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Lema YL, Prodjinotho UF, Makasi C, Nanyaro MWA, Kilale AM, Mfinanga S, Stelzle D, Schmidt V, Carabin H, Winkler AS, Lyamuya EF, Ngowi BJ, Chachage M, Prazeres da Costa C. Evaluating the modulation of peripheral immune profile in people living with HIV and (Neuro)cysticercosis. PLoS Negl Trop Dis 2024; 18:e0012345. [PMID: 39093864 PMCID: PMC11324146 DOI: 10.1371/journal.pntd.0012345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 08/14/2024] [Accepted: 07/05/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND The parasitic infection caused by Taenia solium represents a significant public health concern in developing countries. Larval invasion of body tissues leads to cysticercosis (CC), while central nervous system (CNS) involvement results in neurocysticercosis (NCC). Both conditions exhibit diverse clinical manifestations, and the potential impact of concomitant HIV infection especially prevalent in sub-Saharan Africa on peripheral and CNS immune responses remains poorly understood. This study aimed to identify the potential impact of HIV coinfection in CC and NCC patients. METHODOLOGY A nested study within a cross-sectional analysis in two Tanzanian regions was performed and 234 participants (110 HIV+ and 124 HIV-) were tested for cysticercosis antibodies, antigens, CD4 counts and serum Th1 and Th2 cytokines via multiplex bead-based immunoassay. 127 cysticercosis seropositive individuals underwent cranial computed tomography (CCT) and clinical symptoms were assessed. Multiple regression analyses were performed to identify factors associated with cytokine modulation due to HIV in CC and NCC patients. RESULTS Serologically, 18.8% tested positive for cysticercosis antibodies, with no significant difference HIV+ and HIV+. A significantly higher rate of cysticercosis antigen positivity was found in HIV+ individuals (43.6%) compared to HIV- (28.2%) (p = 0.016). CCT scans revealed that overall 10.3% had active brain cysts (NCC+). Our study found no significant changes in the overall cytokine profiles between HIV+ and HIV- participants coinfected CC and NCC, except for IL-5 which was elevated in HIV+ individuals with cysticercosis. Furthermore, HIV infection in general was associated with increased levels of pro-and some anti-inflammatory cytokines e.g. TNF-α, IL-8, and IFN-γ. However, based on the interaction analyses, no cytokine changes were observed due to HIV in CC or NCC patients. CONCLUSIONS In conclusion, while HIV infection itself significantly modulates levels of key cytokines such as TNF-α, IL-8, and IFN-γ, it does not modulate any cytokine changes due to CC or NCC. This underscores the dominant influence of HIV on the immune system and highlights the importance of effective antiretroviral therapy in managing immune responses in individuals coinfected with HIV and CC/NCC.
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Affiliation(s)
- Yakobo Leonard Lema
- Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
| | - Ulrich Fabien Prodjinotho
- Institute for Medical Microbiology, Immunology, and Hygiene, Technical University of Munich (TUM), Munich, Germany
- Center for Global Health, Technical University of Munich, Munich, Germany
| | - Charles Makasi
- Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Mary-Winnie A. Nanyaro
- Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
| | - Andrew Martin Kilale
- Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
| | - Sayoki Mfinanga
- Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
- Kampala International University, Kampala, Tanzania
- School of Public Health, Muhimbili University of Health & Allied Sciences (MUHAS), Dar Es Salaam, Tanzania
| | - Dominik Stelzle
- Center for Global Health, Technical University of Munich, Munich, Germany
- Department of Neurology, School of Medicine and Health, Technical University Munich (TUM), Munich, Germany
| | - Veronika Schmidt
- Center for Global Health, Technical University of Munich, Munich, Germany
- Department of Neurology, School of Medicine and Health, Technical University Munich (TUM), Munich, Germany
| | - Hélène Carabin
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
- School of Public Health, University of Montreal, Montreal, Quebec, Canada
- Research Group on Epidemiology of Zoonoses and Public Health (GREZOSP), Saint-Hyacinthe, Quebec, Canada
- Public Health Research Center of the University of Montreal and the CIUSSS of Center-Sud-de-l’île-de-Montréal (CReSP), Montreal, Quebec, Canada
| | - Andrea Sylvia Winkler
- Center for Global Health, Technical University of Munich, Munich, Germany
- Department of Neurology, School of Medicine and Health, Technical University Munich (TUM), Munich, Germany
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Eligius F. Lyamuya
- Department of Microbiology & Immunology, Muhimbili University of Health & Allied Sciences (MUHAS), Dar Es Salaam, Tanzania
| | - Bernard J. Ngowi
- Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
- Mbeya College of Health & Allied Sciences, University of Dar Es Salaam, Mbeya Tanzania
| | - Mkunde Chachage
- Mbeya College of Health & Allied Sciences, University of Dar Es Salaam, Mbeya Tanzania
- Mbeya Medical Research Center, National Institute for Medical Research (NIMR), Mbeya, Tanzania
| | - Clarissa Prazeres da Costa
- Institute for Medical Microbiology, Immunology, and Hygiene, Technical University of Munich (TUM), Munich, Germany
- Center for Global Health, Technical University of Munich, Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Germany
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Zibaei M, Hatami Z, Firoozeh F, Bakhshipour F, Miahipour A, Soleimani A, Shokri E. Molecular investigation of Toxocara infection from the serum of people living with HIV in Alborz, Iran. BMC Infect Dis 2023; 23:275. [PMID: 37138234 PMCID: PMC10155370 DOI: 10.1186/s12879-023-08250-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 04/13/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Toxocara infection is one of the most common neglected infections of poverty and a helminthiasis of global importance. Traditional diagnostic methods such as antibodies detection in serum samples are limited due to cross-reactivity and poor sensitivity. The use of molecular base methods for diagnosis of Toxocara infection in Iran has not been fully explored. The purpose of the current study was to estimate the prevalence of Toxocara infection from serum samples of people living with HIV in Alborz province, Iran using serological and molecular methods. METHODS Blood samples were collected from 105 people living with HIV. Epidemiological data of participant were obtained through a structured questionnaire to investigate the risk factors. Patients CD4+ T cell count were recorded. Anti-Toxocara IgG antibodies were detected by ELISA, with a cut-off point of 11. PCR was performed to detect genetic material of Toxocara species in the serum samples. RESULTS The mean CD4+ count in HIV-infected individuals with positive toxocariasis serology was 255.1 ± 21.6 cells/µL. Seropositivity for Toxocara species was observed in 12/105 (11.4%) people living with HIV. Three samples gave positive results on PCR analysis. Based on the data, a statistically significant relationship was found between anti-Toxocara IgG antibodies seropositivity and underlying conditions (p = 0.017). No significant statistical association was observed between seropositivity for Toxocara and gender, age, exposure to domestic animals or pet keeping, education levels, and occupation (p > 0.05). The findings of PCR confirmed Toxocara DNA in 3/12 (25.0%) serum samples. CONCLUSION These findings demonstrated for the first time that people living with HIV from Alborz province, are being exposed to this zoonosis and a relatively high seroprevalence of Toxocara in HIV/AIDS people needs comprehensive health education regarding personal hygiene and how to avoid exposure to this parasite infection, especially in people with an impaired immune system.
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Affiliation(s)
- Mohammad Zibaei
- Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, P.O. Box: 3149779453, Karaj, Iran.
| | - Zahra Hatami
- Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, P.O. Box: 3149779453, Karaj, Iran.
| | - Farzaneh Firoozeh
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Fatemeh Bakhshipour
- Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, P.O. Box: 3149779453, Karaj, Iran
| | - Abolfazl Miahipour
- Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, P.O. Box: 3149779453, Karaj, Iran
| | - Alireza Soleimani
- Department of Infectious Diseases, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Elham Shokri
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Jewell PD, Abraham A, Schmidt V, Buell KG, Bustos JA, Garcia HH, Dixon MA, Walker M, Ngowi BJ, Basáñez MG, Winkler AS. Neurocysticercosis and HIV/AIDS co-infection: A scoping review. Trop Med Int Health 2021; 26:1140-1152. [PMID: 34228854 DOI: 10.1111/tmi.13652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Neurocysticercosis (NCC) and human immunodeficiency virus (HIV) have a high disease burden and are prevalent in overlapping low- and middle-income areas. Yet, treatment guidance for people living with HIV/AIDS (PLWH/A) co-infected with NCC is currently lacking. This study aims to scope the available literature on HIV/AIDS and NCC co-infection, focusing on epidemiology, clinical characteristics, diagnostics and treatment outcomes. METHODS The scoping literature review methodological framework, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. A total of 16,969 records identified through database searching, and 45 additional records from other sources were reduced to 52 included studies after a standardised selection process. RESULTS Two experimental studies, ten observational studies, 23 case series/case reports and 17 reviews or letters were identified. Observational studies demonstrated similar NCC seroprevalence in PLWH/A and their HIV-negative counterparts. Of 29 PLWH/A and NCC co-infection, 17 (59%) suffered from epileptic seizures, 15 (52%) from headaches and 15 (52%) had focal neurological deficits. Eighteen (62%) had viable vesicular cysts, and six (21%) had calcified cysts. Fifteen (52%) were treated with albendazole, of which 11 (73%) responded well to treatment. Five individuals potentially demonstrated an immune-reconstitution inflammatory syndrome after commencing antiretroviral therapy, although this was in the absence of immunological and neuroimaging confirmation. CONCLUSIONS There is a paucity of evidence to guide treatment of PLWH/A and NCC co-infection. There is a pressing need for high-quality studies in this patient group to appropriately inform diagnostic and management guidelines for HIV-positive patients with NCC.
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Affiliation(s)
- Paul D Jewell
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, UK
| | - Annette Abraham
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Community Medicine and Global Health, Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Veronika Schmidt
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Community Medicine and Global Health, Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Kevin G Buell
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, UK
| | - Javier A Bustos
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru.,Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Hector H Garcia
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru.,Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Matthew A Dixon
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, UK.,Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK.,Schistosomiasis Control Initiative Foundation, London, UK
| | - Martin Walker
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, UK.,Department of Pathobiology and Population Sciences, London Centre for Neglected Tropical Disease Research, Royal Veterinary College, Hatfield, UK
| | - Bernard J Ngowi
- Muhimbili Medical Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania.,College of Health and Allied Sciences, University of Dar es Salaam, Dar es Salaam, Tanzania
| | - Maria-Gloria Basáñez
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, UK.,Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
| | - Andrea S Winkler
- Department of Neurology, Center for Global Health, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Community Medicine and Global Health, Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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Hamamoto Filho PT, Fragoso G, Sciutto E, Fleury A. Inflammation in neurocysticercosis: clinical relevance and impact on treatment decisions. Expert Rev Anti Infect Ther 2021; 19:1503-1518. [PMID: 33794119 DOI: 10.1080/14787210.2021.1912592] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Neurocysticercosis is caused by the localization of Taenia solium larvae in the central nervous system. The disease remains endemic in most countries of Latin America, Asia and Africa. While major improvements have been made in its diagnosis and treatment, uncertainties persist regarding the clinical implications and treatment of the inflammatory reaction associated with the disease. AREAS COVERED In this review, based on PubMed searches, the authors describe the characteristics of the immune-inflammatory response in patients with neurocysticercosis, its clinical implications and the treatment currently administered. The dual role of inflammation (participating in both, the death of the parasite, and the precipitation of serious complications) is discussed. New therapeutic strategies of potential interest are presented. EXPERT OPINION Inflammatory reaction is the main pathogenic mechanism associated to neurocysticercosis. Its management is mainly based on corticosteroids administration. This strategy had improved prognostic of patients as it allows for the control of most of the inflammatory complications. On the other side, it might be involved in the persistence of parasites in some patients, despite cysticidal treatment, due to its immunosuppressive properties. New strategies are needed to improve therapeutical management, particularly in the severest presentations.
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Affiliation(s)
- Pedro T Hamamoto Filho
- Department of Neurology, Psychology and Psychiatry, UNESP-Univ Estadual Paulista, Botucatu Medical School, Botucatu, Brazil
| | - Gladis Fragoso
- Department of Immunology, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Edda Sciutto
- Department of Immunology, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Agnès Fleury
- Department of Genomic Medicine and Environmental Toxicology, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico.,Neurocysticercosis Clinic, Instituto Nacional de Neurología Y Neurocirugía, Ciudad de México, Mexico, mexico.,Neuroinflammation Unit, Instituto de Investigaciones Biomédicas-Universidad Nacional Autónoma de México/INNN/Facultad de Medicina-UNAM, Ciudad de México, Mexico
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Abstract
PURPOSE OF REVIEW Space-occupying lesions represent a diagnostic challenge among people with the human immunodeficiency virus, acquired immunodeficiency syndrome (HIV/AIDS). To determine the best diagnostic approach to the wide array of possible etiologies and provide a thorough interpretation of neuroimaging in order to narrow a hierarchical differential diagnosis among these patients. Given that there is no pathognomonic neuroimaging pattern in this clinical setting, we searched results from brain biopsies to best determine the etiology of commonly found lesions. RECENT FINDINGS Multimodal brain MRI and MRI spectroscopy (MRS) often provide the most valuable information in the study of focal masses among people with HIV/AIDS. Brain biopsy appears safe and provides high diagnostic yields in these patients. Among patients with HIV/AIDS who present with space-occupying intracranial lesions, brain MRI and MRS are useful tests. However, in cases of diagnostic uncertainty, brain biopsy is a safe procedure and should be performed. The role of metabolic studies like 201Th-SPECT or PET is useful in the detection of primary central nervous system lymphoma.
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Affiliation(s)
- Isabel Elicer
- Hospital Dr. Sótero del Río, Neurology Service, Av. Concha y Toro 3459, Puente Alto, Santiago, Chile. .,Clinica Las Condes, Lo Fontecilla 441, Las Condes, Santiago, Chile. .,Red Salud UC Christus, Lira 85, Santiago, Chile.
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McCormick DW, Bacha JM, El-Mallawany NK, Kovarik CL, Slone JS, Campbell LR. Disseminated cysticercosis and Kaposi sarcoma in a child with HIV/AIDS: A case report. BMC Infect Dis 2020; 20:309. [PMID: 32334521 PMCID: PMC7183726 DOI: 10.1186/s12879-020-05039-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 04/16/2020] [Indexed: 12/22/2022] Open
Abstract
Background Clinical manifestations of extraneural infection with the pork tapeworm Taenia solium typically affect the muscles, eyes, alimentary canal, and/or subcutaneous tissues. Children living with HIV are at increased risk for more widespread and severe manifestations of food-borne opportunistic infections, including T. solium, due to fluctuating levels of immunosuppression. We present a case of disseminated T. solium in a HIV-positive child with Kaposi sarcoma living in Tanzania with cysticercosis presenting as widespread subcutaneous nodules. Case presentation A 4-year-old HIV-positive boy in Southern Tanzania presented for evaluation of > 30 violaceous skin lesions, few subcutaneous nodules, and a circumferential violaceous penile lesion which rapidly grew after initiation of ART. The patient was clinically diagnosed with Kaposi sarcoma and started on chemotherapy with bleomycin, vincristine, and doxorubicin. He completed 10 cycles of chemotherapy, with full resolution of the violaceous skin and penile lesions but persistence of his subcutaneous nodules, thus paclitaxel was added. After 12 additional cycles of paclitaxel, his subcutaneous nodules enlarged, and biopsy of a scapular subcutaneous nodule was performed. Histopathology revealed a cystic structure with a central larval scolex and serrated spiral canal consistent with T. solium, which confirmed a diagnosis of disseminated cysticercosis. He completed a 10-day course of praziquantel and albendazole with resolution of the subcutaneous nodules. Conclusions Disseminated cysticercosis is an unusual opportunistic infection which can present as subcutaneous nodules without other typical cysticercosis symptoms. Immunosuppression – from HIV and/or chemotherapy – may unmask cysticercosis in children in endemic regions and result in more severe manifestations of this disease. Cysticercosis should remain on a clinician’s differential for subcutaneous nodules, especially in children living with HIV. Cysticercosis can mimic Kaposi sarcoma, and histopathology is essential to accurately diagnose and manage patients with concerning skin lesions.
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Affiliation(s)
- David W McCormick
- Baylor College of Medicine, 1 Baylor Plaza BCM 620, Houston, TX, 77030-3411, USA.
| | - Jason M Bacha
- Baylor College of Medicine, 1 Baylor Plaza BCM 620, Houston, TX, 77030-3411, USA.,Baylor International Pediatric AIDS Initiative (BIPAI) at Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.,Baylor College of Medicine Children's Foundation - Tanzania, Pediatrics, Mbeya, Tanzania
| | - Nader K El-Mallawany
- Baylor College of Medicine - Texas Children's Cancer and Hematology Centers, Houston, TX, USA
| | - Carrie L Kovarik
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - J S Slone
- Baylor College of Medicine - Texas Children's Cancer and Hematology Centers, Houston, TX, USA
| | - Liane R Campbell
- Baylor College of Medicine, 1 Baylor Plaza BCM 620, Houston, TX, 77030-3411, USA.,Baylor International Pediatric AIDS Initiative (BIPAI) at Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.,Baylor College of Medicine Children's Foundation - Tanzania, Pediatrics, Mbeya, Tanzania
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Abstract
Taenia solium cysticercosis and taeniasis (TSCT), caused by the tapeworm T. solium, is a foodborne and zoonotic disease classified since 2010 by WHO as a neglected tropical isease. It causes considerable impact on health and economy and is one of the leading causes of acquired epilepsy in most endemic countries of Latin America, Sub-Saharan Africa, and Asia. There is some evidence that the prevalence of TSCT in high-income countries has recently increased, mainly due to immigration from endemic areas. In regions endemic for TSCT, human cysticercosis can manifest clinically as neurocysticercosis (NCC), resulting in epileptic seizures and severe progressive headaches, amongst other neurological signs and/or symptoms. The development of these symptoms results from a complex interplay between anatomical cyst localization, environmental factors, parasite's infective potential, host genetics, and, especially, host immune responses. Treatment of individuals with active NCC (presence of viable cerebral cysts) with anthelmintic drugs together with steroids is usually effective and, in the majority, reduces the number and/or size of cerebral lesions as well as the neurological symptoms. However, in some cases, treatment may profoundly enhance anthelmintic inflammatory responses with ensuing symptoms, which, otherwise, would have remained silent as long as the cysts are viable. This intriguing silencing process is not yet fully understood but may involve active modulation of host responses by cyst-derived immunomodulatory components released directly into the surrounding brain tissue or by the induction of regulatory networks including regulatory T cells (Treg) or regulatory B cells (Breg). These processes might be disturbed once the cysts undergo treatment-induced apoptosis and necrosis or in a coinfection setting such as HIV. Herein, we review the current literature regarding the immunology and pathogenesis of NCC with a highlight on the mobilization of immune cells during human NCC and their interaction with viable and degenerating cysticerci. Moreover, the immunological parameters associated with NCC in people living with HIV/AIDS and treatments are discussed. Eventually, we propose open questions to understand the role of the immune system and its impact in this intriguing host-parasite crosstalk.
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Joob B, Wiwanitkit V. Neurocysticercosis and HIV Infection. ARQUIVOS DE NEURO-PSIQUIATRIA 2019; 77:836. [PMID: 31826143 DOI: 10.1590/0004-282x20190145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/03/2019] [Indexed: 11/22/2022]
Affiliation(s)
- Beuy Joob
- Sanitation 1 Medical Academic Center, Bangkok Thailand
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Herrera Vazquez O, Romo ML, Fleury A. Neurocysticercosis and HIV Infection. ARQUIVOS DE NEURO-PSIQUIATRIA 2019; 77:837. [PMID: 31826144 DOI: 10.1590/0004-282x20190165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 10/21/2019] [Indexed: 11/22/2022]
Affiliation(s)
- Omar Herrera Vazquez
- Instituto de Investigaciones Biomédicas, Unidad de Neuroinflamación, UNAM, Ciudad de México, México.,Instituto Nacional de Neurología y Neurocirugía, Clínica de Neurocisticercosis. Ciudad de México, México
| | - Matthew L Romo
- The University of Hong Kong, Li Ka Shing Faculty of Medicine, School of Public Health, Hong Kong
| | - Agnès Fleury
- Instituto de Investigaciones Biomédicas, Unidad de Neuroinflamación, UNAM, Ciudad de México, México.,Instituto Nacional de Neurología y Neurocirugía, Clínica de Neurocisticercosis. Ciudad de México, México
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