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MIMM 413 > Cryptosporidiosis > Flashcards

Cryptosporidiosis Flashcards

1
Q

Cryptosporidium is classified in the phylum ….

A

Apicomplexa (apical rings,
micronemes and subpellicular microtubules)

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2
Q

all parasites in the apicomplexa group are reffered as …

A

conccicia

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3
Q

The species of coccidia develop where q

A

in the gastrointestinal tract of
vertebrates include Eimeria, Isospora, Cyclospora, and Cryptosporidium.

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4
Q

apicomplexa species that develop extra intestinal include what ….

A

Neospora, Sarcocystis, and Toxoplasma.

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5
Q

true or false: most Cryptosporidium Species infect what

A

humans

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6
Q

c parvis oocyst shed by

A

cattle

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7
Q

c parvis is infective to

A

Cattle
Cat
Goat
Sheep
Rat
Human
Dog
Pig
Rabbit
Mice

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8
Q

what does Cryptosporidiosis
cause

A

diarrheal outbreaks

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9
Q

who are most at ristk for Cryptosporidiosis

A

kids and immunosupressed

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10
Q

Cryptosporidium parvum:
A threat to….

A

the quality of surface water and the environment

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11
Q

Cryptosporidium: Excystation requires reducing conditions,
pancreatic enzymes, bile salts—-Release of…..

A

4 sporozoites

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12
Q

Differentiation into spherical trophozoites — develop into….

A

Type 1 meronts (schizonts) that
contain 6 -8 merozoites.

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13
Q

Type 1 merozoites invade nearby cells and develop into…..

A

Type 2 meronts or into
trophozoites to complete the asexual cycle
* Merozoites similar in morphology and function to the sporozoites

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14
Q

Type 2 merozoites differentiate into…

A

male microgamonts or female macrogamonts.
-Male microgamonts release microgametes that can
fertilize macrogametes inside the female macrogamonts.

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15
Q

Generation of 2 types of oocysts….

A

-Thin-walled auto-infectious oocysts (20%)
-Thick-walled oocysts (80%) shed in stool

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16
Q

how big are the oocysts

A

4-6um wide

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17
Q

what are the oocysts made up of

A

Composed of tough environmentally resistant wall
enclosing 4 sporozoites – resistant to disinfections

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18
Q

true or false crypto is opportunistic and extracellular

A

false it is intracellular

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19
Q

what does crypto infect

A

Infects gastrointestinal and respiratory epithelial cells

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20
Q

what is quirky about the oocyst crypto walla

A

unique suture. atthe end

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21
Q

The suture dissolves during
excystation, opening the wall to…

A

4 sporozoites

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22
Q

Colonization of the … of the
small intestine by
Cryptosporidium

A

villi

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23
Q

c.parvum oocysts are viable in

A

§ Potassium dichromate
§ Chloroform
§ Ether
§ Ammonia
§ Sodium hydroxide
§ Buffered hypochlorite
§ Potassium permanganate

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24
Q

c parvum oocysts are killed bu

A

§ Freezing
§ Boiling for 30 mins
§ Hydrogen peroxide
§ Ozone (limits: Kitchener-Waterloo outbreak)
§ Oo-cide (Ammonia + sodium hydroxide + biocide)

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25
Q

true. orfalse: Sporozoites and merozoites of c parvum appear similar to those of other coccidias with
the same organelles.

A

true

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26
Q

what are the organelles of c parvum

A

the rhoptries, micronemes, electron dense granules,
nucleus and ribosomes.

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27
Q

what does. cparvum does not have

A

do not have polar rings, mitochondria and micropores.

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28
Q

what are microneme

A

are rod-like structures. Micronemal proteins are important in host celll ocalization, gliding motility and ligand-receptor attachment to host cells. Several classes of
proteins are associated with micronemes: GP900, TRAP-C1, CpSCRP and ABD reactive protein

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29
Q

microneme might secrete their protein through ….

A

the rhoptry duct

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30
Q

what are rhoptroed

A

-are club-shaped membrane-bound organelles.
-C. parvum have single rhoptry. -Rhoptryproteins are involved in transforming the hostcell membrane into a parasitophorous vacuoles
(PV) membrane

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31
Q

what are dense granules involved in

A

in host cell modification following the invasion. DG proteins are released from the parasite surface into the
PV

32
Q

transmission of c parvum

A

The infection is transmitted by the fecal-oral route via the oocyst stage.

33
Q

true or false: c parvum lacks host specificity

A

true

34
Q

groups. at risk for c parvum

A

-workers like vets and farmers
-immunodeficient peeps

35
Q

Analysis of Water Samples for the Presence of Oocysts

A
  • At least 50 litres of water must be
    filtered (1µ porosity)
  • Wash the filter with water
  • Centrifugation
  • Staining
  • Microscope
36
Q

what is the efficacy to analysis. ofwater samples for the presence. of oocysts

A

6.3%

37
Q

true or false: we still get outbreaks. of Cryptosporidium

A

yeah
-most recent in sweden

38
Q

what was the cause of the 1988 crypto outbreak

A

a pool

39
Q

what happened in 1993

A

-crypto outbreak
-wisconsin
-403 000 people aka 25% of peeps
-cause by waterworks
-100-fold increase of C. parvum oocysts found in the water treatment plant

40
Q

what were the main symptoms of the 1993 milwaukee crypto outbreak

A

Diarrhea, fever, abdominal cramps and
vomiting were the main symptoms

41
Q

how many people died in the 1993 crypto outbreak

A

54

42
Q

How do Cryptosporidium species interact with the host?

A
  • Initial interaction via
    receptors
    – CSL ( C parvum sporozoites
    ligand)
    – CP47
  • Attach by anterior
    pole
    – Invagination
    – Microfilamentdependent
  • Causes damage to apical surface of cell
43
Q

crypto in birds infects what

A

respiratory tract

44
Q

crypto infects what in fish and reptiles

A

intestinal tract

45
Q

crypto infects what in immuno competent

A

intestinal tract

46
Q

crypto infects what in immunocompromised peeps

A

Pancreas, liver, respiratory tract, gall and urinary bladders

47
Q

crypto: Inhibition of glucose-stimulation affecting,,,

A

Na absorbtion

48
Q

crypto: Increase production of mucosal prostaglandin which can inhibit…

A

NaCl absorption leading to secretory diarrhea.

49
Q

leukocytes can produce high levels of… in crypto

A

prostaglandins

50
Q

crypto: Alterations in intestinal permeability due to the

A

-immune response to the parasite
-i.e.: Increased secretions of
cytokines like IFN-g and transforming growth factor (TGF)

51
Q

what plays an important role in crypto pathogenesis

A

In patients having large volume of diarrhea (70 bowels movement per day) secretory processes of the parasites or
immune cells

52
Q

what causes diarrhea

A
  • Absorption is impaired
    – Electroneutral (NaCl)
    – Electrogenic (co-transport)
  • Secretion is enhanced
    – Active Cl- or HCO3
  • (bicarbonate)
  • Causes:
    – Toxins
    – Pathogen adherence/invasion
    – Stimulate immune response
53
Q

How do Cryptosporidium cause diarrhea?

A

-inflammation
Increase in intracellular permeability
Inflammation in sub-mucosal layer
-Profuse watery diarrhea
Diarrhea is osmotic
Damage to epithelial cells:
villus blunting and atrophy
Hyperplasia

54
Q

Crypto resides at….

A

-the apical surface of intestinal epithelial cells and does
not invade deeper layers of the human gastrointestinal mucosa

55
Q

moderate to severe infections of crypto stimulate

A

both innate and acquired immunity

56
Q

true or false: in crypto,
mucosal inflammation with the presence of macrophages and neutrophils at the site of infection

A

true

57
Q

what are the key players for immune response to crypto

A

Key players: Epithelial cells, IFN-g, Phagocytes
Players with less-defined roles: Complement, DCs

58
Q

in crypto: cells express the pro inflammatory … which is also a neutrophil attractant

A

il-8

59
Q

in crypto infection: prostaglin is produced by what

A

produced by epithelial cells may serve to influence their
biological function

60
Q

in crypto. nictric oxyde is produced by what

A

produced from arginine by the enzyme nitric oxide synthase (NOS).

61
Q

in crypto: In the mouse model, B-cell-deficient neonatal mice can…..

A

clear the infection, indicating that the role of antibodies plays a minor role in the control of the infection.

62
Q

true or false in crypto: Patients develop both serum and secretory antibodies, but
these specific antibodies are not successful in eliminating
the infection

A

true

63
Q

true or false: in crypto humoral immunity is required for clearing the infection

A

false, it is not an absolute requirement
-it plays secondary role in combination with host factors

64
Q

in crypto: The clearance of the infection in humans correlates with….

A

the CD4 T-cell population, not the CD8 T-cell.

65
Q

The relationship existing between the CD4 T-cell population and Crypto explains why…

A

AIDS patients are seriously affected by Cryptosporidium infection.

66
Q

in crypto, strong early response and late th2 might what

A

help clearing

67
Q

diagnostic tools crypto

A
  • Microscopy
    – Acid fast stain
    – Fluorescent
  • Endoscopic biopsy
  • Immunodiagnosis
    – Immunofluorescence assay *
    – Enzyme linked immunoabsorbant assay (ELISA) *
  • PCR-bassed assays
    – RT-PCR quantify oocysts in stool
    – PCR – standard and multiplex
    – Loop-mediated isothermal DNA amplification (colorimetric)
    – Oligometric gold nanoparticle networks
68
Q

crypto: which diagnostic tools are not confirmative of active lesions

A

– Immunofluorescence assay *
– Enzyme linked immunoabsorbant assay (ELISA) *

69
Q

treatment crypto

A
  • Self-limiting infection
  • Unless immunosuppressed
    – Treatments are most important
    – Chronic diarrhea can lead to malabsorption of
    antiretroviral drugs in HIV patients
    -anti-mobility agents: imodium
    -rehydratation therapy: glutamine based better than glucose
    -drygs
70
Q

drug of choice for crypto for immunocompetent peeps

A

-Nitazoxanide (immunocompetent
people > 1year)
-–inhibits pyruvate:
ferredoxin/flavodoxin
oxidoreductases (PFOR) requiredfor anaerobic respiration
-important for parasites without mitochondria

71
Q

Treatment of HIV-infected patients

A
  • Outcome is inversely related to CD4+ T-cell count
  • Paromomycin
    -rifamycin
72
Q

what is paromymicin

A

– aminoglycoside (inhibits protein synthesis)
– Partial efficacy in AIDs patients
* may relieve some diarrhea
* allows absorption of anti-retrovial drugswhat is

73
Q

what is rifamycin

A

Blocks DNA-dependent RNA synthesis
– Least active
– Can be used for:
* prophylaxis
* In combination with other antiparasitic drugs

74
Q

novel therapy for c parvum

A

PROTEASE INHIBITOR K11777
-Enzymes catalyzes the hydrolysis of peptide bonds
-[ Proteases has been shown to be a critical importance in development
and host cell invasion for other apicomplexan parasites
-momar worked on it

75
Q
A

MIMM 413 (24 decks)

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