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Clinical and microbiological aspects of Trichomonas vaginalis - PubMed

Review

Clinical and microbiological aspects of Trichomonas vaginalis

D Petrin et al. Clin Microbiol Rev. 1998 Apr.

Abstract

Trichomonas vaginalis, a parasitic protozoan, is the etiologic agent of trichomoniasis, a sexually transmitted disease (STD) of worldwide importance. Trichomoniasis is the most common nonviral STD, and it is associated with many perinatal complications, male and female genitourinary tract infections, and an increased incidence of HIV transmission. Diagnosis is difficult, since the symptoms of trichomoniasis mimic those of other STDs and detection methods lack precision. Although current treatment protocols involving nitroimidazoles are curative, metronidazole resistance is on the rise, outlining the need for research into alternative antibiotics. Vaccine development has been limited by a lack of understanding of the role of the host immune response to T. vaginalis infection. The lack of a good animal model has made it difficult to conduct standardized studies in drug and vaccine development and pathogenesis. Current work on pathogenesis has focused on the host-parasite relationship, in particular the initial events required to establish infection. These studies have illustrated that the pathogenesis of T. vaginalis is indeed very complex and involves adhesion, hemolysis, and soluble factors such as cysteine proteinases and cell-detaching factor. T. vaginalis interaction with the members of the resident vaginal flora, an advanced immune evasion strategy, and certain stress responses enable the organism to survive in its changing environment. Clearly, further research and collaboration will help elucidate these pathogenic mechanisms, and with better knowledge will come improved disease control.

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Figures

FIG. 1
FIG. 1

(A) T. vaginalis parasite as seen in broth culture. The axostyle, undulating membrane, and flagella are clearly visible. (B) T. vaginalis on the surface of a vaginal epithelial cell prior to ameboid transformation. (C) Ameboid morphology of T. vaginalis as seen in cell culture. Note that the side opposite the undulating membrane adheres to the vaginal epithelial cell. Bars, 5 μm. Reprinted from reference with permission of the publisher.

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