title: Schistosoma haematobium-induced urinary tract morbidity correlates with increased tumor necrosis factor-alpha and diminished interleukin-10 production.
abstract: This study examined the hypothesis that the nature of the host cellular immune response to schistosome ova is a risk factor for urinary tract morbidity in areas in which Schistosoma haematobium is endemic. S. haematobium-infected children and adolescents with bladder pathology assessed by ultrasonography had 54-fold greater tumor necrosis factor (TNF)-alpha production and a 120-fold greater ratio of TNF-alpha to interleukin (IL)-10 release by peripheral blood mononuclear cells in response to egg antigens, in comparison with control children and adolescents matched by age, sex, and infection severity. Mycobacterial antigens also stimulated 7-fold more TNF-alpha among subjects with bladder morbidity than in control subjects, which suggests an innate predisposition to enhanced TNF-alpha production. Levels of egg antigen-induced IL-4 and -5 and interferon-gamma were equivalent in subjects with and without bladder pathology. Thus, children and adolescents predisposed to increased TNF-alpha production to S. haematobium infection are more likely to develop an exaggerated granulomatous response to ova trapped in the bladder wall, with associated urinary tract pathology.
authors.affiliation: Division of Geographic Medicine, Case Western Reserve University School of Medicine, 10900 Euclid Ave., Cleveland, Ohio 44106-4983, USA. cxk21@po.cwru.edu
authors.forename: C L
authors.initials: CL
authors.lastname: King
authors.forename: I
authors.initials: I
authors.lastname: Malhotra
authors.forename: P
authors.initials: P
authors.lastname: Mungai
authors.forename: A
authors.initials: A
authors.lastname: Wamachi
authors.forename: J
authors.initials: J
authors.lastname: Kioko
authors.forename: E
authors.initials: E
authors.lastname: Muchiri
authors.forename: J H
authors.initials: JH
authors.lastname: Ouma
mesh_terms: D000293:Adolescent; D000818:Animals; D000947:Antigens, Helminth / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000378:metabolism*; D008297:Male; D010270:Parasite Egg Count; D012548:Schistosoma haematobium / Q000254:growth & development / Q000276:immunology*; D012553:Schistosomiasis haematobia / Q000000981:diagnostic imaging / Q000276:immunology* / Q000469:parasitology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D001745:Urinary Bladder Diseases / Q000000981:diagnostic imaging / Q000276:immunology* / Q000469:parasitology
chemical_list: D000947:Antigens, Helminth; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10