Exam 2 Flashcards
Stain blood smear, count parasites manually through a microscope- usually more parasites means a more severe infection
Diagnosis
Detects Plasmodium proteins in blood; some detect only falciparum, some detect other species
Rapid Diagnostic Rest (RDT)
Invade mosquito salivary gland cells, human hepatocytes–motile
Sporozoites
Invade human erythrocytes, non-motile
Merozoites
Packets of hundreds of merozoites surrounded by hepatocyte membrane
-Disintegrate in capillaries, release merozoites into bloodstream
Merosomes
Invade erythrocyte, grow into many merozoites, invade more erythrocytes
Merozoite Plan
- ) Initial attachment of parasite to erythrocyte
- ) Parasite reorientation (apical end faces erythrocyte)
- ) Junction forms between 2 cells
- ) Invasion: Parasite pulls itself into erythrocyte
- ) Vacuole forms: Parasite surrounded by specialized membrane
Merozoite Invasion
Vacuole membrane begins to extend to RBC surface to transport proteins from Plasmodium
Waste from hemoglobin digestion visible in food vacuole
Ring Stage
Continues to feed; volume, food vacuole increase
Knobs form on RBC surface
Trophozoite Stage
Infected erythrocytes from some parasite isolates bind multiple uninfected erythrocytes
Released merozoites are close to new erythrocytes
Rosette
Eggs laid singly, have floats
Larvae parallel to water surface
Proboscis, body in straight line
Anophele Eggs
Eggs laid singly, no floats
Larvae at angle to water surface
Proboscis, body at angle
Aedes Eggs
Eggs in rafts
Larvae at angle to water surface
Proboscis, body at angle
Culex Eggs
Bulb of sensory cells at base antennae, sensitive to vibration of other mosquito buzzing
Johnston’s Organ
Chemicals produced by one species, used by another, often to track them
Kairomones
Preference for non-human animals for nourishment
Zoophilia
Preference for human blood over animal blood
Anthrophilia
Feeds indoors
Endophagic
In mosquito hemocoel, releases sporozoites
Oocyst
Ingested by mosquito, gametes in midgut form ookinete
possible developmental path #2 for ring
Gametocyte
Mitosis within RBC, ~16 merozoites develop
-rbc ruptures, released merozoites invade more rbcs
Schizont
In rbcs, feeds on Hb
Trophozoite
Leaves liver to invade RBCs
- ring stage: earliest form established within rbcs
- possible developmental path #1 for ring: trophozoite
- Schizont
Merozoite
Glides from mosquito to hemocoel to mosquito salivary glands, injected into human
Sporozoite
Chemically related to quinine
Acts on trophozoite, mechanism same as chloroquine
Active against chloroquine–sensitive as well as resistant P. vivax and falciparum
Mefloquine
Only genus that transmits malaria among humans
Anopheles
Not useful for acute attack as blood stages not targeted
Targets hypnozoites and falciparum gametocytes
Increased risk of hemolysis especially among G6PD deficient individuals
Primaquine
Primary host in plasmodium life cycle?
Anopheles
All have apical complex: organelles near anterior end that penetrate host cell tissues
Phylum Apicomplexa
Single celled eukaryote, intracellular parasite #1 parasitic disease of humans
Plasmodium
Infection in pregnant women can be more severe than in non-pregnant women, with increased risk of anemia and death
Increased risk for adverse pregnancy outcomes including
?, ?, ?, ?
Low birth rate, miscarriage, stillbirth, prematurity
Rests indoors
endophilic
Feeding period for A. gambiae?
night time
How many days does it take Plasmodium to develop in mosquito?
10-21 days
Readily soluble in fat, insoluble in water
Poorly absorbed across animal skin, but readily crosses insect cuticle
Low to moderate acute mammalian toxicity, if eaten
Persistent: 10-15 year half-life, so it’s long lasting insecticide
DDT characteristics
Acetylcholinesterase inhibitor
Example: Malathion
Used in anti-malarial campaigns after DDT phased out
Organophosphate
Derived from chrysanthemums
Low mammalian toxicity
Pyrethrins
Clinical symptoms: modified red blood cells clog capillaries, low functionality
Life expectancy:
1973: 14 years
Now: 50+ years
Sickle Cell Anemia
Which has the advantage?
a) homozygous wild-type (AA) malaria
b) homozygous sickle (SS) sickle cell anemia
c) Heterozygous (AS)
c) heterozygous
Used to
- prevent malaria
- treat malaria
- prevent relapse from latent liver infection
Malaria Drugs
Pharmaceutical chemist and educator, discovered references to an ancient, effective drug
Youyou Tu
Secondary host in plasmodium life cycle?
humans
Introduced in the 1940’s
Cheap, non-toxic
Acts on trophozoite, gametocyte to some extent
Side effects: nausea, blurred vision, headaches, sleep disturbance
Chloroquine
Earliest effective treatment known to western countries
From bark of cinchona tree
Drug of choice until 1940’s
Synthesis possible, but not economical
Side effects: tinnitus, nausea, blurred vision, headaches
Quinine
Severe ? due to hemolysis (erythrocyte destruction)
anemia
Infections complicated by serious organ failures or abnormalities in blood metabolism
- Cerebral malaria
- Severe anemia
- Pulmonary edema or acute respiratory distress syndrome
Severe complicated malaria
Infection in pregnant women can be more severe than in non-pregnant women, with increased risk of anemia and death
Increased risk for miscarriage, prematurity, low birth rate, and stillbirth infants
Placental Malaria
Causes about daily fevers, most virulent
P. falciparum
Tertian fever, hypnozoites (dormant stage which persists in liver) (2)
P. vivax, ovale
Quartan fever
P. malariae
Causes malaria among monkeys, occur is southeast Asia, has infected humans
P. knowlesi
Responsible for most cases of severe malaria
P. falciparum
More difficult to control, eliminate than because hyponozoites lead to relapse
P. vivax
Abnormal behavior, impaired consciousness, seizures, coma or other neurologic abnormalities
Cerebral malaria
Extract from leaves, Artemisia annual (sweet wormwood)
Called qinghaosu in China, known for over 1000 years, used as anthelmintics; rediscovered 1970s
Western world didn’t accept until 1990s
Artemisin
When artemisinin given along, 7-day regimens required to maximize cure rates
Adherence with 7-day treatment courses poor, so artemisinin combined with slowly eliminated partner antimalarial drug
Complete treatment course takes 3 days
Artemisinin Combined Therapy (ACT)
What 2 things allows drug resistance to happen?
excessive use, incorrect use
?=ma^2bp^n/-rln(p)
Rsub0 formula
Derived from chrysanthemums
Low mammalian toxicity
Pyrethrins
Non-specific response, present from birth
- External defenses interface with environment
- Internal defense within body
Innate Immunity
Specific response, acquired after exposure (B, T cells)
Acquired Immunity
Ingest pathogens, cellular debris
Phagocytic Cells
Recognize cancer cells, infected cells
Natural Killer Cells
Released upon infection by cells of innate response enhance blood flow, attract more immune cells to site
Signal Molecules
Employ reactive O2 species, proteases to destroy pathogen, however, damage to body’s own tissue often results
Immune Species
Compounds from white blood cells that raise ‘set point’
Pyrogens
? release induces malarial fever
Hemozoin
Foreign molecule that induces immune response
Antigen
Activated B cells produce, secrete antibodies
Humoral Immune Response
Activated cytotoxic T cells directly destroy target cells
Cell-Mediated Immune Response
Climate consistently favors mosquito development; routine exposure leads to some immunity against more severe infection
Nature’s “vaccine” paid for with high childhood mortality
Stable Transmission
Climate, less efficient vectors cause sporadic episodes spread across age-groups; epidemics may occur
Unstable Transmission
Epithelial covering of embryonic placental villi; invades uterus wall to establish circulation between embryo, mother
Syncytiotrophoblast
Invades mosquito midgut epithelium–motile
Ookinete
“bad air”
Disease caused by protist, Plasmodium, of which 4-5 species infect humans; spread by mosquito vector
Malaria
Placental Malaria: Women in first pregnancy ? susceptible, likely due to lack of specific immune response to placental parasites
more
Harmless variant or derivative of pathogen that stimulates immune system to fight pathogen
-Particles of pathogens that have been inactivated by physical or chemical means
Vaccine
Vaccines should…
- Be ?
- Be ? and ?
- Have ? immunity
safe, manufacture and administer, lifelong/longterm
Symptoms of malaria via CDC (9)
Body aches, fever, chills and sweating, headaches, nausea and vomiting, general malaise, confused with flu in non-malarial countries, enlarged spleen, mild anemia, jaundice
Attack lasting 6-10 hours includes
- Cold Stage: Sensation of cold, shivering
- Hot Stage: Fever, headaches, vomiting; seizures in young children
- Sweating Stage: Sweats, return to normal temperature, tiredness
Classic, Uncomplicated Malaria