CNS Infection Mecanism of Schistosoma japonicum

1Zain Irfan Rafii and 2Yudha Nurdian

1Medical Student, Faculty of Medicine, University of Jember, Indonesia
2
Faculty of Medicine, University of Jember, Indonesia
Correspondingauthor:ZainIrfanRafii,zainrafii74@gmail.com
152010101046@students.unej.ac.id.

Abstract
Background
Schistosoma japonicum entering human body by penetrated through the human skin.
Penetration through the skin is due to proteolytic activity of enzymes secreted from the
cercarial acetabular glands. After skin penetration, the cercariae lose their tails and move as
schistomula into the vascular system. After initially residing in the lung, the Schitomula
spread either via the bloodstream or directly through the diaphragm into the intrahepatic
branches of the portal vein, where they mature into schistosomes, mate, and migrate into the
inferior mesenteric vein. At these locations the worms lay eggs which can be excreted in the
feces or urine. However, eggs may also spread to the CNS by the bloodstream as emboli,
which can be sparse and randomly distributed, via previously developed shunts or
anastomoses from veins to arteries. They may also reach the epidural venous plexus around
the spinal cord through retrograde flow in the venules. The eggs are deposited as emboli to
the cerebral vessels and secrete antigens such as glycans and glycoproteins that elicit an
immune response leading to granuloma formation. S. japonicum eggs can reach the brain, and
typically target the cerebral cortex, basal ganglia, and cerebral white matter. In addition, and
probably as a main cause of symptomatic neuroschistosomiasis, adult worms can migrate via
the bloodstream from the mesenteric and pelvic plexus veins to reach meningeal or choroid
plexus vessels. From such sites they may shed massive amounts of eggs into vessels of
confined areas of the spinal cord.

Conclusion
This work explain how Schistosoma japonicum infect human, more precisely on the CNS. the
mechanism of infection starts from penetration through the skin, then into the bloodstream
and form emboli there which later will likely be forwarded to the CNS

Referencee
Kristensson, K., Masocha, W., and Bentivoglio, M. 2013. Mechanism of CNS Invasion and
Damage by Parasites. Handbook of Clinical Neurology, 114 (3): 12-19.