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  Indian J Med Microbiol
 

Figure 1: Proposed hypothesis for the development of symptom (seizure) in neurocysticercosis. Cysticercus fluid antigens induce production of Th-1 cytokines, which enhance the TLR-4 signaling and local inflammation in the brain. TLR-4 (Thr399Ile and Asp299Gly genotypes) promotes production of Th-1 cytokines. ICAM-1 (K469E genotype) enhances the expression of integrins on vascular endothelium resulting in leukocyte adherence and infiltration in the brain. MMP-9 (R279Q genotype) enhances the production of MMP-9 that causes disruption of BBB resulting in leukocyte infiltration. Enhanced Th-1 cytokines and leukocyte infiltration induce inflammation and production of free radicals and ROS that cause local tissue damage and development of symptom (seizure). Low levels of GSTs due to null genotypes of GSTM-1 and GSTT-1 fail to neutralize free radicals and ROS and thus fail to prevent tissue damage. TLR-4: Toll-like receptor-4; MMP-9: Matrix metalloproteinase-9; ICAM-1: Intercellular adhesion molecule-1; BBB: Blood–brain barrier; ROS: Reactive oxygen species; NCC: Neurocysticercosis; GSTM-1: Glutathione S-transferase mu-1, GSTT-1: Glutathione S-transferase theta-1

Figure 1: Proposed hypothesis for the development of symptom (seizure) in neurocysticercosis. Cysticercus fluid antigens induce production of Th-1 cytokines, which enhance the TLR-4 signaling and local inflammation in the brain. TLR-4 (Thr399Ile and Asp299Gly genotypes) promotes production of Th-1 cytokines. ICAM-1 (K469E genotype) enhances the expression of integrins on vascular endothelium resulting in leukocyte adherence and infiltration in the brain. MMP-9 (R279Q genotype) enhances the production of MMP-9 that causes disruption of BBB resulting in leukocyte infiltration. Enhanced Th-1 cytokines and leukocyte infiltration induce inflammation and production of free radicals and ROS that cause local tissue damage and development of symptom (seizure). Low levels of GSTs due to null genotypes of GSTM-1 and GSTT-1 fail to neutralize free radicals and ROS and thus fail to prevent tissue damage. TLR-4: Toll-like receptor-4; MMP-9: Matrix metalloproteinase-9; ICAM-1: Intercellular adhesion molecule-1; BBB: Blood–brain barrier; ROS: Reactive oxygen species; NCC: Neurocysticercosis; GSTM-1: Glutathione S-transferase mu-1, GSTT-1: Glutathione S-transferase theta-1