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Questions and Answers
What causes African sleeping sickness?
What causes African sleeping sickness?
Which of the following is NOT a reason why African sleeping sickness is a major contributor to poverty in Africa?
Which of the following is NOT a reason why African sleeping sickness is a major contributor to poverty in Africa?
What is the primary mode of transmission for the Trypanosoma brucei parasite?
What is the primary mode of transmission for the Trypanosoma brucei parasite?
What is the approximate number of African sleeping sickness cases reported annually?
What is the approximate number of African sleeping sickness cases reported annually?
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Which of the following describes the geographic distribution of African sleeping sickness?
Which of the following describes the geographic distribution of African sleeping sickness?
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What is the name of the disease that Trypanosoma brucei causes in animals, especially livestock?
What is the name of the disease that Trypanosoma brucei causes in animals, especially livestock?
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Which of the following factors influences human exposure to African trypanosomiasis?
Which of the following factors influences human exposure to African trypanosomiasis?
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Why are there no vaccines for African sleeping sickness?
Why are there no vaccines for African sleeping sickness?
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Which of the following statements about African sleeping sickness treatments is TRUE?
Which of the following statements about African sleeping sickness treatments is TRUE?
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What is the primary reason for the economic impact of African sleeping sickness?
What is the primary reason for the economic impact of African sleeping sickness?
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What mechanism allows the trypanosome to keep changing the VSG it expresses?
What mechanism allows the trypanosome to keep changing the VSG it expresses?
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What is the primary function of the variant surface glycoprotein (VSG) in trypanosomes?
What is the primary function of the variant surface glycoprotein (VSG) in trypanosomes?
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How does the trypanosome evade the host immune system?
How does the trypanosome evade the host immune system?
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Why is a vaccine against trypanosomes considered unlikely?
Why is a vaccine against trypanosomes considered unlikely?
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What is the significance of the "waves of parasitemia" observed in chronic trypanosome infections?
What is the significance of the "waves of parasitemia" observed in chronic trypanosome infections?
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How do trypanosomes survive for years in the bloodstream?
How do trypanosomes survive for years in the bloodstream?
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Which of the following is NOT a key feature of trypanosome biology that contributes to the "waves of parasitemia"?
Which of the following is NOT a key feature of trypanosome biology that contributes to the "waves of parasitemia"?
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What is the role of hydrodynamic-flow mediated endocytosis in trypanosome immune evasion?
What is the role of hydrodynamic-flow mediated endocytosis in trypanosome immune evasion?
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How does the trypanosome's VSG repertoire become "unlimited"?
How does the trypanosome's VSG repertoire become "unlimited"?
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Why does the slender form of the trypanosome proliferate rapidly?
Why does the slender form of the trypanosome proliferate rapidly?
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What is the primary reason why African sleeping sickness is a major contributor to poverty in Africa?
What is the primary reason why African sleeping sickness is a major contributor to poverty in Africa?
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How does the trypanosome's ability to switch its Variant Surface Glycoprotein (VSG) relate to the "waves of parasitemia" observed in chronic infections?
How does the trypanosome's ability to switch its Variant Surface Glycoprotein (VSG) relate to the "waves of parasitemia" observed in chronic infections?
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What is the primary reason for the lack of a vaccine against African sleeping sickness?
What is the primary reason for the lack of a vaccine against African sleeping sickness?
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What is the primary mechanism by which the trypanosome evades the host's immune system, leading to chronic infections?
What is the primary mechanism by which the trypanosome evades the host's immune system, leading to chronic infections?
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How does the trypanosome's ability to switch its Variant Surface Glycoprotein (VSG) affect the effectiveness of treatments for African sleeping sickness?
How does the trypanosome's ability to switch its Variant Surface Glycoprotein (VSG) affect the effectiveness of treatments for African sleeping sickness?
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What is the primary mechanism by which trypanosomes evade antibody-mediated immune clearance?
What is the primary mechanism by which trypanosomes evade antibody-mediated immune clearance?
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Which of the following statements accurately describes the role of hydrodynamic-flow mediated endocytosis in trypanosome immune evasion?
Which of the following statements accurately describes the role of hydrodynamic-flow mediated endocytosis in trypanosome immune evasion?
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How does the process of mosaic formation contribute to the "unlimited" VSG repertoire of trypanosomes?
How does the process of mosaic formation contribute to the "unlimited" VSG repertoire of trypanosomes?
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Which of the following best describes the role of the "slender form" and "stumpy form" differentiation in the trypanosome life cycle?
Which of the following best describes the role of the "slender form" and "stumpy form" differentiation in the trypanosome life cycle?
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Which of the following statements correctly explains the reason for the "waves of parasitemia" observed during a chronic trypanosome infection?
Which of the following statements correctly explains the reason for the "waves of parasitemia" observed during a chronic trypanosome infection?
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Which of the following BEST represents the primary reason why vaccination against trypanosomes is considered unlikely?
Which of the following BEST represents the primary reason why vaccination against trypanosomes is considered unlikely?
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Which of the following BEST describes the role of the VSG in trypanosome immune evasion?
Which of the following BEST describes the role of the VSG in trypanosome immune evasion?
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Which of the following best explains why trypanosomes can survive for YEARS in the bloodstream of their host?
Which of the following best explains why trypanosomes can survive for YEARS in the bloodstream of their host?
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Flashcards
VSG (Variant Surface Glycoprotein)
VSG (Variant Surface Glycoprotein)
A protein that shields trypanosomes from the immune system by masking other proteins.
Antigenic variation
Antigenic variation
Process by which trypanosomes change their VSGs to evade immune detection.
Mosaic formation
Mosaic formation
New VSGs created by recombining sub-telomeric VSGs with expression site VSGs.
Slender to stumpy differentiation
Slender to stumpy differentiation
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Parasitemia
Parasitemia
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Immune clearance
Immune clearance
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Hydrodynamic-flow mediated endocytosis
Hydrodynamic-flow mediated endocytosis
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Expression site switching
Expression site switching
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Vaccine challenges for trypanosomes
Vaccine challenges for trypanosomes
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African Sleeping Sickness
African Sleeping Sickness
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Trypanosoma brucei
Trypanosoma brucei
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Tsetse fly
Tsetse fly
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Epidemiology
Epidemiology
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Control measures
Control measures
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Nagana
Nagana
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Sub-Saharan Africa
Sub-Saharan Africa
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WHO report 2016
WHO report 2016
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Rural populations
Rural populations
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Fatal disease
Fatal disease
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Trypanosome transmission
Trypanosome transmission
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Impact of African Sleeping Sickness
Impact of African Sleeping Sickness
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Nagana economic impact
Nagana economic impact
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Disease foci
Disease foci
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Control of HAT
Control of HAT
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Unlimited VSG repertoire
Unlimited VSG repertoire
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VSG recombination
VSG recombination
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Waves of parasitemia
Waves of parasitemia
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Slender form proliferation
Slender form proliferation
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Stumpy form
Stumpy form
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Antibody removal mechanism
Antibody removal mechanism
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Vaccine limitation
Vaccine limitation
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Study Notes
Trypanosomes and African Sleeping Sickness
- Trypanosomes are the cause of African sleeping sickness, a fatal disease.
- In humans, there are approximately 1,000 cases per year, though historically the number was much higher.
- Treatments for sleeping sickness can be highly toxic.
- Nagana is a major contributor to poverty in Africa due to trypanosomes in animals, causing economic impact of US$4.5 billion per year.
- Trypanosomiasis (HAT) only occurs in 36 sub-Saharan countries with tsetse flies.
- Rural populations dependent on agriculture, fishing, or animal husbandry are most vulnerable to this disease caused by tsetse flies.
- Two sub-species of African trypanosomes are responsible for HAT: T.b. rhodesiense (severe, ~10% of cases) and T. b. gambiense (chronic, ~90% of cases). They have distinct geographic profiles.
- Trypanosomes are unicellular and extracellular parasites.
- Transmission occurs via tsetse flies.
Learning Objectives
- Trypanosomes cause African sleeping sickness.
- The epidemiology of sleeping sickness and the role of tsetse flies in spreading it.
- Trypanosomes have distinct life cycle stages adapted to different host and vector niches.
- The mechanisms trypanosomes use to evade the host immune system.
- Biological aspects of trypanosomes that lead to waves of parasitaemia in chronic infections.
African Sleeping Sickness - Epidemiology and Control
- 1896-1906 saw 300,000 to 500,000 deaths in Uganda and Congo Basin due to sleeping sickness (mostly).
- The 1920 epidemic was controlled by mobile teams that screened millions.
- Control measures in the 1960s nearly eliminated the disease but relaxation caused a resurgence in the 1970s.
- A resurgence of human African trypanosomiasis (HAT) caused by Trypanosoma brucei rhodesiense in Ethiopia has been reported in 2022 (after 30 years), with two of the four patients dying before treatment could begin.
Animal Trypanosomiasis
- Cattle and game are affected by a disease known as Nagana.
- Nagana ("to be depressed") in cattle causes lethargy, substantial weight loss, and decreased productivity.
- T. brucei (including rhodesiense and gambiense) cause Nagana.
- Trypanosomes significantly reduce the productivity of livestock in sub-Saharan Africa.
Control of African Sleeping Sickness
- Target the parasites in the host through screening and treatment programs for humans.
- Treat domestic cattle.
- Eliminate wild animal reservoirs of the disease.
- Promote improved public health (better community health).
- Target the vector through spraying insecticides (e.g. DDT - now outlawed in many places), insecticide-treated fly traps, and insecticide-treated bed nets.
- Re-implementing control programs started in the 1990's led to improved outcomes.
Vector Control
- Blue fly traps—cost around $250 per square mile and need replacing every 5 months.
Current Situation
- A resurgence of human African Trypanosomiasis (HAT) caused by Trypanosoma brucei rhodesiense in Ethiopia has been reported in 2022 (after 30 years), with two of the four patients dying before treatment could begin.
African Sleeping Sickness - Symptoms and Pathology
- The first stage involves inflammation at the tsetse fly bite site, often resulting in a local chancre.
- The early stage is characterized by regular bouts of fever and flu-like symptoms.
- Swollen lymph nodes (Winterbottom's sign).
- Early stage symptoms are generally milder in gambiense cases, but can be severe in rhodesiense cases and lead to substantial loss of function, including behavioural changes and potentially coma.
Trypanosome Lifecycle
- Vector: Glossina sp (tsetse flies)
- Host: Mammals (including humans)
- Trypanosomes mature through multiple stages.
- The 4 stages to remember are: Slender (proliferative), Stumpy (non-proliferative), Procyclic, and Metacyclic.
- They inhabit the blood, skin, adipose tissue, and central nervous system (late stage disease only)
- Trypanosomes are taken into the insect midgut upon tsetse biting and travel to salivary glands.
Trypanosome Immune Evasion
- VSG: Variant Surface Glycoprotein.
- Protection.
- Keeps trypanosomes hidden from host immune cells (antibodies, complement, immune cells).
- Constant antigenic variation (switching expression sites and/or swapping in new VSG genes) allows the parasites to continuously switch their surface proteins to evade the host immune response.
- Hydrodynamic Flow: Antibodies are swept to the posterior part of the cell.
- There are three methods to immune evasion.
Trypanosome Motility
- Motility is important for host infection.
- Motility is essential for successful host infection
- Mice infected with parasites that have an inducible motility defect, cleared their parasites in 16 hours.
Hydrodynamic Flow and High Antibody Titers
- Hydrodynamic flow less effective at high antibody titers.
- Trypanosomes express a single VSG at a given time.
- VSG is highly immunogenic (an immune response).
- A strong antibody response eventually overwhelms hydrodynamic flow, which is a defense mechanism, and eventually kills the cell.
- Trypanosomes keep returning (waves) because they keep producing new VSGs.
Summary
- The infection begins with an initial bite and inflammation at the site. Trypanosome numbers increase in the blood, lymphatics and tissues, causing symptoms like fever, and swelling in the lymph nodes. Finally parasites pass into the CNS (central nervous system) causing more serious symptoms (mental/behavioural changes,coma). Trypanosomes remain in the blood, skin, and adipose tissue (fat) for extended periods, largely through evasion mechanisms, most notably antigenic variation of VSG, to evade host immune attacks.
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Description
Explore the effects of trypanosomes on human health and agriculture, particularly focusing on African sleeping sickness. Understanding its economic impact and transmission via tsetse flies is crucial for regional health. Learn about the species involved and vulnerable populations in sub-Saharan Africa.