RESUMO
Helminth infections, including hookworms and Schistosomes, can cause severe disability and death. Infection management and control would benefit from identification of biomarkers for early detection and prognosis. While animal models suggest that Trefoil Factor Family proteins (TFF2 and TFF3) and interleukin-33 (IL-33) -driven type 2 immune responses are critical mediators of tissue repair and worm clearance in the context of hookworm infection, very little is known about how they are modulated in the context of human helminth infection. We measured TFF2, TFF3, and IL-33 levels in serum from patients in Brazil infected with Hookworm and/or Schistosomes, and compared them to endemic and non-endemic controls. TFF2 was specifically elevated by Hookworm infection in females, not Schistosoma or co-infection. This elevation was correlated with age, but not worm burden. TFF3 was elevated by Schistosoma infection and found to be generally higher in females. IL-33 was not significantly altered by infection. To determine if this might apply more broadly to other species or regions, we measured TFFs and cytokine levels (IFNγ, TNFα, IL-33, IL-13, IL-1ß, IL-17A, IL-22, and IL-10) in both the serum and urine of Nigerian school children infected with S. haematobium. We found that serum levels of TFF2 and 3 were reduced by infection, likely in an age dependent manner. In the serum, only IL-10 and IL-13 were significantly increased, while in urine IFN-γ, TNF-α, IL-13, IL-1ß, IL-22, and IL-10 were significantly increased in by infection. Taken together, these data support a role for TFF proteins in human helminth infection.
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Helmintíase/sangue , Helmintos/classificação , Helmintos/fisiologia , Fator Trefoil-2/sangue , Fator Trefoil-3/sangue , Adolescente , Adulto , Fatores Etários , Animais , Brasil , Criança , Estudos de Coortes , Feminino , Helmintíase/parasitologia , Helmintos/genética , Humanos , Interferon gama/sangue , Interleucina-10/sangue , Interleucina-33/sangue , Masculino , Pessoa de Meia-Idade , Especificidade da Espécie , Fator de Necrose Tumoral alfa/sangue , Adulto JovemRESUMO
INTRODUCTION: Inflammation associated with Helicobacter pylori (H. pylori) infection is linked to the development of a gastric precancerous lesion. Helminth infections could influence the pro-inflam matory response to such infection from LTCD4+ Th1 to a less harmful LTCD4+ Th2 response. Ob jective: To characterize the polarization of the LTCD4+ Th2 immune response in co-infected pa tients with H. pylori and helminths from low-risk areas for developing gastric cancer. PATIENTS AND METHOD: We analyzed 63 patients infected by H. pylori (40 adults and 23 children). Through the Multiplex Analysis technology (xMAP), we determined the serum profiles of the interleukins asso ciated with the polarization of the immune response of LTCD4+ Th1 (IL-1Β, INF-γ, TNF-α) as well as the LTCD4+ Th2 (IL-4, IL-10, and IL-13). The ratio between helminths co-infection status in H. pylori-infected patients and the polarization of the immune response mediated by LTCD4+ Th1 and LTCD4+ Th2 was assessed using a Mixed Effects Logistic Regression Model. RESULTS: The frequency of helminths was similar between adults (15%) and children (17%). The polarization of the immu ne response was more prevalent in LTCD4+ Th1. Serum values of interleukins associated with the immune response polarization of LTCD4+ Th1 (IL-1Β, INF-γ, and TNF-α) and LTCD4+ Th2 (IL-4, IL-10, and IL-13) were independent of helminths infection status. CONCLUSION: The prevalence of in testinal parasitic infection was high and the immune response polarization was mainly LTCD4 + Th1.
Assuntos
Linfócitos T CD4-Positivos/imunologia , Coinfecção/imunologia , Infecções por Helicobacter/imunologia , Helicobacter pylori/imunologia , Helmintíase/imunologia , Equilíbrio Th1-Th2 , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Linfócitos T CD4-Positivos/metabolismo , Criança , Pré-Escolar , Coinfecção/sangue , Coinfecção/diagnóstico , Coinfecção/patologia , Feminino , Infecções por Helicobacter/sangue , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/patologia , Helmintíase/sangue , Helmintíase/diagnóstico , Helmintíase/patologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-IdadeRESUMO
Resumen: Introducción: La inflamación asociada con la infección por Helicobacter pylori (H. pylori) se relaciona con la pro gresión de las lesiones precancerosas gástricas. Las infecciones por helmintos podrían modular la respuesta proinflamatoria a la infección por H. pylori desde un perfil tipo LTCD4+ Th1 hacia una respuesta menos perjudicial tipo LTCD4+ Th2. Objetivo: Caracterizar la polarización de la respuesta inmune tipo LTCD4+ Th1/Th2 de pacientes coinfectados por H. pylori y helmintiasis procedentes de áreas de bajo riego para el desarrollo de cáncer gástrico. Pacientes y Método: Se analizaron 63 pacientes, 40 adultos y 23 niños infectados con H. pylori. La determinación de los perfiles séricos de las interleucinas asociadas con la polarización de la respuesta inmune tipo LTCD4+ Th1 (IL-1Β, INF-γ y TNF-α) y tipo LTCD4+ Th2 (IL-4, IL-10 e IL-13) se realizó con Análisis Multiplex (xMAP). La relación entre el estado de coinfección por helmintos en pacientes infectados con H. pylori y la polarización de la respuesta inmune mediada por LTCD4+ Th1 y LTCD4+ Th2, se estudió con un modelo de regresión logístico de efectos mixtos. Resultados: La frecuencia de helmintos fue similar en adultos (15%) y niños (17%). La polarización de la respuesta inmune fue más prevalente hacia el tipo LTCD4+ Th1. Los valores séricos de las interleucinas asociadas con la polarización de la respuesta inmune tipo LTCD4+ Th1 (IL-1 Β, INF-γ y TNF-α) y tipo LTCD4+ Th2 (IL-4, IL-10 e IL-13) fueron independientes del estado de infestación por helmintos. Conclusión: La prevalencia de infección por parasitismo intestinal fue alta y la polarización de la respuesta inmune fue predominantemente hacia un perfil tipo LTCD4 + Th1.
Abstract: Introduction: Inflammation associated with Helicobacter pylori (H. pylori) infection is linked to the development of a gastric precancerous lesion. Helminth infections could influence the pro-inflam matory response to such infection from LTCD4+ Th1 to a less harmful LTCD4+ Th2 response. Ob jective: To characterize the polarization of the LTCD4+ Th2 immune response in co-infected pa tients with H. pylori and helminths from low-risk areas for developing gastric cancer. Patients and Method: We analyzed 63 patients infected by H. pylori (40 adults and 23 children). Through the Multiplex Analysis technology (xMAP), we determined the serum profiles of the interleukins asso ciated with the polarization of the immune response of LTCD4+ Th1 (IL-1Β, INF-γ, TNF-α) as well as the LTCD4+ Th2 (IL-4, IL-10, and IL-13). The ratio between helminths co-infection status in H. pylori-infected patients and the polarization of the immune response mediated by LTCD4+ Th1 and LTCD4+ Th2 was assessed using a Mixed Effects Logistic Regression Model. Results: The frequency of helminths was similar between adults (15%) and children (17%). The polarization of the immu ne response was more prevalent in LTCD4+ Th1. Serum values of interleukins associated with the immune response polarization of LTCD4+ Th1 (IL-1Β, INF-γ, and TNF-α) and LTCD4+ Th2 (IL-4, IL-10, and IL-13) were independent of helminths infection status. Conclusion: The prevalence of in testinal parasitic infection was high and the immune response polarization was mainly LTCD4 + Th1.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Linfócitos T CD4-Positivos/imunologia , Helicobacter pylori/imunologia , Infecções por Helicobacter/imunologia , Equilíbrio Th1-Th2 , Coinfecção/imunologia , Helmintíase/imunologia , Biomarcadores/sangue , Linfócitos T CD4-Positivos/metabolismo , Modelos Logísticos , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/patologia , Infecções por Helicobacter/sangue , Coinfecção/diagnóstico , Coinfecção/patologia , Coinfecção/sangue , Helmintíase/diagnóstico , Helmintíase/patologia , Helmintíase/sangueAssuntos
Gastroenterite/etiologia , Helmintíase/etiologia , Inflamação/etiologia , Solo/parasitologia , Proteína C-Reativa/análise , Camboja/epidemiologia , Criança , Cuba/epidemiologia , Gastroenterite/epidemiologia , Helmintíase/sangue , Helmintíase/epidemiologia , Humanos , Inflamação/epidemiologia , Complexo Antígeno L1 Leucocitário/sangue , Orosomucoide/análise , PrevalênciaRESUMO
The aim of the present study was to evaluate associations between intestinal parasitic infection with intestinal and systemic inflammatory markers in school-aged children with high rates of obesity. Plasma concentrations of C-Reactive Protein (CRP), leptin, TNF-α, IL-6 and IL-10 were measured as systemic inflammation markers and count of stool leukocytes as marker of intestinal inflammation in 291 children (6-10 years). Intestinal parasitic infection was measured by stool examination. Logistic regression analyses were performed to determine the odds of having high inflammatory markers for each parasite or group of parasites as compared to parasite-free children while adjusting for sex, age, mother's educational level and percentage of body fat. The prevalence of soil-transmitted helminths and intestinal protozoa infections was 12% and 36%, respectively. Parasitic infection was not associated with CRP, IL-6, IL-10 or TNF-α. Children infected with Ascaris lumbricoides (aOR: 5.91, 95% CI: 1.97-17.70) and Entamoeba coli (aOR: 8.46, 95% CI: 2.85-25.14) were more likely to have higher stool leucocytes than parasite-free children. Children with multiple infections (aOR: 10.60, 95% CI: 2.85-25.14) were more likely to have higher leptin concentrations than parasite-free children. Intestinal parasitic infection was not associated with systemic inflammation, but was associated with intestinal inflammation. Having multiple infections were associated with higher leptin concentrations.
Assuntos
Helmintíase/sangue , Helmintíase/imunologia , Enteropatias Parasitárias/sangue , Enteropatias Parasitárias/imunologia , Intestinos/parasitologia , Leptina/sangue , Animais , Ascaris lumbricoides/imunologia , Proteína C-Reativa/metabolismo , Criança , Estudos Transversais , Entamoeba histolytica/imunologia , Fezes/parasitologia , Feminino , Helmintíase/parasitologia , Humanos , Inflamação , Interleucina-10/sangue , Interleucina-6/sangue , Enteropatias Parasitárias/parasitologia , Masculino , Obesidade/complicações , Prevalência , Inquéritos e Questionários , Fator de Necrose Tumoral alfa/sangueRESUMO
BACKGROUND: Soil-transmitted helminths (STH) establish chronic infections in the human intestine. The host reacts to these infections with a dominant T-helper type 2 cell (Th2) response that while attempting to control the worm population, can also provide an anti-inflammatory environment favourable for parasite survival. Regulatory cytokine interleukin 10 (IL-10) has been proposed as a key molecule involved in the attenuation of chronic inflammation and the ensuing tolerance for these helminth parasites. The objective of this study was to determine whether STH-infected children from an endemic community had increased circulating IL-10 levels when compared to non-infected children. RESULTS: A total of 39 children (25 boys and 14 girls, 7-15 years of age) were enrolled in study. Utilizing the Kato-Katz method to detect intestinal helminthiases, 10 children were non-infected and 29 were harbouring STH infections by Ascaris lumbricoides, Trichuris trichiura and/or hookworms. Of the 29 infected children, 11 had single-species infections and 18 were polyparasitized with two or three STH species. Serum samples from all 39 children were tested for IL-10 serum concentrations, out of which 12 had undetectable levels while 27 had levels ranging from 0.4-105 pg/mL. Excluding extreme outlying values, 25 samples had IL-10 concentration values ranging from 0.4 -7.2 pg/mL. Differences in IL-10 levels among non-parasitized, monoparasitized, and polyparasitized groups were not statistically significant. However, children infected with any of the three STH species investigated had higher IL-10 levels than non-parasitized children (geometric means: 0.89 pg/mL vs. 0.74 pg/mL, p = 0.428). Similarly, polyparasitized children had higher IL-10 levels than both monoparasitized and non-parasitized children (1.04 pg/mL, 0.69 pg/mL, and 0.74 pg/mL, respectively, p = 0.481). A significant moderate negative correlation between IL-10 levels and children's age was found, but no correlations were observed between IL-10 levels and intensity of infection by any of the parasite species investigated. CONCLUSIONS: We found no strong evidence for an association between STH infection and serum IL-10 concentration levels. However, the trends identified here warrant further investigation. Additional research is needed to expand the current understanding of the immune response elicited by STH infections in children living in endemic communities.
Assuntos
Helmintíase/parasitologia , Helmintíase/transmissão , Interleucina-10/sangue , Solo/parasitologia , Adolescente , Criança , Feminino , Helmintíase/sangue , Helmintíase/imunologia , Honduras , Humanos , MasculinoRESUMO
Soil-transmitted helminth (STH) infections and zinc deficiency are often found in low- and middle-income countries and are both known to affect child growth. However, studies combining data on zinc and STH are lacking. In two studies in schoolchildren in Cuba and Cambodia, we collected data on height, STH infection and zinc concentration in either plasma (Cambodia) or hair (Cuba). We analyzed whether STH and/or zinc were associated with height for age z-scores and whether STH and zinc were associated. In Cuba, STH prevalence was 8.4%; these were mainly Ascaris lumbricoides and Trichuris trichiura infections. In Cambodia, STH prevalence was 16.8%, mostly caused by hookworm. In Cuban children, STH infection had a strong association with height for age (aB-0.438, p = 0.001), while hair zinc was significantly associated with height for age only in STH uninfected children. In Cambodian children, plasma zinc was associated with height for age (aB-0.033, p = 0.029), but STH infection was not. Only in Cambodia, STH infection showed an association with zinc concentration (aB-0.233, p = 0.051). Factors influencing child growth differ between populations and may depend on prevalences of STH species and zinc deficiency. Further research is needed to elucidate these relationships and their underlying mechanisms.
Assuntos
Estatura , Helmintíase/sangue , Helmintíase/epidemiologia , Solo/parasitologia , Zinco/sangue , Animais , Ascaris lumbricoides , Camboja/epidemiologia , Criança , Desenvolvimento Infantil , Estudos Transversais , Cuba/epidemiologia , Países em Desenvolvimento , Feminino , Cabelo/química , Helmintíase/transmissão , Humanos , Modelos Lineares , Masculino , Prevalência , Trichuris , Zinco/administração & dosagem , Zinco/deficiênciaRESUMO
BACKGROUND: Helminths are modulators of the host immune system, and infections with these parasites have been associated with protection against allergies and autoimmune diseases. The human host is often infected with multiple helminth parasites and most studies to date have investigated the effects of helminths in the context of infections with single parasite or types of parasites (e.g. geohelminths). In this study, we investigated how co-infections with three nematodes affect markers of allergic inflammation and asthma in children. We selected Ascaris lumbricoides and Trichuris trichiura, two parasites that inhabit the human intestine and Toxocara spp (Toxocara canis and/or T. cati), intestinal roundworms of dogs and cats that cause systemic larval infection in humans. These parasites were selected as the most prevalent helminth parasites in our study population. RESULTS: 36.4% of children were infected with one parasite; 12.7% with 2 and 5.2% with 3. Eosinophilia>4% and >10% was present in 74.3% and 25.5% of the children, respectively. Total IgE>200 IU/mL, sIgE≥0.70 kU/L and SPT positivity were present in 59.7%, 37.1% and 30% of the children, respectively. 22.7% had recent asthma (12.0% non-atopic and 10.7% atopic). Helminth infections were associated in a dose-dependent way to decrease in the prevalence of SPT and increase in eosinophilia, total IgE, and the production of the regulatory cytokine IL-10 by unstimulated peripheral blood leukocytes. No association with asthma was observed. CONCLUSIONS: Helminth co-infections in this population were associated with increased markers of the Th2 immune response, and with a host immune regulatory phenotype that may suppress allergic effector responses such as immediate hypersensitivity reactions in the skin.
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Asma/complicações , Cidades , Coinfecção/complicações , Citocinas/sangue , Dermatite Atópica/complicações , Helmintos/fisiologia , Pobreza , Animais , Asma/sangue , Asma/parasitologia , Biomarcadores/metabolismo , Criança , Pré-Escolar , Coinfecção/sangue , Coinfecção/parasitologia , Citocinas/biossíntese , Dermatite Atópica/sangue , Dermatite Atópica/parasitologia , Eosinofilia/sangue , Eosinofilia/complicações , Feminino , Helmintíase/sangue , Helmintíase/complicações , Humanos , Hipersensibilidade Imediata/complicações , Hipersensibilidade Imediata/imunologia , Imunoglobulina E/sangue , América Latina , Leucócitos Mononucleares/metabolismo , Masculino , Modelos Biológicos , Parasitos/fisiologia , Testes CutâneosRESUMO
Total serum IgE (tIgE), allergen-specific IgE (sIgE), and skin prick test (SPT) are commonly used markers for atopy and atopic disease. The association between these measures and their relationship to clinical symptoms differs in affluent and non-affluent countries. We investigated the role of intestinal helminth infections in observed variations in atopic markers and asthma, and possible diagnostic and epidemiological consequences. A cross-sectional study was conducted in Cuban schoolchildren (n = 1285; 4-14 yrs). Atopy was determined by SPT, sIgE, and tIgE; asthma by International Study of Asthma and Allergies in Childhood questionnaire; and intestinal helminth infections by stool examination. Percentages of tIgE, sIgE, and SPT positives were 88.9%, 25.5%, and 16.5%, respectively. Asthma was found in 20.8%, and helminth infections in 20.9% of the children. All three atopic markers were significantly associated with each other and with asthma. Median tIgE levels were higher in helminth-infected than in uninfected children, irrespective of their status of atopy/asthma. Discordant results between SPT and sIgE were observed in 22.6% of the children. Among SPT positives, 41% were sIgE negative. The proportion of SPT negatives among sIgE positives was 74% in helminth-infected and 58.4% in uninfected children (p < 0.05). Helminth infections affected tIgE levels, reconfirming the limited value of tIgE for diagnosis of atopy and asthma in tropical areas. Higher frequencies of sIgE than positive SPTs were observed, especially in helminth-infected children. This corresponds with current hypothesis on the role of helminths in atopy. However, the observed proportion of sIgE negatives among children with positive SPT suggests that other mechanisms may also be involved.
Assuntos
Asma/epidemiologia , Helmintíase/epidemiologia , Enteropatias/epidemiologia , Adolescente , Asma/sangue , Asma/diagnóstico , Asma/imunologia , Biomarcadores/sangue , Criança , Pré-Escolar , Estudos Transversais , Cuba/epidemiologia , Fezes/microbiologia , Feminino , Helmintíase/sangue , Helmintíase/diagnóstico , Helmintíase/imunologia , Humanos , Imunoglobulina E/sangue , Imunoglobulina E/imunologia , Enteropatias/sangue , Enteropatias/diagnóstico , Enteropatias/imunologia , Enteropatias Parasitárias , Masculino , Prevalência , Testes CutâneosRESUMO
OBJETIVO: Eosinofilia e elevação de IgE sérica são expressões de atopia, contudo há fatores intervenientes como, por exemplo, as parasitoses intestinais. Esta pesquisa verifica a relação entre IgE sérica total, eosinófilos e IgE específica anti-áscaris em indivíduos portadores de asma e/ou rinite alérgica. MÉTODOS: Estudo do tipo transversal em adolescentes portadores de asma e/ou rinite alérgica que foram examinados quanto ao nível sérico de IgE total, de IgE anti-áscaris e de contagem dos eosinófilos sangüíneos. RESULTADOS: Foram analisados 101 pacientes com idade entre 12 e 21 anos. A mediana da IgE foi 660 UI/mL (P25-75 243,5-1500), e a dos eosinófilos foi 510 células/mm³ (P25-75 284-811). A IgE anti-áscaris foi positiva em 73 por cento (74/101) da amostra, mas houve apenas 33,7 por cento (34/101) de positividade ao parasitológico de fezes. Os coeficientes de correlação encontrados foram: 0,34 (p = 0,001) entre IgE total e eosinófilos, 0,52 (p < 0,001) entre IgE total e IgE anti-áscaris e 0,26 (p = 0,01) entre eosinófilos e IgE anti-áscaris. O modelo de regressão linear múltipla final encontrou que IgE anti-áscaris foi fator contribuinte para IgE sérica total com coeficiente de determinação (r2 ajustado) de 0,25 (F = 12,35; p < 0,001), e esse efeito foi independente de contagem de eosinófilos séricos e de parasitose intestinal por helmintos. CONCLUSÃO: Em pacientes com alergia respiratória e IgE sérica total bastante elevada, oriundos de áreas com alto risco de infecção por helmintos, a pesquisa de IgE anti-áscaris como possível fator explicativo pode ser de maior ajuda que a realização do parasitológico de fezes.
OBJECTIVE: Eosinophilia and increased serum IgE levels are indicators of atopy; however, other factors can also play a key role, such as intestinal parasitic infections. This study assesses the relationship between total serum IgE, eosinophil count, and anti-Ascaris IgE in individuals with asthma and/or allergic rhinitis. METHODS: A cross-sectional study was carried out in adolescents with asthma and/or allergic rhinitis. The patients had their total serum IgE, anti-Ascaris IgE and eosinophil count measured. RESULTS: A total of 101 patients aged 12 to 21 years were assessed. Median IgE level was 660 IU/mL (P25-75 243.5-1500), and the eosinophil count corresponded to 510 cells/mm³ (P25-75 284-811). Anti-Ascaris IgE was positive in 73 percent (74/101) of the individuals, but parasitological stool examination yielded positive results in only 33.7 percent (34/101). The correlation coefficients were the following: 0.34 (p = 0.001) between total IgE level and eosinophil count, 0.52 (p < 0.001) between total IgE level and anti-Ascaris IgE, and 0.26 (p = 0.01) between eosinophil count and anti-Ascaris IgE. The final multiple linear regression model pointed out that anti-Ascaris IgE contributed to a total serum IgE level with a coefficient of determination (adjusted R²) of 0.25 (F = 12.35; p < 0.001). This effect occurred regardless of eosinophil count and of the presence of intestinal helminthic infection. CONCLUSION: In patients with respiratory allergy and increased total serum IgE levels living in areas where there is a high risk for helminthic infections, the quantification of anti-Ascaris IgE can be more useful and more insightful than the parasitological stool examination.
Assuntos
Adolescente , Adulto , Animais , Criança , Feminino , Humanos , Masculino , Ascaris lumbricoides/imunologia , Asma/sangue , Eosinófilos , Imunoglobulina E/sangue , Rinite/sangue , Asma/parasitologia , Biomarcadores , Doença Crônica , Intervalos de Confiança , Estudos Transversais , Helmintíase/sangue , Helmintíase/imunologia , Enteropatias Parasitárias/sangue , Enteropatias Parasitárias/imunologia , Contagem de Leucócitos , Modelos Lineares , Rinite/parasitologiaRESUMO
OBJECTIVE: Eosinophilia and increased serum IgE levels are indicators of atopy; however, other factors can also play a key role, such as intestinal parasitic infections. This study assesses the relationship between total serum IgE, eosinophil count, and anti-Ascaris IgE in individuals with asthma and/or allergic rhinitis. METHODS: A cross-sectional study was carried out in adolescents with asthma and/or allergic rhinitis. The patients had their total serum IgE, anti-Ascaris IgE and eosinophil count measured. RESULTS: A total of 101 patients aged 12 to 21 years were assessed. Median IgE level was 660 IU/mL (P(25-75) 243.5-1500), and the eosinophil count corresponded to 510 cells/mm(3) (P(25-75) 284-811). Anti-Ascaris IgE was positive in 73% (74/101) of the individuals, but parasitological stool examination yielded positive results in only 33.7% (34/101). The correlation coefficients were the following: 0.34 (p = 0.001) between total IgE level and eosinophil count, 0.52 (p < 0.001) between total IgE level and anti-Ascaris IgE, and 0.26 (p = 0.01) between eosinophil count and anti-Ascaris IgE. The final multiple linear regression model pointed out that anti-Ascaris IgE contributed to a total serum IgE level with a coefficient of determination (adjusted R(2)) of 0.25 (F = 12.35; p < 0.001). This effect occurred regardless of eosinophil count and of the presence of intestinal helminthic infection. CONCLUSION: In patients with respiratory allergy and increased total serum IgE levels living in areas where there is a high risk for helminthic infections, the quantification of anti-Ascaris IgE can be more useful and more insightful than the parasitological stool examination.
Assuntos
Ascaris lumbricoides/imunologia , Asma/sangue , Eosinófilos , Imunoglobulina E/sangue , Rinite/sangue , Adolescente , Adulto , Animais , Asma/parasitologia , Biomarcadores , Criança , Doença Crônica , Intervalos de Confiança , Estudos Transversais , Feminino , Helmintíase/sangue , Helmintíase/imunologia , Humanos , Enteropatias Parasitárias/sangue , Enteropatias Parasitárias/imunologia , Contagem de Leucócitos , Modelos Lineares , Masculino , Rinite/parasitologiaRESUMO
It has long been known that leukocytosis and blood eosinophilia are common in the tropical environment, but data derived from population-based studies are scarce. A study was undertaken in a fishing village in north-east Brazil where both intestinal helminthiases and parasitic skin diseases are common. Of 409 individuals studied, 128 (31.3%) were infected with one intestinal helminth or ectoparasite species, 93 (22.7%) with two, 61 (14.9%) with three, 25 (6.1%) with four and 11 (2.7%) with more than four species; no parasites were found in 91 (22.2%) individuals. Leukocyte counts ranged between 3,300 cells/microl and 16,100 cells/microl (median, 7,200 cells/microl) and eosinophil counts between 40 cells/microl and 5,460 cells/microl (median, 455 cells/microl). Eosinophilia (>500/microl) was detected in 44.7% of the individuals, and hypereosinophilia (>1,000/microl) in 12.9%. Thirty-six (8.8%) individuals showed leukocytosis. While 75% of individuals with normal eosinophil counts were considered parasite-free, only 14% with eosinophilia and 11% with hypereosinophilia did not have enteroparasites or ectoparasites. Multivariate regression showed that the probability of eosinophilia and hypereosinophilia, but not of leukocytosis, increased with the number of parasite species present. The data show that eosinophilia occurs in almost one-half of the individuals from a resource-poor setting and that it is significantly associated with the presence of intestinal helminths, but not with the presence of ectoparasites.
Assuntos
Eosinofilia/parasitologia , Helmintíase/complicações , Enteropatias Parasitárias/complicações , Leucocitose/parasitologia , Dermatopatias Parasitárias/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Criança , Pré-Escolar , Países em Desenvolvimento , Eosinofilia/sangue , Feminino , Helmintíase/sangue , Humanos , Lactente , Enteropatias Parasitárias/sangue , Contagem de Leucócitos , Leucocitose/sangue , Masculino , Pessoa de Meia-Idade , Saúde da População Rural , Dermatopatias Parasitárias/sangueRESUMO
BACKGROUND: Strongyloides stercoralis is a world wide distributed small intestinal nematode parasite. In immunocompetent individuals S stercoralis can produce asymptomatic infections or a moderate clinical picture of diarrhea, some cases become chronic. In immunocompromised patients, a disseminated disease may appear, sometimes fatal. In Chile, there is little epidemiological information about S stercoralis infections and appropriate diagnostic techniques are usually not used. AIM: To evaluate the yield of an ELISA test for the diagnosis of strongyloidiasis in Chilean patients. MATERIAL AND METHODS: Ten serum samples from patients with S stercoralis infections confirmed by a positive stool examination, 66 samples from individuals with other infections by tissue helminthes (24 toxocariasis, 15 trichinellosis, 11 hydatidosis, 12 fascioliasis and 4 cysticercosis), 13 samples from subjects with autoimmune diseases and 49 samples from apparently healthy individuals with a normal eosinophil count, were studied. ELISA antigen was prepared using a filariform larval extract obtained from a murine species of Strongyloides, maintained in laboratory animals. RESULTS: Using 0.33 optical density units as a cut off value, 9 of 10 sera of S stercoralis infected individuals, had a positive ELISA test. No cross reactions were observed with sera of patients with other helminthic infections, autoimmune diseases or in healthy individuals. Thus, specificity, positive and negative predictive values were 100 per cent. CONCLUSIONS: The results obtained are similar with those found by other investigators. ELISA test for strongyloidiasis is a useful tool for the diagnosis of clinical cases and for seroepidemiological studies of this nematode infection in Chile.
Assuntos
Humanos , Criança , Adulto , Estrongiloidíase/diagnóstico , Strongyloides stercoralis/imunologia , Doenças Autoimunes , Ensaio de Imunoadsorção Enzimática , Anticorpos Anti-Helmínticos/sangue , Antígenos de Helmintos/sangue , Chile , Estrongiloidíase/sangue , Estrongiloidíase/imunologia , Helmintíase/sangue , Helmintíase/diagnóstico , Helmintíase/imunologia , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: Strongyloides stercoralis is a world wide distributed small intestinal nematode parasite. In immunocompetent individuals S stercoralis can produce asymptomatic infections or a moderate clinical picture of diarrhea, some cases become chronic. In immunocompromised patients, a disseminated disease may appear, sometimes fatal. In Chile, there is little epidemiological information about S stercoralis infections and appropriate diagnostic techniques are usually not used. AIM: To evaluate the yield of an ELISA test for the diagnosis of strongyloidiasis in Chilean patients. MATERIAL AND METHODS: Ten serum samples from patients with S stercoralis infections confirmed by a positive stool examination, 66 samples from individuals with other infections by tissue helminthes (24 toxocariasis, 15 trichinellosis, 11 hydatidosis, 12 fascioliasis and 4 cysticercosis), 13 samples from subjects with autoimmune diseases and 49 samples from apparently healthy individuals with a normal eosinophil count, were studied. ELISA antigen was prepared using a filariform larval extract obtained from a murine species of Strongyloides, maintained in laboratory animals. RESULTS: Using 0.33 optical density units as a cut off value, 9 of 10 sera of S stercoralis infected individuals, had a positive ELISA test. No cross reactions were observed with sera of patients with other helminthic infections, autoimmune diseases or in healthy individuals. Thus, specificity, positive and negative predictive values were 100%. CONCLUSIONS: The results obtained are similar with those found by other investigators. ELISA test for strongyloidiasis is a useful tool for the diagnosis of clinical cases and for seroepidemiological studies of this nematode infection in Chile.
Assuntos
Strongyloides stercoralis/imunologia , Estrongiloidíase/diagnóstico , Adulto , Animais , Anticorpos Anti-Helmínticos/sangue , Antígenos de Helmintos/sangue , Doenças Autoimunes/sangue , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/imunologia , Criança , Chile , Ensaio de Imunoadsorção Enzimática/normas , Helmintíase/sangue , Helmintíase/diagnóstico , Helmintíase/imunologia , Humanos , Sensibilidade e Especificidade , Estrongiloidíase/sangue , Estrongiloidíase/imunologiaRESUMO
Eosinófilos estäo envolvidos em uma série de infecçöes parasitárias mas, nem sempre o número destes está aumentando no sangue circulante. Considera-se nesta breve revisäo alguns dos aspectos envolvidos na produçäo e funçäo destas células em parasitoses causadas por nematódeos, cestódeos, trematódeos e protozoários mais comuns no Brasil. Normalmente ocorre eosinofilia em associaçäo à infecçäo helmíntica, na qual há envolvimento de mucosa. Nos casos de protozooses, a eosinofilia é, praticamente, ausente
Assuntos
Doenças Parasitárias/sangue , Eosinofilia , Helmintíase/sangue , Infecções por ProtozoáriosRESUMO
Two different Echinococcus granulosus antigen B subunits (AgB8/1 and AgB8/2) were characterized and the structure of the genes encoding these two proteins were compared. DNA sequences were expressed in Escherichia coli and the antigens' diagnostic value was then assessed. The genomic sequence of AgB8/1 has a 92 bp intron in the position corresponding to amino acid 16; the AgB8/2 genomic sequence presents a 68 bp intron in the position corresponding to amino acid 20. Both introns are located between the putative N-terminal hydrophobic sequence and the secreted peptide. A comparison between the AgB8/1 and AgB8/2 nucleotide sequences showed a 53.5% identity among exons and a 50% identity between introns. According to the molecular diversity analysis, the elapsed time since both genes shared a common ancestor would be around 4.2x10(7) years. When the native AgB and the two recombinant antigens (rAgB8/1 and rAgB8/2) were tested in an anti-IgG ELISA, the sensitivity of the native antigen B was 77.41% and its specificity was 81.9%, while rAgB8/1 showed 54.84% of sensitivity and 80.17% of specificity and rAg138/2 had an 83.87% sensitivity and a 98.28% specificity. Statistical analysis confirms that rAgB8/2 has a better performance than rAgB8/1 and native AgB in ELISA.
Assuntos
Antígenos de Helmintos/genética , Echinococcus/genética , Proteínas de Helminto/genética , Sequência de Aminoácidos , Animais , Anticorpos Anti-Helmínticos/sangue , Antígenos de Helmintos/biossíntese , Sequência de Bases , Clonagem Molecular , Echinococcus/imunologia , Ensaio de Imunoadsorção Enzimática , Escherichia coli/genética , Genes de Helmintos , Vetores Genéticos , Proteínas de Helminto/biossíntese , Helmintíase/sangue , Humanos , Íntrons , Dados de Sequência Molecular , Proteínas Recombinantes/biossíntese , Sensibilidade e Especificidade , Alinhamento de SequênciaRESUMO
Se estudiaron los sueros de 207 niños, con edades desde 20 meses hasta 17 años 11 meses, con diagnóstico clínico de parálisis cerebral infantil (PCI), de un centro de rehabilitación neurológica en la Ciudad de México, D.F. Objetivo. Detectar reactividad serológica contra antígenos de helmintos con localización extraintestinal, en niños con alteraciones neurológicas. Los antígenos utilizados se obtuvieron de: el metacéstodo de Taenia solium (cisticercos); Fasciola hepatica, Toxocara canis, Ascaris lumbricoides lumbricoides y Trichinella spiralis. Como prueba inmunológica se utilizó la hemaglutinación indirecta; se consideró como título de reactividad positivo la dilución 1:32 o mayor. Diecisiete (8.2 por ciento) de los sueros resultaron con títulos positivos a los siguientes antígenos: 4 (1.9 por ciento) al metacéstodo de T. solium, 1 (0.5 por ciento) a F. hepatica, 4 (1.9 por ciento) a T. canis, 4 (1.9 por ciento) a A. I. lumbricoides y 4 (1.9 por ciento) a T. spiralis. Con base en los resultados obtenidos se hacen recomendaciones al personal médico, paramédico y familiar de extremar las precauciones en la atención y cuidado de los niños con deficiencia motora
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Adolescente , Sorologia , Helmintíase/parasitologia , Helmintíase/sangue , Paralisia Cerebral/parasitologia , Testes de HemaglutinaçãoRESUMO
Human antibody response to total soluble extract of Trichinella spiralis muscle larvae (TSE) was analyzed by Western blot. The most frequently recognized antigens had molecular weights of 96, 67, 63, 60, 55 and 47 kDa. An antigenic fraction containing two peptides with M.W. of 43, 47 kDa from the parasite (p43, 47 Ts L1) was isolated by elution from polyacrylamide gel slabs. It was used as antigen in an ELISA test and compared to that of TSE. Serum samples from 51 symptomatic trichinellosis patients--43 with high antibody levels to TSE, 5 of them with positive biopsy and 8 with low levels of these antibodies--as well as 38 from asymptomatic individuals from the area where the trichinellosis outbreaks had occurred and 43 from apparently healthy individuals from a non-endemic area, 37 from patients with intestinal parasitic infections caused by helminth and protozoan parasites--11 from recurrent and 26 from non-recurrent disease--were analyzed by ELISA using both antigens. The ELISA using p43, 47 Ts L1 detected all trichinellosis patients with high antibody levels as well as 6 out of 8 of those with low antibody levels. All control groups were negative. Therefore, this purified fraction allowed the ELISA to be more specific and sensitive for human trichinellosis diagnosis.
Assuntos
Antígenos de Helmintos/imunologia , Western Blotting , Soros Imunes , Trichinella spiralis/imunologia , Triquinelose/imunologia , Animais , Entamebíase/sangue , Entamebíase/imunologia , Ensaio de Imunoadsorção Enzimática , Helmintíase/sangue , Helmintíase/imunologia , Humanos , Enteropatias Parasitárias/sangue , Enteropatias Parasitárias/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Músculos/parasitologia , Trichinella spiralis/crescimento & desenvolvimento , Trichinella spiralis/isolamento & purificação , Triquinelose/sangue , Triquinelose/parasitologiaRESUMO
Evaluation of two serological techniques for diagnosis cysticercosis: complement fixation reaction and Western blot. Comparative study that includes 49 sera samples and 30 CSF samples belonging to 35 patients with clinical diagnosis of cysticercosis of the CNS. As a control group we used 10 sera samples of patients with Trichinella spiralis infection, 33 sera samples of patients with hydatid cyst disease, 9 sera samples from patients with oxyuriasis, 52 sera samples of healthy blood donors and 22 additional CSF samples from patients with different CNS disorders. Thirty-one samples were positive by Western blot technique and 21 samples by complement fixation reaction technique. Agreement between both techniques was 76%. Gathering clinical and laboratory information we believe that a total of 11 patients had cysticercosis of the CNS (33 samples), and three additional patients remain with indeterminate diagnosis. We have also detected cross-reactions with Western blot techniques (reactivity to more than one band) in 43% of patients with hydatid disease and in 20% of patients with Trichinella spiralis infection, but none in oxyuriasis patients. The CFR technique had cross-reaction with 33% of sera samples from hydatid disease patients and 20% of those from oxyuriasis patients. No cross-reactions were seen in any of control patients with both techniques. The two different techniques tested can be of help, together with clinical and radiology data, in the diagnosis of cysticercosis of the CNS. However, both techniques showed strong cross-reactions with hydatid disease.