Pandian Divakaran, Najer Tomáš, Modrý David
Department of Veterinary Sciences, Faculty of Agrobiology, Food and Natural Resources/CINeZ, Czech University of Life Sciences Prague, 16500 Prague-Suchdol, Czech Republic.
Department of Botany and Zoology, Faculty of Science, Masaryk University, 61137 Brno, Czech Republic.
Pathogens. 2023 Jun 20;12(6):851. doi: 10.3390/pathogens12060851.
Human angiostrongylosis is an emerging zoonosis caused by the larvae of three species of metastrongyloid nematodes of the genus with (Chen, 1935) being dominant across the world. Its obligatory heteroxenous life cycle includes rats as definitive hosts, mollusks as intermediate hosts, and amphibians and reptiles as paratenic hosts. In humans, the infection manifests as eosinophilic meningitis (AEM) or ocular form. Since there is no comprehensive study on the disease in the Indian subcontinent, our study aims at the growing incidence of angiostrongylosis in humans, alongside its clinical course and possible causes. A systematic literature search revealed 28 reports of 45 human cases from 1966 to 2022; eosinophilic meningitis accounted for 33 cases (75.5%), 12 cases were reported as ocular, 1 case was combined, and 1 case was unspecified. The presumed source of infection was reported in 5 cases only. Importantly, 22 AEM patients reported a history of eating raw monitor lizard ( spp.) tissues in the past. As apex predators, monitor lizards accumulate high numbers of L3 responsible for acute illness in humans. For ocular cases, the source was not identified. Most cases were diagnosed based on nematode findings and clinical pathology (primarily eosinophilia in the cerebrospinal fluid). Only two cases were confirmed to be , one by immunoblot and the other by q-PCR. Cases of angiostrongylosis have been reported in Delhi, Karnataka, Kerala, Maharashtra, Madhya Pradesh, Puducherry, Telangana, and West Bengal. With a population of more than 1.4 billion, India is one of the least studied areas for . It is likely that many cases remain undetected/unreported. Since most cases have been reported from the state of Kerala, further research may focus on this region. Gastropods, amphibians, and reptiles are commonly consumed in India; however, typical preparation methods involve cooking, which kills the nematode larvae. In addition to studying rodent and mollusk hosts, monitor lizards can be used as effective sentinels. Sequence data are urgently needed to answer the question of the identity of -like metastrongylid nematodes isolated from all types of hosts. DNA-based diagnostic methods such as q-PCR and LAMP should be included in clinical diagnosis of suspected cases and in studies of genetic diversity and species identity of nematodes tentatively identified as .
人体管圆线虫病是一种新出现的人畜共患病，由管圆线虫属三种后圆线虫的幼虫引起，其中（陈，1935）在全球占主导地位。其 obligatory 异宿主生命周期包括大鼠作为终宿主、软体动物作为中间宿主以及两栖动物和爬行动物作为转续宿主。在人类中，感染表现为嗜酸性粒细胞性脑膜炎（AEM）或眼型。由于印度次大陆尚未对该疾病进行全面研究，我们的研究旨在关注人体管圆线虫病发病率的上升情况、其临床病程及可能病因。系统的文献检索显示，1966年至2022年有28篇关于45例人类病例的报告；嗜酸性粒细胞性脑膜炎占33例（75.5%），12例报告为眼型，1例为混合型，1例未明确。仅5例报告了推测的感染源。重要的是，22例AEM患者报告过去有食用生巨蜥（巨蜥属）组织的病史。作为顶级捕食者，巨蜥体内积聚了大量可导致人类急性疾病的L3幼虫。对于眼型病例，感染源未明确。大多数病例是根据线虫检测结果和临床病理学（主要是脑脊液中的嗜酸性粒细胞增多）诊断的。仅2例通过免疫印迹和q-PCR确诊为。德里、卡纳塔克邦、喀拉拉邦、马哈拉施特拉邦、中央邦、本地治里、特伦甘纳邦和西孟加拉邦均有管圆线虫病病例报告。印度人口超过14亿，是对研究最少的地区之一。很可能许多病例仍未被发现/未报告。由于大多数病例来自喀拉拉邦，进一步的研究可聚焦于该地区。印度常见食用腹足动物、两栖动物和爬行动物；然而，典型的制备方法是烹饪，可杀死线虫幼虫。除了研究啮齿动物和软体动物宿主外，巨蜥可作为有效的哨兵。迫切需要序列数据来回答从所有类型宿主中分离出的类后圆线虫线虫的身份问题。基于DNA的诊断方法如q-PCR和LAMP应纳入疑似病例的临床诊断以及初步鉴定为的线虫的遗传多样性和物种身份研究中。
