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    30 October 2023, Volume 41 Issue 5
    INVITED REVIEWS
    Damage caused by chronic infection of Toxoplasma gondii on the host central nervous system and its mechanism
    XUE Yushan, LIN Ping, CHENG Xunjia, FENG Meng
    2023, 41(5):  527-531.  doi:10.12140/j.issn.1000-7423.2023.05.001
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    Toxoplasma gondii is an obligate intracellular parasite that widely distributes in the world and causes zoonotic toxoplasmosis. In recent years, parasite infection in the brain has been paid more and more attention. T. gondii can cause central nervous system damage, often manifested as depression, schizophrenia, epilepsy and other symptoms. In this paper, the process and mechanism of T. gondii establishing chronic infection through blood-brain barrier, causing central nervous system injury and disease are reviewed.

    ORIGINAL ARTICLES
    Immunoprotection of nuclei acid vaccine dual-targeting rhoptry protein 18 and surface antigen 30 of Toxoplasma gondii in mice
    JIANG Wenjing, MENG Yali, ZHAO Lina, WANG Chunmiao, ZHANG Xiaolei
    2023, 41(5):  532-538.  doi:10.12140/j.issn.1000-7423.2023.05.002
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    Objective To study the immunoprotective effect of a nucleic acid vaccine dual-targeting rhoptry protein 18 (ROP18) and surface antigen 30 (P30) of Toxoplasma gondii. Methods The p30 and rop18 genes of T. gondii were amplified by PCR to construct recombinant plasmids pVAX1-p30 and pVAX1-rop18-p30, which were verified by PCR, enzyme digestion, and sequencing. HeLa cells were transfected with pVAX1 plasmids (2 μg) and pVAX1-rop18-p30 plasmids using LipofectamineTM 3000 transfection reagents, and the expression of target protein was detected by indirect immunofluorescence assay after 24 hours. Seventy-five female BALB/c mice were randomly divided into five groups (pVAX1-rop18-p30 group, pVAX1-rop18 group, pVAX1-p30 group, pVAX1 group, and PBS group), with each group containing 15 mice. The plasmids [100 μg (100 μl)] and PBS (100 μl) were injected into the quadriceps femoris muscle, with a total of three injections at two-week intervals, and the last injection had a plasmid dosage of 200 μg. The levels of serum IgG were quantified by ELISA before each injection and two weeks after the final dose. The spleen cells were collected aseptically from three mice in each group two weeks after the last dose, and the levels of IFN-γ, IL-2, IL-4, IL-10, and IL-12 in the culture supernatant were measured by ELISA. Two weeks after the last immunization, 12 mice were selected from each group, and 1 000 tachyzoites of T. gondii RH strain were injected intraperitoneally into each mouse to induce acute infections. The survival time of the mice was recorded, and their immune protection was evaluated. Single-factor analysis of variance was used for inter-group comparison. Results PCR amplification fragments of p30 and rop18 genes with lengths of 789 bp and 1 665 bp. The pVAX1-rop18-p30 recombinant plasmids were successfully identified through PCR, enzyme digestion, and sequencing. HeLa cells transfected with pVAX1-rop18-p30 exhibited yellow-green fluorescence in the cytoplasm, while no such fluorescence was observed in cells transfected with pVAX1. ELISA results indicated that two weeks after the last immunization, the A450 value in the pVAX1-rop18-p30 group (0.788 ± 0.025) was significantly higher than that in the pVAX1-rop18 group (0.512 ± 0.027), pVAX1-p30 group (0.498 ± 0.027), pVAX1 group (0.122 ± 0.014), and PBS group (0.109 ± 0.011) (F = 77.6, P < 0.05). There was no statistically significant difference in A450 values between the pVAX1-rop18 group and the pVAX1-p30 group (F = 67.80, P > 0.05). The serum IgG levels increased with the frequency and duration of immunization. Two weeks after the final immunization, the levels of IFN-γ, IL-2, IL-4, IL-10, and IL-12 in the supernatant of splenocyte cultures were the highest in the pVAX1-rop18-p30 group [(678.77 ± 3.69), (375.28 ± 2.65), (130.82 ± 4.72), (279.68 ± 3.67), (579.68 ± 3.67) pg/ml], followed by the pVAX1-rop18 group [(448.59 ± 6.52), (256.34 ± 5.58), (126.28 ± 7.48), (156.58 ± 4.59), (231.50 ± 3.21) pg/ml] and pVAX1-p30 group [(423.67 ± 4.82), (277.92 ± 4.23), (115.17 ± 4.37), (137.18 ± 5.62), (190.47 ± 4.18) pg/ml], while the pVAX1 group [(48.97 ± 2.65), (47.65 ± 2.76), (47.14 ± 2.04), (45.29 ± 2.31), (46.21 ± 2.17) pg/ml] and PBS group [(47.69 ± 3.42), (46.77 ± 3.35), (48.59 ± 4.75), (44.92 ± 4.91), (46.88 ± 3.56) pg/ml] showed significantly lower levels (F = 1 582.0, 531.5, 268.7, 215.0, 170.5; all P < 0.05). The levels of IFN-γ, IL-10, IL-12 were elevated in the pVAX1-rop18-p30 group compared with the pVAX1-rop18 group and the pVAX1-p30 group (F = 1 620.8, 1 208.0, 728.0; all P < 0.05), the levels of IL-2 and IL-4 didn’t show significant changes between the pVAX1-rop18-p30 group, the pVAX1-rop18 group and the pVAX1-p30 group (F = 53.21, P > 0.05). After acute infection, the mice mean survival time in the pVAX1-rop18-p30 group, the pVAX1-rop18 group, the pVAX1-p30 group, the pVAX1 group and the PBS group were (288 ± 2), (196 ± 3), (230 ± 6), (144 ± 2), (146 ± 11) h, the mean survival time of mice in the pVAX1-rop18-p30 group was significantly longer than that in the pVAX1 group and PBS group (F = 100.1, P < 0.05), as well as the pVAX1-rop18 and pVAX1-p30 groups (F = 38.7, P < 0.05). Conclusion The pVAX1-rop18-p30 dual-targeting nucleic acid vaccine could induce cellular and humoral immunity in mice; its immunprotectiv effect against T. gondii infection is better than that of the vaccine mono-targeting either pVAX1-rop18 or pVAX1-p30.

    Specie-specific analysis of plasmodia infecting rats and mice
    GUO Shuai, HE Biao, GAO Yuanli, FAN Yongling, ZHU Feng, DING Yan, LIU Taiping, XU Wenyue
    2023, 41(5):  539-545.  doi:10.12140/j.issn.1000-7423.2023.05.003
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    Objective To analyze the infection specie-specificity of Plasmodium yoelii (P.y) BY265 strain and P. berghei (P.b) ANKA-luciferase strain in rats and mice. Methods The sporozoites and merozoites of P.y and P.b were prepared. Infection was performed by injecting 1 × 105 P.y and P.b sporozoites to SD rats and BALB/c mice (P.y infection, 5 SD rats/group, 5 BALB/c mice/group) and SD rats, C57BL/6J mice (P.b infection, 5 SD rats/group, 5 C57BL/6J mice/group) through tail vein, respectively. The tail vein blood samples were collected daily to prepare blood mears for microscopic examination to record the appearance time of erythrosytic stage of Plasmodium. Liver tissue samples were collected at 42 h post‑infection from the SD rats and BALB/c mice of P.y infection group to examine the relative expression level of Plasmodium 18S rRNA by real‑time quantitative PCR (qRT‑PCR), and measure the liver fluorescence signal in SD rats and C57BL/6J mice in P.b infection groups using IVIS Lumina imaging system. A dose of 1 × 108, 1 × 107, 1 × 106 infected red blood cells (iRBCs) of P.y and P.b was used to infect SD rats (P.y infection group and P.b infection group) and susceptible mice (BALB/c and C57BL/6J) (positive control group), the tail vein blood was collected daily for smear to exam the parasitemia. The SD rats and susceptible mice were infected with P.y and P.b merozoites, respectively. The tail vein blood was collected daily for microscopic examination to calculate the parasitemia. When the parasitemia in rats and mice reached its peak, the tail vein blood smears were prepared every 8 hours for 24 hours for microscopic examination, and the proportions of rings, trophozoites, and schizonts were calculated to analyze the developmental rhythm of the rodent Plasmodium. The experimental cerebral malaria (ECM) in rats and mice were recorded. Rag2-KO SD rats, wild‑type SD rats, and susceptible mice were infected with P.y and P.b merozoites respectively, the tail vein blood smears were examined daily to calculate parasitemia. The comparison between the two groups was performed by unpaired t‑test, and the comparison between different groups of parasitemia performed by two‑way analysis of variance (two‑way ANOVA). Results All Plasmodium in the SD rats, BALB/c mice and C57BL/6J mice infected with P.y and P.b sporozoites completed the liver stage development and entered the erythrocytic stage on day 3. The qRT-PCR results showed that the relative expression levels of Plasmodium-specific 18S rRNA in SD rats and BALB/c mice infected with P.y sporozoites were (1.63 ± 0.381) and (1.00 ± 0.232) with statistically significant difference (t = 2.801, P < 0.05). The results of IVIS imaging showed that the total fluorescence intensity of SD rats infected with P.b sporozoites was (6.243 ± 1.425) × 107, which was significantly higher than that of C57BL/6J mice [(1.624 ± 0.530) × 107] (t = 6.077, P < 0.01). The results of erythrocyte stage iRBCs infection showed that in P.y infected groups, the peaks of parasitemia of SD rats infected with three doses were (3.500 ± 1.042)%, (2.850 ± 0.627)%, (3.400 ± 0.962)%, there was no significant difference in the trends of parasitemia among them (F = 0.145, P > 0.05), but there were significant differences in the trends of parasitemia between each group of rats and the positive control [the peak of parasitemia was (43.928 ± 9.448) %)](F = 84.040, 63.760, 58.400; all P < 0.01). In P.b infected groups, the peaks of parasitemia of SD rats were (11.468 ± 1.362)%, (7.398 ± 2.387)%, (2.984 ± 1.881)% which decreased along with infection dose decent, and the trends of parasitemia in the 1 × 108 and 1 × 106 dose infected rat groups was significantly different from that in the positive control (F = 13.83, 17.320; all P < 0.01), while the difference in trends of parasitemia between 1 × 108 dose infected rat group and the positive control group was not significant (F = 2.234, P > 0.05). The results of merozoite infection showed that 6 days after infection, the parasitemia of SD rats and BALB/c mice in P.y infected groups were (0.902 ± 0.235)% and (17.420 ± 4.105)% respectively, which were significant different (t = 9.943, P < 0.01). The parasitemia of SD rats and C57BL/6J mice in P.b infected groups were (6.804 ± 2.978)%, (9.290 ± 1.055)% respectively, and there was no significant difference between the two groups (t = 1.759, P > 0.05). The cumulative incidences of ECM in SD rats and C57BL/6J mice in P.b infected groups were 11/15 and 13/15 respectively, with no statistically significant difference (t = 1.414, P > 0.05). The developmental rhythm analysis results showed that the developmental rhythm of SD rats was different from that of BALB/c mice, and did not exhibit a 24-hour pattern in P.y infected groups. While in P.b infected groups, the developmental rhythm of SD rats was similar to that of C57BL/6J mice, with a 24-hour rhythm. 18 days post-infection with P.y merozoites, the parasitemia in Rag2-KO SD rats, WT SD rats, and BALB/c mice with were (1.326 ± 0.908)%, 0, and (33.937 ± 3.453)% respectively, there was a significant difference of parasitemia between Rag2-KO SD rats and WT SD rats (t = 2.267, P < 0.05). Seventeen days post-infection with P.b merozoites, the parasitemia in Rag2-KO SD rats and WT SD rats were (19.685 ± 15.752)%, (0.007 ± 0.013)% (t = 2.499, P < 0.05), and parasitemia of the remaining one C57BL/6J mouse in the positive control group was 25.410%. Conclusion Sporozoites of P.y and P.b can infect rats, complete their liver stage development and enter the erythrocytic stage. The influencing factor leading to the rats resistant to P.y and P.b infection occurs at the erythrocytic stage, when the rodent Plasmodium in the rats could be cleared. P.y exhibits stronger selectivity for host species. There were no significant differences between rats and mice in P.b parasitemia at acute pahase and the occurring rate of ECM. Adaptive immunity plays an important role in complete clearance of rodent plasmodium in rats.

    Immunogenicity of Schistosoma japonicum Sj26gst mRNA vaccine candidate
    TAN Xiao, ZHU Qi, LIU Zhongqi, LI Jia, PENG Dingjin
    2023, 41(5):  546-551.  doi:10.12140/j.issn.1000-7423.2023.05.004
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    Objective To evaluate glutathione S-transferase subunit of relative molecular mass (Mr) 26 000 (Sj26gst) mRNA of Schistosoma japonicum and assess its immunogenicity. Methods The Sj26gst coding sequence was optimized by the commonly used human codons according to the Sj26gst coding region sequence (NC_002544.1). The gene was synthesized by adding the 3' and 5' non-coding regions (UTR) of beta-globulin at both ends, and then connected to pcDNA3.1(+) to construct the linear pcDNA3.1/Sj26gst plasmid which was used for transient transcription of Sj26gst mRNA in vitro. The Sj26gst mRNA was transfected into HeLa cells by using liposomes. The HeLa cells were collected to detect the relative expression level of Sj26gst mRNA by quantitative immunofluorescence PCR (qRT-PCR) and examine the expression level of Sj26GST protein by Western blotting at 2, 6, 12, 24, 48 hours after the transfection. Female BALB/c mice were randomly divided into four groups: Sj26gst-mRNA group, pcDNA3.1/Sj26gst group, pcDNA3.1 group and PBS group (6 mice in each group). Mice were immunized three times at two-week interval with 100 μg of Sj26gst mRNA, pcDNA3.1/Sj26gst plasmid, pcDNA3.1 plasmid, or PBS (100 μl), respectively. Blood samples were collected from the tail vein before immunization (0 week) and at 2, 4, 6 and 8 weeks after the first immunization for serum preparation which was used to detect SJ26GST specific IgG antibody levels by ELISA. At 8 weeks post-immunization, the mice spleen tissue was collected aseptically to prepare spleen lymphocyte suspension, which was cultured at 37 ℃ for 48 h, subsequently, 10 μl CCK8 reagent (cell counting kit-8) was added for culturing additional 4 h to determine the spleen cell stimulation index. The levels of cytokines Th1 (TNF-α, INF-γ), Th2 (IL-10, IL-4) and Th17 (IL-17) in the lymphocyte supernatant were assayed by ELISA. One-way analysis of variance was used for inter-group comparisons. Results The optimized coding sequence was 858 bp in length, the GC content was 63.2%, and the free energy change of the secondary structure was -485.6 kcal/mol. The in vitro transcribed Sj26gst mRNA band was a single and non-dispersive band. The RT-PCR results showed that the relative expression level of Sj26gst mRNA in HeLa cells is (6.21 ± 0.83) at 2 h after Sj26gst mRNA transfection, and its peak level was (14.26 ± 1.23) at 6 h, followed by a decrease. The western blotting results showed that Sj26GST protein bands of Mr 26 000 were detected at 6, 12, 24 and 48 hours after Sj26gst mRNA transfection. The ELISA results showed that the A450 value of Sj26gst mRNA group, pcDNA3.1/Sj26gst group, pcDNA3.1 group and PBS group were 0.85 ± 0.16, 0.42 ± 0.21, 0.14 ± 0.03 and 0.11 ± 0.02, at eight weeks after the first immunization, respectively. There were statistically significant differences between Sj26gst mRNA group and pcDNA3.1/Sj26gst group, pcDNA3.1/Sj26gst group and pcDNA3.1/Sj26gst group (t = 16.46, 12.35; all P < 0.05). The ELISA results showed that the TNF-α, INF-γ, IL-10, and IL-17 expression levels in the supernatants of splenocytes from Sj26gst mRNA-immunized mice were (756.23 ± 134.35), (598.46 ± 50.47), (713.42 ± 118.25), and (301.45 ± 48.23) pg/ml, respectively. In the PcDNA3.1/Sj26gst group, the corresponding levels were (587.26 ± 32.48), (401.45 ± 46.25), (386.27 ± 23.75) and (175.24 ± 41.23) pg/ml. These levels were higher than those in the pcDNA3.1 group [(19.34 ± 2.01), (35.14 ± 5.25), (32.11 ± 15.20), (19.75 ± 7.21) pg/ml] and the PBS group [(18.75 ± 1.98), (34.12 ± 4.78), (29.36 ± 8.72), (15.34 ± 2.51) pg/ml] (t = 54.59, 19.57, 52.36, 26.47; all P < 0.05). Conclusion The Sj26gst mRNA plasmid with stable expression of Sj26GST was constructed. The Sj26gst mRNA could induce high level of specific antibodies against Sj26GST and stimulate Th1 cellular immune response.

    Identification of gender associated m6A modified circRNA in Schistosoma japonicum
    LIU Huaman, Bikash Giri, FANG Chuantao, ZHENG Yameng, WU Huixin, ZENG Minhao, LI Shan, CHENG Guofeng
    2023, 41(5):  552-558.  doi:10.12140/j.issn.1000-7423.2023.05.005
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    Objective To explore the N6 adenylate methylation (m6A) modification of circular RNA (circRNA) in male and female adult worms of Schistosoma japonicum, and predict its possible role in regulating miRNA. Methods S. japonicum cercariae (100 ± 2) were used to infect mice through abdominal skin for 20 min. On 28 d post-infection, the mice were anesthetized to collect adult worms using hepatic portal vein perfusion method, of which the female and male worms were separated for extracting total RNA, respectively. The RNA samples of 0.5 μg and 1.0 μg were applied by dotting on the nylon membrane, which was transferred to a UV-crosslinker for dot hybridization through successive incubation with m6A antibody (1∶1 000) and HRP labeled secondary antibody (1∶5 000). Immunoprecipitation separation was performed for 1 µg of total RNA from both female and male worms using RNA methylation co-precipitation kit. The RNA library kit was used for library construction. After quality testing with a biological analyzer, sequencing was performed using a 150 bp double-ended mode on a high-throughput sequencer. The Cutadapt software (v1.9.3) was applied to remove joints and low-quality sequences and obtain high-quality sequences. The sequence was aligned with the Schistosoma genome (Sja_WBPS14) using Bowtie2 software, and the Find_circ software was used to identify circRNA, while MACS software was used to recognize methylation sites. Cluster analysis of differentially expressed circRNAs was conducted using Heatmap2 software, and gene ontology (GO) enrichment analysis was performed for the source genes of statistically significant differentiated m6A modified circRNA. DiffReps software was used to analyze the differences in m6A modified circRNA between male and female worms. Using RNAhybrid software, the interaction between miRNA and circRNA was predicted. The reverse-transcribed miRNA was analyzed by qPCR, and all the relative expression level of miRNA was calculated with 2Ct method. Results The dot blot hybridization results showed that there was m6A methylation modification in the total RNA of S. japonicum, and the m6A methylation signal tended to increase with the increase of RNA content. The high-throughput sequencing results showed that the proportion of high-quality sequences in S. japonicum was over 99.9%, and the RNA enrichment and library construction were effective. CircRNAs originating from overlapping regions account for 49%, followed by exons (29%) and intergenes (12%), with fewer circRNAs originating from introns (2%) and antisense chains (8%). Genes derived from highly enriched circRNAs in males may be related to cellular metabolic processes, cellular components, tissue biogenesis, and stress, while genes derived from highly enriched circRNAs in females may be involved in processes such as cell molecule binding. The number of m6A-modified circRNAs enriched in males was higher than that in females (P < 0.05, fold change ≥ 2) with 57 high abundance m6A-modified circRNAs in females and 81 in males. M6A-modified circRNAs in both male and female insects can potentially interact with multiple miRNAs, such as Sja-Bantam and Sja-miR-307, which are highly expressed in females, and Sja-miR-8-3p, Sja-miR-3504 and so on, which are highly expressed in males. Conclusion This study obtained the expression profile of m6A modified circRNA in adult worms of S. japonicum, and preliminarily revealed the miRNA that may be regulated by m6A modified circRNA.

    Echinococcus granulosus infection induces macrophages to express CD73 and A2AR to suppress inflammatory response
    LU Junxia, XU Junying, ZHAO Bin, WANG Qianwen, LI Wenhua, GENG Yuqing, HOU Jun, WU Xiangwei, CHEN Xueling
    2023, 41(5):  559-566.  doi:10.12140/j.issn.1000-7423.2023.05.006
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    Objective To investigate the role and mechanisms of CD73/adenosine/adenosine A2A receptor (A2AR) pathway in suppression of macrophage inflammatory response of Echinococcus granulosus. Methods Healthy C57BL/6 mice were intraperitoneally injected with aseptic starch broth (0.5 ml per mouse). Ascitic fluid was extracted from the mice on 3 d post-injection to separate macrophages, which were inoculated into a 6-well plate at a dose of 1 × 106/ml. After the cells were attached to the plate wall, E. granulosus cyst fluid was added at a final concentration of 0.8 mg/ml, and then cultured for 0 h, 6 h, 12 h, 18 h and 24 h to examine the relative transcriptional levels of CD73, A2AR, tumor necrosis factor-α (TNF-α) and arginase 1 (Arg-1) by qRT-PCR. The expression of CD73 was detected by flow cytometry, and the expression of extracellular signal-regulated kinase 1 (ERK1/2) and phosphorylated ERK1/2 (p-ERK1/2) was detected by Western blotting. The separated macrophages were inoculated onto a 6-well plate with 1 × 106 cells per well, and assigned to three groups: cyst fluid group, drug administration group and control group. Each group had 3 wells, to which E. granulosus cyst fluid (final concentration 0.8 mg/ml), E. granulosus cyst fluid (final concentration 0.8 mg/ml) and drugs (adenosine receptor inhibitor SCH58261, final concentration 50 μmol/L) and the same amount of medium was added, respectively. After 24 hours of culture, the relative transcription levels of TNF-α and Arg-1 were detected by qRT-PCR. The expression of ERK1/2 and p-ERK1/2 was detected by Western blotting. Thirty-six healthy C57BL/6 female mice aged 6-8 weeks were selected. 5 000 protoscolex of E. granulosus (20 μl per mouse) were injected under the liver capsule in the infection group, and the healthy group were not treated. One month later, the livers of 6 mice in each group were selected and embedded in paraffin to prepare slices. HE staining was used to observe liver tissue lesions, and the expression of A2AR was detected by immunohistochemical staining. The expression of CD73 in the proximal and distal vesicles was detected by flow cytometry. Infected mice were taken, and 1 mg/(kg•d) adenosine receptor inhibitor (SCH58261) and an equivalent amount of PBS were intraperitoneally injected into the treatment group (8 mice) and solvent group (8 mice), respectively. Healthy mice (8 mice) were not treated. After 22 days, the mice’s weight, liver, spleen, kidney and heart were weighed, and the ratio of each organ to body weight was calculated. After the mouse liver was embedded in paraffin, the sections were prepared, and the infiltration of inflammatory cells around the vesicles was observed by HE staining. Results The relative transcription level of CD73 mRNA in 18 h group (1.66 ± 0.17) and 24 h group (2.01 ± 0.15) was higher than that in 0 h group (1.00 ± 0.09) after 0 h, 6 h, 12 h, 18 h and 24 h treatment of macrophages with E. granulosus cyst solution (t = 3.35, P < 0.05; t = 5.83, P < 0.01). Flow cytometry showed that the percentage of CD73+ macrophages in 18 h group was (2.74 ± 0.43)%, which was higher than that in 0 h group (1.53 ± 0.10)% (t = 4.72, P < 0.01). The relative transcription levels of A2AR mRNA were 0.29 ± 0.03, 1.00 ± 0.14, 1.02 ± 0.02, 0.72 ± 0.08, 1.03 ± 0.03, respectively. All groups at 6 h, 12 h, 18 h and 24 h were higher than those in 0 h group (t = 4.84, 17.55, 5.21, 15.26; all P < 0.01). The western blotting results showed that the relative expression levels of A2AR protein in each group were 1.00 ± 0.00, 1.22 ± 0.05, 1.32 ± 0.02, 1.40 ± 0.05, and 1.46 ± 0.04, respectively. The relative expression levels of other groups were higher (t = 5.89, 18.35, 9.14, 15.06; all P < 0.01). Western blotting showed that the relative expression levels of A2AR protein in 6, 12, 18 and 24 h groups were 1.22 ± 0.05, 1.32 ± 0.02, 1.40 ± 0.05, and 1.46 ± 0.04,0.04, respectively. All of them were higher than those in the 0 h group (1.00 ± 0.00) (t = 5.89, 18.35, 9.14, 15.06; all P < 0.01). The relative transcription levels of TNF-α mRNA in the 6, 12 and 18 h groups were 1.00 ± 0.04, 0.31 ± 0.03, 0.12 ± 0.01, 0.05 ± 0.01, respectively, which were higher than those in the 0 h group (0.01 ± 0.00) (t = 22.37, 11.33, 11.48; all P < 0.01). The relative transcription level of Arg-1 mRNA in 18 h group (0.69 ± 0.09) and 24 h group (2.10 ± 0.07) was higher than that in 0 h group (0.004 ± 0.00) (t = 7.61, 28.64; both P < 0.01). Western blotting results showed that the relative expression of p-ERK1/2 protein in the 6 h group (3.07 ± 0.71), 12 h group (1.68 ± 0.18) and 18 h group (1.43 ± 0.14) was higher than that in the 0 h group (1.00 ± 0.00) (t = 4.15, 5.40, 4.50; all P < 0.05). The 6 h group was higher than the 18 h and 24 h groups (0.97 ± 0.34) (t = 3.23, 3.80; both P < 0.05). The relative transcription levels of TNF-α mRNA were 0.85 ± 0.05 and 1.56 ± 0.13 in the capsule fluid group and administration group, respectively, and the difference was statistically significant (t = 5.13, P < 0.01). The relative transcription level of Arg-1 mRNA in the capsule fluid group was 147.73 ± 10.06, which was higher than that in the drug administration group (13.94 ± 1.00) (t = 13.23, P < 0.01) and control group (59.59 ± 9.82) (t = 6.27, P < 0.01). The relative transcription level in the administration group was lower than that in the control group, and the difference was statistically significant (t = 4.62, P < 0.01). Western blotting results showed that the relative protein expression of P-ERK1/2 in the administration group (2.08 ± 0.38) was higher than that in the capsule fluid group (0.94 ± 0.29) and control group (1.00 ± 0.00) (t = 3.42, 4.04; both P < 0.05). The HE staining showed that inflammatory cell infiltration zones appeared in the liver tissue of infected mice. The immunohistochemical staining results showed that A2AR was positive in the infection group. The results of flow cytometry showed that the percentage of macrophages with CD73+ in the proximal vesicle was (12.31 ± 0.04)%, which was higher than that at the distal vesicle (5.95 ± 2.36)% (t = 3.81, P < 0.05). After administration, the ratio of weight of liver, spleen, kidney and heart to body mass in the healthy group, solvent group and administration group was 6.13 ± 0.66, 5.90 ± 0.48, 5.47 ± 0.87, 0.44 ± 0.18, 0.41 ± 0.29, 0.33 ± 0.10. There was no significant difference between 0.68 ± 0.03, 0.64 ± 0.05, 0.60 ± 0.09, 0.99 ± 0.15, 0.77 ± 0.13, 0.78 ± 0.19 (F = 0.95, 0.42, 1.46, 2.02; all P > 0.05). HE staining showed that perivascular inflammatory cells increased in the drug administration group compared with the solvent group. Conclusion E. granulosus evades host immunity by inducing macrophages to express CD73 and A2AR and thereby promoting the secretion of its inflammatory inhibitory factors.

    Molecular epidemiological investigation of Babesia infection in ticks parasitized on domestic animals in Xinyang, Henan Province
    JI Penghui, JIANG Tiantian, HE Zhiquan, WANG Dan, YUE Sining, LI Suhua, YANG Chengyun, WANG Hao, ZHANG Hongwei, ZHOU Ruimin
    2023, 41(5):  567-572.  doi:10.12140/j.issn.1000-7423.2023.05.007
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    Objective To understand the infection of Babesia in ticks parasitized on domestic animals in Xinyang, Henan Province. Methods Tick specimens were collected from domestic animals in Guangshan County and Shangcheng County, Xinyang City, Henan Province, from June to August 2022. The tick species were identified by morphology and 16S rDNA. Genomic DNA was extracted from tick specimens, and nested-PCR was performed to amplify 18S rRNA gene sequence of Babesia. The PCR products were sequenced and aligned by BLAST, and phylogenetic trees were constructed by the neighbor-joining method. Using MEGA7.0 software for homology analysis. Results A total of 335 ticks were collected, including the species of 49 Haemaphysalis longicornis, 208 Rhipicephalus microplus, 1 H. flava, 34 R. annulatus, and 43 H. punctataa, identified by morphology and PCR amplification. The PCR amplification results showed that 2 out of 335 tick samples were amplified target bands of 400 bp, and the overall positive rate was 0.6%. The BLAST comparison analysis results showed that the 18S rRNA sequence amplified from one sample had a 99.26% similarity with the sequences of B. microti from the United States (MK609547), Thailand (MG199181), and China (KU204794) in GenBank. The 18S rRNA sequence amplified from another sample shares 100% similarity with the sequences of B. gibsoni from the United States (MH620203), India (MN161136), and China (KP666166) in GenBank. The phylogenetic tree analysis revealed that the B. microti positive sample was clustered on the same branch with B. microti from Russia (KX987864), China (KU204794) and Thailand (MG199179), showing a high homology. The B. gibsoni-positive samples were clustered on the same branch with B. gibsoni from China (FJ769386), USA (MH620203) and India (KF606884), showing a close relation. Conclusion The infections of B. microti and B. gibsoni were detected in ticks parasitized on domestic animals in Xinyang area of Henan Province, which may render risk of disease transmission to humans and domestic animals.

    Epidemiological investigation and case retrospective analysis of echinococcosis in Dali Prefecture, Yunnan Province
    LI Benfu, YANG Jing, YANG Jinyu, LUO Ruijuan, ZHU Binlin, CHEN Tailin, ZHANG Lijuan, LI Xueyao, YAN Xinliu, ZI Jinrong, PENG Jia, WANG Zhengqing, LI Jianxiong, CAI Xuan, XU Qian, WU Fangwei, YANG Yaming
    2023, 41(5):  573-578.  doi:10.12140/j.issn.1000-7423.2023.05.008
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    Objective To understand the endemic status of echinococcosis in Dali Bai Autonomous Prefecture, Yunnan Province (hereafter Dali) to provide reference basis for prevention and control of the disease in the province. Methods According to the Technical Scheme for Hydatid Disease Control in Yunnan Province, a retrospective survey was performed on all retraceable echinococcosis cases recorded in Dali Prefecture First people’s Hospital, the First Affiliated Hospital of Dali University, Dali City First People’s Hospital, The first People’s Hospitals and Centers for Disease Control and Prevention of counties Eryuan, Jianchuan, Heqing, Binchuang, Yangbi and Yunlong, as well as in the National Infectious Disease Reporting Information Management System from 2016 to 2022. In addition, sampling survey was conducted in 2016—2022. Using cluster random sampling method, 6 counties (Er Yuan, Jian Chuan, He Qing, Bin Chuan, Yang Bi and Yun Long) were selected, from each of which 3 townships were seleted annually, and then no less than 3 villages were selected from each township. From the selected villages, no less than 500 permanent residents at the age over 3 years were examined by abdominal ultrasonography. Hydatid disease was diagnosed based on ultrasonic imaging combined with epidemiological history and clinical manifestation. Serological tests were performed for those suspected cases. A questionnaire was carried out in enrolled participants with age over 6 year old for the awareness of infection and prevention of hydatid disease. A dog was selected from each household in each village to detect the coproantigen of Echinococccus by ELISA. In each county (city), visceral organs were collected from locally raised sheep, pigs and cattle for examining hydatid cysts by necropsy. All data were statistically analyzed using SPSS 17.0 software. Results A total of 161 cases were found in 12 counties through retrospective investigation. Among them, the number of cases found in hospitals accounted for 50.01% (95/161), and the number of cases found in surveys accounted for (40.99%, 66/161). The confirmed cases accounted for (78.89%, 127/161), the clinical cases accounted for (21.12%, 34/161). The accounted for cystic echinococcosis in males and females were 40.37% (65/161) and 59.63% (96/161), without statistically significant difference between gender (χ2 = 3.851,P < 0.05). The accounted for increased with age (χ2 = 188.520, P < 0.05), the group of 40-49 years old (22.36%, 36/161) was highest other group, with a statistically significant difference between age groups (χ2 = 188.520,P < 0.05). Most echinococcosis cases were found in farmers (87.58%, 141/161) and students (6.83%, 11/161). The ethnic groups with cases are mainly Bai (63.35%, 102/161) and Han (22.36%, 36/161). There are statistically significant differences among professions and ethnic groups (χ2 = 286.898, 101.030; both P < 0.05). A total of 543 villages were investigated in 6 counties from 2016 to 2022. A total of 265 983 residents were examined by ultrasound, of whom 66 (24.81/100 000) were detected with hydatid disease, all infected with Echinococcus granulosus. Eryuan County has the highest prevalence rate (39.03/100 000, 23/51 248), and Yunlong County has the lowest prevalence rate (5.23/100 000, 2/38 243). The detection rate of echinococcosis in the population was the highest in 2017 (149.03/100 000), and the lowest in 2021 (11.41/100 000), showing a downward trend since 2017. The overall dog coproantigen positive rate was 1.48% (218/14 766), with the highest positive rate (2.40%, 44/1 837) in Yunlong County, and the lowest positive rate (0.73%, 18/2 470) in Binchuan County. The overall hydatid detection rate in livestock (sheep, cattle and pigs) was 0.09% (16/18 416), and the infection rates of Echinococcus in livestock in Eryuan County and Yangbi County were 0.45% (15/3 349) and 0.03% (1/3 202), respectively. No infected livestock were found in other counties, with 0.06% (3/5 369) in 2017, 0.15% (7/4 771) in 2018 and 0.22% (6/2 769), respectively. The infection rates of cattle and pigs were 0.02% (1/4 715) and 0.13% (15/11 427), respectively, and no infection was found in sheep. The overall awareness rate for echinococcosis among the investigated population was 72.71% (4 494/6 181), The awareness rate of Yunlong County, Yangbi County, Heqing County, Jianchuan County, Eryuan County and Binchuan County was 88.76% (1 137/1 281), 79.31% (594/749), 77.66% (918/1 182), 74.49% (800/1 074), 64.10% (759/1 184) and 40.23% (286/711), respectively (χ2 = 109.991, P < 0.05). Conclusion Echinococcosis in Dali showed a moderate prevalence. It is imperative to strengthen health education for key population including women, aged 40-49 group, farmers, and the Bai ethnic group.

    The epidemiological characteristics of visceral leishmaniasis in Longnan City from 2005 to 2021
    WANG Xiaojun, CAI Yucheng, ZOU Xuan, LI Hui, TONG Bobo
    2023, 41(5):  579-585.  doi:10.12140/j.issn.1000-7423.2023.05.009
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    Objective To analyze the epidemiological characteristics of visceral leishmaniasis cases in Longnan City, Gansu Province from 2005 to 2021, to provide scientific basis for formulating prevention and control strategy for visceral leishmaniasis. Methods The information on the visceral leishmaniasis cases residing at the current address in Longnan City, reported by the National Infectious Disease Surveillance Reporting and Management System from 2005 to 2021, was collected. A database was established using Microsoft Excel 2013. Three-dimentional distribution characteristics of visceral leishmaniasis cases were analyzed with descriptive epidemiological method. The distribution map of reported cases was plotted by Arc GIS 10.2. Statistical analysis was performed using SPSS 25.0 software. Results From 2005 to 2021, a total of 1 109 cases of visceral leishmaniasis were reported in Longnan City,among them, 577 cases were of clinical diagnosis, and 532 confirmed cases. The annual average incidence rate was reported at 2.49/100 000, showing a low prevalence status. The incidence rate reached 2.76/100 000 in 2005, rose to 4.53/100 000 in 2009, and gradually dropped to 0.46/100 000 in 2021, indicating a trend of first increase and then decrease (χ2 = 267.561, P < 0.01). The visceral leishmaniasis cases were mainly distributed in Wudu District (606 cases), Wenxian County (323 cases) and Tanchang County (148 cases), accounting for 97.11% of reported cases (1 077/1 109). In some villages/towns of endemic counties, a cluster of high incidence was found. There were 633 male cases and 476 female cases, and the sex ratio was 1.33∶1; the incidence rates in males and females were 2.73/100 000 and 2.23/100 000, respectively (χ2 = 2.699, P > 0.05). The number of reported cases in the 0-4 age group accounted for 50.50% (560/1 109) of the total number of reported cases, with the highest incidence rate of 19.62/100 000. The second is the 5-9 age group, with the number of reported cases accounting for 12.80% (142/1 109) of the total number of reported cases, and the incidence rate is 4.84/100 000. It indicated that the incidence rate tends to decrease with age (χ2 = 14.942, P < 0.01). The first incidence rate was occupied in children of scattered living, accounting for 41.12% (456/1 109), and the second in peasants, accounting for 24.71% (274/1 109). Conclusion In Longnan City of Gansu Province, visceral leishmaniasis remains at a low prevalent status. The reported cases are mainly of children. There is a recurgence trend in historically endemic counties.

    Epidemiological characteristics of malaria in Jiangxi Province from 2015 to 2022
    GONG Yanfeng, LI Zifen, TANG Guai, HUANG Meiqin, ZHOU Binghua, HU Qiang
    2023, 41(5):  586-592.  doi:10.12140/j.issn.1000-7423.2023.05.010
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    Objective To analyze the epidemiological characteristics of malaria in Jiangxi Province from 2015 to 2022, to provide scientific basis for formulating prevention and control strategy. Methods Malaria cases and statistical data were collected from the National Infectious Diseases Reporting and Information Management System and the National Information Management System for Parasitic Diseases Control and Prevention, for those cases locally reported and confirmed during January 1st, 2015 to December 31th, 2022 in Jiangxi Province. The collected malaria cases were classified as confirmed cases (microscopic examination and/or PCR test positives confirmed by provincial reference laboratory for malaria diagnosis), clinically diagnosed cases (blood examination positive found by medical institutions, but microscopic examination and PCR test by provincial reference laboratory were negative), and severe case (with complications). Statistical analysis was performed by LSD-t and mann-whitney Test using SPSS 26.0 software. Results From 2015 to 2022, a total of 241 malaria cases were reported in Jiangxi Province, all of which were imported malaria and no deaths were reported. The reported cases in each year were 53, 52, 30, 41, 46, 12, 3, and 4, respectively. Among them, there were 240 confirmed cases and 1 clinically diagnosed case (reported in 2015). Among the confirmed cases, there were 153 cases of falciparum malaria (63.75%), 50 cases of vivax malaria (20.83%), 31 cases of ovale malaria (12.91%), 5 cases of malariae malaria (2.08%), and 1 case of mixed infection of falciparum malaria and vivax malaria (0.41%). The sources of infection are distributed in 34 countries including Africa, Asia, and Oceania, with Africa (a total of 27 countries) accounting for 92.53% (223/241). There are case reports in each month, with a cumulative increase in cases in January, June, and September, and a decrease in cases in October, November, and December. From 2015 to 2019 (before the COVID-19 epidemic) and from 2020 to 2022 (during the COVID-19), the monthly average number of reported cases was 3.7 and 0.53 respectively (t = 6.369, P < 0.05). All 11 prefectures in Jiangxi Province have reported cases, with the top 3 prefectures reporting cases being Nanchang City (51.45%, 124/241), Ganzhou City (15.77%, 38/241), and Yichun City (7.05%, 17/241); The top three counties (cities, districts) reporting cases are Qingshanhu District of Nanchang City (33.19%, 80/241), Donghu District of Nanchang City (9.54%, 23/241), and Zhanggong District of Ganzhou City (7.88%, 19/241). Among the reported cases of malaria, males accounted for 95.44% (230/241) and females accounted for 4.56% (11/241). The age of onset was mainly concentrated between 20 and 50 years old (97.11%, 234/241), mainly reported by medical institutions and disease control centers at or above the county level (99.59%, 240/241). The median interval between onset and initial visit is 1 day; The average number before the COVID-19 was (2.76 ± 5.00) d, and the average number during the epidemic was (1.79 ± 1.81) d, with no statistically significant difference (Z = -0.155, P > 0.05). The median time interval between initial diagnosis and diagnosis is 2 days; The average number before the COVID-19 was (3.36 ± 3.30) d, and the average number during the epidemic was (2.74 ± 2.90) days, with no statistically significant difference (Z = -0.103, P > 0.05). There were 28 severe cases (11.62%) and 213 non severe cases (88.38%). There was no statistically significant difference in the interval between onset and diagnosis (median 6 d) between severe cases and non severe cases (median 4 d) (Z = -1.242, P > 0.05). Conclusion In the malaria post-elimination stage, there remains retransmission risk caused by imported cases, thus it is imperative to continuously strengthen surveillance to prevent from the occurance of severe cases and deaths.

    Polymorphism analysis of drug resistance genes in imported Plasmodium falciparum isolates from Equatorial Guinea in Henan Province
    ZHOU Ruimin, JI Penghui, LI Suhua, YANG Chengyun, LIU Ying, QIAN Dan, DENG Yan, LU Deling, ZHAO Yuling, ZHAO Dongyang, ZHANG Hongwei
    2023, 41(5):  593-600.  doi:10.12140/j.issn.1000-7423.2023.05.011
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    Objectiv e To analyze the imported Equatorial Guinean Plasmodium falciparum drug resistance gene polymorphisms in Henan Province, and provide a reference for the treatment of imported P. falciparum infections. Methods The medical records and peripheral blood samples were collected from the imported P. falciparum malaria cases original from Equatorial Guinea in Henan Province from 2012 to 2019. The P. falciparum genomic DNA was extracted and the P. falciparum genes, including Kelch 13-propeller (PfK13), chloroquine resistance transporter (Pfcrt), multidrug resistance 1 (Pfmdr1), dihydrofolate reductase (Pfdhfr) and dihydropteroate synthase (Pfdhps), were amplified by nested PCR. Bidirectional sequencing of the secondary PCR products was performed after agarose gel electrophoresis. The obtained sequences were aligned with the corresponding reference P. falciparum 3D7 strain genomes by MEGA7 software. The reference genomes were obtained from the GenBank (GenBank accession numbers: PF3D7_1343700, PF3D7_0709000, PF3D7_0523000, PF3D7_0417200 and PF3D7_1324800 respectively). The data were analyzed by SPPS 21.0 software. Results A total of 1 522 imported malaria cases were reported in Henan Province during 2012 to 2019, including 117 cases imported from Equatorial Guinea. Among the 117 cases, 97 cases were infected with P. falciparum, 16 cases were infected with P. ovale, 1 case was infected with P. vivax, 1 case was infected with P. malariae, 1 case was mixed infected with P. falciparum and P. malariae and 1 case was mixed infected with P. falciparum and P. ovale. The PfK13 gene was successfully amplified from 91 P. falciparum samples and the mutant prevalence was 8.8% (8/91). The non-synonymous mutation sites were M476I mixed type (mixed), A481V mixed, A564E mixed, P574L mixed, A578S, V589I and N609I mixed respectively. The synonymous mutation sites were G625G, N664N and C469C respectively. The Pfcrt gene was successfully amplified from 91 P. falciparum samples and the mutant prevalence was 18.7% (17/91). Three Pfcrt haplotypes were identified, including wild-type C72V73M74N75K76 (81.3%, 74/91), mutant C72V73I74E75T76 (12.1%, 11/91) and mixed-type C72V73M/I74N/E75K/T76 (6.6%, 6/91). The Pfmdr1 gene was successfully amplified from 92 P. falciparum samples and the mutant prevalence was 77.2% (71/92). Three mutant codons were detected, including N86Y (41.3%, 38/92), Y184F (75.0%, 69/92) and D1246Y (1.1%, 1/92). The mutant prevalence of N86Y decreased from 68.8% in 2012 to 11.1% in 2016 (χ2 = 11.58, P < 0.05). Five Pfmdr1 haplotypes were identified, including wild-type N86Y184D1246 (22.8%, 21/92), single mutants Y86Y184D1246 (1.1%, 1/92), N86F184D1246 (34.8%, 32/92), N86Y184Y1246 (1.1%, 1/92) and double mutant Y86F184D1246 (40.2%, 37/92). The Pfdhfr gene was successfully amplified from 90 P. falciparum samples and the mutant prevalence was 96.7% (87/90). Three mutant codons were detected, including N51I (91.1%, 82/90), C59R (93.3%, 84/90) and S108N (96.7%, 87/90). Five Pfdhfr haplotypes were identified, including wild-type N51C59S108 (3.3%, 3/90), single mutant N51C59N108 (2.2%, 2/90), double mutants I51C59N108 (1.1%, 2/90), N51R59N108 (3.3%, 3/90) and triple mutant I51R59N108 (90.0%, 81/90). The Pfdhps gene was successfully amplified from 90 P. falciparum samples and the mutant prevalence was 97.8% (88/90). Six mutant codons were detected, including I431V (8.9%, 8/90), S436A (27.8%, 25/90), A437G (92.2%, 83/90), K540E (3.3%, 3/90), A581G (1.1%, 1/90) and A613S (2.2%, 2/90). Eight Pfdhps haplotypes were identified, including wild-type I431S436A437K540A581A613 (2.2%, 2/90), single mutants I431A436A437K540A581A613 (5.6%, 5/90), I431S436G437K540A581A613 (66.7%, 60/90), double mutants I431A436G437K540A581A613 (10.0%, 9/90), I431S436G437E540A581A613 (3.3%, 3/90), triple mutants V431A436G437K540A581A613 (8.9%, 8/90), I431A436G437K540G581A613 (1.1%, 1/90) and I431A436G437K540A581S613 (2.2%, 2/90). The Pfdhfr and Pfdhps genes were simultaneously successfully amplified from 89 P. falciparum samples and 84 (94.4%) samples had mutations in both genes. The most frequent mutation was the quadruple mutant I51R59N108-G437, which accounting for 64.0% among the gene mutations of Pfdhfr and Pfdhps. Conclusion Multiple mutant codons of PfK13 gene were detected. M476I and P574L had been confirmed to be associated with artemisinin resistance. As the withdrawal of chloroquine, the mutant prevalence of Pfcrt and Pfmdr1 genes associated with artemisinin-compatible drug resistance gradually decreased. The resistance of P. falciparum to sulfadoxine-pyrimethamine were mostly “partial resistance”, with no “super-resistant” haplotype detected.

    Ultrastructural observation on excystment of metacercaria of Clonorchis sinensis
    LI Xiaoqin, LAI Yashi, CHEN Yu, LV Jiahui, WEI Shuai, ZHANG Lilin, HE Shanshan, SHI Yunliang, LI Yanwen
    2023, 41(5):  601-608.  doi:10.12140/j.issn.1000-7423.2023.05.012
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    Objective To observe and analyze the ultrastructure of the metacercariae excystment of Clonorchis sinensis using scanning electron microscope and transmission electron microscope. Methods C. sinensis-positive fish pseudorasbora parva was subject to remove the head, scales and viscera, then weighed and minced. The minced fish was added with artificial digestive fluid (composed of 0.6 g of pepsin, 100 ml of normal saline, and 1 ml of concentrated hydrochloric acid) at a 1 g : 10 ml ratio and was digested overnight at 37 ℃, followed by repeated filtration. The mature metacercaria were separated under a stereomicroscope. Trypsin at a concentration of 0.025% (pH = 7.4) was added to the samples and incubated at 37 ℃ for approximately 3 min. The exysted cercaria, incompletely exysted metacercaria, metacercaria remain comparatively intact appearace, and existed empty sacs were collected separately and fixed with 3% glutaraldehyde supplemented and 1% osmium tetroxide. The fixed samples were dehydrated through a series of ethanol gradients (50%, 70%, 80%, 90%, and 100%, each for 10 min, with 100% ethanol repeated 3 times) and soaked in 100% hexamethyldisilazane 3 times (each for 10 min), dried, coated with gold, and observed using a scanning electron microscope. Gradient dehydration was performed using 50%, 70%, 90% ethanol, 1 : 1 mixture (90% ethanol with 90% acetone), 90% and 100% acetone (each stage was repeated 3 times for 10 min with 100% acetone dehydration). The samples were polymerized in the acetone with embedding reagent (epoxy resin 618) at 1 : 1 and 1 : 3 ratio or the whole embedding agent. The samples were trimmed, sliced and double-stained with uranyl citrate. The sample was observed by transmission electron microscope. Results The scanning electron microscopy revealed local swelling or shrinkage, folding and collapse, and separation of the inner from outer layers of the cyst wall; the linear crack formed during decapsulation was long and had smooth edges. The incompletely emerged metacestodes were wrapped in a soft collapsed cyst wall, with their epidermal spines piercing through the cyst wall; the decapsulated metacestodes were covered with body spines on the dorsal and ventral surfaces. The ventral sucker was significantly larger than the oral sucker, with different inner wall structures. The excretory bladder was filled with spherical excretory particles of various sizes. Transmission electron microscopy showed that the body wall of the decapsulated metacestodes was syncytial, with an electron-dense granular matrix underneath the cortical plasma membrane. The protrusions formed from the matrix towards the surface and numerous secretory granules and vesicles of various sizes within the matrix was seen. The spines originated from the basal membrane, penetrated through the matrix and emerged from the cortical surface. The basal layer had significant thickness variation and contained multiple high-electron-density secretory bodies; the outer circular muscle and inner longitudinal muscle were well-developed, extending into the cell layer with materials transported by cytoplasmic tubes forming vesicles at the distal end. The intercellular substance of the cortical cells was well-developed, filled with chaotically distributed tubular structures, vesicles of various sizes, and mitochondria. Conclusion The metacercariae exhibit vigorous movement via their well-developed muscle tissue, which plays an active role in exysting process. The dermal spines may assist the excysted metacercariae to rapidly escape from the softened wrapping cyst wall. The excysted metacercariae inside the cyst may stimulate the cyst wall via exercising to induce cortical sectetion, which could directly act on the cyst inwall, consequently, facilitate excystment by chemically softening the cyst inner wall.

    Advances in the research development on ticks and tick-borne diseases: a bibliometric analysis
    FEI Siwei, ZHAO Hanqing, YIN Jingxian, SUN Zhishan, GUO Xiaokui, KASSEGNE Kokouvi, ZHOU Xiaonong
    2023, 41(5):  609-618.  doi:10.12140/j.issn.1000-7423.2023.05.013
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    Objective We used bibliometric analysis approach to compare and analyze the current status, hot fields and developing prospects in the research field of ticks and tick-borne diseases in China and worldwide in the last two decades, and put forward recommendations for the future research on tick and tick-borne diseases in China. Methods Relevant literatures about ticks and tick-borne diseases were searched through China National Knowledge Infrastructure (CNKI) and Web of Science (WoS) from January 1, 2003 to December 31, 2022. CiteSpace6.2.R2 was used for the analysis with information of keywords, authors and institutions. Results A total of 944 Chinese and 27 428 English publications were collected and analyzed. The number of literatures on ticks and tick-borne diseases both domestically and internationally showed an increasing trend year after year, with the number of English publications far exceeding that of Chinese publications. The hot fields of domestic research focused on tick-borne encephalitis, Lyme disease, African swine fever, Haemaphysalis longicornis and Dermacentor nuttalli, etc. and several targeted tick-borne diseases, such as tick-borne encephalitis, Lyme disease and African swine fever, etc. The research hot fields from other parts of the world mainly focused on Lyme disease, tick-borne encephalitis, rickettsiosis, anaplasmosis, Ixodes ricinus and Boophilus microplus, etc. Although the research hot fields were generally consistent in the fields between domestic and other parts of the world, the hot topics were different. Domestic frontier research remained focused on specific disease epidemiology and applied regular molecular techniques to detecting ticks and tick-borne pathogens. International research frontier focused on molecular detection, vaccines, and complex infection diagnosis. Conclusion In the last two decades, with the increasing burden of diseases, the research on tick and tick-borne diseases has received more attention and has been improved through cutting-edge multidisciplinary technology along with One Health concept. Although China’s research in this field started late, the research level is already at the forefront. However, domestic research needs to strengthen on the application of new technologies, expand international cooperation networks, and integrative studies that use One Health approach to control tick and tick-borne diseases.

    REVIEWS
    Research advances on transcriptional regulation in plasmodium sexual stages
    LIANG Kejia, LIU Cong, LI Yanlin, LI Xiaoge, LIU Yan, LI Zhenkui
    2023, 41(5):  619-624.  doi:10.12140/j.issn.1000-7423.2023.05.014
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    Malaria is a worldwide infectious disease caused by the Plasmodium spp. Malaria transmission depends on the alternate development of malaria parasites in both vertebrate and anopheles hosts. The sexual stage, consisting of male and female gametocytes, is the only infectious stage in which Plasmodium is transmitted from their vertebrates host to Anopheles mosquitoes. The gametocyte-related processes, including sexual commitment, gametocytogenesis, and subsequent gametogenesis, are critical for Plasmodium transmission. An in-depth understanding of gene expression and regulatory mechanisms in the sexual stage of malaria parasites contributes to the identification of targets for new antimalarial drugs or vaccines. In this review, recent research focusing on transcriptional regulation in the sexual stages was reviewed to provide a comprehensive understanding of gene expression and transcriptional regulation.

    Research progress on the structure and function of tick-derived serine protease inhibitor containing Kunitz domains
    LIU Yueqing, MA Linyuan, CHEN Kaiting, GAO Jinliang, WANG Peng
    2023, 41(5):  625-630.  doi:10.12140/j.issn.1000-7423.2023.05.015
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    Ticks are blood-sucking ectoparasites. During their blood-sucking process, ticks release variou anticoagulant substances to the hosts to facilitate blood meal. Serine protease inhibitors containing Kunitz domains play an important role in anticoagulation. Different Kunitz serine protease inhibitors have similar conserved sequences but with different overall structures. In the coagulation cascade, inhibition of one or more serine proteases can block the activation of downstream coagulation factors, which could achieve the effect of inhibiting coagulation. Targets for different tick-derived Kunitz serine protease inhibitors in the blood clotting system are varied, and so do their inhibitory mechanisms. To summarize, the anticoagulant targets and anticoagulation mechanisms of those protease inhibitors could contribute to the research and development of anticoagulant and antithrombotic drugs. They could further explain the interaction between ticks and their hosts and the pharmacological action of tick-derived anticoagulant drugs. This can also prevent the invasion of ticks to their hosts.

    SHORT COMMUNICATIONS
    Study on the characteristics of Blastocystis cultured in vitro
    YUAN Huizhen, LI Dongliang, CHENG Shuqi, JIAN Fuchun
    2023, 41(5):  631-635.  doi:10.12140/j.issn.1000-7423.2023.05.016
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    The morphology, proliferation and stability of in vitro cultured Blastocystis were studied. Blastocystis were isolated from Blastocystis positive feces of patients with diarrhea and cultured in IMDM medium to observe the parasite morphology and proliferation. The density of Blastocystis was quantified by microscopic counting and the copy number of Blastocystis 18S small subunit ribosomal DNA (SSU rDNA) was measured by fluorescence quantitative PCR (qPCR) to analyze the proliferation of Blastocystis in the in vitro culture, and the proliferation curve was plotted to analyze the correlation between the two methods. Blastocystis were stored at 4, -20, and -80 ℃ for 1 to 7 days and 1 to 5 weeks respectively, and the Blastocystis SSU rDNA was detected by qPCR to analyze the stability. Morphological studies showed that the four common morphological forms were observed in the IMDM medium, including vacuolar form, granular form, ameboid form and cyst form; and the three reproductive modes including fission, gemmation and endodyogeny were observed. The rapid growth period of Blastocystis was observed from day 3 to 7 from the in vitro culture, and the Blastocystis density peaked on day 7. The microscopic counting and qPCR results were (2.55 ± 0.22) × 106/ml and (1.06 ± 0.10) × 106 copies/μl, respectively. Correlation analysis showed that the Pearson correlation coefficient of proliferation curve generated by microscopic counting and qPCR was 0.95, which was highly correlated. The degradation of Blastocystis began on the second day after storage at 4, -20 and -80 ℃, and the copy numbers of SSU rDNA on the seventh day were (2.75 ± 0.20) × 104, (6.84 ± 1.33) × 104 and (1.39 ± 0.06) × 105 copies/μl, respectively, which accounted for 11.65%, 28.67% and 62.42% of the copy volume (2.36 ± 0.06) × 105, (2.39 ± 0.06) × 105, (2.23 ± 0.21) × 105 copies/μl on the first day. The difference was statistically significant (F = 130.67, P < 0.05). At the fifth week, the copy numbers of SSU rDNA were (3.77 ± 0.23) × 103, (4.37 ± 0.59) × 103 and (3.86 ± 0.26) × 104 copies/μl, accounted for 2.98%, 3.41% and 28.74% of the copy volume (2.23 ± 0.21) × 105, (2.23 ± 0.21) × 105, (2.23 ± 0.21) × 105 copies/μl in the first week. The difference was statistically significant (F = 500.51, P < 0.05). The morphology of in vitro cultured Blastocystis showed diversive forms at the rapid proliferation stage. Both microscopic counting and qPCR can be used for the quantification of Blastocystis and the stability of Blastocystis stored at -80 ℃ is less than that stored at 4 and -20 ℃.

    Epidemiological characteristics of echinococcosis cases reported in the National Notifiable Disease Report System in Jiangsu Province, 2015—2022
    NI Bixian, XU Xiangzhen, ZHANG Qiang, TANG Feng, ZHANG Jiayao, MAO Fanzhen, DAI Yang, LIU Yaobao, CAO Jun
    2023, 41(5):  636-639.  doi:10.12140/j.issn.1000-7423.2023.05.017
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    The data of reported echinococcosis cases in Jiangsu Province from 2015 to 2022 were collected from the Chinese Disease Prevention and Control Information System and epidemiological investigations were conducted on individual cases, while infection of intermediate and terminal hosts was monitored. Two key areas of Liyang City and Yixing City, where suspected local cases have occurred in the past were selected to conduct an investigation on the infection status of intermediate and final hosts of echinococcosis. Every year, 100-200 sheep organ samples were collected from slaughterhouses in both cities, and visceral dissection was used to check the infection status of Echinococcus. Fecal samples from at least 100 dogs in 1-3 administrative villages were collected, and canine fecal Echinococcus antigen was detected by ELISA. A descriptive analysis was performed using PASW 18.0 to analyze the time, region, population distribution, treatment status, and surveillance results of intermediate and terminal hosts. From 2015 to 2022, a total of 29 cases of echinococcosis were reported in Jiangsu Province, of which 62.07% (18/29) were confirmed cases, and 37.93% (11/29) were clinically diagnosed cases. There were 14 suspected local cases and 15 imported cases. Twelve of the imported cases were from Xinjiang, China, 2 cases from Xizang, China and 1 case from Pakistan. Thirteen reported cases, which was the highest in number, were from Changzhou (10 of which are suspected local cases in Liyang). Among the 29 reported cases, 34.48% (10/29) were male and 65.52% (19/29) were female, 51.72% (15/29) were 40-60 years old, and 41.38% (12/29) were farmers. All cases were cystic echinococcosis, and the symptoms of upper abdominal discomfort accounted for 51.72% (15/29), and the main parasitic site was the liver (93.10%, 27/29). 75.86% (22/29) of the cases received surgical treatment. The fecal antigen-positive rate of canine Echinococcus was 0.74% (15/2 028), and suspected Echinococcus eggs were found in two canine feces. From 2015 to 2022, echinococcosis cases were reported annually in Jiangsu Province, and in addition to imported cases, there were also suspected local cases. The transmission chain of echinococcosis may exist in local areas. Therefore, follow-up surveillance of echinococcosis should be strengthened, and screening and health education should be actively carried out in key areas and populations.

    Investigation on Angiostrongylus cantonensis infection in Achatina fulica in Haikou wetland park
    HUANG Mengyu, CHEN Dikun, CHEN Huiru, FAN Mengpei, LIU Junyou, QUAN Yunfan
    2023, 41(5):  640-643.  doi:10.12140/j.issn.1000-7423.2023.05.018
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    To investigate the prevalence of Angiostrongylus cantonensis infection in Achatina fulica in a wetland park of Haikou, A. fulica were randomly collected from a public green land and underneath the ripraps of the wetland park during March to July of 2021 and 2022. A. cantonensis infection among the A. fulica was determined by lung examination. A. cantonensis rRNA gene was amplified by PCR and the sequence was compared by BLAST analysis. The result suggested 23 of 207 (11.11%) A. fulica were infected with A. cantonensis. The amplified 400 bp-DNA sequence was close to the reference sequences of A. cantonensis in the NCBI GenBank (Accession number: AY295821.1, FM207759.1, AM039758.1 and ON747308.1). The sequence similarity ranged from 98.49% to 99.75%. In conclusion, A. cantonensis were found in A. fulica collected from the wetland park of Haikou. This will be provide a infection risk upon touching or eating the raw or partially cooked A. fulica.

    A case of ventricular cysticercosis complicated with hydrocephalus
    LIU Wenhu, HUANG Ming, LIANG Jin, LIU Jianxiong, WEN Zhaomeng, MA Shaobo
    2023, 41(5):  644-646.  doi:10.12140/j.issn.1000-7423.2023.05.019
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    A 53-year-old male patient, who is a farmer, lived in Tanchang of Gansu, was treated at the Neurology Clinic of Gansu Provincial People’s Hospital due to “headache, dizziness, nausea, and vomiting for one week” on November 19, 2021. On admission, CT plain scan of the brain showed nodular and slightly high-density lesions in the transparent septum, while MRI of the head showed mild ventricular dilation. Lumbar puncture result showed that the intracranial pressure was 180 mmH2O (1 mmH2O = 9.779 Pa). The cerebrospinal fluid laboratory examination showed that the total protein in cerebrospinal fluid was 0.74 g/L. The second lumbar puncture result showed that the intracranial pressure was 300 mmH2O and the patient was transferred to neurosurgery on the following day. The patient was drowsy with high cranial pressure and unable to speak correctly upon awakening. Repeat CT scan showed lateral ventricular dilatation, which suggested high risks of hydrocephalus and cerebral hernia. The patient had eaten undercooked meat in recent years and a history of liver echinococcosis. To reduce patient’s cranial pressure, ventriculocentesis was performed on November 26 and the patient got the intensive care after surgery. The serum samples were positive for cysticercosis IgG and Toxoplasma gondii IgG. Therefore, the patient was treated with praziquantel (400 mg/8 h) and albendazole (0.4 g/d) for 3 courses (7 d/course, each treatment interval of 5 d). Endoscopic third ventriculostomy (ETV) was performed for the hydrocephalus on December 13. The patient got the antiparasitic therapy after ETV and lumbar ampullary drainage was performed at the same time, but the condition was not improved. The ventriculocentesis was performed twice on December 28 and January 11, 2022 respectively to reduce patient’s cranial pressure. The patient was treated with antiparasitic therapy and tigecycline (50 mg/12 h) and sulperazon (3 g/8 h). The patient’s intracranial infection indicators turned negative on January 25 and enhanced brain MRI showed no obvious tapeworm lesions. Laparoscopic assisted ventriculoperitoneal shunt was performed on January 27. The patient’s was consciouse and the cranial CT scan showed improved hydrocephalus after the surgery. The patient was discharged from the hospital with clear consciousness and no obvious dizziness, headache, nausea, vomiting or seizures on February 11. The patient recovered well after 3 months.

    A case of Balantidium coli infection
    WANG Denghui, ZHANG Yan, NIE Qiang, LIU Hongwei
    2023, 41(5):  647-649.  doi:10.12140/j.issn.1000-7423.2023.05.020
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    The patient was an 87-year-old male farmer from Yongcheng, Henan. He reported having nausea and decreased appetite without obvious causes on June 25th, 2023, accompanied by diarrhea (4-5 times/d) and low-grade fever (body temperature of 37.5 ℃). He was treated at a local community hospital without detailed examinations and showed no improvement after receiving infusions of unknown drugs. Due to a referral, he was admitted to the Yongcheng Central Hospital on July 5th. The patient has been undertaking farming for a long time, and animals such as cats and dogs are bred in his home. He has no history of breeding pigs or close contact, no history of applying pig manure, and no history of drinking unboiled water. On admission, physical examination showed a thin body type, no apparent abnormalities in heart and lung auscultation, a soft and flat abdomen, no gastrointestinal waves or peristalsis, no varicose veins in the abdomen, no liver or spleen felt under the ribs, tenderness in the lower abdomen, no tenderness or rebound tenderness in other parts, negative mobile cloudy urine, active bowel sounds, and no audible gas-water sound. The blood routine test showed a white blood cell count of 11.9 × 109/L, a red blood cell count of 4.11 × 1012/L, a platelet count of 358 × 109/L, a hemoglobin of 119 g/L, a blood potassium of 3.13 mmol/L, and an albumin of 32.5 g/L in the liver function test. The stool routine test showed a dark green loose stool, a positive occult blood test, no red blood cells or white blood cells, no parasitic eggs detected, and no abnormalities in the fecal culture. A plain and enhancement scan of the entire abdomen was performed, which showed an increased volume of the gallbladder, slightly dilated bile ducts, common bile duct, and pancreatic duct in the hepatic portal area, slightly thickened gastric wall near the cardia, and diffuse thickening and edema of the intestinal walls in the rectum and sigmoid colon. The patient was treated for rehydration and correction of electrolyte imbalance. Simultaneously, oral berberine tablets were given (0.1 g each time, 3 times/d), smecta powder (3 g each time, 3 times/d), and bifidobacterium (1 g each time, 3 times/d, taken 2 h apart from smecta powder). The frequency of the patient’s bowel movements gradually decreased and gradually turned to soft and yellow stools. On July 11st and 12th, the stool samples were microscopically observed and both tested positive for suspected Balantidium coli. After consultation with the Yongcheng Center for Disease Control and Prevention, it was confirmed to be B. coli. The patient was adjusted to oral berberine (0.1 g each time, 3 times/d) and metronidazole tablets (0.2 g each time, 2 times/d), and continued to receive nutritional support treatment. On July 13th, the patient’s bowel movements had converted to daily, yellow and soft stools, and no parasites were found under microscopy. On July 18th, the patient was discharged from the hospital after comprehensive treatment, and follow-up observations showed a good prognosis.

    A case of Capillaria hepatica infection
    ZHANG Li, MIAO Feng, SHEN Yanmei
    2023, 41(5):  650-652.  doi:10.12140/j.issn.1000-7423.2023.05.021
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    The patient was a 45-year-old female peasant from Heze City of Shandong Province. While The patient was working in Henan Province, in June and July 2020, she was admitted to the local hospital due to recurrent hyperthermia without inducement. The patient was treated with levofloxacin and piperacillin-tazobactam, but the symptoms did not improve. The PET-CT results showed increased liver volume and uneven hepatic density without obvious occupation. The histopathology examination of the liver biopsy specimen was considered to be a parasitic infection, while the species was yet to be determined. On August 12th, 2020, the patient was transferred to the Affiliated Gastroenterology Hospital of Shandong First Medical University. The physical examination showed recurrent hyperthermia (About 42 ℃) and fatigue. Laboratory tests showed increased peripheral blood eosinophil count (5.49 × 109/L) and decreased haemoglobin was 93 g/L. No parasite eggs were found in the stool sample. The patient had a habit of eating leftovers and drinking unboiled water. The patient had poor residential sanitation with rats. The rats in the residence were captured and dissected. The rat histopathology examination showed a large amount of eggs and cross-section of adult worms in the rat liver parenchyma. The patient blood samples was tested for serum antibodies against common human parasites by ELISA. The results showed only weak reactivities to trichinella. The B ultrasonography showed an enlarged liver with uneven density. The liver biopsy slides was reviewed and a small number of parasite eggs were found in the liver parenchyma, with lymphocytes and eosinophile infiltration and granulomatosis. The eggs in the liver tissue of the patient were the same as liver tissue of the rat, which were identified as Capillaria hepatica eggs. The patient was administrated with albendazole [20 mg/(kg·d)]. Her temperature returned to the normal range after 72 h. The patient had no obvious discomfort, and she was discharged after 7 d. One month later, the patient returned to the hospital for follow-up and recovered well.