Department of Neurology, Psychology and Psychiatry, UNESP-Univ Estadual Paulista, Botucatu Medical School, Botucatu, Brazil.
Department of Immunology, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico.
Expert Rev Anti Infect Ther. 2021 Dec;19(12):1503-1518. doi: 10.1080/14787210.2021.1912592. Epub 2021 Apr 9.
Neurocysticercosis is caused by the localization of 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.
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.
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.
神经囊尾蚴病是由幼虫在中枢神经系统中的定位引起的。该疾病在拉丁美洲、亚洲和非洲的大多数国家仍然流行。虽然在诊断和治疗方面取得了重大进展，但与疾病相关的炎症反应的临床意义和治疗仍存在不确定性。
在这篇综述中，作者根据 PubMed 的检索结果，描述了神经囊尾蚴病患者免疫炎症反应的特征、其临床意义以及目前的治疗方法。讨论了炎症的双重作用（参与寄生虫的死亡和严重并发症的发生）。还介绍了一些具有潜在应用价值的新治疗策略。
炎症反应是与神经囊尾蚴病相关的主要发病机制。其治疗主要基于皮质类固醇的应用。该策略改善了患者的预后，因为它可以控制大多数炎症并发症。另一方面，由于其免疫抑制特性，它可能与一些患者在进行杀虫治疗后寄生虫的持续存在有关。需要新的策略来改善治疗管理，特别是在最严重的情况下。
