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Scientific Reports Jun 2024Helminth infections lead to an overdispersion of the parasites in humans as well as in animals. We asked whether early immune responses against migrating Ascaris larvae...
Helminth infections lead to an overdispersion of the parasites in humans as well as in animals. We asked whether early immune responses against migrating Ascaris larvae are responsible for the unequal distribution of worms in natural host populations and thus investigated a susceptible versus a resistant mouse strain. In mice, the roundworm larvae develop until the lung stage and thus early anti-Ascaris immune responses against the migrating larvae in the liver and lung can be deciphered. Our data show that susceptible C57BL/6 mice respond to Ascaris larval migration significantly stronger compared to resistant CBA mice and the anti-parasite reactivity is associated with pathology. Increased eosinophil recruitment was detected in the liver and lungs, but also in the spleen and peritoneal cavity of susceptible mice on day 8 post infection compared to resistant mice. In serum, eosinophil peroxidase levels were significantly higher only in the susceptible mice, indicating functional activity of the recruited eosinophils. This effect was associated with an increased IL-5/IL-13 production by innate lymphoid cells and CD4 T cells and a pronounced type 2 macrophage polarization in the lungs of susceptible mice. Furthermore, a comparison of wildtype BALB/c and eosinophil-deficient dblGATA-1 BALB/c mice showed that eosinophils were not essential for the early control of migrating Ascaris larvae. In conclusion, in primary infection, a strong local and systemic type 2 immune response during hepato-tracheal helminth larval migration is associated with pathology rather than protection.
Topics: Animals; Ascariasis; Larva; Mice; Th2 Cells; Mice, Inbred BALB C; Lung; Ascaris; Eosinophils; Mice, Inbred C57BL; Mice, Inbred CBA; Liver; Female
PubMed: 38942904
DOI: 10.1038/s41598-024-65281-0 -
International Journal of Surgery Case... Jun 2024Intestinal obstruction from ascariasis is a rare but fatal surgical emergency in endemic areas, such as Ethiopia. Reports of ascariais causing complete bowel obstruction...
INTRODUCTION AND IMPORTANCE
Intestinal obstruction from ascariasis is a rare but fatal surgical emergency in endemic areas, such as Ethiopia. Reports of ascariais causing complete bowel obstruction in adults are rare while having a high rate of morbidity and mortality. Here we present a case of a 35 years old female patient who presented with complete small bowel obstruction caused by >250 ascariasis worm.
CASE PRESENTATION
We report on a case of a 35-year-old female who presented with intermittent crampy abdominal pain of 2 days duration associated with frequent vomiting of ingested matter and failure to pass feces and flatus. The patient underwent an exploratory laparotomy for acute complete small bowel obstruction and the intraoperative finding of a volvulated viable ileum with a visible and palpable ascariasis worms in the lumen of ileum. Enterotomy was done to extract >250 adult ascariasis worms.
CLINICAL DISCUSSION
There are few reports of ascariasis causing complete small bowel obstruction in adults and there is no reported case of a massive number of adult worms from one patient.
CONCLUSION
Though World Health Organization integrated approach, which includes sanitation, hygiene education and preventive chemotherapy brings a significant decrement on prevalence of soil-transmitted helminth, our case indicates that, clinicians should consider ascariasis as a differential diagnosis for SBO even in adult age groups.
PubMed: 38941731
DOI: 10.1016/j.ijscr.2024.109946 -
Medicina (Kaunas, Lithuania) May 2024Hepatobiliary ascariasis is caused by the entry of the nematode from the duodenum into the biliary duct. We report a case of an -induced extrahepatic biliary tract... (Review)
Review
Hepatobiliary ascariasis is caused by the entry of the nematode from the duodenum into the biliary duct. We report a case of an -induced extrahepatic biliary tract obstruction in a pediatric patient admitted to the hospital due to a wide spectrum of symptoms of biliary disease, which included abdominal pain in the upper abdominal quadrants, vomiting, and jaundice. Imaging tests-including ultrasound, magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiopancreatography (ERCP)-were performed to confirm the diagnosis of biliary ascariasis. The tests did, in fact, demonstrate signs of this disease. Nevertheless, during the ERCP, only the remains of parasites in the form of tissue fragments were extracted. We also aim to discuss the prevalence of ascariasis in children, the causes of migration of parasites into the bile ducts, together with its clinical manifestations, as well as the diagnostic and treatment methods of this disease.
Topics: Humans; Ascariasis; Lithuania; Cholangiopancreatography, Endoscopic Retrograde; Child; Animals; Male; Ascaris lumbricoides; Cholangiopancreatography, Magnetic Resonance; Female
PubMed: 38929533
DOI: 10.3390/medicina60060916 -
Current Protocols Jun 2024Ascariasis, caused by both Ascaris lumbricoides and Ascaris suum, is the most prevalent parasitic disease worldwide, affecting both human and porcine populations....
Ascariasis, caused by both Ascaris lumbricoides and Ascaris suum, is the most prevalent parasitic disease worldwide, affecting both human and porcine populations. However, due to the difficulties of assessing the early events of infection in humans, most studies of human ascariasis have been restricted to the chronic intestinal phase. Therefore, the Ascaris mouse model has become a fundamental tool for investigating the immunobiology and pathogenesis of the early infection stage referred to as larval ascariasis because of the model's practicality and ability to replicate the natural processes involved. The Ascaris mouse model has been widely used to explore factors such as infection resistance/susceptibility, liver inflammation, lung immune-mediated pathology, and co-infections and, notably, as a pivotal element in preclinical vaccine trials. Exploring the immunobiology of larval ascariasis may offer new insights into disease development and provide a substantial understanding of key components that trigger a protective immune response. This article focuses on creating a comprehensive guide for conducting Ascaris experimental infections in the laboratory as a foundation for future research efforts. © 2024 Wiley Periodicals LLC. Basic Protocol 1: Acquisition and embryonation of Ascaris suum eggs from adult females Alternate Protocol: Cleaning and purification of Ascaris suum from female A. suum uteri Basic Protocol 2: Preparation of Ascaris suum eggs and murine infection Basic Protocol 3: Measurement of larval burden and Ascaris-larva-induced pathogenesis Basic Protocol 4: In vitro hatching and purification of Ascaris L3 larvae Support Protocol: Preparation of crude antigen from Ascaris infectious stages Basic Protocol 5: Ultrastructure-expansion microscopy (U-ExM) of Ascaris suum larval stages.
Topics: Ascariasis; Animals; Mice; Disease Models, Animal; Ascaris suum; Larva; Female; Ascaris; Humans
PubMed: 38923794
DOI: 10.1002/cpz1.1074 -
Infectious Diseases (London, England) Jun 2024Neglected tropical diseases continue to cause a significant burden worldwide, with Africa accounting for more than one-third of the global burden. Over the past decade,... (Review)
Review
Neglected tropical diseases continue to cause a significant burden worldwide, with Africa accounting for more than one-third of the global burden. Over the past decade, progress has been made in eliminating, controlling, and eradicating these diseases in Africa. By December 2022, 47 out of 54 African countries had eliminated at least one neglected tropical disease, and more countries were close to achieving this milestone. Between 2020 and 2021, there was an 80 million reduction in people requiring intervention. However, continued efforts are needed to manage neglected tropical diseases and address their social and economic burden, as they deepen marginalisation and stigmatisation. Wastewater-based epidemiology involves analyzing wastewater to detect and quantify biomarkers of disease-causing pathogens. This approach can complement current disease surveillance systems in Africa and provide an additional layer of information for monitoring disease spread and detecting outbreaks. This is particularly important in Africa due to limited traditional surveillance methods. Wastewater-based epidemiology also provides a tsunami-like warning system for neglected tropical disease outbreaks and can facilitate timely intervention and optimised resource allocation, providing an unbiased reflection of the community's health compared to traditional surveillance systems. In this review, we highlight the potential of wastewater-based epidemiology as an innovative approach for monitoring neglected tropical disease transmission within African communities and improving existing surveillance systems. Our analysis shows that wastewater-based epidemiology can enhance surveillance of neglected tropical diseases in Africa, improving early detection and management of Buruli ulcers, hookworm infections, ascariasis, schistosomiasis, dengue, chikungunya, echinococcosis, rabies, and cysticercosis for better disease control.
PubMed: 38922811
DOI: 10.1080/23744235.2024.2369177 -
Scientific Reports Jun 2024Natural killer (NK) cells play a key role in defense against Salmonella infections during the early phase of infection. Our previous work showed that the...
Natural killer (NK) cells play a key role in defense against Salmonella infections during the early phase of infection. Our previous work showed that the excretory/secretory products of Ascaris suum repressed NK activity in vitro. Here, we asked if NK cell functionality was influenced in domestic pigs during coinfection with Ascaris and Salmonella enterica serotype Typhimurium. Ascaris coinfection completely abolished the IL-12 and IL-18 driven elevation of IFN-γ production seen in CD16 + CD8α + perforin + NK cells of Salmonella single-infected pigs. Furthermore, Ascaris coinfection prohibited the Salmonella-driven rise in NK perforin levels and CD107a surface expression. In line with impaired effector functions, NK cells from Ascaris-single and coinfected pigs displayed elevated expression of the inhibitory KLRA1 and NKG2A receptors genes, contrasting with the higher expression of the activating NKp46 and NKp30 receptors in NK cells during Salmonella single infection. These differences were accompanied by the highly significant upregulation of T-bet protein expression in NK cells from Ascaris-single and Ascaris/Salmonella coinfected pigs. Together, our data strongly indicate a profound repression of NK functionality by an Ascaris infection which may hinder infected individuals from adequately responding to a concurrent bacterial infection.
Topics: Animals; Killer Cells, Natural; Ascariasis; Coinfection; Swine; Swine Diseases; Salmonella Infections, Animal; Salmonella typhimurium; Ascaris suum; Interferon-gamma; Perforin; Interleukin-12; T-Box Domain Proteins; Interleukin-18
PubMed: 38918457
DOI: 10.1038/s41598-024-64497-4 -
PLoS Neglected Tropical Diseases Jun 2024The standard diagnosis of Ascaris lumbricoides and other soil-transmitted helminth (STH) infections relies on the detection of worm eggs by copromicroscopy. However,...
BACKGROUND
The standard diagnosis of Ascaris lumbricoides and other soil-transmitted helminth (STH) infections relies on the detection of worm eggs by copromicroscopy. However, this method is dependent on worm patency and shows only limited accuracy in low-intensity infection settings. We aimed to decipher the diagnostic accuracy of different antibodies using various Ascaris antigens in reference to copromicroscopy and quantitative PCR (qPCR), four months after national STH preventative chemotherapy among school children in western Kenya.
METHODOLOGY
STH infection status of 390 school children was evaluated via copromicroscopy (Kato-Katz and mini-FLOTAC) and qPCR. In parallel, Ascaris-specific antibody profiles against larval and adult worm lysates, and adult worm excretory-secretory (ES) products were determined by enzyme-linked immunosorbent assay. Antibody cross-reactivity was evaluated using the closely related zoonotic roundworm species Toxocara cati and Toxocara canis. The diagnostic accuracy of each antibody was evaluated using receiver operating curve analysis and the correspondent area under the curve (AUC).
PRINCIPAL FINDINGS
Ascaris was the predominant helminth infection with an overall prevalence of 14.9% (58/390). The sensitivity of mini-FLOTAC and Kato-Katz for Ascaris diagnosis reached only 53.5% and 63.8%, respectively compared to qPCR. Although being more sensitive, qPCR values correlated with microscopic egg counts (R = -0.71, P<0.001), in contrast to antibody levels. Strikingly, IgG antibodies recognizing the ES products of adult Ascaris worms reliably diagnosed active Ascaris infection as determined by qPCR and microscopy, with IgG1 displaying the highest accuracy (AUC = 0.83, 95% CI: 0.75-0.91).
CONCLUSION
IgG1 antibody responses against adult Ascaris-ES products hold a promising potential for complementing the standard fecal and molecular techniques employed for monitoring Ascaris infections. This is of particular importance in the context of deworming programs as the antibody diagnostic accuracy was independent of egg counts.
PubMed: 38889190
DOI: 10.1371/journal.pntd.0012279 -
Cureus May 2024Ascariasis is one of the most common parasitic infections in the world. It is mostly asymptomatic; however, rarely when the worms migrate to the biliary tract, they can...
Ascariasis is one of the most common parasitic infections in the world. It is mostly asymptomatic; however, rarely when the worms migrate to the biliary tract, they can cause biliary ascariasis. It typically presents with pain abdomen, jaundice, and fever. This case report is about a patient who presented with fever, icterus, breathlessness, loose stools, and altered sensorium but had no abdominal pain. The patient was diagnosed with biliary ascariasis using ultrasound and endoscopic retrograde cholangiopancreatography (ERCP). The patient was treated with endoscopic sphincterotomy and albendazole. The patient remained stable after 10 days. The absence of abdominal pain highlights the variability of the presentation of biliary ascariasis.
PubMed: 38887340
DOI: 10.7759/cureus.60537 -
BMJ Case Reports Jun 2024Rarer causes of acute pancreatitis may be considered in certain settings, such as parasitism in endemic regions. This report describes a pregnant female (second...
Rarer causes of acute pancreatitis may be considered in certain settings, such as parasitism in endemic regions. This report describes a pregnant female (second trimester) in her 20s who presented with 3-day steady epigastric pain radiating to the back and passage of worm from the mouth. She was diagnosed with mild acute pancreatitis, given a significantly elevated serum lipase and absence of organ failures. Fecalysis showed ova; hence, she was treated with mebendazole. Plain MR cholangiopancreatography showed an 842 mL necrotic pancreatic fluid collection and tubular flow void foci within the gallbladder and duodenum consistent with helminthiasis. The patient was managed conservatively in the absence of indications for drainage. The abdominal pain remarkably improved, and she underwent eventual vacuum-assisted delivery to a healthy term baby 4 months after the bout of acute pancreatitis.
Topics: Humans; Female; Ascariasis; Pregnancy; Pancreatitis, Acute Necrotizing; Animals; Ascaris lumbricoides; Pregnancy Complications, Parasitic; Adult; Mebendazole; Abdominal Pain; Cholangiopancreatography, Magnetic Resonance
PubMed: 38862191
DOI: 10.1136/bcr-2024-260316 -
Cureus May 2024In clinical practice, the typical approach to ingested foreign bodies in stable patients involves expectant management, as most materials pass through the...
In clinical practice, the typical approach to ingested foreign bodies in stable patients involves expectant management, as most materials pass through the gastrointestinal (GI) tract without adverse effects. However, foreign bodies that travel through the appendix's lumen can cause acute appendicitis due to their inability to exit the colon. Rarer causes of appendicitis include parasitic infiltration by . The wandering behavior of within the GI tract can lead to various surgical complications in the abdomen. Occasionally, these parasites can migrate to the vermiform appendix, where they may either induce pathological changes or remain asymptomatic. We report an unusual case of an eight-year-old Pakistani female patient who presented to the emergency room with pain in the right iliac fossa, associated with anorexia and nausea, for one day. On examination, the patient was found to be vitally stable, with right iliac fossa tenderness noted on palpation. Additionally, the patient exhibited positive pointing, rebound, Rovsing, and psoas signs. Her medical history revealed that she had ingested a metallic needle seven months ago. Blood tests were undertaken, and an abdominal X-ray confirmed the existence of a radiopaque metallic object in the right lower quadrant of the abdomen. The patient underwent an open appendicectomy for acute appendicitis and was discovered to have a metallic needle lodged in the vermiform appendix. Concurrently, she also had ascariasis, as she vomited a 23-cm-long worm. It is important to consider both mechanical and parasitic etiologies in diagnosing acute appendicitis; detailed evaluation and management strategies are necessary to address these unique etiologies effectively.
PubMed: 38832168
DOI: 10.7759/cureus.59632