Re-infection in human schistosomiasis mansoni: a prospective field study 18 months after praziquantel therapy.
Twenty-eight Zairean patients with Schistosoma mansoni infection were investigated and treated with praziquantel. Of these, 22 were re-examined 18 months later and 13 were found to be re-infected. Eighteen uninfected Zaireans were monitored concurrently to control for variations unrelated to schistosomiasis. Pathophysiological changes related to liver fibrosis were assessed by the determination of serum cholylglycine and procollagen-III-peptide. Circulating T-cell subsets were quantitated, and shedded T-cell antigens were measured in sera. In patients initially presenting with hepatomegaly, the biochemical indicators for egg-induced immunopathology became normal after therapy and remained normal even after re-infection, when the parasite load attained about 50% of the pretreatment level. Among T-cell phenotypes, CD4+ cells transiently increased by three months after treatment, but after 18 months the CD4/CD8 ratios both in patients then re-infected and in those not re-infected had reverted to the respective balances which had been observed at the start of the investigation. Both soluble CD8 antigen and interleukin 2 receptor in patients' sera were significantly elevated throughout the study period. The results indicate a dissociation of factors regulating fibrogenesis and immunomodulation after treatment and re-infected.
Zwingenberger
K
K
Landesinstitut für Tropenmedizin, Berlin, F.R.G.
Harms
G
G
Poggensee
U
U
Steiner
A
A
Müller
O
O
Feldmeier
H
H
D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D001708:Biopterins / Q000031:analogs & derivatives / Q000097:blood; D002648:Child; D002675:Child, Preschool; D015023:Democratic Republic of the Congo; D005260:Female; D006000:Glycocholic Acid / Q000097:blood; D006801:Humans; D016131:Lymphocyte Subsets; D008297:Male; D008875:Middle Aged; D019798:Neopterin; D010270:Parasite Egg Count; D011223:Praziquantel / Q000627:therapeutic use*; D011446:Prospective Studies; D015375:Receptors, Interleukin-2 / Q000032:analysis; D012008:Recurrence; D012555:Schistosomiasis mansoni / Q000188:drug therapy* / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology
D015703:Antigens, CD; D015375:Receptors, Interleukin-2; D001708:Biopterins; D011223:Praziquantel; D019798:Neopterin; D006000:Glycocholic Acid