title: Clinical and immunologic evaluation of 31 patients with acute schistosomiasis mansoni.
abstract: 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.
authors.affiliation: Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Universidade Federal da Bahia, Bahia, Brazil.
authors.forename: Amelia Ribeiro
authors.initials: AR
authors.lastname: de Jesus
authors.forename: Angela
authors.initials: A
authors.lastname: Silva
authors.forename: Luciana B
authors.initials: LB
authors.lastname: Santana
authors.forename: Andrea
authors.initials: A
authors.lastname: Magalhães
authors.forename: Adriana Almeida
authors.initials: AA
authors.lastname: de Jesus
authors.forename: Roque Pacheco
authors.initials: RP
authors.lastname: de Almeida
authors.forename: Marco A V
authors.initials: MA
authors.lastname: Rêgo
authors.forename: Marcelo N
authors.initials: MN
authors.lastname: Burattini
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Pearce
authors.forename: Edgar M
authors.initials: EM
authors.lastname: Carvalho
mesh_terms: 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
chemical_list: D000936:Antigen-Antibody Complex; D000947:Antigens, Helminth; D016207:Cytokines; D014867:Water; D007073:Immunoglobulin E