PARASITOLO

GY
TEACHERS:

Mrs. Irish Udtohan

Mr. Harley Partosa

This Photo by Unknown Author is licensed under CC BY

Learning objectives
• Describe parasitic classification, structure, and replication.
• Explain the pathogenesis of parasites.
• Discuss the role of parasites of disease.
 Importance of Parasites
• Medical parasitology is the study of invertebrate animals capable of causing
disease in humans and other animals. Although parasitic diseases are frequently
considered “tropical” and thus of little importance to physicians practicing in the
more temperate, developed countries of the world, it is clear that the world has
become a very small place and that physicians’ knowledge of parasitic diseases is
essential. The global effect of parasitic infections and the number of parasite-
associated deaths is staggering and must be of concern to all health care workers.
• Increasingly tourists, missionaries, Peace Corps volunteers, and others are visiting
and working for extended periods of time in exotic, remote parts of the world.
Thus, they are at risk for parasitic and other infections that are rare in the United
States and other more developed countries. Another source of infected patients is
the ever-increasing number of refugees from developing countries. Finally, the
profound immunosuppression problems that accompany advances in medical
therapy (e.g., organ transplantation), as well as those associated with persons
infected with the human immunodeficiency virus (HIV), place a growing number
of individuals at risk for developing infections caused by certain parasites.
ELEMENTS IN
PARASITISM
•Parasites are organisms
that usually depend on the
host for survival and are
classified in several ways,
namely:
• Based on Habitat
• Based on ability to live
independently of host
• Based on mode of living
ELEMENTS IN
PARASITISM
•The host
Hosts are essential to the
existence of parasites. Hosts are
organisms that harbor parasite
and provide nourishment to the
parasite.
 SUMMARY OF
TERMS
ASSOCIATED WITH
HOST-PARASITE
RELATIONSHIP
 • The eukaryotic parasites of humans are now divided into five
monophyletic lineages called supergroups, of which four include
CLASSIFICATION human parasites: the SAR, Excavata, Amoebozoa, and Opisthokonta.
AND STRUCTURE Traditionally, parasite classification has considered the morphology of
intracytoplasmic structures, such as the nucleus, the type of locomotive
organelles, and the mode of reproduction.
 • The eukaryotic parasites of humans are now divided into five
monophyletic lineages called supergroups, of which four include
CLASSIFICATION human parasites: the SAR, Excavata, Amoebozoa, and Opisthokonta.
AND STRUCTURE Traditionally, parasite classification has considered the morphology of
intracytoplasmic structures, such as the nucleus, the type of locomotive
organelles, and the mode of reproduction.
 GENERAL
LIFE
CYCLE OF
PARASITES
PATHOGENESIS OF
PARASITIC
DISEASES

• Given the wide diversity that exists among human parasites, it is not surprising that the pathogenesis of
protozoan and helminthic disease is highly variable. Although the various human parasites exhibit a wide
range of direct pathogenic mechanisms, in most instances, the organisms themselves are not highly
virulent, are unable to replicate within the host, or have both characteristics. Thus, the severity of illness
caused by many parasites is related to the infecting dose and the number of organisms acquired over
time. Unlike many bacterial and viral infections, parasitic infections are often chronic, lasting months to
years. Repeated exposures result in an ever-increasing parasite burden. When infection with a particular
organism is associated with a strong immune response, there is undoubtedly a considerable
immunopathologic contribution to the disease manifestations attributed to the infection.
CELL AND TISSUE DAMAGE
• Although some microorganisms may cause disease by localized multiplication and elaboration of potent microbial
toxins, most organisms initiate the disease process by invading normally sterile tissue, with subsequent replication
and destruction. Parasitic protozoa and helminths are generally not known to produce toxins with potencies
comparable to those of classic bacterial toxins, such as anthrax toxin and botulinum toxin; however, parasitic
disease can be established by the elaboration of toxic products, mechanical tissue damage, and immunopathologic
reactions
• Proteases and phospholipases may be secreted and are released on the destruction of the parasites. These
enzymes can cause host cell destruction, inflammatory responses, and gross tissue pathology. For example,
the intestinal parasite E. histolytica produces proteinases that can degrade epithelial basement membrane and cell-
anchoring proteins, disrupting epithelial cell layers. Furthermore, the amebae produce phospholipases and an
ionophore-like protein that lyse the responding host neutrophils, resulting in the release of neutrophil constituents
that are toxic to host tissues. The expression of certain proteinases increases relative to the virulence of the strain
of E. histolytica. In contrast to the protozoan parasites, many of the pathogenic consequences of helminthic
infections are related to the size, movement, and longevity of the parasites. The host is exposed to long-term
damage and immune stimulation, as well as the sheer physical consequences of being inhabited by large foreign
bodies. The most obvious forms of direct damage from helminthic parasites are those resulting from
mechanical blockage of internal organs or from the effects of pressure exerted by growing parasites.
 Mechanisms of disease production by
parasites
• Parasites produce disease through five basic
mechanisms: (1) traumatic or physical damage; (2) lytic
necrosis; (3) toxic allergic phenomena; (4) stimulation of
host tissue reaction; and (5) opening of pathways for
entry of other pathogens into the tissues.
 Disruption, Evasion, and Inactivation of Host
Defenses

• Although the processes of cell and tissue destruction are often sufficient to initiate clinical disease,
the parasite must be able to evade the host’s immune defense system for the disease process to be
maintained. Similar to other organisms, parasites elicit humoral and cell-mediated immune
responses; however, parasites are particularly adept at interfering with or avoiding these defense
mechanisms.
• Organisms can shift antigenic expression, such as that observed with the African trypanosomes.
Rapid variation of expression of antigens in the glycocalyces of these organisms occurs each time
the host exhibits a new humoral response. Similar changes have been observed with Plasmodium,
Babesia, and Giardia species. Some organisms may produce antigens that mimic host antigens
(mimicry) or acquire host molecules that conceal the antigenic site (masking), preventing
immune recognition by the host.
ROLE OF PARASITES IN DISEASE
• A summary of the parasites (protozoan and helminths) most associated with human disease is presented in
this chapter. Although many parasites are associated with a single-organ system (e.g., gastrointestinal tract)
and therefore cause a disease process involving that system, some of the most dramatic manifestations of
parasitic disease occur when the parasite leaves its “normal” location in the human body. Also, several
different parasites may produce a similar disease syndrome. The management of a specific parasitic
infection may differ tremendously depending on the etiologic agent, and many antiparasitic treatment
regimens are quite toxic. So, to guide both diagnostic and therapeutic efforts, it is useful to generate a
differential diagnosis that includes the most likely parasites.
• The development and prognosis of a parasitic infection often depend on factors aside from the innate
virulence of the organism. In determining the possibility of a parasitic infection, the meaning of any
microbiologic data and the necessity to treat and with what agent, one must take into account numerous
factors such as exposure history (e.g., travel to an endemic area), the potential infectious dose and/or
organism burden, the use of prophylaxis (e.g., antimalarial prophylaxis), and the immunologic status of the
host. The presentation of a given parasitic infection may be quite different in a nonimmune traveler to an
endemic region versus a semi-immune resident of that same region. The treatment and prevention strategies
will be different as well.
ROLE OF PARASITES IN DISEASE