KRVAVAC Sh., Rustembegovic A.
Public Health Center Stari Grad,University and Medacal Center Center
Sarajevo,Yugoslavia (now Bosnia/Herzegovina)

Trichomonal factors (their metabolites and decay parts) burden immune
apparatus of the patients with their antigenic battery and so they can contribute
to triggering of acute as well as exacerbation of chronic rheumatic disease.

Investigating of trichomonaemia as a potent immunocompromising factor(1)
has resulted in conviction about its possible relation with rheumatic diseases.
Previously reported connection between ankylosing spondylitis and
manly (prostatic) trichomoniasis(2),as well as numerous similar own observations on
gynaecologic patients,prompted the authors to examine the blood sediments under
microscope after determination of ESR in gynacologic patients.In the second
phase,blood sediments by high ESR by rheumatic patients have been
examined.Wet smears of blood sediments have been colored by 1% Methylcresyl (in
physiologic solution) and examined in following several minutes. Higher ESR is,greater
number of round (aflagellary trichomonads with clearer signs of their intracellular
activity,as reflection of their lively metabolism,appears.
Round forms of human trichomonads are often found on the in the
urogenital, respiratory and digestive mucous membranes of poatients with different
diseases,but are considered saprophytes.There is justified dilema,whether it's correct to
think of saprophyte of an agent which (strongly)significantly activates the immune
apparatus of the host,i.e. isn't aflagellary form result of acting of immune
mechanism of the host which in that way controls the invasiveness of parasites,From
this arises a final question what happens if immune apparatus is not capable of
resisting those agegents,only when they penetrate into circulation.
 Regarding that authors have limited investigation only to possible
clinical aspects of trichomonaemia,so they believe that further investigation in
indicated direction will make wider comprehension about possible important contribution
of those neglected infraepithelially localized trichomonads in pathogenesis of
rheumatic diseases.

Ref.(1)Krvavac Sh.:Trichomonas species as dominant immunopathogenic agent of
IXth Eur Immun Meeting (EFIS)Rome 1988,p.23,(2)Kubersky T.T.:Ankylosing
spondylitis associated with Trichomonas vag infectio.J Clin Microbiol,May 1981,p.880.

Presented in Monte Carlo,15-18 March 1989 on 3rd Interscience World
Conference on Inflammation,Antirheumatics,Analgesics,Immunomodulators.Abstracts p. 274.