Neurocysticercosis: Clinical Aspects, Immunopathology, Diagnosis, Treatment and Vaccine Development José Ramón Vielma 1,3 , Haideé Urdaneta-Romero 2 , Juana del Carmen Villarreal 1 , Luis Alberto Paz 1 , Luis Vicente Gutiérrez 1 , Marylú Mora 3 and Leonor Chacín- Bonilla 4* 1 Laboratorio de Análisis Químico (LAQUNESUR), Universidad Nacional Experimental Sur del Lago "Jesús María Semprum" UNESUR, Santa Bárbara de Zulia, estado Zulia, Venezuela 2 Instituto de Inmunología Clínica (IDIC), Facultad de Medicina, Universidad de Los Andes, Mérida, estado Mérida, Venezuela 3 Laboratorio de Neurobiología, Centro de Investigaciones Biomédicas, Instituto Venezolano de Investigaciones Científicas (CIB – IVIC), Maracaibo, estado Zulia, Venezuela 4 Instituto de Investigaciones Clínicas “Dr. Américo Negrette”, Facultad de Medicina, Universidad del Zulia, Maracaibo, estado Zulia, Venezuela * Corresponding author: Leonor Chacín-Bonilla, Instituto de Investigaciones Clínicas “Dr. Américo Negrette”, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela, Tel: +58-414-652-4576; Fax: +58-261-759-7247; E-mail: leonorbonilla42@yahoo.com Received date: January 26, 2014; Accepted date: April 27, 2014; Published date: April 30, 2014 Copyright: © 2014 Vielma JR, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Neurocysticercosis (NCC) is defined as human parasitism caused by Taenia solium in its larval stage, when the parasite is located at the central nervous system of the human beings. This disease represents a serious public health problem in developing countries. Neuroimaging studies are usually abnormal, but in most cases, not pathognomonic. Serological diagnosis of NCC is made by means of tests using crude antigens or semipurified fractions of T. solium cysticerci or the use of recombinant antigens that have improved the sensitivity and specificity of the diagnosis. Treatment of NCC is based upon the use of cystocidal drugs, namely: praziquantel and albendazole. Some vaccines to prevent porcine cysticercosis are in advanced stages of investigation, but they are not to be used in humans. Nowadays, the T. solium genome sequence will allow to create a rational design of new healing and preventive drugs. A vaccine for human taeniosis use could be developed in a short term. The aim of this review is to describe the most important clinical aspects of the NCC with emphasis in immunopathology and immune diagnosis. Keywords: Neurocysticercosis; Taenia solium; Immunopathology; Serological diagnosis; Treatment; Vaccines Introduction There are two types of pathologies caused by Taenia solium infection. The first one is taeniosis, which is caused by the adult parasite that develops exclusively in human intestine. The second one, deals with the infection caused by the larval form, named Cysticercosis (CC). Cysticerci develop in the skeletic muscle, the subcutaneous tissue, and mainly in the central nervous system (CNS), where they lead to a clinical pleomorphic disorder known as neurocysticercosis (NCC) [1-6]. This is the most frequent parasitic disease of the CNS, it also can infect the eyes (ophthalmic cysticercosis), where the larvae can lodge in the retina or in the vitreous humour [2,4,6,7]. The World Health Organization (WHO) estimated more than 2.5 million people are infected with T. solium around the world, and 50 thousand deaths a year can be attributed to NCC [8]. Neurocisticercosis is a reportable disease at the international level [9] due to the impact on developing countries around the world. Cysticercosis is frequent in Latin America, Africa, and Asia, where it is considered as a poverty indicator [10,11]. In Latin America, it is estimated that there are 400,000 people with symptomatic NCC [12,13] and that 18% to 50% of epilepsy cases in adult population are caused by the disease [7,14-17]. In Brazil, prevalence rates of 72 / 100 000 and 96 / 100 000 were reported from two localities of Sao Paulo State [18]. In Peru, different seroepidemiological studies indicate a prevalence of 10-20% of CC / taeniosis in the general population and values two to three times higher in individuals with epilepsy. The main endemic areas are Sierra, North Coast and the High Jungle. NCC is present in low proportion in other zones of the country, with the area of Iquitos, apparently free of the disease [19]. In Colombia, in two rural communities of Antioquia, the prevalence of human CC was 1.2% and 2.2%. These results show that CC is endemic in this area [20]. In Venezuela, although intestinal parasites are very frequent [21-25] and tend to persist [24], very low infection rates, < 1%, of Taenia sp. have been reported [23,25-32]. However, these percentages migth be underestimated due to the low sensitivity of examining single stool specimens. A report documents high circulating T. solium metacestode antigen (64.7%) and anti - parasite antibody seroprevalence of 79.4% in an Amerindian community from the Amazonas State. As the IgM was the predominant antibody class, the findings strongly suggest the recent exposure to T. solium of this population [10]. In three rural communities from Lara and Carabobo States, prevalences of 5.7 - 9.1% were established [11]. The detection of IgG antibodies showed that the exposure to the parasite was 4-36.5%. These findings suggest that there are CC active focal points in Venezuela with a high risk of disease transmission. In Ecuador, a high rate of seropositivity of CC among urban, individuals was found in a region endemic for T. solium was 12% of the case family members and 4% of the control family members by the using the enzyme-linked inmmunoelectrotransfer blot (EITB) assay [33]. In Guayaquil City, in NCC patients admitted in a hospital from Guayaquil, prevalences of 6.4%, 2.7%, and 3.5% were noted from 1982 to 1991, 1992 to 2001, and 2002 to 2012 respectively Epidemiology: Open Access Vielma et al., Epidemiol 2014, 4:3 DOI: 10.4172/2161-1165.1000156 Review Article Open Access Epidemiol ISSN:2161-1165 ECR, an open access journal Volume 4 • Issue 3 • 1000156 E p i d e m i o l o g y : O p e n A c c e s s ISSN: 2161-1165