Lec 21-Immunity To Parasites Flashcards

1
Q

Immune sys and parasites

A
  • Immune sys is designed to fight parasites
  • When immune sys cant fight parasites anymore = infection
  • Parasitic infections are especially prevalent in tropical/subtropical regions
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2
Q

What are parasites?

A
  • Microorganisms
  • Can infect humans (via contact, inhalation, ingestion), arthropods (act as vectors of transmission i.e. mosquitos), nonhuman primates (zoonotic spread)
  • Parasites are a big challenge for the immune sys, harder to get rid of than viruses—they have many diff forms which makes it hard for immune sys to detect
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3
Q

2 main groups of parasites

A

2 main groups: protozoans (unicellular, eukaryotic) and metazoans (helminths/worms)

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4
Q

What is the primary reason parasites are such a big challenge for the immune system?

A

Parasites change their antigenic structure and their location over time to evade immune response

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5
Q

Entry points for parasites

A

Resp tract, GI tract, vaginal tract, anal tract, conjunctiva, epidermis

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6
Q

Eg. Parasites changing location to evade immune response

A
  • Lots of variability, can be in many vectors
  • Worst diseases caused by protozoan parasites that are unicellular, motile eukaryotes. They can be found in contaminated water
  • Protozoan parasites can move from their arthropod vector hosts to mammalian hosts to infect them
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7
Q

Why are parasites bad

A
  • Parasitic infection is endemic/epidemic in LDCs. In MDCs we would have 0 immunity to anything like this so we would die
  • Multicellular parasites influence host immune response—eg. Co-infection with a parasite and a virus/bacteria is very dangerous
  • Eg. Malaria (parasitic infection) kills 2-5 mill children a year
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8
Q

Endemic vs epidemic vs pandemic

A

Endemic: in 1 area
Epidemic: many geo locations in 1 country
Pandemic: has spread across world

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9
Q

Trypanosomes eg

A
  • Trypanosomes are parasites that can evade immune response by changing antigenic signature
  • Host is infected with trypanosome expressing VSG1 protein. As body begins to act against this protein, tryp shuts down VSG1 and begin expressing VSG2 (diff structure), so immune sys mounts a diff response against VSG2, tryp shut down VSG2 and express VSG3. Immune sys cannot kill them bc they will keep going like this
  • All immune sys energy is going into this mechanism, making co-infection w something else i.e. flu, worse
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10
Q

CTL/CD8 job in parasitic infection

A

Main job of CTLs when they encounter parasite is killing

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11
Q

CD4 helper cells (2)

A

Th1 and Th2 are CD4 helper cells

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12
Q

Th1

A

Th1:
- When a T cell is exposed to IL-12, it becomes Th1
- Th1 secretes IL-2 to stimulate Th (helper) and Tc (cytotoxic) proliferation, and IFN-gamma to engage with NK cells and do immune response
- Th1 cells induce cell mediated response—all immune responses are mediated by cells

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13
Q

Th2

A

Th2:
- When T cell is exposed to IL-4, becomes Th2
- Secretes IL-4 to further Th2 response, IL-5 for eosinophil growth, and IL-10 to inhibit Th1 response
- Mediates humoral immunity

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14
Q

Immune response for schistosoma mansoni (worm)

A
  1. Worm into body (likely GI)
  2. Immune sys secretes IgE antibodies
  3. IgE’s tag worm
  4. IgE’s activate complement—>inflammatory molecs—>mast cell activation
  5. When mast cells are activated, they will secrete ECF and NCF (eosinophil and neutrophil)—> calls eosinophils and neutrophils to interact w IgE
  6. Systemic inflammation

**Chemotaxis is required to get to site of infection
**Mast cells main role is to interact with IgE and secrete inflammatory molecs

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15
Q

Ascaris nematodes

A
  • Roundworms
  • Very large
  • In GI tract—eggs hatch in gut, larvae migrate to lungs, burst out of blood into alveoli into grown worm, coughed back into gut
  • Female nematodes can release 500k eggs per day
  • Eggs can live for 15 years in host if they never burst, you can have all these eggs living in your GI tract and not know
  • Once the egg is burst is when immune sys recognizes
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16
Q

Onchocerca nematode

A
  • “River blindness”, can go into eye and cause blindness
  • Transmitted by black fly bite—fly is infected with egg and transmits them into human host. Eggs will burst in human into worms
  • Cause nodules below skin
  • Typically go in brain
  • type 1 immune response
17
Q

Toxocara nematode

A
  • Dog is host
  • Same life cycle as #1
  • If it infects human, it can be in brain/CNS
  • Induce type 1 inflammatory response
  • When infection is too persistent, immune sys will give up. They will form form granulomas (capsule against parasite) to ensure virus doesnt replicate, but it will never get killed
18
Q

Enterobius nematode

A
  • Very common
  • Eggs where embryo of worm is developing are infective along with the worms
  • Usually develop in LI, migrate into anus
  • Not very pathogenic
  • Limited immune response, mainly just itch
  • Treatment over the counter
  • Can live in dust for a long time waiting to infect next person
19
Q

What is VSG

A

Genes encoding for surface glycoproteins

20
Q

Immune modulation by helminths

A
  • Helminths are metozoan parasites
  • Influence activation and induce cell death in T cells
  • Steer T cells response from type-1 immune response (CD8) pathways to type-2 immune response (CD4)
  • Induce polyclonal B cell activation
  • Induce class switch to IgE—this means vaccine is inaffective bc vaccines are targeted toward IgG
21
Q

Implications of IgE on vaccine

A
  • We design vaccines to make IgG antibodies to neutralize antigens
  • With IgE, its main role is to interact with mast cells/neutrophils/basophils to induce degranulation, but not killing
  • Vaccine doesnt work very well against IgE
22
Q

What is chemotaxis?

A

When our immune cells are circulating, secretion of mediators calls them to parasite infection site
Chemotaxis: directed movement of cells to go to site of infection

23
Q

Selected important parasites

A
  • Nematodes (roundworms)
  • Cestodes (tapeworms)
  • Trematodes (flukes)
  • Extracellular Protozoa and amoeba
  • Intracellular Protozoa
24
Q

Trichinella nematode

A
  • Mostly found on uncooked pork
  • Larvae live in muscle, adults live in gut (SI)
  • Can damage immune sys, big inflammatory response can cause organ damage
  • We have limited protective immune response
  • We have medication to protect against it
25
Q

Anisakiases nematodes

A
  • Marine, often called “cod worm”
  • Caused by eating raw fish
  • Final host is seal, intermediate host is fish
  • Was an issue for indigenous ppl
  • Fish are candled to remove them
  • Red in colour
26
Q

Anisakidae nematode

A
  • Similar to Anisakiases
  • Caused by eating raw fish
  • Final host is seal, intermediate host is fish
  • Was an issue for indigenous ppl, still common in Canada
  • Clear in colour
  • Inflammatory response can lead to cancer — go into bile duct
27
Q

Taenia cestodes (tapeworms)

A
  • Usually come from pork or beef we ingest or microbiota our intestines produce
  • Can get up to 10m, can live for a long time in intestines
  • Limited immune response mediated by IgA
  • Cyst (egg form) can go into brain and degrade (make holes) in brain
28
Q

Schistosoma trematodes

A
  • Very tiny
  • Can be in many tissues, typically eggs in gut adults in liver
  • Cause liver inflammation that resembles an alcoholic’s liver
  • Good at escaping immune sys by presenting diff antigens at diff points (similar to trypanosomes)
  • No effective immunity against them bc they can travel from tissue to tissue in diff forms
  • Eggs that stay in liver can cause immunopathology (immune response against a tissue). Mediated by eosinophils (type 2 granulomas) and cytokine IL-5. Causes acute liver failure
29
Q

**Trypanosoma extracellular Protozoa

A
  • Extracellular microorganism
  • African and South American species
  • Creates “sleep sickness”, goes into the blood
  • Caused by tsetse flies
  • Non-protective CNS immunopathology: immune sys creates inflammation but doesnt protect tissues
  • Surface coat changes to evade immune attack (exact same as trypanosome eg)
30
Q

Giardia extracellular protozoa

A
  • Common in day cares in Canada
  • Feco-oral transmission
  • “beaver fever”—canada
  • Simple life cycle—ppl ingest cysts whcih develop into nerves
  • Adults live in the intestine
  • Destroy villi, patients have nutrient deficiencies bc they can’t absorb nutrients from food
  • IgA response
31
Q

Entamoeba extracellular protozoa

A
  • Large single-celled organisms
  • Can destroy RBCs
  • Host response is cell-mediated immunity
  • Adult form typically live in GI tract
    -Sometimes they go into liver which is when patients are effected severely
  • Can also go into CNS, but really is not common
  • Limited protective immunity
  • Can be fatal
32
Q

Parasite #13: Leishmania intracellular protozoa

A
  • Is becoming more common
  • Causes skin lesions
  • Common in Africa and Asia
  • Transmitted by sandfly bite
  • Can infect macrophages. They let macrophages engulf them but then attack them once inside, allowing them to be capable of immune evasion
  • When in spleen and liver are very severe and possibly fatal
33
Q

**Parasite #14: Plasmodium intracellular protozoa

A
  • AKA malaria
  • Common in LDCs
  • Transmitted by mosquitos, hard to control
  • Severe implications in all countries affected
  • Kills 3000 kids everyday, 1-3 mil ppl mostly kids every year
  • Lots of steps to life cycle, hard to develop drug/vaccine. Drug/vaccine recently was approved
  • Life cycle: infection w/ sporozoites via mosquito—>sporozoites migrate into liver, change into merozoites—>merozoites out of liver to infect and lyse RBCs—>asexually repro—> gametocytes—>transmission to mosquito
  • Most common symptom is anemia due to RBC lysis
  • Change expression so its hard for immune sys to keep up
  • Protection by sickle cell anemia trait—their RBCs have diff morphology
  • Look for “ring stage” of RBCs to confirm infection
  • Can be fatal fast
34
Q

Prevention and diagnosis of intracellular protozoa (such as malaria)

A
  • Chloroquine—malaria has resistance
  • Mefloquine—has a lot of bad side effects
  • Doxycycline, malarone
35
Q

3 main diseases that havent been cured:

A
  • HIV
  • TB
  • Malaria
36
Q

Extra cause of malaria

A
  • Ppl who survive malaria have other issues
  • Bc RBCs are killed/deformed, can trouble transporting oxygen
  • Can cause thrombosis, brain bleeding, etc