Hamm David M, Agossou Abram, Gantin Richard G, Kocherscheidt Lars, Banla Meba, Dietz Klaus, Soboslay Peter T
Institute for Tropical Medicine, University Clinics of Tübingen,Tübingen, Germany.
J Infect Dis. 2009 Jun 1;199(11):1583-91. doi: 10.1086/598950.
The effect of polyparasite infections on cytokine and chemokine responses as well as the effect of antiparasite treatment was studied in children without parasite infection (the G0 group), in children singly infected with Schistosoma haematobium (the G1 group), and in children multiply infected with S. haematobium/Schistosoma mansoni, Entamoeba histolytica/Entamoeba dispar, and Necator americanus (the G3+ group). Linear regression analysis disclosed a significant risk for coinfection with hookworm and Schistosoma species. Polyparasite infections detected in 23% of children before treatment were present in 5% at 15 months after treatment. Chemokine responses to S. mansoni adult worm antigen (SmAg) diminished after treatment for macrophage inflammatory chemokine (MIP)-1alpha/chemokine (C-C motif) ligand (CCL)-3 (among G3+ children, by a factor of 200 [95% confidence interval {CI}, 33-1111]) and for MIP-1beta/CCL-4 (among G3+ children, by a factor of 26 [95% CI, 6-117]) but were enhanced for thymus- and activation-regulated chemokine/CCL-17 (among G3+ children, by a factor of 10 [95% CI, 3-32]) (P < .001 for all). In response to E. histolytica antigen, interleukin (IL)-13 levels increased after treatment among G1 children by a factor of 138 (95% CI, 12-1569) and among G3+ children by a factor of 21 (95% CI, 7-64) (P < .001 for both). Cellular production of interferon (IFN)-gamma in response to SmAg decreased 4 weeks after treatment among G3+ children, whereas T helper cell type 2 (Th2) IL-13 production was enhanced among G1 and G3+ children. In summary, polyparasite infections with S. haematobium/S. mansoni, E. histolytica/E. dispar, and N. americanus generated prominent proinflammatory cytokine and chemokine responses, and, after antihelminth treatment, the inflammatory chemokine response lessened as the Th2 responsiveness in coinfected children increased.
在未感染寄生虫的儿童（G0组）、单独感染埃及血吸虫的儿童（G1组）以及同时感染埃及血吸虫/曼氏血吸虫、溶组织内阿米巴/迪斯帕内阿米巴和美洲板口线虫的儿童（G3+组）中，研究了多重寄生虫感染对细胞因子和趋化因子反应的影响以及抗寄生虫治疗的效果。线性回归分析显示，同时感染钩虫和血吸虫属存在显著风险。治疗前在23%的儿童中检测到的多重寄生虫感染，在治疗后15个月时降至5%。治疗后，巨噬细胞炎性趋化因子（MIP）-1α/趋化因子（C-C基序）配体（CCL）-3（在G3+组儿童中，下降了200倍[95%置信区间{CI}，33-1111]）和MIP-1β/CCL-4（在G3+组儿童中，下降了26倍[95%CI，6-117]）对曼氏血吸虫成虫抗原（SmAg）的趋化因子反应减弱，但胸腺和活化调节趋化因子/CCL-17的反应增强（在G3+组儿童中，增强了10倍[95%CI，3-32]）（所有P均<.001）。针对溶组织内阿米巴抗原，G1组儿童治疗后白细胞介素（IL）-13水平升高了138倍（95%CI，12-1569），G3+组儿童升高了21倍（95%CI，7-64）（两者P均<.001）。治疗4周后，G3+组儿童针对SmAg的干扰素（IFN）-γ细胞产生减少，而G1组和G3+组儿童2型辅助性T细胞（Th2）IL-13产生增强。总之，埃及血吸虫/曼氏血吸虫、溶组织内阿米巴/迪斯帕内阿米巴和美洲板口线虫的多重寄生虫感染产生了显著的促炎细胞因子和趋化因子反应，抗蠕虫治疗后，随着合并感染儿童Th2反应性增加，炎性趋化因子反应减弱。
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