs, and PBMCs from endemic normals, produced expected amounts of IFN-gamma when exposed to phytohaemagglutinin. This implies that persons with patent infections have schistosome antigen-specific defects in their ability to respond to IFN-gamma production that are not exhibited by putatively resistant endemic normals.

Schistosoma mansoni: Mortality, pathophysiology, and susceptibility differences in male and female mice

In parallel studies of Schistosoma mansoni infections in male and female CBA/J mice, major sex-related differences are seen in the development of infection and disease. Upon equal subcutaneous exposures to 45 cercariae female mice present a more severe clinical course with consequent higher mortality than male mice. By 12 weeks of infection, more than 80% of female mice die, while less than 20% of infected males succumb to infection. This greater index of mortality is apparently due to the higher susceptibility of female mice to the development of adult worms. Exposed to 45 cercariae, virtually all females develop patent infections, but 8-34% of male mice do not do so. Also, the recovery rate of adult worms per cercariae from female mice is much higher than that from males, indicating that schistosomula are more successful in developing into adult worms in female mice. Additional studies indicate that this dichotomy of schistosomiasis in the sexes is not restricted to mice of the CBA/J strain, but also occurs in C57BL/6 and outbred CF1 strain mice.

Eosinophil-mediated destruction of Schistosoma mansoni eggs III. lymphokine involvement in the induction of eosinophil functional abilities.

Abstract Granulomas isolated from the livers of CBA/J mice infected for 8 weeks with Schistosoma mansoni produced a chemotactic activity for eosinophils, in a manner which correlated with the production of the lymphokine eosinophil stimulation promoter (ESP). ESP and chemotactic activities were also produced when eosinophilrich peritoneal exudative cells from S. mansoni -infected mice were cultured with S. mansoni eggs. These S. mansoni -related eosinophils destroyed approximately 20% of the eggs whereas eosinophils from normal (uninfected) mice did not have this ability. However, normal cells exposed to ESP-containing fluids in the co-cultivation system actively participated in egg destruction. Eosinophil-rich peritoneal exudative cells obtained from Trichinella spiralis -infected mice were incapable of destroying S. mansoni eggs during the normal 24 hr co-cultivation period, but did achieve destruction if the incubation period was extended to 48 hr. Marginal levels of chemotactic activity for eosinophils were detected in the co-cultivation fluids from T. spiralis -related cells and S. mansoni eggs, although these fluids did not contain demonstrable levels of ESP. Together, these data indicate that ESP/chemotactic factor-containing culture fluids can induce in normal, unreactive eosinophils the functional ability to destroy S. mansoni eggs in vitro . This may account for the ability of T. spiralis -related eosinophils to do so upon extended incubation.

Identification of lipoxygenase products from arachidonic acid metabolism in stimulated murine eosinophils

The presence of arachidonic acid lipoxygenase pathways in murine eosinophils was demonstrated by the isolation and identification of several lipoxygenase products from incubations of these cells. The most abundant arachidonate metabolite from murine eosinophils stimulated with ionophore A23187 and exogenous arachidonic acid was 12-S-hydroxyeicosatetraenoic acid (12-S-HETE), and the next most abundant was 15-HETE. Two families of leukotrienes were also recovered from these incubations. One family comprised the hydrolysis products of leukotriene A4, and the other included products derived from the 14,15-oxido analog of leukotriene A4 (14,15-leukotriene A4). Two double oxygenation products of arachidonate were also identified. These compounds were a 5,15-dihydroxyeicosatetraenoic acid (5,15-diHETE) and a 5,12-dihydroxyeicosatetraenoic acid (5,12-diHETE). Eosinophil stimulation promoter is a murine lymphokine which enhances the migration of eosinophils. When murine eosinophils were incubated with eosinophil stimulation promoter in concentrations sufficient to produce a migration response, a 2-3-fold increase in the production of 12-HETE was observed compared to unstimulated cells. Coupled with the recent demonstration that arachidonic acid lipoxygenase inhibitors suppress the migration response to eosinophil stimulation promoter and that 12-HETE induces a migration response, this observation provides further evidence in support of the hypothesis that eosinophil stimulation promoter stimulation of eosinophils results in the generation of lipoxygenase products which modulate the migratory activity of the cells.

A multivariate analysis of socio-demographic factors, water contact patterns and Schistosoma mansoni infection in an endemic area in Brazil

Associations between socio-demographic factors, water contact patterns and Schistosoma mansoni infection were investigated in 506 individuals (87% of inhabitants over 1 year of age) in an endemic area in Brazil (Divino), aiming at determining priorities for public health measures to prevent the infection. Those who eliminated S. mansoni eggs (n = 198) were compared to those without eggs in the stools (n = 308). The following explanatory variables were considered: age, sex, color, previous treatment with schistosomicide, place of birth, quality of the houses, water supply for the household, distance from houses to stream, and frequency and reasons for water contact. Factors found to be independently associated with the infection were age (10-19 and > or = 20 yrs old), and water contact for agricultural activities, fishing, and swimming or bathing (Adjusted relative odds = 5.0, 2.4, 3.2, 2.1 and 2.0, respectively). This suggests the need for public health measures to prevent the infection, emphasizing water contact for leisure and agricultural activities in this endemic area.

Eosinophil-mediated destruction of schistosoma mansoni eggs in vitro. II. The role of cytophilic antibody.

Abstract Peritoneal exudative eosinophils obtained from Schistosoma mansoni -infected CBA/J mice cause morphological damage to isolated S. mansoni eggs in a 24 hr co-cultivation system in vitro . This egg-destructive activity was complement-independent and was abolished by trypsinization of the cells prior to co-cultivation. Trypsinized cells could be passively sensitized to renewed egg-destructive capacity by preincubation or co-gcultivation with immune sera, containing antibodies against a soluble egg antigenic preparation (SEA). Solid phase absorption of immune sera with SEA coupled to Sepharose 4B lowered the anti-egg antibody titers of these sera and eliminated their ability to sensitize trypsinized eosinophils. Sera from uninfected mice or from mice infected with Trichinella spiralis did not sensitize trypsinized cells. Addition of immune sera to eosinophil-rich cell populations obtained from uninfected mice also enhanced the egg-destructive capacity of these otherwise non-reactive cells. Therefore, eosinophil-mediated destruction of S. mansoni eggs may be directed by cytophilic antigen-specific factors in sera from S. mansoni infected hosts.

Infection with Schistosoma mansoni correlates with altered immune responses to Ascaris lumbricoides and hookworm

Studies were performed on humoral and cellular immune responses of patients from areas in Brazil endemic for hookworm and Ascaris lumbricoides, and either endemic or non-endemic for Schistosoma mansoni. Humoral and cellular responses were evaluated by enzyme-linked immunosorbant assay (ELISA) and peripheral blood mononuclear cell (PBMC) proliferation assays against larval hookworm antigens, A. lumbricoides egg antigens, and soluble egg antigens (SEA) or soluble whole adult antigenic preparation (SWAP) from S. mansoni. Patients from S. mansoni-endemic areas, who currently had only hookworm or Ascaris infections, expressed lower humoral and cellular responses to hookworm or Ascaris antigens, respectively, than did their counterparts from areas not endemic for S. mansoni. Individuals from S. mansoni endemic area, although without detectable S. mansoni infection, do mount humoral and cellular responses to SEA and SWAP. This group of individuals has been probably in contact with S. mansoni antigens, since the groups harboring A. lumbricoides or hookworm infections from non-S. mansoni endemic areas do not have detectable anti-S. mansoni responses. PBMC proliferative responses discriminated well between patients with active hookworm infections versus ascariasis, if they were from areas not endemic for S. mansoni.

Adoptive suppression of granuloma formation by T lymphocytes and by lymphoid cells sensitive to cyclophosphamide

Abstract Egg-induced granulomas formed in mice with chronic Schistosoma mansoni infection are smaller than those which develop during early (8-week) infection. Adoptive transfer of spleen cells from chronically infected mice (15–25 week), which displayed modulated granulomas, to 6-week-infected recipients effectively suppressed active granuloma formation in the recipients by 8 weeks after infection. Pretreatment of these suppressive spleen cells with anti-Thy 1.2 serum and complement eliminated their suppressive capacity. Administration of cyclophosphamide (CY) (20 mg/kg, 3 times/week for 3 weeks) to 12- to 15-week-infected mice reversed modulation of granuloma formation resulting in larger granulomas at 15 weeks. This abrogation of suppression was reflected in the spleens of the CY-treated mice, as seen by the inability of their spleen cells to adoptively transfer suppression to 6-week-infected mice. This regimen of CY treatment did not significantly alter anti-schistosome egg antigen hemagglutinating antibody titers. It is reasoned that the modulation of granuloma formation observed during chronic schistosomiasis mansoni is in part dependent upon a T lymphocyte and a CY-sensitive spleen cell.

Schistosoma mansoni: Detection of circulating antigens in murine schistosomiasis by antigen-capture sandwich ELISA using a monoclonal antibody

A monoclonal antibody (MAb) 5H11/B1 that reacts with a repeating epitope on an excretory-secretory (E + S) antigen of adult worms of Schistosoma mansoni was used in the detection of circulating antigen (CA) in sera from S. mansoni-infected mice using an antigen-capture sandwich ELISA. Trichloroacetic acid (TCA) pretreatment of sera from mice infected for 8 or 16 weeks precipitated immune complexes and/or dissociated CA and allowed its detection. Sera obtained 8 weeks after infection contained high levels of CA. Upon treatment with praziquantel (100 mg/kg body wt), this level was significantly less within 1 week. A strong correlation was found between the worm count determined by perfusion and the level of antigenemia detected by the 5H11/B1 assay in light and heavy infection (r = 0.80). Based on the results of both TCA pretreatment and sodium periodate treatment, the 5H11/B1 sandwich ELISA assay detects a repeating carbohydrate epitope on an E + S antigen. This system appears to be a sensitive assay for the detection of schistosomal antigenemia in murine schistosomiasis. Studies on the detection of antigenemia in human schistosomiasis using this assay are in progress.