Parasites that often grow anaerobically in their hosts have adopted a fermentative strategy relying on the production of partially oxidized end products, including lactate, glycerol, ethanol, succinate and acetate. This review focuses on recent progress in understanding acetate production in protist parasites, such as amoebae, diplomonads, trichomonads, trypanosomatids and in the metazoan parasites helminths, as well as the succinate production pathway(s) present in some of them. We also describe the unconventional organisation of the tricarboxylic acid cycle associated with the fermentative strategy adopted by the procyclic trypanosomes, which may resemble the probable structure of the primordial TCA cycle in prokaryotes.

Although schistosomes were thought to be one of the few parasitic helminths that do not produce succinate via fumarate reduction, it was recently demonstrated that sporocysts of Schistosoma mansoni produce, under certain conditions, succinate in addition to lactate. This succinate production was only observed when the respiratory chain activity of the sporocysts was inhibited, which suggested that succinate is produced by fumarate reduction. In this report the presence of essential components for fumarate reduction was investigated in various stages of S. mansoni and it was shown that, in contrast to adults, sporocysts contained a substantial amount of rhodoquinone which is essential for efficient fumarate reduction in eukaryotes. This rhodoquinone was not made by modification of ubiquinone obtained from the host, but was synthesized de novo. Furthermore, it was shown that complex II of the electron-transport chain in schistosomes has the kinetic properties of a dedicated fumarate reductase instead of those of a succinate dehydrogenase. The presence of such an enzyme, together with the substantial amounts of rhodoquinone, shows that in S. mansoni sporocysts succinate is produced via fumarate reduction. Therefore, the energy metabolism of schistosomes does not differ in principle from most other parasitic helminths, which are known to rely heavily on fumarate reduction.

In earlier studies on the supposedly anaerobic metabolism of Leishmania promastigotes it was suggested that the reduction of fumarate to succinate functions as the main electron sink during anoxia. Interestingly, however, our preliminary results demonstrated that rhodoquinone, an essential component for efficient fumarate reduction in eukaryotes, was absent in L. infantum promastigotes. Therefore, we re-investigated the energy metabolism and succinate production of these promastigotes. Our studies demonstrated that L. infantum promastigotes could, to a certain extent, survive periods without respiration but had a low capacity for anaerobic metabolism. When oxygen could not be used as terminal electron acceptor, the degradation of glucose was severely inhibited, forcing the parasite to reduce its energy expenditure, which resulted in inhibited motility and proliferation. In addition, we studied the mechanism of succinate production under aerobic conditions and showed that in L. infantum promastigotes this succinate was mainly produced via an oxidative pathway, the Krebs cycle, and not significantly via fumarate reduction, which correlated with the absence of rhodoquinone. Taken collectively our studies show that L. infantum promastigotes depend mainly on respiratory chain activity for energy generation, have a poor capacity for anaerobic functioning, and go into metabolic arrest during anoxic conditions.