Acute Anisakiasis: Pharmacological Evaluation of Various Drugs in an Animal Model.

BACKGROUND: The accidental ingestion of the third larval stage of Anisakis can cause acute clinical symptoms, which are relieved via extraction of the larvae. Although this is a highly effective technique, it can only be practiced when the larvae are found in accessible areas of the gastrointestinal tract, and therefore instead the condition has often been treated using various different drugs. AIMS: This study evaluates the effectiveness of gastric acid secretion inhibitors (omeprazole and ranitidine), gastric mucosal protectants (sucralfate) and anthelmintics (mebendazole and flubendazole) in treating anisakiasis in Wistar rats. METHODS: Rats were infected with Anisakis-type I larvae and administered the drugs via a gastric probe. Data were recorded regarding the number of live and dead larvae, their location both within the animal and in its feces, and the presence of gastrointestinal lesions. Additionally, gastric pH was measured and histology performed. RESULTS: While rats in all experimental groups exhibited lesions; those treated with ranitidine and mebendazole showed significantly fewer lesions (50% and 35% of rats exhibited lesions, respectively). Histological examination of the gastric lesions revealed infection-induced changes, but no significant differences were observed between the treated and untreated rats. CONCLUSIONS: Mebendazole was found to be most efficacious in preventing gastrointestinal lesions, followed by ranitidine, which was the most effective antacid of those studied. Both these drugs could thus be considered as part of the conservative management of anisakiasis.

Molecular epidemiology and risk factors for Anisakis simplex s.l. infection in blue whiting (Micromesistius poutassou) in a confluence zone of the Atlantic and Mediterranean: Differences between A. simplex s.s. and A. pegreffii.

Our study determined parameters of parasitization of Anisakis simplex s.l. in Micromesistius poutassou in a confluence zone of the Atlantic and Mediterranean, with a total prevalence of 82%. Also, in the three seasons analyzed, high prevalence's values were found, reaching 100% in spring; however mean intensity and abundance values were higher in winter. The use of molecular techniques to differentiate between Anisakis genotypes of the larvae characterized allowed obtaining values of 99.7% Anisakis simplex s.l. (50.1% A. simplex s.s., 42.9% A. pegreffii, 7.0% A. simplex s.s. - A. pegreffii hybrids) and 0.3% A. typica. The infections found in the fish were of both single and mixed species, in all the different possible combinations. The presence of A. simplex s.l. in the viscera varied according to genotype and season. Likewise, factors associated with the presence of the parasite in the ventral or dorsal musculature were different, where A. simplex s.s. proportion was double than that of A. pegreffii. The ecology of the two sibling species with regard to their location in fish and the influence of the season were different.

Peppermint (Mentha piperita) and albendazole against anisakiasis in an animal model.

OBJECTIVES: Therapy against anisakiasis requires invasive techniques to extract L3 , and an effective drug against this nematode is needed. The aim of this study was to determine the efficacy of peppermint essential oil (EO) and its main components against the parasite in comparison to albendazole, a drug currently prescribed to treat anisakiasis. METHODS: We conducted in vitro experiments and studied an experimental model simulating the human infection in Wistar rats. We used polymerase chain reaction restriction fragment length polymorphism to identify A. simplex s.s. and A. pegreffii and determine any differences in their pathogenicity and susceptibility to the treatments. RESULTS: The in vitro and in vivo experiments both showed that the larvicidal activity of peppermint EO, menthol, menthone and menthyl acetate is higher than that of albendazole. Large stomach lesions were observed in 46.7% of the albendazole-treated rats, whereas no gastrointestinal lesions were detected in those treated with peppermint EO, menthol, menthyl acetate or menthone. CONCLUSIONS: In this animal model, treatment with peppermint EO or its main components was more effective than was treatment with albendazole. Lesions were more frequently produced by A. simplex s.s. larvae than by A. pegreffii larvae.

Experimental demonstration of pathogenic potential of Anisakis physeteris and Anisakis paggiae in Wistar rats.

Anisakis morphotype I is the principal etiologic agent of human anisakiasis, with differences in pathogenicity found between the Anisakis simplex s.s. and A. pegreffii species; however, the role of morphotype II larvae in this illness is not well understood. The purpose of this study is to verify the ability of morphotype II larvae to invade tissues via the experimental infection of Wistar rats, an animal model which simulates infection in humans. In the in vivo assay, 7.1% (4/56 L3 morphotype II) showed pathogenic potential, defined as the capacity of the larvae to cause lesions, attach to the gastrointestinal wall or penetrate it. Two of these larvae, one of A. physeteris and one of A. paggiae, penetrated the stomach wall and were found within the abdominal cavity, with the first one producing a small lesion with blood vessel breakage. The majority of the L3 larvae of morphotype II were found in the intestine (51.8%; 29/56) with the caecum being the least frequent location (8.9%; 5/56). In contrast, 44.0% (11/25) of the morphotype I larvae demonstrated pathogenic potential. Isoenzyme electrophoresis, PCR-RFLP of ITS1-5.8 s-ITS2 and PCR-sequencing of the cox2 mitochondrial gene were used to identify these larvae as A. physeteris (42.9%), A. paggiae (30.3%) and A. brevispiculata (1.8%). Although the morphotype II larvae of A. physeteris and A. paggiae have lower pathogenic potential than morphotype I larvae of A. simplex s.s. (93 and 91% lower, respectively), they may still be implicated in human anisakiasis, as they are capable of attaching to and penetrating the gastrointestinal wall of animals, demonstrating a similar pathogenicity to that of A. pegreffii. The techniques used for the identification of species reveal a great genetic heterogeneity of A. paggiae and A. physeteris, suggesting the existence of sibling species.

Impact of climate change and man-made irrigation systems on the transmission risk, long-term trend and seasonality of human and animal fascioliasis in Pakistan.

Large areas of the province of Punjab, Pakistan are endemic for fascioliasis, resulting in high economic losses due to livestock infection but also affecting humans directly. The prevalence in livestock varies pronouncedly in space and time (1-70%). Climatic factors influencing fascioliasis presence and potential spread were analysed based on data from five meteorological stations during 1990-2010. Variables such as wet days (Mt), water-budget-based system (Wb-bs) indices and the normalized difference vegetation index (NDVI), were obtained and correlated with geographical distribution, seasonality patterns and the two-decade evolution of fascioliasis in livestock throughout the province. The combined approach by these three indices proved to furnish a useful tool to analyse the complex epidemiology that includes (i) sheep-goats and cattlebuffaloes presenting different immunological responses to fasciolids; (ii) overlap of Fasciola hepatica and F. gigantica; (iii) co-existence of highlands and lowlands in the area studied; and (iv) disease transmission following bi-seasonality with one peak related to natural rainfall and another peak related to man-made irrigation. Results suggest a human infection situation of concern and illustrate how climate and anthropogenic environment modifications influence both geographical distribution and seasonality of fascioliasis risks. Increased fascioliasis risk throughout the Punjab plain and its decrease in the northern highlands of the province became evident during the study period. The high risk in the lowlands is worrying given that Punjab province largely consists of low-altitude, highly irrigated plains. The importance of livestock in this province makes it essential to prioritise adequate control measures. An annual treatment scheme to control the disease is recommended to be applied throughout the whole province.

Experimental comparison of pathogenic potential of two sibling species Anisakis simplex s.s. and Anisakis pegreffii in Wistar rat.

OBJECTIVES: There are little data available on the pathology caused by the sibling species Anisakis simplex s.s. and Anisakis pegreffii. The differences shown in their ability to penetrate the muscle of fish may also be manifested in humans. The purpose of this study is to confirm possible differences in pathogenicity between A. simplex s.s. and A. pegreffii using an experimental model which simulates infection in humans. METHODS: Female Wistar rats were infected with 190 Anisakis type I L3 larvae from the Iberian coastline. After the animal was sacrificed, these L3 larvae were then recovered and identified via PCR-RFLP of the ITS1-5.8S-ITS2. A logistic regression analysis was performed searching for association between experimental pathogenic potential and species. RESULTS: The distribution of A. simplex s.s. and A. pegreffii between Atlantic and Mediterranean waters of the Iberian Peninsula showed statistically significant differences (P < 0.001) which were not observed in the hybrid genotypes (P > 0.3). 21.6% showed pathogenic potential, interpreted as the capacity of the larvae to cause lesions, stick to the gastrointestinal wall or penetrate it. The species variable showed association with the pathogenic role of the larva (P = 0.008). Taking A. simplex s.s. as our reference, the OR for A. pegreffii is 0.351 (P = 0.028). CONCLUSIONS: Despite this difference, A. pegreffii is also capable of causing anisakiasis, being responsible for 14.3% of the penetrations of the gastric mucosa found in rats, which justifies both species being considered aetiologic agents of this parasitic disorder.

Activity of Matricaria chamomilla essential oil against anisakiasis.

The increase in diagnosed cases of anisakiasis and the virtual absence of effective treatments have prompted the search for new active compounds against Anisakis L(3) larvae. The biocidal efficacy against different pathogens shown by various essential oils (EO) led us to study the Matricaria chamomilla EO and two of its main components (chamazulene and α-bisabolol) against the L(3) larvae of Anisakis type I. The activity of M. chamomilla EO, chamazulene and α-bisabolol was established by in vitro and in vivo experiments. The EO (125µg/ml) caused the death of all nematodes, which showed cuticle changes and intestinal wall rupture. In the in vivo assays, only 2.2%±1.8 of infected rats treated with M. chamomilla EO showed gastric wall lesions in comparison to 93.3%±3.9 of control. Chamazulene was ineffective, while α-bisabolol showed a high activity to that of the EO in vitro tests but proved less active in vivo. These findings suggest that the larvicidal activity may result from the synergistic action of different compounds of M. chamomilla EO. Neither of the tested products induces irritative damage in the intestinal tissues. In conclusion, M. chamomilla EO is a good candidate for further investigation as a biocidal agent against Anisakis type I.

Anisakis simplex s.l. parasitization in mackerel (Scomber japonicus) caught in the North of Morocco--prevalence and analysis of risk factors.

Consumption of mackerel (Scomber japonicus) is very widespread in Morocco, where its production is an important economic pillar. We investigated the prevalence of infection by Anisakis spp. in mackerel caught in Moroccan waters, analyzing infection risk factors. The prevalence was generally higher in fish from the Atlantic (67.9%) than from the Mediterranean (57.0%), but they did not differ in the mean abundance, intensity, or prevalence of muscle parasitization. A. pegreffii was the predominant species (82.6% of larvae) followed by the hybrid A. simplex s.s./A. pegreffii (16.3%). Only one L3 of A. simplex s.s. was found in a specimen of S. japonicus from the Atlantic. Mackerel infection was associated with total fish weight, gonad weight, catch area, and catch season. However, muscle infection was associated solely with total weight and parasite loads. The consumption of lower-weight mackerel may be a good prophylactic measure against human anisakiasis.

In vitro and in vivo activity of three sesquiterpenes against L(3) larvae of Anisakis type I.

In order to investigate the possible use of terpenic derivatives to treat anisakiasis caused by L(3) larvae of Anisakis, we studied the in vitro and in vivo larvicidal activity of three sesquiterpenes (nerolidol, farnesol and elemol). In vitro experiments included the histological study of larval damage and in vivo studies the measurement of myeloperoxidase activity in rat gastrointestinal tract after administration of the sesquiterpenes. In the in vitro assays, the most active compound against the L(3) larvae was nerolidol, followed by farnesol; both caused the death of all nematodes, which showed cuticle changes and intestinal wall rupture. In the in vivo assays, only 20% of infected rats treated with nerolidol or farnesol showed gastric wall lesions in comparison to 86.6% of control animals. According to these results, nerolidol and farnesol are good candidates for further research as biocidal agents against L(3) larvae of Anisakis type I.

Genetic variability of Anisakis simplex s.s. parasitizing European hake (Merluccius merluccius) in the Little Sole Bank area in the Northeast Atlantic.

In this study, we researched the presence of anisakids in specimens of Merluccius merluccius caught in the area of Little Sole Bank, in the Northeast Atlantic, and found that 100% of the European hake examined were infected and showed high average values of abundance (976.88) and intensity (976.88). The larvae were identified in morphological terms as morphotype type I and in molecular terms as Anisakis simplex s.s via polymerase chain reaction (PCR) restriction fragment length polymorphism of the rDNA. The genetic variability of the A. simplex s.s population in the North Atlantic is notable, with at least two ribosomal and three mitochondrial haplotypes which are different from the specimen used as control, reflecting the diversity of this species, an aspect which has scarcely been studied to date. The cox-2 gene appears to be an interesting candidate for generating new genetic markers which can be applied to differentiate between A. simplex s.s and Anisakis pegreffii. We detected 11 fixed differences in this gene, and it also offers the advantage of being easily amplified by PCR. The high prevalence of infection by A. simplex s.s and the extremely high average intensity and abundance values can have significant repercussions on public health, especially among populations which regularly eat insufficiently cooked or raw fish and have a certain genetic predisposition; the genetic variability of the parasite could be another factor to take into account.

CO2-fixing enzymes and phosphoenolpyruvate metabolism in the fish parasite Hysterothylacium aduncum (Ascaridoidea, Anisakidae).

CO2 stimulates the development of many of the intestinal helminths that are able to fix CO2 by means of phosphoenolpyruvate carboxykinase (PEPCK), such as Hysterothylacium aduncum. We determined the activity of CO2-fixing enzymes such as PEPCK and phosphoenolpyruvate carboxylase (PEPC), although no significant activity was detected for pyruvate carboxylase or carboxylating-malic enzyme. The former act on phosphoenolpyruvate (PEP) to yield oxalacetate. In the helminths studied, PEP has a vital role in glucidic metabolism. Consequently, we determined the activity of other enzymes involved in the crossroad of PEP, such as pyruvate kinase (PK), lactate dehydrogenase and malate dehydrogenase. All enzymes detected showed significant variations in activity during the in vitro development of the parasite from the third larval stage to mature adult. Fixing of CO2 by PEPCK decreased during development (from 228 to 115 nmol min(-1) mg(-1) protein), while that by PEPC increased (from 19 to 46 nmol min(-1) mg(-1) protein). This enzyme, which is rare in animals, could play a part in detecting levels of free phosphate, releasing it from PEP when required for processes such as glycogenolysis, glycolysis and adenosine 5'-triphosphate (ATP) synthesis. PK, which showed increasing activity during development up to immature adult (from 56 to 82 nmol min(-1) mg(-1) protein), could act in combination with PEPC to obtain energy in the cytosol (in the form of ATP) and in the mitochondria (possible destination of the pyruvate formed), compensating for the decrease in activity of PEPCK.

The fishing area as a possible indicator of the infection by anisakids in anchovies (Engraulis encrasicolus) from southwestern Europe.

A study was conducted on the parasitization by anisakids of European anchovies (Engraulis encrasicolus) from the Eastern Atlantic (Gulf of Cádiz and Strait of Gibraltar) and Western Mediterranean (Ligurian Sea, Gulf of Lion, Catalonia coast and NW Alborán Sea) throughout 1998 and 1999. The anisakids detected were identified as third larval stages of Anisakis larva type I and Hysterothylacium aduncum. Global prevalence was 9.4% for Anisakis and 24.5% for H. aduncum. Analysis of the origin of the anchovies revealed a higher prevalence of Anisakis than H. aduncum in fish from the Atlantic and vice-versa in fish from the Mediterranean. Analysis of various fishing areas in the Western Mediterranean revealed a prevalence of Anisakis in fish from the Ligurian Sea that was 5-fold or more than in the other three areas, with a significantly greater prevalence of H. aduncum in fish from the NW Mediterranean than from the Spanish Mediterranean coast. The prevalence of infection was found to be significantly related to anchovy length for both Anisakis and H. aduncum. More than 55% of Anisakis larvae were found in the muscle. According to these data, the risk of acquiring anisakiasis/anisakidosis from the consumption of raw or under-cooked anchovies may depend upon the area in which they were caught.

Hysterothylacium aduncum, the only anisakid parasite of sardines (Sardina pilchardus) from the southern and eastern coasts of Spain.

An epidemiological study was carried out on the anisakids in sardines (Sardina pilchardus) from the southern (Atlantic and Mediterranean) and eastern coasts of Spain. Length of fish was from 12.2-21.0 cm. The anisakids found were identified as the third larval stage (L3) of Hysterothylacium aduncum, with a total prevalence of 11.85%. Prevalence within the host was 9.64% in viscera and 4.69 % in muscle. The highest infection parameters were found in fish from the east coast (western Balearic Sea) with prevalence of 25.21%, mean intensity of 2.10, and mean abundance of 0.52. No worms of the genus Anisakis were found in the 359 sardines analyzed.

Anisakis simplex: CO(2)-fixing enzymes and development throughout the in vitro cultivation from third larval stage to adult.

We studied the effect of CO(2) on the in vitro cultivation of Anisakis simplex, an aquatic parasitic nematode of cetaceans (final hosts) and fish, squid, crustaceans and other invertebrates (intermediate/paratenic hosts), and, occasionally, of man (accidental host). The results showed that a high pCO(2), at a suitable temperature, is vital for the optimum development of these nematodes, at least from the third larval stage (L3) to adult. After 30 days cultivation in air, molting to L4 (fourth larval stage) was reduced to 1/3, while survival was about 1/3 of that when cultivated in air + 5% CO(2). The activity of the CO(2)-fixing enzymes, PEPCK and PEPC, was also studied. Throughout the development of the worms studied, PEPCK activity was much higher than that of PEPC (e.g., 305 vs. 6.8 nmol/min.mg protein, respectively, in L3 collected from the host fish). The activity of these enzymes in the worms cultivated in air + 5% CO(2) was highest during M3, and was also generally higher than that of those cultivated in air only, especially during molting from L3 to L4 (e.g., in recently molted L4, PEPCK activity was 3.7 times greater than that of PEPC 2.9 times greater than when cultivated in air).

Actividad de un licuado de Allium sativum (cultivar morado) frente a larvas L3 de Anisakis simplex s. l / No disponible

Los bulbos de ajo (Allium satívum), uno de los principales ingredientes de la cocina española, se emplean desde antiguo con fines terapéuticos, muchos de ellos validados científicamente, como es el caso de su empleo como biocida. En el presente trabajo se ha estudiado la actuación in vitro frente a larvas L3 de Anisakis simplex s.l. de los sobrenadantes de licuados de A. sativum (cultivar morado), obtenidos tanto de bulbos recién recolectados (T1) como tras seis (T2) y doce meses (T3) de la recolección. Los resultados muestran que los sobrenadantes más activos son los correspondientes a T2, con una mortalidad del 100% de las larvas. Los componentes implicados en esta actividad parecen ser el disulfuro y el trisulfuro de dialilo junto con otro derivado azufrado no identificado

The garlic bulbs (Allium sativum), one of the main ingredients of the Spanish cuisine, are employed since ancient times for therapeutic purposes, many of which are now scientifically validated, as it is the case of its use as biocide. In the present study we have established the in vitro activity against Anisakis simplex s.l. L3 larvae of the supernatants of A. sativum (purple cultivar) liquates obtained from bulbs recently collected (TI) or after six (T2) and twelve (T3) months of the harvesting. The results show that the more active supernatant is the corresponding to with a 100% of larvae mortality. The compounds invalved this activity seem to be diallyl disulphide and diallyl trisulphide along with another unidentified sulphured compound

CO(2)-fixing enzymes during moulting from third larval to fourth larval stage of Anisakis simplex and Hysterothylacium aduncum (Nematoda: Anisakidae).

The fixing of CO(2) is an important metabolic process for many organisms. In the anisakid nematodes, CO(2) has been shown to be necessary for their development, at least in vitro. The presence of CO(2) stimulates the moulting (M3) of the larvae from the third (L3) to the fourth (L4) stage and prolongs the survival, at least, in vitro. We determined the activity of CO(2)-fixing enzymes, common to many organisms, in two anisakids: Anisakis simplex, a parasite of cetaceans, and Hysterothylacium aduncum, a parasite of fish. Although no activity was detected for pyruvate carboxylase or carboxylating-malic enzyme, we detected phosphoenolpyruvate carboxykinase (PEPCK) and phosphoenolpyruvate carboxylase (PEPC) activity. In A. simplex, PEPCK was clearly higher than that of PEPC throughout the moulting process studied. In H. aduncum, although the activity of both enzymes was of similar magnitude, they showed different behaviour; PEPCK activity decreased after the moulting to L4, PEPC activity increased so that the ratio PEPCK/PEPC activity decreased from 1.90 before moulting to 0.59 after.

Molecular arguments for considering Hysterothylacium fabri (Nematoda: Anisakidae) a complex of sibling species.

The existence of sibling species is widespread among nematodes and the recognition of these has important epidemiological implications. In an attempt to establish whether this is the case for Hysterothylacium fabri, which is present in many Mediterranean fish species, we studied its genetic diversity and analysed its population structure. To do this, we used 266 fourth stage larvae of H. fabricollected from three different host species and used two different methods for characterising genetic variability: isoenzyme electrophoresis and RAPD. The four isoenzyme loci studied are polymorphic, with five or six alleles at each. Significant differences in the deviations from the Hardy-Weinberg law were detected, especially at the PGM locus. A total of 92.1% of the markers revealed by the RAPD technique were polymorphic, demonstrating a great diversity. The UPGMA dendrogram revealed the existence of four genetic groups. Values of Nei's genetic distance, gene flow and the existence of different fixed alleles, together with the deviations from the Hardy-Weinberg law detected in the isoenzyme study, suggest that H. fabri is a complex comprising at least three sibling species with little host specificity, at least in the case of the most abundant species.