Clinical and immunologic evaluation of 31 patients with acute schistosomiasis mansoni.
Thirty-one patients with acute schistosomiasis were evaluated clinically and immunologically. Cytokine levels were determined in peripheral blood mononuclear cell (PBMC) supernatants. Levels of total and antigen-specific IgE, tumor necrosis factor (TNF)-alpha, and immune complexes were measured in serum samples. Clinical findings included general symptoms, liver damage, pulmonary involvement, and pericarditis. All patients had eosinophilia. Immune complexes were detected in 55% of the patients (mean+/-SD, 7.8+/-7.6 microg Eq/mL) and were associated with cough, dyspnea, and abnormal chest radiographic findings. Levels (mean +/- SD) of TNF-alpha (1349.3+/-767.6 pg/mL), interleukin (IL)-1 (2683+/-1270 pg/mL), and IL-6 (382 +/- 52.3 pg/mL) were elevated in PBMC. Serum TNF-alpha levels were elevated in 87% of the patients and were associated with abdominal pain. Higher interferon-gamma levels were detected in PBMC of patients with acute disease than in those of patients with chronic schistosomiasis; IL-5 levels were higher in those with chronic disease. Low IL-5 levels were associated with weight loss. Proinflammatory cytokines and immune complexes with low Th2 responses might explain the immunopathogenesis of acute schistosomiasis.
de Jesus
Amelia Ribeiro
AR
Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Bahia, Brazil.
Silva
Angela
A
Santana
Luciana B
LB
Magalhães
Andrea
A
de Jesus
Adriana Almeida
AA
de Almeida
Roque Pacheco
RP
Rêgo
Marco A V
MA
Burattini
Marcelo N
MN
Pearce
Edward J
EJ
Carvalho
Edgar M
EM
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000936:Antigen-Antibody Complex / Q000097:blood; D000947:Antigens, Helminth / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002908:Chronic Disease; D016207:Cytokines / Q000378:metabolism; D019353:Endemic Diseases; D005243:Feces / Q000469:parasitology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007963:Leukocytes, Mononuclear / Q000276:immunology; D010270:Parasite Egg Count; D012555:Schistosomiasis mansoni / Q000453:epidemiology / Q000209:etiology / Q000276:immunology*; D014867:Water / Q000469:parasitology; D014881:Water Supply
D000936:Antigen-Antibody Complex; D000947:Antigens, Helminth; D016207:Cytokines; D014867:Water; D007073:Immunoglobulin E