Disruption of gut integrity and permeability contributes to enteritis in a fish‑parasite model: a story told from serum metabolomics

Background In the animal production sector, enteritis is responsible for serious economic losses, and intestinal parasitism is a major stress factor leading to malnutrition and lowered performance and animal production efficiency. The effect of enteric parasites on the gut function of teleost fish, which represent the most ancient bony vertebrates, is far from being understood. The intestinal myxozoan parasite Enteromyxum leei dwells between gut epithelial cells and causes severe enteritis in gilthead sea bream (Sparus aurata), anorexia, cachexia, growth impairment, reduced marketability and increased mortality. Methods This study aimed to outline the gut failure in this fish-parasite model using a multifaceted approach and to find and validate non-lethal serum markers of gut barrier dysfunction. Intestinal integrity was studied in parasitized and non-parasitized fish by immunohistochemistry with specific markers for cellular adhesion (E-cadherin) and tight junctions (Tjp1 and Cldn3) and by functional studies of permeability (oral administration of FITC-dextran) and electrophysiology (Ussing chambers). Serum samples from parasitized and non-parasitized fish were analyzed using non-targeted metabolomics and some significantly altered metabolites were selected to be validated using commercial kits. Results The immunodetection of Tjp1 and Cldn3 was significantly lower in the intestine of parasitized fish, while no strong differences were found in E-cadherin. Parasitized fish showed a significant increase in paracellular uptake measured by FITC-dextran detection in serum. Electrophysiology showed a decrease in transepithelial resistance in infected animals, which showed a diarrheic profile. Serum metabolomics revealed 3702 ions, from which the differential expression of 20 identified compounds significantly separated control from infected groups in multivariate analyses. Of these compounds, serum inosine (decreased) and creatine (increased) were identified as relevant and validated with commercial kits. Conclusions The results demonstrate the disruption of tight junctions and the loss of gut barrier function, a metabolomic profile of absorption dysfunction and anorexia, which further outline the pathophysiological effects of E. leei

Reduced diversity and increased virulence-gene carriage in intestinal enterobacteria of coeliac children

<p>Abstract</p> <p>Background</p> <p>Coeliac disease is an immune-mediated enteropathology triggered by the ingestion of cereal gluten proteins. This disorder is associated with imbalances in the composition of the gut microbiota that could be involved in its pathogenesis. The aim of the present study was to determine whether intestinal <it>Enterobacteriaceae </it>populations of active and non-active coeliac patients and healthy children differ in diversity and virulence-gene carriage, so as to establish a possible link between the pathogenic potential of enterobacteria and the disease.</p> <p>Methods</p> <p><it>Enterobacteriaceae </it>clones were isolated on VRBD agar from faecal samples of 31 subjects (10 active coeliac patients, 10 symptom-free coeliac patients and 11 healthy controls) and identified at species level by the API 20E system. <it>Escherichia coli </it>clones were classified into four phylogenetic groups A, B1, B2 and D and the prevalence of eight virulence-associated genes (type-1 fimbriae [<it>fimA</it>], P fimbriae [<it>papC</it>], S fimbriae [<it>sfaD/E</it>], Dr haemagglutinin [<it>draA</it>], haemolysin [<it>hlyA</it>], capsule K1 [<it>neuB</it>], capsule K5 [<it>KfiC</it>] and aerobactin [<it>iutA</it>]) was determined by multiplex PCR.</p> <p>Results</p> <p>A total of 155 <it>Enterobacteriaceae </it>clones were isolated. Non-<it>E. coli </it>clones were more commonly isolated in healthy children than in coeliac patients. The four phylogenetic <it>E. coli </it>groups were equally distributed in healthy children, while in both coeliac patients most commensal isolates belonged to group A. Within the virulent groups, B2 was the most prevalent in active coeliac disease children, while D was the most prevalent in non-active coeliac patients. <it>E coli </it>clones of the virulent phylogenetic groups (B2+D) from active and non-active coeliac patients carried a higher number of virulence genes than those from healthy individuals. Prevalence of P fimbriae (<it>papC</it>), capsule K5 (<it>sfaD/E</it>) and haemolysin (<it>hlyA</it>) genes was higher in <it>E. coli </it>isolated from active and non-active coeliac children than in those from control subjects.</p> <p>Conclusion</p> <p>This study has demonstrated that virulence features of the enteric microbiota are linked to coeliac disease.</p

A Solve-RD ClinVar-based reanalysis of 1522 index cases from ERN-ITHACA reveals common pitfalls and misinterpretations in exome sequencing

Purpose Within the Solve-RD project (https://solve-rd.eu/), the European Reference Network for Intellectual disability, TeleHealth, Autism and Congenital Anomalies aimed to investigate whether a reanalysis of exomes from unsolved cases based on ClinVar annotations could establish additional diagnoses. We present the results of the “ClinVar low-hanging fruit” reanalysis, reasons for the failure of previous analyses, and lessons learned. Methods Data from the first 3576 exomes (1522 probands and 2054 relatives) collected from European Reference Network for Intellectual disability, TeleHealth, Autism and Congenital Anomalies was reanalyzed by the Solve-RD consortium by evaluating for the presence of single-nucleotide variant, and small insertions and deletions already reported as (likely) pathogenic in ClinVar. Variants were filtered according to frequency, genotype, and mode of inheritance and reinterpreted. Results We identified causal variants in 59 cases (3.9%), 50 of them also raised by other approaches and 9 leading to new diagnoses, highlighting interpretation challenges: variants in genes not known to be involved in human disease at the time of the first analysis, misleading genotypes, or variants undetected by local pipelines (variants in off-target regions, low quality filters, low allelic balance, or high frequency). Conclusion The “ClinVar low-hanging fruit” analysis represents an effective, fast, and easy approach to recover causal variants from exome sequencing data, herewith contributing to the reduction of the diagnostic deadlock

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Hints on t cell responses in a fish-parasite model: enteromyxum leei induces differential expression of t cell signature molecules depending on the organ and the infection status

[Backgroud] Enteromyxum leei is a myxozoan parasite that produces a slow-progressing intestinal disease. This parasite invades the paracellular space of the intestinal epithelium and progresses from the posterior to the anterior intestine. The aim of the present study was to gain insights into fish T cell responses in the gilthead sea bream-E. leei infection model using a PCR-array with 30 signature molecules for different leukocyte responses in head kidney, spleen, anterior and posterior intestine.[Results] The PCR-array results suggest that E. leei induced migration of T cells from head kidney to intestines where TH1, CTL and TH17 profiles were activated and kept in balance by the upregulation of regulatory cytokines. These results were partially validated by the use of cross-reacting antibodies and BrdU immunostaining to monitor proliferation. Zap70 immunostaining supported the increased number of T cells in the anterior intestine detected by gene expression, but double staining with BrdU did not show active proliferation of this cell type at a local level, supporting the migration from lymphohaematopoietic tissues to the site of infection. Global analyses of the expression profiles revealed a clear separation between infected and exposed, but non-infected fish, more evident in the target organ. Exposed, non-infected animals showed an intermediate phenotype closer to the control fish.[Conclusions] These results evidence a clear modulation of the T cell response of gilthead sea bream upon E. leei infection. The effects occurred both at local and systemic levels, but the response was stronger and more specific at the site of infection, the intestine. Altogether, this research poses a promising basis to understand the response against this important parasite and establish effective preventive or palliative measures.This work has been carried out with financial support from the Spanish MINECO under project AGL2013-48560-R. Additional funding was provided by the European Union, through the Horizon H2020 research and innovation programme under grant agreement 634429 (ParaFishControl). This publication reflects only the authors’ view and the European Union cannot be held responsible for any use that may be made of the information contained herein. Further support was provided by Generalitat Valenciana (PROMETEOII/2014/085). MCP was contracted under CSIC PIE project no. 201740E013 and MINECO FPDI-2013-15741, and IE under APOSTD/2016/037 grant by the “Generalitat Valenciana”. We acknowledge support of the publication fee by the CSIC Open Access Publication Support Initiative through its Unit of Information Resources for Research (URICI).Peer reviewe

T cell response in gilthead sea bream after exposure to the myxozoan parasite Enteromyxum leei: Local versus systemic

Trabajo presentado en la 18th International Conference on Diseases of Fish and Shellfish, celebrada en Belfast, del 4 al 8 de septiembre de 2017The study of T cell responses in fish has been hampered by the lack of specific antibodies and molecular tools. Nowadays, several T cell specific antibodies have been developed for a few fish species. However, our knowledge on fish T cell responses is mainly derived from gene expression analyses of signature genes characterized as a result of the recent availability of genomic and transcriptomic information. Enteromyxum leei is a myxozoan intestinal parasite that produces a slow-progressing intestinal disease leading to anorexia, cachexia and mortalities. This parasite invades the paracellular space of the intestinal epithelium and progresses from the posterior to the anterior intestinal segment. In this study, we define the T cell populations in different intestinal segments and in immune relevant tissues of gilthead sea bream after E. leei infection by anal inoculation. Data mining of the gilthead sea bream transcriptomic database (Nutrigroup-IATS) allowed the construction of a PCR-array composed of 20 different T cell signature transcription factors, cytokines and effector molecules. Our results show that upon E. leei infection, the transcription of the pan T cell markers zap70 and cd3¿, the helper T cell (Th) specific cd4 and the cytotoxic T cell (Tc) specific cd8¿ and cd8ß decreased in head kidney and increased in anterior intestine. The parasite induced a shift from a Th2 to a Th1 response in infected anterior intestines, characterized by down-regulation of the transcription factor gata3 and up-regulation of t-bet, respectively. Significant up-regulation of gzmA and prf1 expression also supported the increase of Tc cells in infected intestines. However, the posterior intestine showed a mixed profile skewed to the anti-inflammatory side, characterized by up-regulation of foxp3, gata3, il10 and il6, still with significant presence of t-bet and ifn¿ transcripts. The expression of il17A/F was significantly up-regulated in infected posterior intestines. Analyses of the overall expression of these signature molecules separated groups of fish by their infection status. In conclusion, E. leei infection activated different T cell phenotypes depending on the intestinal segment and the intensity of infection. This could be due to the chronology of the parasite establishment along the intestinal segments.This work was funded by EU H2020 program through ParaFishControl Project (634429) and Spanish MINECO through project AGL2013-48560 and partially supported by the “Generalitat Valenciana” (PROMETEOII/2014/085). M.C.P. was contracted under CSIC PIE project no. 201740E013 and FPDI-2013-15741 and I.E. under APOSTD/2016/037 grant by the “Generalitat Valenciana”.Peer reviewe