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
- Peyer’s 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.

Surface antigens
• Existence of migratory phases. Internal antigens

• Immune evasion.
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
TC
Th1 Cell-
Peptide mediated
IL1 NK
MHC immunity
class 2
IL2 Mac
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 Prevent cell Inactivation of

parasite invasion 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 Antibodies coat the
e.g. red cells infected with parasite making it more
malaria parasite easily phagocytosed
 3- Interaction of antibodies with effector cells

macrophage neutrophil platelet

eosinophil Mast cell NK cell

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:
IgE IgG
seen with helminths that remain Release
localized to the intestinal tract mediators
e.g. Enterobius.

No eosinophilia:
seen in infections with protozoa e.g.
malaria, amoebiasis, toxoplasmosis,
leishmaniasis and trypanosomiasis.
 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 • High or moderate
microparasites. eosinophilia: in helminths
that are invasive.
• Cause Extracellular killing of • Little or no eosinophilia: in
macroparasites. 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:
a- macrophages c- T-helper cells
b- eosinophils d- Natural killer cells

Th1 response is directed mainly against:

a- Protozoa c- Intestinal protozoa
b- Helminths d- Intestinal helmiths

Duffy antigen present on red cells act as a receptor for:

a- Plasmodium falciparum c- Plamodium vivax
b- Plasmodium malariae d- Plasmodium ovale