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DNA vaccines against tropical parasitic diseases.

Parasitic diseases caused by protozoan and helminth parasites are among the leading causes of morbidity and mortality in tropical and subtropical regions of the world. Unfortunately, at present, there is no vaccine against any human parasitic disease. Conventional vaccine methods have largely failed against parasitic infections. This is due, in part, to the complexity of the parasite life cycle, the ability of the parasite to evade the immune system, and difficulties in identifying and eliciting the desired protective immune responses. The discovery of DNA vaccines has renewed hope for vaccine development against parasites. In the last decade, DNA vaccines were successful in inducing at least partial protection against several parasitic diseases. This review discusses the latest developments in DNA vaccines against tropical parasitic diseases.

Animals↗

Radiological manifestations of parasitic disease.

Parasitic diseases are very common on a worldwide basis. In certain cases radiological features are of importance both for primary diagnosis and for detection of complications of infestation. This review concentrates on parasitic diseases of radiological interest.

Bone and Bones↗

Pyogenic abscesses and parasitic diseases.

Parasitic diseases which during their course in the host switch the immune system from a T helper 1 to a T helper 2 response may be detrimental to the host, contributing to granuloma formation, eosinophilia, hyper-IgE, and increased susceptibility to bacterial and fungal infections. Patients and animals with acute schistosomiasis and hyper-IgE in their serum develop pyogenic liver abscess in the presence of bacteremia caused by Staphylococcus aureus. The Salmonella-S. mansoni association has also been well documented. The association of tropical pyomyositis (pyogenic muscle abscess) and pyogenic liver abscess with Toxocara infection has recently been described in the same context. In tropical countries that may be an interesting explanation for the great morbidity of bacterial diseases. If the association of parasitic infections and pyogenic abscesses and/or fungal diseases are confirmed, there will be a strong case in favor of universal treatment for parasitic diseases to prevent or decrease the morbidity of superinfection with bacteria and fungi.

Adolescent↗

The evolution of parasitic diseases.

Parasites are characterized by their fitness-reducing effect on their hosts. Studying the evolution of parasitic diseases is an attempt to understand these negative effects as an adaptation of the parasite, the host, both or neither. Dieter Ebert and E. Allen Herre here discuss how the underlying concepts are general and are applicable for all types of disease-producing organisms, broadly defined here as parasites. The evolutionary processes that lead to the maintenance of the harmful effects are believed to be characterized by genetic correlations with other fitness components of the parasite. Depending on the shape of these correlations, any level of virulence can evolve.

Journal Article↗

The immunological aspects of parasitic diseases.

Parasitic infections present a paradoxal immune situation: the host develops a normal immune response against the parasite but, in general, this response does not result in its elimination. An equilibrium is established which is essential to the survival of the parasite, involving a diminished state of the host, but not necessarily lethal. The mechanisms that allow the parasite to escape the immune defence are varied and include antigenic variation, mimetism, anatomical seclusion, immunomodulation, etc.

Adaptation, Physiological↗

[The blood platelets in parasitic diseases].

Parasitic invasions are the source of foreign antigens and exotoxins which trigger local or systemic inflammatory processes. Antibody-dependent cellular toxicity is the major antiparasitic defensive mechanism, with eosinophils as the effector cells. Macrophages, neutrophils and platelets develop the cytotoxic activity against antibody-coated parasites. Blood platelets participate in various stages of blood clotting, in sclerosis, coronary disease, neoplasms, inflammatory processes and in allergic and immune reactions. Blood platelets actively participate in defense mechanisms of the organism, e.g. in antiparasitic immunology. Platelet stimulation may be a result of direct contact with parasite, increase IgG and/or IgE concentration, the presence of complement components, CRP or lymphokins. Blood platelets reveal cytotoxic activity through release various inflammatory mediators, phagocytic activity and cooperation with other cells of immunologic system.

Animals↗

Musculoskeletal syndromes in parasitic diseases.

Parasitic infestation can induce a variety of rheumatic syndromes as a result of infiltration of musculoskeletal structures by parasites or an immune mediated mechanism. Parasite-induced symptoms should be considered when arthritis, enthesitis, myositis, or vasculitis develop in patients residing in endemic areas and in certain subsets of the population of developed countries, for example, migrants, travelers, and immunocompromised individuals. Diagnosis is based on the demonstration of infection with a pathogenic parasite, lack of response to anti-inflammatory agents, and improvement following antiparasitic therapy. Treatment consists of erradication of the parasite.

Arthritis↗

[Detection of parasites and symptoms of parasitic diseases. 2: Parasites of the gastrointestinal tract, tissue and organ parasites, ecto- and skin parasites].

Intestinal parasites are Giardia lamblia, Cryptosporidium parvum, Entamoeba histolytica, hookworms, ascaris, tape worms and others. As to organ parasites, their life-threatening courses are pointed out: amebiasis in the intestine, liver, lung and brain, toxoplasmosis in the brain, lung and heart muscle, including the danger for the child of a pregnant woman with an acute infection, West African sleeping sickness with encephalitis, the East African form with polyserositis, South American Chagas' disease with intestinal and myocardial involvement, visceral leishmaniasis Kala Azar, the filariasis Onchocerca volvulus with threatening blindness, the dog tapeworm with cysts and Echinococcus multilocularis with carcinoma-like infiltration of the liver and other organs, cysticercosis of the brain, eye and muscle tissue; partly generalizing parasitoses in immuno-suppressed including AIDS patients, finally skin parasites as causes of disease (e.g. scabies), and as potential carriers of pathogens.

Diagnosis, Differential↗

Nongenetic variation, genetic-environmental interactions and altered gene expression. II. Disease, parasite and pollution effects.

The use of protein electrophoretic data for determining the relationships among species or populations is widespread and generally accepted. However, there are many confounding factors that may alter the results of an electrophoretic study and may possibly allow erroneous conclusions to be drawn in taxonomic, systematic or population studies. Measured enzyme activities can also be affected significantly. Parasites, disease and pollution can affect levels of enzyme activity, and electrophoretic results can be affected both quantitatively and qualitatively. Blood serum is particularly vulnerable to variation to variation due to disease, pollution or parasites because damaged tissues may release tissue-specific enzymes into the bloodstream. Capture, handling, chemical treatments, bacteria, natural toxins and consumed food may also contribute to variation. Potential pollution impacts at specimen collection sites should be investigated, and study organisms should be inspected and/or treated for detection and elimination of parasites and disease.

Animals↗

Tissue parasitic diseases in Korea.

Parasitic disease is still important subject in the field of infectious diseases in Korea considering it's number and morbidity. Recently there was conspicuous reduction of parasitic disease in terms of soil-transmitted nematodiasis, but parasitism affecting organs other than intestinal tract is still a considerable problem. This survey covers the parasitic diseases cross-sectioned at a pathology laboratory of a referral hospital, trying to elucidate the significance of its relative frequency and also to describe some histopathological changes made by different parasites. Entire pathological materials of parasitic diseases, that were referred, examined and confirmed at the Department of Pathology, Seoul National University Hospital from 1968 to 1987, were used for the study. There was a total of 594 cases of tissue parasitic diseases. This number accounted for 0.33 per cent of total accessions of surgical pathology. There occurred average 30 cases of tissue parasitic disease each year at this Hospital. Protozoal diseases were constituted of 15 cases of amebiasis, 7 cases of leishmaniasis (imported) and 5 cases of Pneumocystis carinii infections. Among helminthic infections cysticercosis was the most common (425 cases), and was followed by paragonimiasis (35 cases), sparganosis (31 cases), clonorchiasis (32 cases) and ascariasis (16 cases). In addition there were 4 cases of anisakiasis, 2 cases of fascioliasis, 2 cases of echinococcosis (imported) and a case of strongyloidiasis and a case of metagonimiasis respectively. It is emphasized that imported parasitic diseases such as leishmaniasis and hydatid disease become steadily found nowadays. Schistosomiasis is another possible imported disease, but not found in this series. And certain cestodiasis particularly cysticercosis and sparganosis should be the subjects of epidemiologic re-evaluation in view of steady occurrence of their morbidity.

Adult↗

[Parasitic diseases are a risk factor of inflammations of the small pelvis organs. Trichomoniasis].

Clinical and laboratory studies were made in 2259 persons by using serological assays, including cultural and bacterioscopic assays in 1824 and 363 persons, respectively, in order to indicate Trichomonas infection among men, women, and 2-15-year-old children who had chronic inflammation of the urogenital system, as well as among children aged 2 months to 16 years who had a severe somatic disease. Parasitic cenoses of the urogenital tract were studied in women with trichomoniasis and reproductive dysfunction. Trichomonas invasion is an etiological factor of inflammatory small pelvic diseases, chronic prostatitis, reproductive dysfunction in males and females. Furthermore, trichomoniasis is an essential factor, that predisposes to recurrent viral infections: genital herpes and pointed condyloma, and substantially increases the risk of birth of babies with clinical manifestations of intrauterine infection. According to the studies, a laboratory diagnosis of trichomoniasis should be made by cultural assay due to the low sensitivity of bacterioscopy by sampling a biological material from females in the periovulatory period that corresponds to the hyperestrogenicity, which substantially increases the number of isolated cultures and characterizes the depth of integration of metabolic processes of a parasite and its host.

Adolescent↗

[Treatment of cosmopolitan parasitic diseases].

Cosmopolitan parasitic diseases are often unrecognized and misdiagnosed. Treatment can be difficult due mainly to a lack of the therapeutic drugs. The purpose of this review is to update knowledge about the therapy of anisakiasis, cystic echinococcosis, fascioliasis, giardiasis, pinworm/tapeworm infections, strongyloidiasis, and toxoeariasis.

Global Health↗

The economics of parasitic diseases: research priorities.

Parasitic diseases are primarily diseases of poverty. At serious risk are individuals, communities and countries least able to afford the costs of treatment or prevention. In turn, economic development projects which aim to increase income levels may lead to negative results because of increased transmission of parasitic diseases often results. In attempting to analyse the economic consequences of parasitic diseases and the economics of their control, economists have usually relied on the tools of cost-benefit analysis, cost-effectiveness analysis and financial analysis. These efforts are briefly reviewed in the paper. The results have been subject to considerable criticism because of conceptual and methodological problems. For example, most studies have not taken into account the epidemiology and natural history of the disease in estimating the associated economic losses, thereby leading to inappropriate conclusions. The UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases through its Social and Economic Research Scientific Working Group (SER-SWG) is promoting research on the economics of parasitic diseases. In an attempt to improve the usefulness and reliability of such studies, conceptual and methodological approaches have been suggested which are reported on here. To improve the research design of these projects, a conceptual framework is proposed which consists of four components: (1) baseline social, cultural and economic conditions influencing disease transmission; (2) resources already invested in the health system and investments in other related sectors such as agriculture, housing, water supply and sanitation; (3) health consequences resulting from (1) and (2); and (4) social and economic consequences resulting from (3). A key concern in relation to the framework is to determine the most useful basis for linking results from studies of one component to another so as to analyse more systematically the impacts of disease on individuals and society. Such studies are inherently interdisciplinary and close collaboration of economists with medical scientists and disease control programme staff is needed to ensure completeness and reliability of input data and results. Results from these studies could be used to inform national decision-makers about the social and economic consequences of the parasitic diseases and their control and, thus, should strengthen support for increased investment to reduce the parasitic disease burden in developing countries.

Communicable Disease Control↗