4.5 Trichomoniasis
4.5.5 Summary
In conclusion, the fi ndings suggest that both humoral and cellular immune responses might contribute to the varied symptomatology in trichomoniasis-infected patients, thereby reduc- ing symptoms to asymptomatic levels. Periodic changes in immune competence, perhaps induced by parasite-derived products, might be responsi- ble for an increase in parasite numbers, leading to increased epithelial damage and infl ammatory response. However, the current understanding of
139
immunity to T. vaginalis remains unsatisfactory, and it is not clear whether acquired immune responses are required for protection and, if so, what role is played by acquired immunity in con- taining or eliminating infections. Although there is some evidence that protection may be achieved by immunization of laboratory animals, strong protective immunity does not seem to follow natural infection in humans. A study of patients infected with T. vaginalis and HIV indicated no evidence of increased levels or longevity of para- site infection in these patients compared to those in patients infected with T. vaginalis but not HIV positive. These observations may indicate that innate immunity involving chemotaxis and the subsequent infl ux of neutrophils is much more important than acquired immunity in controlling infections with T. vaginalis .
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