Iranian Journal of Parasitology
Volume:17 Issue: 4, Oct-Dec 2022

Toxoplasma gondii infection (toxoplasmosis) has the potential to cause a serious disease in immunocompromised patients and can be fatal in this population. We conducted a systematic review and meta-analysis to assess comprehensively the pooled seroprevalence of toxoplasmosis among immunocompromised patients including HIV/AIDS patients, cancer patients, and transplant recipients in Iran.

PubMed, Web of Science, Scopus, Embase, and Google Scholar databases (international) and Scientific Information Database (SID), Magiran, IranMedex, and IranDoc databases (national) were systematically searched for all reports that possibly contained data for T. gondii prevalence in different immunocompromised populations in Iran between 2013 and 2022.

Overall, IgG seroprevalence rate of toxoplasmosis in Iranian immunocompromised patients was 45.1% (95% confidence interval (CI), 37.4–52.9). IgG seroprevalence rate of toxoplasmosis in 12 studies that included 2279 cancer patients, 19 studies that included 2565 HIV/AIDS patients and in 3 studies that included 200 transplant recipients was 43.6% (95% CI, 30.2–57.0), 45.9% (95% CI, 34.8–57.1) and 45.8% (95% CI, 32.5–59.0), respectively. Moreover, IgM seroprevalence rate in the 26 studies was 2.6% (95% CI, 1.4–3.7).

Our findings represent a high seroprevalence rate of Toxoplasma IgG among immunocompromised patients. Health improvement and education toward prevention of toxoplasmosis is of great importance for these susceptible populations.

This study was designed considering the challenges of leishmaniasis treatment and the benefits of carriers of drug delivery systems to review plant bioactive ingredients in delivery systems and nanocarriers for the treatment of leishmaniasis.

The methodology of this review investigation followed the 06-PRISMA recommendations. The searches were carried out up to January 30, 2022, in the central English databases SCOPUS, WEB OF SCIENCE, EMBASE, PUBMED, and GOOGLE SCHOLAR using the search terms “ç”, “leishmaniasis”, “herbal medicines”, “drug delivery”, “nanocarriers”, “herbal compounds”, and “secondary metabolites”.

Out of 5731 articles, 19 publications, including 12 in vivo (63.15%), 3 in vitro (15.8%), and 4 in vitro/ in vivo (21.1%) up to 2022, fulfilled the criteria presence for argument in the current systematic study. Plant bioactive ingredients were curcumin, betulinic acid, artemisinin, 4-nitrobenzaldehyde thiosemicarbazone, andrographolide, pentalinonsterol, ursolic acid, amarogentin, carvacrol, 14-deoxy-11-oxo-andrographolide, quercetin, beta-lapachone, cedrol, 2ˊ,6ˊ-dihydroxy-4ˊ-methoxychalcone, and oleanolic acid.

The high potential of plant bioactive ingredients in delivery systems due to the load on the nanocarrier for the treatment of leishmaniasis through some main mechanisms of action, e.g. changes in the fluidity and the structure of the cell wall, creation of reactive oxygen species (ROS) and mitochondrial dysfunction, inhibition of DNA topoisomerase I enzyme, minimal cytotoxicity, stimulation of cell cycle disruption, stimulation of apoptosis, enhancement of the immune system. However, further investigations, especially in the clinical setting, are required to confirm these findings.

Pentavalent antimonial has been a drug of choice against leishmaniasis, despite the emergence of treatment failure. Identification of resistance markers is urgently needed to design new therapeutic strategies. Iron-Superoxide dismutases (Fe-SODs) are antioxidant enzymes contributing to detoxify reactive oxygen species to prevent a cell from oxidative stress. Since antimonial compounds induce oxidative stress, in this survey, the expression of SOD genes was investigated to identify their expression pattern in clinical resistant isolates.

This cross-sectional survey was done in Mashhad City, northeast of Iran during 2014 to 2019. The RNA expression level of mitochondrial (SODA) and glycosomal (SODB) superoxide dismutase was investigated in 25 antimony responsive (n=15) and unresponsive (n=10) anthroponotic cutaneous leishmaniasis (ACL) patients. Total RNA extraction and cDNA synthesis, the qRT-PCR approach was utilized to investigate the relative RNA expression level.

The transcript level of SODs was over-expressed in the most resistant isolates. Gene expression analysis demonstrated the over-expression of SODA and B by a factor of 3.8 and 4.81, respectively, in resistance isolates vs. sensitive ones.

Aberrant expression of SODA/B in unresponsive parasites could potentially implicate in detoxifying antimony-induced oxidative stress. Moreover, SODs might be considered as potential predictive markers of the response to antimonials in ACL patients in endemic areas.

Optimal duration for medical therapy of liver hydatid cysts before surgery in not certainly defined yet. In this study, we aimed to evaluate the effectiveness of 2 weeks preoperative albendazole in decreasing viable cysts.

Patients referring to Imam Reza Hospital, Mashhad, Iran with a diagnosis of hepatic hydatid cyst were randomly divided into intervention (44 patients) and control (46 patients) groups. The case group were treated with oral albendazole before surgery and the control group underwent surgery without albendazole therapy. Efficacy of albendazole on the reduction of prevalence and viability of the protoscoleces was finally evaluated.

A number of 90 patients were included in the final analysis. Protoscoleces were reported alive in 10 (22.7%) and 17 (36.9%) of patients in the case and control group, respectively. The decrease of live protoscoleces in case group was not statistically significant (P=0.14).

Decrease in the viability of protoscoleces in hepatic hydatid cysts after 2 weeks administration of oral albendazole at a dose of 10 mg/kg/day preoperatively, is not significant. Optimal duration of medical treatment before surgery seems to be 4 weeks or more.

Giardiasis is one of the leading causes of diarrhea, particularly among children under the age of five in developing countries. Fecal calprotectin (FC) is an important biomarker for diagnosis and monitoring of inflammtory bowel disease, but other diagnoses should be considered in light of its elevation. We aimed to evaluate FC level in patients diagnosed with giardiasis and elucidate a possible correlation between Giardia genotypes and FC levels.

Overall, 120 fecal samples were collected from children aged 4-12 years and tested for giardiasis by light microscopy. Out of which, 50 samples were enrolled within two groups: group I “cases” and group II “controls” and then subjected to PCR amplification, sequencing of the beta-giardin (bg) gene of the parasite, and FC evaluation.

Assemblage B was identified in 75%, and assemblage A in 25% of samples. FC levels were statistically elevated in “group I” in comparison to “group II”. Likewise, there was a statistically significant difference between FC levels in patients infected with assemblage A and assemblage B with a mean of 114 μg/gm and 202 μg/gm, respectively.

The study highlighted the possible association between Giardia genotype B and elevated FC levels, further detailed studies are necessary to clarify these finding.

Cryptosporidium spp. are protozoan parasites that cause diarrhea in humans and animals. Subtyping data about Cryptosporidium spp. in Isfahan, Iran is limited; therefore, we aimed to study the prevalence rate of Cryptosporidium spp. in cancer patients, associated risk factors, and subtypes of Cryptosporidium spp.

Fecal samples were collected from 187 cancer patients from the Oncology Department of Seyed-al-Shohada Hospital, Isfahan University of Medical Sciences during 2014–2020 and screened for Cryptosporidium spp. using microscopical techniques. Nested PCR amplifying 18S rRNA gene was used to detect Cryptosporidium spp. in samples, followed by subtyping using nested PCR amplifying gp60 sequences.

Overall, the rate of infection with Cryptosporidium spp. was 4.3% (n=8). Five samples out of eight samples were identified as Cryptosporidium spp. using a nested PCR for the 18S rRNA gene, two subtypes of C. parvum named IIaA18G3R1 (n = 2) and IIaA17G2R1 (n = 2), and one subtype of C. hominis named IbA6G3 were identified by sequencing of the gp60. The IbA6G3 subtype has rarely been detected in other investigations.

This is the first survey on the subtyping of Cryptosporidium spp. in this region. The results of the present survey show both zoonotic and anthroponotic transmission routes in the region.

Leishmaniasis is a zoonotic disease, which is one of the serious public health problems in the world. Nowadays, antibody production using hybridoma technology may be a correct approach in terms of sensitivity in the diagnosis of diseases such as leishmaniasis. The aim of this study was investigation of the effectiveness of different adjuvants on polyclonal antibody production against L. tropica based on hybridoma technique.

Accordingly, Freund's adjuvant (1956, M. tuberculosis), as a classic adjuvant in studies, was used comparatively with the non-toxic polymeric based Polyoxidonium adjuvant. All animal immunization procedures were conducted at Bezm-i Alem University Experimental Animal Research Center. The adjuvant response was tested both in the serum sample and in the antibodies produced by the hybridomas. The antibody titers were determined with ELISA.

Freund’s and Polyoxidonium (PO) group blood titer’s increased approximately 5.5 fold compared to control after the 6th and 8th immunization. Hybridomas produced from mice immunized with PO adjuvant induced only antigen-specific antibody response and did not develop an immune response against the adjuvant.

Adjuvant selection is very important in terms of the specificity of antibody responses of cells produced in hybridoma technology. Therefore, PO is recommended as a new adjuvant system in this study.

Parasites of the genus Echinococcus are common worldwide and are important cestodes that cause serious infections in humans and animals. This retrospective study evaluated the indirect hemagglutination (IHA) test results of serum samples obtained from patients with a pre-diagnosis of cystic echinococcosis (CE) within ten years. In addition, the role of the IHA test results of the patients in the follow-up of the treatment and determining possible recurrences was investigated.

The IHA test results of 2426 serum samples of patients with a pre-diagnosed CE admitted to Trakya University Health Center for Medical Research and Practice in Edirne, Turkey, between January 2011 and December 2020 were evaluated retrospectively. The data of 53 patients with CE who had medical treatment and/or postoperative follow-up serological records were evaluated.

Of 2426 IHA tests, 376 (15.5%) were seropositive, and 2050 (84.5%) were seronegative. It was determined that 376 serum samples detected as positive belonged to 207 patients with CE. Of 207 CE patients, 109 (52.7%) were female and 98 (47.3%) were male. The most common organ involvement was the liver in 186 (89.9%) cases. Of 53 patients, 16 were considered relapse cases. The median follow-up period for 16 recurrent cases was 31.8 (1-77) months. Our results showed a statistically significant correlation between long-term serological follow-up and recurrence detection (P=0.034).

Long-term serological follow-up after treatment is considered useful in determining possible recurrent cases. CE is an important public health problem for endemic regions, including our country, and we think our study results will contribute to the status and follow-up of the disease.

Infections by Plasmodium falciparum, are becoming increasingly difficult to treat. Therefore, there is an urgent need for novel antimalarial agents’ discovery against infection. In present study, we described a 2’-O-Methyl gapmer phosphorothioate oligonucleotide antisense targeting translation initiation region of 3D7 strain RH5 gene.

The study was conducted in Pasteur Institute of Iran in 2020. ODNs effects were measured by microscopic examination and real time RT-PCR. For microscopy, microplates were charged with 2’-OMe ODNs at different dilutions. Unsynchronized parasites were added to a total of 0.4 ml (0.4% parasitemia, 5% red blood cells), and slides were prepared. Proportion of infected cells was measured by counting at least 500 red blood cells.

RH5 genes start codon regions selected as conserved region besed on alignment results. Gap-RH5-As which was complementary to sequence surrounding AUG RH5 start codon significantly reduced parasite growth (>90% at 50 nM) compared to sense sequence control (Gap-RH5-Se) (17%), (P<0.001). RH5 transcripts were dramatically reduced after exposed to ODNs at a concentration of 5-500 nM for 48 h.

Gemnosis delivery of a chimeric gapmer PS-ODN with 2’-OMe modifications at both sides had high antisense activity at low concentrations (10-100 nM) and shown a good efficiency to reach to target mRNA in human RBCs. Anti-parasite effect was correlated to reduction of target gene mRNA level. In addition, 2’-OMe ODNs free delivery is an effective way and does not need any carrier molecules or particles.

Sarcocystis is a genus of coccidian protozoa that at least seven species of it can parasitize cattle. The global prevalence of Sarcocystis is close to 100% in adult cattle. The main aim of this study was to identify the infection rate of Sarcocystis spp. in heart of cattle in Tehran, Iran by microscopy and PCR-RFLP methods.

Totally, 100 bovine heart samples were collected from the main slaughterhouse of Shahriar, Meysam slaughterhouse, west of Tehran in 2016. At first, heart samples were completely examined for the presence of sarcocystic macrocysts. Then, for microscopic examination, 50 g of each heart was digested in sterile condition using pepsin acid digestion method. Then, the species of the parasite were detected by PCR-RFLP technique and sequencing.

Overall, 97 of 100 of the heart muscle samples were infected with Sarcocystis. All the samples were detected as S. cruzi through similar patterns in PCR-RFLP.

S. cruzi is the most common species in the heart of cattle slaughtered in Shahriar.

Leishmania is a eukaryotic protozoan parasite belonging to the Trypanosomatidae family. The Iranian Lizard Leishmania (I.L.L.), which is non-pathogenic to mammals, shows great promise to be used as an expression system for recombinant protein production. Unlike other Leishmania strains, the ideal culture medium for I.L.L. has not been established, although it is commonly cultured in the RPMI1640 medium.

We investigated the growth rate of the wild and recombinant I.L.L. in BHI, RPMI1640, LB, and M199 media with and without FBS, hemin, or lyophilized rabbit serum. Subsequently, the expression rate of the recombinant protein in these media was compared.

The growth rate of I.L.L. in RPMI1640 medium and LB broth was similar and supplementation with 10% FBS did not affect the growth rate. The amount of protein expression in the LB medium was higher than in the other three media.

The LB broth is an appropriate medium for I.L.L. culture and recombinant protein production.

We aimed to determine the prevalence of Alveolar echinococcusis using ELISA in our region, to perform the specific differentiation of species by using the Western Blott method, to diagnose and treat this disease effectively in early periods, and to inform the patients about the results quickly.

From the provinces of Erzurum, Kars, Ardahan, Iğdır, Ağrı and Erzincan in the Eastern Anatolia Region, Turkey in August-September 2017, blood samples were provided from 305 participants (volunteer patients and their relatives), including 151 females (49.50%), whose ages ranged between 6-85 yr and were diagnosed as Alveolar echinococcosis (AE) and operated in concerned clinics. 

EIgG ELISA was determined as positive in 29 (9.5%) participants, including 17 (11.3%) females and 12 (7.8%) males. In addition, Em2-Em18 ELISA was also determined as positive in 15 (4.9%) participants, including 9 (6%) females and 6 (3.9%) males. Tweleve (3.94 %) of these findings were observed as positive in terms of both tests. Through the verification done by Anti-EWB IgG, Echinococcus multilocularis (EM) was identified in 7 (21.9%) of the female participants, E. granulosus (EG) in 1 (3.1%), and both parasites in 2 (6.2%). For male participants, EM was determined in 3 (9.3%) of them, EG in 1 (3.1%), and both parasites in 1 (3.1%).

AE continues to threaten public health in the region. In families where AE is detected positive, the reason for disease is based on nutrition; thus, it will be proper to check up all family members in the terms of infection.

Leishmania is a parasite causing leishmaniasis with different clinical manifestations depending on the infectious species in many countries worldwide. Although different studies have been taken place to clear the interaction of the parasite with the immune system, many aspects of immunology of leishmaniasis is remained uncertain.

Bone marrow derived dendritic cells (DCs) were cultured in vitro and divided into different groups (Nottingham Trent University, Nottingham, UK). The groups were separately infected with live or autoclaved L. mexicana or loaded with Soluble Leishmania Antigen (SLA). The expression of major histocompatibility complex class I (MHC-I) molecule was checked and compared on the cultured DCs using flow cytometry.

Infection of L. mexicana caused a significant downregulation in expression of molecules where killed Leishmania or SLA could not induce suppression in expression of these molecules.

L. mexicana infection results in downregulation of MHC-I expression on bone marrow-derived dendritic cells.

Cutaneous leishmaniasis (CL) is a chronic granulomatous dermatitis (CGD). Approximately, 90% of CL patients are from seven countries including Iran. We explain polymerase chain reaction (PCR) diagnostic technique for chronic granulomatosis dermatoses including CL in Mashhad, Iran.

This study enrolled 64 patients within 2009-2013 with chronic granulomatosis dermatitis referred to dermatology and pathology departments of Imam Reza Hospital, affiliated to Mashhad University of Medical Sciences (MUMS), Mashhad, Iran. We gathered demographic data from archived folders. Histological light microscopic evaluation and parasitological tests were done on selected specimens. We used PCR diagnostic test on specimens. Statistical analysis was done by SPSS version 15.

Generally, 7 out of 64 specimens had Leishmania DNA and other samples had no Leishmania DNA. The mean age of patients was 46 ± 18.77 years; disease duration was 7 ± 6.73 months ranging from 1-24 months. Most of the lesions were located on face and upper limb. Totally, 5 out of 7 samples were Leishmania major and 2 out of 7 samples were L. tropica. Tuberculoid granuloma was present in L. tropica samples and 3 of L. major samples. Other light microscopic changes were as follow: 42 suppurative granuloma, and epidermal changes including atrophy, pseudoepitheliomatous hyperplasia, and parakeratosis with dermal changes including, plasma cell, involvement of papillary and reticular dermis, and distribution of granuloma to hypodermis.

Our results addressed PCR-based diagnosis of chronic cutaneous leishmaniasis, which is resulted from L. major and L. tropica.

Allergic rhinitis (AR) is one of the most common allergic diseases triggered by indoor and outdoor allergens. Certain arthropods, such as mites and cockroaches, contain protozoa like Lophomonas blattarum in their intestines to help with digestion that may have some role in AR. We aimed to determine the frequency of L. blattarum in nasal smears of patients with AR in comparison with healthy controls.

In this prospective cross-sectional study (March 2015-March 2016), 36 patients with a clinical presentation of AR (with a positive prick test including mites) and 34 normal controls were included at ear, nose, and throat (ENT) clinic at Imam Reza Hospital of Mashhad, Iran. Nasal secretions were evaluated to examine presence of L. blattarum in the patients and control group by direct method. Diagnosis of L. blattarum was based on microscopic observation both on direct smear and Giemsa stained specimens.

Patients with AR had a higher frequency of L. blattarum in their nasal smears than the control group (25% vs. 2.9%) (P=0.001).

We found L. blattarum more frequently in the nasal secretion of AR patients compared with healthy subjects; this protozoon may have some role in this condition. However, the relationship between L. blattarum and AR requires further studies to allow a greater understanding.

To explore the transcriptome profiling of the fourth-stage larvae of Angiostrongylus cantonensis.

Two groups of fourth-stage larvae were collected to extract total RNA in Zhejiang, China 2020. Then, mRNA was separated and reverse transcribed into cDNA. Next-generation sequencing was used to explore the transcriptome information. Finally, to obtain the biological annotation information, the transcriptome information was run against the related databases, including Nr, GO, COG, KOG and ORF.

Overall, 128667 unigenes and 193059 transcripts were obtained. The Nr annotations of unigenes and transcripts showed that A. cantonensis was the 5th and 4th most related species, respectively. Meanwhile, the annotation of unigenes and transcripts by querying GO, COG, KOG and ORF showed that L4 was extremely active in gene expression, concerning signal transduction, transcription, posttranslational modification, metabolism, etc.

The fourth-stage larvae of A. cantonensis have their own profiling in the transcriptome, which is related to signal transduction, transcription, posttranslational modification, metabolism, etc.

Fasciola hepatica is a zoonotic liver trematode that usually causes infection in cattle and sheep, and is transmitted to humans by consuming water and aquatic plants contaminated with metacercaria. The detection of Fasciola eggs in stools, serological evaluation and radiological evaluation are essential for diagnosis. Triclabendazole is the first-line therapy for fascioliasis. However, as triclabendazole is not an easily accessible drug in countries such as Turkey, it reveals a quest for alternative therapies. In this report, we present a 10-year-old boy with fascioliasis successfully treated with a course of metronidazole 1.5 g/ day for 3 weeks in 2020. During the follow-up, eosinophilia and radiological findings completely recovered. Here we report a case of pediatric fascioliasis that was cured with metronidazole successfully.