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Gazzinelli-Guimaraes PH, Dulek B, Swanson P, Lack J, Roederer M, Nutman TB. Single-cell molecular signature of pathogenic T helper subsets in type 2-associated disorders in humans. JCI Insight 2024; 9:e177720. [PMID: 38587077 PMCID: PMC11128205 DOI: 10.1172/jci.insight.177720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/14/2024] [Indexed: 04/09/2024] Open
Abstract
To unravel the heterogeneity and molecular signature of effector memory Th2 cells (Tem2), we analyzed 23 individuals' PBMCs of filaria-infected (Filaria+) and 24 healthy volunteers (Filaria-), with or without coincident house dust mite (HDM) allergic sensitization. Flow cytometry revealed 3 CD4+ Tem subsets - CCR4+CCR6+CRTH2- Tem17, CCR4+CCR6-CRTH2+ Tem2, and CCR6+CCR4+CRTH2+ Tem17.2 - markedly enriched in Filaria+ individuals. These subsets were sorted and analyzed by multiomic single-cell RNA immunoprofiling. SingleR-annotated Th2 cells from Tem2 and Tem17.2 cell subsets had features of pathogenic Th2 effector cells based on their transcriptional signatures, with downregulated CD27 and elevated expression levels of ITGA4, IL17RB, HPGDS, KLRB1, PTGDR2, IL9R, IL4, IL5, and IL13 genes. When the Filaria+ individuals were subdivided based on their allergic status, Tem2 cells in HDM+Filaria+ individuals showed an overall reduction in TCR diversity, suggesting the occurrence of antigen-driven clonal expansion. Moreover, HDM+Filaria+ individuals showed not only an expansion in the frequency of both Tem2 and Tem17.2 cell subsets, but also a change in their molecular program by overexpressing GATA3, IL17RB, CLRF2, and KLRB1, as well as increased antigen-induced IL-4, IL-5, and IL-13 production, suggesting that aeroallergens reshape the transcriptional and functional programming of Th2 cell subsets in human filarial infection toward a pathogenic immunophenotype.
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Affiliation(s)
| | | | - Phillip Swanson
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | | | - Mario Roederer
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
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Reuter S, Raspe J, Taube C. Microbes little helpers and suppliers for therapeutic asthma approaches. Respir Res 2024; 25:29. [PMID: 38218816 PMCID: PMC10787474 DOI: 10.1186/s12931-023-02660-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/28/2023] [Indexed: 01/15/2024] Open
Abstract
Bronchial asthma is a prevalent and increasingly chronic inflammatory lung disease affecting over 300 million people globally. Initially considered an allergic disorder driven by mast cells and eosinophils, asthma is now recognized as a complex syndrome with various clinical phenotypes and immunological endotypes. These encompass type 2 inflammatory endotypes characterized by interleukin (IL)-4, IL-5, and IL-13 dominance, alongside others featuring mixed or non-eosinophilic inflammation. Therapeutic success varies significantly based on asthma phenotypes, with inhaled corticosteroids and beta-2 agonists effective for milder forms, but limited in severe cases. Novel antibody-based therapies have shown promise, primarily for severe allergic and type 2-high asthma. To address this gap, novel treatment strategies are essential for better control of asthma pathology, prevention, and exacerbation reduction. One promising approach involves stimulating endogenous anti-inflammatory responses through regulatory T cells (Tregs). Tregs play a vital role in maintaining immune homeostasis, preventing autoimmunity, and mitigating excessive inflammation after pathogenic encounters. Tregs have demonstrated their ability to control both type 2-high and type 2-low inflammation in murine models and dampen human cell-dependent allergic airway inflammation. Furthermore, microbes, typically associated with disease development, have shown immune-dampening properties that could be harnessed for therapeutic benefits. Both commensal microbiota and pathogenic microbes have demonstrated potential in bacterial-host interactions for therapeutic purposes. This review explores microbe-associated approaches as potential treatments for inflammatory diseases, shedding light on current and future therapeutics.
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Affiliation(s)
- Sebastian Reuter
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany.
| | - Jonas Raspe
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany
| | - Christian Taube
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany
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Vacca F, Le Gros G. Tissue-specific immunity in helminth infections. Mucosal Immunol 2022; 15:1212-1223. [PMID: 35680972 PMCID: PMC9178325 DOI: 10.1038/s41385-022-00531-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/25/2022] [Accepted: 05/16/2022] [Indexed: 02/04/2023]
Abstract
A characteristic feature of host responses to helminth infections is the development of profound systemic and tissue-localised Type 2 immune responses that play critical roles in immunity, tissue repair and tolerance of the parasite at tissue sites. These same Type 2 responses are also seen in the tissue-associated immune-pathologies seen in asthma, atopic dermatitis and many forms of allergies. The recent identification of new subtypes of immune cells and cytokine pathways that influence both immune and non-immune cells and tissues creates the opportunity for reviewing helminth parasite-host responses in the context of tissue specific immunity. This review focuses on the new discoveries of the cells and cytokines involved in tissue specific immune responses to helminths and how these contribute to host immunity against helminth infection and allow the host to accommodate the presence of parasites when they cannot be eliminated.
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Affiliation(s)
- Francesco Vacca
- grid.250086.90000 0001 0740 0291Malaghan Institute of Medical Research, Wellington, New Zealand
| | - Graham Le Gros
- grid.250086.90000 0001 0740 0291Malaghan Institute of Medical Research, Wellington, New Zealand
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Hijano DR, Alvarez-Paggi D, Caballero MT. Editorial: Translational research in pediatric respiratory diseases: From bench to bedside. Front Pediatr 2022; 10:1114549. [PMID: 36683809 PMCID: PMC9853422 DOI: 10.3389/fped.2022.1114549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/12/2022] [Indexed: 01/09/2023] Open
Affiliation(s)
- Diego R Hijano
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Damián Alvarez-Paggi
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.,Fundación INFANT, Buenos Aires, Argentina
| | - Mauricio T Caballero
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.,Fundación INFANT, Buenos Aires, Argentina
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Arrais M, Maricoto T, Nwaru BI, Cooper PJ, Gama JM, Brito M, Taborda-Barata L. Helminth infections and allergic diseases: systematic review and meta-analysis of the global literature. J Allergy Clin Immunol 2021; 149:2139-2152. [PMID: 34968529 DOI: 10.1016/j.jaci.2021.12.777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 12/12/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION There is considerable research interest in the role of helminth infections in the development of allergic diseases. However, findings from previous studies are mixed. Existing systematic reviews of these studies are outdated. We performed a systematic review of the global literature on the association between helminth infections and development and clinical outcomes of allergic diseases. METHODS We searched Cochrane Library, MEDLINE, EMBASE, ISI Web of Science, PubMed, Global Index Medicus, Scielo, KoreaMed, Google Scholar, and Lilacs for studies published up to January 2020. We included observational epidemiological studies (cohort, case-control and cross-sectional studies) of children and adults reporting associations between helminth infections and asthma, allergic rhinitis, eczema and atopy. We performed random-effects meta-analysis to summarize the effect estimates. RESULTS We included 80 studies with 99,967 participants. In the meta-analyses, we did not observe an overall association between helminth infections and allergic diseases. There was, however, evidence that A. lumbricoides infections was associated with an increased risk of bronchial hyperreactivity in children (RR:1.41, 95%CI: 1.17-1.70; I2=50, p for I2=0.09), and was associated with an increased risk of atopy among helminth-infected adults (RR:1.37, 95%CI: 1.18-1.61; I2=52, p for I2=0.02). We found no study that addressed the association between helminth infection and clinical outcomes of allergic diseases. The overall strength of the underlying evidence was low to moderate. CONCLUSION Helminth infections may increase the risk of bronchial hyperreactivity in children and atopy in adults. Well-designed longitudinal cohorts may help clarify potential causal associations between chronic helminth infections and allergic diseases.
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Affiliation(s)
- Margarete Arrais
- Department of Pulmonology, Military Hospital, Luanda, Angola; CISA - Centro de Investigação em Saúde de Angola, Caxito, Bengo, Angola; GRUBI - Systematic Reviews Group, University of Beira Interior, Covilhã, Portugal
| | - Tiago Maricoto
- GRUBI - Systematic Reviews Group, University of Beira Interior, Covilhã, Portugal; Aveiro Healthcare Centre, Aveiro-Aradas Family Health Unit, Aveiro, Portugal; Faculty of Health Sciences, University of Beira Interior, CACB-Clinical Academic Centre of Beiras, Covilhã, Portugal.
| | - Bright I Nwaru
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Philip J Cooper
- Institute of Infection and Immunity, St George's University of London, London, UK; School of Medicine, International University of Ecuador, Quito, Ecuador
| | - Jorge Mr Gama
- GRUBI - Systematic Reviews Group, University of Beira Interior, Covilhã, Portugal; Centre of Mathematics and Applications, Faculty of Sciences, University of Beira Interior, Covilha, Portugal
| | - Miguel Brito
- CISA - Centro de Investigação em Saúde de Angola, Caxito, Bengo, Angola; Health and Technology Research Center (H&TRC), Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Portugal
| | - Luis Taborda-Barata
- GRUBI - Systematic Reviews Group, University of Beira Interior, Covilhã, Portugal; CICS- Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal; Department of Allergy and Clinical Immunology, Cova da Beira University Hospital Centre, Covilhã, Portugal
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Jõgi NO, Kitaba N, Storaas T, Schlünssen V, Triebner K, Holloway JW, Horsnell WGC, Svanes C, Bertelsen RJ. Ascaris exposure and its association with lung function, asthma, and DNA methylation in Northern Europe. J Allergy Clin Immunol 2021; 149:1960-1969. [PMID: 34996616 DOI: 10.1016/j.jaci.2021.11.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 10/29/2021] [Accepted: 11/05/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Ascaris infections, with a worldwide prevalence above 10%, can cause respiratory pathology. However, long-term effects on lung function in humans are largely unknown. OBJECTIVE We investigated the associations of Ascaris exposure with lung function, asthma, and DNA methylation. METHODS Serum Ascaris IgG antibodies were measured in 671 adults aged 18 to 47 years (46% women) from Aarhus, Bergen, and Tartu RHINESSA study centers. Seropositivity was defined as IgG above the 90th percentile. Linear and logistic regressions were used to analyze Ascaris seropositivity as associated with lung function and asthma, adjusted for age, height, and smoking and clustered by center. DNA methylation in blood was profiled by a commercial methylation assay. RESULTS Ascaris seropositivity was associated with lower FEV1 (-247 mL; 95% CI, -460, -34) and higher odds for asthma (adjusted odds ratio, 5.84; 95% CI, 1.67, 20.37) among men but not women, also after further adjusting for house dust mite sensitivity, consistent across study centers. At a genome-wide level, Ascaris exposure was associated with 23 differentially methylated sites in men and 3 in women. We identified hypermethylation of the MYBPC1 gene, which can regulate airway muscle contraction. We also identified genes linked to asthma pathogenesis such as CRHR1 and GRK1, as well as a differentially methylated region in the PRSS22 gene linked to nematode infection. CONCLUSION Ascaris exposure was associated with substantially lower lung function and increased asthma risk among men. Seropositive participants had sex-specific differences in DNA methylation compared to the unexposed, thus suggesting that exposure may lead to sex-specific epigenetic changes associated with lung pathology.
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Affiliation(s)
- Nils O Jõgi
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
| | - Negusse Kitaba
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Torgeir Storaas
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Vivi Schlünssen
- Department of Public Health, Environmental Occupation, and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark; National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Kai Triebner
- Department of Clinical Science, University of Bergen, Bergen, Norway; Core Facility for Metabolomics, University of Bergen, Bergen, Norway
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - William G C Horsnell
- Institute of Infectious Disease and Molecular Medicine/Division of Immunology, University of Cape Town, Cape Town, South Africa; Institute of Microbiology and Infection, University of Birmingham, Birmingham, United Kingdom; Laboratory of Molecular and Experimental Immunology and Neurogenetics, CNRS-University of Orléans and Le Studium Institute for Advanced Studies, Orléans, France.
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Centre for International Health, University of Bergen, Bergen, Norway
| | - Randi J Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway; Oral Health Centre of Expertise in Western Norway, Bergen, Norway
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Sio YY, Chew FT. Risk factors of asthma in the Asian population: a systematic review and meta-analysis. J Physiol Anthropol 2021; 40:22. [PMID: 34886907 PMCID: PMC8662898 DOI: 10.1186/s40101-021-00273-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022] Open
Abstract
Background and objective An increasing trend of asthma prevalence was observed in Asia; however, contributions of environmental and host-related risk factors to the development of this disease remain uncertain. This study aimed to perform a systematic review and meta-analysis for asthma-associated risk factors reported in Asia. Methods We systematically searched three public databases (Web of Science, PubMed, and Scopus) in Feb 2021. We only included articles that reported environmental and host-related risk factors associated with asthma in the Asian population. Random-effect meta-analyses were conducted for frequently reported asthma-associated risk factors to provide an overall risk estimate of asthma development. Results Of 4030 records obtained from public databases, 289 articles were selected for review. The most frequently reported asthma-associated risk factor was the family history of allergy-related conditions. The random-effect asthma risk estimates (pooled odds ratio, OR) were 4.66 (95% confidence interval (CI): 3.73–5.82) for the family history of asthma, 3.50 (95% CI: 2.62–4.67) for the family history of atopy, 3.57 (95% CI: 3.03–4.22) for the family history of any allergic diseases, 1.96 (95% CI: 1.47–2.61) for the family history of allergic rhinitis, and 2.75 (95% CI: 1.12–6.76) for the family history of atopic dermatitis. For housing-related factors, including the presence of mold, mold spots, mold odor, cockroach, water damage, and incense burning, the random-effect pooled OR ranged from 1.43 to 1.73. Other risk factors with significant pooled OR for asthma development included male gender (1.30, 95% CI: 1.23–1.38), cigarette smoke exposure (1.44, 95% CI: 1.30–1.60), cigarette smoking (1.66, 95% CI: 1.44–1.90), body mass index (BMI)–related parameters (pooled OR ranged from 1.06 to 2.02), various types of air pollution (NO2, PM10, and O3; pooled OR ranged from 1.03 to 1.22), and pre- and perinatal factors (low birth weight, preterm birth, and cesarean section; pooled OR ranged from 1.14 to 1.32). Conclusions The family history of asthma was the most frequently reported risk factor for asthma development in Asia with the highest risk estimate for asthma development. This suggests a major role of the genetic component in asthma pathogenesis. Further study on asthma genetics is required to improve the current understanding of asthma etiology. Supplementary Information The online version contains supplementary material available at 10.1186/s40101-021-00273-x.
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Affiliation(s)
- Yang Yie Sio
- Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, off Lower Kent Ridge Road, 117543, Singapore, Singapore
| | - Fook Tim Chew
- Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, off Lower Kent Ridge Road, 117543, Singapore, Singapore.
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Abera D, Wordofa M, Mesfin A, Tadesse G, Wolde M, Desta K, Tsegaye A, Taye B. Intestinal helminthic infection and allergic disorders among school children enrolled in mass deworming program, Sululta, Ethiopia. Allergy Asthma Clin Immunol 2021; 17:43. [PMID: 33892783 PMCID: PMC8063306 DOI: 10.1186/s13223-021-00545-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 04/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intestinal helminths have been proposed to have a protective role against allergic sensitization and atopic diseases. However, consistent data demonstrating this are lacking in Sub-Saharan countries. We aimed to assess the association between intestinal helminths and allergic disorders among school children enrolled in mass deworming program in Sululta, Ethiopia. METHODS A cross sectional study was conducted among 526 school children aged 5 to 14 years old from primary government schools in Sululta district, Ethiopia. An interviewer-led questionnaire administered to parents provided information on demographic and lifestyle variables. Questions on allergic disease symptoms were collected using the International Study of Asthma and Allergies in Children (ISAAC) questionnaire 6 months following deworming treatments. Atopy was defined as a positive skin prick test reaction to one or both dust mite (Dermatophagoides) and German cockroach (Blatella germanica) allergens. Fresh stool samples were collected, processed, and examined by direct wet mount, Kato-Katz technique, and formol-ether concentration technique. Multivariate logistic regressions were used to assess the association between allergic disorder and helminths infection. RESULTS Of the total 526 school children, 58.2% were females. Overall, 24% (126/526) had allergic symptoms, 5.1% (27/526) had atopy, and 16.9% (89/526) had intestinal helminths. There was no association between helminthic infection and self-reported allergic symptoms (P = 0.317), but Ascaris lumbricoides infection was positively associated with atopy (AOR = 4.307, 95% CI 1.143-16.222, P = 0.031). Atopy was related to increased allergy symptoms (AOR = 2.787, 95% CI 1.253-6.197, P = 0.012), and family history of allergy was associated with increased childhood allergy (AOR = 2.753, 95% CI 1.565-4.841, P = 0.001). Deworming in the past 6 months showed a reduced odd of self-reported allergic symptoms (AOR = 0.581, 95% CI 0.366-0.954, P = 0.034). CONCLUSION While no significant association between self-reported allergy and helminths was found in this study, this may have been due to the low prevalence and intensity of helminthic infection in the sample. There was a positive association between Ascaris lumbricoides and atopy. To further examine the underlying mechanism behind this positive association, a longitudinal study is needed.
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Affiliation(s)
- Dessie Abera
- Department of Medical Laboratory Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Moges Wordofa
- Department of Medical Laboratory Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Mistire Wolde
- Department of Medical Laboratory Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kassu Desta
- Department of Medical Laboratory Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aster Tsegaye
- Department of Medical Laboratory Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bineyam Taye
- Department of Biology, Colgate University, 214 Olin Hall, 13 Oak Dr, Hamilton, NY, USA.
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Takeuchi H, Hasan SMT, Zaman K, Takanashi S, Hore SK, Yeasmin S, Ahmad SM, Alam MJ, Jimba M, Iwata T, Khan MA. Impact of Haemophilus influenzae type b combination vaccination on asthma symptoms and pneumonia in 5-year-old children in rural Bangladesh: a longitudinal study and comparison with a previous cross-sectional study. Respir Res 2021; 22:35. [PMID: 33536028 PMCID: PMC7856731 DOI: 10.1186/s12931-021-01629-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the prevalence of bronchial asthma has been increasing worldwide since the 1970's, the prevalence among 5-year-old children was significantly lower in 2016 than in 2001 in rural Bangladesh. We aimed to determine whether the Haemophilus influenzae type b (Hib) combination vaccination (without booster) started in 2009 contributed to this decrease. METHODS A case-control study was conducted among 1658 randomly selected 5-year-old children from Matlab, Bangladesh. Data on wheezing were collected using the International Study of Asthma and Allergies in Childhood questionnaire. The vaccination data were collected from the records of the Matlab Health and Demographic Surveillance System, while data on pneumonia were obtained from the clinical records of Matlab Hospital. Adjusted odds ratios (aORs) were calculated for the risk for wheezing. The reduction rate was calculated to determine the impact of the vaccination on pneumonia history between the present study and our previous study conducted in 2001 by using the following formula: (percentage of pneumonia cases in 2001 - percentage of pneumonia cases in 2016)/(percentage of pneumonia cases in 2001) times 100 (%). RESULTS Hib combination vaccination was a protecting factor against wheezing (aOR: 0.50; p = 0.010), while pneumonia at 1, 2, 3-4 years of age were risk factors for wheezing (aOR: 2.86, 3.19, 2.86; p = 0.046, 0.030, 0.030, respectively). The history of pneumonia was significantly lower in the 2016 study participants than those in 2001 both in the overall cohort and the wheezing group (paired t-test: p = 0.012, p < 0.001, respectively). Whereas the history of pneumonia decreased when the children grew older in the 2001 overall cohort, it peaked at the age of 2 years in 2016 wheezing group. The reduction rate decreased when children grew older in both the overall cohort and the wheezing group, however, it decreased faster in the wheezing group. CONCLUSIONS Hib combination vaccination was a protective factor against wheezing in 0-year-old children. However, the effects of vaccination might have attenuated at the ages of 1-4 years, because no booster dose was administered. The addition of a booster dose might further decrease the prevalence of asthma and wheezing.
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Affiliation(s)
- Haruko Takeuchi
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo City, Tokyo 113-0033, Japan.
| | - S M Tafsir Hasan
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Khalequ Zaman
- Infectious Diseases Division, icddr,b, 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Sayaka Takanashi
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo City, Tokyo 113-0033, Japan
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku City, Tokyo 162-8640, Japan
| | - Samar Kumar Hore
- Organization for Population Health Environment & Nutrition, Adilpur Shastitala, Taltala Kheyaghat Road, Abhaynagar, Jashore 7460, Bangladesh
| | - Sultana Yeasmin
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Shaikh Meshbahuddin Ahmad
- Infectious Diseases Division, icddr,b, 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
- Department of Biochemistry and Microbiology, North South University, Bashundhara, Dhaka 1212, Bangladesh
| | - Md Jahangir Alam
- Infectious Diseases Division, icddr,b, 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
- Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC 3800, Australia
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo City, Tokyo 113-0033, Japan
| | - Tsutomu Iwata
- The Graduate School of Humanities and Life Sciences, Tokyo Kasei University, 1-18-1 Kaga, Itabashi City, Tokyo 173-8602, Japan
| | - Md Alfazal Khan
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
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Abstract
Parasites can cause respiratory symptoms through focal or diffuse lung involvement, depending on the location of the parasite and the host's immune response. Pulmonary involvement can be a major feature of some parasitic infections or a complication during transpulmonary larval migration. Parasites should be included in the differential diagnosis of common lung diseases, especially in the presence of peripheral eosinophilia or extrapulmonary symptoms (abdominal pain, diarrhea, jaundice, skin lesions).
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Affiliation(s)
- Teena Huan Xu
- Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, One Baylor Plaza. BCM 285, Houston, TX 77030, USA
| | - Nair Lovaton
- Department of Pediatrics, Faculty of Medicine, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru
| | - Jose Serpa
- Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, One Baylor Plaza. BCM 285, Houston, TX 77030, USA
| | - Theresa J Ochoa
- Department of Pediatrics, Faculty of Medicine, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru.
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Midha A, Ebner F, Schlosser-Brandenburg J, Rausch S, Hartmann S. Trilateral Relationship: Ascaris, Microbiota, and Host Cells. Trends Parasitol 2020; 37:251-262. [PMID: 33008723 DOI: 10.1016/j.pt.2020.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 12/11/2022]
Abstract
Ascariasis is a globally spread intestinal nematode infection of humans and a considerable concern in pig husbandry. Ascaris accomplishes a complex body migration from the intestine via the liver and lung before returning to the intestine. Tissue migration and the habitat shared with a complex microbial community pose the question of how the nematode interacts with microbes and host cells from various tissues. This review addresses the current knowledge of the trilateral relationship between Ascaris, its microbial environment, and host cells, and discusses novel approaches targeting these interactions to combat this widespread infection of livestock and man.
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Affiliation(s)
- Ankur Midha
- Institute of Immunology, Freie Universität Berlin, Robert von Ostertag-Str. 7-13, D-14163 Berlin, Germany
| | - Friederike Ebner
- Institute of Immunology, Freie Universität Berlin, Robert von Ostertag-Str. 7-13, D-14163 Berlin, Germany
| | | | - Sebastian Rausch
- Institute of Immunology, Freie Universität Berlin, Robert von Ostertag-Str. 7-13, D-14163 Berlin, Germany
| | - Susanne Hartmann
- Institute of Immunology, Freie Universität Berlin, Robert von Ostertag-Str. 7-13, D-14163 Berlin, Germany.
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Bohnacker S, Troisi F, de Los Reyes Jiménez M, Esser-von Bieren J. What Can Parasites Tell Us About the Pathogenesis and Treatment of Asthma and Allergic Diseases. Front Immunol 2020; 11:2106. [PMID: 33013887 PMCID: PMC7516051 DOI: 10.3389/fimmu.2020.02106] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/04/2020] [Indexed: 12/18/2022] Open
Abstract
The same mechanisms that enable host defense against helminths also drive allergic inflammation. This suggests that pathomechanisms of allergic diseases represent evolutionary old responses against helminth parasites and that studying antihelminth immunity may provide insights into pathomechanisms of asthma. However, helminths have developed an intricate array of immunoregulatory mechanisms to modulate type 2 immune mechanisms. This has led to the hypothesis that the lack of helminth infection may contribute to the rise in allergic sensitization in modern societies. Indeed, the anti-inflammatory potential of helminth (worm) parasites and their products in allergy and asthma has been recognized for decades. As helminth infections bring about multiple undesired effects including an increased susceptibility to other infections, intended helminth infection is not a feasible approach to broadly prevent or treat allergic asthma. Thus, the development of new helminth-based biopharmaceutics may represent a safer approach of harnessing type 2–suppressive effects of helminths. However, progress regarding the mechanisms and molecules that are employed by helminths to modulate allergic inflammation has been relatively recent. The scavenging of alarmins and the modulation of lipid mediator pathways and macrophage function by helminth proteins have been identified as important immunoregulatory mechanisms targeting innate immunity in asthma and allergy. In addition, by regulating the activation of dendritic cells and by promoting regulatory T-cell responses, helminth proteins can counterregulate the adaptive T helper 2 cell response that drives allergic inflammation. Despite these insights, important open questions remain to be addressed before helminth molecules can be used for the prevention and treatment of asthma and other allergic diseases.
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Affiliation(s)
- Sina Bohnacker
- Center of Allergy and Environment (ZAUM), Technical University of Munich and Helmholtz Center Munich, Munich, Germany
| | - Fabiana Troisi
- Center of Allergy and Environment (ZAUM), Technical University of Munich and Helmholtz Center Munich, Munich, Germany
| | - Marta de Los Reyes Jiménez
- Center of Allergy and Environment (ZAUM), Technical University of Munich and Helmholtz Center Munich, Munich, Germany
| | - Julia Esser-von Bieren
- Center of Allergy and Environment (ZAUM), Technical University of Munich and Helmholtz Center Munich, Munich, Germany
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Cellular immune response of asthmatic children in the presence of anti-Ascaris antibody. Immunobiology 2020; 225:151978. [PMID: 32747023 DOI: 10.1016/j.imbio.2020.151978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/07/2020] [Accepted: 06/16/2020] [Indexed: 11/22/2022]
Abstract
The presence of anti-Ascaris (anti-Asc) immunoglobin isotypes alters the risk of allergic asthma. In this study, we analyzed the relationships between serum levels of anti-Asc IgE, IgG1, and IgG4, without concurrent infection by the parasite, and the presence of asthma. We measured cytokine levels from Th1, Th2, and Th17 profiles. Children aged 2-14 years old, asthmatics (n = 64), and non-asthmatics (n = 40) were selected according to the International Study of Asthma and Allergies in Childhood criteria. Asthmatic patients who had positive skin allergy tests were considered to have allergic asthma. Stool exams were performed to exclude children who were parasitized by helminths/protozoans and blood samples were collected in non-parasitized individuals. We performed peripheral blood leukocyte counts and in vitro culture following mitogenic stimulation. Levels of cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ, and IL-17) in the supernatants were measured using a cytometric bead array. Titration of serum total IgE and IgE specific to Ascaris were obtained using ImmunoCAP; IgG1 and IgG4 titers were measured using enzyme-linked immunosorbent assays. Anti-Asc IgE was associated with a higher risk of asthma and an increase in the number of eosinophils and neutrophils. By contrast, anti-Asc IgG1 could be considered a protective factor against asthma, associated with lower levels of circulating neutrophils. There were high levels of IL-6 and TNF-α in asthmatics. Levels of IL-6, but not TNF-α, depended on the presence of anti-Asc IgG1 in serum. Anti-Asc IgE appears to increase risk of asthma, and anti-Asc IgG1 appears to favor decreased neutrophil counts and increased IL-6 levels.
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Davlin SL, Jones AH, Tahmina S, Kawsar AA, Joshi A, Zaman SI, Rahman MM, Morawski BM, Deming MS, Imtiaz R, Karim MJ. Soil-transmitted helminthiasis in four districts in Bangladesh: household cluster surveys of prevalence and intervention status. BMC Public Health 2020; 20:672. [PMID: 32397986 PMCID: PMC7218586 DOI: 10.1186/s12889-020-08755-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 04/22/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In 2016, after 8 years of twice-annual nationwide preventive chemotherapy (PC) administration to school-age children (SAC), the Bangladesh Ministry of Health & Family Welfare (MOHFW) sought improved impact and intervention monitoring data to assess progress toward the newly adopted goal of eliminating soil-transmitted helminthiasis (STH) as a public health problem. METHODS We surveyed four Bangladeshi districts between August and October 2017. We conducted a multi-stage, cluster-sample, household survey which produced equal-probability samples for preschool-age children (PSAC; 1-4 years), SAC (5-14 years), and adults (≥ 15 years). Standardized questionnaires were administered, using Android-based smart phones running an Open Data Kit application. Stool samples were collected and testing for STH prevalence and infection intensity used the Kato-Katz technique. RESULTS In all, 4318 stool samples were collected from 7164 participants. Estimates of STH prevalence by risk group in three of the four surveyed districts ranged from 3.4 to 5.0%, all with upper, 1-sided 95% confidence limits < 10%. However, STH prevalence estimates in Sirajganj District ranged from 23.4 to 29.1%. Infections in that district were spatially focal; four of the 30 survey clusters had > 50% prevalence in at least one risk group. Among all tested specimens, Ascaris lumbricoides was the most common STH parasite [8.2% (n = 352)], followed by Trichuris trichiura [0.9% (n = 37)], and hookworm [0.6% (n = 27)]. In each district, PC coverage among SAC was above the 75% program target but did not exceed 45% among PSAC in any district. Improved sanitation at home, school, or work was over 90% in all districts. CONCLUSIONS In the three low-prevalence districts, the MOHFW is considering decreasing the frequency of mass drug administration, per World Health Organization (WHO) guidelines. Also, the MOHFW will focus programmatic resources and supervisory efforts on Sirajganj District. Despite considering WHO guidance, the MOHFW will not expand PC administration to women of reproductive age partly due to the low prevalence of hookworm and T. trichiura, the STH parasites that contribute most to morbidity in that risk group. Data collected from surveys such as ours would help effectively guide future STH control efforts in Bangladesh and elsewhere.
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Affiliation(s)
- Stacy L. Davlin
- Children Without Worms, The Task Force for Global Health, 325 Swanton Way, Decatur, GA USA
| | - Alexander H. Jones
- Children Without Worms, The Task Force for Global Health, 325 Swanton Way, Decatur, GA USA
| | - Sanya Tahmina
- Communicable Disease Control Department, Directorate General of Health Services, Ministry of Health and Family Welfare, Road # 29, New DOHS, Mohakhali, Dhaka, Bangladesh
| | - Abdullah Al Kawsar
- Elimination of Lymphatic Filariasis & STH Control Program, Directorate General of Health Services, Ministry of Health & Family Welfare, Road # 29, New DOHS, Mohakhali, Dhaka, Bangladesh
| | - Anand Joshi
- Children Without Worms, The Task Force for Global Health, 325 Swanton Way, Decatur, GA USA
| | - Sazid I. Zaman
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, C/O DOHS, Road # 29, New DOHS, Mohakhali, Dhaka, Bangladesh
| | - Muhammad M. Rahman
- Elimination of Lymphatic Filariasis & STH Control Program, Directorate General of Health Services, Ministry of Health & Family Welfare, Road # 29, New DOHS, Mohakhali, Dhaka, Bangladesh
| | - Bozena M. Morawski
- Children Without Worms, The Task Force for Global Health, 325 Swanton Way, Decatur, GA USA
| | - Michael S. Deming
- Children Without Worms, The Task Force for Global Health, 325 Swanton Way, Decatur, GA USA
| | - Rubina Imtiaz
- Children Without Worms, The Task Force for Global Health, 325 Swanton Way, Decatur, GA USA
| | - Mohammad J. Karim
- Elimination of Lymphatic Filariasis & STH Control Program, Directorate General of Health Services, Ministry of Health & Family Welfare, Road # 29, New DOHS, Mohakhali, Dhaka, Bangladesh
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Taghipour A, Rostami A, Sepidarkish M, Ghaffarifar F. Is Ascaris lumbricoides a risk factor for development of asthma? A systematic review and meta-analysis. Microb Pathog 2020; 142:104099. [PMID: 32101769 DOI: 10.1016/j.micpath.2020.104099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/18/2020] [Accepted: 02/22/2020] [Indexed: 11/12/2022]
Abstract
There are numerous epidemiological and experimental evidences to suggest that Ascaris lumbricoides infection is a neglected risk factor for development of asthma. For this purpose, we conducted a systematic review and meta-analysis for better understanding of this relationship. Systematic searching (PubMed, Scopus, Web of Science and Google Scholar) was done, up to September 30, 2019 to identify the relevant studies. We applied random-effects meta-analysis model to generate the overall odds ratio (OR) and 95% confidence intervals (CIs). Heterogeneity was assessed with I2 and τ2 statistic. Finally, 19 studies (totally 25 datasets), including 14 datasets with microscopic methods (1830 asthmatic patients (APs) and 3802 healthy controls (HCs)) and 11 datasets with serological methods (1543 APs and 3507 HCs) met the eligibility criteria. Considering to the serological methods, our results demonstrated that the APs had higher seroprevalence rate of A. lumbricoides (48.3% vs. 35.1%) than HCs, showing a significant association (pooled crude OR, 1.53; 95%CI, 1.07-2.18). Moreover, microscopic methods showed a higher prevalence of A. lumbricoides infection in the APs compared to the HCs (37.2% vs. 30.2%), but no significant association was found between APs and HCs (pooled crude OR, 1.19; 95%CI, 0.92-1.55). After adjustment for confounders, results showed no significant association for both serological (pooled adjusted OR, 1.43; 95%CI, 0.93-2.19) and microscopic (pooled adjusted OR, 1.05; 95%CI, 0.78-1.42) methods. Despite heterogeneous results, accurate and better quality studies are needed to determine the effect of A. lumbricoides infection on induction or exacerbation of asthma.
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Affiliation(s)
- Ali Taghipour
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Ghaffarifar
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Abstract
Asthma is a heterogeneous inflammatory disease of the airways that is associated with airway hyperresponsiveness and airflow limitation. Although asthma was once simply categorized as atopic or nonatopic, emerging analyses over the last few decades have revealed a variety of asthma endotypes that are attributed to numerous pathophysiological mechanisms. The classification of asthma by endotype is primarily routed in different profiles of airway inflammation that contribute to bronchoconstriction. Many asthma therapeutics target G protein-coupled receptors (GPCRs), which either enhance bronchodilation or prevent bronchoconstriction. Short-acting and long-acting β 2-agonists are widely used bronchodilators that signal through the activation of the β 2-adrenergic receptor. Short-acting and long-acting antagonists of muscarinic acetylcholine receptors are used to reduce bronchoconstriction by blocking the action of acetylcholine. Leukotriene antagonists that block the signaling of cysteinyl leukotriene receptor 1 are used as an add-on therapy to reduce bronchoconstriction and inflammation induced by cysteinyl leukotrienes. A number of GPCR-targeting asthma drug candidates are also in different stages of development. Among them, antagonists of prostaglandin D2 receptor 2 have advanced into phase III clinical trials. Others, including antagonists of the adenosine A2B receptor and the histamine H4 receptor, are in early stages of clinical investigation. In the past decade, significant research advancements in pharmacology, cell biology, structural biology, and molecular physiology have greatly deepened our understanding of the therapeutic roles of GPCRs in asthma and drug action on these GPCRs. This review summarizes our current understanding of GPCR signaling and pharmacology in the context of asthma treatment. SIGNIFICANCE STATEMENT: Although current treatment methods for asthma are effective for a majority of asthma patients, there are still a large number of patients with poorly controlled asthma who may experience asthma exacerbations. This review summarizes current asthma treatment methods and our understanding of signaling and pharmacology of G protein-coupled receptors (GPCRs) in asthma therapy, and discusses controversies regarding the use of GPCR drugs and new opportunities in developing GPCR-targeting therapeutics for the treatment of asthma.
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Affiliation(s)
- Stacy Gelhaus Wendell
- Department of Pharmacology and Chemical Biology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (S.G.W., C.Z.); Bioinformatics Institute, Agency for Science, Technology, and Research, Singapore (H.F.); and Department of Biological Sciences, National University of Singapore, and Center for Computational Biology, DUKE-NUS Medical School, Singapore (H.F.)
| | - Hao Fan
- Department of Pharmacology and Chemical Biology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (S.G.W., C.Z.); Bioinformatics Institute, Agency for Science, Technology, and Research, Singapore (H.F.); and Department of Biological Sciences, National University of Singapore, and Center for Computational Biology, DUKE-NUS Medical School, Singapore (H.F.)
| | - Cheng Zhang
- Department of Pharmacology and Chemical Biology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (S.G.W., C.Z.); Bioinformatics Institute, Agency for Science, Technology, and Research, Singapore (H.F.); and Department of Biological Sciences, National University of Singapore, and Center for Computational Biology, DUKE-NUS Medical School, Singapore (H.F.)
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Classification of Wheezing Children in Rural Bangladesh by Intensity of Ascaris Infection, Total and Specific IgE Levels, History of Pneumonia, and Other Risk Factors. J Immunol Res 2019; 2019:4236825. [PMID: 31886302 PMCID: PMC6915125 DOI: 10.1155/2019/4236825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/16/2019] [Indexed: 01/09/2023] Open
Abstract
Ascaris lumbricoides is the most common soil-transmitted helminth and infects 447 million people in impoverished areas worldwide. It causes serious morbidity including wheezing and influences various aspects of human immunity, such as type 2 innate lymphoid cells, regulatory T cell function, and acquired immunity. Thus, it is crucial to elucidate its influence on human immunity. We aimed to classify wheezing children based on their Ascaris infection intensity and other risk factors using hierarchical cluster analysis to determine the mechanisms of and the degree to which Ascaris contributes to childhood wheezing in rural Bangladesh. We analyzed relevant data collected in 2001. The participants included 219 5-year-old wheezing children who were randomly selected from 1705 children living in the Matlab Health and Demographic Surveillance area of the International Centre for Diarrhoeal Disease Research, Bangladesh. Hierarchical cluster analysis was conducted using variables of history of pneumonia, total and specific immunoglobulin E levels, Ascaris infection intensity, and parental asthma. Three distinct wheezing groups were identified. Children in Cluster 1 (n = 50) had the highest titers of the total, anti-Ascaris, anti-Dermatophagoides pteronyssinus, and anticockroach IgEs and experienced the fewest episodes of pneumonia. Cluster 2 (n = 114), the largest group, experienced few episodes of pneumonia and had the lowest titers of the total, anti-Ascaris, anti-Dp, and anticockroach IgEs. Cluster 3 (n = 32) consisted of participants with the most episodes of pneumonia and lower titers of the total and specific IgEs. The extremely high prevalence of Ascaris infection found in Clusters 1-3 was 78%, 77%, and 72%, respectively. Childhood wheezing in rural Bangladesh could be divided into three groups, with 26% of wheezing attributable to anti-Ascaris IgE and 16% to history of pneumonia during early childhood, and 58% might have been due to Ascaris infection without elevated anti-Ascaris IgE.
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Takeuchi H, Khan MA, Ahmad SM, Hasan SMT, Alam MJ, Takanashi S, Hore SK, Yeasmin S, Jimba M, Iwata T. Concurrent decreases in the prevalence of wheezing and Ascaris infection among 5-year-old children in rural Bangladesh and their regulatory T cell immunity after the implementation of a national deworming program. Immun Inflamm Dis 2019; 7:160-169. [PMID: 31256445 PMCID: PMC6688081 DOI: 10.1002/iid3.253] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 04/16/2019] [Accepted: 04/26/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Epidemiological research on the prevalence of asthma and helminthic infections in various countries has led to the hypothesis that helminthic infections protect against asthma by suppressing the host's immune response. This study was conducted to elucidate whether decreased Ascaris infection following a national deworming program was associated with increased recurrent wheezing among rural Bangladeshi children and to test their anti-inflammatory immunity. METHODS This nested case-control study was conducted from December 2015 to October 2016 in the rural service area of the International Centre for Diarrhoeal Disease Research, Bangladesh. Of the 1800 5-year old children randomly selected for the study, informed consent was obtained from the guardians of 1658 children. Data were collected using a semistructured questionnaire adopted from the International Study of Asthma and Allergies in Childhood and blood samples for the analysis of regulatory T (Treg) cell immune responses and the balance between Th1 and Th2 immunity in Ascaris infections. RESULTS A total of 145 children were found to have wheezing, yielding a prevalence rate of 8.7%, which was significantly lower than the rate found in 2001 (16.2%, P < .001); Ascaris infection also decreased from 2001 to 2016. The 127 wheezing children who agreed to participate further were compared to 114 randomly selected never-wheezing children. Wheezing had a significant positive association with antibiotic use, history of pneumonia, parents' history of asthma, and Ascaris infection; children with Ascaris infection were twice as likely to have wheezing (adjusted odds ratio = 2.31, P = .053). Flow cytometry found no significant differences in the rates of Th1, Th2, and CD4 + CD25 + CD127low cells by the wheezing group. CONCLUSIONS Ascaris infection had a positive rather than a negative association with wheezing and the rates of wheezing and Ascaris infections both decreased from 2001 to 2016. These findings undermines the hypothesis that such infections provide protection against asthma.
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Affiliation(s)
- Haruko Takeuchi
- Department of Community and Global Health, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Md. Alfazal Khan
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease ResearchBangladesh
| | | | - S. M. Tafsir Hasan
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease ResearchBangladesh
| | - Md. Jahangir Alam
- Infectious Diseases DivisionInternational Centre for Diarrhoeal Disease ResearchBangladesh
| | - Sayaka Takanashi
- Department of Developmental Medical Sciences, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Samar Kumar Hore
- Centre for Equity and Health SystemInternational Centre for Diarrhoeal Disease ResearchBangladesh
| | - Sultana Yeasmin
- Infectious Diseases DivisionInternational Centre for Diarrhoeal Disease ResearchBangladesh
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Tsutomu Iwata
- Department of Education for Childcare, Faculty of Child StudiesTokyo Kasei UniversityTokyoJapan
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Mohammadzadeh I, Rostami A, Darvish S, Mehravar S, Pournasrollah M, Javanian M, Esmaeili Dooki M, Gamble HR. Exposure to Ascaris lumbricoides infection and risk of childhood asthma in north of Iran. Infection 2019; 47:991-999. [PMID: 31350726 DOI: 10.1007/s15010-019-01343-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 07/09/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Asthma and Ascaris lumbricoides infection are common health issues affecting 250 and 700 million people worldwide, respectively. The relationship between ascariasis and asthma is a matter of substantial interest and research. METHODS We performed a case-control study to evaluate whether the exposure to Ascaris infection is associated with asthma in children. We also assessed potential risk factors for Ascaris infection and asthma in study area. We enrolled 145 asthmatic children and 115 healthy controls. The Global Initiative for Asthma guideline was used to evaluate asthma symptoms and severity in study participants. Ascaris infection was assessed by the presence of anti-Ascaris IgG ≥ 11 IU/mL measured by enzyme-linked immunosorbent assay. RESULTS We have found a significant relationship between exposure to Ascaris and asthma (odds ratio, 2.92; 95% CI 1.04-8.18; P value = 0.034), and this relationship remained significant after adjustment for covariates (adjusted OR, 3.36; 95% CI 1.04-13%; P value = 0.047). Ascaris infection was more frequent in children with mild sustainable asthma (13.2%; 15/113) than in children with moderate sustainable asthma (6.2%, 2/32), although there was a non-significant difference between these groups (OR, 2.3; 95% CI 0.5-10.1; P value = 0.35). Based on results of a multi-regression analysis, contact with soil (OR, 6.7; 95% CI 1.9-23.5), and drinking unsafe water (OR, 4.2; 95% CI 1.2-14.2) were significant risk factors for Ascaris infection in the study area. CONCLUSION Results of this study suggest that A. lumbricoides infection might affect susceptibility to asthma in children. These results could be useful in prevention, early diagnosis and management of childhood asthma.
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Affiliation(s)
- Iraj Mohammadzadeh
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Sorena Darvish
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Saeed Mehravar
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Pournasrollah
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mostafa Javanian
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammadreza Esmaeili Dooki
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - H Ray Gamble
- National Academy of Sciences, Washington, DC, USA
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Ascaris Larval Infection and Lung Invasion Directly Induce Severe Allergic Airway Disease in Mice. Infect Immun 2018; 86:IAI.00533-18. [PMID: 30249744 DOI: 10.1128/iai.00533-18] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 09/13/2018] [Indexed: 11/20/2022] Open
Abstract
Ascaris lumbricoides (roundworm) is the most common helminth infection globally and a cause of lifelong morbidity that may include allergic airway disease, an asthma phenotype. We hypothesize that Ascaris larval migration through the lungs leads to persistent airway hyperresponsiveness (AHR) and type 2 inflammatory lung pathology despite resolution of infection that resembles allergic airway disease. Mice were infected with Ascaris by oral gavage. Lung AHR was measured by plethysmography and histopathology with hematoxylin and eosin (H&E) and periodic acid-Schiff (PAS) stains, and cytokine concentrations were measured by using Luminex Magpix. Ascaris-infected mice were compared to controls or mice with allergic airway disease induced by ovalbumin (OVA) sensitization and challenge (OVA/OVA). Ascaris-infected mice developed profound AHR starting at day 8 postinfection (p.i.), peaking at day 12 p.i. and persisting through day 21 p.i., despite resolution of infection, which was significantly increased compared to controls and OVA/OVA mice. Ascaris-infected mice had a robust type 2 cytokine response in both the bronchoalveolar lavage (BAL) fluid and lung tissue, similar to that of the OVA/OVA mice, including interleukin-4 (IL-4) (P < 0.01 and P < 0.01, respectively), IL-5 (P < 0.001 and P < 0.001), and IL-13 (P < 0.001 and P < 0.01), compared to controls. By histopathology, Ascaris-infected mice demonstrated early airway remodeling similar to, but more profound than, that in OVA/OVA mice. We found that Ascaris larval migration causes significant pulmonary damage, including AHR and type 2 inflammatory lung pathology that resembles an extreme form of allergic airway disease. Our findings indicate that ascariasis may be an important cause of allergic airway disease in regions of endemicity.
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Jourdan PM, Lamberton PHL, Fenwick A, Addiss DG. Soil-transmitted helminth infections. Lancet 2018; 391:252-265. [PMID: 28882382 DOI: 10.1016/s0140-6736(17)31930-x] [Citation(s) in RCA: 374] [Impact Index Per Article: 62.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/13/2017] [Accepted: 06/23/2017] [Indexed: 12/13/2022]
Abstract
More than a quarter of the world's population is at risk of infection with the soil-transmitted helminths Ascaris lumbricoides, hookworm (Ancylostoma duodenale and Necator americanus), Trichuris trichiura, and Strongyloides stercoralis. Infected children and adults present with a range of medical and surgical conditions, and clinicians should consider the possibility of infection in individuals living in, or returning from, endemic regions. Although safe and effective drugs are donated free to endemic countries, only half of at-risk children received treatment in 2016. This Seminar describes the epidemiology, lifecycles, pathophysiology, clinical diagnosis, management, and public health control of soil-transmitted helminths. Previous work has questioned the effect of population-level deworming; however, it remains beyond doubt that treatment reduces the severe consequences of soil-transmitted helminthiasis. We highlight the need for refined diagnostic tools and effective control options to scale up public health interventions and improve clinical detection and management of these infections.
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Affiliation(s)
- Peter Mark Jourdan
- Schistosomiasis Control Initiative, Imperial College London, St Mary's Campus, London, UK; DEWORM3, Natural History Museum, London, UK; Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Poppy H L Lamberton
- Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, UK; Institute of Biodiversity, Animal Health and Comparative Medicine, The University of Glasgow, Glasgow, UK; Wellcome Centre for Molecular Parasitology, The University of Glasgow, Glasgow, UK.
| | - Alan Fenwick
- Schistosomiasis Control Initiative, Imperial College London, St Mary's Campus, London, UK
| | - David G Addiss
- The Task Force for Global Health, Decatur, GA, USA; Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA
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23
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Mannan T, Ahmed S, Akhtar E, Roy AK, Haq MA, Roy A, Kippler M, Ekström EC, Wagatsuma Y, Raqib R. Maternal Micronutrient Supplementation and Long Term Health Impact in Children in Rural Bangladesh. PLoS One 2016; 11:e0161294. [PMID: 27537051 PMCID: PMC4990280 DOI: 10.1371/journal.pone.0161294] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 08/03/2016] [Indexed: 12/30/2022] Open
Abstract
Background Limited data is available on the role of prenatal nutritional status on the health of school-age children. We aimed to determine the impact of maternal micronutrient supplementation on the health status of Bangladeshi children. Methods Children (8.6–9.6 years; n = 540) were enrolled from a longitudinal mother-child cohort, where mothers were supplemented daily with either 30mg iron and 400μg folic acid (Fe30F), or 60mg iron and 400μg folic acid (Fe60F), or Fe30F including 15 micronutrients (MM), in rural Matlab. Blood was collected from children to determine the concentration of hemoglobin (Hb) and several micronutrients. Anthropometric and Hb data from these children were also available at 4.5 years of age and mothers at gestational week (GW) 14 and 30. Results MM supplementation significantly improved (p≤0.05) body mass index-for-age z-score (BAZ), but not Hb levels, in 9 years old children compared to the Fe30F group. MM supplementation also reduced markers of inflammation (p≤0.05). About 28%, 35% and 23% of the women were found to be anemic at GW14, GW30 and both time points, respectively. The prevalence of anemia was 5% and 15% in 4.5 and 9 years old children, respectively. The adjusted odds of having anemia in 9 year old children was 3-fold higher if their mothers were anemic at both GW14 and GW30 [Odds Ratio (OR) = 3.05; 95% Confidence Interval (CI) 1.42, 6.14, P = 0.002] or even higher if they were also anemic at 4.5 years of age [OR = 5.92; 95% CI 2.64, 13.25; P<0.001]. Conclusion Maternal micronutrient supplementation imparted beneficial effects on child health. Anemia during pregnancy and early childhood are important risk factors for the occurrence of anemia in school-age children.
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Affiliation(s)
- Tania Mannan
- Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
- Department of Immunology, Bangladesh University of Health Sciences, Mirpur, Dhaka, Bangladesh
| | - Sultan Ahmed
- Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Evana Akhtar
- Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Anjan Kumar Roy
- Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Md Ahsanul Haq
- Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Adity Roy
- Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Maria Kippler
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eva-Charlotte Ekström
- International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Yukiko Wagatsuma
- Department of Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Rubhana Raqib
- Immunobiology, Nutrition and Toxicology Laboratory, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
- * E-mail:
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Takeuchi H, Khan AF, Hasan MI, Hawlader MDH, Yunus M, Zaman K, Chowdhury HR, Takanashi S, Wagatsuma Y, Iwata T. Comment on IgE responses to Ascaris and mite tropomyosins are risk factors for asthma. Clin Exp Allergy 2016; 46:178-80. [PMID: 26587793 PMCID: PMC4738426 DOI: 10.1111/cea.12678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H Takeuchi
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Department of Pediatrics, Funabashi General Hospital, Funabashi, Chiba, Japan
| | - A F Khan
- Centre for Nutrition and Food Security, International Centre for Diarrheal Disease Research, Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - M I Hasan
- Centre for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - M D H Hawlader
- Department of Epidemiology, Bangladesh University of Health Sciences, Mirpur, Dhaka, Bangladesh
| | - M Yunus
- Centre for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - K Zaman
- Centre for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - H R Chowdhury
- Global Burden of Disease Group, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia
| | - S Takanashi
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Y Wagatsuma
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - T Iwata
- Department of Education for Childcare, Faculty of Child Studies, Tokyo Kasei University, Sayama, Saitama, Japan
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25
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Takeuchi H, Khan AF, Yunus M, Hasan MI, Hawlader MDH, Takanashi S, Kano H, Zaman K, Chowdhury HR, Wagatsuma Y, Nakahara S, Iwata T. Anti-Ascaris immunoglobulin E associated with bronchial hyper-reactivity in 9-year-old rural Bangladeshi children. Allergol Int 2016; 65:141-146. [PMID: 26666493 DOI: 10.1016/j.alit.2015.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 06/17/2015] [Accepted: 07/04/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Studies have addressed the immunomodulatory effects of helminths and their protective effects upon asthma. However, anti-Ascaris IgE has been reported to be associated with an increased risk of asthma symptoms. We examined the association between serum levels of anti-Ascaris IgE and bronchial hyper-responsiveness (BHR) in children living in rural Bangladesh. METHODS Serum anti-Ascaris IgE level was measured and the BHR test done in 158 children aged 9 years selected randomly from a general population of 1705 in the Matlab Health and Demographic Surveillance Area of the International Centre for Diarrhoeal Disease Research, Bangladesh. We investigated wheezing symptoms using a questionnaire from the International Study of Asthma and Allergies in Childhood. BHR tests were successfully done on 152 children (108 'current wheezers'; 44 'never-wheezers'). We examined the association between anti-Ascaris IgE level and wheezing and BHR using multiple logistic regression analyses. RESULTS Of 108 current-wheezers, 59 were BHR-positive; of 44 never-wheezers, 32 were BHR-negative. Mean anti-Ascaris IgE levels were significantly higher (12.51 UA/ml; 95% confidence interval (CI), 9.21-17.00) in children with current wheezing with BHR-positive than in those of never-wheezers with BHR-negative (3.89; 2.65-5.70; t test, p < 0.001). A BHR-positive test was independently associated with anti-Ascaris IgE levels with an odds ratio (OR) = 7.30 [95% CI, 2.28-23.33], p = 0.001 when adjusted for total IgE, anti-Dermatophagoides pteronyssinus IgE, pneumonia history, parental asthma, Trichuris infection, forced expiratory volume in one second, eosinophilic leukocyte count, and sex. CONCLUSIONS Anti-Ascaris IgE level is associated with an increased risk of BHR among 9-year-old rural Bangladeshi children.
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26
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Suzuki M, Hara M, Ichikawa S, Kamijo S, Nakazawa T, Hatanaka H, Akiyama K, Ogawa H, Okumura K, Takai T. Presensitization to Ascaris antigens promotes induction of mite-specific IgE upon mite antigen inhalation in mice. Allergol Int 2016; 65:44-51. [PMID: 26666495 DOI: 10.1016/j.alit.2015.07.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 07/02/2015] [Accepted: 07/12/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Patients with house dust mite (HDM) allergy or Ascariasis produce serum IgE specific to the antigens of HDM or nematode Ascaris, respectively. Although human IgE cross-reactivity has been reported between HDM and Ascaris antigens, it remains unclear whether it contributes to the pathogenesis of allergic diseases. We herein investigated the induction of cross-reactive antibodies and T cells in mice and effects of airway exposure to HDM antigens after preimmunization with Ascaris antigens. METHODS Mice were intraperitoneally immunized with HDM or Ascaris antigens with Alum, followed by the intranasal administration of HDM antigens. Serum antigen-specific IgE and IgG were measured by ELISA. Cytokine release in splenocytes from Ascaris-immunized mice upon in vitro restimulation with HDM antigens were measured by ELISA. RESULTS Immunization with Ascaris or HDM antigens induced cross-reactive IgG1. Splenocytes from Ascaris-immunized mice released IL-5 and IL-13 in response to the restimulation with HDM antigens. Subsequent airway exposure to HDM antigens promoted the induction of HDM-specific IgE and upregulation of HDM-specific IgG1 in Ascaris-immunized mice, whereas these responses were not detected or smaller without the Ascaris presensitization. CONCLUSIONS We demonstrated that the immunization of naïve mice with Ascaris antigens induced production of antibodies and differentiation of Th2 cells, which were cross-reactive to HDM antigens, and accelerated induction of serum HDM-specific IgE upon subsequent airway exposure to HDM antigens in mice. These results suggest that sensitization to HDM towards IgE-mediated allergic diseases is faster in individuals with a previous history of Ascaris infection than in those without presensitization to Ascaris.
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Affiliation(s)
- Mayu Suzuki
- Atopy (Allergy) Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Materials and Biological Sciences, Faculty of Science, Japan Women's University, Tokyo, Japan
| | - Mutsuko Hara
- Atopy (Allergy) Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Saori Ichikawa
- Department of Materials and Biological Sciences, Faculty of Science, Japan Women's University, Tokyo, Japan
| | - Seiji Kamijo
- Atopy (Allergy) Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takuya Nakazawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan; Department of Rheumatology, Allergy, and Clinical Immunology, National Hospital Organization Chiba-East National Hospital, Chiba, Japan
| | - Hideki Hatanaka
- National Bioscience Database Center, Japan Science and Technology Agency, Tokyo, Japan
| | - Kazuo Akiyama
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Hideoki Ogawa
- Atopy (Allergy) Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ko Okumura
- Atopy (Allergy) Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toshiro Takai
- Atopy (Allergy) Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.
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