How patient, infection and cysticercus characteristics impact the evolution of Taenia solium larva in the human brain: A unique cyst-level analysis

Neurocysticercosis is a poorly understood infection of the central nervous system with Taenia solium larva, and the treatment often fails to kill all the parasitic larva. Most research on this infection has used patient-level data, looking at summaries of the encysted parasitic cysticercus burden. C...

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Main Authors: Hongbin Zhang, Meghana G. Shamsunder, Pryanka Bawa, Arturo Carpio, W. Allen Hauser, Karina Quinde-Herrera, Alex Jaramillo, Elizabeth A. Kelvin
Format: Article
Language:English
Published: Cambridge University Press
Series:Parasitology
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Online Access:https://www.cambridge.org/core/product/identifier/S003118202400163X/type/journal_article
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author Hongbin Zhang
Meghana G. Shamsunder
Pryanka Bawa
Arturo Carpio
W. Allen Hauser
Karina Quinde-Herrera
Alex Jaramillo
Elizabeth A. Kelvin
author_facet Hongbin Zhang
Meghana G. Shamsunder
Pryanka Bawa
Arturo Carpio
W. Allen Hauser
Karina Quinde-Herrera
Alex Jaramillo
Elizabeth A. Kelvin
author_sort Hongbin Zhang
collection DOAJ
description Neurocysticercosis is a poorly understood infection of the central nervous system with Taenia solium larva, and the treatment often fails to kill all the parasitic larva. Most research on this infection has used patient-level data, looking at summaries of the encysted parasitic cysticercus burden. Cyst-level analysis is needed to identify factors that impact individual cyst trajectories and how that may vary based on characteristics of the patient, infection and cyst being followed. We disaggregated data on 221 cysts from 117 patients who participated in a trial evaluating the impact of albendazole treatment to identify factors that impact cyst evolution over time from the active to the degenerating and calcified phases, and eventual resolution. We found that having calcified cysts at baseline was associated with a faster rate of transition from the degenerative phase to calcified phase or resolution. Age and sex were not associated with cyst evolution in the main effect analysis, but after stratifying on treatment we found that the direction of some associations by patient age and sex was reversed for patients in the albendazole arm compared to those in the placebo arm. These findings suggest that differences in host immune response by sex and age as well as by past exposure, potentially indicated by having calcified cysts together with active cysts at baseline, are important to cyst evolution and may be modified by treatment. Future research is needed to assess if these differences suggest distinct treatment recommendations.
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spelling doaj-art-5269f995ee2a46c78a4a09b5e8e4cb402025-08-20T03:08:21ZengCambridge University PressParasitology0031-18201469-816111210.1017/S003118202400163XHow patient, infection and cysticercus characteristics impact the evolution of Taenia solium larva in the human brain: A unique cyst-level analysisHongbin Zhang0https://orcid.org/0000-0002-2156-1005Meghana G. Shamsunder1Pryanka Bawa2Arturo Carpio3W. Allen Hauser4Karina Quinde-Herrera5https://orcid.org/0000-0001-5423-4361Alex Jaramillo6Elizabeth A. Kelvin7Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA CUNY Institute for Implementation Science in Population Health, City University of New York, New York, NY, USADepartment of Epidemiology & Biostatistics, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USADepartment of Epidemiology & Biostatistics, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USASchool of Medicine, University of Cuenca, Cuenca, EcuadorG.H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USASchool of Medicine, University of Cuenca, Cuenca, EcuadorInstituto de Diagnóstico por Imágenes, Cuenca, EcuadorCUNY Institute for Implementation Science in Population Health, City University of New York, New York, NY, USA Department of Epidemiology & Biostatistics, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA Department of Occupational Health, Epidemiology & Prevention, Donald and Barbara Zucker School of Medicine at Hofstra University/Northwell Health, Hempstead, NY, USANeurocysticercosis is a poorly understood infection of the central nervous system with Taenia solium larva, and the treatment often fails to kill all the parasitic larva. Most research on this infection has used patient-level data, looking at summaries of the encysted parasitic cysticercus burden. Cyst-level analysis is needed to identify factors that impact individual cyst trajectories and how that may vary based on characteristics of the patient, infection and cyst being followed. We disaggregated data on 221 cysts from 117 patients who participated in a trial evaluating the impact of albendazole treatment to identify factors that impact cyst evolution over time from the active to the degenerating and calcified phases, and eventual resolution. We found that having calcified cysts at baseline was associated with a faster rate of transition from the degenerative phase to calcified phase or resolution. Age and sex were not associated with cyst evolution in the main effect analysis, but after stratifying on treatment we found that the direction of some associations by patient age and sex was reversed for patients in the albendazole arm compared to those in the placebo arm. These findings suggest that differences in host immune response by sex and age as well as by past exposure, potentially indicated by having calcified cysts together with active cysts at baseline, are important to cyst evolution and may be modified by treatment. Future research is needed to assess if these differences suggest distinct treatment recommendations.https://www.cambridge.org/core/product/identifier/S003118202400163X/type/journal_articlealbendazoleEcuadormultistate modellingneurocysticercosisTaenia solium
spellingShingle Hongbin Zhang
Meghana G. Shamsunder
Pryanka Bawa
Arturo Carpio
W. Allen Hauser
Karina Quinde-Herrera
Alex Jaramillo
Elizabeth A. Kelvin
How patient, infection and cysticercus characteristics impact the evolution of Taenia solium larva in the human brain: A unique cyst-level analysis
Parasitology
albendazole
Ecuador
multistate modelling
neurocysticercosis
Taenia solium
title How patient, infection and cysticercus characteristics impact the evolution of Taenia solium larva in the human brain: A unique cyst-level analysis
title_full How patient, infection and cysticercus characteristics impact the evolution of Taenia solium larva in the human brain: A unique cyst-level analysis
title_fullStr How patient, infection and cysticercus characteristics impact the evolution of Taenia solium larva in the human brain: A unique cyst-level analysis
title_full_unstemmed How patient, infection and cysticercus characteristics impact the evolution of Taenia solium larva in the human brain: A unique cyst-level analysis
title_short How patient, infection and cysticercus characteristics impact the evolution of Taenia solium larva in the human brain: A unique cyst-level analysis
title_sort how patient infection and cysticercus characteristics impact the evolution of taenia solium larva in the human brain a unique cyst level analysis
topic albendazole
Ecuador
multistate modelling
neurocysticercosis
Taenia solium
url https://www.cambridge.org/core/product/identifier/S003118202400163X/type/journal_article
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