Multiple Sclerosis autopsy cerebrospinal lateral ventricle fluids demonstrate coenurus parasites – 10 patients – 1984-2014
Creators: name: MacDonald, Alan
Publisher: name: F1000 Research Limited
Year: 2020

description: A thirty year retrospective study of archival frozen cerebrospinal fluids from ten Multiple Sclerosis brain autopsies demonstrated unanimous recovery of coenurus group larval cestode parasites as intact cystic forms, Racemose membrane units, intact scolex units with attached ring configuration arrays of hooklets. exfoliated hooklets lying free in fluids, calcospherules within intact cystic structures, separate calclspherules lying free in fluids, intact in situ tegument ( non-laminated), exfoliated tegument strips lying free in fluid and a single juvenile strobilate tapeworm form with scolex (devoid of attached hooklets), neck with "spined texure" tegument, and triangular shaped proglottids ( 7) with minute areas of apparent egg production in the distal proglotttids. No overt "bladder" was associated with the strobilate form. The unique "spined " texture of the tegument of the strobilate argues against its speciation class into any known human tapeworm genospecies pathogen.<br>The size of the cystic larval forms detected in this study is noteworthy because all parasites measured less than 1000 microns in dimension. Other reported cases of human cerebral coenurosis have all described the size of cystic coenurus forms as greater than 20,000 microns in diameter.<br>Autopsy examinations of all ten cases revealed no grossly visible Cystic structures in the brains, Luxol Fast blue stains of grossly visible plaques of demyelination in white matter confirmed the Neuropathologists' final diagnosis of Multiple sclerosis. No evidence of parasites was detected in antemortem lumbar puncture cerebrospinal fluids in any patient in this series. No radiological images of brain antemortem revealed any cystic areas in brain parenchyma or in leptomeningeal membranes.<br>The data herein, taken together, argues for the existence of a group of previously unrecognized cestode species which have a novel clinical phenotype .and novel genotypes which exist as grossly invisible pathogens presenting a "microscopic" scale a which elude detection during the lifetime of the patient and elude detection at the autopsy table and elude detection in Luxol Fast blue-stained brain histology procedures.<br>Tapeworm infestations acquired through the ingestion of contaminated food and water are well known internationally.. Vegetarians in India have acquired Taenia Solium tapeworms by ingestion of contaminated legumes and berries. The vegetarian model appears to provide one possible explanation for the source of the novel genospecies of tapeworms in the ten Multiple Sclerosis patients presented, and additional possible sources of origin for tapeworm eggs include fecal material from dogs, goats, sheep, and other farm animals. <br>Veterinary pathology defines a category of cerebral coenurosis in sheep from Iran and Goats from Egypt which demonstrate microscopic demyelination in autopsy brains. . The possible implications of these observations when combined with evidence for a novel genospecies of Coenurus in human diseases with Demyelination are self-evident.<br>Molecular diagnostics are now established for the detection of non-human DNA derived from cestode<br>mitochondria (mt-DNA) for the diagnosis of histologically occult cestode pathogens in human patients, including the detection of parasites in cerebrospinal fluids. Genospecies assignments are not possible with mtDNA detection methods, but Cestode Class diagnoses are now possible. <br>The Complete genomic sequencing of human cestode pathogens is just beginning. AT least 3900 tapeworm species were defined in 1986 by Dr. Gerald D. Schmidt in his encyclopedic work " Handbook of Tapeworm Identification" ( CRC Press).. Estimates in the year 2020 of up to 6000 tapeworm species are now<br>described..<br>New subspecies within generic tapeworm groups (Taenia, Echinococcus, Multiceps) are now recognized thanks to genetic tools for the detection of molecular variants of tapeworms, Discussions to correlate biological sub-phenotype behavior with DNA variations are found in the literature.<br>I postulate that "agents of human tissue Injury: derived from tapeworm infestations of the brain and spinal cord sites in the mammalian hosts might derive from the special properties of tapeworm membranes which possess abilities to infinitely replicate outside of the eukaryotic nucleus and to metastasize in intermediate host situations, and the ability of Tapeworm nucleotides to insinuate into mammalian genomes sites by lateral DNA Transfer. Exosomes of parasitic origin will be essential as carriers in this scenario<br><br>Respectfully Submitted<br>Alan B. MacDonald, MD <br>August 28, 2020.