20. Protozoa (Trypanosomes) Flashcards
what are the african Trympanosomes?
T. brucei gambiense
T. brucei rhodesiense
what is the american Trympanosome?
T. cruzi
which disease is caused by T. cruzi?
Chagas disease
which disease is caused by T. brucei?
african sleeping sickness
which vector is associated with/can transmit the parasite that causes the disease African sleeping sickness?
Tsetse fly of the genus Glossina
which parasite causes West african sleeping sickness?
T. b. gambiense
which parasite causes East african sleeping sickness?
T. b. rhodesiense
what are the two subspecies of T. brucei?
- gambiense
- rhodesiense
can the two subspecies of T. brucei be differentiated morphologically?
no
what is another subspecies that exists of T. brucei? does it infect humans?
- T. b. brucei
- no
what animals do T. brucei brucei infect?
it is a parasite of antelopes and other African ruminants (cattle, horses, camels) and are pathogenic to domestic ruminants
what disease does T. b. b. cause in animals?
Nagana, a type of african sleeping sickness in animals
what is the phenotype caused by T. b. b.?
reduced growth rate, milk productivity, and strength of farm animals, leading to the eventual death of the infected animals
which vector is associated with/can transmits the parasite that causes Chagas disease?
Triatoma
what are the Trypanosome parasites of equines?
T. equinum
T. equiperdum
what is the disease that is caused when horses are infected with an equine trypanosome?
Dourin
what is the vector for Equine Trypanosomes?
none, it is transmitted through direct blood contact by biting during copulation, or by biting insects such as horse flies
which trypanosome infects camels?
T. evansi
what is the disease that is caused when camels are infected with the camel trypanosome?
Surra
which vector is associated with/can transmits the parasite that causes the disease Surra?
Tabanids
who is the main reservoir for T. brucei gambiense?
humans
who is the main reservoir for T. brucei rhodesiense?
wild game animals and cattle
what are the ways that Trypanosoma brucei can be transmitted?
- mother to child, across the placenta
- blood transfusion
- sexual contact
- laboratories: accidental infections, although this is uncommon
Where is T. b. gambiense found?
central and west Africa
where is T. b. rhodesiense found?
in southern and eastern Africa
what kind of infection does T. b. gambiense cause?
a chronic infection
what kind of infection does T. b. rhodesiense cause?
an acute infection
how long does it take for an infection of T. b. rhodesiense to emerge?
a few weeks
which parasite, T. b. gambiense or rhodesiense causes the more virulent and faster developing disease?
T. b. rhodesiense
what is special about the African Trypanosome life cycle?
the whole life cycle has extracellular stages
what does an infected Tsetse fly inject into the skin tissue during a blood meal in African Trypanosomes?
metacyclic trypomastigotes
what is the infective stage of the African Trypanosome?
metacyclic trypomastigotes
how do the African Trypanosome parasites get to the blood?
through the lymph
what do the metacyclic trypomastigotes transform into in African Trympanosomes and where in the host?
bloodstream trypomastigotes
inside the host blood stream
where do the bloodstream trypomastigotes go in the body in African Trympanosomes?
to other sites throughout the body, in other fluids, lymph, spinal fluid
how do the bloodstream trypomastigotes multiply in the fluids in African Trympanosomes?
by binary fission
what are the intracellular stages of the African Trypanosome life cycle?
THERE ARE NONE
what occurs to the bloodstream trypomastigote in the midgut of the Tsetse fly?
they transform into the procyclic trypomastigotes, multiply by binary fission and transform into epimastigotes
where do the epimastigotes go?
they make their way to the fly’s mouth in the salivary glands and continue multiplication by binary fission
what do the epimastigotes in African Trympanosomes transform into?
metacyclic trypomastigotes and start the cycle again
what is antigenic variation?
- Antigen variation is the process of a parasite changing its surface protein.
- Trypanosomes use the antigen variation of variant surface glycoproteins (VSGs)
what is beneficial about changing the surface glycoproteins?
Change in the antibody epitopes displayed by the pathogen allows escape from antibody mediated responses
what type of infection do the VSGs allow?
chronic infection
around how many vsg genes does the genome of a Trypanosome contain?
over 1000
what happens within the genome to change the expression of the surface proteins?
different VSGs are inserted into a single expression site
what is the theory behind the slender vs stumpy forms?
So in the slender form they have one specific VSG and in the process of growing to the stumpy form they start changing the VSG, so that by the time they are stumpy forms they would have a different VSG and that’s why you would have high amount of stumpy form at that point
what does T. brucei gambiense invade? what does this cause?
the central nervous system, initiating a chronic, sleeping-sickness
what are the symptoms of the sleeping sickness caused by T. brucei gambiense?
- apathy, mental dullness, tremor of hands, tongue, etc. followed by convulsions and paralysis
- sleeping followed with coma and death common.
does T. brucei rhodesiense attach the nervous system?
no
what are the symptoms of T. brucei rhodesiense?
- causes a more rapid death
- rapid weight loss, heart involvement, and death can occur within a few months
- Winterbottom’s sign (swelling of lymph nodes along the back of the neck)
how is African Trypanosomiasis diagnosed?
- by finding the trypomastigote stages, which are only found in humans , in the microscopic examination of lymph node aspirates, blood, bone marrow, or, in the late stages of infection, cerebrospinal fluid
how is the blood smear prepared and examined in African Trympanosomes?
A wet preparation should be examined for the motile trypanosomes, and a smear should be fixed, stained with Giemsa and examined under the microscope
do Tsetse flies lay eggs?
no, they are larviparous
what kind of soil do the pupa occur in?
in dry soil in open country
how do we control tsetse flies?
- chemical spraying of insecticides
- elimination of wild game animals
- selective breeding of cattle
what is relevant about the slender and stumpy forms of VSGs?
in the slender form they have one specific VSG and in the process of growing to the stumpy form they start changing the VSG, so that by the time they are stumpy forms they would have a different VSG and that’s why you would have high amount of stumpy form at that point
is American Trympanosomiasis a zoonosis?
yes
how is T. cruzi transmitted to humans?
by blood sucking triatomine bugs
which are the common genera for the triatomine vector in American Trypanosomiasis?
Triatoma
Rhodinisus
Panstrongylus
what is another name for American Trypanosomiasis?
Kissing bug
what are some alternative methods of transmission of T. cruzi?
- blood tranfusions
- organ transplant
- transplacentally
- in labs
what should American Trypanosomiasis be called?
Latin American Trypanosomiasis
How does transmission occur via the triatomine bug?
it defecates on the wound after a blood meal and then you scratch it into the wound
what is the infective stage of the American Trypanosome?
the metacyclic trypomastigotes, they are ejected in the feces and into the wound made by the blood meal bite
where are possible sites of entry for the parasite in American Trypanosomes?
through wounds or intact mucous membranes
where do the trypomastigotes go in the host in American Trypanosomes?
they invade cells neat the site of inoculation, where they differentiate into intracellular amastigotes
how do the amastigotes multiply in the cells in American Trypanosomes?
binary fission
what do the amastigotes differentiate into in American Trypanosomes and what happens to those?
they differentiate into trypomastigotes and are released into circulation as bloodstream trypomastigotes
what kind of tissues do trypomastigotes infectin American Trypanosomes?
a variety of tissues
what do the trypomastigotes differentiate into at the new tissue they arrive at in American Trypanosomes?
intracellular amastigotes
do the bloodstream trypomastigotes replicate in American Trypanosomes?
no
when does replication continue after bloodstream trypomastigoes in American Trypanosomes?
only when parasites enter another cell
when does the “kissing bug” become infected in American Trypanosomes? what stage does it get infected by?
during a blood meal - gets infected by the bloodstream trypomastigotes
what tranformation does the Ameircan Trypanosome trypomastigote undergo in the kissing bug’s midgut?
transforms into the epimastigote
what tranformation does the Ameircan Trypanosome trypomastigote undergo in the kissing bug’s hindgut?
from the epimastigote to the metacyclic trypomastigote
in what kind of organs does African trypanosomiasis infect?
hallow organs
how long is one infected with African Trypanosomes?
typically for life
what is the major contributor to the pathological consequences?
cell death
what is the most recognized marker of acute chagas disease?
Romana’s sign
what is Romana’s sign?
swelling of the eyelids on the side of the face near the bite wound or where the bug feces were deposited or accidentally rubbed into the eye
what are the symptoms in the early, acute stages of American Trypanosomiasis?
symptoms are mild and usually produce no more than local swelling at the site of infection
what are the symptoms in the stages of American Trypanosomiasis over the course of many years?
serious chronic symptoms can appear, such as heart disease and malformation of the intestines
If untreated, the chronic disease can be fatal
what is the feature of the chronic phase of infection?
one is immune to reinfetion but parasites are not eliminated from the body
how many patients with American Trypanosomiasis are asymptomatic?
41%
how many patients with American Trypanosomiasis have cardiomyopathy? how many of these have sudden death?
45%
58%
how many patients with American Trypanosomiasis get megaesophagus?
11%
how many patients with American Trypanosomiasis get megacolon?
~3%
which stages of the American Trypanosome parasite are found in humans?
amastigotes
trypomastigotes
how is diagnosis of American Trypanosomiasis done?
Microscopic examination of:
a) fresh blood for motile parsites
b) of thin and thick blood smears stained with Giemsa for visualization of parasites
which stage is free swimming in the blood in American Trypanosomisasis?
trypomastigotes
is there a vaccine against Chagas disease?
nop
what is the focus of prevention of Chagas disease?
fighting the vector - using paints and insecticides and improving houses and sanitary conditions in rural areas, mosquito nets also
what is the second most common transmission route of Cagas disease in many latin countries? is this under control?
blood transfusion - in most countries testing of blood donors is mandatory, but not in developed countries because Chagas disease is not endemic