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SUMMARYThe Consortium for Anthelmintic Resistance and Susceptibility (CARS) brings together researchers worldwide, with a focus of advancing knowledge of resistance and providing information on detection methods and treatment strategies. Advances in this field suggest mechanisms and features of resistance that are shared among different classes of anthelmintic. Benzimidazole resistance is characterized by specific amino acid substitutions in beta-tubulin. If present, these substitutions increase in frequency upon drug treatment and lead to treatment failure. In the laboratory, sequence substitutions in ion-channels can contribute to macrocyclic lactone resistance, but there is little evidence that they are significant in the field. Changes in gene expression are associated with resistance to several different classes of anthelmintic. Increased P-glycoprotein expression may prevent drug access to its site of action. Decreased expression of ion-channel subunits and the loss of specific receptors may remove the drug target. Tools for the identification and genetic analysis of parasitic nematodes and a new online database will help to coordinate research efforts in this area. Resistance may result from a loss of sensitivity as well as the appearance of resistance. A focus on the presence of anthelmintic susceptibility may be as important as the detection of resistance.

Studies of the kinetics of adenosine transport were carried out on the P1 and P2 transporters of drug-sensitive Trypanosoma evansi and its cloned derivative, resistant to the melaminophenyl arsenical Mel CY. Characterization of adenosine uptake was made by estimation of the maximum concentration taken up at time infinity ( A max ). A max on the P2 transporter of sensitive T. evansi was greater than A max on the P1 transporter. A max of the P2 transporter was significantly decreased in drug-resistant trypanosomes. The effect of adenosine concentration and inhibitors, on the rate of adenosine uptake, was described by Michaelis-Menten equations. In sensitive T. evansi , the maximum velocity of adenosine uptake ( V max ) of the P2 transporter was 2-fold greater than V max of the P1 transporter. The V max of the P2 transporter in resistant parasites was reduced 9-fold. The binding constants K m and K i on the P2 transporter of resistant T. evansi , showed that resistance was associated with an increased affinity for adenosine, and a decreased affinity for adenine and Berenil. We suggest that resistance to melaminophenyl arsenicals in T. evansi , occurs via 2 mechanisms: (1) a reduction in the number of expressed P2 transporter molecules resulting in decreased uptake of melaminophenyl arsenicals; (2) a change in the binding properties of the P2 transporter.

Ascaris suum possesses a well-developed nervous system which is regulated by a number of classical neurotransmitters including acetylcholine (ACh), γ-aminobutyric acid (GABA), glutamate and serotonin. The vagina vera, the distal part of the ovijector, displays intrinsic, rhythmic activity which has been shown to be modulated by FMRFamide-related peptides (FaRPs) in vitro. Confocal scanning laser microscopy coupled with immunocytochemistry, and histochemical studies, revealed that the nerve plexus of the ovijector contains GABAergic and glutamatergic innervation. Although no distinctive cholinergic or serotoninergic innervation was apparent, cholinesterase activity was localized to discrete areas of the musculature of the vagina vera. The effects of classical transmitters on the activity of the vagina vera in vitro were examined. ACh was excitatory, stimulating a brief but powerful contraction of the vagina vera with a threshold for activity of 1 μM. Both GABA and glutamate were inhibitory, causing a cessation of contractile activity at high concentrations (> 10 μM). Although less potent than glutamate, GABA had more profound effects and induced longer-lasting paralysis of the tissue. The threshold concentrations for activity were 5 μM for glutamate and 10 μM for GABA. Serotonin had no consistent effect on the vagina vera. This study demonstrates that classical transmitters modulate the activity of the ovijector of A. suum.

It is pointed out that two of the three major groups of anthelmintic act by opening membrane ion-channels. It is appropriate, therefore, to use electrophysiological methods to study the properties of the sites of action of these drugs and the changes in the properties of these receptor sites associated with resistance. This paper describes the use of the patch- clamp technique to observe the currents that flow through the levamisole-activated channels as they open and close in levamisole-sensitive and levamisole-resistant isolates. It was found that, on average, the proportion of time the channels are open, is less in the resistant isolate. The patch-clamp technique also showed that the ion-channels are heterogeneous and that one of the subtypes is lost with the appearance of resistance. The use of the current clamp technique is illustrated to record a site of action of ivermectin in the pharyngeal muscle of Ascaris.

This paper reviews sites of action of anthelmintic drugs including: (1) levamisole and pyrantel, which act as agonists at nicotinic acetylcholine receptors of nematodes; (2) the avermectins, which potentiate or gate the opening of glutamate-gated chloride channels found only in invertebrates; (3) piperazine, which acts as an agonist at GABA gated chloride channels on nematode muscle; (4) praziquantel, which increases the permeability of trematode tegument to calcium and results in contraction of the parasite muscle; (5) the benzimidazoles, like thiabendazole, which bind selectively to parasite β-tubulin and prevents microtubule formation; (6) the proton ionophores, like closantel, which uncouple oxidative phosphorylation; (7) diamphenethide and clorsulon, which selectively inhibit glucose metabolism of Fasciola and; (8) diethylcarbamazine, which appears to interfere with arachidonic acid metabolism of filarial parasites and host. The review concludes with brief comments on the development of anthelmintics in the future.

SUMMARYThree groups of anthelmintic drugs act directly and selectively on muscle membrane receptors of parasitic nematodes. These groups of anthelmintics are: (1)The Nicotinic Agonists(levamisole, pyrantel, morantel and oxantel) that act on acetylcholine receptors of nematode somatic muscle; (2)The GAB A Agonist, piperazine, that acts on nematode muscle GABA receptors; and (3)The Avermectinsthat open glutamate gated Cl-channels on nematode pharyngeal muscle. The electrophysiology and pharmacology of muscle and neuromuscular transmission the nematode parasite,Ascaris suum, is outlined and effects of anthelmintics that interfere with transmission described. Resistance to anthelmintics has appeared in some parasitic nematodes but the mechanisms of this resistance remain to be determined

SUMMARYWith increasing resistance to anti-parasitic drugs, it has become more important to detect and recognize phenotypes of resistant isolates. Molecular methods of detecting resistant isolates are limited at present. Here, we introduce a microfluidic bioassay to measure phenotype using parameters of nematode locomotion. We illustrate the technique on larvae of an animal parasiteOesophagostomum dentatum.Parameters of sinusoidal motion such as propagation velocity, wavelength, wave amplitude, and oscillation frequency depended on the levamisole-sensitivity of the isolate of parasitic nematode. The levamisole-sensitive isolate (SENS) had a mean wave amplitude of 135μm, which was larger than 123μm of the levamisole-resistant isolate (LEVR). SENS had a mean wavelength of 373μm, which was less than 393μm of LEVR. The mean propagation velocity of SENS, 149μm s−1, was similar to LEVR, 143μm s−1. The propagation velocity of the isolates was inhibited by levamisole in a concentration-dependent manner above 0·5μm. TheEC50for SENS was 3μmand theEC50for LEVR was 10μm. This microfluidic technology advances present-day nematode migration assays and provides a better quantification and increased drug sensitivity. It is anticipated that the bioassay will facilitate study of resistance to other anthelmintic drugs that affect locomotion.

The distribution of the fluorescent ivermectin derivative (4″ 5,7 dimethyl bodipy proprionylivermectin, referred to here as bodipy ivermectin) was studied in muscle vesicle membranes from the parasite Ascaris suum. Incubation in bodipy ivermectin, at concentrations greater than 1 ng/ml, produced a dose-dependent fluorescence in the vesicles. The level of fluorescence was not depressed (but increased) by prior incubation with 1 μM unlabelled ivermectin. This observation suggested that most of the bodipy ivermectin was free in the lipid phase of the membrane and not associated with a receptor. The trypan blue quenching technique showed that the bodipy ivermectin did not cross the membrane bilayer but remained in the outer monolayer. Lateral mobility of the probe in the membrane was studied using the fluorescence recovery after photobleaching (FRAP) technique. The lateral diffusion coefficient (DL) was 14.0 x 10−10 cm2/s which was nearly three times faster than the lipid probe octadecanoyl-aminofluorescein in membranes from the same preparations; only 46% of the probe was mobile, showing that within a 1.2 μm radius the distribution of the bodipy ivermectin in the membrane was not homogeneous. These observations are used to suggest that: the site of action of livermectin is located in the outer monolayer of the membrane (possibly on the Cl− channel); and that the speed of onset of action in isolated membrane preparations may be limited by diffusion in the membrane.

The organization ofAscarismotoneurones and nervous system is summarized. There is an anterior nerve ring and associated ganglia, main dorsal and ventral nerve cords which run longitudinally, and a small set of posterior ganglia. Cell bodies of motoneurones are found in the ventral nerve cord and occur in 5 repeating ‘segments’; each contains 11 motoneurones. Seven morphological types of excitatory or inhibitory motoneurone are recognized.EachAscarissomatic muscle cell is composed of the contractile spindle; the bag region, containing the nucleus; the arm; and the syncytial region, the location of neuromuscular junctions. The resting membrane potential of muscle is approximately — 30 mV and shows regular depolarizing, Ca-dependent ‘spike potentials’ superimposed on smaller Na+- and Ca2+-dependent ‘slow waves’ and even slower ‘modulation waves’. The membrane shows high Cl-permeability. Adjacent cells are electrically coupled so that electrical activity in the cells is synchronized. Acetylcholine (ACh) and γ-aminobutyric acid (GABA) affect the electrical activity. Bath-applied ACh increases membrane cation conductance, depolarizes the cells, alters the frequency and amplitude of spike potentials and produces contraction. Bath-applied GABA increases Cl-conductance, decreases spike activity and causes hyperpolarization and muscle relaxation.The extra-synaptic ACh receptors on the bag region ofAscarismuscle can be regarded as a separate subtype of nicotinic receptor. ACh and anthelmintic agonists (pyrantel, morantel, levamisole) produce a dose-dependent increase in cation conductance and membrane depolarization which is blocked by tubocurarine, mecamylamine but not by hexamethonium. The potency, of GABA agonists, with the exception of sulphonic acid derivatives, correlates with the vertebrate GABAareceptor. The potency of antagonists does not. Thus, bicuculline, securinine, pitrazepine, SR95531 and RU5135 are potent vertebrate GABAaantagonists but have little effect on GABA receptors. The potency order of the arylaminopyridazine GABA antagonists: SR95103, SR95132, SR42666, SR95133, SR95531, SR42627 and SR42640 at theAscarisGABA receptors contrasts with that at vertebrate GABAareceptors. It has been suggested that the receptor is referred to as a GABAnreceptor.Patch-clamp studies show that ACh activates a non-selective cation channel which has a main conductance of 40–50pS and apparent mean open time of 1·3 ms; a smaller channel of 20–30 pS with a similar open-time is also activated. Pyrantel and levamisole also produce openings with similar conductances and open-times. GABA activates a Cl-channel with a main state conductance of 22 pS and an apparent mean open duration of 32 ms; conductance states of 10 and 15 pS are also seen. Piperazine similarly activates this channel but the mean open-time is shorter (14 ms). Ivermectin in high doses, is an antagonist which reduces the GABA channel conductance and Popen; it does, however, open ‘small’ Cl-channels when applied to the outside surface of membrane. These channels have a conductance of 9–15 pS and very long open times (> 100 mS). 5-HT does not have a direct effect on membrane potential or conductance but acts on cAMP levels and glycogen metabolism. Dopamine, octopamine and AF1 may act as neurotransmitters or neuromodulators.

SUMMARYHere we review molecular information related to resistance to the cholinergic anthelmintics in nematodes. The amount of molecular information available varies between the nematode species, with the best understood so far beingC. elegans. More information is becoming available for some other parasitic species. The cholinergic anthelmintics act on nematode nicotinic acetylcholine receptors located on somatic muscle cells. Recent findings demonstrate the presence of multiple types of the nicotinic receptors in several nematodes and the numerous genes required to form these multimeric proteins. Not only are the receptors the product of several genes but they are subject to modulation by several other proteins. Mutations altering these modulatory proteins could alter sensitivity to the cholinergic anthelmitics and thus lead to resistance. We also discuss the possibility that resistance to the cholinergic anthelmintics is not necessarily the result of a single mutation but may well be polygenic in nature. Additionally, the mutations resulting in resistance may vary between different species or between resistant isolates of the same species. A list of candidate genes to examine for SNPs is presented.

The effects of macrocyclic lactone anthelmintics (MLs) on feeding by Trichostrongylus colubriformis nematodes in vitro were examined using inulin uptake as a measure of ingestion and electropharyngeograms as a record of the electrical events associated with pharyngeal pumping. Inulin uptake was inhibited by the 4 MLs tested (EC50s 0.045–4.57 nM), with an order of potency of eprinomectin (most potent), ivermectin, ivermectin monosaccharide, and ivermectin aglycone. The MLs caused both the frequency and amplitude of pharyngeal electrical events to decrease. In individual worms the inhibition of pump frequency preceded the inhibition of pump amplitude. The order of potency of the MLs as inhibitors of frequency was ivermectin aglycone, ivermectin, ivermectin monosaccharide and eprinomectin. The difference compared with the inulin assay results are probably due to the dynamics of drug uptake in the two systems. It was possible that the nematodes in the electrophysiology experiments were effectively orally ligated by enclosure of the worm's head in the recording pipette which contained no drug. Despite this difference in relative potencies, both the ingestion assays and the electrical events indicate that MLs are potent inhibitors of the pharynx in T. colubriformis in vitro. The sequence of effects on pharyngeal electrical activity suggests that ML action involves an initial inhibitory effect on the rate of pharyngeal contractions, followed by a decrease in the amplitude of the potentials associated with pharyngeal pumping events.

We investigated the effects of PF4 on Ascaris suum somatic muscle cells using a 2 electrode current-clamp technique. PF4 is a FaRP (FMRFamide-related peptide), originally isolated from the free-living nematode Panagrellus redivivus. PF4 caused hyperpolarization and an increase in chloride ion conductance when it was applied to the muscle cells of the Ascaris body wall. The delay between the application of the peptide and the appearance of the response was measured and compared with that of gamma-amino butyric acid (GABA), a compound that directly gates ion channels, and with PF1, a FaRP that acts via an intracellular signal transduction mechanism. The PF4 and GABA delay times were not significantly different; they were 1·51±0·11 sec and 1·22±0·10 sec respectively. The delay following application of PF1, 3·75±0·51 sec, was significantly longer. The rapid response to PF4 is consistent with direct gating of a chloride ion channel, which has not been described elsewhere in the literature.

A tegumental vesicle preparation from adult male Schistosoma mansoni was developed that allows the resolution of single ion-channel currents. Adult male schistosomes were exposed to a low pH (3·75) medium for a period of approximately 30 min at 37°C. During this period smooth vesicles formed from the tegument. Fluorescence microscopy following staining of the tegument with the dye, 5-N-[octadecanoyl]aminofluorescein (AF-18), transmission electron microscopy and scanning electron microscopy revealed that the vesicles were produced from the outer tegumental membrane. The fluorescence studies showed the presence of the double bilayer structure of the outer membrane in >41% of the vesicles. These studies suggested that the preparation is suitable for single-channel recording with the patch-clamp technique. Cell-attached and isolated inside-out patch recordings of ion-channel activity were obtained with giga-ohm resistance seals. Different types of ion-channel were recorded from tegumental vesicles from male schistosomes, illustrating the potential of the technique. The channels observed included: a non-selective cation channel (360 pS); a K+ channel (with a conductance of 115 pS in high bath-K conditions); and a Cl− selective channel (20 pS). The currents of these ion-channels may cross the double bilayer of the outer tegumental membrane.

SUMMARYPlasma membrane vesicles prepared from the bag region of the somatic muscle cells of the parasitic nematodeAscaris suumcontain high conductance, voltage sensitive, Ca-dependent chloride channels, suggested to be involved in the excretion of carboxylic acids produced by the anaerobic respiration of glucose (Valkanov, Martin & Dixon, 1994). The effect of altered pH on this channel was investigated using the patch-clamp technique and isolated inside-out membrane patches. Changes in pH had little effect on channel conductances and only a small effect on reversal potentials. Under control conditions (symmetrical pH 7·2) the channel had the highest probability of opening at ∼ — 35 mV (the resting membrane potential of the cell). At positive membrane potentials the probability of opening decreased. The Boltzmann equation was used to describe the relationship between membrane potential and probability of channel opening, and to calculate the effective gating charge. Reduction of external pH produced an increase in the probability of channel opening at hyper-polarized membrane potentials. An increase in internal pH caused a voltage-independent increase in the probability of channel opening and made the effective gating charge less negative. The effect of reducing internal pH was marked: the channel then opened most frequently at positive membrane potentials and the probability of opening at —35 mV was greatly reduced. The decrease in internal pH changed the polarity of the effective gating charge. A simple model was constructed to describe the effects of pH on channel gating.

SummaryAn electrophysiological preparation ofAscaris suumpharyngeal muscle suitable for recording changes of input conductance using a 2-microelectrode current clamp and pharmacological study is described. The preparation is shown to contain a glutamate-gated Cl (ion sensitive) channel sensitive to the avermectin analogue, milbemycin D. The application of glutamate produces a dose-dependent increase in Cl conductance and the effect of glutamate is potentiated by milbemycin D. Milbemycin D also produced a dose-dependent increase in input conductance.

SUMMARYThe patch clamp technique was used to investigate the action of the anthelmintic drug, oxantel, on nicotinic acetylcholine receptor (nAChR) currents recorded from vesicles of the somatic muscle cells of the nematode parasiteAscaris suum. The amplitudes of the currents were analysed at different membrane potentials to determine the single channel conductance. Also the open and closed durations were measured to determine the kinetic properties of the activated channel. Oxantel activated single nAChR currents throughout a concentration range 10–100 μM, these currents were not observed with oxantel-free pipette solutions. The mean open time of the activated channels at a membrane potential of –75 mV and a concentration of 10 μM was 1·34 ms. At higher concentrations the open times were shorter and voltage sensitive, decreasing in duration on hyperpolarization, thus suggesting open channel block. The kinetics were analysed using a simple channel block model. The forward block rate,K + B, increased with increasing oxantel concentration but showed little increase as the membrane was hyperpolarized.K + Bwas 2·41×107M−1s−1– 50 mV and 2·64 × 107M−1s−1at – 100mV. The unblocking rate constant,K – B, did exhibit voltage sensitivity being 443·6 s−1at – 50 mV and 86·8 s−1at –100 mV. Thus the blocking dissociation constantKB (= K – B/K + B)was 18·5 μM at –50 mV and 3·3 μM at –100 mV. The simple channel block scheme was found to be insufficient to explain fully the observations made; reasons for this are discussed.

Here we review recent studies on the mode of action of the cholinergic anthelmintics (levamisole, pyrantel etc.). We also include material from studies on the free living nematode Caenorhabditis elegans. The initial notion that these drugs act on a single receptor population, while attractive, has proven to be an oversimplification. In both free living and parasitic nematodes there are multiple types of nicotinic acetylcholine receptor (nAChR) on the somatic musculature. Each type has different (sometimes subtly so) pharmacological properties. The implications of these findings are: (1) combinations of anthelmintic that preferentially activate a broad range of nAChR types would be predicted to be more effective; (2) in resistant isolates of parasite where a subtype has been lost, other cholinergic anthelmintics may remain effective. Not only are there multiple types of nAChR, but relatively recent research has shown these receptors can be modulated; it is possible to increase the response of a parasite to a fixed concentration of drug by altering the receptor properties (e.g. phosphorylation state). These findings offer a potential means of increasing efficacy of existing compounds as an alternative to the costly and time consuming development of new anthelmintic agents.

There have been important developments in the field of veterinary parasitology over the last few years. This symposium was called to collect individuals together, who have made significant contributions to their field of study, to present and summarize their work.I would like to pause for a moment before introducing the Symposium in this preface to comment on the sad loss of Professor Peter Nansen, a particularly eminent Danish scientist who developed our field of study. I, like many others, remember him with affection. He was a very helpful colleague and outstanding leader of the Danish Centre for Experimental Parasitology, Royal Veterinary and Agricultural University, Frederiksberg C. We are all saddened by his death and will continue to carry our memories of him with us.