Circulating gut-associated antigens of Schistosoma mansoni : biological,
immunological, and molecular aspects
Dam, G.J. van
Citation
Dam, G. J. van. (1995, February 9). Circulating gut-associated antigens of Schistosoma
mansoni : biological, immunological, and molecular aspects. Retrieved from
https://hdl.handle.net/1887/41317
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The handle http://hdl.handle.net/1887/41317 holds various files of this Leiden University
dissertation.
Author: Dam, G.J. van
Title: Circulating gut-associated antigens of Schistosoma mansoni : biological,
immunological, and molecular aspects
Chapter 1
_S_c_h_is_t_o_s
_
o
_
rn
__
a __
g_u_t_-_a_s_s_o_c_ia_t_e_d __
a_n_t_ig_e_n_s
__________________
__
________________
3_~
Chapter 1
S
c
his
tosoma
gut-associ
at
ed anti
gens
Schistos
ome
s are blood-dw
ell
ing flukes belonging to the
cl
a
ss Trematoda,
but
differ
f
rom
all
other trematodes in that the sexes are separate (
Fig
. 1 ).
T
he
parasites
h
ave a s
ex
ua
l reproduction phase
in
the definitive
h
ost, and an
as
e
xu
a
l
reprodu
c
tio
n
phase
i
n
a snail intermediate host (Fig. 2). D
e
finitive hosts are
e
.g.
hum
ans,
c
a
tt
le,
r
od
ents, primates,
o
r
dogs, depending
o
n
the
Schistoso
ma
species
[
9
]. In
the
labora
t
ory
,
hamsters and mice are oft
en
us
ed
b
o
th as defini
t
i
ve
h
osts
f
or
mai
nta
i
ning
the parasite
-
c
y
c
le and as experimental ani
m
als
.
T
he
Schis
tosoma
s
pec
ies w
hich ar
e most important in huma
n
schi
stos
o
m
ia
sis are
S
.
mans
on
i,
S.
jap
oni
c
u
m,
and
S.
haematob
ium.
Figure 1. Paired adult
Schistosoma mansoni
worms. Clearly visible is how the""l
4
Ch
a
pter
1
Figure 2. Life cycle of
Schistosoma mansoni
andSchistosom
a
hae
mat
o
biu
m.
(courtesy of Dr. A.M. Deelder)The i
n
fe
ct
ive
parasitic stage, the cercaria,
en
ters
t
h
e
hos
t
through the
skin,
evoking an
inf
lammatory response
.
In naive hams
ters
,
ne
u
t
roph
i
l
s
a
re
a
mong
t
he
first cells to attack the parasite, followed after a few days
by
eosinophils
[3
7
].
From thi
s
stage to about 3 weeks after infection, the parasite,
pr
ese
nt
a
s
a
young
schisto
somu
lu
m
,
is
most
susceptible
to
immune
damage
[1
1
,2
1 ,36, 78,
79,82
,
9
7, 132].
Employing a wide range of evasion
m
echan
i
s
m
s
,
the d
e
v
e
lop
in
g
worm be
c
omes refractory or e
v
en invisible to certain parts o
f
t
h
e
h
o
st
's
defense
Schistosoma
g
ut-associated antigens
5
"'
At abo
ut 6
weeks
post
i
nfection
(p.i.) the adult wo
r
m-p
a
i
r
s
start
to
pro
duce
eggs,
w
hi
ch
e
i
ther penetrate the intestinal wall to
b
e vo
i
d
ed
in
the
fae
c
es
(Schistosoma
m
ansoni and
S.
j
ap
onicum) or the bladder
wal
l
to leave the
b
o
d
y v
i
a
the
u
ri
ne
(
S.
hae
m
atobium).
H
ow
ever, a
c
o
nside
r
able
proportion
o
f
the
eggs
i
s
not exc
ret
ed but
e
.g
.
transported with the
b
lood
to
the
live
r
w
h
e
re
t
h
ey
are
retained
an
d
induc
e
granuloma
fo
rm
ation
and
su
bse
quent
live
r-
f
i
bro
sis
[3
,34,
128]. S.
haem
atobium in
d
u
c
ed patholog
y
inv
o
l
v
es
ma
i
nly
the bladder a
nd
kid
ne
y [3
4
,
1
16].
A
st
rik
i
ng gros
s
ob
se
rv
ati
on
o
n
the gut
o
f
schi
st
osomes
is th
at
in he
a
l
t
hy, fr
es
hly
isol
a
t
e
d w
o
r
ms
the
in
t
est
in
al tra
ct
is filled
wi
t
h
a
da
rk sl
u
rry o
f
pa
r
tly
dige
s
ted
bloo
d
. Since the
g
ut is
a
cui
-
de
-sac
, th
e
p
arasit
e has
t
o regurgitate at regular
intervals, releasing a
dark cloud
of un
di
g
e
st
ed
p
a
rticulate m
ater
i
a
l inc
l
uding
parasite anti
g
ens
[
16, 113] {Fig
.
3
).
Thes
e
relatively abund
ant
excreto
r
y antigens
may
e
xhibit v
a
r
i
ous functions
and
c
ha
racteri
sti
cs,
e.g.
in
immune
e
vasion
mechanisms. A numb
e
r of
t
hese
anti
ge
ns
,
which will be disc
us
s
e
d
below, can
a
lso be det
e
cted
i
n
the
circ
u
lat
i
on
of
th
e hos
t
. In this revi
e
w, most a
t
tention will
be given to a group of hi
g
hly
gly
co
s
yla
ted
circ
ula
ting gut
-
assoc
i
a
te
d
a
ntigens
[
9
9].
8
Figure 3. Anterior portion of male and female schistosome worms showing blood pigments (A) in gut and (B) in regurgitant; (C) detail of female gut at level of vitelline gland. Magnification approximately 50 X (A), 20 X (8), 100 X
(C). (photographs taken
by
Dr. A. W. Senft, reproduced with permission from [113])Other ci
r
culating antigens are found among tegument-associated
antigens
~-6
__
____
__________
________
____________
________________
__
C
_
h
_
ap
__
te
_
r __
1
An
t
i
ge
ns pres
e
nt in
t
he schis
tosom
e
g
u
t
,
but
which
have,
so
far, not been
described
as being
de
t
ecta
b
le in
the
circul
a
tion, are proteases
lik
e
hemoglobinase
or
ca
thepsin
8
[16,17,32,71],
phospholipase A2 [105],
a
68
kDa antigen which
might be
a vaccine
candid
a
te
[
13], or gl
u
t
a
thione
-
S
-
transferases [18,81 ].
Although the gut
prote
a
s
e
s th
e
m
sel
ves
have
not been demonstrated in the
circ
u
l
a
t
ion
1,
which
can
be
due
t
o
rapid
degradation
or to
very
low
co
ncen
t
r
ations,
a specific
a
nd
strong
a
ntibody
response
to these antigens has
been
reported [33,107,108]
.
Af
te
r an experimental infection
with
schistosomes, the first antibodies have been
shown
to
be detect
a
ble two to three weeks
p.i.,
using an immunofluorescence
assay on adult
worm
sections
[1 0,46,93,
1 00]. These
antibodies
were directed
against the gut epithelium of the parasi
t
e.
As
the infection progresses, additiona
l
fluorescence has been found at
t
he
level of the tegumental membrane (4
-
5
we
e
ks
p.i.)
and finally within the parenchyma
(
5
-
6 weeks p.i.) [93, 125]. In
general,
the
highest
titr
e
s
are
always
observ
e
d
against
gut
antigens
[45,48,53,84,87,93],
probably because these antigens are excreted in relatively
larg
e
quantities
into the host circul
at
ion [80, 131 ]. Earlier it had been reported that
schistosome
circulating antigens, detected by
immunoelectrophoresis,
appeared in
the serum of mice 26 days
after
infection [1 2], which correlates with the
time
-
point that the antibodies appear. By adsorption of patient serum with
purified antigen preparations
it
has been shown that antibodies against both the
circ
u
lating anodic antigen
(CAA)
and the c
i
rculating cathodic antigen
(CCA)
were
responsible
f
or the gut
-
associated immuno
f
luorescence [46]
.
This finding was
partly contrary to earlier observations,
in
which it had b
ee
n found that only
antibodies specific for CAA were d
e
tected in the gut [84J. Later studi
e
s showed
that 90% of the patient I gM antibodies reactiv
e
with the schistosome gut in an
i
mm
u
nofluorescence assay could be inhibi
t
ed by
anti
-
CCA, but not by anti
-
CAA
or anti-cathepsin B (32 kDa) monoclonal antibodies [
48],
demonstrating the
i
mmunodominance
of
CCA
in
the
lgM
immune
response
against
the
gut
-
associated antigens. This inhibition
was
only slightly lower in more chronic
infections. Antibodies
to ca
t
h
e
psin B present in th
e
schistosome gut were
detectable
from week
3 af
t
er infection [33] and seemed to increase as the
infection
progr
esses
(J.P.
Rotmans,
unpublished observations)
.
Ultrastructural local
i
zation studies
using
monoclonal antibodies (McAbs) specific
for
CAA
and CCA have shown that the antigens are present in the gut of adult
worm,
as well as in the primordial gut cells of cercariae and in 3% week old
worms [ 41 ,42]
.
T
he
l
ocalizat
i
on
pa
t
terns
indicated that the antigens may be
deriv
e
d from the rough endoplasmatic reticulum, and transported via the Golg
i
apparatus and cytoplasmic vesicles to the luminal side of the syncytium where
1
Schistosoma
gut-associated antigens
7
they
f
in
a
lly
m
a
y be rel
ea
s
ed into the gut lumen
[
4
1
,42].
T
hu
s,
th
ey
exhi
b
it
a
biosynthe
si
s
a
nd
trans
po
rt
mechanism
si
m
i
l
ar
t
o
that
pr
o
p
o
s
ed
for
glycoconjugates associated with the gut epithe
l
ium
of o
t
her tr
e
ma
to
des or
vertebrates
[1
4
,15,7
5
]. Deelder and eo-workers described the presence
of
CAA
in epithe
l
i
al
cells lining the schistosome gut from the cerc
ar
i
a
! stage and onwar
d
(as also found by Andrade and Sadigursky (1
97
8) [4]) but never on
th
e
schistos
ome
tegument [42,46]. Like
wi
se, CCA was pri
m
ar
ily
fo
u
n
d in
t
he
schistos
ome
g
u
t
,
b
u
t no
t
o
n the tegument. Conflict
i
ng
resu
lt
s
we
re
obta
in
ed
for
CCA
w
ith
respe
c
t to detecta
b
i
l
ity in egg extract
s
[
44
,46
],
bu
t u
sin
g
M
c
Abs
i
n
im
munoelectropho
r
es
is,
an
d
in im
m
un
o
f
lu
oresce
nce
and/or
in d
ot
-
i
mmu
no
bind
in
g
assay
s,
it
w
as
estab
l
ish
ed that CC
A
was
a
lso
p
res
e
n
t
in sc
h
is
t
os
om
e e
gg
s
(
Ch
apt
er
3,
a
nd
[
48]
).
Pa
rtly
contrary t
o
these
fin
di
ngs,
B
a
r
sou
m
e
t
al.
(1
9
92
)
[8],
s
h
o
wed
t
he
b
in
d
ing
o
f
a
CCA
-spec
i
f
ic
M
cAb
to
the
schistosome
t
egum
e
nt,
al
tho
ugh
the
m
a
j
or
r
ea
c
tiv
i
ty
was to
the
g
ut epi
thel
ial
c
el
ls.
T
he
ea
rly
an
t
ibod
y
r
espo
ns
e
to
gut-ass
oc
i
a
te
d
antig
e
ns
in
c
om
pariso
n
to
teg
u
m
e
nt
or
other
schistosom
e
a
ntig
e
ns
m
i
g
ht
be
the
result
of
v
ery
im
munodom
i
n
ant epi
top
e
s on
th
e
g
u
t-
as
so
ci
a
t
e
d
a
n
t
igens
, or
of
the
r
e
l
ativ
ely
l
a
rge a
mounts of
a
nt
ig
ens
which
are r
e
leased
in
t
o the
host circul
a
tion
early
in
de
v
e
lop
ment of th
e pa
rasite
. T
he
h
ig
h
e
x
cr
et
io
n
ra
te
of
gu
t
-
ass
oc
ia
te
d
a
nti
ge
ns
p
r
ob
a
bly means tha
t
the
worms
exhibi
t
h
i
g
h
me
tab
olic
a
ctivi
ty s
ta
rt
i
ng
ear
l
y
in
lif
e
.
Asi
d
e
from indir
e
c
t
de
monst
r
a
t
io
n
by
the
antibod
y
response
,
t
he
circul
a
ting
antig
ens
them
selv
es
a
re
d
e
tecta
bl
e
i
n
the
circulation
of
the
host. A
circulat
ing
a
nt
igen in t
he
pl
a
sma
of
mic
e
o
r
h
a
ms
t
ers h
ea
vil
y
in
fect
ed
with
Schistosoma
manson
i
was first
descr
i
bed
by
Be
rgg
ren an
d
We
ll
er (1
967
)
[12].
An anodic
preci
pi
t
at
e was observed by
im
munoe
lect
rophores
is
(Fig.
4), which
was
corr
el
a
t
ed w
ith
worm
bu
r
de
n
an
d
du
ration
o
f
i
nfe
c
t
ion.
The
a
ntigen
of non
-
host
origin
was
detect
ed
from
d
ay
26
p.i.
on
wa
rds
i
n m
ic
e
inf
ec
ted w
ith
more th
an
500 cercari
a
e
[12],
and from
day
2
1
p.i.
on
wa
rd
s
in hams
te
rs
inf
ected
w
i
th 1100
ce
rc
a
r
i
ae
[57].
Gold
e
t
al
.
(
1
969)
[5
7
]
d
e
m
on
stra
ted
that
the
ant
ige
n
c
o
uld
also
b
e
found
in ur
i
ne
, alt
hou
g
h
in sm
all q
u
antities. Init
ia
l
ch
ara
cte
rizati
on
s
show
e
d
t
hat this
a
n
t
i
ge
n w
a
s
he
at-stabl
e,
d
i
alyzable
wi
th
a
MW
<
1
0
kOa
,
and had an
UV
abs
orption
max
imu
m at
26
0
n
m.
How
e
ver,
enz
ym
e
in
c
u
bat
ion
s
in
dicat
ed t
hat
it
wa
s not
DNA or
RNA
[57
].
F
u
rth
er
c
h
ar
a
cteriz
at
ions
o
f t
his
antigen, which was
later
n
amed th
e
gut
-a
s
s
oc
ia
ted proteoglycan G
AS
P
[86]
or
the
c
irc
u
la
ti
n
g
ano
d
ic
a
n
tig
en
CAA
[
44]
1,
w
e
re
ca
rried
o
ut b
y
Na
sh
et
a
l.
(197
4,
197
7)
[8
6
,88]
and
by
D
eel
d
er
et al.
(197
6
, 1980)
[4
4
,46
].
R
e
sults
a
r
e
su
mma
riz
e
d
in
Ta
ble 1
.
1
Al
tho
u
g
h a
r
e
com
m
e
ndati
o
n
has been made to
re
na
me the
an
t
i
ge
n
GASCAP
[85
],
CA
A
is
n
o
w w
i
de
l
y
us
ed
to denote this antigen
,
and
throughout t
his the
s
is
t
h
e ac
ro
n
y
m
C
A
A will
be
Table 1
.
C
har
acteri
s
t
i
c
s
of
ci
r
c
ulatin
g
anodi
c
a
nt
i
gen
C
h
a
racteri
sti
c
s
molec
u
lar
pr
operties
5
%a
(w
/
w
)
am
i
n
o acid
s
:
ri
ch
i
n
Gl
ycin
e
,
lo
w prop
o
rt
i
o
n of P
he
n
y
l
a
l
anine and Tyrosine
41 %
a
(
w
/
w
)
carb
o
h
y
dr
a
t
e
s
:
G
aiN
A
c
:
Gal: Glc
N
A
c: M
an
: Glc
A
=17
.
2
:
2
: 1.
9
:
0.4
:
16
.
1
physic
o
-
c
h
em
ical proper
tie
s
ne
g
atively ch
a
r
ge
d
MW
b
y
ul
tra
c
e
ntrifugati
o
n
<
10 kDa
gel
fi
l
tr
at
ion 50 - 300 kDa
p
ol
y
acr
y
l
amid
e
gel
electrop
h
oresis
>
800 kDa
u
ltr
a
filtr
at
i
o
n
>
1
00 k
Da
u
l
trac
e
ntrif
ug
ati
o
n
of
i
m
m
un
e
complexes
7
0 kDa
imm
u
no
e
l
ec
troph
o
re
t
i
c
m
o
t
il
i
t
y
:
h
i
g
hly a
no
d
i
c
re
sistan
t
to
30 min b
oili
ng
7. 5
%
Tric
hl
oro
a
ce
ti
c acid
p
r
onase
,
t
ry
psin
a
lk
al
i
ne pho
s
ph
a
ta
se, D
N
a
s
e,
R
Na
se
,
a-amylase
destro
y
ed by perio
da
te
no absorp
t
ion p
eak
s at
28
0
n
m
or a
t
26
0
nm
i
mmu
n
o
geni
c
propert
i
es
specific ant
i
bodies demonstrated 3 - 4 weeks after infection
l
g
M l
e
vels higher t
h
an lg
G
l
e
vels
biolo
g
ical properties
Reference
[
86
[861
[
861
(57]
[
46,88)
[
44
]
[
88)
[6
7
]
[
1 2,44
,
88
]
(
88)
[
88
)
[
88
1
[
881
[88
]
[
86
]
(
46,84]
(46,871
Schistosoma g
e
nu
s
-
sp
e
cific antig
e
n
,
demonstrated in
Schistosoma mansoni
,
S. haematobium
,
S. japonicum,
S. interca
l
atum,
(S.curassoni,
S.
bovis, S. matthee1b)
(
40
,
73,88]
detect
e
d
i
n host
'
s
s
e
rum and
/o
r ur
i
ne
[
44
,
57,88]
localization
a
b
i
n the adult w
o
rm a
n
d the de
v
elo
p
ing s
c
histosomul
um
:
primarily
i
n ep
it
hel
i
al c
e
lls of the
g
ut
gut lum
e
n
i
n lysoso
me
-
li
ke
b
od
ie
s
,
associated
w
ith host leukocytes
intracellular
l
y in Golg
i a
pparatus and c
y
top
l
asm
i
c vesicles
in cerc
ar
i
a
e
:
pr
i
mordi
a
l oes
o
ph
agu
s
in c
yt
oplasm
an
d su
r
fac
e
coa
t
of gu
t
epi
th
elium
a
lso found in th
e
h
o
st in
:
gl
ome
r
u
lus of
k
idn
e
y
K
u
pffe
r
c
e
lls
m
a
cro
phages in s
p
leen
(
46,83)
[42] [42) [4) [42][
46
,
52
]
[
46
,
52
1
[
5
21
a
m
ino acids and carb
o
h
yd
r
a
tes t
og
e
t
he
r m
a
k
e
s
46
%
of the to
ta
l
we
ight of m
a
t
e
r
i
al
a
na
lyz
e
d; ma
t
eri
al r
e
si
s
t
a
nt to
h
y
dr
o
ly
s
i
s
or in
c
omp
l
ete
ly
de
ri
v
atized, s
a
lts and water may
ac
c
o
u
nt for the
r
em
a
i
n
in
g w
e
igh
t
_s_c_h_is_t_a_s_a_rn
__
a~g_u_t_-_a_s_s_o_c_ia_t_e_d
__
a_n_t_ig_e_n_s ____________________________________
9_
~
Table
2
.
Cha
r
act
eri
stics of circulating cathodic anti
ge
n
Characte
ri
stics
molecular properties
37%a (w/w) amino acids:
rich in Glycine, Serine and Threonine, low proportion of Phenylalanine and Tyrosine 63%a (w/w) carbohydrates:
GaiNAc : Gal : GlcNAc : Fuc : Man
=
1 : 6.6 : 2.9 : 3.0 : 1.6 physico-chemical propertiesneutral or slightly positively charged
MW by gelfiltration 1 0 - 300 kOa
polyacrylamide gel electrophoresis
>
400 kDa ultracentrifugation of immune complexes 40 kDaimmunoelectrophoretic motility: cathodic resistant to 120 min boiling
10% Trichloroacetic acid protease
ribonuclease, neuraminidase, amylase destroyed by periodate
immunogenic properties
specific antibodies demonstrated 3 - 4 weeks after infection lgM levels higher than lgG levels
biological properties
Schistosoma genus-specific antig;en, demonstrated in Schistosoma mansoni,
Refere
n
ce
[27] [271 [27,46] [27 ,46] [27] [68] [25,27,46] [24] [25] [25] [25] [25] [46,47] [46]S. haematobium,
S.
japonicum,S.
intercalatum, IS. curassoni, S. bovis,S.
matthee/J) [25,46, 73,101 Jdetected in host's serum, urine, or milk [25,39,44, 111]
localization
a
b
in the adult worm and the developing schistosomulum:
primarily localized in epithelial cells of the gut
in gut lumen in lysosome-like bodies
intracellularly in Golgi apparatus and cytoplasmic vesicles male tegument
in eggs: contradictory results
in miracidia: not found
in cercariae: in cytoplasm and surface coat of gut epithelium
also found in the host in:
54-5G1 0-A
AWA-TCA
24-1 82-A
Chapter 1
Figure 4. lmmunoelectropherogram of an anti-CAA (upper lane) and an anti-CCA (lower lane) McAb against AWA-TCA.
In the urine of schistosomiasis
patien
t
s
,
earlier
et al.
(
1975) [24]
have
found a
second
circulati
n
g antig
en
,
'M
ant
igen',
which
in
i
mmuno
e
l
e
ctrophoresis
appe
a
red
neutra
l
or slight
l
y cathodic
(F
ig.
4
)
[25,27].
The
latter
phenomenon
cl
e
arly
d
i
st
ingu
i
shed
this
antige
n f
rom CAA.
F
ur
t
her s
tu
dies showed similarities
w
i
th
re
spe
ct to s
ta
bility and so
l
ubility
,
but dist
i
nct differenc
e
s with respect to
monosaccharide
composrt
r
on
[25
,
27]
.
Apart
from
its
presence
in
urine, M antigen
was
also demonstrated in
p
atient sera, milk of
in
fected mothers,
as wel
l
as
i
n sera
a
n
d
urine
of
animals
in
f
ected with
Schistosoma mansoni
[25, 111 ]. Independently, Dee
l
der
et al.
(
1976
)
d
e
monstrated a c
i
rculating
ca
t
hodic ant
i
gen
(CCA
)
presen
t
i
n serum and urine of
infected
hamsters
[44].
This antig
e
n was localized in epi
t
he
lial
ce
l
ls
of
the schistosome gut and detec
t
ed
in
excretory and secretory
products
.
lt
is
now genera
lly
accepted that
M antigen
and CCA are
ide
n
t
ic
al [46,54
]
1•
A summary of the characteristics of
CCA
i
s given
in
T
able 2.
Apart
from
these antigens detec
ta
ble
in
t
h
e circu
la
tion of the
host,
a very early
r
e
po
r
t
by
Okabe and Tan
ak
a
(
1958) [9
1
]
described an antigen
in
the urine of
p
a
t
ients
or experim
e
ntal animals
w
i
th
schistosomiasis
japonica.
This
antigen
appeared
to be
a
hea
t-
la
bi
l
e, eas
i
ly
degradable
protein, but
it
has not been
inves
t
iga
t
ed
whether the antigen was
inde
ed
Schistosoma
-
specif
i
c or whether it
was
e.g.
a host-d
e
rived
infla
mmatory
(
acute-phase
)
protein [92].
Ripert
et al.
(
1988) described a circulating gut
-
associated antigen, excreted
in
t
he
ur
ine
of schistosom
i
asis
patients, which was predominantly present in eggs
[1
03].
Th
is
ant
i
gen showed characteristics similar to those of CCA, such as
being excreted in high concentrations
in
the urine, stability towards protein
denatur
ing
age
nt
s,
sensitivity
to per
i
odate, and
be
i
ng localized in the
schistosome
gut
[5
,6]. However, CCA is
no
t
present in
l
arge amounts
in the
1
L
ike CAA
,
the acronym
CCA
is
now
widely used instead of M antigen, and throughout this
Schisto
som
a
gut-asso
ciate
d
a
nt
igen
s
11
~- - - - -
- - - -
-
- -
- - - -
-
j
)
e
g
gs
, wher
eas
th
e
a
ntig
e
n
de
scrib
ed by
R
i
pe
r
t an
d
Appriou is predominan
tly
an
eg
g
antigen
[6]
.
T
he McAb recogni
zin
g
t
his
antigen
has been investigated
i
n our
lab
or
atory for cross
-
re
a
ctio
ns
with
anti-CAA and
an
ti
-
CCA McA
bs
. The
recognition
and binding pa
tte
rns in
se
veral imm
u
n
o
chemical techniques
i
ndic
ated
an antig
e
n spe
c
ificity
different
fro
m
our
anti
-
CAA or
a
nt
i
-
CCA McAbs.
How
e
ver
,
common epit
ope
s mig
h
t
be
p
res
e
nt
on CCA
as
a f
e
w anti
-
CCA McAbs
(
a
l
so
recognizing an
egg ant
i
ge
n
)
showed inhibi
t
ion of the McAb of Ripe
rt
using
immunofluorescence
ass
ay
on
adu
lt
wor
m
sect
i
o
ns
(Oeelder
et al., unp
ub
lish
e
d
r
e
sults)
.
Very few functional
s
tud
i
es hav
e
been performed on the gut
-
associ
a
t
e
d
antige
ns. While i
t
is cle
a
r that
e.g. t
h
e gut
-
associ
at
ed proteases
cathepsin
B and
he
moglob
i
nase are involv
e
d
in
di
gesti
ve p
ro
ce
sses
,
dif
f
e
re
nt
f
u
nc
t
i
ons for CAA
and
CCA
h
a
v
e
bee
n
suggested,
but
none
of
t
hese could be
experiment
ally
s
upport
e
d.
T
he
loca
lizati
o
n of
CCA
in
th
e
gut epith
e
l
ium
of the adu
l
t
worm
,
as
w
ell
a
s str
u
ctura
l
c
haract
er
iza
tion data
(
molecula
r h
eteroge
ne
ity, glycoprote
in
co
m
position, an
d
the
presence
of 0
-
gl
ycosidic linkages
)
su
p
port the hypot
he
sis
that
t
he an
t
i
g
en
is a
mucin or mucus
g
lyco
pr
ote
in
-
l
i
k
e compon
e
nt [27], which
pr
otects
th
e
g
a
strod
e
rmis o
f
the
worm ag
a
inst proteolytic secre
t
ions. The
o
b
se
rv
ation
t
hat
t
he half
-
life
in the
schistosome
gut
of Gl
c
NAc
-
conta
i
ning
polysaccharides
w
as
si
g
nifican
tl
y
l
o
n
ger than the h
al
f
-
l
ife of
gut
secretory
proteins
also suggests that these
ca
rbohydra
te
structures m
i
ght function
a
s a
prot
e
c
t
ive surf
a
ce co
at
[ 131]
.
D
ee
l
d
er
et
al.
(
1989
)
[ 48]
postulated th
a
t
CCA
and the formation of anti
-
CCA antibodi
e
s m
a
y play a role
in
the parasite's
evasion of the immu
n
e
response o
f
t
he host
.
T
h
e reasons for this were that
many ant
i-
CCA McAbs
r
ecognize epitopes of the sch
i
stosome egg, and
carbohydrate e
g
g
ant
ige
n
s are
su
ppos
e
d
t
o elicit
'bl
ocking'
lgM
anti
bodi
e
s which
may interfere with the binding of prote
ct
iv
e
lgG antibodies dir
e
cted against
surface antigens of the sch
i
s
t
osom
u
lum
[19,20,50]. The
above descr
i
bed lgM
M
cAb
of Appriou
et al.
(
1986) directed
aga
inst
a
gut
-
a
ssociat
e
d antigen sim
i
lar
but not
i
dentical to CCA
[
6], showed an inhibitory e
f
fect on imm
u
nity aft
er
p
a
ssive transf
e
r in
mice
[
5
]
. T
h
e
authors
suggested that the McAb b
l
ock
ing
act
i
vity might
i
nt
erfe
r
e w
it
h non-spec
i
fic
i
mmune mechanisms
.
Us
i
ng several
anti
-
CCA McAbs
i
n pass
i
ve t
r
ansfer exper
i
ments, however, we co
u
ld not
demons
t
rate
a
n
i
nhib
it
ory effect on imm
unity
(unpublished observations
)
.
Van
Egmond
et
al
.
(
1981
)
[ 124] showed that
puri
fied CCA p
r
eparat
i
ons, as well as a
preparat
i
on of excre
t
ory
and
secretory antigens
,
are capab
l
e of
induci
ng
comp
l
emen
t
activa
t
ion
.
The exact mechanism of
t
h
i
s complemen
t
act
i
vation
could no
t
be fou
n
d.
L
i
k
e
wise
,
t
he ro
l
e of CAA in the physiology of the sch
i
stosome remai
n
s
Chapter 1
responses or blood
clot
t
ing
processes [86]
.
A preparation of excretory and
secretory antigens containing CAA in r
e
l
atively
large quantities has been shown
to interfere
with
hemostatic processes [72].
Tsang
et al. (1977) [121, 1221
described an anticoagulatory activity in
a
whole worm homogenate of
Schistosoma mansoni, which is not
destroyed
by heating the antigen to 1 00°C
for 1 0 m
in,
suggesting that CAA might
b
e
involved
.
Robertson and Cain (
1985)
have described the an
a
lysis
of
g
l
ycosamino
glycans
from
Schistosoma mansoni
and
suggested
that
these
structures
(including
CAA
which
has
a
glycosaminoglycan
-li
ke monosaccharide composition) might be involved in the
prevent
i
on of entrapment of the
parasites
by the host's b
l
ood-clotting process
[104].
Both CAA and CCA have been
de
scribed to be
i
n
volved
in
pathology as CAA
-and CCA
-
con
t
aining
imm
une
complexes have been found to be deposited in the
kidney
and
in
the
liver
[
26,52,64,65].
l
t
has
been
reported
that
schistosoma
l
-
speci
f
i
c nephropathy exists and can
lead
to end
-
stage
rena
l
disease,
w
ith
CAA and CCA as major responsible antigens [ 11
7,
118]. This
schis
t
osomal-spec
i
fic
nephrop
a
thy, however, does not show any remission after
anti-sch
istosoma!
trea
t
men
t
[
119], suggesting
that
also other mechanisms are
inv
olved in the induction of patho
l
ogy, as has already been described earlier
[
126]
.
In
schistosomiasis
haematob
i
um an assoc
i
ation between the disease and
bladder
cancer
has
b
een described
[70,
112
,
120], but
it
is
un
l
ikely
that
antigens
or
immune complexes
pl
a
y
a
role herei
n
. Other mechanisms have been suggested
such as
urothelium
chromosomal damage caused by
S. haematobium infect
i
on
[
1 06
].
I
n
conc
l
u
sion, the g
u
t-
associated antigens of
Schistosoma constitute an
immunolog
i
cal
l
y and physiologica
ll
y important group of antigens
.
Analysis
of two
major a
n
tigens, CAA and CCA, wh
i
ch are the targets in two
recently
develop
e
d
im
mu
nodiagnostic assays for sch
i
stosom
i
asis,
in
d
i
cated
t
hat the important
e
p
it
op
e
s are carbohydrates. T
h
erefore
,
a
major theme of this thesis will be the
molecular charac
t
e
r
ization
o
f
these carbohydrate struc
t
ures. Based on the
results,
the
role or effect of
t
h
es
e
antige
ns
w
i
ll be
inv
estigated
in
re
l
ation
t
o the
i
mmune
system of
t
he
h
ost.
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