Inflammation in neurocysticercosis: clinical relevance and impact on treatment decisions

Neurocysticercosis: A Review into Treatment Options, Indications, and Their Efficacy

“…It is becoming increasingly clear that the inflammatory response against parasites is one of the major pathological mechanisms of NC. 30 Before the use of anti-inflammatory drugs, the prognosis of NC patients was poor. For example, in patients with EP-NC complicated by hydrocephalus and requiring ventriculoperitoneal shunt (VPS) placement, the mortality rate was approximately 50%, with most deaths occurring within the first 2 years after placement.…”

“…Mechanic obstruction occurs either by direct cyst entrapment within the narrowest points of the CSF flow or due to inflammatory scars in the ventricular system. 30 , 31 It is also possible that an increase in the CSF viscosity related to high protein levels and obstruction of the arachnoid villi contribute to the development of hydrocephalus. Therefore, if cyst removal is enough to restore the CSF flow by unblocking the ventricular system, no further interventions are needed.…”

Regulation of piglet T-cell immune responses by thioredoxin peroxidase from Cysticercus cellulosae excretory-secretory antigens

“…Among them, neurocysticercosis (NCC) is the most serious condition, which can cause epileptic seizures, increased intracranial pressure, neuropsychiatric disorders, and other central nervous system symptoms. It is often confused with other intracerebral diseases and has a high mortality and disability rate (Prodjinotho et al, 2020;Hamamoto-Filho et al, 2021;Himwaze et al, 2022). Over 50,000 people die of NCC every year worldwide, and it is recognized by WHO as one of the 20 neglected tropical diseases in the world (Engels and Zhou, 2020;WHO, 2022).…”

Cellular and molecular basis associated with metacestode proliferation in subarachnoid neurocysticercosis

“…After a prolonged period of years or even decades ( 15 ), the parasite degenerates naturally or by the use of anthelmintic drugs, releasing antigens that trigger an inflammatory reaction. The cysts are surrounded by a dense fibrous layer rich in collagen, epithelioid cells, multinucleated giant cells, and abundant immune cells such as CD8 + T lymphocytes, plasma cells, and in smaller proportion CD4 + T lymphocytes.…”

“…The fibrotic capsule contains abundant new vessels or capillaries suggesting angiogenesis processes. Additionally, eosinophils are observed with activation and proliferation of microglia, astrogliosis and subsequent glial scar formation, edema, neuronal degeneration, and a strong peripheral response characterized by a mixed profile of Th1/Th2 cytokines ( 15 , 16 ). The precise mechanisms underlying the characteristics and dynamics of the Th1 and Th2 immune response still need to be elucidated.…”