Background: COVID-19 is a worldwide pandemic that stroke almost all countries of the world causing thousands of deaths and disabilities and burdened the economy of countries. One of the main criteria of the immune response against COVID-19 is the “immune exhaustion”, due to increased expression of T cell suppressor molecules e.g. programmed death-1 (PD-1), that leads to flaring of viral multiplication and disastrous clinical outcomes. This immune exhaustion is not restricted to COVID-19 but is also a common complication of chronic infections with the widely spreading protozoan, Toxoplasma (T.) gondii. Thus, theoretically, the toxoplasmosis-associated immune exhaustion can worsen that of COVID-19 and consequently increases its severity. However, the studies on this theory are still insufficient. Objective: this work was designed to answer two questions. Does T. gondii co-infection affect the severity of COVID-19 manifestations? Is this action related to T. gondii-induced PD-1 changes? Methodology: Covid-19+ patients with moderate and severe conditions were screened for T. gondii IgG and compared to healthy controls. Serum levels of IL-1β, IL-6, TNFα, IFNγ, IL-1α cytokines were assessed to evaluate COVID-19 severity and prognosis. Lymphocytic expression of PD-1 was assessed by flowcytometry. Results: We recorded a higher incidence of toxoplasmosis among COVID-19 patients especially patients with severe/critical manifestations. T. gondii positive cases exhibited a statistically significant increase in lymphocytic expression of PD-1 that correlated positively with the proinflammatory and bad prognosis cytokines. With fixation of other risk factors for severity, toxoplasmosis still scored a significant value. Conclusion: toxoplasmosis increased the severity of COVID-19. These effects can be related to the Toxoplasmaassociated increased lymphocytic PD-1 expression. So, toxoplasmosis can be considered as an unrecognized independent risk factor for COVID-19 severity.

Neurotoxocariasis (NT) is a serious condition that has been linked to reduced cognitive function, behavioural alterations and neurodegenerative diseases. Unfortunately, the available drugs to treat toxocariasis are limited with unsatisfactory results, because of the initiation of treatment at late chronic stages after the occurrence of tissue damage and scars. Therefore, searching for a new therapy for this important disease is an urgent necessity. In this context, cytotherapy is a novel therapeutic approach for the treatment of many diseases and tissue damages through the introduction of new cells into the damaged sites. They exert therapeutic effects by their capability of renewal, differentiation into specialized cells, and being powerful immunomodulators. The most popular cell type utilized in cytotherapy is the mesenchymal stem cells (MSCs) type. In the current study, the efficacy of MSCs alone or combined with albendazole was evaluated against chronic brain insults induced by Toxocara canis infection in an experimental mouse model. Interestingly, MSCs combined with albendazole demonstrated a healing effect on brain inflammation, gliosis, apoptosis and significantly reduced brain damage biomarkers (S100B and GFAP) and T. canis DNA. Thus, MSCs would be protective against the development of subsequent neurodegenerative diseases with chronic NT.

While most medical schools in the USA provide opportunities for global health experiences, global health education is not included consistently or emphasized adequately in many medical school curricula. The City University of New York Medical School (CSOM) has a mission to educate and train students who are traditionally underrepresented in medicine to practice primary care in medically underserved communities in New York. This manuscript documents the experience of the CSOM in expanding global health education by introducing a new global health cancer training program, partnering with clinicians at the Ocean Road Cancer Institute (ORCI) in Tanzania. This manuscript illustrates the following points: (1) the CSOM curriculum that focuses on community health and social medicine; (2) the process by which students learn by developing research proposals for global cancer; (3) the field research experience and lessons learned; (4) learning about cancer and medicine in a developing country; and (5) lessons learned for translation from global to domestic underserved populations. We also suggest a checklist for future students interested in pursuing global cancer education and research, and recommendations for maximizing learning and career development of students interested in global cancer research and its application to underserved populations in the USA.

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