Morphological variations in microfilaria of Wuchereria bancrofti in cytology smears: a morphometric study of 32 cases.

OBJECTIVE: Microfilaria of Wuchereria bancrofti has been described in many cytological specimens, where typical blood film morphology has been used for evaluation. However, these studies have not documented the morphological variations in microfilaria in cytological smears. In the present study, cytological findings in 32 clinically unsuspected cases of filariasis were reviewed with emphasis on morphological details and image morphometric measurements. STUDY DESIGN: A retrospective analysis of 32 cases of clinically unsuspected filariasis diagnosed by cytology from April 2001 to March 2011 was carried out. RESULTS: All microfilariae were characterized as W. bancrofti and showed a wide variation in their length (202 to 300 µm) and width (6.2 to 8.4 µm). Terminal and subterminal swellings were seen in one of the cases causing diagnostic confusion with Brugia malayi. Microfilariae were shorter and wider in May-Grünwald-Giemsa stain than in Papanicolaou-stained smears. CONCLUSIONS: Natural variations in the size of microfilariae of W. bancrofti are the probable reason for the range of these findings. The overlapping features with microfilaria of B. malayi might be related to subspecies variations in W. bancrofti. Fixation, degeneration and staining procedure also seem to influence the morphological features. This morphometric study highlights the morphological disparities of microfilaria and the differential diagnostic considerations.

Identification and location of albumin-like antigens in third-stage larva of W. bancrofti, in adult forms of Litomosoides chagasfilhoi and in the free-living nematode Caenorhabditis elegans.

Antigens resembling those of host proteins have been identified on the surface of several filarial parasites, such as immunoglobulins and serum albumins. The origin of albumin-like antigens on filarial parasites remains unclear. Several authors suggested that they have been adsorbed, or that they were metabolic waste products from nutritional utilization of human albumin, or perhaps a contamination with human products. This study searched for human albumin-like antigens by Western blot and ultrastructural analyses on filarial parasites, third stage of W. bancrofti and adult females of Litomosoides chagasfilhoi, and on the free-living Caenorhabditis elegans nematode. Our results showed approximately 67kDa proteins recognized by anti-human albumin antibodies on extracts and excretory-secretory (ES) products of the third-stage W. bancrofti. Similar albumin-like proteins were also detected on the filarial parasite L. chagasfilhoi and on C. elegans extracts. The immunocytochemistry analysis showed human albumin-like antigens on similar tissues of these nematodes. These results provide evidence that these proteins have antigenic similarity and similar distribution in nematodes tissues. Our observations suggest that albumin-like antigens presented on filarial parasites are not acquired from the host, but rather are shared antigenic determinants found even in the third-stage larvae recovered from the invertebrate host.

Some morphological aspects of Wuchereria bancrofti uterus after treatment with diethylcarbamazine.

Confocal and EM analyses revealed that some female Wuchereria bancrofti, obtained from volunteers that received recommended diethylcarbamazine dose regimens, showed few or no embryos. Furthermore, inside the gravid uterus of female W. bancrofti treated with DEC we observed a finely granular, electron-dense material organised as strings of pearls, approximately 70 nm in maximal length surrounding intra-uterine microfilariae and apparently secreted by the embryo. Over the eggshells a similar material was also observed, possibly secreted by the uterine wall. The surface of intra-uterine microfilariae presented a material with identical electron-density to the scattered structures observed inside the egg. Similarly, the sheath of blood microfilariae of W. bancrofti also showed electron-dense projections, with shape and size similar to that observed inside the uterus.

The ultrastructure of infective larvae (L3) of Wuchereria bancrofti after treatment with diethylcarbamazine.

Although the large use of diethylcarbamazine (DEC), as the major anti-filaricide drug, its mechanism of action remains a matter of controversy. Several authors defend the hypothesis that DEC has no direct effect on nematodes. This study demonstrated that infective larvae (L3) of Wuchereria bancrofti treated in vitro with DEC presented several behaviour and morphological changes. The first alteration produced by treatment for 2 h with 3, 5, 10 microg/ml of DEC was the reduction of motility. Larvae treated with 5, 10 microg/ml DEC showed severely affected organelles, formation of several vacuoles, mainly in neurocytes and in the muscle cells, and dissolution of cytoplasm. Some larvae showed extreme cellular disorganization with abundance of large and dense mitochondria and numerous large vacuoles containing residual organelles. Lamellar bodies, probably related to an assembly of hipodermal membranes, were also observed in some damaged larvae. Thus, undoubtedly in vitro treatment with concentrations of DEC similar to therapeutic conditions, which are 1-5 microg/ml (Hawking, 1979), had a direct effect on infective larvae of W. bancrofti by causing, primarily neuromuscular alterations with subsequent damage to organelles.

An ultrastructural, cytochemical and freeze-fracture study of the surface structures of Brugia malayi microfilariae.

Ultrastructural analysis of the cuticle of Brugia malayi microfilariae indicated that it is composed of 2 regions: the inner one 15-20 nm thick with a homogeneous aspect and the outer one, designated as epicuticle, which is 15-20 nm thick. Three laminae separated by electron-lucent regions were seen in the epicuticle. Labeling of the cuticle and epicuticle of B. malayi and Wuchereria bancrofti microfilariae was observed when thin sections of Lowicryl-embedded parasites were incubated in the presence of gold-labeled phospholipase-C. Replicas of freeze-fractured microfilariae showed the presence of 2 fracture planes in the epicuticle and no fracture plane in the inner region of the cuticle. The P face of the epicuticle outer fracture plane presented few particles similar to intramembranous particles (IMPs). The epicuticle inner fracture plane P and E faces presented large numbers of densely-packed small particles and many protuberances. Also, fracture faces of hypodermal and muscle cell plasma membranes were analyzed. Faces P and E of fractured membranes showed the presence of typical IMPs. P faces of both membranes showed larger amounts of particles than E faces. Fracture of muscle plasma membrane revealed a linear array of particles disposed in parallel rows on its P face.

Ultrastructural and cytochemical aspects of the cuticle of adult Wuchereria bancrofti (Nematoda: Filarioidea).

Because of the practical limitations of obtaining viable adult forms of the Wuchereria bancrofti, the major species responsible for human lymphatic filariasis, only few ultrastructural studies were carried out. Adult worms present the cuticle as the interface structure between host and parasite. Cuticle structure and the demonstration of the presence of basic proteins, lipids, small amounts of terminal carbohydrate residues, phospholipids and collagen in the cuticle was undertaken on thin sections of embedded parasites. Using immunocytochemical methods, antigenic epitopes similar to those found in the extra cellular matrix of vertebrates were localized on thin sections of the Lowicryl embedded adult filariae.

In vitro cultivation of third stage larvae of Wuchereria bancrofti to the fourth stage.

Third stage larvae of Wuchereria bancrofti obtained from laboratory-infected mosquitoes grew and molted to the fourth stage in vitro. The culture medium which supported the best growth and development consisted of a 1:1 mixture (v/v) of two commercially available cell culture media, NCTC 135 and Iscove's modified Dulbecco's medium supplemented with 10% human serum or plasma and an antibacterial/antimycotic mixture. Cultures were incubated at 37 degrees C in an atmosphere of either 5% or 8% CO2 in air. After 35 days of culture, 65% to 100% of the larvae were fourth stage. They were motile and in excellent morphological condition with development of the reproductive system in males and females. This culture system will provide an important tool for biochemical and immunological studies.

Ultrastructural characterization of intracellular bacteria of Wuchereria bancrofti.

Ultrastructural observations on the structure and distribution of endosymbiotic bacteria within the tissues of Wuchereria bancrofti are described. In female worms the organisms were observed in the lateral cords of the hypodermis, oocytes, developing eggs and in intrauterine microfilariae. Organisms were also detected in blood microfilariae and in the intestine of third-stage larvae. Bacteria were not observed in male worms.

Interaction of monoclonal antibodies with cuticular antigens of filarial parasites, Brugia malayi and Wuchereria bancrofti.

Monoclonal antibodies (mAbs) have been prepared against excretory-secretory-metabolic (ESM) antigens of microfilariae (mf) of Wuchereria bancrofti (WbmfESM) and against third stage larvae (L3) of Brugia malayi (BmL3), and purified from ascites fluids with ammonium sulphate. Both antibodies were of the IgM type and did not react with phosphorycholine. The mAb against BmL3 (F46) reacted in ELISA with antigens of L3 of B. malayi, B. pahangi and W. bancrofti and of adults of B. malayi. The mAb raised against wbmfESM (F32) resembled F46 in this respect, though with a lower titer towards the antigens, and in addition reacted with the ESM-antigens of mf and of L3 of W. bancrofti. F46 was able to detect L3 antigens of filarial parasites in spiked serum samples with a detection limit of 8-16 ng in absolute amount. The antibody was found to label the cuticular portion of L3 and adults of the lymphatic parasites, and not the epicuticular surface, in immunoelectron microscopic studies. The antibody recognized a 36 kDa component of the beta-mercaptoethanol extracts of B. pahangi-adults in Western blot analysis.

Diethylcarbamazine induces loss of microfilarial sheath of Wuchereria bancrofti.

Light microscopy analyses of microfilariae of Wuchereria bancrofti treated with DEC revealed a striking loss of the microfilarial sheath. However, no effect was observed on microfilariae of Litomosoides chagasfilhoi treated with DEC. For quantitative analyses microfilariae of W. bancrofti were processed for SEM. Controls, which have not received DEC, had 29.8% of exsheathed microfilariae. Conversely, the number of exsheathed microfilariae increased as increased DEC concentrations: 5 microg/ml (75.9%), 10 microg/ml (80.1%), and 50 microg/ml (87.7%). After DEC treatment some of sheathed microfilariae showed a wrinkled surface, and in some microfilariae, sheaths were observed being liberated almost intact from the larvae surface. But, frequently residues of the lost sheath over the surface were also observed. No damage was observed in the microfilariae cuticle. The present work shows quantitative data on the loss of the microfilarial sheath of W. bancrofti after treatment with DEC. Since no loss of microfilarial sheath was observed in microfilariae of L. chagasfilhoi submitted to the same conditions, DEC may present different mechanisms of action for distinct filarial species.

Immunocytochemical localization and distribution of human albumin in Wuchereria bancrofti adult worms.

To determine whether albumin is present on adult worms of Wuchereria bancrofti, thin sections of resin-embedded parasites were incubated with a specific antiserum to human albumin. With the exception of the epicuticle, all layers of the cuticle and the hypodermis were intensely labeled. Concentration of gold particles was observed within infoldings of the hypodermal membrane. Moderate labeling of the thin basement membrane that lines the pseudocelomic cavity and the gonoduct was also observed. Within the uterus, ovular membranes labeled intensely; groups of organized particles were seen below ovular membranes and also within invaginations of microfilarial embryos. In contrast, few gold particles were seen on the surface of mature intrauterine microfilariae. No labeling was observed in control sections incubated with antiserum preadsorbed with purified human albumin. The findings suggest that human albumin may be essential for the nutrition and development of W bancrofti microfilariae.

Scanning electron microscopy of adult Wuchereria bancrofti (Nematoda: Filarioidea).

Despite the great importance of Wuchereria bancrofti in causing human lymphatic filariasis, only conventional morphological studies have been completed with adult forms of this filaria. No ultrastructural studies have been carried out, mainly due to the difficulty in obtaining viable parasites from human tissues and the lack of a suitable experimental model or in vitro cultivation. With the recent success in using ultrasound to localize adult worms in living tissues and their surgical recovery from human lymphatic vessels, we show in the present paper the first ultrastructural observations of this filarial form. The cuticle surface analyzed by scanning electron microscopy showed a transversal striated aspect with periodic annulations and many small protuberances irregularly distributed along the filaria. The adults present a specialized cephalic area, with the oral opening surrounded by a circular mouth, papillae, and amphidial opening. Other structures, for example the anal, vulvar, and cloacal opening and spicules, were also observed and are described herein.

Ultrastructure of the rectum of infective-stage Wuchereria bancrofti (Nematoda: Filarioidea).

The authors have examined the ultrastructure of the rectum of infective-stage Wuchereria bancrofti by transmission electron microscopy. Our observations show that the rectum is divided into anterior and posterior segments. The cells of the anterior rectum appear to be derived from the microfilarial R (rectal) cells described by other authors. In both stages, these cells show voluminous nuclei, abundant mitochondria, and small cytoplasmic processes which contain fibrillar components. Amorphous material associated with these processes appears throughout the larval rectum and may protrude from the anus as the rectal plug. In the specimens examined, a patent lumen could not be traced completely through the anterior rectum. The posterior rectum has no counterpart in published accounts of microfilarial ultrastructure and probably arises during larval morphogenesis; it is lined with invaginated body cuticle, overlaid by a single layer of epithelial cells which may be of hypodermal origin.

Immunocytochemical localization of antigens recognized by human antisera in infective larvae of Wuchereria bancrofti.

Ultrathin sections of L3 of Wuchereria bancrofti embedded in hydrophilic resin were incubated with antisera pools from individuals (1) asymptomatic microfilaremic with different microfilaria (mf) densities (1-100, 101-500, and >1,000 mf/ml); (2) chronic with hydrocele or lymphedema; and (3) with no evidence of microfilaremia or clinical filariasis but residing in an endemic area. The groups of microfilaremic subjects studied presented differences relative to the intensity of labeling, with the density of gold particles per square micrometer proportional to microfilaremia. Incubation of ultrathin sections of W. bancrofti L3 larvae in the presence of antisera from patients exhibiting chronic obstructive lymphatic pathology of hydrocele and from individuals with clear clinical evidence of lymphedema exhibited a strong reaction in the same tissues. Except for the endemic normal group, all groups studied showed reactivity against epitopes in all tissues of infective larvae of W. bancrofti. The cuticle presented an intense labeling, suggesting a possible target structure for immune response.

Immunocytochemical localization of surface and intracellular antigens recognized by human sera in microfilariae of Wuchereria bancrofti.

Sera from patients with various clinical pictures of lymphatic filariasis, including tropical pulmonary eosinophilia (TPE), were used for the localization of surface and intracellular antigens in microfilariae of Wuchereria bancrofti embedded in Lowicryl K4M. Very few or no antigenic sites were located on the outer face of the sheath. The most inner layer, as well as the space between the cuticle and the sheath, was intensely labeled. Sera from TPE patients intensely labeled the cuticle and the cytoplasm of muscle cells.

Fine structure and localization of anionic sites on the surface of microfilaria of Wuchereria bancrofti.

The fine structure of the sheath and the cuticle of microfilaria of Wuchereria bancrofti was analysed and the results obtained were compared with those from other filarial parasites. Cationized ferritin particles bind to the surface of the sheath and the epicuticle. No binding of colloidal iron hydroxyde particles to the microfilaria surface was observed. Reaction product indicative of carbohydrates containing vic-glycol groups was not observed in thin sections of microfilaria submitted to the periodic acid-thiosemicarbazide-silver proteinate technique. The results obtained are discussed in relation to previous studies using lectins.

Immunocytochemical localization of surface antigens in microfilariae of Wuchereria bancrofti.

Antigenic sites were localized on the surface structure (sheath and cuticle) of microfilariae of Wuchereria bancrofti using sera from microfilaraemic and amicrofilaraemic patients using antibodies associated to colloidal gold particles and transmission electron microscopy. No labeling was observed on the surface of intact parasites. Microfilariae without the sheath and isolated sheath were obtained by ultrasound treatment. Using these preparations labeling of the inner portion of the sheath was observed when sera from amicrofilaraemic patients were used. Labeling of the cuticle surface was observed mainly in the regions of the cuticular annulations.

Fine structure of intrascrotal lymphatic vessels infected by Wuchereria bancrofti adult worms.

Lymphangiectasia represents a basic phenomenon of acute and chronic pathology in lymphatic filariasis, and the prevalence or degree of lymphatic dilation caused by filarial worms is considered an indirect measurement of the altered lymphatic function. We examined the morphological alterations of intrascrotal lymphatic vessels surgically removed from a volunteer infected by adult worms of Wuchereria bancrofti. Scanning electron microscopy revealed lymphatic vessels with an irregular endothelium and adherent flattened lymphocytes and macrophages in variable proportions. On transmission electron microscopy the lymphatic vessels showed a thin endothelium which had an irregular contour and projected several cytoplasmic processes into the lumen. Numerous micropinocytotic vesicles and collagen fibers were abundant and disorganized. The hyperplastic endothelial cells and the subendothelial fibrosis suggest that abnormal changes in these cells may play a crucial role in the development of lymphangiectasia.

Localisation and distribution of Wuchereria bancrofti antigens recognised by antisera from tropical pulmonary eosinophilia and from individuals with intestinal helminths.

Serological analyses of sera from patients with a typical picture of filarial tropical pulmonary eosinophilia (TPE) and sera from patients from a region non-endemic for filariasis harbouring intestinal helminths, as Ascaris lumbricoides and Strongyloids stercoralis, revealed equally high titers of IgG4, usually considered diagnostic for filariasis. Ultrathin sections of adult worms of W. bancrofti embedded in the hydrophilic resin L.R. White were incubated with sera from patients with a typical picture of filarial tropical pulmonary eosinophilia (TPE) and sera from patients of a region that was non-endemic for filarial TPE but endemic for intestinal helminths. Both groups had a similar pattern of labelling, except that the labelling intensity was higher with the sera of patients with filarial TPE. The present study indicates relevant epitopes recognised by sera from TPE-patients and also individuals with intestinal helminths in all tissues of adult and intra-uterine microfilaria of W. bancrofti, instead of being localised in a specific nematode region. These findings suggest that people from areas not endemic for filariasis, but who harbour intestinal helminths, also share antifilarial antibodies in their serum that recognise antigens of adult worms and intrauterine microfilaria of W. bancrofti.

Scanning electron microscopic study of microfilaria and the third stage larva of Wuchereria bancrofti.

The surface structures of microfilaria and of the third stage larva of Wuchereria bancrofti were studied by scanning electron microscopy. Distinct features were observed that could be used for differentiating species of this parasite. Specifically, the sheath of microfilariae of W. bancrofti projected beyond the head. The head region of the microfilaria was composed of a cephalic cap with hook, mouth and amphidial opening, and its cuticle showed annulation. Spines were absent at the first transverse annulation, and the tail end showed a slight constriction. In the infective stage larva, characters which are used for differentiating species, such as the two bubble-like ventro-lateral papillae and one dorso-terminal papilla were rather similar to each other in size, but the grooves seen around the base were absent. A previously unreported feature of the third stage larva of W. bancrofti that was discovered in this study is a papilliform process on the left side of the posterior region, between the anus and the tail end.