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Kunwar CB, Birstonas S, McPhee JB, Barnett Foster D. Molecular basis of bile-salt- and iron-induced enterohaemorrhagic E. coli resistance to cationic antimicrobial peptides. Microbiology (Reading) 2020; 166:1149-1159. [PMID: 33205745 DOI: 10.1099/mic.0.000988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Colonization of the gastrointestinal tract by enterohaemorrhagic Escherichia coli (EHEC) is critically dependent on its ability to sense and respond to various microenvironments within the host. EHEC exposure to physiologically relevant levels of bile salts upregulates the two-component system, pmrAB, and the arnBCADTEF operon, resulting in lipopolysaccharide modification and increased resistance to the cationic antimicrobial peptide, polymyxin B (PMB). A similar pmrAB- and arn-dependent PMB resistance has been observed in Salmonella enterica in the presence of ferric iron. Limiting magnesium levels and mild acid can also induce Salmonella resistance to PMB through another two-component system, PhoPQ and the connector protein, PmrD. This study aims to evaluate the relative contributions of a bile-salt mix (BSM), iron, limiting magnesium as well as the roles of pmrAB, phoPQ and pmrD to EHEC's resistance to PMB. Killing assays show that EHEC treatment with the BSM or iron under excess magnesium and neutral pH conditions induces a pmrAB-dependent, phoP-independent PMB resistance. By contrast, exposure to limiting magnesium triggers a pmrB-, phoP- and pmrD-dependent PMB resistance. The iron-induced PMB resistance is independent of phoP and pmrD under limiting magnesium conditions while the bile-salt-induced PMB resistance is independent of pmrD only under non-PhoP-inducing conditions. GFP-pmrD transcriptional reporter studies reveal that the limiting magnesium enhances pmrD expression, which is repressed upon additional exposure to either BSM or iron. Our results also show that exposure to mild acid enhances PMB resistance in a pmrD-independent manner and GFP reporter results confirm minimal expression of pmrD at this pH regardless of the magnesium level. This study provides novel insights into how EHEC differentially employs PmrAB, PhoPQ and PmrD to monitor and respond to bile salts, iron, acidic pH and magnesium typically encountered within the gastrointestinal tract in order to modulate its survival against cationic antimicrobial peptides.
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Affiliation(s)
- Chhatra B Kunwar
- Department of Chemistry & Biology, Ryerson University, Toronto, ON, Canada
| | - Sarah Birstonas
- Department of Chemistry & Biology, Ryerson University, Toronto, ON, Canada
| | - Joseph B McPhee
- Department of Chemistry & Biology, Ryerson University, Toronto, ON, Canada
| | - Debora Barnett Foster
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Department of Chemistry & Biology, Ryerson University, Toronto, ON, Canada
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Hagge DA, Parajuli P, Kunwar CB, Rana DRSJB, Thapa R, Neupane KD, Nicholls P, Adams LB, Geluk A, Shah M, Napit IB. Opening a Can of Worms: Leprosy Reactions and Complicit Soil-Transmitted Helminths. EBioMedicine 2017; 23:119-124. [PMID: 28882756 PMCID: PMC5605364 DOI: 10.1016/j.ebiom.2017.08.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/30/2017] [Accepted: 08/30/2017] [Indexed: 12/11/2022] Open
Abstract
Background > 94% of new annual leprosy cases are diagnosed in populations co-endemic for soil-transmitted helminths (STH). STH can profoundly dysregulate host immune responses towards Th2 bias, which can be restored over time after deworming. We hypothesize that STH co-infection is associated with leprosy reaction (denoted as simply “reaction” herein) occurrence within a co-endemic population. Methods A cohort study was performed on a cohort of Nepalese leprosy patients across treatment and diagnostic classifications who were screened by routine fecal smear microscopy and multiplex quantitative PCR (qPCR) for Ascaris lumbricoides (Al), Strongyloides stercoralis (Ss), Ancyclostoma duodenale (Ad) and Necator americanus (Na). Results Among 145 patients, 55% were positive for ≥ 1 STH (STH +): 34% Al +, 18% Ss +, 17% Ad + and 5% Na +. Significant inverse STH and reaction relationships were evidenced by the bulk of cases: 63% reaction-negative were STH + of total cases (p = 0.030) while 65% reaction-positive were STH − in new cases (96; p = 0.023). Strikingly, the majority of STH + were reaction-negative, even when considering each species: 59% Al +, 60% Ss +, 62% Ad + and 67% Na + of new leprosy cases. Conclusions Absence of STH co-infection is associated with leprosy reaction at diagnosis within a co-endemic population. This is likely due to immune reconstitution effects after deworming or interruption of chronic STH-mediated immune dysregulation. Fecal screening by qPCR revealed that 55% of 145 leprosy patients hosted 1 or more soil-transmitted helminth (STH) co-infections STH coinfection was significantly and inversely associated with leprosy reaction Chronic STH-induced immune bias followed by disruption of co-infection, potentially by deworming, may initiate immune reconstitution that can lead to reaction development
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Affiliation(s)
- Deanna A Hagge
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal.
| | - Pawan Parajuli
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Chhatra B Kunwar
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Divya R S J B Rana
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Ruby Thapa
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Kapil D Neupane
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Peter Nicholls
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Linda B Adams
- Department of Health and Human Services, Health Resources and Services Administration, Health Systems Bureau, National Hansen's Disease Programs (DHHS/HRSA/HSB/NHDP), Baton Rouge, Louisiana, USA
| | - Annemieke Geluk
- Department of Infectious Diseases, Leiden University Medical Center, The Netherlands
| | - Mahesh Shah
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Indra B Napit
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
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Shah JA, Berrington WR, Vary JC, Wells RD, Peterson GJ, Kunwar CB, Khadge S, Hagge DA, Hawn TR. Genetic Variation in Toll-Interacting Protein Is Associated With Leprosy Susceptibility and Cutaneous Expression of Interleukin 1 Receptor Antagonist. J Infect Dis 2015; 213:1189-97. [PMID: 26610735 DOI: 10.1093/infdis/jiv570] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 11/19/2015] [Indexed: 01/03/2023] Open
Abstract
Leprosy is a chronic disease characterized by skin and peripheral nerve pathology and immune responses that fail to control Mycobacterium leprae. Toll-interacting protein (TOLLIP) regulates Toll-like receptor (TLR) and interleukin 1 receptor (IL-1R) signaling against mycobacteria. We analyzed messenger RNA (mRNA) expression of candidate immune genes in skin biopsy specimens from 85 individuals with leprosy. TOLLIP mRNA was highly and specifically correlated with IL-1R antagonist (IL-1Ra). In a case-control gene-association study with 477 cases and 1021 controls in Nepal, TOLLIP single-nucleotide polymorphism rs3793964 TT genotype was associated with increased susceptibility to leprosy (recessive, P = 1.4 × 10(-3)) and with increased skin expression of TOLLIP and IL-1Ra. Stimulation of TOLLIP-deficient monocytes with M. leprae produced significantly less IL-1Ra (P < .001), compared with control. These data suggest that M. leprae upregulates IL-1Ra by a TOLLIP-dependent mechanism. Inhibition of TOLLIP may decrease an individual's susceptibility to leprosy and offer a novel therapeutic target for IL-1-dependent diseases.
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Affiliation(s)
- Javeed A Shah
- University of Washington School of Medicine, Seattle, Washington
| | | | - James C Vary
- University of Washington School of Medicine, Seattle, Washington Puget Sound VA Health Care System, Seattle, Washington
| | - Richard D Wells
- University of Washington School of Medicine, Seattle, Washington
| | | | - Chhatra B Kunwar
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Saraswoti Khadge
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Deanna A Hagge
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Thomas R Hawn
- University of Washington School of Medicine, Seattle, Washington
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Khadge S, Banu S, Bobosha K, van der Ploeg-van Schip JJ, Goulart IM, Thapa P, Kunwar CB, van Meijgaarden KE, van den Eeden SJF, Wilson L, Kabir S, Dey H, Goulart LR, Lobato J, Carvalho W, Bekele Y, Franken KLMC, Aseffa A, Spencer JS, Oskam L, Otttenhoff THM, Hagge DA, Geluk A. Longitudinal immune profiles in type 1 leprosy reactions in Bangladesh, Brazil, Ethiopia and Nepal. BMC Infect Dis 2015; 15:477. [PMID: 26510990 PMCID: PMC4625471 DOI: 10.1186/s12879-015-1128-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 09/18/2015] [Indexed: 12/30/2022] Open
Abstract
Background Acute inflammatory reactions are a frequently occurring, tissue destructing phenomenon in infectious- as well as autoimmune diseases, providing clinical challenges for early diagnosis. In leprosy, an infectious disease initiated by Mycobacterium leprae (M. leprae), these reactions represent the major cause of permanent neuropathy. However, laboratory tests for early diagnosis of reactional episodes which would significantly contribute to prevention of tissue damage are not yet available. Although classical diagnostics involve a variety of tests, current research utilizes limited approaches for biomarker identification. In this study, we therefore studied leprosy as a model to identify biomarkers specific for inflammatory reactional episodes. Methods To identify host biomarker profiles associated with early onset of type 1 leprosy reactions, prospective cohorts including leprosy patients with and without reactions were recruited in Bangladesh, Brazil, Ethiopia and Nepal. The presence of multiple cyto-/chemokines induced by M. leprae antigen stimulation of peripheral blood mononuclear cells as well as the levels of antibodies directed against M. leprae-specific antigens in sera, were measured longitudinally in patients. Results At all sites, longitudinal analyses showed that IFN-γ-, IP-10-, IL-17- and VEGF-production by M. leprae (antigen)-stimulated PBMC peaked at diagnosis of type 1 reactions, compared to when reactions were absent. In contrast, IL-10 production decreased during type 1 reaction while increasing after treatment. Thus, ratios of these pro-inflammatory cytokines versus IL-10 provide useful tools for early diagnosing type 1 reactions and evaluating treatment. Of further importance for rapid diagnosis, circulating IP-10 in sera were significantly increased during type 1 reactions. On the other hand, humoral immunity, characterized by M. leprae-specific antibody detection, did not identify onset of type 1 reactions, but allowed treatment monitoring instead. Conclusions This study identifies immune-profiles as promising host biomarkers for detecting intra-individual changes during acute inflammation in leprosy, also providing an approach for other chronic (infectious) diseases to help early diagnose these episodes and contribute to timely treatment and prevention of tissue damage. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1128-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Saraswoti Khadge
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal.
| | - Sayera Banu
- International Center for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh.
| | - Kidist Bobosha
- Dept. of Infectious Diseases, Leiden University Medical Center (LUMC), PO Box 9600, 2300 RC, Leiden, The Netherlands. .,Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
| | | | - Isabela M Goulart
- National Reference Center for Sanitary Dermatology and Leprosy, Faculty of Medicine, Federal University of Uberlandia, Minas Gerais, Brazil.
| | - Pratibha Thapa
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal.
| | - Chhatra B Kunwar
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal.
| | - Krista E van Meijgaarden
- Dept. of Infectious Diseases, Leiden University Medical Center (LUMC), PO Box 9600, 2300 RC, Leiden, The Netherlands.
| | - Susan J F van den Eeden
- Dept. of Infectious Diseases, Leiden University Medical Center (LUMC), PO Box 9600, 2300 RC, Leiden, The Netherlands.
| | - Louis Wilson
- International Center for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh.
| | - Senjuti Kabir
- International Center for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh.
| | - Hymonti Dey
- International Center for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh.
| | - Luiz R Goulart
- National Reference Center for Sanitary Dermatology and Leprosy, Faculty of Medicine, Federal University of Uberlandia, Minas Gerais, Brazil.
| | - Janaina Lobato
- National Reference Center for Sanitary Dermatology and Leprosy, Faculty of Medicine, Federal University of Uberlandia, Minas Gerais, Brazil.
| | - Washington Carvalho
- National Reference Center for Sanitary Dermatology and Leprosy, Faculty of Medicine, Federal University of Uberlandia, Minas Gerais, Brazil.
| | - Yonas Bekele
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
| | - Kees L M C Franken
- Dept. of Infectious Diseases, Leiden University Medical Center (LUMC), PO Box 9600, 2300 RC, Leiden, The Netherlands.
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
| | - John S Spencer
- Dept. of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, USA.
| | - Linda Oskam
- National Reference Center for Sanitary Dermatology and Leprosy, Faculty of Medicine, Federal University of Uberlandia, Minas Gerais, Brazil.
| | - Tom H M Otttenhoff
- Dept. of Infectious Diseases, Leiden University Medical Center (LUMC), PO Box 9600, 2300 RC, Leiden, The Netherlands.
| | - Deanna A Hagge
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal.
| | - Annemieke Geluk
- Dept. of Infectious Diseases, Leiden University Medical Center (LUMC), PO Box 9600, 2300 RC, Leiden, The Netherlands.
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Berrington WR, Kunwar CB, Neupane K, van den Eeden SJF, Vary JC, Peterson GJ, Wells RD, Geluk A, Hagge DA, Hawn TR. Differential dermal expression of CCL17 and CCL18 in tuberculoid and lepromatous leprosy. PLoS Negl Trop Dis 2014; 8:e3263. [PMID: 25412496 PMCID: PMC4238987 DOI: 10.1371/journal.pntd.0003263] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 09/10/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Leprosy is characterized by polar clinical, histologic and immunological presentations. Previous immunologic studies of leprosy polarity were limited by the repertoire of cytokines known at the time. METHODOLOGY We used a candidate gene approach to measure mRNA levels in skin biopsies from leprosy lesions. mRNA from 24 chemokines and cytokines, and 6 immune cell type markers were measured from 85 Nepalese leprosy subjects. Selected findings were confirmed with immunohistochemistry. PRINCIPAL RESULTS Expression of three soluble mediators (CCL18, CCL17 and IL-10) and one macrophage cell type marker (CD14) was significantly elevated in lepromatous (CCL18, IL-10 and CD14) or tuberculoid (CCL17) lesions. Higher CCL18 protein expression by immunohistochemistry and a trend in increased serum CCL18 in lepromatous lesions was observed. No cytokines were associated with erythema nodosum leprosum or Type I reversal reaction following multiple comparison correction. Hierarchical clustering suggested that CCL18 was correlated with cell markers CD209 and CD14, while neither CCL17 nor CCL18 were highly correlated with classical TH1 and TH2 cytokines. CONCLUSIONS Our findings suggest that CCL17 and CCL18 dermal expression is associated with leprosy polarity.
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Affiliation(s)
- William R. Berrington
- University of Washington School of Medicine, Seattle, Washington, United States of America
- * E-mail:
| | - Chhatra B. Kunwar
- Mycobacterial Research Laboratory, Anandaban Hospital, Kathmandu, Nepal
| | - Kapil Neupane
- Mycobacterial Research Laboratory, Anandaban Hospital, Kathmandu, Nepal
| | | | - James C. Vary
- University of Washington School of Medicine, Seattle, Washington, United States of America
| | - Glenna J. Peterson
- University of Washington School of Medicine, Seattle, Washington, United States of America
| | - Richard D. Wells
- University of Washington School of Medicine, Seattle, Washington, United States of America
| | - Annemieke Geluk
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Deanna A. Hagge
- Mycobacterial Research Laboratory, Anandaban Hospital, Kathmandu, Nepal
| | - Thomas R. Hawn
- University of Washington School of Medicine, Seattle, Washington, United States of America
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Bobosha K, Tang ST, van der Ploeg-van Schip JJ, Bekele Y, Martins MVSB, Lund O, Franken KLMC, Khadge S, Pontes MADA, Gonçalves HDS, Hussien J, Thapa P, Kunwar CB, Hagge DA, Aseffa A, Pessolani MCV, Pereira GMB, Ottenhoff THM, Geluk A. Mycobacterium leprae virulence-associated peptides are indicators of exposure to M. leprae in Brazil, Ethiopia and Nepal. Mem Inst Oswaldo Cruz 2013; 107 Suppl 1:112-23. [PMID: 23283462 DOI: 10.1590/s0074-02762012000900018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 07/03/2012] [Indexed: 12/13/2022] Open
Abstract
Silent transmission of Mycobacterium leprae, as evidenced by stable leprosy incidence rates in various countries, remains a health challenge despite the implementation of multidrug therapy worldwide. Therefore, the development of tools for the early diagnosis of M. leprae infection should be emphasised in leprosy research. As part of the continuing effort to identify antigens that have diagnostic potential, unique M. leprae peptides derived from predicted virulence-associated proteins (group IV.A) were identified using advanced genome pattern programs and bioinformatics. Based on human leukocyte antigen (HLA)-binding motifs, we selected 21 peptides that were predicted to be promiscuous HLA-class I T-cell epitopes and eight peptides that were predicted to be HLA-class II restricted T-cell epitopes for field-testing in Brazil, Ethiopia and Nepal. High levels of interferon (IFN)-γ were induced when peripheral blood mononuclear cells (PBMCs) from tuberculoid/borderline tuberculoid leprosy patients located in Brazil and Ethiopia were stimulated with the ML2055 p35 peptide. PBMCs that were isolated from healthy endemic controls living in areas with high leprosy prevalence (EChigh) in Ethiopia also responded to the ML2055 p35 peptide. The Brazilian EChigh group recognised the ML1358 p20 and ML1358 p24 peptides. None of the peptides were recognised by PBMCs from healthy controls living in non-endemic region. In Nepal, mixtures of these peptides induced the production of IFN-γ by the PBMCs of leprosy patients and EChigh. Therefore, the M. leprae virulence-associated peptides identified in this study may be useful for identifying exposure to M. leprae in population with differing HLA polymorphisms.
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Affiliation(s)
- Kidist Bobosha
- Department of Infectious Diseases, University Medical Center, Leiden, The Netherlands
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de Gruijter JM, Polderman AM, Dijkshoorn L, Roberts H, Ziem J, Kunwar CB, Gasser RB. AFLP fingerprinting for the analysis of genetic diversity within Necator americanus. Mol Cell Probes 2006; 20:317-21. [PMID: 16716566 DOI: 10.1016/j.mcp.2006.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2006] [Revised: 03/01/2006] [Accepted: 03/24/2006] [Indexed: 10/24/2022]
Abstract
In the present study, we utilised the method of AFLP to screen for genetic variation within and among individuals of the blood-feeding human hookworm Necator americanus (Nematoda) from Africa, Asia and South America. A total of 45 adult worms (i.e. 20 from Ghana, 16 from Colombia and 9 from Nepal) were subjected to analysis using the restriction enzyme/primer combination HindIII+AG/BglII+AC. Cluster analysis divided N. americanus into multiple, genetically distinct groups, consistent with previous findings using ribosomal and mitochondrial DNA data sets. The results demonstrated the usefulness of AFLP fingerprinting for establishing genetic variation within N. americanus and reinforce its applicability to other parasitic helminths of human and/or veterinary health importance.
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Affiliation(s)
- Johanna M de Gruijter
- Leiden University Medical Center, University of Leiden, PO Box 9600, 2300 RC Leiden, The Netherlands.
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Kunwar CB, Chapagain RH, Subba B, Shrestha M, Jha B, Subedi J, Blangero J, Williams-Blangero S, Towne B. Occurrence of soil-transmitted helminths in women at the Himalayan region of Nepal. Kathmandu Univ Med J (KUMJ) 2006; 4:444-447. [PMID: 18603951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To find the occurrence pattern and prevalence of the soil transmitted helminths in women of child bearing age group. METHODS AND MATERIALS The study was conducted in Jiri , an area of Dolakha district at the altitude of 2100 meter from sea level. The faecal sample of 478 women of childbearing age (15 to 45 years) were taken randomly and examined for the ova of soil transmitted helianthus. RESULT The occurrence pattern was 53.0%, 20.0% and 2.7% for Hookworms, Ascaries lumbricoids and Trichuris Trichuria respectively. Both Ascaries and Hookworm prevalence rates noticeably increased with increasing age, with the highest infection rate between the age of 36-45 years while trichuris infection reached the highest in women of 15-25 years of age. CONCLUSION There is a high prevalence of hookworm and ascaries in women of childbearing age and necessary intervention is needed according to WHO guidelines.
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Affiliation(s)
- C B Kunwar
- Jiri Helminth Project/Jiri Growth Study, Jiri-9, Naya Bazaar, Dolakha, Nepal
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Chapagain RH, Subba B, Kunwar CB, Subedi J, Blengero J, Williams S, Towne B. Trend of blood group distribution among the Jirels of Nepal. JNMA J Nepal Med Assoc 2005; 44:121-3. [PMID: 16751813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
This study was undertaken to find out the trend of blood group distribution among the Jirels, a small tribe, descended from Kirat tribe and to compare with other castes within Nepal and with people of other continents. Blood group distribution (ABO grouping and Rh typing) was studied among 2093 Jirels (Male-1057 and Female-1036). The frequency of distribution of A, B, O and AB was 55.05%, 14.72%, 21.64% and 8.6% respectively. The group A was found to be most common among the Jirels where as O is most common in the world. Only 0.14%of the Jirels were was found to be Rhesus Negative (Rh -ve).
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Affiliation(s)
- R H Chapagain
- Jiri Helminth Project/Jiri Groth Study, Dolakha, Nepal.
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