Hatem Tallima

Schistosoma mansoni ex vivo lung-stage larvae excretory-secretory antigens as vaccine candidates against schistosomiasis.

Schistosoma mansoni lung-stage larvae are known to be the major target of innate and acquired immunity to schistosomiasis. Lung schistosomula cytosolic or surface membrane antigens are hidden, entirely inaccessible to the host immune system, and hence are not particularly important as vaccine candidates. Conversely, excretory-secretory (E-S) products released from intact, viable, elongated, and contractile schistosomula are ideal potential vaccines, as such molecules can readily play a central role in the induction of local primary and memory immune response effectors that would directly target, surround, and pursue the larvae while negotiating the lung capillaries. Therefore, 6-day-old ex vivo larvae were isolated from mouse or hamster lung cells and used for generation of E-S products, which were shown to elicit strong immune responses and significant (P<0.05) protection against challenge infection in BALB/c mice. Proteomic analysis of E-S molecules following 10x concentration and sodium dodecyl sulfate-polyacrylamide gel electrophoresis identified peptides related to innumerable host and about 15 S. mansoni-specific proteins. Selected S. mansoni-specific E-S peptides prepared in a multiple antigen peptide (MAP) or recombinant form were shown to stimulate considerable specific antibody response and peripheral blood mononuclear cell expression of mRNA for several cytokines in immunized C57BL/6 and BALB/c mice. However, highly significant (P<0.05 to <0.005) reduction in challenge infection worm burden and egg load was recorded only when the immunization conditions in test mice provided the S. mansoni antigen-specific T helper (Th) type response milieu favorable for each immunogen. That was polarized Th1 for S. mansoni aldolase and thioredoxin peroxidase 1 MAPs, polarized Th2 for recombinant 14-3-3-like protein, mixed Th1/Th17 for calpain MAP, and mixed Th1/Th2 for recombinant p18 protein. The findings together indicated that the immune responses issue is as critical as the nature and source of the antigen for the development of vaccine against schistosomiasis.

In Vitro and In Vivo Activities of Arachidonic Acid against Schistosoma mansoni and Schistosoma haematobium

ABSTRACT The development of arachidonic acid (ARA) for treatment of schistosomiasis is an entirely novel approach based on a breakthrough discovery in schistosome biology revealing that activation of parasite tegument-bound neutral sphingomyelinase (nSMase) by unsaturated fatty acids, such as ARA, induces exposure of parasite surface membrane antigens to antibody binding and eventual attrition of developing schistosomula and adult worms. Here, we demonstrate that 5 mM ARA leads to irreversible killing of ex vivo 1-, 3-, 4-, 5-, and 6-week-old Schistosoma mansoni and 9-, 10-, and 12-week-old Schistosoma haematobium worms within 3 to 4 h, depending on the parasite age, even when the worms were maintained in up to 50% fetal calf serum. ARA-mediated worm attrition was prevented by nSMase inhibitors, such as CaCl2 and GW4869. Scanning and transmission electron microscopy revealed that ARA-mediated worm killing was associated with spine destruction, membrane blebbing, and disorganization of the apical membrane structure. ARA-mediated S. mansoni and S. haematobium worm attrition was reproduced in vivo in a series of 6 independent experiments using BALB/c or C57BL/6 mice, indicating that ARA in a pure form (Sigma) or included in infant formula (Nestle) consistently led to 40 to 80% decrease in the total worm burden. Arachidonic acid is already marketed for human use in the United States and Canada for proper development of newborns and muscle growth of athletes; thus, ARA has potential as a safe and cost-effective addition to antischistosomal therapy.

Transforming growth factor-β and Th17 responses in resistance to primary murine schistosomiasis mansoni

Discovery of the T-helper (Th) 17 cell lineage and functions in immune responses of mouse and man prompted us to investigate the role of transforming growth factor-beta (TGF-beta) and interleukin (IL)-17 in innate resistance to murine schistosomiasis mansoni. Schistosoma mansoni-infected BALB/c and C57BL/6 mice were administered with recombinant TGF-beta or mouse monoclonal antibody to TGF-beta to evaluate the impact of this cytokine on host immune responses against lung-stage schistosomula, and subsequent effects on adult worm parameters. Developing schistosomula elicited increase in peripheral blood mononuclear cells (PBMC) mRNA expression and/or plasma levels of IL-4, IL-17, and interferon-gamma (IFN-gamma), cytokines known to antagonize each other, resulting in impaired Th1/Th2, and Th17 immune responses and parasite evasion. Mice treated with TGF-beta showed elevated PBMC mRNA expression of IL-6, IL-17, TGF-beta, and TNF-alpha mRNA and increased IL-23 and IL-17 or TGF-beta plasma levels, associated with significantly (P<0.02-<0.0001) lower S. mansoni adult worm burden compared to controls in both mouse strains, thus suggesting that TGF-beta led to heightened Th17 responses that mediated resistance to the infection. Mice treated with antibody to TGF-beta showed increase in PBMC mRNA expression and plasma levels of IL-4, IL-12p70, and IFN-gamma, and significantly (P<0.02 and <0.0001) reduced worm burden and liver worm egg counts than untreated mice, indicating that Th1/Th2 immune responses were potentiated, resulting in significant innate resistance to schistosomiasis. The implications of these observations for schistosome immune evasion and vaccination were discussed.

Vaccine-Induced Protection Against Murine Schistosomiasis Mansoni with Larval Excretory–Secretory Antigens and Papain or Type-2 Cytokines

Abstract: Schistosoma mansoni glyceraldehyde 3-phosphate dehydrogenase (SG3PDH), peroxiredoxin (TPX), and other larval excretory–secretory products (ESP) essentially induce T helper (Th) 1 and Th17 immune responses during a non-protective natural infection. Such an immune environment promotes production of nitric oxide and hydrogen peroxide by interferon-γ–activated monocytes and interleukin (IL)-17–mediated recruitment and activation of neutrophils; however, it also likely prevents engagement of eosinophils and basophils in the hunt for developing larvae. We reasoned that polarizing ESP-induced immune responses toward a Th2 phenotype, via the use of cysteine proteases or type-2 cytokines, would lead to almost total parasite elimination. Accordingly, outbred mice were immunized with 10 μg recombinant SG3PDH and 15 μg TPX-derived peptide together with 10 μg papain, or 200 ng thymic stromal lymphopoietin, IL-25, or IL-33 as an adjuvant. Two weeks later, untreated mice, adjuvant controls, and immunized mice were challenged with 100 or 125 cercariae. Results of 6 experiments indicated that these formulations elicited IgM, IgG1, and IgA specific antibodies, and an increase in ex vivo spleen cells release of IL-4 and IL-5 correlated with highly significant (up to P < 0.0001) reduction of 62 to 78% in challenge worm burden. Improvement of ESP selection, singly or in a combination, and immunization regimen, namely ESP and type-2 cytokine dose and injection site and schedule, could lead to a sterilizing schistosomiasis vaccine in the foreseeable future.

Novel therapeutic and prevention approaches for schistosomiasis: review.

Schistosomiasis is a debilitating disease affecting approximately 600 million people in 74 developing countries, with 800 million, mostly children at risk. To circumvent the threat of having praziquantel (PZQ) as the only drug used for treatment, several PZQ derivatives were synthesized, and drugs destined for other parasites were used with success. A plethora of plant-derived oils and extracts were found to effectively kill juvenile and adult schistosomes, yet none was progressed to pre- and clinical studies except an oleo-gum resin extracted from the stem of Commiphora molmol, myrrh, which action was challenged in several trials. We have proposed an essential fatty acid, a component of our diet and cells, the polyunsaturated fatty acid arachidonic acid (ARA) as a remedy for schistosomiasis, due to its ability to activate the parasite tegument-bound neutral sphingomyelinase, with subsequent hydrolysis of the apical lipid bilayer sphingomyelin molecules, allowing access of specific antibody molecules, and eventual worm attrition. This concept was convincingly supported using larval and adult Schistosoma mansoni and Schistosoma haematobium worms in in vitro experiments, and in vivo studies in inbred mice and outbred hamsters. Even if ARA proves to be an entirely effective and safe therapy for schistosomiasis, it will not prevent reinfection, and accordingly, the need for developing an effective vaccine remains an urgent priority. Our studies have supported the status of S. mansoni calpain, glutathione-S-transferase, aldolase, triose phosphate isomerase, glyceraldehyde 3-phosphate dehydrogenase, enolase, and 2-cys peroxiredoxin as vaccine candidates, as they are larval excreted-secreted products and, contrary to the surface membrane molecules, are entirely accessible to the host immune system effector elements. We have proposed that the use of these molecules, in conjunction with Th2 cytokines-inducing adjuvants for recruiting and activating eosinophils and basophils, will likely lead to development and implementation of a sterilizing vaccine in a near future.

Cysteine Peptidases as Schistosomiasis Vaccines with Inbuilt Adjuvanticity

Schistosomiasis is caused by several worm species of the genus Schistosoma and afflicts up to 600 million people in 74 tropical and sub-tropical countries in the developing world. Present disease control depends on treatment with the only available drug praziquantel. No vaccine exists despite the intense search for molecular candidates and adjuvant formulations over the last three decades. Cysteine peptidases such as papain and Der p 1 are well known environmental allergens that sensitize the immune system driving potent Th2-responses. Recently, we showed that the administration of active papain to mice induced significant protection (P<0.02, 50%) against an experimental challenge infection with Schistosoma mansoni. Since schistosomes express and secrete papain-like cysteine peptidases we reasoned that these could be employed as vaccines with inbuilt adjuvanticity to protect against these parasites. Here we demonstrate that sub-cutaneous injection of functionally active S. mansoni cathepsin B1 (SmCB1), or a cathepsin L from a related parasite Fasciola hepatica (FhCL1), elicits highly significant (P<0.0001) protection (up to 73%) against an experimental challenge worm infection. Protection and reduction in worm egg burden were further increased (up to 83%) when the cysteine peptidases were combined with other S. mansoni vaccine candidates, glyceraldehyde 3-phosphate dehydrogenase (SG3PDH) and peroxiredoxin (PRX-MAP), without the need to add chemical adjuvants. These studies demonstrate the capacity of helminth cysteine peptidases to behave simultaneously as immunogens and adjuvants, and offer an innovative approach towards developing schistosomiasis vaccines

Innate immunogenicity and in vitro protective potential of Schistosoma mansoni lung schistosomula excretory-secretory candidate vaccine antigens.

Excretory-secretory products (ESP) of Schistosoma mansoni developing larvae are ideal potential vaccines as such molecules may readily induce host primary immune responses, and local memory immune response effectors that would target, surround, and pursue the larvae while negotiating the lung blood capillaries. We herein characterized the cytokines response ESP, e.g., SG3PDH, 14-3-3-like protein, TPX, and calpain induce in the natural context of infection, and defined the global cytokine profile conducive to effective schistosome larvae killing. Accordingly, spleen cells (SC) taken from naïve, and 7-, or 9-day S. mansoni-infected mice were stimulated in vitro with the selected ESP, in a recombinant or multiple antigen peptide (MAP) form, and examined for production of T helper type (Th) 1, Th2, and Th17 cytokines, and the ability to mediate in vitro attrition of lung-stage schistosomula. The study indicated that larval ESP principally elicit Th1 and Th17 type cytokines. Recombinant SG3PDH was the only test ESP to additionally activate SC from S. mansoni-infected BALB/c mice to release higher IL-4 levels than unstimulated SC and mediate significant (P < 0.0001) in vitro attrition of lung-stage larvae. Thus, our data suggested that a balance between Th1, Th17, and Th2 cytokines is required for effective schistosome larval elimination.

IN VITRO AND IN VIVO EFFECTS OF UNSATURATED FATTY ACIDS ON SCHISTOSOMA MANSONI AND S. HAEMATOBIUM LUNG-STAGE LARVAE

Incubation of Schistosoma mansoni lung-stage larvae in 90% corn oil for 6 hr was shown to elicit exposure of their, otherwise masked, apical membrane antigens to binding of anti-schistosome antibodies in the indirect membrane immunofluorescence test (IF). The possibility that unsaturated fatty acids (FA) are responsible for this effect was herein supported by IF data on ex vivo lung-stage larvae of S. mansoni and S. haematobium incubated for ½–2 hr with 80% corn oil, 50% olive oil, or 10– 20 μM arachidonic acid. Treatment with unsaturated FA followed by filipin staining for cholesterol visualization indicated that unsaturated FA do not induce exposure of schistosomular surface membrane antigens via extraction of surface membrane cholesterol. Evidence using inhibitors and stimulators of neutral sphingomyelinase suggested that unsaturated FA perhaps activate worm tegument-bound neutral sphingomyelinase, leading to sphingomyelin hydrolysis and changes in surface membrane fluidity. Larval apical membrane antigens are, thus, allowed to diffuse freely in the plane of the membrane and bind specific antibodies in IF. Excessive sphingomyelin hydrolysis might explain why high FA concentrations or long incubation periods eventually lead to larval death. The significant decrease (P < 0.01) in S. mansoni and increase (P < 0.02) in S. haematobium worm recovery in BALB/c mice given unsaturated FA-high and -poor diets, respectively, indicated these findings have in vivo relevance and led to the proposal that unsaturated FA likely plays a role in natural attrition of S. mansoni and S. haematobium lung-stage larvae.

Equilibrium in lung schistosomula sphingomyelin breakdown and biosynthesis allows very small molecules, but not antibody, to access proteins at the host-parasite interface

The mechanism by which lung-stage schistosomula expose proteins at the host–parasite interface to nutrient, but not antibody, uptake has been obscure. We have found that Schistosoma mansoni and Schistosoma haematobium larvae emerging from host lung at a pH of around 7.5, and fixed with diluted formaldehyde (HCHO), readily bind specific antibodies in indirect membrane immunofluorescence. Data on inhibitors and activators of parasite tegument-bound, magnesium-dependent, neutral sphingomyelinase (nSMase), and sphingomyelin biosynthesis inhibitors revealed that equilibrium in schistosomular sphingomyelin breakdown and biosynthesis prevents antibody binding, yet permits access of small HO-CH2-OH polymers to interact with and cross-link proteins at the host–parasite interface, allowing for their serological visualization.

Methyl-β-Cyclodextrin Treatment and Filipin Staining Reveal the Role of Cholesterol in Surface Membrane Antigen Sequestration of Schistosoma mansoni and S. haematobium Lung-Stage Larvae

Ex vivo lung-stage larvae of Schistosoma mansoni and S. haematobium do not bind specific antibodies in the indirect membrane immunofluorescence test (IF), probably as a result of confinement of the surface membrane antigens in immobile, lipid-rich sites. Treatment with the membrane-impermeable, cholesterol-extracting drug methyl-β-cyclodextrin (MBCD) and staining with filipin III (filipin), a fluorescent polyene antibiotic widely used for the detection and quantitation of cholesterol in biomembranes, allowed us to examine the role of cholesterol in surface membrane antigen sequestration of S. mansoni and S. haematobium ex vivo lung-stage larvae. Treatment of S. mansoni larvae with MBCD elicited appreciable cholesterol depletion as judged by filipin–cholesterol fluorescence diminution, which was accompanied by a considerable increase in specific antibody binding in IF, thus suggesting that cholesterol plays a predominant role in sequestration of the surface membrane antigens of S. mansoni lung-stage schistosomula. Despite that, MBCD induced an almost complete depletion of cholesterol from the outer membrane of S. haematobium larvae; no increase in specific antibody binding in IF was evident, implying that cholesterol is not responsible for masking surface membrane antigens of S. haematobium lung-stage larvae.