A study of the environmental determinants of malaria and schistosomiasis in the Philippines using Remote Sensing and Geographic Information Systems.

Malaria and schistosomiasis are two water-related parasitic diseases affecting millions of people worldwide particularly tropical and subtropical countries. In the Philippines, malaria is found in 72 out of 78 provinces while schistosomiasis is endemic in 24 provinces. The Anopheles mosquito and the Oncomelania snail involved in the transmission of these diseases depend on certain environmental determinants that support mosquito and snail populations. This study, done for the first time in the Philippines, successfully showed how Remote Sensing (RS) and Geographical Information Systems (GIS) can be effectively used in showing how these environmental factors affect the spatial distribution of these two diseases. The study sites, i.e. the municipalities of Asuncion and Kapalong, are known endemic sites for both malaria and schistosomiasis. Georeferenced data enabled visualization of prevalence data in relation to physical maps thus facilitating assessment of disease situation in the two municipalities. RS and GIS data proved that other factors aside from climate influence the epidemiology of the diseases in the two sites. Topography and slope as main physical factors influence the vegetation cover, land use and soil type prevailing in particular areas. In addition, water sources especially irrigation networks differed in various places in the study sites in turn affecting the magnitude and distribution of malaria and schistosomiasis. Significant correlations found between the diseases and the environmental variables formed the basis for development of models to predict the disease prevalence in the two municipalities. Proximity to snail breeding sites and irrigation networks and the highly agricultural nature of the barangays were identified as the most common factors that define the high prevalence areas for schistosomiasis confirming the fact that conditions that support the snail populations will in turn favor the presence of the disease. For malaria, the predictive models included temperature, humidity, soil type, predominance of reproduction brush, presence of cultivated areas, distance from deep wells and distance from conventional water source which are in turn influenced by the factor of elevation.

Chromosomal differentiation of the Schistosoma japonicum complex.

The C-banding pattern, location of telomere sequence and chiasma frequency of four species of the Schistosoma japonicum complex were compared with those of two African species, Schistosoma mansoni and Schistosoma haematobium. In the six species, C-banding patterns of seven autosomes and the two sex chromosomes (Z and W) showed relatively species-specific and geographical (Asian and African) differences. Particularly, a plausible pathway of alteration of chromosome 2 revealed a direction from the A-chromosome to the M- chromosome in terms of rearrangements of pericentric inversion and elimination of constitutive heterochromatin (AM inversion). This chromosome change suggested hypothetically that the S. japonicum complex is the original type, and the African species represents the derived type. Moreover, the mosaic construct of the Asian and African types in Schistosoma sinensium chromosomes prompted us to propose that the species might have been formed by hybrid speciation of the genomes of Asian and African species. Localisation of telomeric repeats enabled Asian and African schistosomes to be distinguished clearly by simple terminal location and by terminal and interstitial locations, respectively. Change of chiasma frequency in the S. japonicum complex might be caused by the reduction of interstitial chiasmate (Xi) in the larger chromosomes, 1 and Z (or W), and the change seems to have progressed to Japan from South East Asia. These data enabled us to predict a tentative evolutionary pathway of schistosomes at the cytogenetic level.

Generation, identification, and evaluation of expressed sequence tags from different developmental stages of the Asian blood fluke Schistosoma japonicum.

Here we report 658 expressed sequence tags (ESTs) generated from the 5'-termini of clones randomly selected from directional cDNA libraries constructed from mRNAs from three developmental stages of Schistosoma japonicum. Putative identifications were assigned to 46. 2% of the ESTs; 6.4% were previously known from S. japonicum, 5.6% were previously known from S. mansoni, 34.2% were known from other organisms, and the remaining 53.8% may represent S. japonicum-specific genes. These 658 ESTs appeared to be derived from 457 unique genes, which together represent 2 to 3% of the 15,000 to 20,000 genes predicted to occur in the schistosome genome.

Immunity and morbidity in schistosomiasis japonicum infection.

Schistosomiasis japonica differs significantly from Schistosoma mansoni infection in several epidemiologic, immunologic, and operational characteristics for control. Because of numerous nonhuman hosts, transmission remains high despite aggressive case finding and treatment of human cases. Diagnosis of infection using the Kato-Katz stool technique is less sensitive and specific in this than in other species of human schistosomes, making case finding and treatment a less effective approach to control. Clinically, morbidity induced by S. japonicum appears unrelated to intensity of infection, and is more severe than that of S. mansoni in terms of liver pathology and stunting of child growth and development. Both hepatic enlargement and fibrosis appear to be reversible and preventable with aggressive treatment but several operational characteristics for control of infection due to S. japonicum make the community impact of case-finding and treatment with praziquantel less pronounced than would have been predicted by the analysis of individual cases. In the Philippines, rebound morbidity following reinfection mandates short treatment intervals between screening and treatment to have a significant impact on morbidity, while in China inapparent infection (infection not diagnosed by a single stool examination) appears to be a common cause for persistent hepatic pathology. The authors conclude that for S. japonicum, mass treatment or targeted mass treatment is a more cost-effective approach than case-finding and treatment for control.

Characterization and cloning of the cathepsin L proteinases of Schistosoma japonicum.

Adult Schistosoma japonicum parasites synthesize and secrete both cathepsin L and cathepsin B cysteine proteinases. The specific activities of cathepsin L were many-fold higher than that of cathepsin B. The cDNAs encoding two distinct cathepsin L proteinases, here termed cathepsin L1 and L2, were isolated. The deduced amino acid sequences of the mature cathepsin L1 and L2 were approximately 41% identical, and moreover, S. japonicum cathepsin L2 showed more similarity with human cathepsin L than with schistosome cathepsin L1. Schistosome cathepsin L proteinases may be involved in the digestion of hemoglobin obtained from host erythrocytes. However, since we detected their presence in schistosome eggs, the release of these enzymes by eggs trapped in the liver and other organs may be associated with the granulomatous responses which characterize the pathology of human schistosomiasis.

Anti-embryonation immunity in murine schistosomiasis japonica (Philippines)

The hypothesis that granuloma modulation and disease abatement in chronic infection with Schistosoma japonicum could be ascribed to antibody-mediated effects on egg maturation and egg viability, arose from studies performed with mice in the Philippines. This novel hypothesis has not yet been integrated into the schistosomiasis literature despite being formulated more than a decade ago. One reason for this is that the phenomenon might be confined to S. japonicum, even S. japonicum (Philippines).

Anti-embryonation immunity in murine schistosomiasis japonica (Philippines).

The hypothesis that granuloma modulation and disease abatement in chronic infection with Schistosoma japonicum could be ascribed to antibody-mediated effects on egg maturation and egg viability, arose from studies performed with mice in the Philippines. This novel hypothesis has not yet been integrated into the schistosomiasis literature despite being formulated more than a decade ago. One reason for this is that the phenomenon might be confined to S. japonicum, even S. japonicum (Philippines).

Nuclear and mitochondrial genetic markers highly conserved between Chinese and Philippine Schistosoma japonicum.

Geographical isolates of S. japonicum, and particularly isolates from China and the Philippines, were examined at the molecular level for genetic divergence. Sequences from both nuclear and mitochondrial genomes were selected as markers of evolutionary divergence and S. mekongi and S. mansoni were included in the study for comparison purposes. Restriction fragment length polymorphism (RFLP) and PCR-RFLP analysis of the rDNA repeat unit and sequence analysis of the second internal transcribed spacer region (ITS2) within the rDNA repeat and the cytochrome c oxidase I (COI) gene of the mitochondrial genome were performed. No intra-specific variation in S. japonicum was found in the rDNA repeat and only very slight variation was detected within the COI sequence. A survey of the entire genome, using random amplified polymorphic DNA (RAPD) analysis, again showed that Chinese and Philippine S. japonicum are remarkably similar at the DNA sequence level. We were thus unable to obtain direct molecular evidence in support of previous findings, particularly those based on isoenzyme analysis, that a very high level of intra-specific variation exists in S. japonicum.

Schistosome circulating anodic antigen in serum of individuals infected with Schistosoma japonicum from the Philippines before and after chemotherapy with praziquantel.

The presence of the schistosome circulating anodic antigen (CAA) in serum of patients infected with Schistosoma japonicum from The Philippines has been investigated using an enzyme-linked immunosorbent assay (ELISA). Serum samples were tested from 48 patients who excreted S. japonicum eggs, 9 individuals with a negative stool examination, and 20 controls with both a negative stool and a negative circumoval precipitin test. No false positive result was detected for the unequivocally negative controls. CAA could be demonstrated in 72.9% of the egg-excreting patients. A positive correlation between parasite burden (eggs per gram of faeces) and antigen level (CAA titre) was found (Spearman's rho = 0.48, P < 0.001, n = 48). Four of 18 sera from the egg-negative individuals were positive in the ELISA. In view of the fact that anti-worm antibodies were also detected in these 4 sera, those reactions suggest active infection not detected by stool examination. In serum from patients treated with praziquantel, a significant drop in CAA titre was seen within 5 d after treatment (Wilcoxon's chi T = -2.23, P = 0.0258, n = 21). In conclusion, the detection of CAA by ELISA in S. japonicum infection can give valuable information in both individual diagnosis and therapeutic drug monitoring, as well as in epidemiological studies or disease control programmes.

A preliminary examination of the major integral membrane protein antigens of Schistosoma japonicum and Schistosoma mansoni adult worms for glycosyl-phosphatidylinositol membrane anchors.

Integral membrane protein (IMP) antigens isolated from S. japonicum and S. mansoni adult worms using Triton X-114 phase partitioning were treated with phosphatidylinositol-specific phospholipase C (piPLC). Following piPLC treatment, only one IMP antigen of 58 kDa from each species was released from the hydrophobic fraction and remained soluble in the absence of detergent. An additional 23 kDa antigen was identified following piPLC treatment of S. japonicum IMP's. This molecule has been previously characterized as an important species specific immunodiagnostic antigen. Alkaline phosphatase activity was observed in both the detergent and aqueous phases following treatment with piPLC but only in the hydrophobic fraction of the controls. These data suggest that only a small number of IMP antigens from both S. japonicum and S. mansoni adult worms possess glycosyl-phosphatidylinositol (GPI) lipid membrane anchors in a form which can be hydrolysed by a heterologous piPLC.

Attempts to induce resistance in mice to Schistosoma japonicum and Schistosoma mansoni by exposure to crude schistosome antigens plus cloned glutathione-S-transferases.

Several attempts have been made to induce resistance in mice to Schistosoma japonicum (Philippines) or Schistosoma mansoni by exposure to living male and/or female adult worms, their antigens or irradiated cercariae. No resistance was demonstrated in the following cases: re-exposure of mice to cercariae following praziquantel (PZQ) treatment of existing infection; re-exposure of mice following cyclosporin A (CsA) treatment at the time of first cercarial exposure; subcutaneous or intraperitoneal deposition of living male or female worms; repeated intranasal administration of crude worm homogenates plus Bordetella pertussis vaccine (BPV) as adjuvant. Homologous 60Co-irradiated cercariae were very effective at inducing resistance to infection with S. mansoni but not to infection with S. japonicum (Philippines) in a limited series of experiments. A regime of infection, immunization with homologous Escherichia coli-derived glutathione-S-transferases (GST), then PZQ treatment followed by homologous re-exposure did not result in significant resistance in either the S. mansoni or the S. japonicum (Philippines) systems. Mice given irradiated cercariae plus GST were not more resistant to subsequent S. mansoni infection than mice given irradiated cercariae alone. The results generally confirm and extend those reported by others with the conclusion that resistance to schistosomes in mice is difficult to achieve by exposure to adult worm antigens alone. Moreover, additional immunization with the GST available to date as cloned gene products, and injected in Freund's complete adjuvant, does not influence the outcome of exposure to crude worm antigens including any additive effects of protective irradiated cercariae.

Further studies on variable resistance of 129/J and C57BL/6 mice to infection with Schistosoma japonicum and Schistosoma mansoni.

Two mouse strains maintained in this laboratory (WEHI) are variably resistant to infection with Schistosoma japonicum and S. mansoni in that worms cannot be found in the liver and portal system in a high proportion (WEHI 129/J mice) or low proportion (C57BL/6 mice) some weeks after exposure to cercariae. Resistance can be as high as 100% in WEHI 129/J mice and is usually around 20% in C57BL/6 mice. The proportion of resistant mice closely parallels the proportion of mice that demonstrate a shunting of microbeads, injected into a mesenteric vein, from liver to lungs. This applies to F1 x WEHI 129/J backcross mice in which the data suggest oligogenic genetic effects although no evidence for a participation of MHC-linked genes in the phenomenon has emerged. 129/J mice derived from the Jackson Laboratory do not show a shunting of beads from the portal system to the lungs but their progeny bred at WEHI do. Germ-free WEHI 129/J mice resemble conventionally-maintained, SPF-derived WEHI 129/J mice in their variable resistance to schistosome infection. No satisfactory explantation for hepato-portal system peculiarities in WEHI 129/J and C57BL/6 mice can be advanced as yet and a possibility raised in this paper is a contribution from nutritional factors such as hypervitaminosis A superimposed on a genetic predisposition in these two related mouse strains.

Studies on the sex ratio of worms in schistosome infections.

Sex ratios of adult schistosomes in mice are almost invariably different from 1.0 and are biased towards males. The bias applies to wild rats infected with Schistosoma japonicum and trapped in an endemic area of the Philippines (male:female ratio = 1.7). It also applies to cercariae of snails collected in such areas and assessed by infection of laboratory mice using cercariae from individual snails (male:female ratio may approach 6.0). Experiments were designed to determine if duration of infection in the mammalian host was a factor that influenced the sex ratio of miracidia used for infecting snails and subsequently mice. BALB/c and C57BL/6 mice were infected with 100 cercariae of S. mansoni, and liver eggs harvested at early and late time points for infection of snails and production of cercariae. Two phenomena were demonstrated: firstly, a more pronounced male bias when eggs were harvested late compared with early in infection; secondly, a reduced apparent hatchability of eggs in BALB/c compared with C57BL/6 livers. The possibility is raised by the data that female miracidia within eggs of chronically infected individuals may be more prone to immune damage than male miracidia with important epidemiological consequences.

Schistosoma japonicum: monoclonal antibodies to the Mr 26,000 schistosome glutathione S-transferase (Sj26) in an assay for circulating antigen in infected individuals.

Two monoclonal antibodies have been produced that bind to separate epitopes on the Mr 26,000 glutathione S-transferase (GST) of Schistosoma japonicum worms (Sj26). Both antibodies have been used in an enzyme immunoassay (EIA) with sera from infected individuals from the Philippines. Relatively high signals were obtained with sera from some, but not all, individuals who are positive for fecal eggs. Evidence was obtained that the material detected by the monoclonal antibodies was present in minute amounts and in some sera was bound in a complex with phosphorylcholine-containing molecules. It could not be absorbed by reaction with glutathione-agarose columns. There was no detectable immunoglobulin in the complex. The possibility exists that the complexes are composed of schistosome GST, or fragments, and damaged tegumental lipids shed as a result of surface immune attack. However, the presence of the native Sj26 molecule has not been proven. More detailed longitudinal studies in endemic areas are required to determine whether the assay can be used as an indicator of acquired resistance ("concomitant immunity") and whether it will be useful in the search for immunological correlates of this resistance in humans.

Monoclonal antibodies reacting with Schistosoma japonicum eggs and their target epitopes.

Ten monoclonal antibodies (McAbs) raised to Schistosoma japonicum eggs could be assigned using several serological and immunochemical techniques to 3 groups. The McAbs, termed A, B and C-McAbs, apparently recognize carbohydrate epitopes that can be located on the same antigen molecule. The antibodies, generally of IgM isotype, are idiotypically related. They are distinct from another IgM McAb (Group D-McAb) the carbohydrate target epitope of which can also be associated with the epitopes of A, B and C-McAbs. The McAbs produce large vacuolated bleb reactions in the circumoval precipitin test (COPT) and target epitopes have different representations in various life cycle stages such as immature and mature eggs, male and female worms (including S. mansoni). Antigens affinity purified on columns containing A, B, C and D-McAbs stimulate proliferation of T cells from egg-sensitized mice and elicit DTH reactions in such mice. This raises the possibility that the target antigens of these carbohydrate-reactive monoclonal antibodies are immunopathologic and involved in egg-induced granuloma formation.

Effects of induction of anti-embryonation immunity on liver granulomas, spleen weight and portal pressure in mice infected with Schistosoma japonicum.

BALB/c mice sensitized with injections of viable immature Schistosoma japonicum eggs had significantly fewer and smaller granulomas in the liver, lower portal pressure and smaller spleens at D + 75 of infection compared to similarly infected unsensitized controls. The portal pressure and spleen weights of the mice sensitized with immature eggs were not different from uninfected unsensitized mice of similar ages at D + 75 of infection. The results strongly support our hypothesis that it should be possible to prevent serious hepatosplenic disease in schistosomiasis japonica by vaccination to induce anti-embryonation immunity.

Molecular and serological characteristics of the glutathione S-transferases of Schistosoma japonicum and Schistosoma mansoni.

When aqueous extracts of Schistosoma japonicum and S. mansoni adult worms are passed over columns of glutathione-conjugated agarose, two molecular species of Mr 26,000 and Mr 28,000 are detected in eluates as analysed by SDS-PAGE, these eluates having glutathione S-transferase (GST) activity. The molecules, termed Sj26 and Sj28 from S. japonicum and Sm26 and Sm28 from S. mansoni, can be immunogenic in rabbits or mice and appear not to be linked together as subunits of GST heterodimers. The elution profile of SjGST (Sj26+Sj28) from glutathione columns resembles that of SmGST (Sm26+Sm28) and, by peptide mapping, radioiodinated Sj26 and Sm26 are related as are the two Mr 28,000 molecules. Similarities between radioiodinated Sj28 and Sm28 are also obvious on two-dimensional gel electrophoresis with some differences being observed between Sj26 and Sm26. The Mr 28,000 molecules are more prominent than the Mr 26,000 molecules and, although Sj28 and Sm28 is a poor immunogen in mice, immunological cross-reactivity between Sj28 and Sm28 is generally more readily detected than that between Sj26 and Sm26. Whether experimental vaccination against schistosomiasis japonica and schistosomiasis mansoni reported with cloned GSTs can be improved by incorporation of both Mr 28,000 and Mr 26,000 species into the vaccine remains to be determined. On this point, the present data suggest that vaccination of mice with Sj26 plus Sm28 should be a useful means of increasing antibody responses to the GSTs of S. japonicum.

Schistosoma mansoni and S. japonicum worm numbers in 129/J mice of two types and dominance of susceptibility in F1 hybrids.

In a study on the genetics of resistance to schistosomiasis in WEHI 129/J mice, susceptibility to either Schistosoma mansoni or Schistosoma japonicum was shown to be unequivocally dominant in F1 hybrid crosses between genetically resistant WEHI 129/J and susceptible BALB/c mice. The operation of only 1 or 2 genes in the expression of resistance to S. mansoni was suggested by backcross analysis. Thus, approximately 25% of (BALB/c x WEHI 129/J) F1 x WEHI 129/J mice were resistant to S. mansoni infection, whereas resistance was manifest in approximately 50% of WEHI 129/J mice. The data are consistent with resistance being controlled by 1 recessive gene having 50% penetrance. We also report that 129/J mice obtained directly from the Jackson Laboratories (Bar Harbor, Maine) (designated JAX 129/J), differ from locally bred WEHI 129/J in being entirely susceptible to S. mansoni infection. However, both WEHI 129/J and JAX 129/J are relatively resistant to S. japonicum infection.