Synthetic hookworm-derived peptides are potent modulators of primary human immune cell function that protect against experimental colitis in vivo.

The prevalence of autoimmune diseases is on the rise globally. Currently, autoimmunity presents in over 100 different forms and affects around 9% of the world's population. Current treatments available for autoimmune diseases are inadequate, expensive, and tend to focus on symptom management rather than cure. Clinical trials have shown that live helminthic therapy can decrease chronic inflammation associated with inflammatory bowel disease and other gastrointestinal autoimmune inflammatory conditions. As an alternative and better controlled approach to live infection, we have identified and characterized two peptides, Acan1 and Nak1, from the excretory/secretory component of parasitic hookworms for their therapeutic activity on experimental colitis. We synthesized Acan1 and Nak1 peptides from the Ancylostoma caninum and Necator americanus hookworms and assessed their structures and protective properties in human cell-based assays and in a mouse model of acute colitis. Acan1 and Nak1 displayed anticolitic properties via significantly reducing weight loss and colon atrophy, edema, ulceration, and necrosis in 2,4,6-trinitrobenzene sulfonic acid-exposed mice. These hookworm peptides prevented mucosal loss of goblet cells and preserved intestinal architecture. Acan1 upregulated genes responsible for the repair and restitution of ulcerated epithelium, whereas Nak1 downregulated genes responsible for epithelial cell migration and apoptotic cell signaling within the colon. These peptides were nontoxic and displayed key immunomodulatory functions in human peripheral blood mononuclear cells by suppressing CD4+ T cell proliferation and inhibiting IL-2 and TNF production. We conclude that Acan1 and Nak1 warrant further development as therapeutics for the treatment of autoimmunity, particularly gastrointestinal inflammatory conditions.

Phenolic Metabolites of Dalea ornata Affect Both Survival and Motility of the Human Pathogenic Hookworm Ancylostoma ceylanicum.

Hookworms are ubiquitous human parasites, infecting nearly one billion people worldwide, and are the leading cause of anemia and malnutrition in resource-limited countries. Current drug treatments rely on the benzimidazole derivatives albendazole and mebendazole, but there is emerging resistance to these drugs. As part of a larger screening effort, using a hamster-based ex vivo assay, anthelmintic activity toward Ancylostoma ceylanicum was observed in the crude extract of aerial parts of Dalea ornata. These studies have led to the isolation and characterization of phenolic metabolites 1-10. The structures were determined by 1D and 2D NMR spectroscopy, and the absolute configuration of 1 was assigned using electronic circular dichroism data. The new compound, (2S)-8-(3-methylbut-2-en-1-yl)-6,7,4'-trihydroxyflavanone (1), was weakly active at 7.3 µM, with 17% reduction in survival of the hookworms after 5 days. The rotenoids deguelin (9) and tephrosin (10), predictably perhaps, were the most active, with complete worm mortality observed by day 4 (or earlier) at 6.3 and 6.0 µM, respectively. The effects of 1-10 on hookworm motility and on toxicity to hamster splenocytes were also explored as important measures of treatment potential.

Molecular identification of hookworms in stray and shelter dogs from Guangzhou city, China using ITS sequences.

Canine hookworm infections are endemic worldwide, with zoonotic transmission representing a potentially significant public health concern. This study aimed to investigate hookworm infection and identify the prevalent species from stray and shelter dogs in Guangzhou city, southern China by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) based on internal transcribed spacer (ITS) sequences. From March 2011 to July 2012, fresh faecal samples from a total of 254 dogs were obtained from five locations, namely Conghua, Baiyun, Liwan, Haizhu and Panyu, in Guangzhou. These samples were screened for the presence of hookworm eggs using light microscopy, with an overall prevalence of 29.53% being recorded. The highest prevalence of 45.28% was found in suburban dogs from Conghua compared with lower values recorded in urban dogs in Haizhu (21.43%), Baiyun (18.97%), Panyu (18.18%) and Liwan (15%). The prevalence in stray dogs was significantly higher than that in shelter dogs. PCR-RFLP analysis showed that 57.33% were detected as single hookworm infections with Ancyclostoma caninum, and 22.67% as A. ceylanicum, while 20% were mixed infections. This suggests that high prevalences of both hookworm species in stray and shelter dogs in China pose a potential risk of transmission from pet dogs to humans.

The hookworm pharmacopoeia for inflammatory diseases.

In the developed world, declining prevalence of parasitic infections correlates with increased incidence of allergic and autoimmune disorders. Current treatments for these chronic inflammatory conditions have little to no effect on their prevalence and are referred to as "controllers" rather than cures. There has been limited success in therapeutically targeting allergic and autoimmune pathways, leaving an unmet need for development of effective anti-inflammatories. We discuss the benefit of hookworm infections and the parasite's ability to condition the immune system to prevent allergic asthma and inflammatory bowel diseases. We then examine the immunomodulatory properties of selected hookworm-derived proteins in these two models of inflammation. While hookworm protein therapy has yet to be fully exploited, the identification of these proteins and the mechanisms by which they skew the immune system will provide new avenues for controlling and optimally reversing key pathological processes important in allergic and inflammatory bowel diseases.

Discovery and pre-clinical development of antithrombotics from hematophagous invertebrates.

Bloodfeeding (hematophagous) parasites have evolved effective means of inhibiting mammalian thrombosis, thereby facilitating the acquisition and digestion of a bloodmeal. To date, specific inhibitors of coagulation and platelet function have been identified from numerous invertebrate species, representing an impressive array of convergent functional strategies. These parasite antithrombotics, in addition to playing a critical role in the diseases caused or transmitted by bloodfeeding invertebrates, may also serve as potentially useful therapeutic agents for the treatment of a variety of conditions associated with activation of thrombosis. A number of naturally occurring anticoagulants and platelet inhibitors have been evaluated in vivo, with some currently in varying stages of preclinical and clinical development. Because of the unique specificity and potency of parasite antithrombotics, these invertebrate natural products hold great promise for improving the treatment of a variety of human illnesses, including heart disease, stroke, and cancer.

Immune responses in hookworm infections.

Hookworms infect perhaps one-fifth of the entire human population, yet little is known about their interaction with our immune system. The two major species are Necator americanus, which is adapted to tropical conditions, and Ancylostoma duodenale, which predominates in more temperate zones. While having many common features, they also differ in several key aspects of their biology. Host immune responses are triggered by larval invasion of the skin, larval migration through the circulation and lungs, and worm establishment in the intestine, where adult worms feed on blood and mucosa while injecting various molecules that facilitate feeding and modulate host protective responses. Despite repeated exposure, protective immunity does not seem to develop in humans, so that infections occur in all age groups (depending on exposure patterns) and tend to be prolonged. Responses to both larval and adult worms have a characteristic T-helper type 2 profile, with activated mast cells in the gut mucosa, elevated levels of circulating immunoglobulin E, and eosinophilia in the peripheral blood and local tissues, features also characteristic of type I hypersensitivity reactions. The longevity of adult hookworms is determined probably more by parasite genetics than by host immunity. However, many of the proteins released by the parasites seem to have immunomodulatory activity, presumably for self-protection. Advances in molecular biotechnology enable the identification and characterization of increasing numbers of these parasite molecules and should enhance our detailed understanding of the protective and pathogenetic mechanisms in hookworm infections.