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Innate defence: evidence for memory in invertebrate immunity.

Acquired immunity in vertebrates is characterized by immunological memory and specificity, whereas the innate defence systems of invertebrates are assumed to have no specific memory. Here we use a model system of a copepod, which is a minute crustacean, and a parasitic tapeworm to show that the success of reinfection depends on the antigenic resemblance between the consecutively encountered parasites. This finding indicates that an invertebrate defence system may be capable of specific memory.

Animals↗

Vaccination against cestode parasites.

Cestodes are tapeworm parasites. Infection in the intermediate host with larval (metacestode) parasites causes medically and economically important diseases known as hydatidosis and cysticercosis. Immunization against experimental infection with metacestode parasites has been highly successful, in marked contrast with the relative ineffectiveness of vaccines against infection with most parasitic organisms. High levels of immunity against a challenge infection with taeniid cestode eggs can be stimulated by immunization with extracts of the parasites, particularly with extracts of the oncosphere life-cycle stage. This led to the production of a recombinant antigen vaccine against infection in sheep with the parasite Taenia ovis, the first highly effective, non-living vaccine against a parasitic infection in animals or humans. This paper reviews immunity to the adult and metacestode life-cycle stages of cestode parasites, development and application of the T. ovis vaccine, and prospects for vaccines against other cestode infections.

Animals↗

Spinal cysticercosis. Case report and review.

Cysticercosis is the commonest parasitic disease to affect the central nervous system (CNS). According to the World Health Organisation (1988), more than 2.5 million people worldwide are infected. Neurocysticercosis (NCC) is caused by the encysted larval form (porcine tapeworm) of Taenia solium (Cysticerus cellulosae). The ways in which the eggs of T Solium penetrate the CNS are illustrated in Table I. Involvement of the spinal cord in NCC varies between 1% and 5%. The isolated medullary form is very rare, only 50 cases having been reported up to 1988. The appearance of a spinal cord compression syndrome (SCCS) is unusual and late, according to reported series, the largest being that of Sotelo with 753 cases of NCC, including 10 causing SCCS, corresponding to 1.4%; also the classic Dixon and Lipscomb series of 450 NCC with only one patient with SCCS.

Adult↗

Cysticercosis cellulosae. An unusual cause of a labial swelling.

A case of cysticercosis cellulosae presenting as an isolated swelling of the labial mucosa, clinically diagnosed as a mucocele, is described. The important implications of such a diagnosis are discussed along with a resumé of the natural history of Taenia solium, the pork tapeworm.

Adult↗

Correlation of antigen specific IgG and IgG(T) responses with Anoplocephala perfoliata infection intensity in the horse.

There is increasing interest in the application of serological methods to macro-parasite infections to indicate infection intensity, which in turn is related to pathogenicity. Colic is the single most important cause of mortality in horses and there is evidence that a proportion of colic cases are associated with infection with the intestinal cestode Anoplocephala perfoliata. In order to develop better tools to investigate this association, the correlation between antigen-specific equine IgG and IgG(T) and infection intensity of A. perfoliata was investigated. Affinity purification of a 12/13 kDa protein doublet from crude excretory/secretory (E/S) products, and its use in enzyme linked immunosorbent assays (ELISA) is described. Its use in the immunodiagnosis of equine cestodosis and the correlation of anti-12/13 kDa IgG and IgG(T) with parasite burden is investigated using sera from 94 horses of known tapeworm infection intensity. The anti-12/ 13 kDa IgG and IgG(T) ELISAs gave correlation coefficients with infection intensity of 0.56 and 0.63 respectively. Linear regression analysis also indicated that anti-12/ 13 kDa IgG(T) was the best predictor of infection intensity. The decay of anti-12/13 kDa IgG(T) in horses following the elimination of A. perfoliata is demonstrated for four horses. Specificity of the anti-12/13 kDa IgG(T) ELISA is investigated with sera from 33 A. perfoliata negative horses with other helminth infections. Immunoblotting studies demonstrate no cross-reactivity between A. perfoliata 12/13 kDa antigen and the protein antigens of other helminths. It is concluded that assay of anti-12/13 kDa IgG(T) provides a useful tool for the assessment of A perfoliata infection intensity for clinical diagnosis and for epidemiological studies.

Animals↗

Immunoglobulin E and mast cell responses are related to worm biomass but not expulsion of Hymenolepis diminuta during low dose infection in rats.

It is well known that the destrobilation and later expulsion are characteristics of multiple Hymenolepis diminuta infections in rats. This process is suggested to be mediated by a variety of host cellular responses. It has also been suggested that immunoglobulin (Ig) E may have a beneficial role for some cestodes including H. diminuta. We examined the intestinal mast cell and serum IgE responses to a 10-H. diminuta infection in three different rat strains. Tapeworm infection induced no increased mast cell and IgE responses in F344 rats in which neither worm biomass nor worm burden decreased during 6 weeks of observation. The number of mast cells and amounts of serum rat mast cell protease (RMCP) II and IgE markedly increased from 3 weeks postinfection (p.i.) in BN rats. The worm biomass in BN rats was significantly lower than that in F344 rats, but worm burden was not different from that in F344 rats at 3 or 6 weeks p.i. In DA rats, the number of mast cells and levels of serum RMCP II and IgE increased at 6 weeks but not at 3 weeks p.i. Although numbers of mast cells and serum RMCP II and IgE levels were lower in DA rats than in BN rats, smaller and fewer worms were recovered in DA rats than in F344 and BN rats at from 3 and 6 weeks p.i. Worms were recovered from all of F344 and BN rats, while only 40% of DA rats harboured worms at 6 weeks p.i. These results suggested that the worm biomass was related to mast cell and IgE responses, but these responses were not required for worm expulsion during low dose H. diminuta infection in rats.

Animals↗

An enzyme-linked immunosorbent assay for detection of IgG1 antibodies specific to human cystic echinococcosis in Egypt.

Human cystic hydatidosis (cystic echinococcosis) is a chronic zoonotic disease that results from infection with the dog tapeworm Echinococcus granulosus. In Egypt, cystic echinococcosis (CE) is recognized in slaughtered livestock by veterinarians, however, there is little information about human CE infection rates. We describe an immunological assay useful for the diagnosis of human cystic hydatidosis. Sera were collected from surgically confirmed hydatid cases (34), nonendemic subjects free from parasitic infection (20) and from subjects (109) infected with other helminths (Hymenolepis nana, Schistosoma mansoni, Fasciola hepatica and Ancylostoma duodenale). Hydatid cyst fluid (HCF) of camel origin was used as antigen in an ELISA format to measure total E. granulosus specific IgG antibodies and IgG subclasses. Sensitivity measurements of total IgG, and IgG1-4 were 100, 100, 79.4, 61.8 and 55.9%, respectively, whereas respective specificity reached 65.1, 97.7, 98.4, 96.1 and 83. 7%. The diagnostic value of measuring IgG1 (97.7%), as assessed by a rating index (J) for combined sensitivity and specificity, was superior to total IgG (65.1%) and IgG2-4 (77.8, 57.9 and 39.6%, respectively). These findings set the stage for field evaluation of the IgG1 assay in areas endemic with human cystic hydatidosis.

Adolescent↗

Hydatid disease of bone: a mimic of other skeletal pathologies.

Skeletal hydatidosis results from the deposition of the larval form of the Echinococcus, a genus of tapeworm. The incidence of bone disease is extremely low as most larvae are trapped by the liver and lung upon release of the embryo into the portal blood stream. The interpretation of imaging studies can prove very confusing because bone changes evolve with time, and the non-specificity of these findings often leads to a mistaken diagnosis. We present the case of a 35-year-old woman with long-standing pain in the left hip joint in which the findings on CT were thought of as being either tuberculous or neoplastic in nature. The result of a CT-guided biopsy and another done following surgery concurred on an unexpected diagnosis of a hydatid cyst. This case illustrates that in the absence of a high index of suspicion for echinococcal infection, the semblance of imaging findings of hydatid disease in bone to those of other skeletal pathologies can lead to misinterpretation.

Adult↗

[Euzetiella tetraphylliformis n. gen., n. sp., (Eucestoda: Proteocephalidae), parasite of the neotropical sweat-water fish Paulicea luetkeni (Siluriforme, Pimelodidae)].

Description of a new genus and new species of proteocephalid tapeworm in Paulicea luetkeni, which shows superficial resemblance to tetraphyllids, especially in its gravid proglottides. Euzetiella tetraphylliformis belongs to the Proteocephalidae, Proteocephalinae due to the presence of medullary gonads as well as the shape of the scolex and the presence of uniloculate suckers. Furthermore, this species is characterized by an apolytic strobila, which represents an exception within the Proteocephalidea.

Animals↗

The many faces of cysticercosis.

Cysticercosis in humans results from infestation with the larval stage of the parasite Cysticercus cellulosae of the tapeworm Taenia solium. Man normally acts as a definitive host. However, man can occasionally be the intermediate host, when cysticercosis becomes clinically manifest. Larvae lodge in the target organs, the brain, eyes, spine and skeletal muscles, where their appearances are highly suggestive or specific. We present a spectrum of such images, as encountered in Western India.

Animals↗

Hydatid disease of the tarsal bones. A case report.

Hydatid disease is caused by the larval form of the tapeworm Echinococcus. Osseous cysts are rare and very few cases of foot infestation have been reported. We present the case of a 51-year-old woman who developed a palpable mass at the medial dorsal aspect of the right midfoot. Radiological examination showed cystic lesions in the cuneiforms and the navicular. The lesion was explored and several small cysts containing clear fluid were found. They were evacuated and the bone was curetted. The diagnosis of E. granulosus infestation was made histologically. After 15 years' follow-up there were no signs of recurrence. Osseous echinococcosis is a rare disease that may present as infective or neoplastic pathology. A high index of suspicion is necessary for its diagnosis, especially in patients who live in or travel to sheep-raising areas where hydatid disease is endemic.

Curettage↗

[Painless orbital swelling after sojourn in tropics. Cysticercosis and other parasitic eye diseases].

BACKGROUND: The differential diagnosis of painless orbital swelling is complex and based on radiological and physical examination as well as laboratory tests. Due to increasing tourism to exotic countries a thorough history is important to observe diseases which are rare in industrialised countries but frequent in developing countries. PATIENT: A 30-year-old man complained about a painless orbital swelling in the absence of general symptoms. Orbital examination revealed a normal globe. MRI scan and B-scan ultrasounds showed an orbital cyst with a diameter of 1 cm. The patient's history disclosed lengthy travel to India as well as South East Asia. RESULTS: Histopathological examinations following excision of a whitish intraorbital mass showed a cream-white, thin walled cyst with a single central invaginated scolex with suckers and hooklets. This finding is characteristic for cysticercosis. CONCLUSIONS: Cysticercus cellulose is the larval stage of the pork tapeworm Taenia solium. It is transmitted by ingestion of contaminated food or water. Ocular affection is reported concerning the vitreous or subretinal localisation, less often in the anterior segment, subconjunctiva or orbita. Especially after trips to tropical regions, parasitic diseases should be kept in mind when dealing with unusual eye symptoms. Besides cysticercosis there are e.g. echinococcosis, onchocercosis (river blindness) and infections with toxocara or Loa loa.

Adult↗

[Cysticercosis as a rare cause of a tumor of the tongue].

This article presents the case of a 19-year-old male patient with cysticercosis in the tongue and the CNS. It also presents images of histological sections of the cysticercus parasite situated in the tongue muscles and CT and MRI images of cerebral clusters. Cysticercosis is a disease caused by the hydatid of the porcine tapeworm (cysticercus). Cysticercus normally dwells in the organs of pigs. Infection of human tissues is much more unusual and affliction of the oral cavity can be regarded as a rarity. In this case the patient complained about a painless, clearly delineated induration in the anterior third of the left half of the tongue. Histological investigation resulted in the diagnosis of cysticercosis. The patient was referred to an Institute for Tropical Medicine which confirmed the diagnosis serologically. CT and MR images revealed two additional lesions in the CNS. After treatment with anthelminthics these lesions in the CNS disappeared.

Adult↗

Endoscopic discovery and capture of Taenia saginata.

The authors report the first case of endoscopic finding and removal of a beef tapeworm (Taenia saginata). The parasite was discovered in the duodenal bulb of a 72-year-old woman, who complained of epigastric pain.

Aged↗

[Neurocysticercosis].

A 49-year-old woman from Croatia, resident in Switzerland for 22 years, had a history of headaches and arterial hypertension for 8 years. While in hospital for assessment and treatment she developed focal seizures. She had an eosinophilia (10%) and computed tomography of the skull demonstrated cysts and multiple calcified foci in the left cerebral hemisphere. Antibodies against Taenia solium antigen were found in both serum and cerebrospinal fluid. Anthelminthic treatment with albendazole (15 mg/kg daily for 25 days) and anticonvulsive treatment with phenytoin (serum levels between 10 and 20 mg/l) markedly improved the symptoms and the cysts regressed. Neurocysticercosis, caused by the larvae of the pork tapeworm, is occurring even more frequently because of the migration of people from countries where the disease is endemic.

Albendazole↗

[Taenia crassiceps infection in AIDS].

A 33-year-old patient with AIDS, and a history of episodes of Pneumocystis carinii pneumonia and cerebral toxoplasmosis, developed a subcutaneous paravertebral infiltrate, which at first resembled a haematoma. Over a period of several weeks, the lesion spread to cover almost the entire back. Initially, numerous investigations failed to reveal the aetiology. His general condition worsened progressively, and intermittent bleeding into the soft tissue of the back occurred, requiring transfusion. This was associated with the development of an isolated deficiency of clotting factor V and a fall in Quick values to 10%. On the 22nd day after admission, the infiltrate ruptured spontaneously, releasing blood and a large number of whitish spherical masses 2-3 mm in diameter. These were identified as Cysticerci longicolles, the larval form of Taenia crassiceps, a tapeworm occurring in Canidae. The blood clotting values returned to normal within two days of incision of the infiltrate and commencement of therapy with mebendazole (6 g/day) and praziquantel (3.6 g/day). The infiltrate subsequently regressed almost completely. After combination treatment for 2 weeks, treatment was continued with praziquantel alone, which, however, the patient stopped himself after 10 weeks. A recurrence at the same site 4 months later was successfully treated with a further course of mebendazole and praziquantel.

Acquired Immunodeficiency Syndrome↗

Medical treatment for neurocysticercosis characterized by giant subarachnoid cysts.

BACKGROUND: Infection with the larval form of the pork tapeworm, Taenia solium, can lead to the development of cysts in the brain. Surgical removal of cysts has been the accepted treatment for neurocysticercosis characterized by giant cysts when there is associated intracranial hypertension. METHODS: We describe 33 patients whom we treated medically for malignant forms of neurocysticercosis. All patients had evidence of intracranial hypertension and subarachnoid cysts at least 50 mm in diameter. All patients received 15 mg of albendazole per kilogram of body weight per day for four weeks. Ten patients were also treated with 100 mg of praziquantel per kilogram per day for four weeks. Seventeen patients received a second course of albendazole, three received a third course, and one received a fourth course. During the first cycle of treatment, all patients also received dexamethasone. Five patients had previously undergone neurosurgery for giant cysts. RESULTS: After a median of 59 months of follow-up (range, 7 to 102), the condition of all 33 patients had improved, and the cysts had disappeared or become calcified. Of the 22 patients with a history of seizures, only 11 continued to receive antiseizure medications. The median quality-of-life score on the Karnofsky scale improved from 40 to 100. Fifteen patients received a ventriculoperitoneal shunt because of hydrocephalus. Four patients had persistent sequelae (bilateral partial optic atrophy, stroke, or diplopia) of the cysts. CONCLUSIONS: Intensive medical treatment can be effective in patients with neurocysticercosis characterized by giant cysts. Neurosurgery may be required only when there is an imminent risk of death.

Adolescent↗

A case of subcutaneous cysticercosis (Cysticercus cellulosae cutis).

Cysticercosis is an infection resulting from the larval form of the pork tapeworm, and domestic infection is rare in Japan. We report a case of Cysticercus cellulosae cutis in a Japanese woman who was thought to be infected in an endemic area and offer a brief review of the literature.

Animals↗