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Announcements • Thursday April 29, 2010: Review session- 5 PM. Coverdell room S175. Please bring questions for discussion. • May 3, 2010, noon: Deadline for CBIO6500 paper. • Tuesday May 4, 2010: FINAL EXAM: Coverdell, room S175: 8-11 AM CONTROL MEASUR2ES Vector control Medical Parasitology CBIO4500 April 27, 2010 Silvia N J Moreno PARASITE CONTROL Prevention of Environmental Contamination: Antiparasite drugs. Treated hosts should be protected from re-infection. Sanitation. Destruction of Free-Living Stages: Protozoan cysts, helminth eggs and infective larvae are often extremely resistant to toxic chemicals. Destruction of Intermediate Hosts and Vectors: chemicals to kill snails, insecticides. Altering the environmental conditions so the the target species do not find the suitable habitat for its survival. Does not rely on public cooperation. Destruction of Reservoir Hosts: dogs in leishmaniasis, game animals in trypanosomiasis Prevention of Infection: Many infective stages gain entry in drinking water, Cryptosporidium, Giardia, Dracunculus etc. These can be controlled by safe water supplies. Meat inspection to prevent Taenia. Bednets prevents mosquito bites. Shoes stops hookworm larvae burrowing through the skin. Prevention of Parasite Maturation: chemoprophylaxis and vaccination Integrated Control 400,000 long-lasting insecticide-treated bed nets start the last leg of their journey from a Red Cross warehouse in Mozambique into the hands of families who need them VECTOR CONTROL Major vector-borne diseases of humans, and associated aetiological agents and arthropod vectors DISEASE PATHOGEN/PARASITE Protozoan diseases Malaria Plasmodium falciparum, Plasmodium vivax, P. ovale, P. malariae Leishmania Leishmania spp. Trypanosoma brucei gambiense Trypanosoma brucei rhodesiense Chagas disease Trypanosoma cruzi Filarial nematodes Lymphatic Brugia malayi, Brugia timori, Wuchereria filariasis bancrofti Onchocerc iasis Onchocerca volvulus Viral diseases Dengue DEN-1, DEN-2, DEN-3, DEN-4 flavivirus Trypa nosomiasis hemorrhagic fever Ye llow fever Encephalitis Yellow fever flavivirus Flavi-, alpha- and bunyaviruses ARTHROPOD VECTOR Anopheles spp. mosquitoes Lutzomyia and Phlebotomus spp. sandflies Glossina spp Triatomine spp Anopheles, Culex, Aedes and Ochlerotatus mosquitoes Simulium spp. blackflies Aedes aegypti mosquito Aedes aegypti mosquito Various mosquito and ixodid tick species Global estimates of human mortality caused by vector-borne diseases The total numbers of human deaths that are attributed to specific vector-borne diseases are shown and can be compared with the numbers of human deaths caused by two non-vector-borne diseases — HIV/AIDS and tuberculosis. The percentages of human deaths attributed to specific diseases as a percentage of the total number of deaths attributed to all vector-borne diseases are shown in the pie chart. Mortality estimates are based on data collected from 112 countries by the World Health Organization. Yellow fever estimate is based on data published by the Centers for Disease Control and Prevention. Nature reviews Microbiology 3:262 (2005). The global distribution and burden of major vector-borne diseases The distribution of mortality due to major vector-borne diseases in different WHO regions. Most vector-borne diseases occur in tropical and subtropical regions of the world and the burden of these diseases is greatest in developing countries. Mortality estimates for all major vector-borne disease (in parentheses) for each region are shown in thousands. Nature reviews Microbiology 3:262 (2005). The global distribution and burden of major vector-borne diseases The burden of vector-borne disease in disability-adjusted life years (DALYs) for all major vector-borne diseases in WHO regions (thousands). One DALY is defined as one lost year of 'healthy' life. The burden of disease is a measurement of the gap between the current health of a population and an ideal situation where everyone in the population lives into old age in full health. Morbidity and mortality estimates are based on data published by the WHO. Nature reviews Microbiology 3:262 (2005). VECTOR CONTROL Vector control has proven successful for disease control: Malaria: eradication of malaria from most of the temperateclimate countries in the northern hemisphere Onchocerca: the insecticide phase of the Onchocerciasis Control Prgramme (OCP) in West Africa has almost eliminated onchocerciasis from11 countries (www.who.int/ocp/index.htm) However there is paucity of effective vectorcontrol programmes: past neglect in this area of research, potential environmental impact of existing agents, reduction of their effectiveness because of resistance and other biological complexities of vector populations. DTT spraying does reduce disease transmission but environmentalists have opposed to their use on large scale. Bednets impregnated with pyerethroids offer a simple and effective approach to reduce vector-human contact and transmission. Limited adoption of this approach, improper use and the emergence of vector populations with resistance to pyrethroids limit their effectiveness. Abandoned village near the Volta river high blindness rates resulted in the depopulation of entire villages. The result has been increased activity and productivity in many of these areas. New villages in areas formerly uninhabitable because of river blindness VECTOR CONTROL Advances in vector genomics: an important advance is the sequencing of the genome of the A. gambiae mosquito (Science, 2002 298:129). The genome of Aedes aegypti (Science (2007) 316:1718-23) (yellow fever) was also sequenced, and a project is in place for the genome of Glossina morsitans (Tsetse fly vector). This information will provide opportunities for understanding better vectors and devising new methods for their control. Vector biology is poised to explore new strategies for vector-based disease control: Mosquitos refractory to pathogen infection Novel insecticides targets Understanding the molecular basis for vector behavior, ecology and host-parasitevector interactions Manipulation of insect vector by their parasite • Parasites alter their host in some way. Does this alteration affect transmission? (increase would be favorable for a successful parasite) • Parasite undergo a period of growth, development and sometimes reproduction within their vector. Parasite fitness is linked to vector fitness. Two factors that would improve parasite success: Vector longevity Fast Development Lutzomyia longipalpis feeding Host manipulation by parasite: Hematophagy: Infection results in altered vector feeding behavior. Most-studied examples in parasite affecting vector feeding behavior: Leishmania and plasmodium. Fecundity, blood feeding, and infection: Blood is important for the vector and the parasite. Parasite-induced fecundity reduction. Allows vector survival until transmission can occur? Anopheles albimanus mosquito feeding on a human arm. This mosquito is a vector of malaria and mosquito control is a very effective way of reducing the incidence of malaria. Infection and survivorship: Do infected mosquitoes live longer? High infectivity also results in increase in mortality. Studies are not conclusive. Manipulation of insect vector by their parasite Hematophagy: Malaria-infected mosquitoes: Infected mosquitoes makes many attempts to feed, each time depositing parasites at the feeding site. ADP stimulates platelet recruitment to the wound site. Apyrase is an enzyme which degrades ADP and is present in the mosquito saliva and would inhibit host hemostasis promoting easier and longer blood feeding. Apyrase activity is reduced in the salivary glands of P. gallinaceum- infected Aedes Aegypti resulting in an increase in the times of the median blood location time. One study showed that P. falciparum infected An. gambiae bite more hosts and also that infected mosquitoes were more likely to take multiple meals and become fully engorged. This would increase their chances for transmission. Leishmania manipulates sandfly feeding to enhance its transmission Hematophagy: •Difficulty in ingesting a blood meal leads to more probing. Increased probing favors transmission of the parasite. • Metacyclic promastigotes of L. mexicana are regurgitated from the midgut accompanied by a secretory gel (PSG) and with sand fly saliva. • The major component of the gel is filamentous proteophosphoglycan (fPPG) a parasite secretion. • The resulting blockage interferes with feeding and limits the volume of blood a fly can obtain; and this could explain why infected flies probe the skin more frequently and spend more time feeding. • Experiments with Phlebotomus chinensis showed that flies were more likely to transmit L. donovani to hamsters when they probed and took no blood compared to those infected flies that took a blood meal. Transmission from the Vertebrate host • Host attractiveness is enhanced possibly due to modified host odor and vectors such as tsetse flies feed more frequently on infected hosts. • Host defensive behaviors may be reduced making feeding on infected hosts less risky. Manipulation of insect vector by their parasite FECUNDITY, BLOOD FEEDING, AND INFECTION • Blood feeding is essential for both: vector and parasite. • Blood meal quantity and quality are important for egg production. • There is a reduction in fecundity (ability to reproduce) in plasmodiuminfected mosquitoes, specially when oocysts are developed. • This loss of fecundity may be attributed to reduced blood intake or intake of impoverished blood when mosquitoes fed on infected hosts. • The most important reason for the reduced fecundity it is still not clear. • How can reduced fecundity benefit the parasite? Since increased reproductive effort decreases lifespan; if vector survival results from fecundity reduction then the parasite increases its chances of successful transmission. Larval development Gonotrophic status Blood meal quality Blood meal source Teneral reserves Mosquito fecundity Body size Number of ovaries Blood meal size Recommendations for vector control • Genetic manipulation of vectors: Transgenic mosquitoes with impaired ability to transmit the parasite. This is attractive because is likely to be economically viable and relatively “low technology”. • Vector immunity and vector-parasite interactions: Genome projects would help identify novel targets in the mosquito gut and salivary glands involved in digestion of the blood meal and host-parasitevector interactions which could be used to develop vaccines that block the transmission of parasites and mosquito immune regulators or ‘smart sprays’ that disrupt the development of the parasite in the mosquito. • Vector behavior and other approaches to vector control: Elucidating the molecular basis of many mosquito behavior may be an expensive research investment, but the simple traps and repellant devises anticipated from this research could be easily adopted in malaria-endemic countries Genetic manipulation of vectors Two broad categories: • Genetic modification of mosquito populations. Could be achieved by releasing transgenic mosquitoes carrying genes whose products impair pathogen development. • Population suppression: use of sterile insect technique (SIT) in conjunction with “release of insects carrying a dominant lethal” (RIDL). Insects are transformed with a transgene whose product suppresses offspring production, leading to a decrease of the vector population. A transgenic mosquito carrying a gene that confers resistance to the malaria parasite. The mosquito can be recognized as transgenic by the green fluorescence of the eye facets. http://news.mongabay.com/2007/0319-mosquitoes.html Genetic manipulation of vectors Controversial but attractive and potentially selfpropagating. Many questions need to be addressed first about the feasibility and consequences of this approach. Serious issues are: reduced fitness of modified vectors, the ecological impact of transgenic arthropods and the evolutionary consequences of their release. In addition scientists need: • Methodologies to introduce foreign genes into vectors mosquitoes (e.g. transposable elements) • Promotores that can drive the expression of foreign genes in the correct tissues and at the appropriate times need to be characterized • Find “blocking gene products” capable of interfering with parasite development in the mosquito. Deleterious effects of these gene products on the mosquito should be considered and avoided. Laser scanner image of transgenic mosquito larvae. The white areas of high fluorescent intensity indicate a high level of transgene expression - particularly in the gut of the larvae The transformation technique involves the microinjection of the recombinant DNA into the posterior end of mosquito embryos (fresh laid eggs) prior to pole cell formation. Genetic manipulation of vectors • Transgenic: A genetically modified organism (GMO): an organism whose genetic material has been altered using genetic engineering techniques. DNA molecules from different sources are combined in vitro into one molecule to create a new gene. This DNA is transferred into an organism and causes the expression of modified or novel traits. In transgenic mosquitoes the idea is to alter the transmission of the malaria parasite. • The appropriate tools are needed for the transfer of genetic material. A plasmid containing the gene for Green Fluorescent Protein (EGFP), was created Nature 405:959 (2000). •Pre-blastoderm embryos were injected with the plasmid and an average of 29% of the injected ones survived. From these, 50% were fluorescent. Confocal fluorescence and transmission microphotographs of putative homozygous (left) transgenic larvae expressing EGFP compared with a wild-type mosquito (right). Effector strategies that could inactivate malaria parasites within the mosquito One example of a Parasite-secreted protein: CHITINASE CHITIN • Ookinetes secrete chitinases that facilitate their crossing of the peritrophic matrix. • Parasite strains carrying mutations or gene knockouts of chitinase are markedly impaired in their ability to form oocysts. • Feeding anti-chitinase antibodies to mosquitoes also impaired the development of oocysts. • Involvement of other proteins in parasite development has been implicated in a study where monoclonal antibodies made to parasite proteins secreted by ookinetes in culture bind P. gallinaceum zygotes and ookinetes in diverse patterns of spatial localization and temporal expression. Ookinete (O) penetration of the chitin-containing peritrophic matrix (PM) of the mosquito midgut. The parasite is exiting the bloodmeal on the left, producing chitinase focally to disrupt the peritrophic matrix, en route to the microvilli of the midgut epithelial surface at the right. Trends in parasitology, (2001) 17:269 Another example • The ookinete cross the midgut epithelium and differentiate into oocyst which after 10-15 days liberate sporozoites into the hemocel. The development of the parasite in the mosquito is completed when sporozoites cross the salivary gland epithelium. • Scientists identified a peptide (SM1 for salivary glandand midgut-binding peptide 1) that binds specifically to the two epithelia that are traversed by the parasite: the distal lobes of the salivary glands and the lumenal surface of the midgut. SM1 inhibits crossing of the two epithelia by the parasites. • The idea is that if you can produce SM1 into the gut lumen when with a blood meal the Plasmodium development would be blocked. • They created a synthetic gene AgCP[SM1]4. They used a promoter which is activated by a blood meal, and a signal sequence to drive secretion of the protein into thebmidgut lumen. The gene was inserted into a vector and transformed into the germ line of Anopheles stephensi. Nature (2002) 417:452.17 • The expression of the peptide produced a reduction in the number of oocysts formed (69-95% inhibition) and also these transgenic mosquitos had fewer sporozoites in their salivary glands Detection of AgCP[SM1]4 transgenic mosquitoes by transformation marker-mediated fluorescence. Top, a wild-type (non-transgenic) larva (middle) flanked by transgenic larvae viewed from the dorsal (top) or ventral (bottom) sides. Bottom, the head of a wild-type (left) and a transgenic (right) mosquito. The entire eye expresses GFP. http://www.genomenewsnetwork .org/articles/05_02/transgenic_m osquitoes.shtml Population reduction: SIT and RIDL SIT: Sterile Insect technique: male insects are mass-reared, sterilized by irradiation and then released in large numbers in the infested areas in order to contribute to sterile mating with wild mosquitoes. SIT lacks efficient methods to select for males and irradiation-caused lethality. RIDL: release of insects with a dominant lethal . RIDL uses males carrying female dominant lethal transgenes that can produce purely male offspring. In the laboratory, this strain is maintained by using a repressible system to control transgene expression; absence of the repressor from the insect diet in the field activates the lethal trait. Sterilized male flies are mass released This approach does not appear suitable for malaria control because of its susceptibility to immigration from outside the target area. across the target area by airplanes. The sexually sterile males, which outnumber the wild-type males, mate with wild-type females resulting in infertile mating events. This results in a decrease of the pest levels and, if continued over several generations, the potential eradication of the pest from the target area. Nature Biotechnology 23:433 SIT has been used successfully to eradicate tsetse flies from Burkina Faso, Tanzania, Nigeria and Zanzibar where it eradicated Glossina austeni from the 1600 km2 Unguja Island. Population replacement An important issue to consider before the release of genetically manipulated organisms is the fitness of the mosquitoes carrying the transgene. The transgenic insect needs to compete with the local populations to efficiently introgress the effector genes into the wild gene pool. Fitness is the relative success with which a genotype transmits its genes to the next generation. Survival and reproduction are the important components. A transgenic mosquito (Left) with green fluorescent eyes, and a nontransgenic mosquito (Right), with no eye fluorescence. The transgenic mosquito carries a gene that confers resistant to the malaria parasite. Fitness costs: Burden from the transgene product: Transgenic insects may express multiple genes (a fluorescent marker and an anti-pathogen effector protein. In addition constructs for RIDL contain a repressible transactivator protein for tight control of the system. Insertional mutagenesis: Disruption of native gene function. Fitness reduction through this strategy is not frequent. Viability is not changed because any random insertion is likely to be deleterious. Insect immunity This approach studies vector immune responses, and its effect on parasite transmission. The idea is to develop vaccines that block parasite transmission and antimalarial agents that target vector immunity and parasite development. Insect Killing mechanisms: • Antimicrobial peptides: defensin and cecropin genes in A. gambiae. Highly induced by malaria infection • Melanotic encapsulation: Two mechanisms: Cellular encapsulation mediated by haemocytes that surround and attach to the microorganism to form a capsule that becomes melanized. Humoral encapsulation is the formation of a melanized proteinaceous capsule around the microorganism without participation of haemocytes. • Phagocytosis: involves killing of microorganisms through engulfment and subsequent degradation by haemocytes. It is mediated by pattern recognition receptors that can bind to the particle and trigger intracellular cascades leading to its internalization through an actin-dependent mechanism. Other research initiatives Understanding vector biology Mosquitoes show a remarkable preference for humans as hosts for blood-feeding They are highly susceptible to infection Olfaction plays a crucial role in shaping behaviors such as host seeking and feeding and determines their vectorial capacity. Research on the behavior of vectors: • Modification of vector behavior for disease control • Basic research to understand the genetic and environmental components of vector behavior and reproductive biology • Mosquito genomics: comparative genomics to provide information about lineage-specific adaptations, population biology, ecology and genetics, dynamics, regulation and variation of vector populations, and vector survival strategies. • The gene families implicated in olfactory processes are regarded as promising novel targets for the design of mosquito attractants and/or repellents. Other research initiatives Investigating mechanisms of insecticide resistance • At present, the control of malaria vectors relies extensively on the use of indoor house spraying with residual insecticides and the use of insecticideimpregnated bednets. • The problem is the lack of available licensed insecticides and the growing resistance. • Novel targets and the understanding of resistance are also important areas of research. • Scientists are trying to identify specific members of the detoxification enzymes whose expression are elevated in insecticide-resistant populations Other research initiatives Entomology and epidemiology studies: correlation of entomological measures of risk to infection and disease, evaluation of the impact of interventions on epidemiology and disease, and quantitative analysis of mosquito biology, disease and control. Sandfly habitat in Jacarepagua district on the outskirts of Rio de Janeiro. Infrastructure initiatives: Development of field-study centers for long-term research programmes, research centers of excellence in disease-endemic countries, multi-disciplinary research strategies, databases to monitor long-term and an infrastructure network to facilitate studies and training and the provision of opportunities for technology transfer and recruitment Network Development: Creating an international consortium to integrate the results of laboratory and fieldbased approaches to develop and compare new and existing strategies; promoting the rapid communication of scientific advances, making particular use of internetbased resources; promoting recruitment and training and improving present strategies SUMMARY • Progress has been made towards a better understanding of parasite biology and the potential manipulation of its host for its own benefit (transmission and metacyclogenesis). • New tools are available and are being produced for the production of transgenic vectors. • Fitness of the transgenic population in the wild is a problem to be solved. • Mosquito control measures are often complicated by the presence of multiple vectors in the same area. In Africa, as many as five different anopheline species can function as malaria vectors, either simultaneously or seasonally. • The A. gambiae genome has been completed so the number of neutral genetic markers for estimating gene glow between populations has increased.