Immunity in parasitic diseases

Dr. M. Fachrizal
Department of Parasitology

Cells in immune system

Defense mechanism of mucosa to

orally infected parasites
:Non immunological
Physical barrier: gut motility, epithelial cell layer Chemical barrier: gastric acid, pancreatic enzyme, bile, mucus
:Immunological factors
:Gut associated lymphoid tissues (GALT)
lymphoid aggregates in the tonsils Peyers patch (PPs) in the ileum mucosal lymphoid follicles immunological active cells in the laminal propria
lymphocytes scattered between the -

enterocytes

Immune Response to Parasites

Is complex
Complexity of parasite structure. Excretory/Secretory
antigens

Complexity of parasite metabolism.

Complexity of parasite life cycle.
Existence of migratory phases.
Immune evasion.

Surface antigens
Internal antigens

Shed surface antigens

Innate Immunity to Parasitic Infections

1- The skin: forms an important barrier
against penetration e.g. Schistosoma
and Ancylostoma, W.bancrofti and T.cruzi.

2- Body secretions:
- Intestinal secretions wash away
luminal parasites e.g. Trichinella spiralis.
- Mucus prevents invasion mucosa
by helminths and protozoa.
3- Serum factors: high-density
lipoproteins (naturally present
in serum) may kill parasites as
Trypanosoma.

4- Macrophages:
attack parasites and destroy them.
5- Red cell structure factor:
Duffy antigen
Absence of Duffy antigen: provides
resistance to P.vivax infection.
Haemoglobin S: provides resistance to P.falciparum
infection. This type of haemoglobin is not suitable
for the parasite
Deficiency of G6PD: provides resistance to
P.falciparum infection. The parasite needs this
enzyme for its development.

Acquired immunity to Parasitic infections

When a parasite enters the human body an immune
response is initiated by antigen presenting cells
Parasite

Peptide
MHC
class 2

TC
Th1
IL1

NK

IL2

Mac

Cellmediated
immunity

Th2
Humoral
B cell
Ab immunity
Eosinophils + mast cells

Role of T cytotoxic cells

MHC class1

Release toxic molecules

Lysis

Tc cells identify infected cell (target cell) expressing

parasite Ag associated with MHC class I.
Tc cells release toxic molecules that induce pore
formation in cell membrane of infected cell resulting
in cell lysis.

Role of NK cells

Cell lysis
Enzymes + toxic granules

Cell lysis
NK cell attacks parasite infected cell directly or by
the help of antibody then release toxic products that
.cause lysis of the target cell

Role of Macrophages
Antigen presenting cell:
Degrading parasite Ag into
simple peptides and present
them on its surface associated
with MHC class 2 molecules.
Intracellular killing of microparasites:
Phagocytosing the parasite then
killing it inside the phagolysosome.
Extracellular killing of macroparasites:
Releasing toxic products onto the
parasite.

Role of B cells
B cells develop into Plasma cells produce Antibodies

Secretory IgA
Direct killing of
parasite

Prevent cell
invasion

Inactivation of
parasite products

1- Direct action of antibodies

2- Contribution of Ab with other immune elements

Complement activation

Opsonization

Complement
activation
Cell lysis

IgM and IgG activate

complement in the classical
pathway leading to cell lysis
e.g. red cells infected with
malaria parasite

Antibodies coat the

parasite making it more
easily phagocytosed

3- Interaction of antibodies with effector cells

macrophage

neutrophil

platelet

Mast cell
NK cell
eosinophil
Immunoglobulin molecules act as a link between parasite and
effector cells. These cells become activated and release toxic
products to digest the parasite

Role of Eosinophils
Play an essential role against helminths
High or moderate eosinophilia:
seen with helminths that are invasive
and cause inflammation of tissues
e.g. Schistosoma and
Fasciola.
Little or no eosinophilia:
seen with helminths that remain
localized to the intestinal tract
e.g. Enterobius.

IgE
Release
mediators

No eosinophilia:
seen in infections with protozoa e.g.
malaria, amoebiasis, toxoplasmosis,
leishmaniasis and trypanosomiasis.

IgG

Compare Between
Role of Macrophages and Eosinophils in parasitic
infections
Macrophages

Eosinophils

Act as antigen presenting cell. Play an essential role against

helminths.
Cause Intracellular killing of
microparasites.

High or moderate
eosinophilia: in helminths that
are invasive.

Cause Extracellular killing of

macroparasites.

Little or no eosinophilia: in
helminths that remain
localized in the intestinal tract.
No eosinophilia: against
Protozoa.

Thank You

M.C.Q.
Antigen presenting cells initiate immune response by
presenting antigen to:
c- T-helper cells
a- macrophages
d- Natural killer cells
b- eosinophils
Th1 response is directed mainly against:
a- Protozoa
c- Intestinal protozoa
d- Intestinal helmiths
b- Helminths
Duffy antigen present on red cells act as a receptor for:
a- Plasmodium falciparum c- Plamodium vivax
d- Plasmodium ovale
b- Plasmodium malariae