Introduction to Parasitology, Protozoa and Their Infections, Helminths and Their Infections, Antiprotozoal and Antihelminthic Agents, PDF

PHAR 215 PHARMACEUTICAL MICROBIOLOGY AND IMMUNOLOGY Introduction to Parasitology, Protozoa and their Infections, Helmints and their Infections, Antiprotozoal-Antihelminthic Agents Asst. Prof. Dr. Cansu VATANSEVER E-mail: [email protected] ...

PHAR 215 PHARMACEUTICAL MICROBIOLOGY AND IMMUNOLOGY Introduction to Parasitology, Protozoa and their Infections, Helmints and their Infections, Antiprotozoal-Antihelminthic Agents Asst. Prof. Dr. Cansu VATANSEVER E-mail: [email protected]  Parasitology is a discipline study with animal parasites, relationship between parasite and host and relationship between parasite and environment Introduction to Parasites are organisms which live on or within its host for nutrition and physical protection but they are harmful to Parasitology human health Parasites are heterotrophic organisms Parasites obtain nutrition from the host This interaction is harmful to the host Parasites depend on other organisms for maintain their lives Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Host In the parasitism, the partners that provide the food and shelter to parasites are called hosts Host are larger, more complex and better organized living organisms Types of the host; Definitive host is the host in which the parasite become sexually mature - E.g. mosquitoes are definitive hosts of Plasmodium spp. Intermediate host is the host in which the parasite undergoes larval development but does not reach sexual maturity - E.g. mammals, including humans, are intermediate hosts of Plasmodium spp. Reservoir host is the host harbor an infection that can be transmitted to humans - E.g. The rabies virus normally infects wild mammals, but rabies virus can infect domestic animals and thus infect humans Transport host is the host when parasite enters the body of an abnormal host and not undergoes any development but continues to survive and be infective to the normal host Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Types of A. Residing site Parasites B. Ecology C. Duration of parasitism Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  A. Residing site Endoparasite; parasite that lives inside the body of its host - E.g. Entamoeba histolytica Endoparasites can be intercellular or intracellular parasites Intercellular parasites live in spaces within the host - E.g. gastrointestinal system Intracellular parasites live in cells within the host - E.g. erythrocytes Intracellular parasites typically need a third organism, a vector, to transmit the parasite between hosts Ectoparasite; parasite that lives on the outer surface of its host - E.g. mites Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  B. Ecology Obligate parasite; parasite is completely dependent on the host during its life cycle - E.g. Plasmodium spp. Facultative parasite; parasite exhibits both parasitic and non-parasitic livestyles and does not absolutely depend on the host -E.g. Naegleria fowleri Accidental parasite; parasite infects an unnatural host and survives -E.g. Hymenolepis diminuta C. Duration of parasitism Temporary or intermittent parasite; parasite occasionally visits its host for nutrition - E.g. soft ticks Permanent or obligate parasite; parasite is completely dependent on its host throughout its life - E.g. Plasmodium spp. Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Vector is a living organism that carries a parasite from one host to another host If the vector is a simple passive transfer instrument, it is called mechanical vector Vector - E.g. flies can be mechanical vectors for feces-born pathogens such as Salmonella spp. If the parasite undergoes some aspect of its life cycle in vector, it is called biological vector - E.g. female anopheles mosquitoes are biological vector for Plasmodium spp. Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Life cycle of a parasite consists of two common phases; One phase involves the route a parasite follows inside the host body (intracorporeal) This phase provides an understanding of the pathology of the Life Cycle of parasite Diagnosis method and appropriate medication may also be Parasites determined according to intracorporeal phase The other phase, the route a parasite follows outside of the body (extracorporeal) This phase provides important information about epidemiology, prevention and control Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Infection is the result of entry and growth of the parasite within the host body When the parasite enters into the host body, host reacts in different ways and this could result in; Host-parasite a. Carrier state; Tissue destruction by a parasite is balanced with the tissue repair by host Relationship In this case, the parasite and the host live harmoniously b. Disease state; Parasite is dominant It can result from lower resistance of the host or higher pathogenicity of the parasite c. Parasite destruction; Host is dominant Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  A. Pathogenic parasite causes pathological lesions - E.g. Ancylostoma B. Non-pathogenic (commensal) parasite obtains food and protects itself from host without causing pathological Pathogenesis lesions of Parasitic - E.g. Entamoeba coli Infection C. Opportunistic parasite causes mild disease in immunologically healthy individuals and severe pathological lesions in immunocompromised patients -E.g. Cryptosporidium Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Parasitic infections can be transmitted by; Fecal-oral route - E.g. amebiasis Direct penetration of unbroken skin infection - E.g. schistosomiasis Bites of arthropod vectors - E.g. malaria From the mother to the baby - E.g. toxoplasmosis Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Classification of Medical Parasitology; 1. Protozoa Flagellates, amoebae, malarial organisms 2. Helminthes Medical Parasitic worms such as the flukes, tapeworms and Parasitology roundworms 3. Arthropods Insects and arachnids that are ectoparasites and vectors of some diseases Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  1. Protozoa Protozoa consist of a single "cell-like unit" and can perform all functions of life They consist of a mass of protoplasm Protoplasm is differentiated into cytoplasm and nucleoplasm The cytoplasm consists of an ectoplasm and an endoplasm The ectoplasm provides protection, ingestion of food, excretion of waste products and respiration The vacuoles are responsible for storage of food, digestion and excretion of waste products The nucleus is responsible for reproduction and maintaining of life Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Cystostome provides taking of food Ciliates wave cilia toward cytosome Food is digested in vacuoles Cytoproct provides exocytosis of waste products Contractile vacuole provides movement of water out of the cell for osmotic regulation Most protozoa have an outer protective pellicle, requiring specialized structures to take in food Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  The protozoa have the ability to transfrom an active stage (trophozoite) to an inactive stage (cyst) In this transformation process, it loses motility and enclosing itself within a rough wall The protoplasmic body thus formed is known as a cyst At this stage the parasite loses its grow and multiply abilities The cyst is the resistant stage and is also infective to the human Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Reproduction of protozoa 1. Asexual multiplication: - Simple binary fission - Multiple fission or schizogony – in this process, more than two individuals are produced 2. Sexual reproduction: - Conjugation – in this process, union of two individuals and two individuals separate - Syngamy – in this process, sexually differentiated cells, called gametes, fuse together permanently and a complete fusion of the nuclear material occurs. The resulting product is known as a zygote Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Types of medically important protozoa; A. Pseudopodia B. Ciliates C. Flagellates D. Coccidia Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  A. Pseudopodia Locomotor organs: Pseudopodia Habitat: Intestinal and free living Important stages in the life cycle: Trophozoite and cyst B. Ciliates Locomotor organs: Cilia Habitat: Intestinal Important stages in the life cycle: Trophozoite and cyst Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  C. Flagellates Locomotor organs: Flagella Habitat: Intestinal, urogenital and blood Important stages in the life cycle: Trophozoite and cyst D. Coccidia Habitat: Intestinal, tissue and blood Important stages in the life cycle: Sporozoite, schizont, merozoite, gametocytes, oocyst Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  2. Helminths The helminths are multicellular, bilaterally symmetrical organisms having three germ layers Types of medically important helminths; A. Trematodes (Flat Worms or Flukes) B. Cestodes (Tape worms) C. Nematodes (Round worms) -Intestinal nematodes -Tissue nematodes Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Helminths are eukaryotic organisms Specialized to live in hosts; - May lack digestive system - Reduced nervous system - Reduced or lacking locomotion - Complex reproductive system Life Cycle of Helminths - Dioecious; Separate male and female - Monoecious (hermaphroditic); Male and female reproductive systems in one animal Egg → larva(e) → adult Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  A. Trematodes Un-segmented, leaf-shaped, hermaphrodite and bilaterally symmetrical Habitats; intestinal, hepatic, blood and lung Adult → egg → miracidium → sporocyst→ redia→ cercaria →metacercaria→ adult The diagnostic stage is the egg The infective stage is the encysted metacercaria Infection develops by; Ingestion of food contaminated with the infective stage Skin penetration of the cercaria Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  B. Cestodes Long, segmented, tape-like and hermaphrodite They are all intestinal parasites Adult → egg → cysticercus (the larval stage) → adult The diagnostic stage is the egg The infective stage is the larval stage Infection develops by ingestion of food contaminated with the infective stage Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  C. Nematodes Elongated, cylindrical, bilateral symmetrical, separate sexes Adult → egg → larvae → adult Intestinal Nematodes Diagnostic stage is egg or larvae Infective stage is egg containing larvae Infection develops by ingestion of food contaminated with the infective stage Tissue Namatodes Diagnostic stage is larvae Infective stage is larvae Infection develops by ingestion or bitten by infective vector Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  3. Arthropods Bilaterally symmetrical and segmented body with jointed appendages They have a hard exoskeleton Exoskeleton helps to cover and protect the muscles and other organs They have an open circulatory system Open circulatory system pumps the blood (hemolymph) via arteries with or without a dorsally situated heart Blood is returned to heart through body spaces known as hemocoeles They have respiratory, excretory and nervous systems Arthropods cause disease development or provide disease transmission Medical importance arthropods are found in classes Insecta, Arachnida and Crustacia Diseases such as malaria, yellow fever are primarily transmitted by insects Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  1. Pseodopodia Entamoeba histolytica (Amoebiasis) Intestinal infections occur through the ingestion of food or drink contaminated with an infective cyst and also by hand to mouth contact Due to the cyst wall is resistant to acid pH, parasite can pass the stomach Protozoa and Cysts transform to trophozoites in terminal ileum (excystation) their Infections Trophozoites invade the tissues and settle in the submucous layer of the large intestine They grow and multiply by binary fission Trophozoites produce lesions Trophozoites can pass to blood and cause extra intestinal lesions on liver, lungs, brain and heart Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  2. Ciliate Balantidium coli (Balantidiasis) Intestinal infections occur through the ingestion of food or drink contaminated with an infective cyst After excystation, trophozoites invade the mucosal surface of the large intestine, caecum and terminal ileum The trophozoite is covered with hair like cilia Cilia help motility of trophozoite Symptomatic disease is characterized by abdominal pain, nausea, anorexia and watery stools with blood Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  3. Flagellate Leishmania donovani (Leishmaniasis) Parasites affect liver, spleen and bone marrow They reduce the bone marrow activity and cause anemia, leukopenia and thrombocytopenia This leads to secondary infections and a tendency to bleed Symptoms begin with intermittent fever, weakness, diarrhea, chills and sweating When parasites invade liver and spleen cells, they cause enlargement of the organs, weight loss and anemia With persistence of the disease, granulomatous skin lesions occur This disease is called as post-kala-azar dermal leishmaniasis Untreated leishmaniasis is almost always fatal as a result of secondary infection Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  4. Coccidia Plasmodium malariae (Malaria) P. malariae can infect only mature erythrocytes Distinctive shapes of the parasite in the host cell are seen as band and rod forms and very compact dark staining forms The incubation period is usually 18 to 40 days, but it may take from several months to years The early symptoms are flu-like with fever patterns of 72 hours in periodicity Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  4. Cocidia Toxoplasma gondii (Toxoplasmosis) The definite host is the domestic cat and other felines Humans and other mammals are intermediate hosts T. gondii is acquired by ingestion or transmission from an infected mother to the fetus After infection of the intestinal epithelium, they spread brain, lungs, liver and eyes Congenital infection can result in abortion, stillbirth, or neonatal disease such as encephalitis Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  1. Trematode Schistosoma mansoni (Intestinal schistosomiasis) Lives in the intestinal veins After fertilization, eggs can pass into the venules Helmints and The eggs pass into the lumens and other organs and are excreted in the feces their Infections It can cause; - Cercarial dermatitis (swimmers itch) - Dysentery (mucus and blood in stool) - Enlargements of the spleen and liver Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  2. Cestode Taenia saginata (Taeniasis) Eggs are ingested by an intermediate host (cattle) Eggs penetrate into the blood vessels and is carried to the muscles and develops into a larval stage (cysticercus bovis) Parasite is acquired by ingestion of raw or insufficiently cooked beef In adult stage, T. saginata inhabits the upper jejunum It may survive for as long as 25 years Symptoms are epigastric pain, abdominal discomfort, vomiting and diarrhea Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  3. Nematodes Ascaris lumbricoides (Ascariasis) Infection is developed by ingestion of raw vegetables contaminated with eggs containing larvae The larvae penetrate the intestinal wall, circulate in the blood and migrate to the lungs Adult worms cause abdominal pain and may cause intestinal obstruction especially in children Larvae in the lungs may cause inflammation of the lungs (Loeffler’s syndrome)-pneumonia-like symptoms Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  3. Nematodes Trichuris trichiura (Trichuriasis) Infection is developed by ingestion of raw vegetables contaminated with eggs containing larvae Ingested eggs uncoating in the small intestine and the larvae migrate to the large intestine to become adult After maturation, the female parasites produce immature eggs Eggs are excreted with the stool to the soil and maturation occurs in 2 weeks Patients has complain of dysentery (blood and mucus in stool) Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Entemoeba histolitica (Amoebiasis) Acute amebiasis is treated with metronidazole Metronidazole inhibits DNA replication Metronidazole and chloroquine can be used in the treatment of Antiprotozoal extra intestinal amoebiasis such as amoebic liver abscess and Chloroquine inhibits DNA replication Antihelminthic Asymptomatic carriage can be eradicated with iodoquinol, diloxanide furoate, or paromomycin Agents Balantidium coli (Balantidiasis) Iodoquinol (Chelates ferrous ions) Metronidazole Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Leishmania donovani (Leishmaniasis) Stibogluconate Allopurinol Plasmodium malariae (Malaria) Chloroquine Pyrimethamine/Sulfonamides (Inhibit the folate metabolism) Toxoplasma gondii (Toxoplasmosis) Pyrimethamine/Sulfonamides Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Schistosoma mansoni (Intestinal schistosomiasis) Praziquantel (Alters membrane permeability) Taenia saginata (Taeniasis) Niclosamide (Prevents ATP generation) Mebendazole (Inhibits nutrient absorption) Ascaris lumbricoides (Ascariasis) Mebendazole Albendazole Trichuris trichiura (Trichuriasis) Mebendazole Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology  Thank you for listening Altınbaş Üniversitesi Asst. Prof. Dr. Cansu VATANSEVER [email protected] PHAR 215 Pharmaceutical Microbiology and Immunology