RESUMO
Human abdominal angiostrongyliasis (HAA) is a parasitic disease caused by the accidental ingestion of the nematode Angiostrongylus costaricensis in its larval form. Human infection can lead to severe ischemic and inflammatory intestinal lesions, sometimes complicated by life-threatening ileal perforations. Only one case had been reported in Martinique, an Island in the French Antilles, in 1988. We retrospectively reviewed the medical charts of patients diagnosed with abdominal angiostrongyliasis at the University Hospital of Martinique between 2000 and 2017. The objectives of this study were to evaluate the incidence and perform a descriptive analysis of the clinical, biological, radiological, and histopathological features of HAA in Martinique. Two confirmed cases and two probable cases were identified in patients aged from 1 to 21 years during the 18-year period, with an estimated incidence of 0.2 cases per year (0.003 case/year/100.000 inhabitants (IC95% = 0.00-0.05)). All patients presented with abdominal pain associated with high blood eosinophilia (median: 7.24 G/L [min 4.25; max 52.28 G/L]). Two developed ileal perforation and were managed by surgery, with diagnostic confirmation based on histopathological findings on surgical specimens. The other two cases were probable, with serum specimens reactive to Angiostrongylus sp. antigen in the absence of surgery. All cases improved without sequelae. The description of this case series highlights the need to increase awareness of this life-threatening disease in the medical community and to facilitate access to specific diagnostic tools in Martinique. Environmental and epidemiological studies are needed to broaden our knowledge of the burden of this disease.
TITLE: Infections par Angiostrongylus costaricensis à la Martinique, Antilles, de 2000 à 2017. ABSTRACT: L'angiostrongylose abdominale humaine (AAH) est une maladie parasitaire causée par l'ingestion accidentelle du nématode Angiostrongylus costaricensis sous sa forme larvaire. L'infection humaine peut conduire à des lésions intestinales ischémiques et inflammatoires sévères, parfois compliquées par des perforations iléales menaçant le pronostic vital. Un seul cas avait été signalé en Martinique, une île des Antilles françaises, en 1988. Nous avons revu rétrospectivement les dossiers médicaux des patients ayant reçu un diagnostic d'angiostrongylose abdominale au CHU de la Martinique entre 2000 et 2017. Les objectifs de cette étude étaient d'évaluer l'incidence et effectuer une analyse descriptive des caractéristiques cliniques, biologiques, radiologiques et histopathologiques de l'AAH en Martinique. Deux cas confirmés et deux cas probables ont été identifiés chez des patients âgés de 1 à 21 ans au cours de la période de 18 ans, avec une incidence estimée à 0,2 cas par an (0,003 cas / an / 100 000 habitants (IC95% = 0,00 − 0,05)). Tous les patients présentaient une douleur abdominale associée à une éosinophilie sanguine élevée (médiane: 7,24 G/L [min 4,25; max 52,28 G / L]). Deux ont développé une perforation iléale et ont été traités par chirurgie, avec une confirmation diagnostique basée sur les résultats histopathologiques sur des échantillons chirurgicaux. Les deux autres cas étaient probables, avec des échantillons sériques réagissant aux antigènes d'Angiostrongylus sp. en l'absence de chirurgie. Tous les cas se sont améliorés sans séquelles. La description de cette série de cas souligne la nécessité de sensibiliser davantage la communauté médicale à cette maladie potentiellement mortelle et de faciliter l'accès à des outils diagnostiques spécifiques en Martinique. Des études environnementales et épidémiologiques sont nécessaires pour élargir nos connaissances sur cette parasitose.
Assuntos
Infecções por Strongylida/epidemiologia , Dor Abdominal/parasitologia , Adolescente , Angiostrongylus/imunologia , Animais , Anticorpos Anti-Helmínticos/sangue , Criança , Pré-Escolar , Colo/diagnóstico por imagem , Colo/parasitologia , Colo/patologia , Eosinofilia/parasitologia , Feminino , Humanos , Íleo/parasitologia , Íleo/patologia , Incidência , Lactente , Masculino , Martinica/epidemiologia , Artérias Mesentéricas/parasitologia , Artérias Mesentéricas/patologia , Radiologia , Chuva , Estudos Retrospectivos , Estações do Ano , Infecções por Strongylida/sangue , Infecções por Strongylida/diagnóstico por imagem , Infecções por Strongylida/patologia , Adulto JovemRESUMO
Angiostrongylus cantonensis produces eosinophilic meningitis in humans and is endemic in Thailand, Taiwan, China, and the Caribbean region. During infection with this parasite, it is important to know if the complement system may be activated by the classical or lectin pathway. Cerebrospinal fluid and serum samples from 20 patients with meningitic angiostrongyliasis were used to quantify C4 levels and albumin. Results were plotted on a C4 CSF/serum quotient diagram or Reibergram. Twelve patients showed intrathecal synthesis of C4. Antibody-dependent complement cytotoxicity should be considered as a possible mechanism that destroys third-stage larvae of this helminth in cerebrospinal fluid of affected patients.
Assuntos
Angiostrongylus cantonensis , Complemento C4/líquido cefalorraquidiano , Eosinofilia/parasitologia , Meningite/líquido cefalorraquidiano , Meningite/parasitologia , Infecções por Strongylida/líquido cefalorraquidiano , Adolescente , Adulto , Animais , Anticorpos Anti-Helmínticos , Criança , Pré-Escolar , Complemento C4/metabolismo , Eosinofilia/sangue , Eosinofilia/líquido cefalorraquidiano , Feminino , Humanos , Lactente , Masculino , Meningite/sangue , Infecções por Strongylida/sangue , Adulto JovemRESUMO
Plasma butyrylcholinesterase (BChE) hydrolyzes ester-containing compounds such as succinylcholine, as well as acting as a scavenger against neurotoxic organophosphates (OPs). We previously found that Nippostrongylus brasiliensis infection makes rats more susceptible to OP toxicity by decreasing serum paraoxonase-1 (PON1) activity. In the present study, we examined the effects of N.brasiliensis infection on acetylcholinesterase (AChE) activity in plasma, red blood cells (RBCs), brain and diaphragm, as well as serum PON1 activity, in rats at day 7 after infection. N.brasiliensis infection significantly decreased plasma BChE and PON1 activities without significantly altering AChE activity in RBCs, brain and diaphragm. These results provide further insight into the unusual deleterious effects of intestinal nematode infections on body homeostasis.
Assuntos
Butirilcolinesterase/sangue , Nippostrongylus/fisiologia , Infecções por Strongylida/enzimologia , Acetilcolinesterase/análise , Acetilcolinesterase/sangue , Animais , Arildialquilfosfatase/sangue , Encéfalo/enzimologia , Hidrolases de Éster Carboxílico/metabolismo , Diafragma/enzimologia , Eritrócitos/enzimologia , Fezes/parasitologia , Masculino , Contagem de Ovos de Parasitas , Distribuição Aleatória , Ratos , Ratos Wistar , Infecções por Strongylida/sangueRESUMO
Reduced paraoxonase-1 (PON1) activity has been observed in a number of pathological conditions; however, little is known about the effects of intestinal nematode infections, such as Nippostrongylus brasiliensis, on paraoxonase activity. We observed a significant reduction in serum paraoxonase and arylesterase activity after N. brasiliensis infection in Wistar rats from Day 6 until Day 12 post-infection (p.i.) for serum paraoxonase and from Day 3 until Day 24 p.i. for arylesterase. In addition, N. brasiliensis infection increased serum concentrations of pro-inflammatory cytokines (interleukin-1, interleukin-6, and tumor necrosis factor-alpha), with maximum concentrations observed on Day 9 p.i. These cytokines are known to inhibit the synthesis of hepatic PON1 mRNA. Thus, the observed reduction in PON1 activity during N. brasiliensis infection is likely associated with inflammatory reactions mounted against the parasites.
Assuntos
Arildialquilfosfatase/sangue , Infecções por Strongylida/sangue , Animais , Hidrolases de Éster Carboxílico/sangue , Citocinas/sangue , Fezes/parasitologia , Feminino , Inflamação/sangue , Inflamação/parasitologia , Larva , Masculino , Nippostrongylus/crescimento & desenvolvimento , Oviposição , Ratos , Ratos WistarRESUMO
INTRODUCTION: 25 years ago was first reported in Cuba and in the western hemisphere an emergent disease: eosinophilic meningoencephalitis due to Angiostrongylus cantonensis larvae. AIM: To collect in a summary form the accumulated experience and the findings of the study of this parasitosis during the period in the Western hemisphere. DEVELOPMENT AND CONCLUSIONS: There have been collected the first evidences, the parasitological and malacological findings, the experimental and molecular studies on immunology and neuroimmunology, the clinic-pathological findings in children and adults with the particularities of this diseases in our environment with special emphasis in the never-before scientific findings reported. It has been documented the testimony, the main findings among the malacological studies, the role of the immunoglobulin E and the mechanism involved in the central nervous system, the intrathecal synthesis patterns of immunoglobulins and the clinical elements in children and adults.
Assuntos
Angiostrongylus cantonensis , Meningoencefalite/parasitologia , Infecções por Strongylida/epidemiologia , Adulto , Angiostrongylus cantonensis/isolamento & purificação , Angiostrongylus cantonensis/fisiologia , Animais , Anticorpos Anti-Helmínticos/imunologia , Sudeste Asiático/etnologia , Criança , Pré-Escolar , Cuba/epidemiologia , Vetores de Doenças , Emigrantes e Imigrantes , Eosinofilia/etiologia , Interações Hospedeiro-Parasita , Humanos , Imunoglobulina E/líquido cefalorraquidiano , Imunoglobulina E/imunologia , Imunoglobulina G/líquido cefalorraquidiano , Imunoglobulina G/imunologia , Lactente , América Latina/epidemiologia , Meningoencefalite/sangue , Meningoencefalite/epidemiologia , Meningoencefalite/imunologia , Meningoencefalite/patologia , Ratos/parasitologia , Caramujos/parasitologia , Infecções por Strongylida/sangue , Infecções por Strongylida/imunologia , Infecções por Strongylida/patologia , Infecções por Strongylida/transmissão , Estados Unidos/epidemiologiaRESUMO
INTRODUCTION: Angiostrongylus cantonensis meningoencephalitis is an emergent disease in the Americas. METHOD: Twelve children suffering from eosinophilic meningoencephalitis due to this parasite aged between 6-10 years were studied. Cerebrospinal fluid (CSF) and serum samples were taken simultaneously in the first diagnostic puncture at admission. RESULTS: All cases showed typical findings on the routine CSF and serum analysis: increased CSF total protein, increased Q (CSF/serum) albumin accompanied by eosinophilia in CSF. No intrathecal synthesis of immunoglobulins was found. Mean serum and CSF sICAM-1 values were 337.4 and 3.97 ng/mL. Qalbumin and QsICAM-1 mean values were 4.1 and 6.2 respectively. In 50% of the patients an increased brain-derived fraction of sICAM-1 was found. CONCLUSION: It may be suggested that a dynamic of the sICAM-1 brain derived fraction is perhaps associated to the immune response in the evolution of the disease.sICAM-1 may be an agent in negative feedback for eosinophils passage through the blood-CSF barrier into the inflammatory brain response.
Assuntos
Angiostrongylus cantonensis , Eosinofilia/parasitologia , Molécula 1 de Adesão Intercelular/sangue , Molécula 1 de Adesão Intercelular/líquido cefalorraquidiano , Meningoencefalite/parasitologia , Infecções por Strongylida , Animais , Biomarcadores/sangue , Biomarcadores/líquido cefalorraquidiano , Estudos de Casos e Controles , Criança , Ensaio de Imunoadsorção Enzimática , Eosinofilia/sangue , Eosinofilia/líquido cefalorraquidiano , Humanos , Meningoencefalite/sangue , Meningoencefalite/líquido cefalorraquidiano , Infecções por Strongylida/sangue , Infecções por Strongylida/líquido cefalorraquidiano , Infecções por Strongylida/parasitologiaRESUMO
INTRODUCTION: Angiostrongylus cantonensis meningoencephalitis is an emergent disease in the Americas. METHOD: Twelve children suffering from eosinophilic meningoencephalitis due to this parasite aged between 6-10 years were studied. Cerebrospinal fluid (CSF) and serum samples were taken simultaneously in the first diagnostic puncture at admission. RESULTS: All cases showed typical findings on the routine CSF and serum analysis: increased CSF total protein, increased Q (CSF/serum) albumin accompanied by eosinophilia in CSF. No intrathecal synthesis of immunoglobulins was found. Mean serum and CSF sICAM-1 values were 337.4 and 3.97 ng/mL. Qalbumin and QsICAM-1 mean values were 4.1 and 6.2 respectively. In 50 percent of the patients an increased brain-derived fraction of sICAM-1 was found. CONCLUSION: It may be suggested that a dynamic of the sICAM-1 brain derived fraction is perhaps associated to the immune response in the evolution of the disease.sICAM-1 may be an agent in negative feedback for eosinophils passage through the blood-CSF barrier into the inflammatory brain response.
INTRODUCCION: La meningoencefalitis por Angiostrongylus cantonensis es una enfermedad emergente en las Américas. MÉTODO: Doce niños con meningoencefalitis eosinofílica por Angiostrongylus cantonensis con edades entre 6 y 10 años fueron estudiados. Se tomaron muestras simultáneas de suero y líquido cefalorraquídeo (LCR) en la primera punción lumbar diagnóstica. RESULTADOS: Todos los casos evidenciaron hallazgos típicos en los análisis de rutina del LCR y suero: incremento de proteínas totales, aumento de la razón albúmina Q (LCR/suero) acompañado de eosinofilia en LCR. No se encontró síntesis intratecal de inmunoglobulinas. Los valores medios de sICAM-1 en suero y LCR fueron de 337,4 y 3,97 ng/mL respectivamente. Los valores medios de Q albúmina y Q sICAM-1 fueron de 4,1 y 6,2 respectivamente. En el 50 por ciento de los pacientes se encontró un incremento de la fracción de sICAM-1 derivado del cerebro. CONCLUSION: Se puede sugerir que la dinámica de la fracción sICAM-1 derivada del cerebro ocurre quizas asociada a la respuesta inmune frente a la enfermedad. sICAM-1 puede ser un agente de retroalimentación negativa para el paso de eosinófilos de la sangre a través de la barrera sangre-LCR en el cerebro inflamado.
Assuntos
Humanos , Animais , Criança , Angiostrongylus cantonensis , Eosinofilia/parasitologia , Molécula 1 de Adesão Intercelular/sangue , Molécula 1 de Adesão Intercelular/líquido cefalorraquidiano , Meningoencefalite/parasitologia , Infecções por Strongylida/parasitologia , Biomarcadores/sangue , Biomarcadores/líquido cefalorraquidiano , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Eosinofilia/sangue , Eosinofilia/líquido cefalorraquidiano , Meningoencefalite/sangue , Meningoencefalite/líquido cefalorraquidiano , Infecções por Strongylida/sangue , Infecções por Strongylida/líquido cefalorraquidianoRESUMO
The biochemical profiles of crossbred dogs experimentally infected with the parasite Angiostrongylus vasorum were studied. Two groups of five dogs were experimentally inoculated with 50 and 100 third stage infective larvae (L3) of A. vasorum per kilogram of body weight. A third group of five uninfected animals were used as control. Serum from these animals were used for biochemical tests to measure total and fractioned proteins, urea, creatinine and to determine the activities of aspartate (AST), alanine (ALT) aminotransferase, gamma-glutamyl transferase (GGT), alkaline phosphatase (PAL) and creatine kinase isoenzyme MB (CK-MB). The alpha-1, alpha-2 and beta-globulins fractions showed alterations during acute phase of the infection. No modifications were observed in the biochemical profiles of ALT, AST, GGT, PAL, urea and creatinine. CK-MB was shown to be a good early indicator of cardiac injury in dogs experimentally infected with A. vasorum.
Assuntos
Angiostrongylus/crescimento & desenvolvimento , Doenças do Cão/sangue , Doenças do Cão/parasitologia , Infecções por Strongylida/sangue , Infecções por Strongylida/veterinária , Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Animais , Aspartato Aminotransferases/sangue , Proteínas Sanguíneas/metabolismo , Creatina Quinase/sangue , Creatina Quinase Forma MB , Creatinina/sangue , Doenças do Cão/enzimologia , Cães , Globulinas/metabolismo , Isoenzimas/sangue , Infecções por Strongylida/enzimologia , Infecções por Strongylida/parasitologia , Ureia/sangue , gama-Glutamiltransferase/sangueRESUMO
Seven cross-bred dogs were inoculated with Angiostrongylus vasorum and serum samples were analyzed using the enzyme-linked immunosorbent assay (ELISA) and Western blot (WB). ELISA detected specific antibodies anti-A. vasorum, from 14 to 28 days after inoculation (DAI) and persisted throughout the experiment. Using WB, the main antigens detected had molecular weight of approximately 115, 102, 86, 76, 69, 56, 41, 32, 28, 20-22 and 10kDa.
Assuntos
Angiostrongylus/imunologia , Doenças do Cão/imunologia , Doenças do Cão/parasitologia , Infecções por Strongylida/veterinária , Angiostrongylus/crescimento & desenvolvimento , Animais , Anticorpos Anti-Helmínticos/sangue , Antígenos de Helmintos/sangue , Western Blotting/veterinária , Cães , Ensaio de Imunoadsorção Enzimática/veterinária , Feminino , Distribuição Aleatória , Infecções por Strongylida/sangue , Infecções por Strongylida/imunologia , Infecções por Strongylida/parasitologiaRESUMO
Hematological and coagulation profiles were studied in crossbred dogs experimentally infected with Angiostrongylus vasorum. Two groups of five dogs were experimentally inoculated with 50 and 100 third stage infective larvae (L(3)) of A. vasorum per kilogram of body weight. A third group of five uninfected animals was used as control. One sample of 10 ml of blood was collected from each animal on the 10, 20, 30, and 45 days after inoculation (dai) and at 30-day intervals thereafter for the remainder of the 210-day experimental period. The blood sample was used for the complete hemogram and platelet count, as well as measurements of prothrombin time, partial thromboplastin time and factors V and VIII. Anemia was observed in infected dogs, 6 weeks after the infection. The eosinophils presented peaks in four periods after infection. Thrombocytopenia became accentuated on the 72 dai. Decreased prothrombin time activity and increased partial thromboplastin time were observed at the 6 and 9 weeks after infection and decreased of factors VIII and V activities occurred from 4 to 6 weeks after infection. It may be conclude that infection by A. vasorum in dogs may cause a discrete anemia during the acute phase which is probably regenerative. In addition, important hemostatic alterations due to the infection suggest a chronic intravascular consumption coagulopathy.