United States
                     Environmental Protection
                     Agency
 Health Effects
 Research Laboratory
 Research Triangle Park NC 27711
                     Research and Development
 EPA/600/S1 -87/011  Jan. 1988
4>EPA          Project  Summary

                     Cytochemical  Methods  for
                    Assessing  Giardia  Cysts
                    Viability
                     Donald G. Lindmark
                      Because of the high incidence, symp-
                    tomology, and waterborne dissemina-
                    tion of Giardia, improved methods for
                    determination  of viability of cysts
                    detected after isolation from  water
                    systems is necessary to assess poten-
                    tial danger to human health.
                      The viability of Giardia cysts has been
                    assessed by eosin exclusion, in vitro
                    excystation, and animal infectivity.
                      While each of these methods has its
                    own value,  none are both rapid and
                    reliable.
                      The objective  of this study was to
                    develop a reliable, rapid, microscopi-
                    cally read method for determining the
                    viability  of Giardia cysts which is
                    comparable to excystation and would
                    provide a more practical method of
                    estimating cyst viability.
                      Though methods dependent on cyst
                    metabolism such as the activity of
                    pyruvate: ferredoxin oxidoreductase
                    (PFOR) and cell respiration gave prom-
                    ising results with trophozoites,  they
                    proved unreliable with cysts.
                      Hence, exclusion of the fluorescent
                    dye,  3-(Dansylamido)-phenyl boronic
                    acid (FluoroBora I) from Giardia muris
                    cysts was compared with excystation
                    as a measure of cyst viability. The effect
                    of 22 different chemicals on excysta-
                    tion was determined and compared
                    with the exclusion of the fluorescent
                    dye FluoroBora I (FBI) under identical
                    conditions. These data indicate that the
                    dye exclusion method has potential for
                    use as an alternative method to excys-
                    tation as a measure of cyst viability.
                      Preliminary evidence  suggests that
                    the method, with some modifications,
                    has the potential for use in the deter-
                    mination of the  viability of Giardia
                    lamblia cysts.
                      This  Project Summary was devel-
                    oped by EPA's Health Effects Research
Laboratory, Research Triangle Park,
NC. to announce key findings of the
research project  that is  fully docu-
mented in a separate report of the same
title  (see  Project Report ordering
information at back).
Introduction and Project Goals

  Giardia lamblia is the most common
human intestinal protozoan parasite
reported in the United States and Eng-
land. The organism exists in two mor-
phologically distinct forms, the tropho-
zoite and the cyst. The infective cyst form
is transmitted via the fecal-oral route.
  The high incidence, symptomology and
waterborne dissemination of Giardia has
resulted in improved methods for cyst
detection in water systems.  However a
rapid, simple,  reliable method for deter-
mining the viability of cysts, detected in
water  systems,  and exposed to  water
treatment procedures is needed.
  The viability of Giardia cysts has been
assessed  by  eosin  exclusion, in vitro
excystation, and animal infectivity. While
each of these methods has its own value,
none  are  both  rapid  and reliable.
Although eosin exclusion  is a rapid
method, it indicates higher cyst viability
than can be demonstrated by excystation
and shows little correlation with excys-
tation. Excystation is the most frequently
used method for determining  cysts
viability.  It is tedious (2-3 h), and
subjective. It cannot be used for  deter-
mining the viability of individual or small
numbers of cysts. The cost, time and
large numbers of  cysts required  to
perform animal infectivity studies make
the method impractical for routine use.
  The  objective of  this study was  to
develop a reliable, rapid, microscopically
read method for determining the viability

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of Giardia cysts which when compared
to excystation would  provide a  more
practical  method of estimating  cyst
viability. The initial studies into develop-
ing an  assay for  viable cysts  were
dependent on various metabolic param-
eters such as cyst respiration and specific
enzyme activities.  The research  was
based on some preliminary data on cyst
metabolism  obtained  in  the  author's
laboratory. Cysts of G. lamblia respire m
the presence of Qz without added exo-
genous substrate at approximately 1/10
the rate  of trophozoites (8  nmoles Oz
consumed mm"1 mg protein"1 at  37°C).
Cysts after  activation at  low pH and
subsequent  placement  in  nutrient
medium increase their respiration five
fold. The  enzyme, pyruvate: ferredoxin
oxidoreductase (PFOR)—a major enzyme
in cell energy metabolism and an enzyme
found only in  anaerobes such as Giar-
dia—is  active in cyst homogenates.
These data, though preliminary, were
used in  part in our attempts to develop
a  metabolic  dependent  direct  micro-
scopic measure of cyst viability.
  Initially, attempts were made to assess
viability with  indicators  of  metabolic
activity.  These metabolic studies using
PFOR and cell respiration were equivocal
in that they were not effective with cysts,
Triton treated  cysts or induced cysts for
measuring cyst viability. Unlike respira-
tion,  PFOR  activity  as  measured  by
accumulation  of  nitroblue tetrazolium
(appearance of a  blue color  throughout
the cell) could be used for determining
G. lamblia trophozoite viability. Neither
method proved useful for determining
cyst viability possibly because of cyst
permeability.
  In  1982  investigators  published  a
method called boronic acid-dependent
phase transfer, or "boradeption." In this
method,  specific fluorescent  water-
insoluble boronates are excluded by non-
viable cells in vitro. When this technique
was attempted with Giardia, the  results
using FBI with Giardia lamblia trophoz-
oites, were  similar to those found  by
previous investigators using CHO cells,
i.e , non-viable cells excluded the dye. In
contrast, viable Giardia cysts  excluded
the dye. This exclusion method using G.
muris cysts, when compared with excys-
tation, showed a high degree of asso-
ciation and a higher degree of reproduc-
ibility and precision  as  compared  to
excystation. Preliminary evidence sug-
gests that the method, with  some mod-
ifications, has  the potential for use in the
determination of the viability of Giardia
lamblia cysts.
  The goals of  the project were the
following:

  1.  to  develop  a simple and quick
     microscopically read  method  for
     determining Giardia cyst viability,
     useful to investigators with min-
     imal training.

  2.  to correlate the new method with
     the currently accepted method  of
     determining   cyst    viability,
     excystation.

  3.  to use the new method with G.
     lamblia as well as G. muris cysts.

  4.  to establish the reliability of the
     new method on low  numbers  of
     cysts (<50).

  5.  to assess the compatibility of the
     new method with immunological
     detection methods for Giardia cysts
     in water samples.

Conclusions and
Recommendations
a.  Enzymatic and metabolic  methods
    for  determining viability of Giardia
    cysts proved unfeasible at the micro-
    scopic level.

b.  Exclusion of the fluorescent dye  3-
    (Dansylamido)-phenyl  boronic  acid
    (FluoroBora I,  FBI)  from  Giardia
    muris cysts shows good correlation
    (at cyst viability > 60%) with excys-
    tation as a method for  determining
    cyst viability when viability of cysts
    was measured after contact with
    different disinfectants under identi-
    cal conditions.

c.  The FBI method is simple to perform,
    rapid (5 mm) and can be microscop-
    ically read.

d.  For untreated cysts, the FBI method
    shows a higher degree of precision
    between investigators than excysta-
    tion at viability levels above 60%.

e.  The FBI method is  less subjective
    than excystation since (1) it relies on
    the observation of fluorescence  or
    non-fluorescence as a measure of
    viability,  whereas   excystation
    requires differentiation between
    several stages of excysting  orga-
    nisms and (2) the excystation proce- I
    dure is  long and  tedious  (2-3  h)
    requiring control  of  a number  of
    variables (temperature, pH, reducing
    conditions, etc.) not encountered in
    the FBI method.

f.   The FBI  method  can be used  to
    assess the efficacy of disinfectants
    in a rapid  manner even if these
    compounds cause clumping. Clump-
    ing  makes the excystation  method
    not possible because of the difficulty
    in counting.

g.   The FBI  method has not yet been
    shown to be  compatible with  an
    immunofluorescence method  for
    detecting  Giardia  cysts  in water
    samples.

h.   FBI estimates of viability are consist-
    ently higher than by excystation.

i.   FBI can be used to estimate viability
    of G. lamblia cysts if the FBI  method
    is compared with motility of trophoz-
    oites inside the cyst  during excys-
    tation in  contrast to excystation. This
    may point to the suggestion that low
    excystation rates of G. lamblia may
    be due to the  excystation environ- i
    ment.

j.   Based on the available data, the FBI
    method  has the potential  for use in
    the rapid assessment of Giardia cyst
    viability  in the laboratory. The  FBI
    method  can be  used for a  quick
    assessment of disinfectants and
    chemotherapeutic agents  in the
    laboratory.

k.   Recommendations  for further work
    include:

    1.  comparison of optimized G.
        lamblia excystation method.

    2.   comparison of  excystation with
        FBI  at  viability 0-100  (esp <
        50%).

    3.  if no optimal G. lamblia excys-
        tation, in depth comparison of
        motility within the cyst  and FBI
        under conditions of chemical
        treatment.

    4.   improve compatibility of FBI with
        existing detection methods (con-
        ventional and  immunofluores-
        cence).                       A

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     Donald G. Lindmark is with Cleveland State University, Cleveland, OH 44102.
     Judith F. Sauch is the EPA Project Officer (see below).
     The complete report, entitled "Cytochemical Methods for Assessing  Giardia
       Cysts Viability." (Order No. PB 88-124  748/AS; Cost:  $14.95; subject to
       change) will be available only from:
             National Technical Information Service
             5285 Port Royal Road
             Springfield. VA 22161
             Telephone: 703-487-4650
     The EPA Project Officer can be contacted at:
             Health Effects Research Laboratory
             U.S. Environmental Protection Agency
             Research Triangle Park, NC 27711
United States
Environmental Protection
Agency
Center for Environmental Research
Information
Cincinnati OH 452GO
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                                                                                      (   JAN2 9 83   I ^,v;,rE !

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Official Business
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