Extraparenchymal human neurocysticercosis induces autoantibodies against brain tubulin and MOG35–55 in cerebral spinal fluid

Molecular Mimicry Drives Locally Produced Autoantibodies in Subarachnoid Neurocysticercosis

Background

Subarachnoid neurocysticercosis (SANCC) is a condition manifested by chronic meningitis induced by infection with Taenia solium. We sought to determine if there is evidence of autoantibody production in SANCC and whether local production of autoantibodies could be driven by immunogenic homologues found in T. solium.

Methods

Reactivity of pooled cerebral spinal fluid (CSF) from SANCC patients and uninfected controls was screened against a human proteome chip. Serum from 27 SANCC patients was then tested for antibodies to the 15 top screen hits using a Luciferase ImmunoPrecipitation System (LIPS). Eight human proteins were further tested using CSF from SANCC and controls. In parallel, Taenia homologues were expressed and screened using LIPS. Antibodies directed at the 2 proteins with significant reactivity were then used to probe Taenia crassiceps crude antigen using a 2D immunoblot. Reactive proteins were subjected to mass spectroscopy for identification.

Results

Significant immunoglobulin G reactivity was seen in the CSF of SANCC compared with uninfected controls to both human annexin A8 (ANXA8) and chromatin complexes subunit BAP18 (BAP18) and their T. solium homologues on LIPS testing. 2D-separated Taenia crassiceps soluble antigen was probed with either antihuman-ANXA8 or antihuman BAP18 antibodies in immunoblotting. The antihuman ANXA8 antibody identified T. solium annexin B3 (GenBank: AAY27744.1), whereas the antihuman BAP18 antibody identified cestode enzymes involved in metabolic pathways.

Conclusions

Taenia-derived annexin and metabolic enzymes contain epitopes that likely drive local CSF antibody production that cross-reacts with human ANXA8 and BAP18 and may contribute to the pathology underlying SANCC.

Immunologic Profiling of CSF in Subarachnoid Neurocysticercosis Reveals Specific Interleukin-10-Producing Cell Populations During Treatment

BACKGROUND AND OBJECTIVES

Subarachnoid neurocysticercosis (SANCC) is the most severe form of Taenia solium CNS infection and accounts for the majority of neurocysticercosis-associated mortality. Inflammation is important in the treatment of SANCC because overactivity can lead to serious complications, but excessive suppression may be counterproductive toward parasite eradication. A relative abundance of CSF IL-10 to IL-12 has been associated with increased treatment duration for patients with SANCC, suggesting that IL-10 plays an important role in this disease process. To better understand SANCC immunology and the major sources of IL-10 during anthelmintic treatment, we took an unbiased and comprehensive approach to phenotype the immune cell populations in the CSF and peripheral blood of patients with SANCC.

METHODS

Eight samples of CSF cells collected from 5 patients with SANCC during treatment were evaluated using single-cell RNA sequencing. Matched CSF and peripheral blood mononuclear cells from 4 patients were assessed using flow cytometry. Staining for extracellular and intracellular markers allowed for the characterization of IL-10-producing T cells.

RESULTS

The CSF during SANCC contains a diversity of immune cell populations including multiple myeloid and lymphoid populations. Although there were changes in the composition of CSF cells during treatment, the largest population at both early and late time points was CD4+ T cells. Within this population, we identified 3 sources of IL-10 unique to SANCC CSF compared with controls: natural regulatory T cells (nTregs), induced regulatory T cells (iTregs), and Th17 cells. The abundance and phenotype of these IL-10-producing populations differed between CSF and blood in patients with SANCC, but iTregs were the single most productive population in the CSF. During treatment, these IL-10 producers persisted in consistent proportions despite decreases in parasite antigen over time.

DISCUSSION

This profile of immune cell populations in the CSF provides a comprehensive blueprint of the local and systemic immunology associated with SANCC. The identification of IL-10-producing cells in the CSF and peripheral blood deepens our understanding of the immunosuppressive phenotype that deters SANCC treatment success. Finally, the discovery that these IL-10 producers persist throughout treatment highlights the endurance of these populations in the CNS.

Neurocysticercosis-related Seizures: Imaging Biomarkers

Neurocysticercosis (NCC)-a parasitic CNS infection endemic to developing nations-has been called the leading global cause of acquired epilepsy yet remains understudied. It is currently unknown why a large proportion of patients develop recurrent seizures, often following the presentation of acute seizures. Furthermore, the presentation of NCC is heterogenous and the features that predispose to the development of an epileptogenic state remain uncertain. Perilesional factors (such as oedema and gliosis) have been implicated in NCC-related ictogenesis, but the effects of cystic factors, including lesion load and location, seem not to play a role in the development of habitual epilepsy. In addition, the cytotoxic consequences of the cyst's degenerative stages are varied and the majority of research, relying on retrospective data, lacks the necessary specificity to distinguish between acute symptomatic and unprovoked seizures. Previous research has established that epileptogenesis can be the consequence of abnormal network connectivity, and some imaging studies have suggested that a causative link may exist between NCC and aberrant network organisation. In wider epilepsy research, network approaches have been widely adopted; studies benefiting predominantly from the rich, multimodal data provided by advanced MRI methods are at the forefront of the field. Quantitative MRI approaches have the potential to elucidate the lesser-understood epileptogenic mechanisms of NCC. This review will summarise the current understanding of the relationship between NCC and epilepsy, with a focus on MRI methodologies. In addition, network neuroscience approaches with putative value will be highlighted, drawing from current imaging trends in epilepsy research.

Scientific Research in Ecuador: A Bibliometric Analysis

Ecuador has shown a growth in its scientific production since 2011, representing 85% of the total historical production. These investigations are reflected in scientific publications, which address world interest topics and serve as a link for the university, business, and society. This work aims to analyze the scientific production generated by Ecuador in the period of 1920–2020 using bibliometric methods to evaluate its intellectual structure and performance. The methodology applied in this study includes: (i) terms definition and search criteria; (ii) database selection, initial search, and document compilation; (iii) data extraction and software selection; and finally, (iv) analysis of results. The results show that scientific production has been consolidated in 30,205 documents, developed in 27 subject areas, in 13 languages under the contribution of 84 countries. This intellectual structure is in harmony with the global context when presenting research topics related to “Biology and regional climate change”, “Higher education and its various approaches”, “Technology and Computer Science”, “Medicine”, “Energy, food and water”, and ”Development and applications on the Web”. Topics framed in the Sustainable Development Goals (SDGs), sustainability, climate change, and others. This study contributes to the academic community, considering current re-search issues and global concerns, the collaboration between universities and countries that allow establishing future collaboration links.

Inflammation in neurocysticercosis: clinical relevance and impact on treatment decisions

INTRODUCTION

Neurocysticercosis is caused by the localization of Taenia solium larvae in the central nervous system. The disease remains endemic in most countries of Latin America, Asia and Africa. While major improvements have been made in its diagnosis and treatment, uncertainties persist regarding the clinical implications and treatment of the inflammatory reaction associated with the disease.

AREAS COVERED

In this review, based on PubMed searches, the authors describe the characteristics of the immune-inflammatory response in patients with neurocysticercosis, its clinical implications and the treatment currently administered. The dual role of inflammation (participating in both, the death of the parasite, and the precipitation of serious complications) is discussed. New therapeutic strategies of potential interest are presented.

EXPERT OPINION

Inflammatory reaction is the main pathogenic mechanism associated to neurocysticercosis. Its management is mainly based on corticosteroids administration. This strategy had improved prognostic of patients as it allows for the control of most of the inflammatory complications. On the other side, it might be involved in the persistence of parasites in some patients, despite cysticidal treatment, due to its immunosuppressive properties. New strategies are needed to improve therapeutical management, particularly in the severest presentations.