title: Immunocytochemistry of mucosal changes in patients infected with the intestinal nematode Strongyloides stercoralis.
abstract: OBJECTIVE
  To investigate the immunopathological changes in duodenal tissues induced by strongyloidiasis and to relate these to degrees of clinical severity.
  
  
  METHODS
  Tissues taken from 21 patients showing mild, moderate or severe symptoms of strongyloidiasis, and from non-infected controls, were sectioned and stained immunocytochemically for IgA, secretory component (SC) and HLA-DR. Immunopathology was assessed by changes in numbers, intensity and distribution of stained cells.
  
  
  RESULTS
  Parasitised individuals showed villous atrophy and crypt hyperplasia. There was notable infiltration of the lamina propria by IgA positive plasma cells and of the epithelium by intraepithelial lymphocytes. Infection was also associated with increased expression of SC and decreased expression of HLA-DR in epithelial cells. Changes in all parameters correlated with degree of clinical severity.
  
  
  CONCLUSIONS
  Profound mucosal changes are induced by strongyloidiasis. Some are analogous to those seen in coeliac disease, but others seem quite unusual. It is likely that these changes are functionally related to the immunopathophysiological consequences of infection seen in patients with severe disease.
authors.affiliation: Centro de Pesquisas Aggeu Magalhaes/FIOCRUZ, Recife, Brazil.
authors.forename: H B
authors.initials: HB
authors.lastname: Coutinho
authors.forename: T I
authors.initials: TI
authors.lastname: Robalinho
authors.forename: V B
authors.initials: VB
authors.lastname: Coutinho
authors.forename: J R
authors.initials: JR
authors.lastname: Almeida
authors.forename: J T
authors.initials: JT
authors.lastname: Filho
authors.forename: G
authors.initials: G
authors.lastname: King
authors.forename: D
authors.initials: D
authors.lastname: Jenkins
authors.forename: Y
authors.initials: Y
authors.lastname: Mahida
authors.forename: H F
authors.initials: HF
authors.lastname: Sewell
authors.forename: D
authors.initials: D
authors.lastname: Wakelin
mesh_terms: D000328:Adult; D000938:Antigen-Presenting Cells; D004378:Duodenal Diseases / Q000175:diagnosis* / Q000469:parasitology; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism; D007150:Immunohistochemistry / Q000379:methods; D007411:Intestinal Diseases, Parasitic / Q000175:diagnosis*; D007413:Intestinal Mucosa / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D012635:Secretory Component / Q000032:analysis; D013322:Strongyloidiasis / Q000175:diagnosis*
chemical_list: D006684:HLA-DR Antigens; D007070:Immunoglobulin A; D012635:Secretory Component