Granulomas in parasitic diseases: the good and the bad

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IMMUNOLOGY AND HOST-PARASITE INTERACTIONS - REVIEW

Granulomas in parasitic diseases: the good and the bad Selma Giorgio 1

&

Pedro Henrique Gallo-Francisco 1 & Guilherme Augusto Sanches Roque 1 & Marina Flóro e Silva 1

Received: 7 April 2020 / Accepted: 2 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020

Abstract Parasitic diseases affect more than one billion people worldwide, and most of them are chronic conditions in which the treatment and prevention are difficult. The appearance of granulomas, defined as organized and compact structures of macrophages and other immune cells, during various parasitic diseases is frequent, since these structures will only form when individual immune cells do not control the invading agent. Th2-typering various parasitic diseases are frequent, since these structures will only form when individual immune cells do not control the invading agent. The characterization of granulomas in different parasitic diseases, as well as recent findings in this field, is discussed in this review, in order to understand the significance of the granuloma and its modulation in the host–parasite interaction and in the immune, pathological, and parasitological aspects of this interaction. The parasitic granulomatous diseases granulomatous amebic encephalitis, toxoplasmosis, leishmaniasis, neurocysticercosis, and schistosomiasis mansoni are discussed as well as the mechanistic and dynamical aspects of the infectious granulomas. Keywords Granuloma . Granulomatous amebic encephalitis . Toxoplasmosis . Leishmaniasis . Neurocysticercosis . Schistosomiasis mansoni

Introduction The term granuloma was first coined by Rudolf Virchow in 1863 to refer to usual “tissue granulation” found in tuberculous lungs (tubercle) and some tumors (Turk 1998; Klippe et al. 2004). At the end of the nineteenth century, other pathologists defended the use of granuloma instead of tubercle and associated other infectious diseases with granuloma formation (Turk 1998; Klippe et al. 2004). Some definitions of granuloma found in important reviews are cited below and complement each other. Boros (1986) defined it as a chronic, mainly mononuclear, inflammatory tissue response to slowly degradable or insoluble live or inanimate agents. For Mariano (1995), the granulomatous inflammation is the morphological substrate for many infections and non-infectious agents. The unique morphological Section Editor: Ramaswamy Kalyanasundaram * Selma Giorgio [email protected] 1

Department of Animal Biology, Biology Institute, State University of Campinas, Campinas 13083-865, Brazil

characteristic of the granuloma is the occurrence of epithelioid cells and the concentric appearance of the whole lesion. For Seitzer et al. (2001), the term granuloma is applied to any small nodular delimited aggregation of mononuclear inflammatory cells or a collection of modified macrophages, usually surrounded by a rim of lymphocytes and often containing multinucleated cells. Recently, Págan and Ramakrishnan (2018) based in Adams and Willi