Cysticercosis, caused by Taenia solium larva is a major public health problem, especially in the developing world and neurocysticercosis (NCC) is considered to be the most common parasitic infestation of the central nervous system. NCC is identified as the single most common cause of community acquired active epilepsy; 26.3% to 53.8% active epilepsy cases in the developing world including India and Latin America are due to NCC. It is also becoming more common in the developed world because of increased migration of people with the disease or Taenia solium carriers and frequent travel to the endemic countries. It is estimated that three quarters of the estimated 50 million people with active epilepsy live in the poor countries of the world. Recent Indian studies using neuroimaging techniques suggest that the disease burden in India surpasses many other developing countries. Hence it is important to know the epidemiology, pathogenesis and diagnostic criteria so as to assess the disease burden and adopt interventional strategies for its control. Literature search was done for this review with special emphasis on Indian studies to create awareness about the disease in India, since cysticercosis is preventable and potentially eradicable.

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Human cysticercosis and Indian scenario: a review

Neurocysticercosis in Mexico.

NADH dehydrogenase subunit 1 and cytochrome c oxidase subunit I sequences compared for members of the genus Taenia (Cestoda)

The life cycle of Taenia solium, the pork tapeworm, is continuously closed in many rural settings in developing countries when free roaming pigs ingest human stools containing T solium eggs and develop cysticercosis, and humans ingest pork infected with cystic larvae and develop intestinal taeniasis, or may also accidentally acquire cysticercosis by faecal-oral contamination Cysticercosis of the human nervous system, neurocysticercosis, is a major cause of seizures and other neurological morbidity in most of the world The dynamics of exposure, infection and disease as well as the location of parasites result in a complex interaction which involves immune evasion mechanisms and involutive or progressive disease along time Moreover, existing data are limited by the relative lack of animal models This manuscript revises the available information on the immunology of human taeniasis and cysticercosis

Immunology of Taenia solium taeniasis and human cysticercosis

According to a previous report, the degree of the host immune response highly correlates with severity of the disease in the murine model for neurocysticercosis. In wild-type mice, Mesocestoides corti infection induced a rapid and extensive accumulation of γδ T cells and macrophages in the brain. NK cells, dendritic cells, αβ T cells, and B cells were also recruited to the brain but at lower levels. In contrast, γδ T-cell-deficient mice exhibited decreased cellular infiltration and reduced central nervous system (CNS) pathology. To understand the mechanisms of leukocyte recruitment into the CNS, chemokine expression was analyzed in infected brains in the present study. MCP-1 (CCL2), MIP-1α (CCL3), and MIP-1β (CCL4) were up-regulated within 2 days after M. corti infection. Protein expression of RANTES (CCL5), eotaxin (CCL11), and MIP-2 was detected later, at 1 week postinfection. Correlating with the decreased cellular infiltration, delta chain T-cell receptor-deficient (TCRδ−/−) mice exhibited substantially reduced levels of most of the chemokines analyzed (with the exception of eotaxin). The results suggest that γδ T cells play an important role in the CNS immune response by producing chemokines such as MCP-1 and MIP-1α, enhancing leukocyte trafficking into the brain during murine neurocysticercosis.

CC chemokines mediate leukocyte trafficking into the central nervous system during murine neurocysticercosis: Role of γδ T cells in amplification of the host immune response

Twelve Taenia solium cysticerci, obtained from several human organs, were examined by immunofluorescence for IgG, IgM, IgA, IgE and C3b on their surfaces. Anti-cysticercus antibodies of the 4 classes of immunoglobulins were looked for in the cerebrospinal fluid of most neurologic patients, in the intraocular humors of a patient with eye cysticercosis, and in the serum of some other patients. The morphological appearance of the parasites as well as the clinical features of the patients were recorded. The distribution of components was heterogeneous among the different parasite surfaces. IgG was the most frequent, followed by IgA, IgM, C3b and IgE. No correlation was found between the presence of these molecules and signs of damage in the cysticerci, or with the classes of immunoglobulins found as anti-cysticercus antibodies. Possible explanations of these findings as well as the implications of heterogeneity in cysticercosis are discussed.

Heterogeneity of humoral immune components in human cysticercosis.

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Heterogeneity of humoral immune components in human cysticercosis.