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Case 9: Liver > Helminths Worms > Flashcards

Helminths Worms Flashcards

1
Q

What is the classification of Helminth & their site of infection

A
  1. Flat worms:
    A. Tapeworm infecting the intestine
    B. Flukes infecting the liver
  2. Round worms:
    A. Mature in human infecting intestine & tissue
    B. Fail to mature in humans infecting cutaneous & viscera
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2
Q

What is the 3 types of transmission

A
  1. Direct
  2. Modified direct
  3. Penetration of the skin
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3
Q

How does direct transmission work

A

Eggs are passed into the stool, hatch & reinfect
The eggs are passed into the stool due to oxygen requirement for maturation but does not require soil for maturation

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4
Q

What is the 3 manners in which the female pinworm deposit her eggs

A

Contracting & expelling eggs
Dying & disintegrating
Bodily rupture due to host scratching

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5
Q

What worms uses direct transmission

A

Threadworms

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6
Q

How does modified direct transmission work

A

Eggs are passed into stool, develop in soil, ingested again, hatch & penetrate stomach wall into circulation moving to the lungs & gets re-swallowed into intestine & mature

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7
Q

What worms uses modified direct transmission

A

Roundworms

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8
Q

How does penetration of the skin transmission work

A

Eggs are passed into stool, hatched & develop in soil, penetrate the skin to enter circulation & move to lungs, it gets swallowed & move to intestines & mature

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9
Q

What worms uses penetration of the skin

A

Hookworms

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10
Q

What is the 5 factors affects the immune response

A
  1. Antigenically complex
  2. Specific modes of entry
  3. Complex life cycle
  4. Survival strategies in unfavourable environments
  5. Stimulate innate, antibody & T cell mediated immune response
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11
Q

What is the 5 survival strategies of helminths in unfavourable environments

A
  1. Thick integumentary & large - not phagocytoses
  2. To kill host because the need them to complete life cycle
  3. Vary/shed surface antigen (stage specific)
  4. Coat themself in host proteins to avoid immune detection
  5. Modulate immune response through immunosupression/-evasion
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12
Q

What is the 3 systemic impacts of helminth

A
  1. DC can migrate to mesenteric lymph nodes & promote Th2 cell differentiation
  2. Helminth ES products enter circulation & contribute to development of Th2 immune response
  3. ES products can also cause a local response that adds on to the systemic response
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13
Q

What is the 2 functions of Th1 cells

A
  1. Activation of macrophages resulting in tissue damage & remodelling
  2. Activatio of B cells to produce IgG2a which act as component fixing antibodies
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14
Q

What is the 4 functions of Th2 cells

A
  1. Produce IL-13 that induce epithelial cell repair & mucous
  2. Produce IL-5 that recruits & activates eosinophils that produce MBP which can kill parasites & mediate ADCC
  3. Produce IL-4 that drive B cells to produce IgE & mediate ADCC
  4. Produce IL-3,-9 that drive mast cells & can release histamine, TNF-alpha & MMCP which recruite inflammatory cells & remodel mucosa
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15
Q

What is the actions of the innate immune response to Helminths

A
  1. Infection results in the secretion of IL-25 & IL-33 cytokines by intestinal epithelial cells
  2. This activates ILC2, mast cells, basophils & dendritic cells
  3. ILC2 resembles & mimic Th2 cells & produce cytokines IL-4, 5 & 13 & promote the formation of Th2 cells, eosinophils & macrophages
    Macrophages tissue damage & tissue remodelling
    Th1 activation of B cells that produces complete Ab
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16
Q

What is the actions of the adaptive immune response to Helminths

A
  1. DC cells present to naive T cells that differentiate into Th2 cells
  2. Release of numerous cytokines including IL-4, 5, 9 & 13
    IL-4 drive B cells to produce IgE & ADCC
    IL-5 recruiter & activate eosinophils & MBP that can lead to killing or ADDC
    IL-3 & 9 mast cells that release histamine, TNF-a & MMCP that release inflammatory cells & mucosa remodelling
    Il-13 induce epithelial cell repair & mucous production
    IL-4 & 13 increase smooth muscle motility, stimulate intestinal permeability & elevate mucous secretion
17
Q

What is ADCC

A

Antibody dependent cell mediated cytotoxicity

18
Q

What is the process of ADCC

A
  1. Cytokines produced by Th2 cells enable B lymphocytes to activate eosinophils & produce more IgE against helminths
  2. IgE then acts as an opsonin & help phagocytic eosinophils for extracellular killing (Fab binds to helminth epitope & Fc bind to Fc on eosinophils) * promote inflammation
  3. Lysosomal proteases of eosinophils destroy tough integumentary of helminths

Case 9: Liver (8 decks)

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