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PubMed1991

Parasitic diseases. Diseases associated with acquired immunodeficiency syndrome.

There are several protozoan infections that cause relatively benign illness in normal individuals but result in severe disease manifestations in patients with AIDS. These diseases include Pneumocystis carinii pneumonia, CNS toxoplasmosis, cryptosporidiosis, and isosporiasis. Pneumocystis carinii pneumonia (PCP) caused by Pneumocystis carinii, is the most common opportunistic infection in AIDS. It is seen in more than 80% of individuals with this syndrome. Although historically classified as a protozoan, this organism shares many biochemical characteristics with fungi. The onset of PCP may be insidious, and cough and dyspnea are the most common presenting symptoms. Auscultation of the lungs is often unremarkable, but diffuse infiltrates are commonly seen on chest radiographs. The diagnosis of PCP can be confirmed by identifying the organism on specimens obtained by sputum induction or bronchoalveolar lavage. Trimethaprim-sulfamethoxazole is the treatment of choice but is unfortunately associated with leukopenia and rash in many individuals. Both trimethaprim-sulfamethoxazole and aerosolized pentamidine are used prophylactically in patients at high risk for initial or relapsing infection. The appropriate use of these agents has resulted in improved survival for AIDS patients with PCP. Toxoplasmosis, due to Toxoplasma gondii, affects the central nervous system in patients with AIDS. Headache is a common presenting symptom, and both seizures and paresis can occur. A diagnosis of toxoplasmosis is strongly suspected in symptomatic individuals with ringed mass lesions noted on head CT. Patients with this condition are treated with a combination of sulfadiazine, pyrimethamine, and folinic acid. Cryptosporidiosis and isosporiasis are coccidian protozoan diseases that can result in severe, acute, and chronic diarrhea in immunocompromised individuals. Cryptosporidiosis is the more common of the two and is caused by an unknown species of the genus crytosporidium. Isosporiasis is due to infection with Isospora belli. Dehydration and weight loss are a common result of infection with either agent. A definitive diagnosis can be made by examining an acid fast stain of a diarrheal stool specimen and demonstrating oocysts that are specific for each of these organisms. Fluid replacement and general supportive care are essential in the treatment of both of these diseases. Spiramycin is an unproven treatment modality that is often used in patients with cryptosporidiosis. Isosporiasis responds to initial therapy with trimethaprim-sulfamethoxazole, followed by prophylaxis with pyrimethamine. The adoption of safe sexual practices that minimize fecal-oral contamination should decrease the future prevalence of these diseases and other enteric parasitic infections.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Application of hybridoma technology to the diagnosis of parasitic disease.

Recent applications of hybridoma-derived monoclonal antibodies to the diagnosis of parasitic disease are reviewed. Diagnostic tests, utilizing monoclonal antibodies, have included radioimmunoassay (RIA) and enzyme-linked immunosorbent assay (ELISA) techniques to detect parasite antigen in host tissues and body fluids and circulating host antiparasite antibody. In general, the use of monoclonal-derived reagents has greatly increased the specificity of diagnosis by eliminating cross-reactions between closely related parasite species, without suffering a significant loss of sensitivity.

Animals↗
PubMed1981

The parasitic diseases of school children in Lagos State, Nigeria.

A survey of 5,595 primary school children in Lagos State showed that most of the children were over-loaded with parasitic infestations which included malaria (37.7%), schistosomiasis (13.4%). ascariasis (74.2%), trichuriasis (75.8%), hookworm (29.5%) and tungiasis (49.5%). Multiple infections were observed with about 16.2% harbouring all the causative organisms of the parasitic diseases enumerated above. The high prevalence of parasitic infestations among these children is an index of the community's low level of health and also of inadequate health education, because most of these diseases are preventable if the people are told what to do.

Adolescent↗
PubMedDate not supplied

Fibronectin in parasitic diseases.

Fibronectin, a major interstitial matrix protein with binding sites for a variety of molecules and with multiple biologic activities, may play an important role in certain parasitic diseases. Leishmania and Trypanosoma cruzi bind host fibronectin, which, in turn, facilitates their association with the cells they parasitize. Invasive Entamoeba histolytica and Schistosoma produce proteases that degrade fibronectin and other matrix proteins, presumably facilitating the breaching of intestinal mucosa and dermal barriers to infection. The granulomatous inflammation that accompanies tissue deposition of schistosomal eggs promotes excess matrix production and scar formation. Granuloma macrophages and fibroblasts secrete fibronectin, which may serve to recruit additional fibroblasts and also may aid in maintaining the structural integrity of the granulomas. These early findings suggest that parasite-fibronectin interactions may be a fertile area for further research.

Animals↗
PubMed2006

Progresses in the field of drug design to combat tropical protozoan parasitic diseases.

The progresses made in the field of drug design to combat tropical protozoan parasitic diseases, such as Chagas' disease, leishmaniasis, and sleeping sickness are discussed. This article is focused on different approaches based on unique aspects of parasites biochemistry and physiology, selecting the more promising molecular targets for drug design. In spite of the enormous amount of work on the above features, the chemotherapy for all of these diseases remains unsolved. It is based on old and fairly not specific drugs associated, in several cases, with long-term treatments and severe side effects. Drug resistance and different strains susceptibility are further drawbacks of the existing chemotherapy. In this review article, a thorough analysis of selected molecular targets, mainly those that are significantly different compared with the mammalian host or, even, are not present in mammals would be described in terms of their potencial usefulness for drug design. Therefore, this article covers rational approaches to the chemotherapeutic control of these parasitic infections, such as the progresses in the search for novel metabolic pathways in parasites that may be essential for parasites survival but with no counterpart in the host. Ergosterol biosynthesis is a very interesting example. There are many enzymes involved in this biosynthetic pathway such us squalene synthase, farnesylpyrophosphate synthase, and other enzymes that are able to deplete endogenous sterols will be treated in this article. The enzymes involved in trypanothione biosynthesis, glutathionyl spermidine synthetase and trypanothione synthetase do not have an equivalent in mammals, and therefore it can be predicted low toxicity for compounds that are able to produce highly selective inhibition. Trypanothione reductase (TR), glyceraldehyde-3-phosphate dehydrogenase, dihydrofolate reductase, prenyltransferases, ornithine decarboxylase, etc, will be thoroughly analyzed. The design of specific inhibitors of such metabolic activities as possible means of controlling the parasites without damaging the hosts will be presented. The recent advances in the biochemistry of pathogenic parasites including the discovery of novel organelles will be discussed.

Antiprotozoal Agents↗
PubMed1993

A synoptic inventory of needs for research on women and tropical parasitic diseases. I. Application to urinary and intestinal schistosomiasis.

The determinants of major parasitic infections in women have never been studied systematically. Much work remains to be done before vital gaps in our knowledge will be filled. The protocol presented here categorizes the determinants of parasitic diseases, and functions as an inventory for research needs and priorities. In this paper, the synoptic inventory is tested by matching it against the scientific knowledge of schistosomiasis that is at hand. Available data and existing lacunae are discussed. We conclude that the environmental, economic, socio-cultural, nutritional, genetic, biological and immunological factors which determine schistosomiasis in women are largely unknown. There is an urgent need for systematic and interdisciplinary investigations before appropriate and sustainable interventions can be initiated.

Adult↗