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International Journal of Infectious... Apr 2020To describe and analyse the epidemiological and clinical characteristics of imported human angiostrongyliasis in Europe. (Review)
Review
OBJECTIVES
To describe and analyse the epidemiological and clinical characteristics of imported human angiostrongyliasis in Europe.
METHODS
A systematic literature review of cases of human angiostrongyliasis in Europe was performed. Seven databases were searched. The epidemiological and clinical characteristics were extracted from included records and simple summary statistics were performed on extracted data.
RESULTS
Twenty-two cases reported between 1988 and 2019 were identified. They were mainly from French Polynesia, Southeast Asia, and the Caribbean Islands. The dominant suspected mode of transmission was ingestion of prawns, shrimp, or salad. For patients with data, 90% had a history of headache, often lasting, and half had paresthesia. Eighty-nine percent had eosinophilia, 93% had cerebrospinal fluid (CSF) eosinophilia, and 92% had elevated CSF protein. Central nervous system (CNS) imaging was normal in most cases. Two-thirds received albendazole or mebendazole treatment, although this is not currently recommended.
CONCLUSIONS
We have increased previous numbers to 22 reported cases in total since 1988. Angiostrongyliasis should generally be suspected in patients with a lasting headache who have returned from Southeast Asia, China, the Caribbean Islands, Australia, or French Polynesia, as well as parts of North America and Tenerife, Spain, although one autochthonous case from mainland Europe has also been reported. A dietary history should focus on prawns, shrimp, and salad, whilst also including slugs and snails and other paratenic hosts where relevant. The clinical diagnosis is supported by the presence of blood eosinophilia, CSF eosinophilia, and elevated CSF protein. A definitive laboratory diagnosis should be sought, and CNS imaging should be used to support, not to rule out the diagnosis. The most up-to-date evidence should always be consulted before initiating treatment. Current recommendations include analgesics, corticosteroids, and periodic removal of CSF for symptom relief, while antihelminthic treatment is debated.
Topics: Adolescent; Adult; Angiostrongylus cantonensis; Animals; Asia, Southeastern; Australia; Eosinophilia; Europe; Female; Humans; Infant; Male; Meningitis; Middle Aged; Polynesia; Seafood; Snails; Strongylida Infections; West Indies
PubMed: 31972289
DOI: 10.1016/j.ijid.2020.01.012 -
Acta Tropica Jan 2015Over 20 species of Angiostrongylus have been described from around the world, but only Angiostrongylus cantonensis has been confirmed to cause central nervous system... (Review)
Review
Over 20 species of Angiostrongylus have been described from around the world, but only Angiostrongylus cantonensis has been confirmed to cause central nervous system disease in humans. A neurotropic parasite that matures in the pulmonary arteries of rats, A. cantonensis is the most common cause of eosinophilic meningitis in southern Asia and the Pacific and Caribbean islands. The parasite can also cause encephalitis/encephalomyelitis and rarely ocular angiostrongyliasis. The present paper reviews the life cycle, epidemiology, pathogenesis, clinical features, diagnosis, treatment, prevention and prognosis of A. cantonesis infection. Emphasis is given on the spectrum of central nervous system manifestations and disease pathogenesis.
Topics: Angiostrongylus cantonensis; Animals; Asia; Encephalomyelitis; Eosinophilia; Humans; Infectious Encephalitis; Larva; Life Cycle Stages; Meningitis; Strongylida Infections
PubMed: 25312338
DOI: 10.1016/j.actatropica.2014.10.002 -
Iranian Journal of Parasitology 2022To explore the transcriptome profiling of the fourth-stage larvae of .
BACKGROUND
To explore the transcriptome profiling of the fourth-stage larvae of .
METHODS
Two groups of fourth-stage larvae were collected to extract total RNA in Zhejiang, China 2020. Then, mRNA was separated and reverse transcribed into cDNA. Next-generation sequencing was used to explore the transcriptome information. Finally, to obtain the biological annotation information, the transcriptome information was run against the related databases, including Nr, GO, COG, KOG and ORF.
RESULTS
Overall, 128667 unigenes and 193059 transcripts were obtained. The Nr annotations of unigenes and transcripts showed that was the 5th and 4th most related species, respectively. Meanwhile, the annotation of unigenes and transcripts by querying GO, COG, KOG and ORF showed that L4 was extremely active in gene expression, concerning signal transduction, transcription, posttranslational modification, metabolism, etc.
CONCLUSION
The fourth-stage larvae of have their own profiling in the transcriptome, which is related to signal transduction, transcription, posttranslational modification, metabolism, etc.
PubMed: 36694564
DOI: 10.18502/ijpa.v17i4.11287 -
Journal of Neurology, Neurosurgery, and... Sep 1992
Topics: Angiostrongylus cantonensis; Animals; Brain Abscess; Developing Countries; Diagnostic Errors; Humans; India; Sparganosis; Spirometra; Strongylida Infections
PubMed: 1285777
DOI: 10.1136/jnnp.55.9.861 -
Parasitology Jul 2021The nematode Angiostrongylus cantonensis is the most common cause of neuroangiostrongyliasis (manifested as eosinophilic meningitis) in humans. Gastropod molluscs are...
The nematode Angiostrongylus cantonensis is the most common cause of neuroangiostrongyliasis (manifested as eosinophilic meningitis) in humans. Gastropod molluscs are used as intermediate hosts and rats of various species are definitive hosts of this parasite. In this study, we identified several environmental factors associated with the presence and abundance of terrestrial gastropods in an impoverished urban region in Brazil. We also found that body condition, age and presence of co-infection with other parasite species in urban Rattus norvegicus, as well as environmental factors were associated with the probability and intensity of A. cantonensis infection. The study area was also found to have a moderate prevalence of the nematode in rodents (33% of 168 individuals). Eight species of molluscs (577 individuals) were identified, four of which were positive for A. cantonensis. Our study indicates that the environmental conditions of poor urban areas (presence of running and standing water, sewage, humidity and accumulated rain and accumulation of construction materials) influenced both the distribution and abundance of terrestrial gastropods, as well as infected rats, contributing to the maintenance of the A. cantonensis transmission cycle in the area. Besides neuroangiostrongyliasis, the presence of these hosts may also contribute to susceptibility to other zoonoses.
Topics: Angiostrongylus cantonensis; Animals; Brazil; Feces; Female; Gastropoda; Male; Mollusca; Nervous System Diseases; Poverty Areas; Prevalence; Rats; Strongylida Infections; Urban Population
PubMed: 33843507
DOI: 10.1017/S0031182021000597 -
The Cochrane Database of Systematic... Feb 2015Angiostrongylus cantonensis (A. cantonensis) is the major cause of infectious eosinophilic meningitis. Dead larvae of this parasite cause inflammation and exacerbate... (Review)
Review
BACKGROUND
Angiostrongylus cantonensis (A. cantonensis) is the major cause of infectious eosinophilic meningitis. Dead larvae of this parasite cause inflammation and exacerbate symptoms of meningitis. Corticosteroids are drugs used to reduce the inflammation caused by this parasite.
OBJECTIVES
To assess the efficacy and safety of corticosteroids for the treatment of eosinophilic meningitis.
SEARCH METHODS
We searched CENTRAL (2014, Issue 11), MEDLINE (1950 to November Week 3, 2014), EMBASE (1974 to December 2014), Scopus (1960 to December 2014), Web of Science (1955 to December 2014), LILACS (1982 to December 2014) and CINAHL (1981 to December 2014).
SELECTION CRITERIA
Randomised controlled trials (RCTs) of corticosteroids versus placebo for eosinophilic meningitis.
DATA COLLECTION AND ANALYSIS
Two review authors (SiT, SaT) independently collected and extracted study data. We graded the methodological quality of the RCTs. We identified and analysed outcomes and adverse effects.
MAIN RESULTS
We did not identifiy any new trials for inclusion or exclusion in this 2014 update. One study involving 110 participants (55 participants in each group) met our inclusion criteria. The corticosteroid (prednisolone) showed a benefit in shortening the median time to resolution of headaches (five days in the treatment group versus 13 days in the control group, P value < 0.0001). Corticosteroids were also associated with smaller numbers of participants who still had headaches after a two-week course of treatment (9.1% versus 45.5%, P value < 0.0001). The number of patients who needed repeat lumbar puncture was also smaller in the treatment group (12.7% versus 40%, P value = 0.002). There was a reduction in the median time of analgesic use in participants receiving corticosteroids (10.5 versus 25.0, P value = 0.038). There were no reported adverse effects from prednisolone in the treatment group.
AUTHORS' CONCLUSIONS
Corticosteroids significantly help relieve headache in patients with eosinophilic meningitis, who have a pain score of four or more on a visual analogue scale. However, there is only one RCT supporting this benefit and this trial did not clearly mention allocation concealment and stratification. Therefore, we agreed to grade our included study as a moderate quality trial. Future well-designed RCTs are necessary.
Topics: Animals; Central Nervous System Parasitic Infections; Eosinophilia; Glucocorticoids; Humans; Meningitis; Prednisolone; Randomized Controlled Trials as Topic
PubMed: 25687750
DOI: 10.1002/14651858.CD009088.pub3 -
American Journal of Translational... 2021The two most common causes of eosinophilic meningitis (EOM) are the parasites: and . This study aimed to evaluate whether clinical factors can predict either...
OBJECTIVE
The two most common causes of eosinophilic meningitis (EOM) are the parasites: and . This study aimed to evaluate whether clinical factors can predict either neuroangiostrongyliasis or gnathostomiasis in EOM patients.
MATERIALS AND METHODS
We included reports of patients with eosinophils in the CSF and either serological or pathological diagnosis of neuroangiostrongyliasis or gnathostomiasis published in 2014 or earlier and available on PubMed. Predictive clinical models were generated for neuroangiostrongyliasis and gnathostomiasis.
RESULTS
In total, 155 patients were included in the study, 24 in the gnathostomiasis group and 131 in the neuroangiostrongyliasis group. According to the separate models, factors associated with neuroangiostrongyliais were gender of male, snail exposure, and headache, and independent factors for gnathostomiasis were weakness (adjusted odds ratio 50.8) and radicular pain (adjusted odds ratio 35.3). The combined model identified two independent factors for neuroangiostrongyliasis: weakness and radicular pain. The laboratory models revealed that xanthochromic CSF perfectly predicted both neuroangiostrongyliasis and gnathostomiasis. Two other predictive factors were blood eosinophilia and CSF eosinophils, which positively predicted gnathostomiasis (adjusted odds ratios of 1.13 and 1.08, respectively).
CONCLUSION
Clinical factors may be predictive of neuroangiostrongyliasis and gnathostomiasis in EOM.
PubMed: 34650710
DOI: No ID Found -
Food and Waterborne Parasitology Sep 2021, the main causative agent of human neuroangiostrongyliasis, is a food-borne parasitic zoonosis, particularly in Southeast Asia and Mainland China. , a cryptic species,...
, the main causative agent of human neuroangiostrongyliasis, is a food-borne parasitic zoonosis, particularly in Southeast Asia and Mainland China. , a cryptic species, has not been unequivocally identified as a causative agent for human angiostrongyliasis. Here, we investigated a local incidence of human angiostrongyliasis in Kalasin Province, northeastern part of Thailand. Field and laboratory investigations, clinical symptoms, and treatment of the disease are also discussed. Five sera and three cerebrospinal fluid samples were taken from each patient who displayed clinical symptoms of mild or severe headache without neck stiffness after ingesting a local dish containing . With molecular evidence using PCR and DNA sequencing approaches, we confirmed the presence of and DNA in the patient samples. In addition, and collected in the vicinity were also examined for the existence of angistrongylid larvae. The rate of infection in the snail population was 33.3% (18 infection out of 54 examined), with as the predominant species. Notably, two snails were found to be co-infected with both and . This discovery comes after several years of suspicion that it could be a zoonotic pathogen. Therefore, our findings are important for public health and clinical diagnosis since clinicians are not aware of the zoonotic potential of in humans.
PubMed: 34458598
DOI: 10.1016/j.fawpar.2021.e00128 -
Membranes Jan 2022Angiostrongyliasis, the leading cause universal of eosinophilic meningitis, is an emergent disease due to (rat lungworm) larvae, transmitted accidentally to humans. The...
BACKGROUND
Angiostrongyliasis, the leading cause universal of eosinophilic meningitis, is an emergent disease due to (rat lungworm) larvae, transmitted accidentally to humans. The diagnosis of human angiostrongyliasis is based on epidemiologic characteristics, clinical symptoms, medical history, and laboratory findings, particularly hypereosinophilia in blood and cerebrospinal fluid. Thus, the diagnosis is difficult and often confused with those produced by other parasitic diseases. Therefore, the development of a fast and specific diagnostic test for angiostrongyliasis is a challenge mainly due to the lack of specificity of the described tests, and therefore, the characterization of a new target is required.
MATERIAL AND METHODS
Using bioinformatics tools, the putative presenilin (PS) protein C7BVX5-1 was characterized structurally and phylogenetically. A peptide microarray approach was employed to identify single and specific epitopes, and tetrameric epitope peptides were synthesized to evaluate their performance in an ELISA-peptide assay.
RESULTS
The data showed that the PS protein presents nine transmembrane domains, the catalytic aspartyl domain [(XD (aa 241) and GLGD (aa 332-335)], between TM6 and TM7 and the absence of the PALP and other characteristics domains of the class A22 and homologous presenilin (PSH). These individualities make it an atypical sub-branch of the PS family, located in a separate subgroup along with the enzyme and separated from other worm subclasses. Twelve B-linear epitopes were identified by microarray of peptides and validated by ELISA using infected rat sera. In addition, their diagnostic performance was demonstrated by an ELISA-MAP4 peptide.
CONCLUSIONS
Our data show that the putative AgPS is an atypical multi-pass transmembrane protein and indicate that the protein is an excellent immunological target with two (PsAg3 and PsAg9) cross-reactive epitopes and eight (PsAg1, PsAg2, PsAg6, PsAg7, PsAg8, PsAg10, PsAg11, PsAg12) apparent unique epitopes. These epitopes could be used in engineered receptacle proteins to develop a specific immunological diagnostic assay for angiostrongyliasis caused by .
PubMed: 35207030
DOI: 10.3390/membranes12020108 -
Iranian Journal of Parasitology 2023The pathogen of angiostrongyliasis is the parasite and the transcriptome profiling of the male adult was unclear. We aimed to understand how the male adults adapt, so...
BACKGROUND
The pathogen of angiostrongyliasis is the parasite and the transcriptome profiling of the male adult was unclear. We aimed to understand how the male adults adapt, so the expression profile of adult males was analyzed.
METHODS
In order to improve the understanding of the transcriptome of adult males, RNA from three groups of male adult was extracted and reverse transcribed to construct cDNA libraries. After sequencing, annotation of unigenes and transcripts was performed by querying the NR (Non-Redundant Protein Sequence Database), GO (Gene Ontology) and COG/KOG (Clusters of Orthologous Groups of proteins/euKaryotic Ortholog Groups) databases.
RESULTS
For each group of adults, 43,260,894 raw reads and 43,200,341 clean reads were obtained. After successful assembly, 87,649 unigenes and 146,895 transcripts were obtained. Annotation of the unigenes and transcripts was identical and male adults expressed a series of genes encoding proteins specific to the male gender at the adult stage, such as proteins involved in energy metabolism, energy synthesis and transport. Expression of the ribosome pathway suggests a relationship with the physical activities during the adult male stage.
CONCLUSION
The transcriptome analysis is a good reference to understand further the expression profile of male adult .
PubMed: 37886258
DOI: 10.18502/ijpa.v18i3.13761