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Fakhar M, Ghaffari J, Dabbaghzadeh A, Charati JY, Ghaffari B, Esboei BR. Prevalence of Intestinal Parasites among Patients with Chronic Urticaria in Northern Iran. Infect Disord Drug Targets 2021; 21:130-133. [PMID: 32342822 DOI: 10.2174/1871526520666200428095729] [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: 09/21/2019] [Revised: 12/15/2019] [Accepted: 03/14/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Chronic urticaria (CU) has a range of clinical demonstrations and causes. Parasitic infections are mentioned as one of the main causes of the CU. OBJECTIVES The aim of this study was to investigate the prevalence of intestinal parasites in patients with CU (with duration time of more than 6 weeks) compared healthy subjects. METHODS A total of 169 cases and 210 controls were included in this study. Ages ranged from 1 to 77 years old. Three samples were gathered from each patients and direct wet mount, formol-ether concentration, Ziehl-Neelsen and trichrome staining were used. RESULTS Out of the 379 individuals examined here, 208 were from urban areas and 171 from rural areas. Three stool samples were taken from each patient in three consecutive days. Based on parasitological tests, 7 (4.1%) cases from 169 patients with CU and 6 (2.9%) cases from 210 non- CU group individuals were positive for intestinal parasites. CONCLUSION The prevalence of various parasites between case and control groups was not significant.
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Affiliation(s)
- Mahdi Fakhar
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Sari, Iran
| | - Javad Ghaffari
- Pediatric Infectious Diseases Research Center, Mazandaran University of medical sciences, Sari, Iran
| | - Abbas Dabbaghzadeh
- Pediatric Infectious Diseases Research Center, Mazandaran University of medical sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Bahman Ghaffari
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Bahman Rahimi Esboei
- Department of Parasitology and Mycology, Tonekabon Branch, Faculty of Medicine, Islamic Azad University, Tonekabon, Iran
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Viñas M, Postigo I, Suñén E, Martínez J. Urticaria and silent parasitism by Ascaridoidea: Component-resolved diagnosis reinforces the significance of this association. PLoS Negl Trop Dis 2020; 14:e0008177. [PMID: 32243436 PMCID: PMC7170265 DOI: 10.1371/journal.pntd.0008177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 04/20/2020] [Accepted: 02/27/2020] [Indexed: 12/11/2022] Open
Abstract
Urticaria remains a major problem in terms of aetiology, investigation, and management, and although parasitic diseases are considered potential causes, the absence of a consistent link between parasitic infections and skin allergy symptoms leads to the need for a deeper study of parameters that support this association. The objectives of this study were to analyse a possible relationship between parasitism by Ascarididae (Toxocara canis and Anisakis simplex) and the clinical expression of urticaria and to identify possible parasitic molecular markers for improving the diagnosis of unknown urticaria aetiology. The prevalence of Toxocara and Anisakis infestations was evaluated by measuring the levels of specific IgG (sIgG) and IgE (sIgE) antibodies against crude extracts and isolated components from whole larvae of Anisakis simplex (Ani s 1, Ani s 3 and Ani s 7) and Toxocara canis (TES-120, TES-70, TES-32 and TES-26) using immunologic and molecular diagnostic methods. A cross-sectional study was performed in a group of 400 individuals. The study group consisted of 95 patients diagnosed with urticaria (55 with chronic urticaria and 40 with acute urticaria). A control group consisted of 305 subjects without urticaria (182 diagnosed with respiratory allergy and 123 without allergy). Statistically significant differences were demonstrated in the seroprevalence of specific IgG and IgE antibodies between the urticaria patients and the healthy general population when isolated ascarid antigens were evaluated. The prevalence of IgG antibodies against Ani s 1, IgE antibodies against TES-120 and IgE antibodies against TES-70 were significantly different between the control individuals (healthy general population) and patients with urticaria. Moreover, the urticaria patient group demonstrated a higher seroprevalence of antibodies (sIgE and sIgG) against Anisakis simplex larva whole extract than the control group but just with statistically diferences when sIgE was evaluated. The presence of IgE and/or IgG antibodies against Ani s 3 (tropomyosin) can help to discriminate between patients with and without urticaria. Both ascarids seem to be associated with urticaria, although in our region, Anisakis seems to have greater involvement than Toxocara in this relationship. Molecular diagnostics can be used to associate urticaria with parasite infestations. Tropomyosin and Ani s 1 were the most relevant markers to demonstrate the association between urticaria and the most relevant Ascarididae parasites in our region.
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Affiliation(s)
- Marta Viñas
- Allergy Service, Hospital de Terrassa, Consorci Sanitari de Terrassa, Carretera de Torrebonica, Barcelona, Spain
| | - Idoia Postigo
- Laboratory of Parasitology and Allergy, Research Center Lascaray, Department of Immunology, Microbiology and Parasitology, University of the Basque Country, Faculty of Pharmacy, Paseo de la Universidad, Vitoria, Spain
| | - Ester Suñén
- Laboratory of Parasitology and Allergy, Research Center Lascaray, Department of Immunology, Microbiology and Parasitology, University of the Basque Country, Faculty of Pharmacy, Paseo de la Universidad, Vitoria, Spain
| | - Jorge Martínez
- Laboratory of Parasitology and Allergy, Research Center Lascaray, Department of Immunology, Microbiology and Parasitology, University of the Basque Country, Faculty of Pharmacy, Paseo de la Universidad, Vitoria, Spain
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Melo GBD, Malta FDM, Maruta CW, Criado PR, Castilho VLP, Gonçalves EMDN, Espirito-Santo MCDCD, Paula FMD, Gryschek RCB. Characterization of subtypes of Blastocystis sp. isolated from patients with urticaria, São Paulo, Brazil. Parasite Epidemiol Control 2019; 7:e00124. [PMID: 31872093 PMCID: PMC6911935 DOI: 10.1016/j.parepi.2019.e00124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/18/2019] [Accepted: 11/05/2019] [Indexed: 01/01/2023] Open
Abstract
Blastocystis sp. is described as an enteric protist prevalent in fecal samples from humans and animals; its pathogenicity and epidemiology are still controversial. Currently, it has been associated with intestinal diseases such as irritable bowel syndrome and clinical manifestations of allergic skin, such as chronic urticaria. In the context of urticaria, it is still uncertain whether this organism is directly related to the allergic manifestation or just a common component of the intestinal microbiota. This study aimed to evaluate the occurrence and molecular diversity of Blastocystis sp. in individuals with urticaria from a dermatology outpatient clinic, São Paulo, Brazil. Fecal samples of 58 patients with urticaria were examined using parasitological methods; and subsequently tested by polymerase chain reaction using Blastocystis-specific primers. The subtypes (STs) and alleles (a) were determined using BLASTn and MLST tools. ST1, ST2, ST3, ST4, ST6 and mixed infection (ST1 + ST3) were identified in the patients with urticaria; ST1 (a4), ST3 (a34 and a36) and ST4 (a42) were the most prevalent. Our molecular analyses allowed an initial description of Blastocystis subtypes in patients with urticaria from São Paulo city, Brazil.
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Affiliation(s)
- Gessica Baptista de Melo
- Laboratório de Imunopatologia da Esquistossomose (LIM-06), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Corresponding author.
| | - Fernanda de Mello Malta
- Laboratório de Gastroenterologia e Hepatologia Tropical (LIM-07), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Celina Wakisaka Maruta
- Departamento de Dermatologia, Hospital Das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Ricardo Criado
- Departamento de Dermatologia, Hospital Das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Faculdade de Medicina Do ABC, São Paulo, Brazil
| | - Vera Lucia Pagliusi Castilho
- Seção de Parasitologia, Divisão Do Laboratório Central, Hospital Das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Fabiana Martins de Paula
- Laboratório de Imunopatologia da Esquistossomose (LIM-06), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ronaldo Cesar Borges Gryschek
- Laboratório de Imunopatologia da Esquistossomose (LIM-06), Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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El Saftawy EA, Amin NM, Hamed DH, Elkazazz A, Adel S. The hidden impact of different Blastocystis genotypes on C-3 and IgE serum levels: a matter of debate in asthmatic Egyptian children. J Parasit Dis 2019; 43:443-451. [PMID: 31406409 PMCID: PMC6667542 DOI: 10.1007/s12639-019-01108-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/26/2019] [Indexed: 01/19/2023] Open
Abstract
Blastocystis hominis is highly prevalent with respiratory allergies among Egyptian children. Yet, little is known about the possible immunological relationship. Aims of this study were to measure complement-3 (C-3), total and specific IgE to intestinal allergens in patients' serum regarding the identified B. hominis genotypes. In a cross-sectional study, three hundred children (150 asthmatics and 150 non asthmatics) participated in the study from both sexes, mean age 7.5 ± SD (3-4) years after a questionnaire administration. PCR-based genotyping of B. hominis selective in vitro cultivation was performed. C-3, total and specific IgE were all measured in patients' serum utilizing ELISA. Blastocystosis was detected in 100 out of 300 children, 65 (43.3%) out of 150 asthmatics and 35 (23.3%) out of 150 non-asthmatics. Vacuolar forms were the most prevalent in both direct wet mount and stool cultures. Forty (61.5%) out 65 asthmatics and 5 (14.2%) out of 35 non-asthmatics were ≥ 5 organisms/HPF. Sex and irritable bowel disease were statistically insignificant (p value < 0.05). Urticaria was coincided in 15.4% of asthmatics and 8.6% of non-asthmatics. Of 100 cases of blastocystosis, eighty-four were genotype-3 and sixteen were genotype-4. Out of these, 55 cases of genotype-3 and 6 cases of genotype-4 were asthmatics. Positive C-3 serum levels were in 46 (54.81%) of genotype-3 and 2 (12.5%) of genotype-4. High total IgE levels in 30 (35.7%) out of 84 cases of genotype-3 and 4 (25%) out of 16 cases of genotype-4. Positive specific IgE was in 25 (29.8%) of genotype-3 and 3 (18.75%) of genotype-4. Genotype-3 was of higher infection intensity (p value = 0.0001). In conclusion, B. hominis possess a hidden allergy triggering impact that can be obscured by simultaneous high (total and specific) IgE levels towards specific common intestinal allergens. Blastocystosis induces allergy by increasing C-3 serum levels in a genotype-dependent manner being higher in genotype-3. Virulence of genotype-3 seems to stand beyond increased parasite intensity and wide absorption of intestinal allergens that indirectly elevate IgE serum levels.
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Affiliation(s)
- Enas A. El Saftawy
- Medical Parasitology Department, College of Medicine, Cairo University, Cairo, Egypt
- Medical Parasitology Department, College of Medicine, Armed Forces College of Medicine, Cairo, Egypt
| | - Noha M. Amin
- Medical Parasitology Department, College of Medicine, Cairo University, Cairo, Egypt
| | - Dina H. Hamed
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Aly Elkazazz
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sherihan Adel
- Medical Biochemistry and Molecular Biology Department, College of Medicine, Ain Shams University, Cairo, Egypt
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Kumar S, Jeong Y, Ashraf MU, Bae YS. Dendritic Cell-Mediated Th2 Immunity and Immune Disorders. Int J Mol Sci 2019; 20:ijms20092159. [PMID: 31052382 PMCID: PMC6539046 DOI: 10.3390/ijms20092159] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 04/29/2019] [Accepted: 04/29/2019] [Indexed: 12/24/2022] Open
Abstract
Dendritic cells (DCs) are the professional antigen-presenting cells that recognize and present antigens to naïve T cells to induce antigen-specific adaptive immunity. Among the T-cell subsets, T helper type 2 (Th2) cells produce the humoral immune responses required for protection against helminthic disease by activating B cells. DCs induce a Th2 immune response at a certain immune environment. Basophil, eosinophil, mast cells, and type 2 innate lymphoid cells also induce Th2 immunity. However, in the case of DCs, controversy remains regarding which subsets of DCs induce Th2 immunity, which genes in DCs are directly or indirectly involved in inducing Th2 immunity, and the detailed mechanisms underlying induction, regulation, or maintenance of the DC-mediated Th2 immunity against allergic environments and parasite infection. A recent study has shown that a genetic defect in DCs causes an enhanced Th2 immunity leading to severe atopic dermatitis. We summarize the Th2 immune-inducing DC subsets, the genetic and environmental factors involved in DC-mediated Th2 immunity, and current therapeutic approaches for Th2-mediated immune disorders. This review is to provide an improved understanding of DC-mediated Th2 immunity and Th1/Th2 immune balancing, leading to control over their adverse consequences.
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Affiliation(s)
- Sunil Kumar
- Science Research Center (SRC) for Immune Research on Non-Lymphoid Organ (CIRNO), Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do 16419, Korea.
| | - Yideul Jeong
- Science Research Center (SRC) for Immune Research on Non-Lymphoid Organ (CIRNO), Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do 16419, Korea.
- Department of Biological Sciences, Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do 16419, Korea.
| | - Muhammad Umer Ashraf
- Science Research Center (SRC) for Immune Research on Non-Lymphoid Organ (CIRNO), Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do 16419, Korea.
- Department of Biological Sciences, Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do 16419, Korea.
| | - Yong-Soo Bae
- Science Research Center (SRC) for Immune Research on Non-Lymphoid Organ (CIRNO), Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do 16419, Korea.
- Department of Biological Sciences, Sungkyunkwan University, Jangan-gu, Suwon, Gyeonggi-do 16419, Korea.
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Nkurunungi G, Lubyayi L, Versteeg SA, Sanya RE, Nassuuna J, Kabagenyi J, Kabuubi PN, Tumusiime J, Zziwa C, Kizindo R, Niwagaba E, Nanyunja C, Nampijja M, Mpairwe H, Yazdanbakhsh M, van Ree R, Webb EL, Elliott AM. Do helminth infections underpin urban-rural differences in risk factors for allergy-related outcomes? Clin Exp Allergy 2019; 49:663-676. [PMID: 30633850 PMCID: PMC6518997 DOI: 10.1111/cea.13335] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/20/2018] [Accepted: 12/06/2018] [Indexed: 01/17/2023]
Abstract
Background It is proposed that helminth exposure protects against allergy‐related disease, by mechanisms that include disconnecting risk factors (such as atopy) from effector responses. Objective We aimed to assess how helminth exposure influences rural‐urban differences in risk factors for allergy‐related outcomes in tropical low‐ and middle‐income countries. Methods In cross‐sectional surveys in Ugandan rural Schistosoma mansoni (Sm)‐endemic islands, and in nearby mainland urban communities with lower helminth exposure, we assessed risk factors for atopy (allergen‐specific skin prick test [SPT] reactivity and IgE [asIgE] sensitization) and clinical allergy‐related outcomes (wheeze, urticaria, rhinitis and visible flexural dermatitis), and effect modification by Sm exposure. Results Dermatitis and SPT reactivity were more prevalent among urban participants, urticaria and asIgE sensitization among rural participants. Pairwise associations between clinical outcomes, and between atopy and clinical outcomes, were stronger in the urban survey. In the rural survey, SPT positivity was inversely associated with bathing in lakewater, Schistosoma‐specific IgG4 and Sm infection. In the urban survey, SPT positivity was positively associated with age, non‐Ugandan maternal tribe, being born in a city/town, BCG scar and light Sm infection. Setting (rural vs urban) was an effect modifier for risk factors including Sm‐ and Schistosoma‐specific IgG4. In both surveys, the dominant risk factors for asIgE sensitization were Schistosoma‐specific antibody levels and helminth infections. Handwashing and recent malaria treatment reduced odds of asIgE sensitization among rural but not urban participants. Risk factors for clinical outcomes also differed by setting. Despite suggestive trends, we did not find sufficient evidence to conclude that helminth (Sm) exposure explained rural‐urban differences in risk factors. Conclusions and clinical relevance Risk factors for allergy‐related outcomes differ between rural and urban communities in Uganda but helminth exposure is unlikely to be the sole mechanism of the observed effect modification between the two settings. Other environmental exposures may contribute significantly.
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Affiliation(s)
- Gyaviira Nkurunungi
- Immunomodulation and Vaccines Programme, (MRC/UVRI and LSHTM) Uganda Research Unit, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Lawrence Lubyayi
- Immunomodulation and Vaccines Programme, (MRC/UVRI and LSHTM) Uganda Research Unit, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.,Department of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Serge A Versteeg
- Departments of Experimental Immunology and of Otorhinolaryngology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Richard E Sanya
- Immunomodulation and Vaccines Programme, (MRC/UVRI and LSHTM) Uganda Research Unit, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.,College of Health Sciences, Makerere University, Kampala, Uganda
| | - Jacent Nassuuna
- Immunomodulation and Vaccines Programme, (MRC/UVRI and LSHTM) Uganda Research Unit, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Joyce Kabagenyi
- Immunomodulation and Vaccines Programme, (MRC/UVRI and LSHTM) Uganda Research Unit, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Prossy N Kabuubi
- Immunomodulation and Vaccines Programme, (MRC/UVRI and LSHTM) Uganda Research Unit, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Josephine Tumusiime
- Immunomodulation and Vaccines Programme, (MRC/UVRI and LSHTM) Uganda Research Unit, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Christopher Zziwa
- Immunomodulation and Vaccines Programme, (MRC/UVRI and LSHTM) Uganda Research Unit, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Robert Kizindo
- Immunomodulation and Vaccines Programme, (MRC/UVRI and LSHTM) Uganda Research Unit, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Emmanuel Niwagaba
- Immunomodulation and Vaccines Programme, (MRC/UVRI and LSHTM) Uganda Research Unit, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Carol Nanyunja
- Immunomodulation and Vaccines Programme, (MRC/UVRI and LSHTM) Uganda Research Unit, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Margaret Nampijja
- Immunomodulation and Vaccines Programme, (MRC/UVRI and LSHTM) Uganda Research Unit, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Harriet Mpairwe
- Immunomodulation and Vaccines Programme, (MRC/UVRI and LSHTM) Uganda Research Unit, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ronald van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Emily L Webb
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Alison M Elliott
- Immunomodulation and Vaccines Programme, (MRC/UVRI and LSHTM) Uganda Research Unit, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
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Strongyloides stercoralis is associated with significant morbidity in rural Cambodia, including stunting in children. PLoS Negl Trop Dis 2017; 11:e0005685. [PMID: 29059195 PMCID: PMC5695629 DOI: 10.1371/journal.pntd.0005685] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 11/02/2017] [Accepted: 06/07/2017] [Indexed: 01/01/2023] Open
Abstract
Background Strongyloides stercoralis is a soil-transmitted nematode that can replicate within its host, leading to long-lasting and potentially fatal infections. It is ubiquitous and highly prevalent in Cambodia. The extent of morbidity associated with S. stercoralis infection is difficult to assess due to the broad spectrum of symptoms and, thus, remains uncertain. Methodology/Principal findings Clinical signs were compared among S. stercoralis infected vs. non-infected participants in a cross-sectional survey conducted in 2012 in eight villages of Northern Cambodia, and before and after treatment with a single oral dose of ivermectin (200μg/kg BW) among participants harboring S. stercoralis. Growth retardation among schoolchildren and adolescents was assessed using height-for-age and thinness using body mass index-for-age. S. stercoralis prevalence was 31.1% among 2,744 participants. Urticaria (55% vs. 47%, OR: 1.4, 95% CI: 1.1–1.6) and itching (52% vs. 48%, OR: 1.2, 95% CI: 1.0–1.4) were more frequently reported by infected participants. Gastrointestinal, dermatological, and respiratory symptoms were less prevalent in 103 mono-infected participants after treatment. Urticaria (66% vs. 11%, OR: 0.03, 95% CI: 0.01–0.1) and abdominal pain (81 vs. 27%, OR: 0.07, 95% CI: 0.02–0.2) mostly resolved by treatment. S. stercoralis infection was associated with stunting, with 2.5-fold higher odds in case of heavy infection. Conclusions/Significance The morbidity associated with S. stercoralis confirmed the importance of gastrointestinal and dermatological symptoms unrelated to parasite load, and long-term chronic effects when associated with malnutrition. The combination of high prevalence and morbidity calls for the integration of S. stercoralis into ongoing STH control measures in Cambodia. Strongyloides stercoralis is an intestinal parasite that infects humans by penetrating intact skin. It thrives particularly in tropical countries with poor sanitation. Because it can replicate within its host, it causes long-lasting infections and is potentially fatal in patients with a disseminated infection. S. stercoralis is largely neglected due to the difficulty in detecting it with standard field diagnostic techniques but has recently been found to be very common in Cambodia, with prevalence rates exceeding 40%. It is difficult to identify symptoms associated with infection in endemic areas because co-infections with other helminths or protozoan parasites, which cause similar health problems, are common. We compared clinical signs in infected vs. non-infected participants living in eight villages in Northern Cambodia, and before and after treatment with ivermectin, the drug of choice against S. stercoralis, among 103 patients infected with S. stercoralis only. We also assessed the association between infection and growth retardation among children and adolescents. Of the participants, 31.1% were infected with S. stercoralis. Infected participants were more likely to report itching and urticaria. After treatment, fewer participants reported urticaria, abdominal pain, vomiting and, to a lesser extent, nausea, diarrhea, cough, and tiredness. S. stercoralis infection was associated with growth retardation as expressed by stunting.
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Mingomataj EÇ, Bakiri AH. Regulator Versus Effector Paradigm: Interleukin-10 as Indicator of the Switching Response. Clin Rev Allergy Immunol 2016; 50:97-113. [PMID: 26450621 DOI: 10.1007/s12016-015-8514-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The interleukin-10 (IL-10) is generally considered as the most important cytokine with anti-inflammatory properties and one of the key cytokines preventing inflammation-mediated tissue damage. In this respect, IL-10 producing cells play a crucial role in the outcome of infections, allergy, autoimmune reactions, tumor development, and transplant tolerance. Based on recent findings with regard to the mentioned clinical conditions, this review attempts to shed some light on the IL-10 functions, considering this cytokine as inherent inducer of the switching immunity. While acute infections and vaccinations are associated by IL-10 enhanced during few weeks, chronic parasitoses, tumor diseases, allergen-specific immunotherapy, transplants, and use of immune-suppressor drugs show an increased IL-10 level along months or years. With regard to autoimmune pathologies, the IL-10 increase is prevalently observed during early stages, whereas the successive stages are characterized by reaching of immune equilibrium independently to disease's activity. Together, these findings indicate that IL-10 is mainly produced during transient immune conditions and the persistent IL-10-related effect is the indication/prediction (and maybe effectuation) of the switching immunity. Actual knowledge emphasizes that any manipulation of the IL-10 response for treatment purposes should be considered very cautiously due to its potential hazards to the immune system. Probably, the IL-10 as potential switcher of immunity response should be used in association with co-stimulatory immune effectors that are necessary to determine the appropriate deviation during treatment of respective pathologies. Hopefully, further findings would open new avenues to study the biology of this "master switch" cytokine and its therapeutic potential.
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Affiliation(s)
- Ervin Ç Mingomataj
- Department of Allergy & Clinical Immunology, "Mother Theresa" School of Medicine, Tirana, Albania. .,Faculty of Technical Medical Sciences, Department of Preclinical Disciplines, University of Medicine, Tirana, Albania.
| | - Alketa H Bakiri
- Hygeia Hospital Tirana, Outpatients Service, Allergology Consulting Room, Tirana, Albania.,Faculty of Medical Sciences, Department of Preclinical Disciplines, Albanian University, Tirana, Albania
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