Department of Veterinary Pharmacy, Clinical and Comparative Medicine, Makerere University, Kampala, Uganda ; Uganda Virus Research Institute, Entebbe, Uganda.
PLoS Negl Trop Dis. 2013 Oct 17;7(10):e2501. doi: 10.1371/journal.pntd.0002501. eCollection 2013.
Offspring of Schistosoma mansoni-infected women in schistosomiasis-endemic areas may be sensitised in-utero. This may influence their immune responsiveness to schistosome infection and schistosomiasis-associated morbidity. Effects of praziquantel treatment of S. mansoni during pregnancy on risk of S. mansoni infection among offspring, and on their immune responsiveness when they become exposed to S. mansoni, are unknown. Here we examined effects of praziquantel treatment of S. mansoni during pregnancy on prevalence of S. mansoni and immune responsiveness among offspring at age five years.
In a trial in Uganda (ISRCTN32849447, http://www.controlled-trials.com/ISRCTN32849447/elliott), offspring of women treated with praziquantel or placebo during pregnancy were examined for S. mansoni infection and for cytokine and antibody responses to SWA and SEA, as well as for T cell expression of FoxP3, at age five years.
Of the 1343 children examined, 32 (2.4%) had S. mansoni infection at age five years based on a single stool sample. Infection prevalence did not differ between children of treated or untreated mothers. Cytokine (IFNγ, IL-5, IL-10 and IL-13) and antibody (IgG1, Ig4 and IgE) responses to SWA and SEA, and FoxP3 expression, were higher among infected than uninfected children. Praziquantel treatment of S. mansoni during pregnancy had no effect on immune responses, with the exception of IL-10 responses to SWA, which was higher in offspring of women that received praziquantel during pregnancy than those who did not.
We found no evidence that maternal S. mansoni infection and its treatment during pregnancy influence prevalence and intensity of S. mansoni infection or effector immune response to S. mansoni infection among offspring at age five years, but the observed effects on IL-10 responses to SWA suggest that maternal S. mansoni and its treatment during pregnancy may affect immunoregulatory responsiveness in childhood schistosomiasis. This might have implications for pathogenesis of the disease.
曼氏血吸虫感染的女性的后代在血吸虫病流行地区可能在子宫内致敏。这可能会影响他们对血吸虫感染和血吸虫病相关发病率的免疫反应。孕妇接受吡喹酮治疗曼氏血吸虫对其后代感染曼氏血吸虫的风险以及他们在接触曼氏血吸虫时的免疫反应的影响尚不清楚。在这里，我们研究了孕妇接受吡喹酮治疗曼氏血吸虫对五岁时子女的曼氏血吸虫感染率和免疫反应的影响。
在乌干达进行的一项试验中（ISRCTN32849447，http://www.controlled-trials.com/ISRCTN32849447/elliott），用吡喹酮或安慰剂治疗的孕妇的子女在五岁时接受检查，以确定是否感染曼氏血吸虫，并检测对 SWA 和 SEA 的细胞因子和抗体反应，以及 T 细胞表达 FoxP3。
在接受检查的 1343 名儿童中，根据单次粪便样本，有 32 名（2.4%）五岁时感染了曼氏血吸虫。感染率在接受治疗和未接受治疗的母亲的子女之间没有差异。感染儿童的细胞因子（IFNγ、IL-5、IL-10 和 IL-13）和抗体（IgG1、Ig4 和 IgE）对 SWA 和 SEA 的反应以及 FoxP3 表达均高于未感染儿童。孕妇接受吡喹酮治疗曼氏血吸虫对免疫反应没有影响，除了对 SWA 的 IL-10 反应，接受治疗的母亲的子女高于未接受治疗的母亲的子女。
我们没有发现母亲感染曼氏血吸虫及其在怀孕期间的治疗会影响五岁时子女的曼氏血吸虫感染的流行率和强度或对曼氏血吸虫感染的效应免疫反应的证据，但对 SWA 的 IL-10 反应的观察结果表明，母亲的曼氏血吸虫及其在怀孕期间的治疗可能会影响儿童期血吸虫病的免疫调节反应。这可能对疾病的发病机制产生影响。
