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1986 Isolation, in vitro excystation, and in vitro development of sp from calves Douglas Byron Woodmansee Iowa State University

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T TA yf.T Dissertation iJ iVll Information Service University Microfilms International A Bell & Howell Information Company 300 N. Zeeb Road, Ann Arbor, Michigan 48106

8627163

Woodmansee, Douglas Byron

ISOLATION, IN VITRO EXCYSTATION, AND IN VITRO DEVELOPMENT OF CRYPTOSPORIDIUM SP. FROM CALVES

Iowa State University PH.D. 1986

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University Microfilms International

Isolation, in vitro excystation, and in vitro development of

Cryptosporidium sp. from calves

by

Douglas Byron Woodmansee

A Dissertation Submitted to the

Graduate Faculty in Partial Fulfillment of the

Requirements for the Degree of

DOCTOR OF PHILOSOPHY

Department: Zoology Major; Zoology (Parasitology)

Approved:

Signature was redacted for privacy. In Charge of Maj^r Work

Signature was redacted for privacy. For the Major Department

Signature was redacted for privacy. For the Graduate College

Iowa State University Ames, Iowa

1986 ii

TABLE OF CONTENTS

Page

GENERAL INTRODUCTION 1

Explanation of Dissertation Format 3

LITERATURE REVIEW 4

Historical Aspects 4

Taxonomy 10

Life Cycle and Morphology 15

Diseases Associated with Cryptosporidium 29

SECTION I. DEVELOPMENT OF CRYPTOSPORIDIUM SP. IN CULTURED CELLS 46

Abstract 46

Introduction 46

Materials and Methods 47

Results 49

Discussion 51

Literature Cited 52 iii

SECTION II. AN IN VITRO STUDY OF SPORULATION IN CRYPTOSPORIDIUM SP. 71

Abstract 71

Introduction 71

Materials and Methods 73

Results 74

Discussion 75

Literature Cited 75

SECTION III. TAUROCHOLIC ACID AFFECTS MOTILITY AND MORPHOLOGY OF CRYPTOSPORIDIUM SPOROZOITES IN VITRO 84

Abstract 84

Introduction 84

Materials and Methods 85

Results 88

Discussion 89

Literature Cited 91 iv

SECTION IV. STUDIES OF IN VITRO EXCYSTATION OF CRYPTOSPORIDlUM SP. FROM CALVES 106

Abstract 106

Introduction 106

Materials and Methods 107

Results 112

Discussion 115

Literature Cited 118

SECTION V. TECHNIQUES FOR THE RECOVERY OF CRYPTOSPORIDIUM OOCYSTS AND SPOROZOITES FROM CALF FECES 142

Abstract 142

Introduction 142

Materials and Methods 143

Results and Discussion 146

Literature Cited 149

GENERAL SUMMARY 151

LITERATURE CITED 154

ACKNOWLEDGMENTS 184 1

GENERAL INTRODUCTION

The genus Cryptosporidium consists of intracellular parasitic protozoa which infect the apical portions of epi­ thelial cells of several organs. The implication of infec­ tion by Cryptosporidium as a cause of disease (particularly diarrhea) has attracted substantial interest from research­ ers in human and veterinary medicine. In cattle and sheep, the infection appears to be a cause of the neonatal diarrhea syndrome known as scours. In humans, infections are associ­ ated with severe, protracted diarrhea in immunosuppressed patients and with less severe, self resolving diarrhea in immunologically normal people (43a, 199).

Most of the recent research on Cryptosporidium has been

done by pathologists "and clinicians rather than parasitolo­

gists. Therefore, the research emphasis has been heavily

weighted toward studies of the pathological, clinical and

epidemiological features of the disease rather than toward

the taxonomy, physiology and comparative biology of the

parasite. As a result of this emphasis, there is strong

evidence that Cryptosporidium is a primary pathogen and the

clinical aspects of the disease are well documented. We

have a poorer understanding of the taxonomy, life history

and basic biology of the parasite. 2

Studies of the biology of Cryptosporidium in comparison to other coccidian parasites are few, despite a number of unusual features of Cryptosporidium which are quite inter­ esting. The most common reason given for this neglect is that Cryptosporidium is difficult to work with. It is the smallest coccidian, with oocysts only about half the size of most other species. Furthermore, growth of the parasite in cultured cells (difficult for any coccidian) has not yet been achieved in a manner conducive to physiological studies. Finally, isolation of Cryptosporidium life cycle

stages from in vivo sources has been far less efficient than

the isolation of similar stages of other species.

This dissertation reports efforts to address some of

these problems. Specifically, efforts to grow Cryp­

tosporidium in cell culture, an examination of the sporula­

tion phase of the life cycle, a study of coccidian excysta-

tion using Cryptosporidium as a model organism, and new

techniques for the isolation of oocysts and sporozoites are

reported. The variety of topics approached in this disser­

tation is a reflection of the breadth of the work that still

needs to be done with this sometimes fascinating, and some­

times frustrating organism. 3

Explanation of Dissertation Format

This dissertation is written in the alternate format.

Five papers are presented in addition to a general introduc­ tion, a general literature review, and a general summary.

References for the general introduction and literature re­ view follow the general summary. Portions of the paper en­ titled "Development of Cryptosporidium sp. in cultured cells" were published in the Proceedings of the Fourth

International Symposium on Neonatal Diarrhea, 1983, Veteri­ nary Infectious Disease Organization, Saskatoon, Sask.,

Canada, pp. 306-319. The paper entitled "An in vitro study of sporulation in Cryptosporidium sp." has been accepted for publication in the Journal of Parasitology. All parts of this dissertation have been written to conform to the style required by the Journal of Protozoology. 4

LITERATURE REVIEW

Historical Aspects

The genus Cryptosporidium was first erected by Tyzzer in 1907 in a preliminary description of Cryptosporidium muris (172); a complete report followed in 1910 (173). Tyz­ zer found large numbers of protozoans infecting the gastric glands of laboratory mice- He thoroughly described these parasites with light microscopy using both stained and un­ stained preparations, and experimentally infected weanling mice with mucosal scrapings from naturally infected mice.

His work demonstrated that these parasites were not develop­ mental stages of other murine protozoan parasites and that reports by other investigators (34, 194) describing small developmental stages of (Coccidium) falciformis may have been misinterpreted observations of Cryptosporidium.

Tyzzer recognized Cryptosporidium muris to be a sporozoan parasite. He used the nomenclature established for sporozoans to describe the life cycle stages: schizonts for the asexual developmental stage, micro- and macrogametes for the sexual stages, oocysts for the resistant stage which

develops after fusion of gametes, and sporozoites for the

individual parasites which develop by asexual reproduction

within the oocyst. The name Cryptosporidium is derived from

Greek roots and was intended to "signify that it is a 5

sporozoan in which spores are indistinguishable or absent in the oocyst..." (173).

In 1912 Tyzzer described a second species, Cryp­ tosporidium parvum (174). The two species were differen­ tiated on the basis of site specificity, C. muris infecting the gastric glands and C. parvum infecting the small intes­ tine. Cross transmission experiments were performed to sup­ port the separation. The developmental stages of C. mur is tended to be larger than similar stages of C. parvum; for example, the oocysts of C. muris measured 7x5 jam while the oocysts of C. parvum were more spherical and measured 4.5 ;um at their greatest diameter. Both species were attached to the apical portion of epithelial cells by a specialized zone of attachment. In C. muris, this structure was frequently visible on parasites which had detached from epithelial cells in stained smear preparations (173), but C. parvum rarely detached, and the attachment zone was much less dis­ tinct (174). Neither C. muris nor C. parvum infections were associated with disease in the mice.

Tyzzer's work is important because it was the first set of published observations of Cryptosporidium and also be­ cause the quality of the work was so high. His light

microscopy observations are still the most complete in the

literature, and most of them have been confirmed by modern

methods. 6

Since Cryptosporidium was not initially recognized as a cause of disease, interest in the genus was limited to, as

Levine (96) put it, "serindipitists and taxonomists." Most of the papers published from 1907 to 1975 were descriptions of new species. During these years, the concept of strict host specificity within the was dogma. It was, and to a certain extent still is, common practice to create a new species designation each time a coccidian parasite was discovered in a new host. Tables were published in which the genera of the Coccidia were grouped according to their oocyst morphology (see pp. 92-93 of reference 86 for exam­ ple). If a coccidian oocyst was found in a fecal sample, the table could be used to assign it to a genus. If a re­ view of the literature revealed that no members of that ge­ nus had previously been described in that host species, then a new species could be erected. Strict host specificity was usually assumed but cross-transmission experiments were often not performed. In retrospect, it is clear that such

practices led to an inflated list of species within the

genus Cryptosporidium. Levine (9 6) has recently reviewed

the species erected within the genus.

The first serious adjustment to the list of species was

made by Vetterling et al. in 1971 (189). He pointed out

that in some cases, species described on the basis of oocyst

morphology were probably misinterpreted observations of free 7

Isospora-like sporocysts. Isosporan sporocysts and Cryp­ tosporidium oocysts both contain four free sporozoites, so it would be natural to assign such sporocysts to the genus

Cryptosporidium if cyst morphology were the only criterion used. Vetterling stated that species named on the basis of cyst morphology alone should be considered invalid.

A second major development was the discovery by Tzipori and his colleagues in 1980 (177) that at least some isolates of Cryptosporidium could be readily transmitted to various host species; demonstrating that strict host specificity can not be assumed in the case of Cryptosporidium. These find­ ings raised doubts about the validity of most of the remain­ ing species. As a result of these problems, most authors

have been reluctant to use a species name to refer to the

isolates they work with. Thus, one often sees the parasite

referred to as Cryptosporidium sp., Cryptosporidia or just

Cryptosporidium.

The first association of Cryptosporidium infections

with disease came in 1955 when Slavin (159) reported mild

diarrhea causing unthriftiness and occasional death in in­

fected turkey polts. In 1966, another report described in­

fection associated with microscopic lesions in the small

intestine of guinea pigs (81). In the early and mid 1970s,

reports of disease associated with Cryptosporidium infec­

tions began to appear with more frequency. Among them were 8

reports describing an association between Cryptosporidiuin infection and diarrhea in calves (121, 138, 153). A group

of papers published in the late 1970s (114, 117, 136) showed that Cryptosporidium is probably common in calves with scours. These papers changed the emphasis of research on

in calves away from case reports and to­

ward critical attempts to demonstrate that Cryptosporidium

was a primary pathogen. This objective appears to have been

achieved by recent work with germ-free animals and purified

inocula (64, 187). In these studies, Cryptosporidium infec­

tions resulted in clinical disease in the absence of ex­

traneous agents.

The first report of infection of a human came in 197 6

when Nime et al. (120) observed Cryptosporidium in a three

year old girl with diarrhea. Other reports followed quickly

and it became clear that Cryptosporidium was associated with

diarrheal disease in humans, particularly in immunocompro-

mized individuals. Late in 1982, the Centers for Disease

Control published a report of 21 cases of protracted, in­

curable diarrhea caused by Cryptospordium in patients suf­

fering from the acquired immunodeficiency syndrome (AIDS)

(31). Reports of Cryptosporidium in AIDS patients began to

appear in the standard medical literature in 1983 and have

continued with some frequency until the present time. 9

In 1983 Current and co-workers (43a), in addition to describing one of the first cases of cryptosporidiosis in an

AIDS patient, proposed that cryptosporidiosis was a cause of diarrhea in immunologically normal humans. Prior to this paper, reports of the disease in normal individuals were relatively infrequent. Animal reservoirs were implicated as

being important in the epidemiology of the disease (43a) and

the suggestion was made that it should be considered a

zoonosis (155). This concept was disputed by Casemore and

Jackson (30) who, based on observations of cryptosporidosis

in a "semi-rural population" in Wales, hypothesized that

person to person transmission was probably more common than

zoonotic transmission. This hypothesis has received strong

support in recent papers (169, 199).

Research is continuing into many aspects of Cryp­

tosporidium and cryptosporidiosis. These areas include

efforts to clarify the status of the species within the ge­

nus, the establishment of suitable laboratory models for

cryptosporidiosis (including both in vitro and in vivo mod­

els), studies of the pathogenesis of the.disease, and

studies of immune responses to the parasite. Finally, an

important area of current research is the search for an ef­

fective treatment. To date, cryptosporidiosis has defied

chemotherapy despite repeated attempts with a wide variety 10

of drugs (see 175 for review). The lack of effective treat­ ment results in a grave prognosis for AIDS patients with cryptosporidiosis (43a).

Taxonomy

The genus Cryptosporidium Tyzzer, 1907 is classified as

follows: phylum Levine, 1970; class Sporozoasida

Leuckart, 1879; subclass Coccidiasina Leuckart, 1879; order

Eucoccidiorida Leger & Duboscq, 1910; suborder

Leger, 1911; family Cryptosporidiidae Leger, 1911 (95). The

characteristics of each of these taxa have recently been

described in detail (96, 98) and will not be reviewed here.

Among the Eimeriorina the family Cryptosporidiidae ap­

pears to be most closely related to the , a family

which includes the genera Eimeria, , and several

others. The two families are similar to each other in terms

of their basic life cycles and morphology. They differ in

that the Cryptosporidiidae develop just beneath the host

cell membrane while the Eimeriidae develop in the host cell

cytoplasm proper. Levine (97) moved the genus

from the Eimeriidae to the Cryptosporidiidae on the basis of

its site of development within host cells, illustrating the

closeness of the two families.

The confusion surrounding the validity of named species

within the genus Cryptosporidium has already been alluded 11

to. The work of Vetterling et al. (189) and Tzipori et al.

(177) cast serious doubt on almost all of the species named within the genus through about 1980, and Tzipori et al. went so far as to suggest that Cryptosporidium was a single-

species genus. Levine (96) reviewed the literature through

1982 and concluded that four species should be recognized as

valid: Cryptosporidium muris Tyzzer, 1907; C. crotali, Trif-

fit, 1925; C. meleagridis Slavin, 1955; and C. nasorum

Hoover, Hoerr, Carlton, Hinsman and Freguson, 1981. Essen­

tially, Levine lumped all those species described from mam­

mals into C. muris, all those described from snakes into C.

crotali, all those from birds into C. meleagridis, and the

one species from fish was left as C. nasorum.

Levine justified this scheme on the basis that cross-

transmission experiments, when they had been performed, had

tended to show transmission within host classes rather than

across them. Levine's scheme, however, does not account for

all of the experimental evidence. Tzipori et al. (177) re­

ported tranmission of Cryptosporidium from calves to one day

old chickens, an exception to the rule that these parasites

do not infect across host class boundaries. Current et al.

(43b) were unable to transmit an isolate from chickens to

quail or turkeys. Unpublished studies (D. B. Woodmansee, I.

Pavalasek and J. F. L. Pohlenz, National Animal Disease Cen­

ter, Ames, lA) have demonstrated transmission of an isolate 12

of Cryptosporidium from turkeys to calves and mice. As more experiments are performed more exceptions are likely to be found, and Levine's scheme (or at least the arbitrary dis­ tinction between C. muris and C. meleagridis) may become untenable.

Tyzzer (174) separated C. parvum from C. muris on the basis of site specificity, not host specificity. In light of Tyzzer's careful description of the morphologic differen­ ces between the two species and the cross-transmission ex­ periments which were performed, proposals to synonymize them

(96, 177) would seem unreasonable. It would appear that only rediscovery of C. muris as described by Tyzzer will clarify this point completely. Upton and Current (188) claimed to have rediscovered C. muris upon observing large

Cryptosporidium oocysts in the feces of cattle. They felt that these large oocysts were C. muris oocysts, and that the

smaller forms seen in most other studies of Cryptosporidium

in cattle were oocysts of C. parvum. While it is clear that the large oocysts they observed appeared different from the oocysts most commonly seen in calf feces, it is not certain

that they were actually C. muris. To be sure of that, it

would be necessary to transmit the parasites to mice, demon­

strate infection of the gastric glands, and show that other

stages of the life cycle, not just the oocyst, are similar

to Tyzzer's original description. Reports of the discovery 13

of Cryptosporidium-like parasites infecting the abomassum of cattle which were shedding the large form of the oocyst in their feces (B. C. Anderson, Caldwell Veterinary Teaching

Center, Caldwell, ID, unpublished) encourages one to believe that Upton and Current may be essentially correct. One can only hope that the next "rediscovery" of C. muris will be more convincing than the first.

The case of Cryptosporidium crotali is another case in which Levine appears to be mistaken. The species was

described by Triffit (171) on the basis of oocyst morphol­ ogy. The oocysts measured at least 10 and up to 12.5 jam in

diameter, far larger than any known Cryptosporidium oocyst.

As pointed out by Vetterling et al. (189), oocyst morphology

is not adequate for the description of a species of Cryp­

tosporidium. Judging by their size, the cysts Triffit saw

were far more likely to be sporocysts of or per­

haps, Isospora than oocysts of Cryptosporidium. At this

time the data are insufficient to determine the true

relationship of Cryptosporidia from snakes to Cryptosporidia

from other animals. The same statement is also true for the

cryptosporidian observed in a fish (71).

While the species within the genus Cryptosporidium are

far from being resolved, it is possible to make some hypoth­

eses to frame future work in this area. First, it appears

that one species of Cryptosporidium is resposible for most 14

of the infections which result in clinical disease in laam- mals. Abundant examples of cross transmission experiments and case studies implicating infection across species lines now exist (39, 97, 188). This parasite matches, in most

respects, the description given by Tyzzer (174) for Ç. par-

vum and many investigators in the field believe that it

should be referred to as such (188). It is reasonable to

hypothesize that the species described as C. muris is valid

and efforts should be made to rediscover this parasite and

confirm the hypothesis.

Recent, unsuccessful attempts to infect mammals with

certain isolates of Cryptosporidium from chickens (43b) and

vice versa (125) have indicated to some that differences

between Cryptosporidia of birds and mammals great enough to

deserve species ranking exist. Exceptions also exist

however (177), and until more studies are performed, it may

be best to take the position that all new isolates of Cryp­

tosporidia are C. parvum until proven otherwise. Proof may

take the form of mutually exclusive cross-transmision ex­

periments, distinctive and consistent morphological or

developmental differences, or perhaps distinctive and con­

sistent differences in isozyme or nucleotide restriction

patterns. 15

Life Cycle and Morphology

Sporozoites

The life cycle of coccidian parasites is initiated when sporozoites are released from oocysts and invade hosr cells.

The sporozoites of Cryptosporidium have been variously described as boomerang (173), banana (76, 78), or comma (42) shaped. The cytoplasm stains blue and the nucleus red with

Giemsa's stain (76). The nucleus appears rod-shaped in stained smears (173, 174) but round in fresh preparations observed with interference contrast microscopy (42). Re­ ported sizes of these organisms vary from 4-6 x 0.5-1.2 jum

(42, 78, 145, 174, 188). Sporozoites believed to be those

of Cryptosporidium muris are larger and have been reported

to measure 11.1 x 1.0 aim (173, 188).

The ultrastructure of Cryptosporidium sporozoites is

similar to that of other coccidians (for a review of coc­

cidian ultrastructure see 33). Features include the pelli­

cle, rhoptries, micronemes, a nucleus, and ribosomes (76,

78). Examination of the surface of sporozoites by scanning

electron microscopy shows numerous, randomly scattered pits,

the function of which is unknown (145).

Host cell penetration

Discussion of host cell penetration is complicated by

claims that Cryptosporidium is actually extracellular and 16

thus does not invade host cells at all (135, 173, 174). The bulk of the data support the idea of intracellular develop­ ment, and examination of papers which claim the contrary show that the data are not inconsistent with the intracellu­ lar hypothesis. Since mechanisms of host cell invasion ap­ pear to be similar for both sporozoites and merozoites, the following description is based on data from both forms.

Vetterling et al. (190) likened invasion to inverting the finger of a rubber glove; membrane from the host cell

moves up the invading sporozoite and seals at the top, leav­

ing the parasite covered with a double membrane of host ori­

gin called the parasitophorous envelope (135). Unlike other

apicomplexan parasites, Cryptosporidia do not penetrate into

the host cell cytoplasm proper, but stop such that only the

anterior end of the organism interfaces with the host cell

while the posterior end remains in the lumen of the infected

organ. Several transmission electron micrographs of zoite

invasion have been published (19, 42, 74, 76, 78, 107, 130,

190). The source of available host membrane required by

this model is unknown, but one possibility is that microvil­

li adjacent to the site of attack fuse and donate the

membranes covering them to the envelope (57, 74, 130).

Tyzzer (174) observed movement of a granule from the

cytoplasm of the sporozoite to the zone of attachment during

invasion. Other investigators have described vacuolation of 17

the anterior end of sporozoites during penetration (42, 76,

190). It is likely that these observations represent empty­ ing of rhoptries and micronemes as seen in penetrating

Eimeria sporozoites (79).

Trophozoites

After penetration, sporozoites round up and are called trophozoites or uninucleate raeronts. The host-parasite relationship and much of the ultrastructure is identical in all the attached stages of the life cycle, so much of the description of the trophozoite will carry over to the later stages. Trophozoites are round to oval with blue cytoplasm and a reddish nucleus after Giemsa staining (159, 173, 174).

They grow as they mature (58), and reported sizes range from

1.5-5.0 |im in diameter (11, 42, 78, 159, 174).

The parasite is covered with the parasitophorous enve­ lope. The outer membrane of the envelope is continuous with the apical membrane of the epithelial cell (58, 76, 78, 105,

190) and is covered with a glycocalyx (57, 58, 105, 135).

Beneath the envelope is a space, known as the

parasitophorous vacuole. The trophozoite itself is covered

by a three membrane pellicle, the inner two membranes of

which regress as the parasite grows until they only appear

at the top of the cell (42, 78, 105, 190). Freeze fracture

studies of the trophozoite pellicle show that the outer two 18

membranes have low numbers of intramembranous particles while the inner membrane is rich in them (105). This find­ ing is typical for the pellicles of other coccidians (33).

At the base of the parasite is an unusual structure called the attachment organ (173) or feeder organelle (135).

It is a network of membranous folds which forms the inter­ face between the parasite and the host cell. It is believed that during early development of the trophozoite, the host cell membrane separating the parasite pellicle from the host cell cytoplasm disintegrates (42, 58, 105) and the outer

pellicle membrane hypertrophies to form the organelle (105).

While its function has never been proven, authors have fre­

quently speculated that it is involved in nutrition of the

parasite (135, 173, 174, 190).

The edges of the feeder organelle are defined by a

structure called the annular ring (135). One author

described this structure as a junctional complex (42), while

another described it as a pentilaminar membrane fusion site

(105). Beneath the feeder organelle is an electron dense

band (58, 76, 130) which was once thought to be a remnant of

the host cell plasma membrane (58) but this interpretation

is no longer in favor (105). Together, the annular ring and

dense band form a stable and strong attachment between the

the parasite and the host cell. 19

The cytoplasm of young trophozoites contains only a nucleus with a large nucleolus, Golgi anlagen and ribosomes

(76, 78, 190). Mitochondria are believed to be absent from all stages of the life cycle (42, 190). As the trophozoite grows, rough endoplasmic reticulum develops near the nucleus and expands until it fills the entire cytoplasm. The feeder organelle also increases in size as the trophozoite matures

(42, 78, 107, 190).

Trophozoites are indistinguishable from gametes by scanning electron microscopy. These forms show fluting of the parasitophorous envelope around the base (74, 129, 130).

It has been suggested that these folds represent fusion of microvilli to the envelope (57, 74) but it is also possible that they are processing artifacts (129, 200).

Meroqony

After a mature trophozoite begins nuclear division it is called a meront or schizont. During merogony the parasites reproduce by multiple fission and the population of parasites in the tissue grows rapidly. The number of offspring (known as merozoites) per meront and the number of types (also called generations) of meronts which occur

varies among the species of the Coccidia (86).

In the case of Cryptosporidium, multiple meront types

have been described. Type I meronts give rise to eight 20

merozoites while Type II meronts give rise to four merozoites (42, 110, 135, 189). The two types are also dif­ ferentiated by the arrangement of the merozoites within the meront. Type I merozoites lie randomly in the parasitophorous envelope while Type II merozoites are ar­ ranged like the sections of an orange, with their anterior ends oriented away from the feeder organelle (42). Some authors have described only Type I meronts (19, 76, 78, 159,

173, 174) and there is some debate whether or not the Type

II meront is truly a life cycle stage. A third meront type

(Type III) has also been described on one occasion (43b).

Nuclear division occurs to yield a number of nuclei equal to the number of merozoites which will ultimately be formed (19, 42, 76, 78, 173, 174, 189). Vetterling et al.

(190) failed to observe centrioles, spindles, plaques or intranuclear filaments during nuclear division. After

nuclear division, the nuclei move to the periphery of the cell in preparation for cytokinesis (42, 173, 174, 189).

Merozoites bud off from anterior to posterior (190).

Each merozoite has a three membrane pellicle despite the

fact that the inner two membranes are limited in the

trophozoite (42, 76, 105, 190). A nucleus, Golgi apparatus,

and rough endoplasmic reticulum are included in each

merozoite (42, 76, 190). The apical complex forms rapidly

and it is not unusual to find ultrastructurally complete 21

merozoites still attached to the feeder organelle by a small peduncle (42, 135, 190). Most of the meront's cytoplasm

becomes incorporated into the merozoites. When cytokinesis

is complete, the merozoites lie free in the parasitophorous

vacuole and the remainder of the meront, together with the

feeder organelle, is left as a residual body covered with a

single unit membrane (190).

Scanning electron microscopy of meronts demonstrates

the delicate nature of the parasitophorous envelope. The

envelope may collapse around the merozoites leaving their

outlines clearly visible (200) or it may be torn away, leav­

ing the merozoites exposed (135).

Like trophozoites, meronts vary in size. Reports of

meront diameter range from 3-8 ;im but reports of 4-5 jom are

most common (42, 52, 76, 110, 159, 174, 190). Since, mea­

surements are affected by fixation and staining techniques

(110), measurement of live specimens using interference con­

trast microscopy (42) may be the best method.

Vetterling et al. (189) observed Type I meronts 7-9

days post inoculation (p.i.) and Type II meronts from 11-14

days p.i. in the guinea pig intestine. Current and Reese

(42) observed early Type I meronts at 12 h p.i. and mature

Type I meronts at 16 h p.i. in the intestine of mice while

Type II meronts were first observed at 16 h p.i. Both types 22

were seen up to 9 days p.i. Current and Haynes (40), work­ ing with infected cell cultures, observed Type I meronts from 12-96 h p.i. and Type II meronts from 24-144 h p.i.

Merozoites

The morphology of merozoites is similar to the morphol­ ogy of sporozoites. They are banana shaped (42, 78) and have been reported to measure 0.7-1.2 x 2-8 jom (42, 52, 76,

78, 159, 173, 189). The nucleus is spherical to subspheri-

cal and subterminal (42, 76, 159, 173, 174). Tyzzer

described a granule in the anterior portion of the merozoite

identical to the granule found in the sporozoite (173, 174).

Merozoites move by gliding and flexing (42).

Rhoptries, micronemes and a conoid have been observed

by electron microscopy (19, 42, 76, 78, 190). Polar rings

have been reported (19, 190) but a recent paper has inter­

preted these structuras as preconoidal rings (42). The pel­

licle consists of two membranes (42, 78) and may not cover

the anterior end of the merozoite (42). Micropores and sub-

pellicular microtubules, conspicuous features of other coc-

cidian zoites (33), are absent from Cryptosporidium

merozoites (19, 42, 190), but microtubules supporting ducts

leading from rhoptries have been described (42). A Golgi

apparatus and rough endoplasmic reticulum also occur (19,

76, 78, 190). 23

Current and Reese (42) have described differences between merozoites arising from Type I and Type II meronts.

They describe Type I merozoites as slightly shorter and slightly wider than Type II and claim that Type I merozoites may give rise to either Type I meronts or Type II meronts while Type II merozoites only give rise to gametes.

Microqamonts and microqametes

Microgamonts give rise to microgametes, the male ga­ mete. They are shaped similar to immature meronts and mea­ sure 2-9-6 Jim (42, 52, 57, 110, 159, 173). They have up to

16 dense, peripherally arranged nuclei, ribosomes, endoplas­ mic reticulum and vacuoles (19, 42, 57, 78, 159, 173, 174,

189).

The nuclei and a small amount of cytoplasm bud off to form the microgametes, leaving a large residuum (19, 57, 78,

173). Microgametes have been reported to measure 0.2-0.4 x

9.5-1.1 jam (42, 57, 78, 189). They have been described as bullet shaped (42), wedge shaped (57), or tubular (78), but all descriptions mention an expanded and flattened anterior end and a pointed posterior end. The pellicle is a double membrane (57, 78, 190) and there are no flagella (19, 42,

76, 173). On two occasions authors described tubular

mitochondria within microgametes, (19, 57) but the photo­

graphs are unconvincing and have been challenged (42). 24

The microgamete interacts with the female or macroga- mete by its anterior end (57). This portion, called the adhesion zone, is composed of granular osmiophilic material, polar rings and several associated microtubules (57, 78).

The mechanisms by which microgametes recognize and interact with macrogametes are unknown. Microgametes are motile and have been observed to exibit "jerky foward gliding move­ ments" (42).

Macrogametes

Macrogametes are the female sexual stage. Reported sizes range from 3-7 ;iim in diameter (11, 42, 52, 57, 76, 78,

110, 159, 174, 189). The cytoplasm of these cells stains blue with Giemsa and takes on a characteristic spongy ap­ pearance due the extraction of material from numerous granules (57, 159, 173, 174). These granules are stainable with Lugol's solution (76, 173), indicating the presence of carbohydrate.

Ultrastructural studies of macrogametes reveal a cyto­

plasm containing polysaccharide granules. Similar granules

in Eimeria oocysts have been shown to contain amylopectin

(150). In addition to these granules, the cytoplasm con­

tains wall forming bodies. These membrane-bound bodies,

typical for coccidian macrogametes, contain material which

will later be laid down to form the oocyst wall (33). 25

Scholtyseck et al. have described two types of wall forming bodies in Eimeria, WFl and WF2 (154). Some authors claim that both types are present in Cryptosporidium (42, 78) while others claim that only WFl occur (57, 190). Rough endoplasmic reticulum and large membrane bound vacuoles, thought to contain lipid, also occur (57, 75, 78, 135, 189).

Fertilization and Sporulation

Fertilization of macrogametes by microgametes to form zygotes has been observed with both light and electron microscopy (57, 159, 173, 174). After fertilization, the wall forming bodies move to the periphery of the macrogamete and release their contents into the parasitophorous envelope

(42). As a result, the cytoplasm of the zygote becomes sep­

arated from the feeder organelle by the newly formed oocyst

wall and the zygote lies free in the parasitophorous vacuole

(11, 42). This stage is called the unsporulated oocyst.

Oocysts complete their development and form sporozoites

by a form of multiple fission known as sporulation. In

other coccidians, sporulation is believed to be a meiotic

event (27). Sporulation of Cryptosporidium may occur in the

parasitophorous envelope (11, 42, 76) but some authors have

suggested that substantial sporulation occurs in the intes­

tinal lumen (173, 174) or outside of the host (3). 26

Spomlated Oocysts

Sporulated oocysts are passed in feces and may infect a new host if they are ingested. They are resistant to en­ vironmental stress, particularly chemical disinfectants (9,

26, 126) and may maintain viability for several months if

kept cool and wet (42). Oocysts of C. muris measure 5-5.6 x

7-7.4 jam (173, 188) while other cryptosporidian oocysts

(probably C, parvum) measure 3.3-5.0 x 4.0-5.2 jam (42, 76,

145, 159, 174, 188).

The time from infection to the onset of oocyst shedding

(the prepatent period) and the duration of oocyst shedding

(the patent period) has been reported for a number of ex­

perimental hosts (8, 40, 42, 61, 76, 113, 115, 116, 177,

178, 183, 186, 187). Prepatent periods are commonly about

three days and patent periods usually 10-14 days.

The ultrastructure of mature oocysts is difficult to

study because they become severely distorted by conventional

electron microscopic techniques (11, 42). It is generally

agreed that mature cysts contain four sporozoites, and a

membrane bound residuum filled with polysaccharide granules

(42, 76, 78, 135, 145, 173, 174, 188).

The oocyst wall is made up of an inner, electron dense

layer and an outer, electron lucent layer (42, 78). Its

structure has recently been described in detail (144). The 27

wall is interrupted by a well defined suture line which ex­ tends roughly 1/3 to 1/2 the way around the oocyst (42, 145,

188). Dltrastructurally, the suture consists of a series of alternating electron dense and electron lucent bands (144).

Some investigators have claimed the existence of a second type of oocyst, the thin-walled oocyst. This form was first described by Current and colleagues from ex­ perimentally infected chicken embryos (41) and mice (42).

The four sporozoites are surrounded by a membranous cyst wall which is easily ruptured. It was proposed that autoin­ fection as a result of release of sporozoites into the in­ testinal lumen from thin-walled oocysts is an important mechanism by which Cryptosporidium infections become persis­

tent in immunocompromized hosts (42).

Some authors have argued that the cyst stage of Cryp­

tosporidium should be referred to as a sporocyst rather than

an oocyst (21). This position has not gained general accep­

tance (42). Levine's uniform terminology for apicomplexans

(94) defines the oocyst as "A cyst formed around a zygote."

and the sporocyst as "A cyst formed within the oocyst...."

Since only one cyst wall develops around the Cryptosporidium

zygote (42, 76, 173, 174) that cyst is, by definition, an

oocyst. This interpretation is consistent with the original

definition of the genus (173). 28

Excystation

Excystation is the process by which sporozoites escape the oocyst so that they may infect new host cells. Excysta­ tion of eimerian oocysts is well studied and some of the biochemical mechanisms have been worked out (149, 191).

The suture in the oocyst wall of Cryptosporidium is the structure through which sporozoites escape. Reduker et al.

(144) have described the dissolution of the suture in response to excystation stimuli. The data suggest that excystation proceeds from the inside out. The first changes are a loss of an internal ridge directly beneath the suture.

This is followed by separation of the internal aspects of the bands making up the suture. Finally, the outermost part of the inner oocyst wall and the outer wall rupture. Scan­ ning electron microscopic observations show a depression in the suture prior to the formation of the cleft-like opening through which the sporozoites escape (145).

Studies of excystation in response to various stimuli

have established that the excystation process in Cryp­

tosporidium may not be identical to excystation of

eimerians. It appears that Cryptosporidium oocysts do not

require activation by reducing conditions and CO2 (49,

143b). Furthermore, it is possible for Cryptosporidium

oocysts to excyst in the absence of host digestive enzymes 29

and bile salts (49) but this may require a chemical pre- treatment (143b). These observations led Payer and Leek

(49) to hypothesize that excystation in Cryptosporidium is

mediated by an internal enzyme system. Such systems have

been proposed for Eimeria but never proven to exist (191).

Diseases Associated with Cryptosporidium

Cryptosporidiosis in humans

Clinical Aspects The clinical presentation of in­

testinal cryptosporidiosis in humans is variable. In the

case of non-immunosupressed persons, the disease is a self

limiting, non-life threatening diarrhea. Case reports have

described diarrhea with the following characteristics in

various combinations: usually mild (22, 166) but sometimes

severe (16, 120, 133, 146), watery (16, 22, 51, 87, 102,

120, 180), foul smelling (148), green (51), and sometimes

containing mucus (133, 201) and/or blood (120, 133).

Reports of the duration of diarrhea in non-

immunosuppressed humans vary from 1 day (43a) to 5 months

(75), but the majority of cases last 1 to 2 weeks (14, 22,

59). Cases of people shedding oocysts without diarrhea have

occurred (43a, 69, 164) and shedding may continue for a time

after the diarrhea resolves (14, 69). In some cases the

diarrhea is discontinuous (59). 30

Abdominal pain, anorexia, vomiting, and fever in addi­ tion to diarrhea are commonly reported (14, 69, 201). De­ hydration (16, 166), headache (102), malaise (43a, 87, 10 2,

146, 148, 180), fatigue (87, 180), flatulence (69), hot and cold flushes (5, 180) and constipation (146) are less com­ mon. Diarrhea tends to be the last of the clinical signs to resolve (43a, 59, 180).

Cryptosporidiosis of immunosuppressed people is usually severe, persistent and often life threatening. The disease is most frequent in patients with AIDS (31) but also occurs in patients with congenital hypogammaglobulinemia (43a, 91,

160), immunodeficiencies of unclear origin (89, 165) and persons undergoing immunosuppressive chemotherapy (109, 111,

193).

Clinical signs are qualitatively similar to those found in immunologically normal people but are usually more severe and often complicated by the presence of other diseases.

Mean fecal output of 21 patients was reported to be 3.6

liters/day with one patient excreting 17 liters/day (31).

Diarrhea and oocyst shedding fail to resolve and continue

until the death of the patient in most cases. Exceptions to

this scenario including spontaneous resolution of diarrhea

have been known to occur (18, 160, 2 02) and it is common for

patients taking immunosuppressive drugs to clear the infec­

tion if taken off of the drugs (109, 111). Supportive 31

therapy may keep persistently infected patients alive indef­ initely but malnutrition as a result of severe diarrhea has been listed as contributing to death in some instances (89,

160, 165).

Pathology Knowledge of the pathology of human cryp- tosporidiosis has come primarily from the study of intes­ tinal biopsy specimens. Changes observed in these specimens include shortened villi (20, 89, 91,109, 165, 193), in­ creased crypt depth (20, 91, 109, 165) and increased numbers of inflammatory cells in the lamina propria (7, 19, 91, 109,

165, 193). Changes at the cellular level are cuboidal epi­

thelial cells (19, 91, 109), disrupted microvilli (19, 91,

120, 193, 165), and peaks in the cytoplasm of the cells at

the point of parasite attachment (91, 93).

The parasites can colonize a number of sites within the

digestive tract including the stomach (7, 20), duodenum (7,

19, 93, 165), jejunem (20, 89, 91, 93, 109, 165, 193), ileum

(7, 19, 109), colon (19), and rectum (19, 120) as well as

extra-intestinal sites including the gall bladder (20, 91,

134), respiratory tract (23, 89) and pancreatic duct (89).

It is difficult to determine the relative importance of the

various sites because biopsy specimens are often taken from

only one site in a given patient and in no case do the au­

thors give an objective evaluation of the number of

parasites in the samples. 32

Little is known of the pathogenesis of cryp- tosporidiosis but some authors have speculated that the di­ arrhea is of the secretory type based on its sometimes se­ vere, watery nature and on the outcome of preliminary pathophysiological tests (7, 89). The histopathology of the intestine, with its characteristic villus atrophy, crypt hyperplasia, and colonic lesions suggests that malabsorption may also contribute to the diarrhea.

Diagnosis The earliest cases of cryptosporidiosis in humans were diagnosed by microscopic examination of in­ testinal biopsy specimens (120, 109). Soon thereafter, techniques developed in veterinary medicine for finding oocysts in feces were applied to human cases. Tzipori et al. (180) used Giemsa stained fecal smears as developed by

Pohlenz et al. (136). Reese et al. (146) and later Current et al. (43a) used Sheather's sucrose flotations (a standard technique for diagnosis of parasitic infections in animals).

Ma and Soave (103) introduced the Ziehl-Neelsen technique described by Henriksen and Pohlenz (65) to human medicine.

Current (38) recommended the negative staining technique of

Heine (60). A number of other techniques have been reported to be useful for demonstrating oocysts in feces (12, 13, 24,

28, 37, 72, 83, 119, 128, 203).

Detection of oocysts in feces is currently the diagnos­

tic method of choice but comparative studies have failed to 33

agree on which procedure is best. Ma and Soave (103) exam­ ined eight methods and recommended a three step procedure using iodine wet mounts as an initial screen, Ziehl-Neelsen stain as a permanent record, and Sheather's flotation for cases in which the number of oocysts in the sample might be small. Garcia et al. (53) compared 15 methods and preferred

Ziehl-Neelsen stains of sediments of formalinized fecal sam­ ples which had been extracted with 10% KOH (to remove mu­ cus). Less comprehensive comparisons have also been made

(15, 108, 196) but no consensus has been reached on the best diagnostic method.

Prevalence The most common approach to determine the prevalence of cryptosporidiosis in human populations is to screen diarrheic fecal specimens submitted to central diagnostic laboratories. These studies have now been car­ ried out throughout the world and they indicate that Cryp­ tosporidium is common in diarrheic stool samples. Reported incidences in developed countries range from 0.35% to 5%

(14, 29, 59, 69; 70, 84, 112, 143a, 158, 185, 198, 199, 201) while incidences in third world countries vary from 4% to

10.8% (22, 68, 106, 133, 143a, 156, 192). The relative

prevalence of Cryptosporidium compared to other agents that

cause diarrhea varies from study to study but it is clear

that Cryptosporidium is of comparable prevalence to better 34

known diarrheal agents including enteropathogenic Escheri­

chia coli, Campylobacter, Salmonella, Giardia, and Entamoeba

histolytica (22, 59, 69, 192).

Studies which have included non-diarrheic stool samples

have shown that the parasite is more prevalent in patients

with diarrhea than in the overall population (185, 192).

Studies which include data on other pathogens in the samples

show that the majority of specimens containing Cryp­

tosporidium oocysts contain no other known pathogens (59,

106, 192). These observations strengthen the concept that

Cryptosporidium is an important cause of diarrhea in humans.

Most studies have found the parasite to be more preva­

lent in children than in adults (22, 29, 112, 156, 185, 192,

199). Several studies have found a distinct seasonality to

cases of cryptosporidiosis; warm, wet weather is often as­

sociated with increased incidences (69, 106, 112, 185, 192,

199).

Ep i demiclogy Cryptosporidiosis is spread through

fecal-oral contamination. Tzipori et al. (177) demonstrated

cross-transmission of Cryptosporidium from humans to mice

and lambs. Later reports documented cases of human cryp­

tosporidiosis which were probably acquired from infected

animals (5, 43a, 88, 99, 140, 146). These results led to

the feeling that zoonotic infection was the most common mode

of transmission (43a, 155). 35

Soon, person to person transmission was documented

(16). Prevalence studies failed to link a large proportion of cases to animal contacts but repeatedly demonstrated clustering of cases within families and day-care centers

(22, 30, 59, 69, 169, 199). Based on these findings, it has been suggested that transmission from person to person is a more important mode of transmission than zoonotic infection

(30, 67, 82).

Infection as a result of contamination of the environ­ ment can also occur. An outbreak of waterborne cryp­ tosporidiosis probably resulting from contamination of the water supply by sewage has recently been reported (44).

Cryptosporidiosis has been documented in travelers returning from Leningrad (well known for outbreaks of waterborne giar­ diasis) (82, 84), Mexico (166), and the Caribbean (102).

Reported associations between cases of cryptosporidiosis and giardiasis suggest that the two parasites can be transmitted simultaneously (83, 84, 198, 199).

Treatment There is currently no treatment which will consistently cure cryptosporidiosis. In immunological­

ly normal people, supportive therapy is recommended until

the disease resolves spontaneously (118). The prognosis for

immunologically suppressed people is grave unless the im­

munosuppression can be reversed. Many drugs have been tried 36

in an attempt to treat cryptosporidiosis of the immunosup­ pressed but improvement is rarely reported (31, 118).

A few patients responded favorably to treatment with spiramycin (36, 137), raising hopes that an effective drug had been found. Most recent reports, however, suggest that the drug is inconsistent (32, 82). It must be remembered that spontaneous resolution can occasionally occur, even in the immunosuppressed (18). This observation complicates the

interpretation of chemotherapy trials in humans which are

usually uncontrolled.

Cryptosporidiosis of calves

Association of Cryptosporidium with calf scours In

the early 1970s Cryptosporidium infections were discovered

in calves dead or dying from neonatal diarrhea (calf scours)

(11, 73, 110, 121, 122, 131, 138, 153, 177). An overview of

these reports shows that the calves were typically 1-3 weeks

old, dehydrated and suffering from severe diarrhea which was

unresponsive to treatment with antibiotics. The parasites

were usually found in histological specimens taken at

necropsy. Some investigators examined the calves for other

enteric pathogens; specifically rotavirus, coronavirus and

enteropathogenic E. coli'. In some cases other pathogens

were found (129, 153) but in several they were not (11, 73,

110, 138). 37

Morin et al. (117), Moon et al. (114) and Pohlenz et al. (136) surveyed calves with diarrhea (together with healthy calves as controls) for viruses, bacteria and Cryp­ tosporidium. Their results showed that Cryptosporidium in­ fections were common in diarrheic calves but less common in healthy calves. The parasites were found both in the pres­ ence and in the absence of other pathogens. Snodgrass et al. (162) and Tzipori et al. (181) found Cryptosporidium to be widespread in two herds suffering scours outbreaks. In one of these herds, no other known enteropathogens were

found (181). These results suggested that Cryptosporidium

may be a cause of calf scours.

Later surveys have confirmed that Cryptosporidium in­

fections are widespread among calves in general and in

calves with diarrhea in particular (6, 61, 80, 92, 124, 127,

151). Some reports suggest that all calves may encounter

the parasite at some time during their lives (1, 124, 132).

Experimental infection of calves with the parasites

resulted in clinical scours (13 6, 181, 186). The disease

was characterized by watery diarrhea, sometimes with fibrin

and mucus, which began 2-4 days after inoculation. Calves

were often depressed, emaciated and anorexic. The disease

resolved spontaneously in 8-10 days and mortality was low. 38

It was difficult for the investigators to rule out the pos­

sibility that the disease was being caused by an unrecog­

nized pathogen co-transmitted with the parasites. In one

study, disease appeared to be associated with contaminating

Clostridium perfringens (48). The experiments of Heine et

al. (64) using germ free calves inoculated with peracetic

acid sterilized oocysts are the strongest evidence to date

that Cryptosporidium infection alone can cause scours.

Pathology Parasites and lesions are most commonly

observed in the ileum of infected calves (11, 73, 110, 121,

129, 138, 151, 162, 186). Parasites and lesions in the

upper small intestine and large intestine are less frequent­

ly reported (64, 110, 131, 136, 151, 186). The primary

microsocpic lesion is atrophy of villi (64, 73, 110, 121,

129, 138, 151, 162, 186). Villus fusions, crypt hyperpla­

sia, distention of crypts with cellular debris and inflamma­

tion of the lamina propria are also commonly observed (64,

73, 110, 121, 138, 151, 186). Cellular changes include re­

duced epithelial cell height, sloughing of epithelial cells,

microvillus disruption and increased numbers of lysosomes in

parasitized cells (64, 73, 121, 136, 151, 162). Membrane

bound lactase activity may be decreased during the clinical

illness (186). Microscopic lesions appear to be consistent

whether or not other pathogens are present. 39

Diagnosis As with cryptosporidiosis of humans, di­ agnosis by demonstration of oocysts in feces is preferred.

Giemsa (136) or acid-fast stained (65) fecal smears, sucrose flotations (1, 123), and carbol-fuchsin stained native smears (60) are all effective. As in human medicine, com­ parisons between the various methods fail to agree on an optimum procedure (1, 132, 196).

Treatment Supportive therapy to carry calves through the clinical disease is the only approach currently • available (4). A wide range of drugs have been given to calves without success (50, 116).

Cryptosporidiosis of lambs

As researchers were becoming aware of the presence of

Cryptosporidium in calves, reports of the parasite in 1-3 week old scouring lambs began to appear (2, 11, 17, 176).

The early reports could not eliminate the possibility that other agents were responsible for the disease- Subsequent studies using germ free lambs and bacteria free inocula have strongly supported the idea that Cryptosporidium is pathogenic for lambs (161, 184).

Experimental infections showed that strains of the parasite which infected calves could also infect and produce

diarrhea in lambs (177). The intensity of Cryptosporidium-

associated diarrhea in lambs appeared to be more severe than 40

in calves and was also more severe than diarrhea due to E. coli or rotavirus in 1-2 week old lambs (177, 184).

While parasites and lesions may occur throughout the intestine they appear to be most common and severe in the ileum (11, 161, 176, 177). Pathological changes in the in­ testine include villus atrophy and villus fusions, disten­ sion and hyperplasia of crypts, inflammation of the lamina propria and reduction of epithelial cell height (10, 11, 17,

161, 177, 184). A reduction in lactase activity has also been described (184).

Cryptosporidiosis of pigs

Most reports of Cryptosporidium in pigs are based on experimental infections. These studies were initiated after it was realized that the parasite caused disease in other animals. Reports of Cryptosporidium associated with diar­ rhea in the field are few and do not adequately assess the potential role of other pathogens (85, 101, 152). The cur­ rent data suggest that cryptosporidiosis is not a signifi­ cant cause of scours in pigs in the field.

The results of experimental infections (including

studies of germ free animals) show that Cryptosporidium is

capable of producing diarrhea in pigs (113, 115, 177, 183,

187). The severity of the disease is reported to be greater

in artificially raised pigs than in pigs nursing a sow 41

(183). Younger animals may be more susceptible than older

ones (187). Reported prepatent and patent periods are 2-4

days and 10-17 days respectively (113, 115, 177, 183). Di­

arrhea and oocyst shedding are usually closely correlated.

Intestinal lesions are similar to those found in calves and

lambs and may sometimes be severe (113, 183, 187).

In one study, respiratory and conjunctival infections

were established experimentally. Infection was associated

with microscopic lesions but not with clinical signs (63).

Cryptosporidiosis of birds

Infections with Cryptosporidium have been described in

turkeys (159), chickens (45, 52) pheasants (195), quail

(170), geese (139), peacocks (104), and pet birds (46, 54).

Many of these reports describe infection of the intestinal

tract but clinical intestinal disease has been reported only

once (159). Infections can occur throughout the lower small

intestine and large intestine but are most commonly observed

in the bursa of Fabricius (52, 77, 100, 141, 142).

Infection of the respiratory tract (especially the

trachea) is associated with disease in several host species.

Case reports typically describe flocks in respiratory dis­

tress, sometimes with high mortality (104, 170, 195).

Pathological changes commonly reported are excess mucus in

the trachea, congestion and inflammation of the tracheal 42

mucosa, and epithelial hyperplasia (66, 168, 170, 195).

Parasites and lesions have also been found in the air sacks, nasal mucosa, larynx, and sinuses (56, 66, 104, 170, 195).

Infection of the conjunctiva by Cryptosporidium may be as­ sociated with epithelial metaplasia leading to eye abnor­ malities (104, 142).

Cryptosporidiosis of laboratory animals

Cryptosporidium readily infects laboratory mice. Tyz- zer (173, 174) did not observe disease in his studies of infected mice. Subsequent investigations have also failed to associate clinical disease with infection of immunologi­ cally normal mice (42, 47, 157). Athymic nude mice, on the other hand, develop persistent infections with diarrhea and extensive intestinal lesions (62). Mice demonstrate age- dependent resistance to infection (47, 62, 157). It is not clear if other host species also show this phenomenon.

Infection of guinea pigs has been associated with in­ testinal disease. Some reports describe intestinal lesions

without clinical signs (81, 190) while others describe

clinical disease and death (8). The differences may be due

to differences in strains of the parasite. 43

Infection of monkeys appears to be associated with a diarrheal syndrome not unlike that found in humans. Out­ breaks as well as isolated cases have been documented among macaques (35, 90, 197).

Infection of laboratory rats and rabbits has not been associated with disease (74, 146, 147, 177).

Cryptosporidiosis of other animals

Cryptosporidiosis appears to be a cause of hypertrophic gastritis in snakes (25, 167). The condition is infrequent­ ly reported but is characterized by severe gastric lesions leading to inappetance and eventual starvation of the animals.

Cryptosporidium has been observed in association with intestinal disease in goat kids (107, 182), red deer (179) and immunodeficient Arabian foals (55, 163). To date, the data are insufficient to assess the importance of cryp­ tosporidiosis in these hosts. 44

Running Title: Cryptosporidium in culture

Development of Cryptosporidium sp. in cultured cells^.

DOUGLAS B. W00DMANSEE*2 AND JOACHIM F. L. POHLENZ**

* U. S. Department of Agriculture, Agricultural Research

Service, National Animal Disease Center, Ames Iowa, *

Department of Zoology and

** Department of Veterinary Pathology, Iowa State

University, Ames, Iowa 45

1 This study was supported by the U. S. Department of

Agriculture, cooperative agreement #58-5196-2-1160.

2 Address correspondence to D. B. Woodmansee, U. S.

Department of Agriculture, National Animal Disease Center,

P. 0. Box 70, Ames, lA 50011. 46

SECTION I. DEVELOPMENT OF CRYPTOSPORIDIUM SP. IN CULTURED

CELLS

Abstract

Sporozoites of Cryptosporidium developed into immature and mature schizonts after inoculation into human rectal tumor cell cultures and into mature macro- and microgametes after inoculation into human embryonic lung cell cultures.

The relationship between parasites and the cultured cells was ultrastructurally comparable to the in vivo host- parasite relationship. The parasites were visible with

Giemsa's stain and with interference contrast microscopy.

They stained acid fast with carbol-fuchsin and reacted with anti-Cryptosporidium antibodies in an indirect im­

munofluorescence test.

Introduction

In vitro growth of enteric Coccidia has been an active

area of research for several years. Doran (3) lists 28 spe­

cies of Eimeria and 5 species of Isospora which have been

successfully grown in cell cultures. Of these species, only

three have been observed to undergo gametogony and only one

(Eimeria tenella) has successfully produced oocysts in vitro

when sporozoites were used as inoculum. 47

In this paper, we describe the development of Cryp­ tosporidium sporozoites through the asexual stages of the life cycle in a human rectal tumor (HRT) cell line and through the initiation of gametogony in a human embryonic lung (HEL) cell line.

Materials and Methods

HRT and HEL cells were routinely maintained in 75 cm^

plastic tissue culture flasks (Falcon Div., Becton, Dicker-

son and Co., Oxnard, CA) with RPMI 1640 medium (DIFCO

Laboratories, Detroit, MI) supplemented with 10%, heat inac­

tivated, fetal calf serum (PCS). Cells were incubated at

370c in 5% CO2 in air and passed into new flasks regularly.

To initiate cultures for inoculation, cells were

removed from flasks by trypsinization and 1 ml of medium

containing cells was seeded into Leighton tubes containing

10.5 mm X 35 mm coverslips. Cells were allowed to grow in

the tubes for 48 hours prior to inoculation.

Feces containing Cryptosporidium oocysts were collected

from an experimentally infected calf, mixed with 5% potas­

sium dichromate (1 volume feces to 2 volumes of K2Cr207

solution) and stored for up to 4 months at 4°C. Inocula for

cell cultures were prepared as shown in Fig. 1. 48

After excystation, the inocula contained fecal debris, oocysts, empty oocyst shells and free sporozoites. No sterilization of the oocysts prior to inoculation into cul­ tures was necessary. To inoculate cultures, the medium was

aspirated from the Leighton tubes and replaced with fresh

RPMI (no PCS, 200 units/1 penicillin, 0.2 mg/l streptomycin

sulfate, 4 g/1 amphotericin B) containing 10^ to 10^ Cryp­ tosporidium sporozoites.

For transmission electron microscopy, monolayers were

scraped from coverslips 1-3 days post inoculation (p.i.),

fixed in glutaraldehyde for 1-1.5 hr, processed and sec­

tioned routinely, and observed with a Hitachi HS 9 electron

microscope. Samples were taken for scanning electron

microscopy 2 days p.i. Coverslips were flooded with

glutaraldehyde for 1 hr, postfixed in 1% OSO4 for 30 mi­

nutes, dehydrated, critical point dried, coated with gold

paladium in a sputter coater and observed with a Joel S35 or

a Hitachi S520 scanning electron microscope.

For interference contrast microscopy, coverslips were

removed from tubes 1-6 days p.i., inverted onto a microscope

slide and observed with a Leitz Orthoplan microscope with

interference contrast optics. Cultures for staining were

removed from tubes 2 days p.i., allowed to dry, fixed in

absolute methanol, and stained with either a modified Ziehl- 49

Neelsen technique (6) or Giemsa's. Cultures were prepared for immunofluorescence microscopy 2 days p.i. using the sera

and techniques of Campbell and Current (1).

Results

Transmission electron microscopy revealed immature and

mature schizonts developing in association with HRT cells as

early as 1 day p.i. (Figs. 2-4). The morphology of the

host-parasite relationship including the parasitophorous

envelope, feeder organelle, and attachment zone appeared

similar to the morphology of these structures in vivo (8).

The morphology of the parasites themselves ranged from in­

tact (Fig. 2b) to apparently degenerate (Fig. 4).

Cryptosporidia were seen in scanning electron micro­

scopic (SEM) preparations made 2 days p.i. Fig. 5a shows a

mature schizont. The parasitophorous envelope has collapsed

during processing, leaving the outlines of the merozoites

visible. A similar parasite from the small intestine of a

calf is seen in Fig. 5b. Fig. 6a shows an unidentified

developmental stage in which the parasitophorous envelope is

fluted around the base of the parasite, a morphological fea­

ture typical of Cryptosporidia in SEM preparations (7). A

similar stage from a calf is shown in Fig. 6b. 50

Developing parasites were visible with interference contrast microscopy 1 to 6 days p.i. They appeared as round to oval bodies, 3-5 jam in diameter, within a depression in the cells (Fig. 7). It was difficult to identify stages of the life cycle in these preparations but zoites were detect­ able in some specimens (Fig. 7a, 7c, 7d).

Cryptosporidia stained intensely acid-fast in cultures stained with the the modified Ziehl-Neelsen technique (Fig.

8a). The appearance of the parasites in Giemsa-stained cul­ tures was similar to their appearance in fecal smears (9) except that no red granules were visible (Fig. 8b). In stained preparations, it was often difficult or impossible to distinguish life-cycle stages which had developed in the culture from those introduced with the inoculum.

The parasites fluoresced brightly when treated with an indirect immunofluorescence (IIP) system directed against

Cryptosporidium (Fig. 9a). No fluorescence was observed in uninfected cultures (Fig. 9b) or infected cultures treated with non-immune sera.

Development of Cryptosporidia in HEL cells was similar to their development in HRT cells except that macro- and microgametes were observed in addition to stages of the asexual cycle (Figs. 10, 11). 51

Discussion

The results of this study show that sporozoites of

Cryptosporidium can develop at least through the asexual portion of the life cycle in HRT cells and into the sexual portion of the life cycle in HEL cells. While evidence for development beyond these stages was not found, it is pos­ sible that oocysts may have developed in numbers so low that they were not detected.

Current and Haynes (2) observed development through the the oocyst stage in human fetal lung cells. It may be that the choice of cell line is important in determining the ex­ tent and degree to which the parasites will develop in vi­ tro. This phenomenon has been observed in in vitro infec­ tions with other coccidians (4, 5, 10). To date, trial and error is the only method to determine which cell line is

optimal for a given parasite.

Transmission and scanning electron microscopy showed that the ultrastructure of the host-parasite interface, in­

cluding the so-called feeder organelle, in vitro is similar

to its appearance in vivo. This indicates that in vitro

systems may provide useful models for the study of these

poorly understood structures.

The remarkably intense staining of the parasites by the

modified Ziehl-Neelsen technique may provide a basis for the 52

quantitation of in vitro infections, provided that the prob­ lem of differentiating developing versus introduced forms can be overcome. The reactivity of the parasites to anti-

Cryptosporidium antibodies may also provide a basis for quantification and leads to the hope that in vitro systems may eventually provide a useful source of Cryptosporidium antigens.

The failure of the parasites to produce large numbers of oocysts or to establish a persistent infection of the cultured cells precludes the use of this system as a method to produce large numbers of parasites or to maintain long term in vitro cultures for experimental or reference pur­ poses. However, it is still anticipated that in vitro sys­ tems may serve as useful tools in the study of cryp- tosporidiosis, particularly host cell-parasite interactions, parasite metabolism and the interaction of the parasites with drugs.

Literature Cited

1. Campbell, P. N. and Current, W. L. 1983. Demon­

stration of serum antibodies to Cryptosporidium sp.. in nor­

mal and immunodeficient humans with confirmed infections.

J. Clin. Microbiol. 18: 165-169. 53

2. Current, W. L. and Haynes, T. B. 1984. Complete development of Cryptosporidium in cell culture. Science

224: 603-605.

3. Doran, D. J. 1982. Behavior of Coccidia in vi­ tro. pp. 229-285. ^ Long, P. L., ed. The Biology of the

Coccidia. University Park Press, Baltimore.

4. Doran, D. J. and Augustine, P. C. 1973. Compara­ tive development of Eimeria tenella from sporozoites to oocysts in primary kidney cell cultures from gallinaceous

birds. J. Protozool. 20: 658-661.

5. Hammond, D. M. and Payer, R. 1968. Cultivation

of Eimeria bovis in three established cell lines and in bo­

vine tracheal cell line cultures. J. Parasitol. 54: 559-

568.

6. Henriksen, S. A. and Pohlenz, J. F. L. 1981.

Staining of Cryptosporidia by a modified Ziehl-Neelsen tech­

nique. Acta Vet. Scand. 22: 594-596.

7. Pearson, G. R. and Logan, E. F. 1983. Scanning

and transmission electron microscopic observations on the

host-parasite relationship in intestinal cryptosporidiosis

of neonatal calves. Res. Vet. Sci. 34: 149-154. 54

8. Pohlenz, J., Bemrick, W. J., Moon, H. W. and Che­ ville, N. F. 1978. Bovine cryptosporidiosis: a transmis­ sion and scanning electron microscopic study of some stages in the life cycle and of the host-parasite relationship.

Vet. Pathol. 15; 417-427.

9. Pohlenz, J., Moon, H. W., Cheville, N. F. and Bem­ rick, W. J. 1978. Cryptosporidiosis as a probable factor in neonatal diarrhea of calves. J. Vet. Med. Assoc.

172; 452-457.

10. Turner, M. B. F. and Box, E. D. 1970. Cell cul­ ture of Isospora from the English sparrow. Passer domesticus domesticus. J. Parasitol. 56: 1218-1223. Fig. 1. Procedures for the isolation and excystation of Cryptosporidium oocysts for inoculation into cell cultures 56

FECES IN KgCr^O? -o CENTRIFUGE 1,200 xg, 5 MIN. O . RESUSPEND IN SUCROSE SOLUTION (1.18 g/cm^)

COVER MENISCUS WITH COVERSLIP

CENTRIFUGE 1,200 xg, 5 MIN

REPLACE COVERSLIP

REPEAT 4 TIMES

POOL MATERIAL ATTACHED TO COVERSLlPS

WASH TWICE IN PBS o SUSPEND IN 0.02M CYSTEINE HYDROCHLORIDE IN 0.85% NaCL, OVERLAY WITH 50% COj IN AIR O INCUBATE, 37»C, OVERNIGHT

WASH 3 TIMES IN PBS

•o RESUSPEND IN 0.75% SODIUM TAUROCHOLATE, 0.25% TRYPSIN IN PBS -o INCUBATE 37°C. 30 MIN.

WASH IN TISSUE CULTURE MEDIUM o INOCULATE Fig. 2A-B. Mature schizonts of Cryptosporidium in HRT cells, 2 days p.i., showing parasitophorous envelope (pe), feeder organelle (fo), electron dense band (ar­ row) and merozoites (m). Magnification: X26,600 58 Fig. 3. Immature schizont of Cryptosporidium in HRT cells, 2 days p.i. Magnifcation: X79,800

Fig. 4. Apparently degenerate stages of Cryp­ tosporidium in HRT cells, 3 days p.i., showing vacuolization (V), disruption of the limiting membrane (arrows), and vesicles within the parasitophouous vacuole (v). Magnifcation; X13,300 60 Fig. 5. Scanning electron micrographs of mature schizonts showing outlines of merozoites (arrows). 5A. HRT cells 2 days p.i. 5B. From the small intestine of a calf

Fig. 6. Scanning electron micrographs of uniden­ tified stages of Cryptosporidium showing fluting of the parasitophorous envelope (arrows). 6A- In HRT cells 2 days p.i. 6B. From the small intestine of a calf §2 Fig- 7. Interference contrast photographs of Cryptosporidia in HRT cells. 7A-C, 3 days p.i. 7D. 4 days p.i. 64 Fig. 8. Stained Cryptosporidia in HRT cells 2 days p.i. 8A- Mature sciiizont, Ziehl-Neelsen. 8B. Unidentified stage, Giemsa

Fig- 9. HRT cells after treatment with the IIP tech nique. 9A. Infected cells. 9B. Uninfected cells

Fig. 10. Cryptosporidium macrogamete in HEL cells, 3 days p.i. Magnification: X23,500

Fig. 11. Cryptopsoridium microgamete (bottom) and unidentified stage, probably a macrogamete (top) in HEL cells, 3 days p.i. Magnification X23,500 68 69

Running title; Sporulation of Cryptosporidium

An In Vitro Study of Sporulation in Cryptosporidium sp.l

DOUGLAS B. W00DMANSEE2

Departments of Zoology and Veterinary Pathology, Iowa State

University and the U. S. Department of Agriculture,

Agricultural Research Service, National Animal Disease

Center, Ames, Iowa. 70

^ This study was supported by the U. S. Department of

Agriculture, cooperative agreement #58-519B-2-1160.

2 Address correspondence to D. B. Woodraansee, U. S.

Department of Agriculture, National Animal Disease Center,

P. 0. Box 70, Ames, lA 50010. 71

SECTION II. AjN IN VITRO STUDY OF SPORULATION IN

CRYPTOSPORIDIUM SP.

Abstract

Sporulation of Cryptosporidium oocysts was studied using an in vitro excystation procedure. No evidence was found that significant numbers of Cryptosporidium oocysts sporulate when exposed to standard in vitro sporulation con­ ditions, strengthening the concept that sporulation of Cryp­ tosporidium is completely endogenous.

Introduction

Oocysts of coccidian parasites complete their develop­ ment either within the host (endogenous sporulation) or out­ side, in the environment (exogenous sporulation). Sporula­ tion involves cell division within the oocyst resulting in the formation of sporozoites and, in some genera, the development of internal cyst walls to form sporocysts.

Sporulation may be induced in vitro by holding the oocysts

at room temperature with exposure to oxygen for a period of

days, usually in dilute solutions of potassium dichromate.

Coccidian oocysts are believed to be infective only if they

are sporulated (5).

Cryptosporidium sp. (Apicomplexa, Coccidiasina, Cryp-

tosporidiidae) is a pathogenic coccidian of several animal 72

species. It can infect various mucosal epithelia, but is most commonly found in the intestine (11). The parasite has an oocyst which contains four naked sporozoites and was originally described as having endogenous sporulation (10).

Subsequently, in vivo (2, 6) and in vitro (3, 4) studies confirmed that sporulation can occur while the oocyst is within the host cell. Furthermore, calf feces containing

Cryptosporidium oocysts are infective immediately after pas­ sage (8).

Anderson (1), however, indicated that while some oocysts were sporulated at the time of passage in feces, a substantial number were not, and that sporulation of these oocysts would occur if they were exposed to sporulating con­

ditions for five to seven days. Since no objective data were presented to support these statements, it seemed worth­ while to examine this possibility experimentally.

The sporulation status of most coccidian oocysts can

easily be determined microscopically. While sporozoites can

be seen inside some Cryptosporidium oocysts, the small size

of the oocysts (4 to 5 jum) and the high refractiveness of

the cyst wall can make interpretation of the internal struc­

ture of most oocysts difficult (Fig. 1). In this study, the

sporulation status of Cryptosporidium oocysts was analyzed

using an in vitro excystation procedure. It was reasoned

that the percentage of sporulated oocysts in a sample would 73

have an effect either on the percentage of oocysts which would excyst (if sporulated oocysts excyst more readily than unsporulated oocysts) or on the number of sporozoites released per excysting oocyst (if sporulated and unsporu- lated oocysts are equally likely to excyst).

Materials and Methods

Feces from infected calves were collected in metal pans over a 24 hour period beginning one or three days after the onset of oocyst shedding. Feces were mixed with two volumes of 2.5% potassium dichromate, and passed through a graded series of sieves (smallest sieve size 60 jam) to remove fecal debris.

The resulting suspension was placed in petri dishes

(fluid depth < 2 mm) and held at room temperature (about

23°C) without agitation. At various times after collection,

oocysts were isolated by coverslip flotation in Sheather's

sucrose solution (9) which had been diluted to a specific

gravity of 1.177 g/ml. Oocysts were washed in phosphate

buffered saline (PBS) and excysted for one hour at 37^0 in a

solution of 1.5% taurocholic acid (sodium salt, crude, Sig­

ma) and 0.5% trypsin (1:250, Difco) in PBS.

After excystation, the suspension was cooled in an ice

bath, and the number of sporozoites, oocysts and empty

oocyst walls in two 1 mm^ areas of a hemacytometer were 74

determined (the sum of the numbers of oocysts and cyst walls was always greater than 200). From these data, the percent excystation [number cyst walls/(number cyst walls + number intact oocysts)] and sporozoite/cyst wall ratios were calcu­ lated. The assay was performed on the day of collection and

1-5, 7, 9, and 11 days after collection. The experiment was

performed twice, using oocysts from two different calves.

Results

Combined results of the experiments are shown in Fig.

2. There was no apparent correlation between either percent

excystation or sporozoite/cyst wall ratio and time in

sporulation conditions. Inspection of data from both calves

independently gave similar results.

Excystation rates below 100% and sporozoite/cyst wall

ratios below the expected value of 4 were observed. It is

likely that these low values are due to less than optimal

excystation conditions. In preliminary experiments to opti­

mize excystation conditions, values approaching the

theoretical values have been observed for both parameters

(data not shown). Sporulation during the experimental peri­

od should have been reflected as an upward trend in one or

both of the measured parameters, whether or not the assay

was being run at conditions optimal for excystation. 75

Discussion

The data show no indication that sporulation occurred during the 11 day observation period. It is possible that sporulation occurred between the time the feces were actual­ ly passed and the time the day 0 sample was assayed (about

24 hours). Most coccidia require a period longer than 24 hours to sporulate (7), but even if significant sporulation did occur, these results still do not agree with Anderson

(1), who stated that sporulation occurred in five to seven days. It is concluded that exposure of Cryptosporidium oocysts to standard sporulation conditions does not result in significant sporulation, a result consistent with the concept that sporulation of Cryptosporidium oocysts is com­ pletely endogenous. Any attempt to increase the number of sporozoites obtained from an in vitro excystation by first exposing the oocysts to standard conditions for sporulation of coccidia would appear to be futile. Furthermore, it is concluded that analysis of in vitro excystation is a useful tool in studies of oocyst sporulation, where microscopic determination of sporulation status is difficult.

Literature Cited

1. Anderson, B. C. 1983. Cryptosporidiosis. Lab.

Med. 14: 55-56. 76

2. Barker, M. J. and Carbonell, P. L. 1974. Cryp­ tosporidium agni sp. n. from lambs and Cryptosporidium bovis sp. n. from a calf with observations on the oocyst. Z.

Parasitenkd. 44; 289-298.

3. Current, W. L. and Haynes, T. B. 1984. Complete development of Cryptosporidium in cell culture. Science

224; 603-605.

4. Current, W. L. and Long, P. L. 1983. Development of human and calf Cryptosporidium in chicken embryos. J.

Inf. Dis. 148: 1108-1113.

5. Hammond, D. M. 1973. Life cycles and development of Coccidia. pp. 45-79. ^ Hammond, D. M. and Long, P. L., eds. The Coccidia: Eimeria, Isospora, Toxoplasma and Re­ lated Genera. University Park Press, Baltimore.

6. Iseki, M. 1979. Cryptosporidium felis sp. n.

(Protozoa: Eimeriorina) from the domestic cat. Jpn. J.

Parasitol. 28: 285-308.

7. Kheysin, Y. M. 1972. Life Cycles of Coccidia of

Domestic Animals. University Park Press, Baltimore.

8. Moon, H. W. and Bemrick, W. J. 1981. Fecal transmission of calf Cryptosporidia between calves and pigs.

Vet. Pathol. 18: 248-255.

9. Sloss, M. W. and Kemp, R. L. 1978. Veterinary

Clinical Parasitology. Iowa State University Press, Ames. 77

10. Tyzzer, E. E. 1910. An extracellular coccidium,

Cryptosporidium muris (gen. et sp. nov.) of the gastric glands of the common mouse. J. Med. Res. 23: 478-509.

11. Tzipori, S. 1983. Cryptosporidiosis in animals and humans. Microbiol. Rev. 47; 84-96. Fig. 1. Typical Cryptosporidium oocysts from calf feces. Note difficulty of interpretation of internal structure. Nomarski interference contrast, bar = 10 pm

Fig. 2. Mean excystation and sporozoite/cyst wall ratio data for oocysts from two sporulation trials using oocysts from two different calves. Failure of either parameter to change over time indicates no change in the sporulation status of the oocyst population 81

-20 w

2 3 4 5 6 7 TIME IN SPORULATION CONDITIONS (DAYS) 82

Running title: Cryptosporidium sporozoite morphology

Factors affecting motility and morphology of

Cryptosporidium sporozoites in vitro.1

DOUGLAS B. W00DMANSEE*2, EDWIN C. POWELL*,

JOACHIM F. L. POHLENZ**, and HARLEY W. MOON***

* Department of Zoology and ** Department of Veterinary

Pathology, Iowa State University, Ames, Iowa 50011, and ***

U. S. Department of Agriculture, Agricultural Research Ser­

vice, National Animal Disease Center, P. 0. Box 70, Ames,

Iowa 50010. 83

^ This research was supported by USDA cooperative agreement #58-519B-2-1160. The authors wish to thank Dr.

Jerome Sacks and Mr. Danny Wolfgram for assistance with the statistical analysis and Mr. Gary Fry for technical assistance.

2 Address correspondence to D. B. Woodmansee, U. S.

Department of Agriculture, Agricultural Research Service,

National Animal Disease Center, P. 0. Box 70, Ames, lA

50011. 84

SECTION III. TAUROCHOLIC ACID AFFECTS MOTILITY AND

MORPHOLOGY OF CRYPTOSPORIDlUM SPOROZOITES IN VITRO

Abstract

In vitro motility and morphology of Cryptosporidium sporozoites was examined in the presence of various solu­ tions. Crude preparations of the bile salt taurocholic acid were found to affect both motility and morphology in a dose- dependent manner. These effects appeared to be due to the taurocholic acid itself and not simply due to pH variations, osmotic factors, or contaminants. Lysis of sporozoites was also observed and was found to be dependent on pH, with acidic conditions (pH < 6.2) triggering the lysis.

Introduction

Cryptosporidium sp. is a pathogenic coccidian parasite infecting intestinal, respiratory and other mucosal surfaces of several animal species (3, 5, 8). Infections are ini­ tiated when sporozoites excyst from oocysts onto mucosal surfaces. Sporozoites invade the apical portion of epi­ thelial cells and establish themselves in a position immedi­

ately beneath the host cell membrane (4, 9). In addition to

its role as the infectious stage, the sporozoite has also

been implicated as the stage responsible for autoinfection,

believed to be the mechanism by which infections persist in 85

immunocompromized hosts (2, 4). Thus, the sporozoite may be a stage at which pharmacologic or immunologic attack could be of both therapeutic and prophylactic value.

Research on cryptosporidiosis would be greatly facili­ tated if methods for cultivation and maintenance of the or­ ganism in vitro could be developed. The methods for growth of Cryptosporidium in tissue culture which are currently

available (1, 10) can not be used for indefinite maintenance

or expansion of the parasite population. Knowledge of the

excystation process and the development of techniques for

the in vitro study of sporozoites are logical first steps

toward the ultimate goal of cultivation and maintenance of

Cryptosporidium in vitro. For these reasons we have been

studying in vitro excystation and sporozoite survival.

This paper describes a system for assessing sporozoite

motility and morphology. Studies using this system indicate

that Cryptosporidium sporozoites have specific environmental

requirements, the absence of which can result in morphologi­

cal changes in the sporozoites.

Materials and Methods

Feces from calves experimentally infected with Cryp­

tosporidium were collected, mixed with two volumes of 2.5%

potassium dichromate, passed through a graded series of

sieves and stored at 4°C for up to three months. Oocysts 86

were isolated by coverslip flotations in sucrose solution

(s.g. 1.177g/ml), sterilized by suspension in 5.25% sodium hypochlorite solution (full strength commercial bleach) for five minutes at O^C followed by three washes in sterile Dul- becco's phosphate buffered saline (DPBS), and excysted at

37°C for 30 min. The excystation solution consisted of 1.5% crude taurocholic acid (#T-0750, Sigma) and 0.5% trypsin

(1:250, Difco) in DPBS. Portions of excysted preparations were placed in plastic centrifuge tubes and centrifuged at

1000 2 for 5 min. Pellets, which contained oocysts, oocyst

shells and free sporozoites, were washed once in the test

solutions, resuspended, and the tubes were coded for blind

scoring.

Samples from each tube were placed in a phase contrast

hemacytometer and scored using Nomarski interference micros­

copy. Thirty to forty five sporozoites were scored for each

sample and care was taken that sporozoites at all fluid

depths beneath the coverslip were scored.

Spcrozoites which did not move were given a motility

score of 0. Sporozoites which changed shape, flexed or

glided were assigned a motility score of 1. Sporozoites

which were shortened to less than half the length of freshly

excysted sporozoites were given a length score of 0, while

sporozoites of normal or somewhat shorter length were given

a length score of 1. Sporozoites which failed to show the 87

characteristic shape of freshly excysted sporozoites (dis­ tinctly crescent shaped with one end noticeably more pointed than the other) were given a shape score of 0, while sporozoites that were of the characteristic shape were given a shape score of 1. Data are expressed either as the per­ centage of sporozoites scoring 1 for each parameter (length, shape, motility) or as an average sporozoite score, defined as the siam of all the shape scores, length scores, and motility scores in a trial divided by the number of sporozoites scored in that trial. Data are expressed as average sporozoite scores only when trends for length, shape and motility are similar.

Osmolality and pH of some of the test solutions were determined. Average sporozoite score was plotted against osmolality and pH and the hypothesis that changes in the score were due to these factors was tested by linear regre- sion anlaysis.

In some solutions, sporozoites showed a dramatic loss of refractiveness, combined with loss of motility and ap­ peared thinner than freshly excysted sporozoites. This set

of changes was interpreted to represent lysis of the

sporozoites and was distinct from the length, shape and

motility changes described above. Lysed sporozoites were

not scored. 88

Results

Observations of sporozoites being prepared for inocula­ tion into tissue culture suggested that changes in sporozoite motility and morphology occurred when sporozoites were washed to remove excystation fluid. When the scoring system was applied, it was found that sporozoite length, shape and motility scores were significantly higher for un­ washed sporozoites and sporozoites washed in excystation fluid than for sporozoites washed in DPBS or 50 mM TRIS buffer supplemented with 225 mM glucose (TB). Addition of

1.5% crude taurocholic acid to DPBS or TB resulted an in­ crease in sporozoite scores (Table 1).

Sporozoite scores were recorded in the presence of ten­

fold serial dilutions of 1.5% crude taurocholic acid in

DPBS. The results showed a correlation between sporozoite

scores and crude taurocholic acid concentration for all

three parameters (Table 2, Figs 1-5). The dilution experi­

ment was repeated using a synthetic taurocholic acid prepa­

ration (#T-4009, Sigma). In this experiment, the trends

between shape and length scores and taurocholic acid con­

centration still held and differences between the two com­

pounds were small at all dilutions (Table 2, Figs. 1,2).

Sporozoite motility scores showed differences at some dilu­

tions, specifically a marked drop at the 1.5% concentration

point and a more rapid decline to baseline levels (Fig. 3). 89

Correlations between the pH and oslomolality of some test solutions and mean sporozoite score were found to be small and insignificant (-0.11 +/- 0.15 for pH and 0.1 +/-

0.007 for osmolality). Osmolarity values ranged from 278 mos to 372 mos and pH values ranged from 5.91 to 8.62.

In preliminary experiments, sporozite lysis was ob­ served in solutions where the pH was below 6.2, and was most readily observed in Hank's balanced salt solution (HBSS).

The hypothesis that sporozoite lysis is mediated by pH was tested by adjusting the pH of HBSS solutions with HCl, in the presence and absence of taurocholic acid. The results indicated that lysis is indeed dependent on pH (Figs. 4).

It was observed that lysis did not occur immediately but required 10 to 15 min of incubation and was arrested at 0°C.

Discussion

In this study, taurocholic acid acted to maintain motility and morphology of Cryptosporidium sporozoites in vitro. Experiments with synthetic taurocholic acid indi­ cated that the effects on shape and length were due to the taurocholic acid itself and not a contaminant of the crude

preparation (the type normally used for in vitro work with

coccidian sporozoites). This statement may be true for the

motility parameter as well as for the shape and length

parameters, despite the fact that motility scores declined 90

markedly in 1.5% synthetic taurocholic acid. It was not possible for us to test the synthetic and crude preparations at equimolar concentrations of taurocholic acid. The man­ ufacturer estimates that the crude preparation of taurocholic acid contains approximately 40% taurocholic acid by weight while the synthetic preparation contains about 98% taurocholic acid. It is possible that sporozoite motility scores would have been more similar if taurocholic acid had been present in equimolar concentrations.

The trends observed in the dilution experiments cannot be explained solely by pH or osmotic factors. The pH and osmotic pressures of the solutions studied in the dilution experiments were within the ranges tested for correlation- to average sprorozoite score. This is not to say that these factors have no effect on sporozoites at all, as evidenced

by the pH-mediated lysis observed in this study. Lysis of

sporozites at low pH suggests that excysted sporozoites may

not be able to survive passage through the stomach of an

animal.

The changes observed in this study have not previously

been reported for other coccidian sporozoites but increases

in in vitro motility of Eimeria merozoites have been ob­

served in the presence of whole bile, taurocholic acid and

other bile salts (7). Other investigators have noted that

the number of Cryptosporidium sporozoites observed after 91

excystation in the presence of taurocholic acid and trypsin was greater than the number observed when the excystation was performed in buffer after hypochlorite treatment (6).

These authors hypothesized that excystation fluid enhanced sporozoite survival after excystation. Our data are consis­ tent with this hypothesis.

The importance of these observations to in vivo condi­ tions is unclear. The study suggests that the concentration of bile salts or other compounds in the in vivo environment may have important effects on sporozoites. The implications of this study for work with Cryptosporidium sporozoites in vitro are more clear. Sporozoites appear to be more deli­ cate and demanding of their environment than previously sup­ posed. Investigations of sporozoite biology should take into account the considerable effects that the in vitro en­ vironment (including the presence of compounds such as taurocholic acid) may have on the parasites.

Literature Cited

1. Current, W. L. and Haynes, T. B. 1984. Complete

development of Cryptosporidium in cell culture. Science

224; 603-605.

2. Current, W. L. and Long, P. L. 1983. Development

of human and calf Cryptosporidium in chicken embryos. J.

Infect. Dis. 148: 1108-1113. 92

3. Heine, J., Pohlenz, J. P. L., Moon, H. W. and Woode,

G. N. 1984. Enteric lesions and diarrhea in gnotobiotic calves monoinfected with Cryptosporidium species. J. In­ fect. Pis. 150; 768-775.

4. Iseki, M. 1979. Cryptosporidium felis sp. n. (Pro­ tozoa; Eimeriorina) from the domestic cat. Jpn. J. Parasi- tol. 28; 285-307.

5. Navin, T. R. and Juranek, D. D. 1984. Cryp- tosporidiosis: clinical, epidemiologic, and parasitologic

review. Rev. Infect. Pis. 6; 313-327.

6. Reduker, D. W. and Speer, C. A. 1985. Factors in­

fluencing excystation in Cryptosporidium oocysts from cat­

tle. J. Parasitol. 71: 112-115.

7. Speer, C. A., Hammond, P. M. and Kelly, G. L. 1970.

Stimulation of motility in merozoites of five Eimeria spe­

cies by bile salts. J. Parasitol. 56; 927-929.

8. Tzipori, S. 1983. Cryptosporidiosis in animals and

humans. Microbiol. Rev. 47: 84-96.

9. Vetterling J. M., Takeuchi, A. and Madden, P. A.

1971. Ultrastructure of Cryptosporidium wrairi from the

guinea pig. J. Protozool. 18; 218-260. 93

10. Woodmansee, D. B. and Pohlenz, J. F. L. 1983.

Develpoment of Cryptosporidium sp. in a human rectal tumor cell line. pp. 306-319. ^ Proceedings of the 4th Interna­ tional Symposium on Neonatal Diarrhea. Veterinary Infectious

Disease Organization, Saskatoon. Table 1. Shape, length, and motility scores for Cryptosporidium sporozoites in

various test solutions

Total % Sporozoites Scoring 1

Sporozoites Number of Shape Length Motility

Treatment Scored Experiments + SEM + SEM + SEM

Not Washed 386 11 97 + 1 96 + 1 86 + 3

Excystation Fluid^ 200 6 95 + 1 95 + 3 83 + 3

DPBS 380 12 59 + 5 61 + 6 27 + 4

DPBS + 1.5% CTA 347 11 90 + 2 88 + 2 66 + 4

TB^ 65 2 78 + 2 67 + 4 26 + 3

TB + 1.5% CTA 63 2 97 + 3 94 + 6 74 + 14

^ Fluid consisted of 1.5% crude taurocholic acid (CTA) and 0.5% trypsin in

Dulbecco's phosphate buffered saline (DPBS).

^ 50 mMolar TRIS + 225 mM glucose in H^O, pH = 8.0. Table 2. Mean and standard error values for experiment described in Figs. 1-3, n

= 3

Taurocholic % Sporozoites Scoring

Acid Type Dilution Shape + SEM Length + SEM Motility + SEM

Crude 0 91 + 3 86 + 4 67 + 5

1 83 + 9 83 + 3 66 + 7

2 6 6 + 5 76 + 2 49 + 8

3 68 + 11 74 + 16 25 + 3

4 55 + 21 59 + 18 33 + 22

5 45 + 19 54 + 11 18 + 7

Synthetic 0 89 + 1 79 + 3 22 + 6 1 85 + 3 82 ± 3 55 + 7 2 77 + 4 69 + 5 24 + 13

3 70 + 4 69 + 9 29 + 12

4 52 + 6 44 + 11 12 + 5

5 69 + 10 62 + 9 20 + 8 Fig. 1. Sporozoite shape scores for sporozoites washed in tenfold dilutions of 1.5% crude and synthesized taurocholic acid in Dulbec- co's phosphate buffered saline (DPBS) compared to sporozoite scores in DPBS without taurocholic acid. Points represent the mean of three trials, 30-45 sporozoites were scored per trial 97

100 CRUDE TAUROCHOLATE a. SYNTHESIZED TAUROCHOLATE OPBS CO 80 •ce.

o

N 40 en

CO I I I I I 0 12 3 4 5 TAUROCHOLIC ACID DILUTION Fig. 2. Sporozoite length scores for experiment described in Fig. 1 99

= 100 h— CRUDE TAUROCHOUTE O Z SYNTHESIZED TAUROCHOUTE LU DPes

O

8 - o ^ 40H CO LU P

§5

! I I I I 0 12 3 4 5 TAUROCHOLIC ACID DILUTION Fig. 3. Sporozoite motility scores for experiment described in Fig. 1

I

I

! 101

«=« CRUDE TAUROCHOUTE O—< SYNTHESIZED TAUROCHOUTE — — — OPBS

or

CO LU 'y g

TAUROCHOLIC ACID DILUTION Fig. 4. Results of a representative experiment show­ ing average scores for sporozoites washed in Hank's balanced salt solution (HBSS), with and without crude taurocholic acid, at two pH levels. * = lysis observed but at least 30 intact sporozoites were found. ** = lysis so severe that 30 intact sporozoites could not be found 103

3.0-1

LU CE

HBSS+1.5 pH53 CTA pH7.0 CTA pH 5.9 pH 7.0 TREATMENT 104

Running title; Excystation of Cryptosporidium

Studies of In Vitro Excystation of Cryptosporidium sp. from

Calves.1

DOUGLAS B. W00DMANSEE2

Departments of Zoology and Veterinary Pathology, Iowa State

University and The U. S. Department of Agriculture,

Agricultural Research Service, National Animal Disease

Center, Ames, Iowa. 105

1 This study was supported by the D. S. Department of

Agriculture, cooperative agreement #58-519B-2-1160 and by a fellowship provided by the J. E. Salsbury Foundation. The author wishes to thank Ms. Deborah Hammen for technical

assistance.

2 Address correspondence to D. B. Woodmansee, U. S.

Department of Agriculture, Agricultural Research Service,

National Animal Disease Center, P. 0. Box 70, Ames, lA

50010. 106

SECTION IV. STUDIES OF IN VITRO EXCYSTATION OF

CRYPTOSPORIDIUM SP. FROM CALVES

Abstract

Studies of in vitro excystation of Cryptosporidium sp. from calves showed that sporozoite yields were optimum when oocysts were treated with bleach (sodium hypochlorite) then incubated at 37°C for 60 min in the presence of taurocholic acid solutions at pH about 7.0. Trypsin was not required for excystation and high concentrations were inhibitory.

Studies using protease inhibitors and direct assays for pro­ teolysis failed to implicate proteolytic enzymes as effec­ tors of excystation. The results suggest that Cryp­ tosporidium uses excystation mechanisms which are fundamen­ tally different from those used by Eimeria spp.

Introduction

Cryptosporidium (Apicomplexa, Coccidiasina) is a parasite of mucosal surfaces of many host species (16). It is believed to be a significant cause of diarrhea in humans

(3) and domestic animals (7). The life cycle is direct and

infection is transmitted by the ingestion of oocysts (2)..

After ingestion, coccidian oocysts release sporozoites

by a process called excystation. Excystation by members of

the coccidian genus Eimeria has been well studied and shown 107

to be a biphasic process- In the first phase, the oocyst wall is opened by either mechanical disruption or by the synergystic activities of reducing agents and C02- In the second phase, sporozoites are released from sporocysts by the activities of host digestive enzymes and surface active agents such as detergents or bile salts (11, 18).

Some coccidian species have oocysts and sporocysts which differ morphologically from Eimeria (1). The Eimeria oocyst and sporocyst walls are each interrupted by plugs known as the micropyle and . These are removed during phases one and two, respectively. Other coccidians release sporozoites through sutures in their cyst walls. In the case of Cryptosporidium, sporocysts are absent and the suture is in the oocyst wall (2). In Sarcocystis and

Toxoplasma, the oocyst wall lacks morphological specializa­ tions and the suture is in the sporocyst wall (1). It has been thought that excystation mechanisms for suture bearing coccida are similar to those of Eimeria because in vitro excystation procedures which work for Eimeria also work for suture bearers.

Materials and Methods

Oocysts

Feces containing Cryptosporidium oocysts were collected

from experimentally infected calves, sieved, mixed with 108

K2Cr207/ and stored as previously described (6). Oocysts were isolated by layering 25 ml of feces over sucrose step gradients made up of 25 ml of Sheather's sucrose solution

(14) diluted to a specific gravity of 1.18 g/ml, covered by

50 ml of Sheather's diluted to 1.09 g/ml, covered by 25 ml of Sheather's at 1.22 g/ml. Gradients were centrifuged for

15 min at 900 £ in a swinging bucket rotor. The 1.09 g/ml fraction was collected and diluted in Dulbecco's phosphate buffered saline (PBS). The oocysts were pelleted by cen- trifugation at 900 £ for 10 min and stored in 2.5% K2CT2O1 at 4OC until used (up to 2 months).

Data collection and handling

After excystation, oocysts, sporozoites and cast oocyst walls were counted in a phase contrast hemacytometer (Ameri­ can Optical, Buffalo, NY) using Nomarski interference con­ trast microscopy (Leitz Orthoplan, E. Leitz and Co.,

Rockleigh, NJ). Enough 1 mm^ areas were counted for the number of oocysts and cast walls to total at least 100.

Percent excystation was calculated by dividing the number of empty cyst walls by the'sum of the cyst walls and unexcysted

oocysts. Sporozoite/cyst wall ratio was calculated by di­

viding the number of sporozoites by the number of cyst

walls. The theoretical value of this ratio is 4 because 109

each oocyst contains 4 sporozoites (15). Percent theoreti­ cal sporozoite yield was calculated by dividing the number of sporozoites observed by four times the sum of the number of cyst walls and the number of xinexcysted oocysts. Experi­ ments were performed three times unless otherwise noted.

Data points on graphs represent means of three trials.

Standard errors for points on graphs ranged from +/- 2 to

+/- 15 but most points had errors within 15% of the value of the mean.

Excystation assays

Experiments to determine optimum excystation procedures used oocysts which were washed three times in cold (0°C) PBS

and once in 3 ml of cold test fluid. Pellets were resuspen-

ded in 1 ml of test fluid at room temperature (about 20°C)

and placed in a 37°C water bath. Tubes were removed to an

ice bath after the appropriate incubation time. Bleach

treatment, when used, consisted of resuspending washed

oocysts in full strength commercial bleach (5.25% sodium

hypochlorite) in an ice bath for 5 min, then washing 3 times

in cold PBS. The taurocholic acid (CTA) used was crude

taurocholic acid, sodium salt (Sigma Chem. Co., St. Louis,

MO). Trypsin was the "1:250" trypsin of Difco (Difco Labs.,

Detroit, MI). 110

To further study the effects of trypsin on excystation, oocysts were treated with bleach, resuspended in test solu­ tions in centrifuge tubes and placed in a 37°C water bath.

Tubes were removed to an ice bath at 5 min intervals from 0 to 30 min. All test solutions contained 0.15% CTA. To test reversibility of trypsin activity, bleach treated oocysts were incubated with 5% trypsin in PBS for 20 min at 37°C, washed 3 times in PBS, then assayed for excystation in 0.15%

CTA.

To compare the effects of bleach and cysteine/CO2 pre- treatments, one group of washed oocysts was suspended in

0.02 M cysteine HCl (Sigma) in 0.85% saline. The fluid was overlaid with a 50% mixture of CO2 and air, the tube was sealed and incubated at 370C for 16 hrs. A second group of washed oocysts was mixed with saline, overlaid with air, and incubated- At the end of the incubation, both groups were divided into two parts, one treated with bleach and washed in PBS, the other was only washed in PBS. All groups were suspended in 0.15% CTA in test tubes and excysted at 37°C.

Tubes were removed to an ice bath at intervals and scored.

To test the effects of enzyme inhibitors on excysta­ tion, bleach treated oocysts were resuspended to a con­

centration of 1.1x10^ oocysts/ml and held on ice. Fifty jliI

of inhibitor solution or PBS and 50 pi of 0.33% CTA were

placed into test tubes in a 37°C water bath and allowed to Ill

warm for about 5 min. Ten jul of oocyst suspension were add­ ed to each tube at 5 min intervals for 30 min. Immediately after addition of oocysts to the last tube, all tubes were removed to an ice bath and % excystation determined. In­ hibitors used were phenylmethylsulfonyl fluoride (PMSF), a noncompetitive inhibitor of serine proteases; N-c<

-p-tosyl-L-arginine methyl ester (TAME), a competitive sub­ strate analog for serine proteases; N-e<-p-tosyl-L-lysine chloromethyl ketone (TLCK), a noncompetitive inhibitor of serine proteases with specificity for trypsin, N-tosyl-L- phenylalanine choloromethyl ketone (TPCK), a compound simi­ lar to TLCK but with specificity for chymotrypsin; pepsta- tin, a pepsin inhibitor; and leupeptin, a competitive in­ hibitor of both trypsin and papain. All inhibitors were purchased from Sigma. PMSF and TPCK were made up as stock solutions in ethanol and methanol respectively and diluted with PBS prior to use.

Azocoll assays

Bleach treated oocysts were suspended in 0.15% CTA in

0.1 M phosphate buffer (1 x 10^ oocysts/ml), pH 7.0 (PB) and

excysted for 45 min at SV^C. Azocoll (Calbiochem, San Die­

go, CA), a general proteolytic substrate, was added to a

concentration of 5 mg/ml to PB, 0.1 M acetate buffer, pH

5.0, or 0.1 M Tris, pH 9.0 in 1.5 ml microfuge tubes. One 112

hundred ^1 of excysted oocysts, PB or 1 mg/ml trypsin was added to the microfuge tubes and they were incubated at 37°C for 24 hr. After incubation, tubes were centrifuged at 6630

£ for 2 min. Supernatants were collected and absorbance at

520 nm was read with a spectrophotometer.

Results

Table 1 shows results of preliminary experiments to examine the effects of trypsin and CTA on excystation of non-bleach treated oocysts. The results suggested that trypsin was unnecessary for excystation and may have been

detrimental to sporozoite survival. Reduction of CTA con­

centration decreased excystation but increased sporozoite

survival. Little or no excystation was observed in the ab­

sence of CTA.

Experiments to determine optimal sporozoite excystation

conditions were designed on the basis of the preliminary

experiments. Fig. 1 shows the results of time course ex­

periments using non-bleach treated oocysts exposed to 0.15%

CTA. Excystation occurred rapidly between 15 and 60 min but

leveled off thereafter. Sporozoite/cyst wall ratios were

impossible to interpret at 0 and 15 min because of the small

numbers of sporozoites observed, but were close to the

theoretical value of 4 at 3 0 min. The steady decline in the

ratio after 30 min was due to disappearance of sporozoites. 113

If samples were placed in an ice bath after 30 min, excysta­ tion stopped and sporozoite/cyst wall ratios stabilized.

Calculation of sporozoite yields from the data from Fig. 1

shows that 1 hr of excystation gave the best sporozoite

yield (Fig. 2).

The effect of pH on excystation was examined by excyst-

ing non-bleach treated oocysts at 3T^C for 1 hr to 0.15% CTA

solutions adjusted with HCl or NaOH (Fig. 3). Higher excys­

tation rates were observed at lower pH but sporozoite sur­

vival was poor at pH £ 6.5. pH vales of approximately 7.0

gave optimum sporozoite yields.

Non-bleach treated oocysts exposed to two-fold serial

dilutions of 1.5% CTA were incubated at 370c for 1 hr to

determine the effects of taurocholic acid concentration

(Fig. 4). Substantial excystation occurred over a wide

range of concentrations but values tended to decline as the

concentration was reduced. Sporozoite/cyst wall ratios

similarly declined as CTA concentrations were reduced.

The following experiments were performed to examine

effects of various pretreatments on excystation rather than

to optimize sporozoite yields; thus, sporozoite survival

data were not collected. Fig. 5 shows the results of side-

by-side comparisons of bleached and unbleached oocysts in

the presence and absence of taurocholic acid. Bleach treat­

ment enabled excystation to occur in the absence of CTA. 114

Highest levels of excystation were observed when bleach treatment was combined with taurocholic acid exposure.

Fig. 6 shows the effect on excystation of exposure of oocysts to cysteine HCl and CO2. Data are expressed as change in % excystation (excystation value at time 0 sub­ tracted from excystation values for each subsequent time) because spontaneous excystation of 5-10% was observed after incubation for 16 hr at 37®C either in the presence or ab­ sence of cysteine/C02. Treatment of oocysts with cysteine/

CO2 increased excystation rates upon exposure to 0.15% CTA compared to controls which were incubated in saline. The combination of cysteine/CO2 and bleach treatments did not increase excystation rates over bleach treatment alone. The

controls in this experiment were expected to behave similar­

ly to non-bleach treated oocysts but excystation after 30

min exposure to CTA was low. Presumedly, exposure of

oocysts to 37°C for 16 hr adversely affected their ability

to respond to taurocholic acid.

Figs. 7-9 show results of experiments to further ex­

amine the potential role of trypsin in excystaion. Addition

of 10-50 mg/ml of trypsin to 0.15% CTA reduced excystation

in a dose-dependent manner (Fig. 7). Inhibition by trypsin

was found to be reversible (Fig. 8) and could not be

mimicked by bovine serum albumin (Fig. 9). 115

PMSF, TAME, TPCK, TLCK, leupeptin, and pepstatin could not be shown to inhibit excystation (Figs. 10-15), but low concentrations of ethanol and methanol were inhibitory

(Figs. 10, 13). Attempts to detect protease activity with

Azocoll were unsuccessful (Table 2).

Discussion

From the results of these experiments it is possible to suggest efficient conditions for in vitro excystation of

Cryptosporidium sporozoites. Taurocholic acid is required unless the oocysts are bleach-treated, but concentrations can be varied over a wide range with little effect on sporozoite recovery. Best excystation is achieved when bleach pretreatment is combined with taurocholic acid expo­ sure. Sixty minute incubations at 37^0, pH 7.0 gave the

best results in this study.

Sporozoites were short-lived at 37°C and removal of the

sporozoites to an ice bath after excystation stabilized

sporozoite numbers. This result demonstrates that excysta­

tion and sporozoite loss are temperature dependent and that

holding the samples in an ice bath until they were scored

did not affect the outcome of the kinetic experiments. In. a

previous investigation, sporozoite loss after excystation

was observed to a far lesser extent (12). 116

Examination of the kinetics of excystation consistently revealed a lag time of 10-15 min before excystation began.

Excystation occurred rapidly from 15-60 min and leveled off by 90 min. In the only experiment in which lag time was

reduced (Fig. 6), the oocysts were incubated at 37°C over­

night prior to the experiment which seemed to change the

oocyst's reactivity to taurocholic acid. The consistent

appearance of the lag under standard conditions suggests

that it is a necessary consequence of the excystation

mechanism and may be a clue to the nature of the mechanism.

These experiments reinforce the role of bile salts as a

trigger for excystation of Cryptosporidium. The conclusion

of Payer and Leek (5) that excystation can occur without

host stimuli was not strongly supported, except in the case

of bleach treated oocysts. My results are consistent with

and extend those of Reduker and Speer (12).

Reduker and Speer (12) hypothesized that bleach treat­

ment removed a portion of the oocyst wall normally removed

by bile and/or trypsin, but this speculation was not sup­

ported by morphologic evidence published subsequently by the

same group (13). The observation of multiplicative effects

between bleach and taurocholic acid found in the current

study suggests that the two stimuli work via different

mechanisms. 117

Failure of bleach and cysteine/C02 pretreatments to show additive effects suggests that they operate via the same mechanism. Cysteine/CO2 increases the number of sulfhydryl groups on the exterior of Eimeria oocysts (10) and is thought to mimic stomach passage in vivo (9). Bleach treatment may also mimic some process that occurs in the stomach.

The observations that trypsin is unnecessary for excys­ tation and that high concentrations are inhibitory were un­ expected. Previous publications describing excystation of

Cryptosporidium consistently include trypsin as part of the excystation fluid (5, 12, 13, 17, 19). Experiments using protease inhibitors and the artificial protease substrate

Azocoll failed to implicate proteolytic enzymes as mechanisms for excystation- Since host-derived proteolytic enzymes are believed essential to the excystation of Eimeria

(11), the excystation mechanism used by Cryptosporidium would appear to be fundamentally different.

Payer and Leek (4) observed excystation of Sarcocystis fusiformis sporocysts in the absence of trypsin provided that the sporocysts were treated with cysteine/C02• Their results, combined with mine, suggest that all suture bearing coccidia may use an alternate excystation mechanism.

The existence of parasite-derived enzymatic pathways for excystation has been proposed for Cryptosporidium (5) 118

and other coccidians (8, 9). The evidence suggests that enzymes are involved in excystation of Cryptosporidium since the process is temperature dependent and responsive to changes in pH. The excystation of bleach treated oocysts requires only a rise in temperature and therefore must be effected by mechanisms within the oocyst. Reduker et al.

(13) showed that the morphological changes during excysta­ tion appear first on the internal aspects of the excystation suture, further supporting the idea that excystation is ef­ fected from the inside.

The current experiments raised important questions about the mechanism of excystation in Cryptosporidium and perhaps the other suture bearing coccidia. The data suggest that oxidation/reduction reactions and bile salts can serve

as triggers for excystation- It appears that these triggers

do not just pave the way for the activity of host pro­

teolytic enzymes. They may, in fact, activate an enzymatic

system inside the oocyst which, in turn, effects

excystation.

Literature Cited

1. Chobotar, B. and Scholtyseck, E. 1983. Ultra-

structure. pp. 101-106. In Long, P. L., ed. The Biology

of the Coccidia. University Park Press, Baltimore. 119

2. Current, W. L. and Reese, N. C. 1986. A compari­ son of endogenous development of three isolates of Cryp­ tosporidium in suckling mice. J. Protozoal. 33; 98-108.

3. Current, W. L., Reese, N. C., Ernst, J. V., Bailey,

W. S., Heyman, H. B. and Weinstein, W. M. 1933. Human cryptosporidiosis in immunocompetent and immunodeficient persons. N. Engl. J. Med. 308: 1252-1257.

4. Payer, R. and Leek, R. G. 1973. Excystation of

Sarcocystis fusiformis sporocysts from dogs. Proc. Helm.

Soc. Wash. 40: 294-296.

5. Payer, R. and Leek, R. G. 1984. The effects of

reducing conditions, medium, pH, temperature, and time on in

vitro excystation of Cryptosporidium. J. Protozool. 31:

567-569.

6. Heine, J., Moon, H. W. and Woodmansee, D. B. 1984.

Persistent Cryptosporidium infection in congenitally athymic

(nude) mice. Infec. Immun. 43; 856-859.

7. Heine, J., Pohlenz, J. P. L., Moon, H. W. and

Woode ; G. N. 1984, Enteric lesions and diarrhea in

gnotobiotic calves monoinfected with Cryptosporidium spe­

cies. J. Inf. Pis. 150: 768-775.

8. Hibbert, L. E. and D. M. Hammond. 1968. Effects

of temperature on in vitro excystation of various Eimeria

species. Exp. Parasitol. 23: 161-179. 120

9. Jackson, A. R. B. 1962. Excystation of Eimeria arlonqi (Marotel, 1905): stimuli from the host sheep. Na­ ture (London) 194: 847-849.

10. Jolley, W. R., Burton, S. D., Nyberg, P. A. and

Jensen, J. B. 1976. Formation of sulfhydryl groups in the walls of Eimeria stiedai and E. tenella oocysts subjected to

in vitro excystation. J. Parasitol. 62; 119-202.

11. Ryley, J. F. 1973. Cytochemistry, physiology,

and biochemistry, pp. 145-181. In Hammond, D. M. and Long,

P. L., eds. The Coccidia; Eimeria, Isospora, Toxoplasma.

and Related Genera. University Park Press, Baltimore.

12. Reduker, D. W. and Speer, C. A. 1985. Factors

influencing excystation in Cryptosporidium oocysts from cat­

tle. J. Parasitol. 71: 112-115.

13. Reduker, D. W., Speer, C. A. and J. A. Blixt.

1985- Ultrastructural changes in the oocyst wall during

excystation of (Apicomplexa; Eucoc-

cidiorida). Can. J. Zool. 63: 1892-1896.

14. Sloss; M- W. and Kemp. R. L. 1978. Veterinary

Clinical Parasitology. Iowa State University Press, Ames,

lA.

15. Tyzzer, E. E. 1910. An extracellular coccidium,

Cryptosporidium muris (gen, et sp. nov.) of the gastric

glands of the common mouse. J. Med. Res. 23: 478-509. 121

16. Tzipori, S. 1983. Cryptosporidiosis in animals and humans. Microbiol. Rev. 47; 84-96.

17. Upton, S. J. and Current, W. L. 1985. The spe­ cies of Cryptosporidium (Apicomplexa: Cryptosporidiidae) infecting mammals. J. Parasitol. 71: 625-629.

18. Wang, C. C. 1983. Biochemistry and physiology of

Coccidia. pp. 167-228. ^ Long, P. L., ed. The Biology of the Coccidia. University Park Press, Baltimore.

19. Woodmansee, D. B. and Pohlenz, J. F. L. 1983.

Development of Cryptosporidum sp. in a human rectal tumor cell line. pp. 306-317. ^ Proceedings of the Fourth

International Symposium on Neonatal Diarrhea. Veterinary

Infectious Disease Organization, Saskatoon. Table 1. Excystation of non-bleach-treated oocysts in different excystation solu­

tions

Mean

Sporozoite

Base Mean % Cyst Wall

Solution [T.A. [TRYP]^ Time^ Excystation Ratio N

DPBS 1.5 0.5 30 56 1.54 4

DPBS 1.5 0 30 52 2.62 4

DPBS 0.15 0 30 38 4.11 3

DPBS 0 0 30 0 ——— 3

HgO 0 0 60 2 0.33 3

^ Concentration (% w/v) of crude taurocholic acid.

^ Concentration (% w/v) of trypsin.

In minutes. Table 2. Results of incubation of Azocoll with 0.15% CTA and 0.15% CTA containing

1 X 10^ excysted Cryptosporidium oocysts. Differences between oocyst

and no oocyst groups are not statistically significant (P <0.05)

Mean

Buffer pH Oocysts + SEM N

Phosphate 7.0 No 0.256 + 0.027 8

Phosphate 7.0 Yes 0.209 + 0.022 8

Tris 9.0 No 0.502 + 0.052 5

Tris 9.0 Yes 0.498 + 0.021 10

Acetate 5.0 No 0.138 + 0.017 8

Acetate 5.0 Yes 0.131 + 0.018 8 Fig. 1. Time course for excystation of non-bleach treated oocysts. Dashed lines represent values for tubes placed in ice at 30 min. Excystation conditions: 0.15% CTA in PBS, 370c

Fig. 2. Sporozoite yield calculated from data in Fig. 1 % THEORETICAL SPOROZOITE YIELD % EXCYSTATIÛM oôë^êSSSSSS o

CJI

o

—I SPOROZOITE/CYST WALL RATIO m 3 _ ro o 5 o 3

s-

o Fig. 3. Effects of pH on excystation of non-bleach treated oocysts. Excystation conditions: 0.15% CTA, 370c, 60 min

Fig. 4. Effects of CTA concentration on excystation of non-bleach treated oocysts. Dilutions are two-fold dilutions of 0.15% CTA in PBS. Excystation conditions: 37°C, 60 min., pH 7.0 % EXCYSTATION % EXCYSTATION ooSSêSSSSSS

cr> - H to SPOROZOITE/CYST WALL RATIO SPCROZOITE/CYST WALL RATIO O ro CM O -L.

ro Fig. 5. Effects of bleach treatment on excystation in the presence and absence of 0.15% CTA. Excystation conditions; 37°C, pH 7.0

Fig. 6. Effect of cysteine HCl and CO2 pretreatment compared to bleach treatment. Excystation conditions: 0.15% CTA, 370C, pH 7.0 129

100 T A NO TREATMENT BLEACH TREATED XaUROCHOLIC ACID EXPOSED BLEACH TREATED + TAUROCHOIIC ACID EXPOSED

60- co ^40 4 I t t

20 -

60 90 120 TlME(min)

100 ùr-ù>. CYSTIE* HQf BLEACH 0-K3 BLEACH TREATED CTSTIENE HCt TREiSTED 80 A—A NO TREATMENT

i 60 1 ^ 40

20

0 10

TlMElmin) Fig. 7. Effect of trypsin on excystation of bleach treated oocysts. Excystation conditions as in Fig. 6

Fig. 8. Reversibility of trypsin effects. Treatment conditions: 5% trypsin in PBS, 21'^C, 20 min, washed 3X in PBS. Excystation conditions as in Fig. 6 131

MO TRYPSIN

en ^ 40 /15% TRYPSIN. LU

TIME (min)

80 NO PRETREATMENT

60 TRYPSIN PRETREATMENT

0

TIME (min) Fig. 9. Effects of BSA on excystation of bleach treated oocysts- Excystation conditions as in Fig. 6 % EXCYSTATION o o o o 8 I I I I I I I tm K K s if î g ï. » g g §

H U> W Figs. 10-15. Effects of protease inhibitors on ex cystation of bleach treated oocysts. \ Excystation conditions as in Fig. 6. Fig. 10. PMSF in ethanol and ethanol alone

Fig. 11. TAME, experiment similar to Fig. 10 135

100 0PNSF,0 ETHANOL /ml ùr^ 8.9 ni ETHANOL/ml O—• 8.9wl ETHANOL + 89 jig PNSF/ ml

^ 40 -

T r 10 15 20 TIME (min)

100

a—a 9IO,ig TWE/ml

60- co Pu 40 -

20-

15 20 25 30 TIME (mini Fig. 12. TLCK, experiment similar to Fig. 10

Fig. 13. TPCK in methanol and methanol alone, ex­ periment similar to Fig. 10 137

100 T O/ig TLCX/ml 455/iq TUCK/ml D—• 910/uq TICK/ml 80-

O B 60 CO >- X LU 40- é / 20- / /-

10 15 20 25 30 TIME (min]

100 0TPCX,0 METHANOL/ml 10.2^1 METHANOL/ml 380 lUj TPCK + 10.2 ^1 METHANOL / ml

O i5 60- CO X 40 -

TlME(min) Fig. 14. Pepstatin, experiment similar to Fig. 10

Fig. 15. Leupeptin, experiment similar to Fig. 10 % EXCYSTATION % EXCYSTATION o È o o S j «J u

en • II

o -| g H 9 U) m VD Ul

8^ 140

Running title: Isolation of Cryptosporidium

Techniques for the Isolation of Cryptosporidium Oocysts and

Sporozoites from Calf Feces.^

DOUGLAS B. W00DMANSEE*2 and THOMAS A. CASEY**

*Departments of Zoology and Veterinary Pathology, Iowa State

University and **The National Animal Disease Center, Ames,

Iowa, 50011 141

1 This study was supported by The United Stated Depart­ ment of Agriculture, cooperative agreement #58-5195-2-1160 and by a fellowship from the Salsbury Foundation. The au­ thors wish to thank Ms. Deborah Hammen and Mr. Gary Fry for technical assistance. No endorsements are herein implied.

2 Address correspondence to D. B. Woodmansee, U. S.

Department af Agriculture, National Animal Disease Center,

P. 0. Box 70, Ames, lA 50011. 142

SECTION V. TECHNIQUES FOR THE RECOVERY OF CRYPTOSPORIDIUM

OOCYSTS AND SPOROZOITES FROM CALF FECES

Abstract

Cryptosporidium oocysts were isolated from calf feces using sucrose step gradients. The gradients yielded oocysts in two grades of purity, Grade A (higher purity) and Grade B

(lower purity). Oocysts could be further purifed by extrac­ tion with chloroform or 5% SDS followed by washing over

Nuclepore filters. The resulting suspensions could be treated with bleach and taurocholic acid to excyst sporozoites. Purified sporozoites could be recovered by filtration.

Introduction

Studies of the biochemistry and molecular biology of

Cryptosporidium (Apicomplexa, Coccidiasina) have been ham­ pered by difficulties in obtaining adequate numbers of clean oocysts and sporozoites» A number of techniques for isola­ tion of Cryptosporidium oocysts from feces have been re­

ported (3, 5, 6, 7). No procedures for producing purified

sporozoites have yet been reported. In our hands, percoll

gradients, coverslip flotations, glass bead filtrations and

DEAE cellulose chromatography were inadequate for isolation 143

of oocysts from feces or sporozoites from excystation mix­ tures despite the fact that all of these methods have been reported useful for isolation of various life cycle stages

of other coccidians. Therefore, we developed new techniques

which may be of wide spread utility.

Materials and Methods

Animals

Calves, purchased from local farms or born at the cen­

ter, were immediately housed in isolation in calf crates.

They were inoculated with 10^ Grade B oocysts (see below)

mixed with the feed as soon as they were eating well (usual­

ly less than 24 hrs). Feed was a commercial milk replacer

(Land '0 Lakes) used according to manufacturer's instruc­

tions. Calves were checked daily for oocyst shedding by

carbol-fuchsin stained fecal smears (1).

When calves developed diarrhea and began to shed heavi­

ly, they were taken off feed and given a commercial oral

rehydration solution (Life Guard, Norden). Heavy shedding,

which typically began three to four days post inoculation

(p.i.), was defined as ++ or higher on a + to ++++ scale

(2). Feces were allowed to fall into metal pans containing

about 500 ml of a 2.5% potassium dichromate solution and

were collected daily for four to six days depending on the 144

duration of heavy shedding. After the feces were collected, the calves were returned to noinaal feed and allowed to re­ cover spontaneously.

Preparation of raw pools

Feces and dichromate from the pans were stored at 4^0 until collection was complete. The material was then passed through standard testing sieves as previously described (2).

Sieved fecal suspensions were centrifuged at 4600 £ to pel­ let the solid material. Pellets were resuspended in ap­ proximately equal volumes of 2.5% potassium dichromate, pooled, and stored at 4^0 for up to three months.

Isolation of Grade A and Grade B oocysts

Sucrose step gradients were formed by placing 25 ml of

Sheather's sucrose solution (4) diluted to a specific gravi­ ty of 1.18 g/ml in the bottom of a 200 ml glass centrifuge bottle. This was overlaid by 50 ml of Sheather's diluted to

1-09 g/ml, 25 ml of Sheather's at 1.02 g/ml and 25 ml of the raw pool. Gradients were centrifuged at 900 £ for 15 min in

a swinging bucket rotor.

After centrifugation, the 1.09 g/ml fraction was col­

lected and diluted with 3 volumes of Dulbecco's phosphate

buffered saline (PBS). The bands at the 1.18/1.09 and 1.09/

1.02 interfaces were collected into a separate container and 145

also diluted. The remainder of the gradient was discarded.

Solid material was collected from both fractions by cen- trifligation at 900 £ for 10 min and resuspended in 2.5%

potassium dichromate. Oocysts obtained from the 1.09 g/ml

fraction were called Grade A while those from the bands were called Grade B,

Preparation of purified oocysts

Lipids were removed from oocyst suspensions by mixing

equal volumes of Grade A or Grade B material and chloroform,

and immediately separating the phases by a brief centrifuga-

tion. The water phase was collected, leaving the layer of

debris at the interface of the phases. This was repeated

until the water phase was almost transparent. In an alter­

nate procedure, Grade A material was extracted by two washes

in 5% sodium dodecyl sulfate (SDS) in 0.05M Tris buffer, pH

9.0 followed by one wash in PBS.

After extraction, oocysts were placed in a stirred cell

(Model 52, Amicon Corporation, Danvers, MA) fitted with a

Nuclepore membrane with a 3 ;ain pore size (#111012, Nuclepore

Corporation, Pleasanton, CA). The stirred cell was connect­

ed to a reservoir (#XX6700P05, Millipore Corporation, Bed­

ford, MA) containing 2 liters of sterile PBS. PBS was

flushed through the cell under pressure (5-10 psi) with

vigorous stirring until all the PBS except 10 ml had passed 146

through. Oocysts were retained by the membrane while small debris were washed through the pores. The last 10 ml were left stirring in the cell for 30 min to remove oocysts from the surface of the membrane. The purified oocysts were re­ covered from the stirred cell, placed in sterile injection vials and stored at 4°C.

Preparation of sporozoites

Purifed oocysts were mixed with full strength commer­ cial bleach (5.25% sodium hypochlorite) for 5 min at O^C then washed three times in PBS. Washed oocysts were sus­ pended in warm, 0.15% taurocholic acid (#T-0750, Sigma

Chemical Company, St. Louis, MO) in PBS and placed in the stirred cell in a 37^0 incubator and stirred slowly.

Sporozoites were collected after 30 min by carefully drawing fluid through the membrane with a syringe. The filtrate was placed in a centrifuge tube in an ice bath and fresh taurocholic acid solution was added to the cell. A second

group of sporozoites was collected after 30 min and pooled

with the first.

Results and Discussion

Our laboratory is concerned primarily with cryp-

tosporidiosis of cattle. Cryptosporidium infections of 147

calves follow a predictable clinical course and produce pro­

digious numbers of oocysts (lOlO-loll oocysts per animal),

thus they were an obvious source of oocysts and sporozoites.

Our early efforts to isolate oocysts were hampered by

inconsistent behavior of feces-dichromate mixtures. The

practice of placing the calves on oral rehydration solu­

tions, which have less solid matter than milk replacer,

eliminates some of the variability (W. L. Current, Lilly

Research Laboratories, Greenfield, IN, pers. comm.). Pel­

leting and resuspending the sieved suspensions also led to

more consistent results. Oocyst numbers in the raw pools

were difficult to determine because of the large amount of

debris, but in one typical pool, the oocyst concentration

was estimated to be 8x10^ oocysts/ml. Four to five liters

of raw pool per calf were obtained.

Examination of the various fractions from the sucrose

gradients showed that oocysts could be found in all of them,

but large numbers of oocysts appeared in the 1.09 g/ml frac­

tion and in the two bands. In one typical isolation, 42% of

the oocysts loaded onto the gradient were recovered as Grade

A while 22% were recovered as Grade B. Yield and purity

varied from raw pool to raw pool.

Grade A material had a better ratio of oocysts to de­

bris than Grade B. In the remainder of the gradient, the

ratio of oocysts to debris was so poor that the oocysts were 148

not used. Grade B oocysts were clean enough to be accurate­ ly counted in a hemacytometer and are routinely used in this laboratory for inoculation of experimental animals. There were no obvious morphological differences between Grade A oocysts and Grade B oocysts.

The filtration of small debris through Nuclepore fil­ ters was found to be an excellent method of purification of oocysts provided that the material was extracted with chlo­ roform or SDS beforehand. Insufficient extraction resulted in rapid plugging of the membranes by an amorphous material, presumedly lipid. Chloroform extraction usually gave lower yields than SDS extraction but oocyst purity after filtra­ tion was excellent. SDS extraction gave consistently high yields, but in certain pools large debris contaminating the oocysts were retained in the final preparation. The number of oocysts which could be filter purified at one time was limited to 1-2x10® because the oocysts themselves can oc­ clude the holes in the membrane, resulting in unacceptably low flow rates. Recovery of purifed oocysts from the stirred cell was good provided that plugging did not occur and that the oocysts were vigorously stirred to remove them from the surface of the membrane.

The number of sporozoites recovered was limited primarily by the number of purified oocysts available.

Plugging of membranes during sporozoite isolations was not 149

observed. Sporozoite recoveries ranged from one sporozoite per oocyst to almost four sporozoites per oocyst. The primary contaminant of these preparations was residual bodies, but contamination by oocysts and cast oocyst shells also occurred. In the worst case of contamination observed, sporozoite numbers were 100 times higher than cast shell numbers and 10,000 times higher than oocyst numbers. On occasion, we obtained preparations with no detectable oocyst or cast shell contamination.

The procedures described are now in routine use in this laboratory. They have proven to be reliable methods for the isolation of oocysts and sporozoites. Filtration of ex­ tracted oocysts is currently the limiting step. We are at­ tempting to modify the procedures to increase yields from this step.

Literature Cited

1. Heine, J. 1982. Eine einfache Nachweismethode fur

Kryptosporidien im Kot. Zentralbl. Veterinaermed. Reihe B

29: 324-327.

2. Heine, J., Moon, H. W. & Woodmansee, D. B. 1984.

Persistent Cryptosporidium infection in congenitally athymic

(nude) mice. Infect. Immun. 43; 856-859. 150

3. Heyman, M. B., Shigekuni, L. K. & Amman, A. J-

1986. Separation of Cryptosporidium oocysts from fecal de­ bris by density gradient centrifugation and glass bead columns. J. Clin. Microbiol. 23; 789-791.

4. Sloss, M. W. and Kemp, R. L. 1978. Veterinary

Clinical Parasitology. Iowa State University Press, Ames,

lA.

5. Ungar, B. L. P., Soave, R., Payer, R. & Nash, T. E.

1986. Enzyme immunoassay detection of immunoglobulin M and

G antibodies to Cryptosporidium in immunocompetent and im-

munodeficient persons. J. Infect. Pis. 153: 570-578.

6. Waldman, E., Tzipori, S. & Forsyth, J. R. L. 1986.

Separation of Cryptosporidium species oocysts from feces by

using Percoll discontinuous density gradient. J. Clin.

Microbiol. 23; 199-200.

7. Woodmansee, D. B. & Pohlenz J. F. L. 1983.

Development of Cryptosporidium sp. in a human rectal tumor

cell line. pp. 306-317. ^ Proceedings of the Fourth

International Symposium on Neonatal Diarrhea. Veterinary

Infectious Disease Organization, Saskatoon. 151

GENERAL SUMMARY

Review of the published literature on Cryptosporidium shows that most of the available information is observation­ al. Experimental work has been hampered in part by a lack of in vitro techniques. This thesis reports efforts to develop new techniques and to apply techniques used to study other coccidian parasites to Cryptosporidium. Each of the papers presented here addresses a topic related to the han­ dling of Cryptosporidium in vitro.

In the work reported in Section I, standard techniques were used in an attempt to grow the parasites in cell cul­ ture. While development of the parasites through most of the life cycle was observed, the system was found to be in­

sufficient in that productive infections were not es­

tablished. These initial studies pointed out a need for

more information about the behavior of the parasites during

and immediately after excystation.

Section II answers a question raised by a paper

published by Anderson (3), in which he stated that substan­

tial sporulation occurred after oocysts are passed in calf

feces. The question is important because if sporulation

does occur, then sporozoite yields from in vitro excysta-

tions should increase if one passes the oocysts through the

sporulation procedure. My experiments showed no increase in

sporozoite yields after running a sporulation procedure. 152

This result is consistent with the long standing belief that sporulation of Cryptosporidium oocysts is complete when the oocysts are shed.

Section III reports findings related to survival of sporozoites after excystation. Taurocholic acid was found to help in the maintenance of motility and morphology of sporozoites. Neutral pH and low temperatures also improved sporozoite survival. These findings should alert research­ ers that Cryptosporidium sporozoites may be more delicate than sporozoites of other coccidians and help researchers to develop protocols which maximize sporozoite survival.

Section IV reports the effects of various factors on in vitro excystation. In addition to establishing optimum (in my hands) excystation conditions, the data suggest that the mechanisms of excystation may be different for Cryp­ tosporidium than they are for Eimeria. Reported procedures

for excystation of Cryptosporidium are essentially copies of

procedures for excystation of Eimeria. Review of the

literature gives one reason to believe that other coccidian

parasites may also use alternate excystation mechanisms.

Elucidation of these mechanisms may lead to more efficient

approaches to in vitro excystation of these species and per­

haps to approaches to block excystation in vivo.

Section V reports new methods of isolation of Cryp­

tosporidium oocysts from feces and sporozoites from oocysts. 153

We are currently using oocysts and sporozoites isolated by the new procedures in studies of the biochemistry and

molecular biology of sporozoites. It is hoped that these

procedures will come into widespread use and that they will

contribute substantially to our understanding of the biology

of Cryptosporidium. 154

LITERATURE CITED

1. Anderson, B. C. 1981. Patterns of shedding of cryptosporidial oocysts in Idaho calves. J. Vet. Med.

Assoc. 178: 982-984.

2. Anderson, B. C. 1982. Cryptosporidiosis in Idaho lambs: natural and experimental infections. J. Vet.

Med. Assoc. 181: 151-155.

3. Anderson, B. C. 1983. Cryptosporidiosis. Lab.

Med. 14: 55-56.

4. Anderson, B. C. and Bulgin M. S. 1981. Enteritis caused by Cryptosporidium in calves. Vet. Med. Small Anim.

Clin. 76: 865-868.

5. Anderson, B. C., Donndelinger, T., Wilkins R. M. and Smith, J. 1982. Cryptosporidiosis in a veterinary stu­ dent. J. Vet. Med. Assoc. 180: 408-409.

6. Anderson, B. C. and Hall, R. F. 1982. Cryp­ tosporidial infection in Idaho dairy calves. J. Vet.

Med. Assoc. 181: 484-485.

7. Andreani, T., Modigliani, R., Le Charpentier, Y.,

Galian, A., Brouet, J. C., Liance, M., Lachance, J. R.,

Messing, B. and Vernisse, B. 1983. Acquired im­

munodeficiency with intestinal cryptosporidiosis: possible

transmission by Haitian whole blood. Lancet i: 1187-1191.

8. Angus, K. W., Hutchison, G. and Munro, H. M. C.

1985. Infectivity of a strain of Cryptosporidium found in 155

the guinea-pig (Cavia porcellus) for guinea-pigs, mice and

lambs, J. Comp. Pathol. 95: 151-165.

9. Angus, K. W., Sherwood, D., Hutchison, G. and Camp­

bell, I. 1982, Evaluation of the effect of two aldehyde-

based disinfectants on the infectivity of faecal Cryp­

tosporidia for mice. Res. Vet, Sci, 33: 379-381.

10. Angus, K. W,, Tzipori, S. and Gray, E, W, 1982,

Intestinal lesions in specific-pathogen-free lambs associ­

ated with a Cryptosporidium from calves with diarrhea. Vet.

Pathol. 19: 67-78.

11. Barker, I. K. and Carbonell, P, L, 1974. Cryp­

tosporidium aqni sp. n, from lambs, and Cryptosporidium

bovis sp, n. from a calf with observations on the oocyst.

Parasitenkd. 44: 289-298.

12. Baxby, D, and Blundell, N. 1983. Sensitive, rap­

id, simple methods for detecting Cryptosporidium in faeces.

Lancet ii: 1149.

13. Baxby, D,, Blundell, N, and Hart, C. A, 1984,

The development and performance of a simple, sensitive meth­

od for the detection of Cryptosporidium oocysts in faeces.

J. H^, 92: 317-323.

14. Baxby, D. and Hart, C. A. 1984. Cryp-

tosporidiosis, Br, Med, J. 289: 1148. 156

15. Baxby, D., Hart, C. A, and Blundell, N. 1985.

Shedding of oocysts by immunocompetent individuals with cryptosporidiosis. J. Hyg. 95; 703-709.

16. Baxby, D., Hart, C. A. and Taylor, C. 1983. Hu­ man cryptosporidiosis; a possible case of hospital cross infection. Br. Med. J. 287; 1760-1761.

17. Berg, I. E., Peterson, A. C. and Freeman, T. P.

1978. Ovine cryptosporidiosis. J. Vet. Med. Assoc.

173: 1586-1587.

18. Berkowitz, C. D. and Seidel, J. S. 1985. Spon­ taneous resolution of cryptosporidiosis in a child with ac­ quired immunodeficiency syndrome. J. Pis. Child. 139;

967.

19. Bird, E.G. and Smith, M. D. 1980. Cryp­ tosporidiosis in man: parasite life cycle and fine struc­ tural pathology. J. Pathol. 132: 217-233.

20. Blumberg, R. S., Kelsey, P., Perrone, T., Dicker- son, R., Laquaglia, M. and Ferruci, J. 1984. Cytomegalovi­ rus- and Cryotosporidium-associated acalculous gangrenous cholecystitis. J. Med. 76: 1118-1123.

21. Boch, J., Gobel, E., Heine, J., Brandler U. and

Schloemer, L. 1982. Kryptosporidien-Infektion bei Haustie-

ren. Berl. Muench. Tieraerztl. Wochenschr, 95; 316-367.

22. Bogaerts, J., Lepage, P., Rouvroy, D. and Van-

depitte, J. 1984. Cryptosporidium spp., a frequent cause 157

of diarrhea in central Africa. J. Clin. Microbiol. 20: 874-

876.

23. Brady, E. M., Margolis, M. L. and Korzeniowski, 0.

M. 1984. Pulmonary cryptosporidiosis in acquired immune deficiency syndrome. J. Med. Assoc. 252: 89-90.

24. Bronsdon, M. A. 1984. Rapid dimethyl sulfoxide- modified acid-fast stain of Cryptosporidium oocysts in stool specimens. J. Clin. Microbiol. 19: 952-953.

25. Brownstein, D. G., Strandberg, J. D. and Montali,

R. J., Bush, M. and Fortner, J. 1977. Cryptosporidium in

snakes with hypertrophic gastritis. Vet. Pathol. 14; 606-

617.

26. Campbell, I., Tzipori, S., Hutchison, G. and

Angus, K. W. 1982. Effect of disinfectants on survival of

Cryptosporidium oocysts. Vet. Rec. Ill: 414-415.

27. Canning, E. U. and Anwar, M. 1968. Studies on

meiotic division in coccidial and malarial parasites. J.

Protozool. 15: 290-298.

28. Casemore, D. P., Armstrong, M. and Jackson, B.

1984. Screening for Cryptosporidium in stools. Lancet

1:734-735.

29. Casemore, D. P. and Jackson, B. 1983. Sporadic,

cryptosporidiosis in children. Lancet 11: 679. 158

30. Casemore, D. P. and Jackson, F. B. 1984. Hypoth­ esis: cryptosporidiosis in htaman beings is not primarily a zoonosis. J. Infection 9: 153-156.

31. Centers for Disease Control. 1982. Cryp­ tosporidiosis: assessment of chemotherapy of males with ac­ quired immune deficiency syndrome (AIDS). Morbid. Mortal.

Wkly. Repts. 31: 589-592.

32. Centers for Disease Control. 1984. Update:

Treatment of cryptosporidiosis in patients with acquired immune deficiency syndrome (AIDS). Morbid. Mortal. Wkly.

Repts. 33: 117-119.

33. Chobotar, B., and Scholtyseck, E. 1983. Ultra- structure. pp. 101-166. ^ Long, P. L., ed. The Biology of the Coccidia. University Park Press, Balitmore.

34. Clarke, J. J. 1895. A study of coccidia met with in mice. Q. J. Microsc. Sci. 37: 277-283.

35. Cockrell, B. Y., Valeric, M. G. and Garner, F. M.

1974. Cryptosporidiosis in the intestines of rhesus monkeys

(Macaca mulatta). Lab. Anim. Sci. 24: 881-887.

36. Collier, A. C., Miller, R. A. and Meyers, J. D.

1984. Cryptosporidiosis after marrow transplantation: per- son-to-person transmission and treatment with spiramycin.

Ann. Intern. Med. 101: 205-206. 159

37. Cross, R. F. and Moorhead, P. D. 1984. A rapid staining technic for Cryptosporidia. Mod. Vet. Pract. 65;

307.

38. Current, W. L. 1983. Human cryptosporidiosis.

N. Engl. J. Med. 309: 1326-1327.

39. Current, W. L. 1985. Cryptosporidiosis. J. Am.

Vet. Med. Assoc. 12: 1334-1338.

40. Current, W. L. and Haynes, T. B. 1984. Complete

development of Cryptosporidium in cell culture. Science

224: 603-605.

41. Current, W. L. and Long, P. L. 1983. Development

of human and calf Cryptosporidium in chicken embryos. J.

Infect. Pis. 148: 1108-1113.

42. Current, W. L. and Reese, N. C. 1986. A compari­

son of endogenous development of three isolates of Cryp-

tosproidium in suckling mice. J. Protozool. 33: 98-108.

43a. Current, W. L., Reese, N. C., Ernst, J. V.,

Bailey, W. S., Heyman M. B. and Weinstein, W. M. 1983. Hu­

man cryptosporidiosis in immunocompetent and immunodeficient

persons. N. Engl. J. Med. 308: 1252-1257.

43b. Current, W. L., Upton, S. J. and Haynes, T. B.

1986,. The life cycle of Cryptosporidium baileyi n. sp.

(Apicomplexa, Cryptosporidiidae) infecting chickens. J.

Protozool. 33: 289-296. 160

44. D'Antonio, R. G., Winn, R. E., Taylor, J. P., Gus- tafson, T. L., Current, W. L., Rhodes, M. M., Gary, G. W.

Jr., and Zajac, R. A. 1985. A waterborne outbreak of cryp- tosporidiosis in normal hosts- Ann. Intern. Med. 103: 886-

888.

45. Dhillon, A. S., Thacker, H. L., Dietzel, A. V. and

and Winterfield, R. W. 1981. Respiratory cryptosporidiosis

in broiler chickens. Avian Pis. 25: 747-751.

46. Doster, A. R,, Mahaffey, E. A. and McClearen, J.

R. 1979. Cryptosporidia in the cloacal coprodeum of Red-

lored parrots (Amazona autumnalis)• Avian Pis. 23: 654-661.

47. Eberhardt, U., Boch, J. and Heine, J. 1985.

Parasitologische und klinische Untersuchungen an experimen-

tell rait Kryptosporidien infizierten NMRI-Mausen. Berl.

Muench. Tieraerztl. Wochenschr. 98: 266-268.

48. Payer, R., Ernst, J. V., Miller, R. G. and Leek,

R. G. 1985. Factors contributing to clinical illness in

calves experimentally infected with a bovine isolate of

Cryptosporidium. Proc. Helminthol. Soc. Wash. 52: 64-70.

49. Payer, R., and Leek, R. G. 1984. The effects of

reducing conditions, medium, pH, temperature, and time on in

vitro excystation of Cryptosporidium. J. Protozool. 31:

567-569. 161

50. Fischer, 0. 1983. Attempted therapy and pro­ phylaxis of cryptosporidiosis in calves by administration of sulphadimidine. Acta Vet. BRNO 52: 183-190.

51. Fletcher, A., Sims, T. A. and Talbot, I. C. 1982.

Cryptosporidial enteritis without general or selective im­ mune deficiency. Br. Med. J. 285: 22-23.

52. Fletcher, 0. J., Munnell, J. F. and Page, R. K.

1975. Cryptosporidiosis of the bursa of Fabricius of chickens. Avian Pis. 19: 630-639.

53. Garcia, L. S., Bruckner, D. A., Brewer T. C. and

Shimizu, R. Y. 1983. Techniques for the recovery and iden­ tification of Cryptosporidium oocysts from stool specimens.

J. Clin. Microbiol. 18: 185-190.

54. Gardiner, C. H. and Imes, G. D. Jr. 1984. Cryp­ tosporidium sp. in the kidneys of a black-throated finch.

J. Vet. Med. Assoc. 185: 1401-1402.

55. Gibson, J. A., Hill, M. W. M. and Huber, M. J.

1983. Cryptosporidiosis in Arabian foals with severe com­

bined immunodeficiency. Aust, Vet. J, 60: 378-379.

56. Glisson, J. R., Brown, T. P., Brugh, M., Page, R.

K., Kleven, S. H. and Davis, R. B. 1984. Sinusitis in

turkeys associated with respiratory cryptosporidiosis.

Avian Pis. 28: 783-790.

57. Goebel, E. and Braendler, U. 1982. Ultrastruc­

ture of microgametogenesis, microgametes and gametogamy of 162

Cryptosporidium, sp. in the small intestine of mice. Protis- toloqica 18: 331-334.

58. Hampton, J. C. and Rosario, B. 1966. The attach­ ment of protozoan parasites to intestinal epithelial cells of the mouse. J. Parasitol. 52: 939-949.

59. Hart, C. A., Baxby, D. and Blundell, N. 1984.

Gastro-enteritis due to Cryptosporidium: a prospective sur­ vey in a children's hospital. J. Infection 9: 264-270.

60. Heine, J. 1982. Eine einfache Nachweismethode fur Kryptosporidien im Kot. Zentralbl. Veterinaermed. Reihe

B 29: 324-327.

61. Heine, J. and Boch, J. 1981. Kryptosporidien-

Infectionen beim Kalb. Nachweis, Vorkommen, und experimen- telle Ubertragung. Berl. Muench. Tieraerztl. Wochenschr.

94: 289-292.

62. Heine, J., Moon, H. W. and Woodmansee, D. B.

1984. Persistent Cryptosporidium infection in congenitally

athymic (nude) mice. Infect. Immun. 43: 856-859.

63. Heine, J., Moon, H. W., Woodmansee, D. B. and Poh-

lenz, J. F. L. 1985. Experimental tracheal and conjuncti­

val infections with Cryptosporidium sp. in pigs. Vet.

Parasitol. 17: 17-25.

64. Heine, J., Pohlenz, J. F. L., Moon, H. W. and

Woode, G. N. 1984. Enteric lesions and diarrhea in 163

gnotobiotic calves monoinfected with Cryptosporidium spe­ cies. J. Infect. Pis. 150: 768-775^

65. Henriksen, Sv. Aa. and Pohlenz, J. F. L. 1981.

Staining of Cryptosporidia by a modified Ziehl-Neelsen tech­ nique. Acta Vet. Scand. 22: 594-596.

66. Hoerr, F. J., Ranck, F. M. Jr. and Hastings, T. F.

1978. Respiratory cryptosporidiosis in turkeys. J. Am.

Vet. Med. Assoc. 173: 1591-1593.

67. H0jlyng, N., M0lbak, K. and Jepsen, S. 1985.

Cryptosporidiosis in human beings is not primarily a zoonosis. J. Infection 11: 270-272.

68. H^jlyng, N., M^lbak, K., Jepsen, S. and Hansson,

A. P. 1984. Cryptosporidiosis in Liberian children. Lan­

cet i: 734.

69. Holley, H. P. Jr. and Dover, C. 1986. Cryp­

tosporidium: a common cause of parasitic diarrhea in other­

wise healthy individuals. J. Infect. Dis. 153: 365-368.

70. Eolten-Andersen, W., Gerstoft, J., Henriksen, Sv.

Aa. and Pederson, N. S. 1984. Prevalence of Cryptosporidi­

um among patients with acute enteric infections. J. Infec­

tion 9: 277-282.

71. Hoover, D. M., Hoerr, F. J., Carlton, N. W., Kins­

man, E. J. and Ferguson, H. W. 1981. Enteric cryp­

tosporidiosis in a naso tang, Naso lituratus Bloch and

Schneider. J. Fish Dis. 4: 425-428. 164

72. Horen, W. P. 1983. Detection of Cryptosporidium in human fecal specimens. J. Parasitol. 69: 622-624.

73. Howerth, E. W. 1981. Bovine cryptosporidiosis.

J. S^. Afr. Vet. Assoc. 52: 251-253.

74. Inman, L. R. and Takeuchi, A. 1979. Spontaneous cryptosporidiosis in an adult female rabbit. Vet. Pathol.

16: 89-95.

75. Isaacs, D., Hunt,'G. H., Phillips, A. D., Price,

E. H., Raafat, F. and Walker-Smith, J. A. 1985. Cryp­ tosporidiosis in immunocompetent children. J. Clin. Pathol.

(Lond.) 38: 76-81.

76. Iseki, M. 1979. Cryptosporidium felis sp. n.

(Protozoa: Eimeriorina) from the domestic cat. Jpn. J.

Parasitol. 28: 285-307.

77. Itakura, C-, Goryo, M. and Umemura, T. 1984.

Cryptosporidial infection in chickens. Avian Pathol. 13:

487-499.

78. Itakura, C., Nakamura, H., Umemura, T. and Goryo,

M. 1985. Ultrastructure of cryptosporidial life cycle in chicken host cells. Avian Pathol. 14: 237-249.

79. Jensen, J. B. and Edgar, S. A. 1976. Possible secretory function of the rhoptries of Eimeria magna during penetration of cultured cells. J. Parasitol. 62: 988-992. 165

80. Jerrett, I. V., and Snodgrass, D. R. 1981. Cryp­ tosporidia associated with outbreaks of neonatal calf diar­ rhea. Aust. Vet. J. 57: 434-435.

81. Jervis, H. R., Merrill, T. G. and Sprinz, H.

1966. Coccidiosis in the guinea pig small intestine due to a Cryptosporidium. Am. J. Vet. Res. 27: 408-414.

82. Jokipii, A. M. M., Hemila, M. and Jokipii, L.

1985. Prospective study of acquisition of Cryptosporidium,

Giardia lamblia and gastrointestinal illness. Lancet ii:

487-489.

83. Jokipii, L., Pohjola, S. and Jokipii, A. M. M.

1983. Cryptosporidium; a frequent finding in patients with gastro-intestinal symptoms. Lancet ii: 358-360.

84. Jokipii, L., Pohjola, S. and Jokipii, A. M. M.

1985. Cryptosporidiosis associated with traveling and giar­ diasis. Gastroenterology 89; 838-842.

85. Kennedy, G- A., Kreitner, G. L. and Strafuss, A.

C. 1977. Cryptosporidiosis in three pigs. J. Vet.

Med. Assoc. 170; 348-350,

86. Kheysin, E. M. 1972. Life Cycles of Coccidia of

Domestic Animals. University Park Press, Baltimore.

87. Koch, K. L., Phillips, D. J., Aber, R. C. and Cur­ rent, W. L. 1985. Cryptosporidiosis in hospital personnel.

Ann. Intern. Med. 102; 593-596. 166

88. Koch, K. L., Shankey, T. V., Weinstein, G. S.,

Dye, R. E., Abt, A. B., Current, W. L. and Eyster, M. E.

1983. Cryptosporidiosis in a patient with hemophilia, com­ mon variable hypogammaglobulinemia, and the acquired im­ munodeficiency syndrome. Ann. Intern. Med. 99: 337-340.

89. Kocoshis, S. A., Cibull, M. L., Davis, T. E., Hin- ton, J. T., Seip, M. and Banwell, J. G. 1984. Intestinal and pulmonary cryptosporidiosis in an infant with severe combined immune deficiency. J. Pediatr. Gastroenterol.

Nutr. 3; 149-157.

90. Kovatch, R. M. and White, J. D. 1972. Cryp­ tosporidiosis in two juvenile rhesus monkeys. Vet. Pathol.

9: 426-440.

91. Lasser, K. H., Lewin, K. J. and Ryning, F. W.

1979. Cryptosporidia! enteritis in a patient with congeni­ tal hypogammaglobulinemia. Hum. Pathol. 10: 234-240.

92. Leek, R. G. and Payer, R. 1984. Prevalence of

Cryptosporidium infections, and their relation to diarrhea in calves on 12 dairy farms in Maryland. Proc. Helminthol.

Soc. Wash. 51: 360-361.

93. Lefkowitch, J. H., Krumholz, S., Feng-Chen, K.

-C., Griffin, P., Despommier D. and Brasitus, T. A. 1984.

Cryptosporidiosis in the human small intestine: a light and

electron microscopic study. Hum. Pathol. 15: 746-752. 167

94. Levine, N. D. 1971. Uniform terminology for the protozoan subphylum Apicomplexa. J. Protozool. 18: 352-355.

95. Levine, N. D. 1983. Taxonomy and life cycles of coccidia. pp. 1-33. ^ Long, P. L., ed. The Biology of the Coccidia. University Park Press, Baltimore.

96. Levine, N. D. 1984. Taxonomy and review of the coccidian genus Cryptosporidium (Protozoa, Apicomplexa). J.

Protozool. 31: 94-98.

97. Levine, N. D. 1984. The genera Cryptosporidium and Epieimeria in the coccidian family Cryptosporidiidae.

Trans. Am. Microsc. Soc. 103: 205-206.

98. Levine, N. D., Corliss, J. 0., Cox, F. E. G.,

Deroux, G., Grain, J., Honigberg, B. M., Leedale, G. F.,

Loeblich, A. R. Ill, Lom, J., Lynn, D., Merinfeld, Z. G.,

Page, F. C., Poljansky, G., Sprague, V., Varva, J. and

Wallace, F. G. 1980. A newly revised classification of the protozoa. J. Protozool. 27: 37-58.

99. Lewis I. J., Hart, C. A. and Baxby, D. 1985.

Diarrhoea due to Cryptosporidium in acute lymphoblastic leukaemia. Arch. Pis. Child. 60: 60-62.

100. Lindsay, D. S., Blagburn, B. L., Sundermann, C.

A., Hoerr F. J. and Ernest, J. A. 1986. Experimental Cryp­ tosporidium infections in chickens; oocyst structure and tissue specificity. J. Vet. Res. 47: 876-879. 168

101. Links, I. J. 1982. Cryptosporidial infection of piglets. Aust. Vet. J. 58: 60-62.

102. Ma, P., Kaufman, D. L., Hemlick, C. G., D'Souza,

A. J. and Navin, T. R. 1985. Cryptosporidiosis in tourists returning from the Caribbean. N. Engl. J. Med. 312: 647-

648.

103. Ma, P. and Soave, R. 1983. Three-step stool examination for cryptosporidiosis in 10 homosexual men with protracted watery diarrhea. J. Infect. Pis. 147; 824-828.

104. Mason, R. W. and Hartley, W. J. 1980. Respira­ tory cryptosporidiosis in a peacock chick. Avian Pis. 24;

771-776.

105. Marcial, M. A. and Madara, J. L. 1986. Cryp­ tosporidium: cellular localization, structural analysis of absorptive cell-parasite membrane-membrane interactions in guinea pigs, and suggestion of protozoan transport by M cells. Gastroenterology 90; 583-594.

106. Mata, L., Bolanos, H., Pizarro, P. and Vives, M.

1984. Cryptosporidiosis in children from some highland Cos­ ta Rican rural and urban areas. J. Trop. Med. Hyg. 33:

24-29.

107. Matovelo, J. A., Landsverk, T. and Amaya-Posada,

G. 1984. Cryptosporidiosis in Tanzanian goat kids; scan­

ning and transmission electron microscopic investigations.

Acta Vet. Scand. 25: 322-326. 169

108. McNabb, S. J. N.; Hensel, D. M., Welch, D. F.,

Heijbel, H., McKee, G- L., and Istre, G. R. 1985. Compari­ son of sedimentation and flotation techniques for iden­ tification of Cryptosporidium sp. oocysts in a large out­ break of human diarrhea. J. Clin. Microbiol. 22 ;587-589.

109. Meisel, J. L., Perera, D. R., Meligro, C. and

Rubin, C. E. 1976. Overwhelming watery diarrhea associated with a Cryptosporidium in an immunosupressed patient. Gas­ troenterology 70: 1156-1160.

110. Meuten, D. J., Van Kruiningen, H. J. and Lein, D.

H. 1974. Cryptosporidiosis in a calf. J. Vet. Med.

Assoc. 165: 914-917.

111. Miller, R. A., Holmberg, R. E. Jr. and Clausen,

C. R. 1983. Life-threatening diarrhea caused by Cryp­ tosporidium in a child undergoing therapy for acute lym­ phocytic leukemia. J. Pediatr. 103: 256-259.

112. Montessori, G. A. and Bischoff, L. 1985. Cryp­

tosporidiosis: a cause of summer diarrhea in children. Can.

Med. Assoc. J. 132: 1285.

113. Moon, H. W. and Bemrick, W. J. 1981. Fecal

transmission of calf Cryptosporidia between calves and pigs.

Vet. Pathol. 18: 248-255.

114. Moon, H. W., McClurkin, A. W., Isaacson, R. E.,

Pohlenz, J,, Skartvedt, S. M., Gillette, K. G. and Baetz, A. 170

L. 1978. Pathogenic relationships of rotavirus, Escheri­ chia coli, and other agents in mixed infections in calves.

J. Vet. Med. Assoc. 173; 577-583.

115. Moon, H. W., Schwartz, A., Welch, M. J., McCann,

P. P. and Runnels, P. L. 1982. Experimental fecal trans­ mission of human Cryptosporidia to pigs, and attempted treatment with an ornithine decarboxylase inhibitor. Vet.

Pathol. 19: 700-707.

116. Moon, H. W., Woode, G. N. and Ahrens, F. A.

1982. Attempted chemoprophylaxis of cryptosporidiosis in calves. Vet. Rec. 110 ;181.

117. Morin, M., Lariviere, S. and Lallier, R. 1976.

Pathological and microbiological observations made on spon­ taneous cases of acute neonatal calf diarrhea. Can. J.

Comp. Med. 40: 228-240.

118. Navin, T. R. and Juranek, D. D. 1984. Cryp­

tosporidiosis: clinical, epidemiologic,- and parasitologic

review. Rev. Infect. Pis. 6; 313-327.

119. Nichols, G. and Thorn, B. T. 1984. Screening for

Cryptosporidium in stools. Lancet i: 735.

120. Nime, F. A., Burek, J. D., Page, D. L., Holscher,

M. A. and Yardley, J. H. 1976. Acute.enterocolitis in a

human being infected with the protozoan Cryptosporidium.

Gastroenterology 70: 592-598. 171

121. Panciera, R. J., Thomassen, R. W., and Garner, F.

M. 1971. Cryptosporidial infection in a calf. Vet.

Pathol. 8; 479-484.

122. Pavlasek, I. 1981. First record of Cryp­ tosporidium sp. in calves in Czechoslovakia. Folia Parasi- tol. (Prague) 28: 187-189.

123. Pavlasek, I. 1982. First detection of Cryp­ tosporidium sp. oocysts in calf faeces by floatation method.

Folia Parasitol. (Prague) 29: 115-118.

124. Pavlasek, I. 1982. The occurrence of Cryp­ tosporidium sp. in emergency-slaughtered calves and the course of excretion of the protozoan oocysts in calves on two farms in the South Bohemian Region. Vet. Med. (Prague)

27: 729-740.

125. Pavlasek, I. 1983. Experimental infection of

cat and chicken with Cryptosporidium sp. oocysts isolated

from a calf. Folia Parasitol. (Prague) 30: 121-122.

126. Pavlasek, I- and Mares, J. 1983. The effect of

single disinfection of a farm on the course of cryp-

tosporidiosis infections in calves. Vet. Med. (Prague) 28:

449-455.

127. Pavlasek, I. and Nikitin, V. F. 1983. Finding

of Cryptosporidium sp. in calves in the USSR. Folia Parasi­

tol. (Prague) 30: 4. 172

128. Payne, P., Lancaster, L. A., Heinzman, M. and

McCutchan, J. A. 1983. Identification of Cryptosporidium in patients with the acquired immunodeficiency syndrome. N.

Engl. J. Med. 309: 613-614.

129. Pearson, G. R. and Logan, E. F. 1978. Demon­ stration of Cryptosporidia in the small intestine of a calf by light, transmission electron and scanning electron microscopy. Vet. Rec. 103: 212-213.

130. Pearson, G. R. and Logan, E. F. 1983. Scanning and transmission electron microscopic observations on the host-parasite relationship in intestinal cryptosporidiosis of neonatal calves. Res. Vet. Sci. 34: 149-154.

131. Pearson, G. R., Logan, E. F. and McNulty, M. S.

1982. Distribution of Cryptosporidia within the gastroin­ testinal tract of young calves. Res. Vet. Sci. 33: 228-231.

132. Peeters, J. E., Van Openbosch, E. and Glorieux,

B. 1982. Demonstration of Cryptosporidia in calf faeces: a comparative study. Vlaams Diergeneeskd. Tijdschr. 51: 513-

523.

133. Perez-Schael, I., Boher, Y., Mata, L., Perez, M. and Tapia, F. J. 1985. Cryptosporidiosis in Venezuelan children with acute diarrhea. J. Trop. Med. Hyg. 34:

721-722. 173

134. Pitlik, S. D., Fainstein, V., Rios, A., Guarda,

L., Mansell, P. W. A. and Hersh, E, M. 1983. Cryp­ tosporidia! cholecystitis. N. Engl. J. Med. 308: 967.

135. Pohlenz, J., Bemrick, W. J., Moon, H. W. and Che­ ville, N. F. 1978. Bovine cryptosporidiosis: a transmis­ sion and scanning electron microscopic study of some stages in the life cycle and of the host-parasite relationship.

Vet. Pathol. 15: 417-427.

136. Pohlenz, J., Moon, H. W., Cheville N. F. and Bem­ rick, W. J. 1978. Cryptosporidiosis as a probable factor in neonatal diarrhea of calves. J. Vet. Med. Assoc.

172: 452-457.

137. Portnoy, D., Whiteside, M. E., Buckley E. Ill and

McLeod, C. L. 1984. Treatment of intestinal cryp­ tosporidiosis with spiramycin. Ann. Intern. Med. 101: 202-

204.

138. Powell, H. S., Holscher, M. A., Heath J. E. and

Beasley, F. F. 1976. Bovine cryptosporidiosis (a case re­

port). Vet. Med. Small Amin. Clin. 71: 205-207.

139. Proctor, S. J. and Kemp, R. L. 1974. Cryp­

tosporidium ansinum sp. n. (Sporozoa) in a domestic goose

Anser anser L. from Iowa. J. Protozool. 21: 664-666.

140. Rahaman, A. S. M. H., Sanyal, S. C., Al-Mahmud,

K. A., Sobhan, A., Hossain K. S. and Anderson, B. C. 1984. 174

Cryptosporidiosis in calves and their handlers in

Bangladesh. Lancet ii: 221.

141. Randall, C. J. 1982. Cryptosporidiosis of the bursa of Fabricius and trachea in broilers. Avian Pathol.

11: 95-102.

142. Randall, C. J. 1986. Conjunctivitis in pheas­ ants associated with cryptosporidial infection. Vet. Rec.

118: 211-212.

143a. Ratnam, S., Paddock, J., McDonald, E., Whitty,

D., Jong, M. and Cooper, R. 1985. Occurrence of Cryp­ tosporidium oocysts in fecal samples submitted for routine microbiological examination. J. Clin. Microbiol. 22: 402-

404.

143b. Reduker, D. W. and Speer, C. A. 1985. Factors

influencing excystation in Cryptosporidium oocysts from cat­

tle. J. Parasitol. 71: 112-115.

144. Reduker, D. W., Speer, C. A. and Blixt, J. A.

1985. Ulrastructural changes in the oocyst wall during ex­

cystation of Cryptosporidium parvum (Apicomplexa; Eucoc-

cidiorida). Can. J. Zool. 63: 1892-1896.

145. Reduker, D. W., Speer, C. A. and Blixt, J. A.

1985. Ultrastructure of Cryptosporidium parvum oocysts and

excysting sporozoites as revealed by scanning electron

microscopy. J. Protozool. 32: 708-711. 175

146. Reese, N. C., Current, W. L., Ernst, J. V. and

Bailey, W. S. 1982. Cryptosporidiosis of man and calf: a case report and results of experimental infections in mice and rats. J. Trop. Med. Hyg. 31: 226-229.

147. Rehg, J. E., Lawton, G. W. and Pakes, S. P.

1979. Cryptosporidium cuniculus in the rabbit (Oryctolaqus cuniculus). Lab. Anim. Sci. 29: 656-660.

148. Ribeiro, C. D. and Palmer, S. R. 1986. Family outbreak of cryptosporidiosis. Br. Med. J. 292: 337.

149. Ryley, J. F. 1973. Cytochemistry, physiology and biochemistry, pp. 145-182. ^ Hammond, D. M. and Long,

P. L., eds. The Coccidia. University Park Press,

Baltimore.

150. Ryley, J. F., Bentley, M., Manners, D. J. and

Stark, J. R. 1969. Amylopectin, the storage polysaccharide of the coccidia Eimeria burnetti and E. tenella. J. Parasi- tol. 55: 839-845.

151. Sanford, S. E. and Josephson, G. K. A. 1982.

Bovine cryptosporidiosis: clinical and pathological findings

in forty-two scouring neonatal calves. Can. Vet. J. 23:

343-347.

152. Schmidt, U. and Nienhoff, H. 1982. Kryp-

tosporidiose beim Schwein. Dtsch. Tieraerztl. Wochenschr.

89: 437-439. 176

153. Schmitz, J. A. and Smith, D. H. 1975. Cryp­ tosporidium infection in a calf. J. Vet. Med. Assoc.

167: 731-732.

154. Scholtyseck, E., Rommel, A. and Heller, G. 1969.

Licht- und elektronenmikroskopishe Untersuchungen zur Bil- dund der Oocystenhulle bei Eimerien (Eimeria perforans, E. stiedae und E. tenella). Z, Parasitenkd. 31; 289-298.

155. Schultz, M. G. 1983. Emerging zoonoses. N.

Engl. J. Med. 308: 1285-1286.

156. Shahid, N. S., Rahman, A. S. M, H., Anderson, B.

C., Mata, L. J. and Sanyal, S. C. 1985. Cryptosporidiosis

in Bangladesh. Br. Med. J. 290: 114-115.

157. Sherwood, D., Angus, K. W., Snodgrass D. R. and

Tzipori, S- 1982. Experimental cryptosporidiosis in

laboratory mice. Infect. Immun. 38: 471-475.

158- Skeels, M. R., Sokolow, R., Hubbard, C. V. and

Foster, L. R.. 1986. Screening for coinfection with Cryp­

tosporidium and Giardia in Oregon public health clinic pa­

tients. J. Public Health 76: 270-273.

159. Slavin, D. 1955. Cryptosporidium meleagridis

(sp. nov.). J. Comp. Pathol. 65: 262-266.

160. Sloper, K. S., Dourmashkin, R. R., Bird, R. B.,

Slavin, G. and Webster, A. D. B. 1982. Chronic malabsorp­

tion due to cryptosporidiosis in a child with immunoglobulin

deficiency. Gut 23: 80-82. 177

161. Snodgrass, D. R., Angus, K. W. and Gray, E. W.

1984. Experimental cryptosporidiosis in germfree lambs. J.

Comp. Pathol. 94; 141-152.

162. Snodgrass, D. R., Angus, K. W., Grpy, E. W.,

Keir, W. A. and Clerihew, L. W. 1980. Cryptosporidia as­ sociated with rotavirus and an Escherichia coli in an out­ break of calf scour. Vet. Rec. 106: 458-460.

163. Snyder, S. P., England, J. J. and McChesney, A.

E. 1978. Cryptosporidiosis in immunodeficient Arabian foals. Vet. Pathol. 15: 12-17.

164. Soave, R. and Ma, P. 1985. Cryptosporidiosis.

Traveler's diarrhea in two families. Arch. Intern. Med.

145: 70-72.

165. Stemmermann, G. N., Hayashi, T., Glober, G. A.,

Oishi N. and Frankel, R. 1980. Cryptosporidiosis. Report of a fatal case complicated by disseminated .

J. Med. 69: 637-642.

166. Sterling, C. R., Seegar, K. and Sinclair, N. A.

1986. Cryptosporidium as a causative agent of traveler's

diarrhea. J. Infect. Pis. 153: 380-381.

167. Szabo, J. R. and More, K. 1984. Cryp­

tosporidiosis in a snake. Vet. Med. Small Anim. Clin., 79:

96-98. 178

168. Tarwid, J. N., Cawthorn, R. J. and Riddell, C.

1985. Cryptosporidiosis in the respiratory tract of turkeys in Saskatchewan. Avian Pis. 29: 528-532.

169. Taylor, J. P., Perdue, J, N., Dingley, D., Gus- tafson, T. L., Patterson, M. and Reed, L. A. 1985. Cryp­ tosporidiosis outbreak in a day-care center. J. Pis.

Child. 139: 1023-1025.

170. Tham, V. L., Kniesberg, S. and Pixon, B. R.

1982. Cryptosporidiosis in quails. Avian Pathol. 11; 619-

626.

171. Triffit, M. J. 1925. Observations on two new

species of Coccidia parasitic in snakes. Protozoology 1:

19-26.

172. Tyzzer, E. E. 1907. A sporozoan found in the

peptic glands of the common mouse- Proc. Soc. Exp. Biol.

Med. 5: 12-13.

173. Tyzzer, E. E. 1910. An extracellular coccidium,

Cryptosporidium muris (gen. et sp. nov.) of the gastric

glands of the common mouse. J. Med. Res. 23: 487-509.

174. Tyzzer, E. E. 1912. Cryptosporidium parvum (sp.

nov.) a coccidium found in the small intestine of the common

mouse. Arch. Protistenkd. 26: 394-412.

175. Tzipori, S. 1983. Cryptosporidiosis in animals

and humans. Microbiol. Rev. 47: 84-96. 179

176. Tzipori, S., Angus, K. W., Campbell I. and

Clerihew, L. W. 1981. Diarrhea due to Cryptosporidium in­ fection in artificially reared lambs. J. Clin. Microbiol.

14: 100-105.

177. Tzipori, S., Angus, K. W., Campbell, I. and Gray,

E. W. 1980. Cryptosporidium: evidence for a single-species

genus. Infect. Immun. 30: 884-886.

178. Tzipori, S., Angus, K. W., Campbell, I. and Gray,

E. W. 1982. Experimental infection of lambs with Cryp­

tosporidium isolated from a patient with diarrhoea. Gut 23:

71-74.

179. Tzipori, S., Angus, K. W., Campbell, I. and Sher­

wood, D. 1981. Diarrhea in young red deer associated with

infection with Cryptosporidium. J. Infect. Dis. 144: 170-

175.

180. Tzipori, S., Angus, K. W., Gray, E. W. and Camp­

bell, I. 1980. Vomiting and diarrhea asociated with cryp-

tosporidial infection. N. Engl. J. Med. 303: 818.

181. Tzipori, S., Campbell, I., Sherwood, D., Snod-

grass, D. R. and Whitelaw, A. 1980. An outbreak of calf

diarrhoea attributed to Cryptosporidia! infection. Vet.

Rec. 107: 579-580.

182. Tzipori, S., Larsen, J., Smith, M. and Luefl, R.

1982. Diarrhoea in goat kids attributed to Cryptosporidium

infection. Vet. Rec. Ill: 35-36. 180

183. Tzipori, S., McCartney, E., Lawson, G. H. K.,

Rowland. A. C. and Campbell, I. 1981. Experimental infec­ tion of piglets with Cryptosporidium• Res. Vet. Sci. 31:

358-369.

184. Tzipori, S., Sherwood, D., Angus, K. W., Camp­ bell, I. and Gordon, M. 1981. Diarrhea in lambs: ex­ perimental infections with enterotoxigenic Escherichia coli, rotavirus, and Cryptosporidium sp. Infect. Immun. 33: 401-

406.

185. Tzipori, S., Smith, M., Birch, C., Barnes, G. and

Bishop, R. 1983. Cryptosporidiosis in hospital patients with gastroenteritis, to. J. Trop. Med. Hyg. 32: 931-934.

186. Tzipori, S., Smith, M., Kalpin, C., Angus, K. W.,

Sherwood, D. and Campbell, I. 1983. Experimental cryp­ tosporidiosis in calves: clinical manifestations and pathological findings. Vet. Rec. 112: 116-120.

187. Tzipori, S., Smith, M., Makin, T. and Halpin, C.

1982. Enterocolitis in piglets caused by Cryptosporidium sp. purified from calf faeces. Vet. Parasitol. 11: 121-126.

188. Upton, S. J. and Current, W. L. 1985. The spe­ cies of Cryptosporidium (Apicomplexa: Cryptosporidiidae) infecting mammals. J. Parasitol. 71: 625-629.

189. Vetterling, J. M., Jervis, H. R., Merrill, T. G.

and Sprinz, H. 1971. Cryptosporidium wrairi sp. n. from 181

the guinea pig Cavia porcellus, with an emendation of the genus. J, Protozool. 18: 243-247.

190. Vetterling, J. M., Takeuchi, A- and Madden, P. A.

1971. Ultrastructure of Cryptosporidium wrairi from the guinea pig. J. Protozool. 18: 248-260.

191. Wang, C. C. 1983. Biochemistry and physiology of coccidia. pp. 167-228. ^ Long, P. L., ed. The Biol­ ogy of the Coccidia. University Park Press, Baltimore.

192. Weikel, C. S., Johnston, L. I., De Sousa, M. A. and Guerrant, R. L. 1985. Cryptosporidiosis in northeast­ ern Brazil; association with sporadic diarrhea. J. Infect.

Dis. 151: 963-965.

193. Weisburger, W. R., Hutcheon, D. F., Yardley, J.

H., Roche, J. C., Hillis, W. D. and Charache, P. 1979.

Cryptosporidiosis in an imiaunosuppressed renal-transplant recipient with IgA deficiency. J. Clin. Pathol. 72:

473-478.

194. Wenyon, C. M. 1907. Observations on the proto­ zoa in the intestine of mice. Arch = Protistenkd. (Supp. i);

169.

195. Whittington, R. J. and Wilson, J. M. 1985.

Cryptosporidiosis of the respiratory tract in a pheasant.

Aust. Vet. J. 62: 284.

196. Willson, P. J. and Acres, S. D. 1982. A com­

parison of dichromate solution flotation and fecal smears 182

for diagnosis of cryptosporidiosis in calves. Can. Vet. J.

23: 240-246.

197. Wilson, D. W., Day, P. A. and Brummer, M. E. G.

1984. Diarrhea associated with Cryptosporidium spp. in juvenile macaques. Vet. Pathol. 21: 447-450.

198. Wolfson, J. S., Hopkins, C. C., Weber, D. J.,

Richter, J. M., Waldron, M. A. and McCarthy, D. M. 1984.

An association between Cryptosporidium and Giardia in stool.

N. Engl. J. Med. 310: 788.

199. Wolfson, J. S., Richter, J. M., Waldron, M. A.,

Weber, D. J., McCarthy D. M. and Hopkins, C. C. 1985.

Cryptosporidiosis in immunocompetent patients. N. Engl. J.

Med. 312: 1278-1282.

200. Woodmansee, D. B. and Pohlenz, J. F. L. 1983.

Development of Cryptosporidium sp. in a human rectal tumor

cell line. pp. 306-317. ^ Proceedings of the Fourth

International Symposium on Neonatal Diarrhea. Veterinary

Infectious Disease Organization, Saskatoon.

201= Wright, P= A., Harrison, J. M. and Byrom, I.

1984. Cryptosporidiosis. Br. Med. J. 289: 1148.

202. Zar, F., Geiseler, P. J. and Brown, V. A. 1985.

Asymptomatic carriage of Cryptosporidium in the stool of a

patient with the acquired immunodeficiency syndrome. J.

Infect. Dis. 151: 195. 183

203. Zierdt, W. S. 1984. Concentration and iden­ tification of Cryptosporidium sp. by use of a parasite con­ centrator. J. Clin. Microbiol. 20: 860-861. 184

ACKN0WLEDGÎ4ENTS

I am most grateful to the large number of people who have helped me in the work described in this dissertation.

In particular, I wish to acknowledge the cooperative efforts of Drs. Edwin Powell, Joachim Pohlenz, and Harley Moon.

They have done more for me than I can remember, and I would have been unable to do any of this work without their sup­ port and assistance. Thanks to Drs. Sheldon Shen and Warren

Dolphin who were always helpful, supportive and friendly as members of the graduate committee.

Special thanks to the whole crew in B-14; Mayo, Gary,

Paul, Tom, Jim, Bruce, Rob, Doug, and Becky have all helped me immensely at one time or another. Deb Hainmen should be singled out for the great job she did for me in the ell-too- brief time we worked together. Thanks to Jane, Sally, and

Joan in the Vet Path EM lab ; Wayne, Gene, and Tom in the

NADC Photo Lab; Kathleen in the front office; Karen and Phil in B-8; Gary, Don, Roger, and John in Animal Care; Pete in

Animal Supply; Keeta and Ron in Office Services; and to everyone else who lent a helping hand.

Financial support was provided by a cooperative agree­

ment between the United Stated Department of Agriculture and

Iowa State University and by a fellowship from the Salsbury

Foundation. I am indebted to Dr. Philip 0'Berry and Dr. 185

William Switzer for providing for the administration of these funds.

Finally, I would like to acknowledge the loving support of my wife, Valerie, and my parents, who showed infinite patience with my seemingly endless education. This disser­ tation is dedicated to my grandmother, Martha Woodmansee, who I miss very much.