The developing gut microbiota and its consequences for health.

The developmental origin of health and disease highlights the importance of the period of the first 1000 days (from the conception to the 2 years of life). The process of the gut microbiota establishment is included in this time window. Various perinatal determinants, such as cesarean section delivery, type of feeding, antibiotics treatment, gestational age or environment, can affect the pattern of bacterial colonization and result in dysbiosis. The alteration of the early bacterial gut pattern can persist over several months and may have long-lasting functional effects with an impact on disease risk later in life. As for example, early gut dysbiosis has been involved in allergic diseases and obesity occurrence. Besides, while it was thought that the fetus developed under sterile conditions, recent data suggested the presence of a microbiota in utero, particularly in the placenta. Even if the origin of this microbiota and its eventual transfer to the infant are nowadays unknown, this placental microbiota could trigger immune responses in the fetus and would program the infant's immune development during fetal life, earlier than previously considered. Moreover, several studies demonstrated a link between the composition of placental microbiota and some pathological conditions of the pregnancy. All these data show the evidence of relationships between the neonatal gut establishment and future health outcomes. Hence, the use of pre- and/or probiotics to prevent or repair any early dysbiosis is increasingly attractive to avoid long-term health consequences.

Ageing impairs parasite-specific antibody responses in cystic echinococcosis.

Humoral immunity wanes during healthy ageing, increasing susceptibility to infections in the elderly. In this sense, information about parasite infections and human immunosenescence is scarce. Cystic echinococcosis (CE) is an infectious disease caused by the larval stage of the cestode parasite Echinococcus granulosus, whose prevalence in humans shows an increase with host age. Susceptibility to human CE has been associated with humoral immunity to some extent, and, therefore, we have here analysed the influence of host age on the serological profile of young, middle-aged and aged patients. Our results highlighted the detrimental influence of ageing on the intensity and quality of the antiparasite antibody response. Remarkable differences in serological profiles between young and aged individuals were observed. In this sense, through Principal Components Analysis, we identified aged patients as those exhibiting overall less intense antibody responses, mainly in isotypes/subclasses supposed to exert efficient antiparasite activities (eg IgE and IgG1). Thus, these humoral defects could at least partially explain the reported increase in CE prevalence among older individuals, as a weaker immune response in the elderly might facilitate the establishment and maintenance of the parasite infection. Finally, a possible association between age-dependent susceptibility to CE and host immunosenescence is discussed.

Antibody profiling in ultrasound normal individuals with positive serology for cystic echinococcosis.

Cystic echinococcosis is a zoonotic disease caused by the cestode parasite Echinococcus granulosus. In endemic regions, seropositive individuals to E. granulosus usually and markedly outnumber image-confirmed cases of cystic echinococcosis, suggesting that some parasite challenges derive in unsuccessful infection establishments. However, it is still unknown whether such parasite-specific antibodies in healthy individuals might play a role in resistance/susceptibility to the infection. Therefore, we have here analysed the profile of antibodies recognizing E. granulosus antigens in seropositive but ultrasound normal individuals, as well as in surgery-confirmed patients and healthy donors. Our results showed that ultrasound normal individuals exhibited low avidity IgG antibodies, as well as low levels of parasite-specific IgG1 and IgG4 antibodies. In addition, they displayed significant levels of specific IgE, and thus, they revealed a uniquely high IgE:IgG4 ratio. Moreover, high levels of parasite-specific IgM were detected in such individuals, which showed characteristics of natural cross-reacting antibodies. Therefore, our results indicate that ultrasound normal individuals but seropositive for E. granulosus antigens exhibit a distinctive antibody profile. In this regard, possible associations between their antiparasite antibodies and potential resistance mechanisms to cystic echinococcosis are discussed.

Synthesis and evaluation of a new 99mTc(I)-tricarbonyl complex bearing the 5-nitroimidazol-1-yl moiety as potential hypoxia imaging agent.

The objective of this work was to develop a novel (99m) Tc complex bearing the 5-nitroimidazol-1-yl moiety with recognised selectivity towards hypoxic tissue, as a potential radiopharmaceutical for imaging tumour hypoxia. The new metronidazole derivative (2-amine-3-[2-(2-methyl-5-nitro-1H-imidazol-1-yl)ethylthio]propanoic acid) (L) containing adequate groups to coordinate technetium through the formation of a Tc(I)-tricarbonyl complex was synthesised with adequate yield (33%) and characterised by spectroscopy. Labelling was performed by substitution of three labile water molecules of the technetium tricarbonyl precursor, fac-[(99m)Tc(CO)3 (H2O)3](+) with the ligand. A radiochemical purity higher than 90% was achieved and remained unchanged for more than 4 h. The complex has a high stability in plasma, a moderate plasma protein binding and a moderate hydrophilicity. In vitro cell uptake studies showed a ratio between the activity taken up by cells in hypoxia/normoxia of 1.6 ± 0.4 (p < 0.5). Biodistribution in normal mice showed rapid depuration and low uptake in all organs and tissues except liver. Biodistribution in mice bearing induced tumours showed a low tumour uptake, but tumour/muscle ratio was favourable thanks to depuration. Comparison with biological results of other metronidazole derivatives clearly shows that modifications of the chelator are very important and contribute to improve the biological behaviour.

Echinococcus granulosus pig strain (G7 genotype) protoscoleces did not develop secondary hydatid cysts in mice.

Echinococcus granulosus, the aetiological agent of cystic hydatid disease, exists as a series of strains or genotypes which differ in biological features. Pig strain (G7 genotype) has been shown to differ from sheep strain (G1 genotype) in phenotypical characters such as intermediate host range, geographical distribution and rate of development of the adult worm. Since in vivo studies of different parasite genotypes can provide insights into host-parasite relationship we analysed for the first time the behaviour of E. granulosus G7 genotype protoscoleces in the murine experimental model. Our results show that G7 protoscoleces were unable to establish a regular infection in mice in contrast to G1 protoscoleces which developed intraperitoneal hydatid cysts. This inability was observed in co-infection experiments, i.e. even in the presence of a controlled immune response that allows G1 genotype protoscoleces establishment. In addition, the implantation of in vitro obtained E. granulosus G7 genotype microcysts resulted in a low percentage of hydatid cysts establishment. These results show a difference in the biological ability of both E. granulosus strains to develop secondary hydatid cysts in mice. We suggest that the comparison of infective and non infective genotypes of E. granulosus in the experimental host can be regarded as a new model to study the mechanisms of infection of Echinococcus spp. This knowledge could provide helpful information for the development of therapies, drugs and/or vaccines against cystic hydatid disease.

Echinococcus granulosus glycoconjugates induce peritoneal B cell differentiation into antibody-secreting cells and cytokine production.

Helminth parasite infections are associated with predominant Th2-type cytokine responses, and parasite glycoconjugates have been recognized as partially responsible for such immune bias. It has been proved that Echinococcus granulosus evokes a Th2-type cytokine pattern characterized by a high production of IL-4, IL-5, IL-6 and IL-10, and no or mild IFN-γ levels in animal models and in patients with cystic echinococcosis, respectively. Here, we show that E4(+) (a glycoconjugate-enriched fraction from E. granulosus protoscolex) stimulated the secretion of a high concentration of IL-6, followed by IL-10 and TNF-α by normal peritoneal B cells. We determined that E4(+) bound to the surface of peritoneal B cells and induced their activation and, also, triggered the differentiation of peritoneal B cells into IgM-, IgG2b- and IgG3-secreting cells in a T-independent way. Interestingly, the IgM released by E4(+) -stimulated peritoneal B cells from normal mice recognized protoscolex antigens. Results showed that, after the encounter with antigens from E. granulosus protoscolex, peritoneal B cells are a source of Th2-type cytokines and polyclonal antibodies, some of which recognize parasite antigens, suggesting that peritoneal B cells can condition the outcome of the infection.

Identification of Echinococcus granulosus microRNAs and their expression in different life cycle stages and parasite genotypes.

The aetiological agent of cystic hydatid disease, the platyhelminth parasite Echinococcus granulosus, undergoes a series of metamorphic events during its complex life cycle. One of its developmental stages, the protoscolex, shows a remarkable degree of heterogeneous morphogenesis, being able to develop either into the vesicular or strobilar direction. Another level of complexity is added by the existence of genotypes or strains that differ in the range of intermediate hosts where they can develop and form fertile cysts. These features make E. granulosus an interesting model for developmental studies. Hence, we focused on the study of the regulation of gene expression by microRNAs (miRNAs), one of the key mechanisms that control development in metazoans and plants and which has not been analysed in E. granulosus yet. In this study, we cloned 38 distinct miRNAs, including four candidate new miRNAs that seem to be specific to Echinococcus spp. Thirty-four cloned sequences were orthologous to miRNAs already described in other organisms and were grouped in 16 metazoan miRNA families, some of them known for their role in the development of other organisms. The expression of some of the cloned miRNAs differs according to the parasite life cycle stage analysed, showing differential developmental expression. We did not detect differences in the expression of the analysed miRNAs between protoscoleces of two parasite genotypes. This work sets the scene for the study of gene regulation mediated by miRNAs in E. granulosus and provides a new approach to study the molecules involved in its developmental plasticity and intermediate host specificity. Understanding the developmental processes of E. granulosus may help to find new strategies for the control of cystic hydatid disease, caused by the metacestode stage of the parasite.

Cystic echinococcosis: analysis of the serological profile related to the risk factors in individuals without ultrasound liver changes living in an endemic area of Tacuarembó, Uruguay.

Cystic echinococcosis (CE) is a high prevalence zoonosis among the rural population of Tacuarembó (Uruguay). The correlation between serological data and the incidence of risk factors was studied in a survey carried out in 1998 among rural communities where 480 individuals were examined by means of abdominal sonography (local prevalence = 0.8%). Serum samples (305) were analysed by ELISA to determine specific IgG against crude antigens from Echinococcus granulosus. A total of 27 individuals exhibiting no detectable changes in abdominal sonographic examination were found to be seropositive ('ultrasound normal group'). Of these individuals 9 were seroreactive against purified antigen B. A significant degree of correlation was found between seroreactivity and the incidence of some risk factors (CE antecedent in the family, P < 0.005 and use of rural water, P < 0.0001) among this group. Follow-up of individuals of the 'ultrasound normal group' was carried out after 2 years to evaluate the implications of this serological reactivity. No predictive value for cyst development was assessed with complementary image study; in contrast transient antibodies were observed with both crude and purified antigen as approximately 60% of individuals became negative when re-sampled.

Modulation of the cellular immune response by a carbohydrate rich fraction from Echinococcus granulosus protoscoleces in infected or immunized Balb/c mice.

Infection of Balb/c mice with Echinococcus granulosus protoscoleces constitutes the model for secondary hydatid infection. The immune response of Balb/c mice infected with E. granulosus is characterized by secretion of antibodies specific for carbohydrate epitopes and production of type-2 cytokines. A role for glycoconjugates in the induction of type-2 responses has been suggested in other host--parasite systems. Although glycoconjugates are immunogenic in E. granulosus infection, the role of these molecules in the establishment of the type-2 response has never been analysed. In this study, a carbohydrate rich fraction (E4+) from E. granulosus protoscoleces was obtained using the monoclonal antibody E492/G1 specific for the moiety Galalpha(1,4)Gal which is widely represented in protoscoleces and other E. granulosus antigenic preparations. The results showed that E4+ was immunogenic in Balb/c mice evoking an antibody response mainly directed against carbohydrate epitopes. In addition, splenocytes from E4+-immunized mice showed suppressed proliferative responses to Con A and E4+ induced IL-10 secretion by E4+-primed and naive splenocytes. The fraction E4+ also was immunogenic in infected mice during early infection. In this case also, splenocytes from infected mice as well as peritoneal cells from infected or naive mice, when stimulated in vitro with E4+, secreted IL-10. Collectively, these results suggest that E4+ may be involved in immunosuppression phenomena and, by stimulating IL-10 secretion, may contribute to the induction and sustaining of the type-2 cytokine response established in early experimental infection.

Antibody response in CD4-depleted mice after immunization or during early infection with Echinococcus granulosus.

The aims of this work were to investigate the existence of T-independent antigens in Echinococcus granulosus protoscoleces and to evaluate the relative contribution of T-independent stimulation to the overall antibody response in early infection. Mice depleted of CD4(+)-cells were immunized with protoscolex somatic antigens (PSA) or infected with E. granulosus protoscoleces (PSC). Results showed that the response of CD4-depleted immunized mice had the expected characteristics of a T-independent stimulation and that such T-independent stimulation was important mainly during primary response. During infection absence of CD4(+)-cells affected mainly the secretion of all IgG subclasses with the exception of IgG3 and IgM. To carry out a preliminary isolation of PSC T-independent antigens we prepared a carbohydrate enriched fraction from protoscolex antigens, using a monoclonal antibody specific for the carbohydrate moiety Gal alpha(1,4)Gal highly expressed in PSC. This fraction was mitogenic for naive mouse splenocytes and was recognized by a high percentage of the specific antibodies secreted by CD4-depleted immunized or infected mice. In summary, these results suggest that E. granulosus protoscoleces contain immunogenic T-independent antigens. Primary antibody responses to protoscolex somatic antigens and the production of IgM and IgG3 in early infection would be mainly stimulated by a T-independent mechanism.

Antibody and Th1/Th2-type responses in BALB/c mice inoculated with live or dead Echinococcus granulosus protoscoleces.

The aims of this study were to investigate whether a Th1- or a Th2-type response is stimulated in the first stages of experimental infection with Echinococcus granulosus, and to determine whether live or dead protoscoleces equally contribute to such Th1/Th2-type polarization. Live parasites stimulated the production of IL-10, IL-4 and IL-5 as early as week 1 postinoculation. The levels of IL-10 and IL-4 decreased towards week 4 p.i. and that of IFN gamma increased. The production of specific antibodies was characterized by high levels of systemic IgG1 and local IgM and IgG3 (measured in peritoneal lavages). In contrast, dead parasites induced elevated levels of IL-4, IFN gamma, IL-10 and IL-5 on week 1 postinoculation followed by a decrease of IFN gamma and an increase of IL-4. Low levels of specific antibodies were stimulated by dead parasites both systemically and in the peritoneal cavity. These results show that E. granulosus infection induced an early Th2-type response and that live parasites stimulated stronger antibody responses than dead parasites. In addition, they strongly suggest that both phenomena were modulated by live protoscoleces.

Idiotypic modulation of the antibody response of mice to Echinococcus granulosus antigens.

In this work we analysed the modulation of the antibody response to Echinococcus granulosus antigens via anti-idiotype (Ab2) administration. In a first set of experiments, we determined the antibody response to hydatid cyst fluid antigen (HCFA) of mice immunized with Ab2. Results showed that Ab2 elicited anti-HCFA antibodies in mice that had never been exposed to HCFA before. Moreover, that response was characterized by booster effect, avidity maturation and an inverse correlation between avidity and Ab2 dose. We infected these mice and measured the titre and avidity of anti-HCFA antibodies during 250 days of infection. Lack of avidity maturation was the most important feature observed, suggesting that the parasite (either protoscolex or cyst) could modulate the antibody response of its host. In a second set of experiments, we investigated the presence of regulatory anti-idiotypes in the Ab2 preparation. In this context we treated neonates with different doses of Ab2, immunized them with HCFA 12 weeks later and determined their anti-HCFA titres. A specific and Ab2 dose-dependent suppression of the response to HCFA was observed, suggesting the existence of regulatory anti-idiotypes in the Ab2 preparation. Although this Ab2 could be involved in the regulation of the anti-HCFA response, other anti-idiotypes could also be involved. Our results show that it may be possible to improve the avidity of the anti-HCFA response via the administration of the anti-idiotype Ab. However, the live parasite could successfully revert this effect by mechanisms not yet characterized.

Quantitative determination of anti-hydatid antibodies by ELISA without a colorimetric reading.

A simple and sensitive immunoenzymatic technique for titration of anti-E. granulosus antibodies is described. The method employs the Diffusion-In-Gel-ELISA (DIG-ELISA) technique that needs no plate reader and thus could be widely used in endemic areas. Seventy five human sera, including patients with hydatid disease (26), other parasitic diseases (20), infectious diseases (9), non-infectious diseases (4) and healthy donors (16), were assayed to evaluate diagnostic specificity. The results obtained indicate that DIG-ELISA exhibits sensitivity and specificity similar to other serological techniques for hydatid diagnosis, and in addition improves simplicity.