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    30 August 2021, Volume 39 Issue 4
    INVITED REVIEW
    Malaria elimination in China: an eminent milestone in the anti-malaria campaign and challenges in the post-elimination stage
    FENG Jun, ZHANG Li, XIA Zhi-gui, XIAO Ning
    2021, 39(4):  421-428.  doi:10.12140/j.issn.1000-7423.2021.04.001
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    Malaria is one of the oldest and most severe infectious diseases in China. After over 70 years of comprehensive control and prevention measures, great achievements have been made in malaria control in China, with a remarkable decline in morbidity and mortality. The malaria epidemic has been controlled effectively, ensuring people’s health, reducing the poverty due to illness, and promoting social and economic development. The milestone achievements in elimination of indigenous malaria cases nationwide has been maintained for 4 consecutive years since 2017, and thereafter the World Health Organization certificated malaria elimination in China on June 30, 2021, which is a significant milestone in the public health in China and the global history of malaria elimination. This paper systematically reviews the great impacts, performance characteristic and experiences gained from malaria elimination program, and the challenges in post-elimination stage in China.

    New progress in basic and clinical research of advanced schistosomiasis
    LIU Rong, WEN Li-yong
    2021, 39(4):  429-436.  doi:10.12140/j.issn.1000-7423.2021.04.002
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    At present, the endemic situation of schistosomiasis is at the lowest level in history in China, and the infection rate has decreased significantly, but there are still a large number of patients with advanced schistosomiasis. Advanced schistosomiasis is the most serious type of schistosomiasis, which seriously endangers the health and quality of life of patients. Liver granuloma and fibrosis caused by Schistosoma eggs are the leading cause for the death of advanced schistosomiasis patients. This article summarizes the pathological mechanism, determine approaches, treatment and prognosis of liver fibrosis in basic and clinical research of advanced schistosomiasis, hoping to provide reference information for future schistosomiasis prevention and treatment.

    ORIGINAL ARTICLES
    Affect of aminoalcohol compound HT24 on the expression of tubulin in Echinococcus multilocularis protoscoleces
    SHI Qi-qi, LIU Cong-shan, HUO Le-le, WEI Yu-fen, JIANG Bin, YIN Meng, XUE Jian, TAO Yi, ZHANG Hao-bing
    2021, 39(4):  437-443.  doi:10.12140/j.issn.1000-7423.2021.04.003
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    Objective To understand the affect of aminoalcohol compound HT24 on the expression of tubulin in Echinococcus multilocularis protoscoleces. Methods Protoscoleces were isolated from BALB/c mice infected with E. multilocularis metacestode, and cultured in vitro for 1 day. Then they were assigned into groups of low, medium and high concentration of HT24 treatment, which were added with 0.5% DMSO (control group) and 25 μmol/L, 50 μmol/L or 100 μmol/L HT24, respectively. Each group was set with 3 replicates, and 2 000 protoscoleces in each well. The viability and morphological changes of the protoscoleces were observed in first 3 days after addition of HT24. Samples were collected on the third day and subjected to transmission electron microscopy (TEM) to observe the ultrastructural changes of flame cells. Samples were collected at 3, 5, and 7 days for real-time fluorescence quantitative PCR (qPCR) to examine the mRNA expression levels of α9-, β2-, β4- and β6-tubulin, and Western blotting to examine the protein levels of β-tubulin. Two-way ANOVA was applied for between-group comparisons. Results After 3 days of HT24 treatment, in the low-concentration group, the E. multilocularis protoscoleces had unclear outline, swollen body, decreased transparency, and detachment of some hooks. In the medium-concentration group, the protoscoleces were obviously enlarged and hooks were detached. All protoscoleces in the high-concentration group died and dwindled in size. TEM showed that in the medium- and high-concentration groups, the membranes of flame cells were broken, ciliary in the cytoplasm ruptured with large notches or fracture openings, and some cilia spilled out and were free outside the cells. qPCR showed that compared to the control group, the mRNA expression of α9-tubulin on day 7 in the low-, medium- and high-concentration groups was 8.01 ± 1.54, 9.84 ± 0.40 and 7.85 ± 2.60, respectively, there was significant difference between the 3 groups (P < 0.01); the mRNA expression of β2-tubulin in the low-, medium- and high-concentration group on day 7 was 10.97 ± 0.69,11.83 ± 0.97 and 6.48 ± 1.52, respectively, there was significant difference between the 3 groups (P < 0.01); the mRNA expression of β4-tubulin on day 7 in the low-, medium- and high-concentration groups was 10.61 ± 1.24, 8.31 ± 1.05 and 7.47 ± 0.96, respectively, there was significant difference between the 3 groups (P < 0.01); the mRNA expression of β6-tubulin on day 7 was 8.83 ± 0.80, 7.89 ± 1.30 and 5.63 ± 2.25 in the low-, medium- and high-concentration groups, respectively, there was significant difference between the 3 groups (P < 0.01). Western blotting results showed that on day 3 after treatment, the β-tubulin protein levels at the low-, medium- and high-concentration groups were 0.36 ± 0.06, 0.23 ± 0.03, and 0.61 ± 0.06, respectively, all lower than the control group (0.67 ± 0.05) (P < 0.01); on day 5 after treatment, the β-tubulin protein levels in the low-, medium- and high-concentration groups were 1.12 ± 0.03, 0.55 ± 0.04, and 0.30 ± 0.02, respectively, all higher than the control group (0.26 ± 0.03) (P < 0.01); on day 7 after treatment, they were 0.73 ± 0.05, 0.36 ± 0.04, and 0.40 ± 0.04, respectively, The latter two were lower than control group (0.73 ± 0.05) (P < 0.01). Conclusion HT24 can lower the mRNA and protein levels of β-tubulin and affect the function of microtubules, thereby suppressing the viability of E. multilocularis metacestodes.

    Therapeutic effect of intensity modulated radiation therapy on secondary femur infection with Echinococcus granulosus in rats
    ZHOU Wen-zheng, SUN Jun-gang, ZHAO Xi-bin, CAO Li
    2021, 39(4):  443-448.  doi:10.12140/j.issn.1000-7423.2021.04.004
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    Objective To observe the therapeutic effect of intensity modulated radiation therapy (IMRT) on secondary femur infection with Echinococcus granulosus in rats. Methods Seventy-five male Wistar rats with secondary femur infection of Echinococcus metacestode were used in this study. They were divided into the IMRT group (n = 50) and the control group (n = 25). In the IMRT group, the left thighbone of the rat was irradiated at irradiation dose of 40 Gy. The rats in the control group received no treatment. E. granulosus cysts were obtained from the left and right thighbones respectively, from which the germinal layer cells were extracted. Hoechst 33258 staining was performed to observe morphological changes of nuclei, and immunohistochemistry was conducted to detect the expression of apoptosis-related Caspase-3 and p53. ELISA was used to detect the difference of interferon γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4) and IL-10 cytokine levels in the mice serum of IMRT group and control group. Flow cytometry was used to detect the CD4+/CD8+ ratio in splenic lymphocytes. Results One week after IMRT treatment, the absorbance (A490 value) of Th1 cytokines IFN-γ and TNF-α in the rat serum of the IMRT group were 322.45 ± 94.42 and 28.76 ± 6.23, respectively, which were higher than those of the control group (277.82 ± 65.48 and 19.63 ± 4.76) (P < 0.05). The A490 value of Th2 cytokine IL-4 was 11.02 ± 2.55, which was lower than that of the control group (13.22 ± 3.13) (P < 0.05). The IL-10 A490 value was 16.57 ± 3.02, which showed no statistical difference from the control group (20.51 ± 3.17) (P > 0.05). Hoechst 33258 fluorescent staining showed apoptosis of the germinal layer cells of the left femoral hydatid cysts of the IMRT group, while the right germinal layer cells were normal. The results of immunohistochemistry showed abundant expression of Caspase-3 and p53 in the germinal layer cells of the left femoral hydatid cyst of rats in the IMRT group, but not in the right germinal cells. The results of flow cytometry showed that the CD4+/CD8+ ratio in the IMRT group (2.96 ± 1.90) was much higher than that in the control group (1.65±1.31)(P < 0.05). Conclusion IMRT can induce apoptosis of the germinal layer cells of the femoral hydatid cyst in rats. The mechanisms may involve the regulation of Caspase-3 and p53, and the radiation triggering host immune responses to the parasites.

    Analysis of immune genes of anopheline mosquitoes induced by Plasmodium yoelii hemolymph sporozoites
    QIN Xin, ZHU Feng, ZHANG Kun, ZHANG Jian
    2021, 39(4):  449-454.  doi:10.12140/j.issn.1000-7423.2021.04.005
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    Objective To investigate the possible immune signaling pathways in Anopheles stephensi induced by hemolymph sporozoites and the underlying mechanisms, through transcriptome sequencing of the mosquitoes at 8, 11 and 14 days after infection with Plasmodium yoelii. Methods The BY265 strain of P. yoelii was inoculated into healthy Kunming mice through routine intraperitoneal inoculation. After 3 days, mice with gametophytes in the blood were selected for blood sucking by female An. stephensi mosquitoes. At 8, 11 and 14 days after blood-sucking infection, 20 mosquitoes were collected to extract total RNA. Gene expressionsin Anopheles were analyzed by high-throughput transcriptome sequencing. The statistical algorithm Bray Curtis dissimilarity was used to perform hierarchical clustering analysis of the difference of gene expression between samples. Differential gene analysis based on the value of transcripts per million was performed; the gplots package software was used to draw cluster heat maps to analyze the expression changes of important immune signal pathways (Toll-like receptor signaling, immune deficiency signaling pathway, signal transducer and activator of transcription, c-Jun N-terminal protein kinse) and effector molecules (thioester-containing proteins, antimicrobial peptide, nitric oxide synthase, nitrification-related molecules) in An. stephensi infected with P. yoelii at 8, 11 and 14 days. Based on the transcription sequencing data, four immune genes were screened out, which were thioester-containing protein 1 (TEP1), transcription factor Rel1 and Rel2, and heme peroxidase (HPX8). Real-time fluorescent quantitative PCR (qPCR) was performed to examine the expression level of these genes in An. stephensi 8, 11 and 14 d post-infection. Results The hierarchical cluster analysis of the transcriptome sequencing samples indicated that the gene expression at 11 days after infection with P. yoelii was quite different from that at 8 and 14 days. Differential gene analysis showed that there were 1 109 genes up-regulated and 257 gene down-regulated at 11 days versus 8 days after infection; 62 genes up-regulated and 136 gene down-regulated at 14 days versus 8 days after infection; and 174 genes up-regulated and 196 gene down-regulated at 14 days versus 11 days after infection. Clustering heat map analysis showed that the Rel1 transcription factor, Toll5A and Toll1A receptors of Anopheles Toll-like receptor signaling pathway were up-regulated by 1.9 times, 1.8 times and 2.1 times at 11 days versus 8 and 14 days after infection; double peroxidase and dual oxidase up-regulated by about 2 times; and HPX8 up-regulated by 1.5 times. qPCR verified that the relative expression levels of Rel1, Rel2 and HPX8 were 3.43, 3.95 and 4.01 at 11 days after infection, which had significant statistically difference with that of the control group (0.82, 0.88 and 1.01). Conclusion The hemolymph sporozoites of P. yoelii can induce the Toll signaling pathway in An. stephensi through directly or coordinately with other pathways regulating the expression of nitrification-related molecules.

    Giardia lamblia trophozoites induce the formation of neutrophil extracellular traps in vitro
    LI Shu-ning, LI Wen-lin, SHEN Hai-e, WANG Yang, TIAN Xi-feng
    2021, 39(4):  455-460.  doi:10.12140/j.issn.1000-7423.2021.04.006
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    Objective To study the induction of neutrophil extracellular traps (NETs) by Giardia lamblia using qualitative and quantitative methods. Methods Neutrophils were collected from blood samples of a healthy participant by using isolation reagent kit, and cultured with G. lamblia (4 × 105/ml) in M199 medium for 30, 60, 120, 180 or 240 min. The concentration of double-stranded DNA (dsDNA) in the supernatant at the defined time points was determined by PicoGreen staining method. The concentration of myeloperoxidase (MPO) in the supernatant was assayed by ELISA. In the test group designed, 200 μl of neutrophils was added with 200 μl of G. lamblia (both 4 × 105/ml) into 24-well plates and cultured at 37 ℃ for 4 h. Neutrophils producing extracellular trap nets were double-stained with anti-H3Cit and anti-MPO fluorescence. For visualization, DNA was labeled with blue fluorescence, citrullinated histone H3 protein was labeled with green fluorescence, and MPO was labeled with red fluorescence. Laser confocal microscopy was used to observe the formation of NETs. The positive group was set by using the neutrophils treated with 100 nmol/L phorbol ester, while the negative control group was the untreated neutrophils. SPSS software was used for statistical analysis, and the experimental data were analyzed with independent sample t-test. Results The purity of neutrophils isolated from the blood was over 75%. The neutrophils with rod-shaped or lobulated nuclei could be observed under a microscope. The fluorescence intensities after mixing the neutrophils with Giardia (4 × 105/ml) for 30, 60, 120, 180, and 240 min were 7.30 ± 1.12, 11.15 ± 1.10, 21.69 ± 2.71, 26.35 ± 2.26, and 29.29 ± 3.27, respectively, while those in the negative control group and the positive control group were 3.79 ± 0.48 and 35.78 ± 2.83, respectively. The level of dsDNA in the supernatant of the test group was higher than that of the negative control group, and the content of dsDNA increased with prolonged culture time(P < 0.05). ELISA results showed that the absorbance related to the MPO content in the supernatant of the negative control group, test group and positive control group were 0.209 4 ± 0.018 2, 0.611 5 ± 0.060 7, and 0.721 7 ± 0.087 9, respectively. The MPO content of the test group was higher than that of the negative control group (P < 0.05). Laser confocal microscopy revealed presence of a reticular substance between neutrophils and Giardia, which was enriched with histone and MPO. Conclusion Giardia trophozoites have the potential to activate neutrophils releasing extracellular traps in vitro.

    Analysis of case-based malaria surveillance and response during the period of COVID-19 outbreak in China
    YIN Jian-hai, ZHANG Li, TU Hong, ZHOU He-jun, XIA Zhi-gui
    2021, 39(4):  461-465.  doi:10.12140/j.issn.1000-7423.2021.04.007
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    Objective To assess the case-based malaria surveillance and response during the period of COVID-19 outbreak in China, in order to provide reference for malaria elimination under the COVID-19 pandemic. Methods Information of malaria cases reported during the four months pre- and post-COVID-19 outbreak (December 1, 2019—March 31, 2020) and in the same time period of past two years in China (excluding Hong Kong, Macau and Taiwan regions) was obtained from the Parasitic Disease Control Information Management System. Cross-sectional survey and comparison were conducted for malaria surveillance and response data in 3 four-month time periods (December 1, 2019 to January 22, 2020; January 23 to March 17, 2020; and March 18—31, 2020). The number of malaria cases including deaths, the median and average time interval from disease onset to the first visit, the median and average of time interval from the first visit to the confirmed diagnosis, the completion status of the “1-3-7” task and the source of infections in each period were analyzed and compared to the same times in the past two years. Results From December 1, 2019 to March 31, 2020, a total of 750 malaria cases, which were all imported cases, were reported in China, decreased by 9.2% from that reported during December 2018 and March 2019 (826 cases) and by 13.1% from that reported during December 2017 to March 2018 (863 cases). The decrease mainly occurred in February and March in 2020; there were no statistical differences in the time interval from onset to first visit (median 1 day, mean 2.0 days), time interval from first visit to confirmed diagnosis (median 1 day, mean 1.8 days), case reporting rate within 1 day (100%), case epidemiological investigation rate within 3 days (98.4%), epidemic site disposal rate within 7 days (100%) between the time period of COVID-19 outbreak and the same time in the past year (December 2018 to March 2019). In addition, no statistical difference (P > 0.05) was found in the time intervals from onset to first visit among the first period [median 1 d, average (1.9 ± 0.2) d], the second period [median 1 d, average (2.1 ± 0.3) d] and the third period [median 1 d, mean (1.5 ± 0.3) d], while the time interval from the first visit to the confirmed diagnosis was statistically different (P < 0.05) among the first period[median 0 d, average (1.5 ± 0.2) d], the second period [median 1 d, mean (2.3 ± 0.3) d] and the third period [median 0.5 d, average (1.5 ± 0.4) d], where the time interval in the second period was longer than that in the first period (P < 0.01). Conclusion China’s core measures to eliminate malaria have been carried out as planned, although the timely malaria diagnosis was slightly affected in the second time period (January 23 to March 17, 2020).

    Epidemiological characteristics of imported severe malaria cases in Zhejiang Province from 2012—2020
    ZHANG Xuan, RUAN Wei, WANG Xiao-xiao, CHEN Hua-liang, LU Qiao-yi, ZHANG Jia-qi, YU Ke-gen, YAO Li-nong
    2021, 39(4):  466-472.  doi:10.12140/j.issn.1000-7423.2021.04.008
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    Objective To understand the epidemiological characteristics and influencing factors of imported severe malaria cases in Zhejiang Province. Methods The epidemiological data of imported severe malaria cases in Zhejiang Province from 2012 to 2020 were collected. SPSS 20.0 software was used to analyze the species of Plasmodium, distribution of cases, countries source of infection, interval time from disease onset to diagnosis were analyzed. Multivariate logistic regression analysis was conducted to analyze factors affecting severe malaria. Results A total of 127 severe malaria cases were reported in Zhejiang Province from 2012 to 2020, all were imported from abroad. Of them, 107 were infected with Plasmodium falciparum (84.25%), 11 with P. vivax (8.66%), 7 with P. ovale (5.51%), and 2 with mixed infection (1.57%). The severe malaria cases were distributed in 11 cities of Zhejiang Province, with the top 3 cities with the percentage to total reported cases being Taizhou (17.65%, 24/136), Ningbo (13.45%, 16/119) and Wenzhou (11.64%, 22/189). The number of severe cases in January, October and December accounted for more than 10% of the total reported cases, respectively. Among the 127 cases, 116 were males and 11 were females, and the mala/female ratio was 10.55 : 1, mainly occurred in the age of 30-59 years (98 cases, 77.17%), and among workers and businessmen. There were 9 foreigner cases, and 2 deaths occurred in 2013 and 2016. The source place of infection showed that 93.70% of the severe cases were imported from African countries, with top countries of Nigeria (35, 27.56%), Equatorial Guinea (13, 10.24%) and Democratic Republic of Congo (11, 8.66%). The time interval from initial diagnosis to diagnosis of severe malaria was longer than that of non-severe malaria cases (Z = -3.285, P < 0.05). Age (OR = 1.022, 95%CI: 1.004-1.041) and the time interval from initial diagnosis to diagnosis (OR = 1.046, 95%CI: 1.004-1.089) were the risk factors for severe disease. Foreign nationality (OR = 0.488, 95%CI: 0.241-0.990) and previous history of malaria (OR = 0.598, 95%CI: 0.399-0.895) had less chance causing severe malaria. Conclusion Imported severe malaria cases in Zhejiang Province are distributed in Hangzhou, Taizhou, Wenzhou and other cities. Most of them are males, aged 30-59 years, among workers and businessmen. The severe cases were mainly imported from Africa. Age and the time interval between first diagnosis and diagnosis are risk factors leading to severe malaria.

    Gene expression profiling of human lung adenocarcinoma of A549 cells induced by Toxoplasma virulence-related effector ROP16Ⅲ
    SU Ya-jing, QIAO Xia, WANG Peng-tao, KANG Yu-ting, YANG Ning-ai, JIA Wei, ZHAO Zhi-jun
    2021, 39(4):  473-480.  doi:10.12140/j.issn.1000-7423.2021.04.009
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    Objective To analyze the gene expression profile in the A549 human lung adenocarcinoma cell line transfected with the expression vector of Toxoplasma gondii rhoptry protein 16Ⅲ (ROP16Ⅲ), using bioinformatics methods, in order to identify candidate pathogenic genes. Methods The eukaryotic expression vector pEGFP-N1-ROP16Ⅲ was constructed. The A549 cells were assigned to three groups: untransfected, pEGFP-N1 and pEGFP-N1-ROP16Ⅲ groups. Cells in the latter two groups were instantantaneously transfected with pEGFP-N1 and pEGFP-N1-ROP16 plasmid, respectively. After 48 h, the cells were harvested and RNA was extracted. After RNA purification, microarray hybridization analysis was performed to identified differentially expressed genes (DEGs) which were further analyzed by Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) for functional enrichment classification and pathway analysis. ToppGene was used to screen for Toxoplasma ROP16Ⅲ pathogenic candidate genes from DEGs. The STRING online analysis software was used to analyze the protein-protein interaction (PPI) network for protein products of the candidate genes. Results A total of 566 genes were differentially expressed in A549 transfected with Toxoplasma ROP16Ⅲ, of which 382 genes were up-regulated and 184 genes down-regulated. Bioinformatics analysis of the DEGs revealed 997 GO annotations and 50 KEGG signaling pathways. The DEGs were significantly enriched in defense response, type I interferon signaling pathway, innate immune response, and response to external biotic stimulus. KEGG pathway enrichment analysis suggested the DEGs were most significantly enriched in antigen processing and presentation, cytosolic DNA-sensing pathway, Toll-like receptor signaling pathway, and NOD-like receptor signaling pathway. In addition, 14 candidate genes were screened out from the DEGs by the ToppGene Suite. Among them, C-X-C motif chemokine 11 (CXCL11), toll-like receptor 3 (TLR3), C-C motif chemokine ligand 26 (CCL26), human leukocyte antigen E(HLA-E), promyelocytic leukemia protein (PML) and signal transducer and activator of transcription 2 (STAT2) had not been reported in Toxoplasma studies. The PPI network of the DEGs comprised 376 nodes and 1 152 edges, in which STAT2, HLA-E and PML were just located at the core position of the PPI network. Deletion of these key nodes led to the PPI network structure disorganized. Pathway enrichment analysis of 6 genes including CXCL11 resulted in 12 signaling pathways, which were mainly related to chemokine signaling pathway, Toll-like receptor signaling pathway, necroptosis, endocytosis and cytokine-cytokine receptor interaction. These bio-signal pathway may be related to the pathogenic mechanism of Toxoplasma ROP16Ⅲ. Conclusion CXCL11, TLR3, CCL26, HLA-E, PML and STAT2 were identified as candidate pathogenic genes, providing theoretical basis for further investigation of pathogenic mechanism of toxoplasmosis.

    Comparative analysis of transcriptomes in Toxoplasma gondii before and after invasion in human foreskin fibroblasts
    WANG Long-jiang, LI Jin, YIN Kun, XU Chao, LIU Gong-zhen, HUANG Bing-cheng, WEI Qing-kuan, SUN Hui
    2021, 39(4):  480-486.  doi:10.12140/j.issn.1000-7423.2021.04.010
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    Objective To investigate transcriptome changes in Toxoplasma gondii before and after invasion in human foreskin fibroblasts (HFF) by RNA-seq. Methods Tachyzoites of T. gondii RH strain were added to monolayered HFF cells at a parasite-cell infection ratio of 3 : 1 and incubated at 37 ℃ with 5% CO2 for 24 h. Following the incubation, the cells (infection group) were harvested and RNA extracted, using tachyzoites of RH strain as a blank control (control group). The mRNA was purified for high-throughput sequencing using the BGISEQ-500 platform. The eligible sequence data obtained were aligned with T. gondii genome data (GCF_000006565.2_TGA4_ncbi) in NCBI database. Differentially expressed genes (2.0-fold change with a P-value of < 0.05 in the infection group in comparison with the control group) were selected for Gene Ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment and protein interaction network analysis. Results A total of 5 888 genes were detected, 986 differentially expressed genes were identified, in which 533 upregulated and 453 downregulated. GO analysis showed that the GO items significantly enriched were membrane, integral component of membrane, intrinsic component of membrane, and membrane part. KEGG enrichment pathways mainly involving gastric cancer, fatty acid biosynthesis, and calcium signaling pathway. In protein-protein interaction network analysis, the top six interacting proteins were TGME49_282200, TGME49_305980 (PDHE3I), TGME49_316310 (SOD), TGME49_310440 (MORN1), TGME49_237110 and TGME49_222020 (PGKII). Conclusion There are significant differences in transcriptome in T. gondii before and after invasion in HFF cells. The KEGG enrichment pathways mainly involve gastric cancer, fatty acid biosynthesis, and calcium signaling pathway, and six top genes with regard to the number of interaction proteins are screened.

    Characterization of ubiquitinated protein profile change in host cells caused by Toxoplasma gondii infection
    LIAO Wen-zhong, XU Li-qing, YAO Li-jie, CHEN Min, PENG Hong-juan
    2021, 39(4):  487-493.  doi:10.12140/j.issn.1000-7423.2021.04.011
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    Objective To explore the changes of ubiquitinated protein profile in host cells infected with Toxoplasma gondii. Methods After induced into macrophages, the human acute monocytic leukemia cell line (THP-1) cells were assigned into three groups: uninfected group, RH infected group, and ME49 infected group. Cells in the infection groups were infected with strain RH and strain ME49 T. gondii tachyzoites with difference virulence, respectively, for 4 h. Then total proteins were extracted from the cells, and the ubiquitinated proteins were enriched using anti-ubiquitin antibody FK-2, followed by protein separation by sodium lauryl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) for qualitative mass spectrometry identification. Human source information was searched from UniProt databse, and the protein species were identified using Mascot. The ubiquitination level of CDC42 was verified by Western blotting. The proteins were digested into peptides and underwent liquid chromatography-tandem mass spectrometry (LC-MS/MS). Using the DAVID Bioinformatics Resources 6.8, Gene Ontology (GO) annotation and enrichment analysis was performed for significantly differentially ubiquitinated proteins (DUPs) between the infection and control groups and between the infection groups with different virulence. The pathway enrichment of DUPs was analyzed with KEGG online tool. The protein-protein interaction (PPI) network was analyzed with online STRING 11.1. Results LC-MS/MS results showed that compared with the control group, there were 194 DUPs in the RH infected group, 47 DUPs in the ME49 infected group, and 31 DUPs in both groups. Western blotting assay confirmed that the ubiquitination level of host CDC42 was increased significantly after T. gondii infection. GO clustering analysis showed that the DUPs in the RH infected group were mainly involved in energy metabolism and organelles of protein synthesis and processing (67 proteins), while the DUPs in the ME49 infected group were mainly involved in cytoskeleton structure (11 proteins). With regard to biological process clustering, no significant difference was found between the RH and ME49 infected groups, however, the DUPs of the ME49 infected group were enriched in Ephrin receptor signaling pathway (3 proteins) and clathrin-mediated endocytosis proteins (2 proteins). With regard to molecular function clustering, the DUPs of the RH infected group were significantly enriched in GO terms of RNA transcription/processing (47 proteins), GTPase activity (7 proteins) and ubiquitin ligase (11 proteins), while the DUPs of the ME49 infected group were significantly enriched in actin filament binding (3 proteins) and other GO terms. The enrichment of KEGG signaling pathway showed that DUPs in the RH infected group were mainly enriched in ribosome (12 proteins), ubiquitin-mediated proteolysis (8 proteins), phagosome (7 proteins), nucleotide excision repair (4 proteins) and pathogenic E. coli infection (4 proteins); while the DUPs in the ME49 infected group were mainly enriched in ribosome (3 proteins), actin cytoskeleton regulation (3 proteins) and pathogenic E. coli infection (2 proteins). The main node proteins of DUP interaction network in RH infection group included 60S ribosomal protein L9, protein transporter SEC61 subunit α subtype 1 and RAS related C3 botulinum toxin substrate 1. And in the interaction network of ubiquitinated proteins shared by RH infection group and ME49 infection group, the main node proteins were a cluster of ribosomal proteins and cell division control protein 42. Conclusion T. gondii infection results in significant changes in the ubiquitinated protein spectrum of host cells, which is related to virulence of the parasite strain. The DUPs involve in cytoskeleton, ribosome and ubiquitin proteasome pathway.

    Construction of an infection model of Toxoplasma gondii RH tachyzoite invasion to mouse macrophage cell line in vitro
    ZHANG Li-xin, ZHAO Gui-hua, XU Chao, XIAO Ting, SUN Hui, LI Jin, LIU Gong-zhen, YIN Kun
    2021, 39(4):  494-501.  doi:10.12140/j.issn.1000-7423.2021.04.012
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    Objective To establish an infection model for Toxoplasma gondii RH strain tachyzoites infection to mouse macrophage cell line RAW264.7, and to define a rapid and efficient method to culture tachyzoites in vitro. Methods The tachyzoites of T. gondii RH strain were purified with a 5 μm filtration membrane after 3 passages in Kunming mice, and then co-cultured with mouse macrophage cell RAW264.7 (ratios to tachyzoites set at 20 : 1, 10 : 1, 1 : 1 and 1 : 5) and human foreskin fibroblasts (HFF) cells (ratio to tachyzoites 1 : 1). The cells without tachyzoites were set as the control group. The co-cultures were observed at 10 min, 0.5 h, 1 h, 2 h, 4 h, 8 h, 12 h, 24 h, 32 h and 48 h under a high-power microscope, and underwent Wright-Giemsa staining to observe the adhesion invasion of tachyzoites. The tachyzoites were inoculated at 1.5 × 106/vial in a RAW264.7 T25 cell culture flask for co-culture. After 80% of pseudomonts were destroyed, the tachyzoites were collected and counted, and the productivity of tachyzoites was calculated. After staining with 0.4% trypan blue dye, the tachyzoite’s survival rate was calculated in the culture system. The harvested T. gondii tachyzoites were further used to infect new RAW264.7 cells, and the tachyzoites at each passage were inoculated at 1 × 106/mouse in five healthy female Kunming mice. Meanwhile, the same amount of tachyzoites at passage 3 were inoculated in five healthy female mice as the control. The survival time of mice inoculated with tachyzoites at each passage was recorded. The statistical software SPSS 21.0 was used for statistical analysis. One-way analysis of variance was used for comparison between groups. Results When the ratio of RAW264.7 cells and tachyzoites was over 10 : 1, the boundary of infected cells turned obscure after infection for 24 h, and the cytoplasm was increased, with increased number of vesicles. After infection for 30 h, a large number of cells died, with no appearance of free tachyzoites. When the ratio was less than or equal to 1 : 1, fine particles could be seen in the cytoplasm within 24 h with no vacuoles. After infection for 30 h, more than 90% of pseudocysts were ruptured, and a plenty of tachyzoites were released into the medium. The completion in vitro development process of tachyzoites could be observed under this conditions. Therefore, tachyzoites were co-cultured with RAW264.7 cells at a ratio of 1 : 1. After infection for 0.5-1 h, about 80% of tachyzoites could invade into RAW264.7 cells, and enter both cytoplasm and nucleus. After 2-4 h, pseudocysts began to form. At 8 h, a part of pseudocysts proliferated into visible chrysanthemum shape. After 24 h, partial pseudocysts began to rupture. After 32 h, the cells were suspended and unable to adhere to the wall, most of pseudocysts ruptured and free tachyzoites were released. The morphology of the newborn tachyzoites was fine. We harvested 6 × 108 tachyzoites, among which, the average live rate was higher than 92%. Tachyzoites were co-cultured with HFF cells, and the tachyzoites basically invaded the cells after 2-4 h; after 8 h, tachyzoites began to divide and proliferate; after 24 h of co-culture, the tachyzoites could divide into chrysanthemum shape; After 36 h, the cells began to burst and the tachyzoites released began a new round of HFF cell attack and infection. All passages of in vitro cultured tachyzoites showed an average lethal time to mice around 3.94-4.10 days, and the virulence of the tachyzoites was not weakened compared with those harvested under in vivo conditions in mice. Conclusion Mouse macrophage RAW264.7 cells could be used to produce large amounts of T. gondii RH tachyzoites quickly in vitro, and the yields are about 400 times of that by the in vivo culture method. Further, the in vitro produced tachyzoites have a comparable virulenc to those obtained by in vivo method, and are superior to those obtained in the HFF cells in the yield time and rate.

    TEACHING RESEARCH
    Integrative design of human parasitology course with “Belt and Road Initiative and global health”general education
    CHEN Lin, QIU Jing-fan, ZHOU Sha, LIU Xin-jian, XU Zhi-peng, JI Min-jun
    2021, 39(4):  501-504.  doi:10.12140/j.issn.1000-7423.2021.04.013
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    With the emergence of the global health concept, there are arising some questions for parasitology teaching that need to be urgently addressed, including how to reflect innovation, high performance and challenges, how to train students’ scientific view on health, how to enhance students’ application, analysis, evaluation and innovation capabilities, and how to promote an international perspective and strengthen mission responsibility among students. The “Belt and Road Initiative and global health” course may help college students to focus on the major health issues of global health. We integrated Belt and Road Initiative education into human parasitology teaching and carried out teaching practice. We integrated parasitology into the category of “pathogen biology” to cultivate students′ holistic view, integrated parasitology into the field of “global health” to cultivate students’ global outlook, and immersed parasitology theory into the whole process of “social practice”, so that students can apply what they have learned. This teaching strategy can improve the teaching effect and cultivate qualified medical workers for China and the whole world.

    REVIEWS
    Research progress on immunosuppressive function of myeloid-derived suppressor cells and its role in parasitic infection
    SUN Ye-ting, CAO Jian-ping, SHEN Yu-juan
    2021, 39(4):  505-513.  doi:10.12140/j.issn.1000-7423.2021.04.014
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    Myeloid-derived suppressor cells (MDSCs) are a group of immature heterogeneous myeloid cells, which are the precursors of dendritic cells, macrophages, and granulocytes. These precursor cells can be recruited to microenvironments, such as lymph nodes, spleen, peripheral blood and tumor, under pathological conditions, where they are further activated. After activation, MDSCs can suppress T cell immune response through various mechanisms, which are widely involved in different stages of parasitic infection. This review summarizes the research progress on the immunosuppressive function of MDSCs in the field of parasitic infection.

    Progress and challenges on global schistosomiasis control
    HONG Zhong, WU Ling-ling, WANG Li-ping, XU Jing
    2021, 39(4):  514-519.  doi:10.12140/j.issn.1000-7423.2021.04.015
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    Schistosomiasis is distributed worldwide and listed as one of the neglected tropical diseases by the World Health Organization. Although many countries have made certain achievements in the prevention and control of schistosomiasis, there are still many challenges for global elimination of the disease due to the complex life cycle of schistosomes, limited health resources, and unitary prevention and control measure. This review systematically summarizes the current status of global schistosomiasis epidemic, the goals, main strategies and measures for prevention and control, analyzes the current challenges and proposes pertinent recommendations, in order to provide reference for the professionals in schistosomiasis control and management.

    The interactions between malaria and gut microbiota
    ZHONG Qiu-ting, SONG Jian-ping, LV Fang-li
    2021, 39(4):  520-525.  doi:10.12140/j.issn.1000-7423.2021.04.016
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    Intestine is the largest and most important micro-ecosystem in the human body, and gut microbiota is closely related to human health and various diseases. This review summarizes the relationship between gut microbiota and diseases, the impact of malaria on gut microbiota, including damage of gastrointestinal type malaria to the intestine, and alterations of the composition, constitution, and function of gut microbiota caused by malaria; and the impact of gut microbiota on malaria, including the impact of gut microbiota on the risk of malaria and the outcome of malaria. Exploring the interactions between malaria and gut microbiota may provide clues for prevention and control of malaria.

    Advances in research on parasite proteomics of extracellular vesicles
    XU Feng-yan, YANG Yong, GAO Xin, LIU Xiao-lei, WANG Yang, LIU Ming-yuan, ZHANG Yuan-yuan, BAI Xue
    2021, 39(4):  526-532.  doi:10.12140/j.issn.1000-7423.2021.04.017
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    Extracellular vesicles are lipid-bilayer vesicles containing proteins, nucleic acids and lipids, secreted by a variety of cells, and are important mediators involving in intercellular interactions. Parasites use extracellular vesicles to secrete proteins during invasion, survival and reproduction, thereby regulating the host immune response to benefit parasitism. This review summarizes the recent research progress on extracellular vesicle proteomics of parasitic helminths and protozoan, in order to provide clues for characterizing the mechanisms of host-parasite interplay.

    Affect of Trichomonas vaginalis infection on male reproductive system and its mechanisms
    DUAN Yu-juan, LI Peng-ju, SANG Yu-hui, WU Pu-cheng, SHANG Yu-jia, HAO Li-xia, WANG Shuai, LI Xiang-rui, ZHANG Zhen-chao
    2021, 39(4):  532-536.  doi:10.12140/j.issn.1000-7423.2021.04.018
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    Trichomonas vaginalis is a type of flagellated protozoan and the most common sexually transmitted pathogens in the world. T. vaginalis mainly parasitizes in the female vagina, leading to trichomonal vaginitis. In addition, T. vaginalis can also infect males, and the parasites may retrograde to the bladder, prostate, seminal vesicle, testis, epididymis and other tissues, through the urogenital tract, thus causing serious damage to sperm cells or other tissues; causing urethritis, prostatitis, prostate cancer, asthenospermia or azoospermia, eventually affecting the male fertility. However, T. vaginalis infection in males often presents mild or no clinical symptoms, resulting in ignorance of the infection. In this paper, we review the related mechanisms underlying the T. vaginalis infection-induced abnormal sperm, testicular and prostate functions, and thereby male infertility.

    The interplay between Toxoplasma gondii infection and autophagy in host cells
    HOU Yong-heng, LV Fang-li
    2021, 39(4):  537-542.  doi:10.12140/j.issn.1000-7423.2021.04.019
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    Toxoplasma gondii is an important obligate intracellular pathogenic protozoan with worldwide distribution that may cause zoonotic toxoplasmosis, severely impacting the human health and the economy of animal husbandry. Studies have shown that the type I strain of T. gondii can escape from the killing effect of autophagy in host cells by changing the expression of autophagy-related proteins in the host, while the type Ⅱ and Ⅲ strains of T. gondii can be effectively cleared up or suppressed by the autophagy system of host cells. This review provides an update on the interplay between T. gondii infection and host cell autophagy system and the related molecular mechanisms.

    Research progress on tick protective antigens
    LV Li-hong, ZHANG Jin-cheng, HU Yong-hong
    2021, 39(4):  542-547.  doi:10.12140/j.issn.1000-7423.2021.04.020
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    Ticks are obligate hematophagous ectoparasites that can transmit a variety of pathogens, having harmful impacts on human health and the husbandry industry. Screening for efficient protective antigens to develop anti-tick vaccines has become a safe and effective strategy for tick control. This paper briefly introduces the commercial Bm86 protective antigen, and summarizes current status of protective antigens with different characteristics derived from tick salivary glands, midgut, gonads and eggs, as well as protective antigens of enzymes, protease inhibitors and conservative proteins. The review will provide a scientific basis for the development of anti-tick vaccines.

    SHORT COMMUNICATIONS
    Establishment and application of real-time fluorescence quantitative PCR for detection of Leishmania
    MA Lin, ZHANG Zheng, WANG An-li, LIU Dong-li
    2021, 39(4):  548-552.  doi:10.12140/j.issn.1000-7423.2021.04.021
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    To establish a real-time fluorescence quantitative PCR (qPCR) method for rapid and accurate detection of Leishmania. A pair of specific primers and a Taq-Man probe were designed, based on the conserved sequence of the small circle in kinetoplast of Leishmania, and the DNA of bone marrow samples from positive cases of Leishmania was used as a template for PCR amplification. The amplified product was 83 bp long, and ligated to the pESI-T vector for cloning and sequencing. The sequences were BLAST aligned on GenBank, and found 100% homologous to L. infantum and L. donovani. The plasmids with correct sequences were diluted to 102-107 copies/μl as the standard sample for qPCR. The obtained standard curve equation was y = 39.23-2.956 x, the amplification efficiency was 117.93%, R2 was 0.994, and when the threshold cycle number was 35, the minimum detection limit was 26.98 copies/μl, theoretically less than 1 Leishmania parasite could be detected. The qPCR was used to detect 14 bone marrow and 26 blood samples from leishmaniasis patients, and respective, 1 sample of bone marrow, blood, spleen, lung, lymph node, liver, and kidney from dogs with leishmaniasis, 2 samples of sandfly positive for Leishmania, and 2 samples of Leishmania culture from bone marrow of patient and dog with leishmaniasis, and all had positive results; 56 blood samples from persons with negative Leishmania seroantibodies, 1 DNA sample of each of Salmonella, Shigella, and Bacillus cereus, 4 blood samples from patients with malaria, 1 blood sample from each of patients with toxoplasmosis gondii or paragonimiasis wesleyi, and all had negative results. The method has high sensitivity and specificity, and can be applied to the rapid detection of infection and carrier status of leishmaniasis patients, host animals, and vectors, and can also be used to determine the therapeutic efficacy in patients.

    Laboratory diagnosis of two misdiagnosed imported Plasmodium ovale malaria cases in Shanghai
    ZHANG Yao-guang, JIANG Li, WANG Zhen-yu, ZHU Min, ZHU Qian, MA Xiao-Jiang, WU Huan-yu
    2021, 39(4):  553-556.  doi:10.12140/j.issn.1000-7423.2021.04.022
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    Laboratory diagnosis was performed using microscopic examination, rapid malaria diagnostic test (RDT) and malaria nucleic acid test (NP-2002 method, multiplex PCR method and qPCR method) on two blood samples of imported malaria patients, to which there was controversy on the Plasmodium species. The initial examination of case 1 in a district-level center for disease control and prevention (CDC) in region A found P. falciparum (Pf) by microscopy, and Pf by RDT, whereas nucleic acid test was not done. The examination result was rechecked by Shanghai Municipal Center for Disease Control and Prevention (SCDC), presenting confirmation of P. ovale (Po) by microscopy, Pf by RDT, and Po by nucleic acid detection. The initial examination results of case 2 using microscopy, RDT, and nucleic acid detection in the district B CDC all revealed P. vivax (Pv). The recheck results of SCDC were Po by microscopy, negative finding by RDT, and Po by nucleic acid detection.

    Surveillance and analysis of important human parasitic infections in Beijing during 2016—2020
    HE Zhan-ying, WANG Xiao-mei, WU Wen-ting, LI Xu, REN Hai-lin, LI Xin-yu
    2021, 39(4):  557-561.  doi:10.12140/j.issn.1000-7423.2021.04.023
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    To understand the infection status of soil-transmitted helminthes(STH) and the prevalence of clonorchiasis in Beijing from 2016 to 2020, and provide scientific basis for formulation of prevention and control measures. Three surveillance sites were set up every year in Beijing to survey the infection status of STH and clonorchiasis prevalence, including one fixed surveillance site and one mobile surveillance site for STH, and one mobile surveillance site for Clonorchis infection. Each surveillance site was divided into 5 parts according to the geographical directions, including the east, west, south, north and middle parts, and a township was randomly selected from each part. Then, an administrative village was randomly selected from each township, where 200 permanent residents over 3 years of age were randomly selected using the cluster sampling method. The participants were surveyed by fecal examination for helminth infection using the modified Kato-Katz thick smear method (one sample, two slide-readings). Children aged 3 to 9 years in the surveillance sites for STH further underwent pinworm infection examination using the anal transparent tape test. The data of clonorchiasis were obtained from the Infectious Disease Surveillance Reporting System and epidemiological investigation, the place and source of infection were investigated and analyzed retrospectively. A total of 15 200 residents were surveyed during 2016—2020, and 10 were found positive. The overall prevalence was 0.07% (10/15 200). The infection rate of Ascaris lumbricoides and pinworm was 0.06% (9/15 200) and 0.01% (2/15 200), respectively. No resident was found infected by Clonorchis sinensis. The infection rate was 0.13% (6/4 697) in mountainous areas, and 0.04% (4/10 503) in plain, hilly, and basin areas (P > 0.05). The infection rate in females was 0.09% (7/8 052), and that in males was 0.04% (3/7 148), with no significant difference (P > 0.05). The residents infected were between the ages of 33 and 65, and their occupation were mainly farmers (6 persons), followed by unemployed persons (2 persons). A total of 16 cases of clonorchiasis were reported in Beijing during 2016—2020. Among them, 14 cases had eaten sashimi and two cases had eaten insufficiently cooked fish. The infection rate of soil-transmitted helminths is very low. Rural areas in the suburbs and outer suburbs are the focus of prevention and control. Clonorchiasis cases were reported occasionally, thus surveillance and health education should be strengthened.