Heligmosomoides bakeri and Toxoplasma gondii co-infection leads to increased mortality associated with changes in immune resistance in the lymphoid compartment and disease pathology.

Co-infections are a common reality but understanding how the immune system responds in this context is complex and can be unpredictable. Heligmosomoides bakeri (parasitic roundworm, previously Heligmosomoides polygyrus) and Toxoplasma gondii (protozoan parasite) are well studied organisms that stimulate a characteristic Th2 and Th1 response, respectively. Several studies have demonstrated reduced inflammatory cytokine responses in animals co-infected with such organisms. However, while general cytokine signatures have been examined, the impact of the different cytokine producing lymphocytes on parasite control/clearance is not fully understood. We investigated five different lymphocyte populations (NK, NKT, γδ T, CD4+ T and CD8+ T cells), five organs (small intestine, Peyer's patches, mesenteric lymph nodes, spleen and liver), and 4 cytokines (IFN©, IL-4, IL-10 and IL-13) at two different time points (days 5 and 10 post T. gondii infection). We found that co-infected animals had significantly higher mortality than either single infection. This was accompanied by transient and local changes in parasite loads and cytokine profiles. Despite the early changes in lymphocyte and cytokine profiles, severe intestinal pathology in co-infected mice likely contributed to early mortality due to significant damage by both parasites in the small intestine. Our work demonstrates the importance of taking a broad view during infection research, studying multiple cell types, organs/tissues and time points to link and/or uncouple immunological from pathological findings. Our results provide insights into how co-infection with parasites stimulating different arms of the immune system can lead to drastic changes in infection dynamics.

Causes of Fatal Cyathostomiasis in Brown Booby (Sula leucogaster) from Brazil: Identification of Pathogen and Implications for Management.

Fatal infection by Cyathostoma (Cyathostoma) phenisci (Nematoda: Syngamidae), was identified in 2 of 52 brown boobies (Sula leucogaster) collected on beaches in the state of Rio de Janeiro, Brazil, and admitted to the veterinary clinic for rehabilitation. Both infected birds were in poor physical condition, with atrophied pectoral muscles, and died soon after starting treatment. The parasitological and pathological examination of the carcasses revealed the presence of C. (C.) phenisci in the trachea, resulting in tracheitis, as well as severe parasitic granulomatous bronchopneumonia caused by eggs deposited in the lungs. In our opinion, these serious pathological changes were the primary cause of chronic respiratory illness. This is the first description of fatal cyathostomiasis in a fish-eating avian host caused by infection by a member of the subgenus Cyathostoma (Cyathostoma). Therefore, it is reasonable to consider C. (C.) phenisci to be a real threat to a wide range of their definitive hosts, and cyathostomiasis should be considered in the differential diagnosis for fish-eating marine birds, even in cases without respiratory signs. This is also the first record of the genus Cyathostoma in Brazil.

Evaluating host-parasite co-adaptation relationships involving Angiostrongylus costaricensis.

Angiostrongylus costaricensis is a parasite that infects rodents, including the wild cotton rat Sigmodon hispidus and pygmy rice rats Oligoryzomys spp., among others. However, urban Rattus norvegicus and Mus musculus have not been identified as important hosts of A. costaricensis. In this study, Swiss mice (SW), Wistar R. norvegicus (RN), wild Oligoryzomys nigripes (ON) and a local strain of M. musculus (RGS) were experimentally infected with A. costaricensis. Survival, elimination of L1 (total sum per group, A0), and the number of adult worms recovered divided by the dose of each L3 inoculum (yield ratio, YR) were examined for each group after a 40-day post-infection period. The survival rates, A0 and YR values were: 27%, 207,589 and 0.42 for the SW group; 81%, 8691 and 0.01 for the RN group; and 63.6%, 26,560 and 0.16 for the RGS group, respectively, in each case. The survival rate for the ON group was 100% and the A0 value was 847,050. A YR was not calculated for the ON group since the ON group was maintained up to 565 days post-infection (pi) to examine long-term mortality. At 500 days pi (16 months), 50% of the ON group had died, while one animal (10%) survived 595 days pi (20 months). Taken together, these data indicate that A. costaricensis has undergone a greater degree of adaptation to the wild rodent, O. nigripes, than to R. norvegicus or a local M. musculus strain. In addition, titre curve (A0) modelling of adaptation status proved to be useful in evaluating A. costaricensis-rodent interactions.

MENINGEAL WORM ( PARELAPHOSTRONGYLUS TENUIS) AS A CAUSE OF MORTALITY IN THE RESTORED ELK ( CERVUS CANADENSIS) POPULATION IN MISSOURI, USA.

: Meningeal worm ( Parelaphostrongylus tenuis) is an important cause of mortality of elk ( Cervus canadensis) in populations in the eastern US and has been implicated in the failure of several restoration attempts. From 2011 to 2013, the Missouri Department of Conservation translocated 108 adult and yearling elk from Kentucky (US) to southern Missouri (US) to establish a free-ranging population. From release in spring 2011 through August 2015, we monitored 167 elk (adult, yearling, and calf) to determine causes of mortality. Of 78 mortalities, 26 (33%) were linked to meningeal worm based on necropsy results and/or observed behavior; this group included 19 elk with confirmed or suspected cases of meningeal worm infection that died of other proximate causes. Other important mortality sources included euthanasia ( n=11, 14%), emaciation ( n=7, 9%), and predation ( n=5, 6%). Eleven of the 26 (42%) meningeal worm-related mortalities were adults, and 22 (85%) were female. Meningeal worm was an important cause of mortality during the restoration of Missouri elk, potentially contributing to the loss of 16% of the monitored individuals. Greater mortality in adult female elk could reduce initial population growth by limiting reproductive output in the restored herd, especially given that females were disproportionately affected in Missouri. Because translocated Missouri elk undoubtedly were exposed to meningeal worm in Kentucky, our results could be explained by exposure to a different genetic strain of meningeal worm once in Missouri, loss of immune response due to translocation, increased dose of larval worms, or some unquantified factor.

Reaction norms of host immunity, host fitness and parasite performance in a mouse--intestinal nematode interaction.

The outcome of the encounter between a host and a parasite depends on the synergistic effects of the genetics of the two partners and the environment (sensulato) where the interaction takes place. Reaction norms can depict how host and parasite traits vary across environmental ranges for different genotypes. Here, we performed a large scale experiment where three strains of laboratory mice (SJL, BALB/c and CBA) were infected with four doses of the intestinal nematode Heligmosomoides polygyrus. An increasing infective dose can be considered as a proxy for the environment-dependent risk incontracting the infection. We looked at the fitness traits of hosts and parasites, and assessed the underlying immunological functions likely to affect the observed pattern of resistance/susceptibility/tolerance. We found that the infective dose had a strong effect on both host fitness and parasite performance. Interestingly, for most traits, host genotypes did not rank consistently across the increasing infective doses and according to the expected pattern of strain-specific resistance/susceptibility/tolerance. Analyses of cytokine production allowed better understanding of the mechanistic basis underlying variations in fitness-linked traits. The infective dose affected the shape of the reaction norms of the cytokines IL-4, IL-10 and IL-6. Dose-dependent variation in cytokine production explained, moreover, the strain-specific pattern of infection cost, host resistance and parasite performance. As long as the infective dose increased, there was a marked shift towards a pro-inflammatory status in the SJL strain of mice that was positively correlated with cost of the infection and parasite performance. Overall, our study strongly suggests that the notion of host resistance is labile and depends on the environmental conditions where the interaction takes place. Moreover, integrating information on fitness-linked traits and the underlying mechanisms seems essential for a better understanding of host and parasite adaptations across variable environments.

Dusp5 negatively regulates IL-33-mediated eosinophil survival and function.

Mitogen-activated protein kinase (MAPK) activation controls diverse cellular functions including cellular survival, proliferation, and apoptosis. Tuning of MAPK activation is counter-regulated by a family of dual-specificity phosphatases (DUSPs). IL-33 is a recently described cytokine that initiates Th2 immune responses through binding to a heterodimeric IL-33Rα (ST2L)/IL-1α accessory protein (IL-1RAcP) receptor that coordinates activation of ERK and NF-κB pathways. We demonstrate here that DUSP5 is expressed in eosinophils, is upregulated following IL-33 stimulation and regulates IL-33 signaling. Dusp5(-/-) mice have prolonged eosinophil survival and enhanced eosinophil effector functions following infection with the helminth Nippostrongylus brasiliensis. IL-33-activated Dusp5(-/-) eosinophils exhibit increased cellular ERK1/2 activation and BCL-XL expression that results in enhanced eosinophil survival. In addition, Dusp5(-/-) eosinophils demonstrate enhanced IL-33-mediated activation and effector functions. Together, these data support a role for DUSP5 as a novel negative regulator of IL-33-dependent eosinophil function and survival.

Retrospective evaluation of moderate-to-severe pulmonary hypertension in dogs naturally infected with Angiostrongylus vasorum.

OBJECTIVES: The outcome in dogs with pulmonary hypertension associated with natural Angiostrongylus vasorum infection is unclear. This study aimed to report long-term outcome of dogs with A. vasorum and pulmonary hypertension, and to evaluate factors associated with pulmonary hypertension development. It was hypothesised that dogs with pulmonary hypertension had a shorter survival time than dogs without pulmonary hypertension. METHODS: Retrospective review of clinical records of dogs diagnosed with A. vasorum. Dogs were classified as having or not having pulmonary hypertension based on clinical signs and imaging findings. Signalment, signs and outcome were recorded. DNA obtained from banked samples was genotyped for the PDE5a:E90K polymorphism, a possible factor in development of pulmonary hypertension. RESULTS: The proportion of dogs with moderate-to-severe pulmonary hypertension and A. vasorum infection in the study population was 14 · 6%. No difference in the population characteristics or PDE5a genotype was detected between dogs with and without pulmonary hypertension. Dogs with pulmonary hypertension had a significantly shorter survival time (P = 0 · 006) and a greater risk of death within 6 months of diagnosis (odds ratio 12 · 5, 95% confidence interval 2 · 1 to 74 · 9; P = 0 · 0053). CLINICAL SIGNIFICANCE: A. vasorum-associated pulmonary hypertension is an important problem in naturally infected dogs and has a negative effect upon survival.

An 8-week brain MRI follow-up analysis of rat eosinophilic meningitis caused by Angiostrongylus cantonensis infection.

Early differential diagnosis and timely follow-up are advantageous in the management of Angiostrongylus cantonensis infection. This study aimed to characterize angiostrongyliasis in the rat brain for an 8-week period using magnetic resonance imaging (MRI) with contrast-enhanced T1-weighted images (T1WI), T2-weighted imaging (T2WI), fluid attenuation inversion recovery (FLAIR) and R2 mapping sequences. The data were analysed with Mathematica and Matlab software programs for weekly changes in each brain following the infection of 20, 50, 100 and 300 third-stage larvae (L3), respectively. The results showed that the average subarachnoid space detected by T2WI technique was peaked up to 10% increase of original size on day 35 after 100 or 300 larvae infection, while those infected with 20 or 50 larvae showed less than 4% increase during the entire course of observation. This increase was relevant to the mortality of the infected rats, because those with 100 or 300 larvae infections showed a sharp decrease in survival rate before day 40. After day 40, the average subarachnoid space was decreased, but the average ventricle size was persistently increased, with the highest increase observed in the group infected with 300 larvae on day 56. Furthermore, the R2 mapping mean and R2 mapping size were significantly different between the brains with severe infection (100 and 300 larvae groups together) and those with mild infection (20 and 50 larvae groups together) on day 49, but not on day 35. Our results showed that diagnosis for different quantity of larvae infection using MRI is possible and follow-up characterization is informative in revealing the effects of angiostrongyliasis on different brain areas. In conclusion, our results support the use of MRI as a non-invasive diagnostic technique for eosinophilic meningitis caused by A. cantonensis infection.

Monoclonal antibody 12D5 inhibits eosinophil infiltration in the brain of Angiostrongylus cantonensis-infected BALB/c mice.

Each of BALB/c mice was infected with 50 Angiostrongylus cantonensis larvae. One group of mice received an intraperitoneal injection of 50 µg 12D5 monoclonal antibody (mAb) against a 98 kDa antigen of adult worms at 10 days post-infection (dpi), with a booster injection of 25 µg at 12 dpi. Five mice from each group were sacrificed at 14 dpi for pathological examination and RNA extraction. The infiltration of eosinophils and severity of eosinophilic meningitis were reduced in 12D5 mAb-treated mice compared with the infected mice without 12D5 treatment. The levels of eotaxin mRNA expression in spleen significantly increased and the expression of the Th2-type cytokine IL-5 significantly decreased. However, the expression of IL-4 was not changed. 12D5 mAb can observably enhance the survival rate of infected mice and reduce symptoms of angiostrongyliasis. A. cantonensis infection is a major cause of eosinophilic meningoencephalitis. The results of this study could be helpful for the development of treatment of human angiostrongylosis.

Outcomes in mice with abdominal angiostrongyliasis treated with enoxaparin.

Abdominal angiostrongyliasis (AA) is caused by the nematode Angiostrongylus costaricensis. Parasite-associated thrombosis of mesenteric vessels may lead to intestinal infarction, which might be prevented with anti-thrombotic agents. This study assessed the effect of enoxaparin on survival and pathological findings in Swiss mice with AA. In this experiment, 24 mice were infected with A. costaricensis (10 L3 per animal) followed by treatment with subcutaneous enoxaparin (40 mg/kg/day) or water (sham), starting from 15 days post-infection (dpi) and continued until animal death. Animals were monitored until death or sacrifice at the 50th dpi. Ten mice (42%) were dead after 36 ± 8 dpi. Of these, five (50%) were treated with enoxaparin. Animals treated with enoxaparin and sham did not differ in terms of weight loss (median, 1.3 vs. 4.2 g; P = 0.303) and macroscopical findings. Microscopically, no difference was found in regard to vascular granuloma (median grade, 2 vs. 3; P = 0.293) and presence of either vasculitis (75% vs. 100%; P = 0.217), mesenteric thrombosis (33% vs. 50%; P = 0.680), or bowel necrosis (25% vs. 50%; P = 0.400). Mice dead before the 50th dpi showed more pneumonia (90% vs. 21%; P = 0.002), bowel infarction (40% vs. 0%; P = 0.02), and purulent peritonitis (60% vs. 7%; P = 0.008) compared to survivors. Prophylactic enoxaparin in mice did not prevent tissue damage and mortality related with AA. The lower prevalence of mesenteric thrombosis and bowel infarction regardless of treatment were notorious. Frequent septic complications suggest the need of studies addressing the effect of antibiotics in AA.

Efficacy of combined treatment with albendazole and baicalein against eosinophilic meningitis induced by Angiostrongylus cantonensis in mice.

Angiostrongylus cantonensis infection causes eosinophilic meningitis in humans. Baicalein is a flavonoid originally isolated from the roots of Scutellaria baicalensis Georgi. In this study we evaluated the efficacy of the combination of albendazole and baicalein for treating eosinophilic meningitis in BALB/c mice. Therapeutic efficacy included the survival time, body weight, neurological function, leucocyte and eosinophil counts, eotaxin concentration, matrix metalloproteinase-9 (MMP-9) activity, larval recovery and histopathological examination. The results showed that the combination of albendazole and baicalein was more effective than either drug administered singly. Combination therapy increased the survival time, decreased body weight loss, neurological dysfunction, leucocyte response, eotaxin concentration and MMP-9 activity. Our results suggest that the combination of albendazole and baicalein may exhibit synergistic beneficial effects in the treatment of eosinophilic meningitis induced by A. cantonensis.

Gastrointestinal nematode infection exacerbates malaria-induced liver pathology.

Mixed parasite infections are common in many parts of the world, but little is known of the effects of concomitant parasite infections on the immune response or severity of clinical disease. We have used the nonlethal malaria infection model of Plasmodium chabaudi AS in combination with the gastrointestinal nematode Heligmosomoides bakeri polygyrus to investigate the impact of nematode infections on malarial morbidity and antimalarial immunity. The data demonstrate that wild-type C57BL/6 mice coinfected with both parasites simultaneously exhibit a striking increase in mortality, while mice deficient in IFN-gamma or IL-23 survive coinfection. The increase in mortality in wild-type mice was associated with severe liver pathology characterized by extensive coagulative necrosis and an increase in hepatic IFN-gamma, IL-17, and IL-22 mRNA expression. This is the first demonstration of increased malaria-associated pathology associated with a switch toward a proinflammatory environment, involving not only IFN-gamma but also the IL-17/IL-23 axis, as a result of coinfection with a gastrointestinal helminth.

Evidence of Parelaphostrongylus tenuis infections in free-ranging elk (Cervus elaphus) in southern Ontario.

The antemortem detection of a Parelaphostrongylus tenuis infection in a free-ranging wild elk (Cervus elaphus) in southern Ontario is documented. Postmortems on other free-ranging elk that died during 2000-2005 indicated that 59% (17/29) were infected with P. tenuis, based on presence of lesions in the brain.

Concurrent infection with an intestinal helminth parasite impairs host resistance to enteric Citrobacter rodentium and enhances Citrobacter-induced colitis in mice.

Infections with intestinal helminth and bacterial pathogens, such as enteropathogenic Escherichia coli, continue to be a major global health threat for children. To test the hypothesis that intestinal helminth infection may be a risk factor for enteric bacterial infection, a murine model was established by using the intestinal helminth Heligomosomoides polygyrus. To analyze the modulatory effect of a Th2-inducing helminth on the outcome of enteric bacterium Citrobacter rodentium infection, BALB/c and STAT 6 knockout (KO) mice were infected with H. polygyrus, C. rodentium, or both. We found that only BALB/c mice coinfected with H. polygyrus and C. rodentium displayed a marked morbidity and mortality. The enhanced susceptibility to C. rodentium and intestinal injury of coinfected BALB/c mice were shown to be associated with a significant increase in helminth-driven Th2 responses, mucosally and systemically, and correlated with a significant downregulation of protective gamma interferon and with a dramatic upregulation of the proinflammatory tumor necrosis factor alpha response. In addition, C. rodentium-associated colonic pathology in coinfected BALB/c mice was significantly enhanced, whereas bacterial burden was increased and clearance was delayed. In contrast, coinfection in STAT 6 KO mice failed to promote C. rodentium infection or to induce a more severe intestinal inflammation and tissue injury, demonstrating a mechanism by which helminth influences the development of host protective immunity and susceptibility to bacterial infections. We conclude that H. polygyrus coinfection can promote C. rodentium-associated disease and colitis through a STAT 6-mediated immune mechanism.

Mortality of Rocky Mountain elk in Michigan due to meningeal worm.

Mortality from cerebrospinal parelaphostrongylosis caused by the meningeal worm (Parelaphostrongylus tenuis) has been hypothesized to limit elk (Cervus elaphus nelsoni) populations in areas where elk are conspecific with white-tailed deer (Odocoileus virginianus). Elk were reintroduced into Michigan (USA) in the early 1900s and subsequently greatly increased population size and distribution despite sympatric high-density (>or=12/km2) white-tailed deer populations. We monitored 100 radio-collared elk of all age and sex classes from 1981-94, during which time we documented 76 mortalities. Meningeal worm was a minor mortality factor for elk in Michigan and accounted for only 3% of mortalities, fewer than legal harvest (58%), illegal kills (22%), other diseases (7%), and malnutrition (4%). Across years, annual cause-specific mortality rates due to cerebrospinal parelaphostrongylosis were 0.033 (SE=0.006), 0.029 (SE=0.005), 0.000 (SE=0.000), and 0.000 (SE=0.000) for calves, 1-yr-old, 2-yr-old, and >or=3-yr-old, respectively. The overall population-level mortality rate due to cerebrospinal parelaphostrongylosis was 0.009 (SE=0.001). Thus, meningeal worm had little impact on elk in Michigan during our study despite greater than normal precipitation (favoring gastropods) and record (>or=14 km2) deer densities. Further, elk in Michigan have shown sustained population rates-of-increase of >or=18%/yr and among the highest levels of juvenile production and survival recorded for elk in North America, indicating that elk can persist in areas with meningeal worm at high levels of population productivity. It is likely that local ecologic characteristics among elk, white-tailed deer, and gastropods, and degree of exposure, age of elk, individual and population experience with meningeal worm, overall population vigor, and moisture determine the effects of meningeal worm on elk populations.

Mortality of Creole kids during infection with gastrointestinal strongyles: a survival analysis.

Mortality due to strongyles infection in small ruminants is a critical component of flock productivity in a tropical climate. In goat production, few experiments have been conducted to estimate the variability of this trait. A survival analysis study was carried out in the Creole experimental flock of INRA-Gardel (Moule, Guadeloupe) to identify management and genetic factors influencing mortality of kids reared at pasture and infected with gastrointestinal strongyles, predominantly Haemonchus contortus and Trichostrongylus colubriformis. Survival curves from 3 and 11 mo of age were analyzed for 837 kids sired by 48 bucks and 250 does. The causes of death were recorded. Mortality due to gastrointestinal strongyles was the variable considered. The flock management included drenchings with levamisole every 8 wk. Fecal egg counts and packed cell volume were regularly measured after 7 wk of natural infection. All but 6.7% of the records were uncensored, with an average failure time of 165 d. The probability of death following gastrointestinal infection was more than three times greater in males than in females. Kids raised by their mother before weaning had a lower (P < 0.05) relative risk of dying than those reared in nursery (0.40 vs. 1). Parity of the dam and litter size effects were not significant. The risk of death was reduced by approximately 80% during the 3 wk that followed a drenching (P < 0.01). Risk decreased by about 25% for each additional kilogram of body weight at weaning. Live weight, fecal egg counts, and packed cell volume all had significant effects on risk of death when introduced as time-dependent covariates in the model (P < 0.0001 for live weight and packed cell volume, and P < 0.01 for fecal egg counts). The estimated genetic variability was small and inaccurate. These results demonstrated that risk of death from gastrointestinal infection could be reduced with appropriate flock management. High infection levels increased the risk of death, but they were not the direct cause. The important mediation of reduced body weight and anemia in likelihood of death is highlighted. More data are needed to better assess the possibility for genetic improvement of viability in Creole kids during gastrointestinal strongyle infection.

Meningeal worm in a reintroduced elk population in Kentucky.

Meningeal worm (Parelaphostrongylus tenuis) has been implicated in the failure of several elk (Cervus elaphus) restoration attempts in the eastern United States. However, limited post-release monitoring and a paucity of published literature prevents a clear understanding of this parasite's role in past failures. During winters of 1997-2001, the Kentucky Department of Fish and Wildlife Resources translocated 1,044 elk from western states to eastern Kentucky (USA) in an effort to restore a free-ranging population. We monitored 521 radio-collared elk over 4 yr to determine the impact meningeal worm had on population establishment. Thirty (23%) of 129 non-capture related mortalities were attributed to meningeal worm. Twenty-two (73%) of these meningeal worm-caused mortalities were animals < 3 yr old. If younger elk born in Kentucky suffer higher mortality rates than older translocated elk, the population growth observed during the initial years of restoration may be temporary. Additional research is necessary to determine the influence meningeal worm will have on elk population growth in Kentucky.

Intraocular nematodiasis caused by Parelaphostrongylus tenuis in an eland antelope (Taurotragus oryx).

A 10-mo-old female eland (Taurotragus oryx) at the Wilds exhibited recalcitrant, progressive unilateral uveitis for a 5-wk period, despite constant medical treatment. Unilateral enucleation was performed because of blindness and animal discomfort evidenced by continuous blepharospasm. Histopathologic examination of the eye demonstrated intraocular larvae morphologically consistent with Parelaphostrongylus tenuis, the first known case of intraocular P. tenuis migration. This animal subsequently was euthanatized because of severe, nonresponsive neurologic signs associated with P. tenuis infection.