title: Cryptosporidiosis stimulates an inflammatory intestinal response in malnourished Haitian children.
abstract: The mechanisms by which Cryptosporidium parvum cause persistent diarrhea and increased morbidity and mortality are poorly understood. Three groups of Haitian children <18 months old were studied: case patients, children with diarrhea not due to Cryptosporidium, and healthy control subjects. Compared with both control groups, children with acute cryptosporidiosis were more malnourished (including measures of stunting [P=.03] and general malnutrition [P=.01]), vitamin A deficient (P=.04), and less often breast-fed (P=.04). Markers of a proinflammatory immune response, interleukin (IL)-8 and tumor necrosis factor-alpha receptor I, were significantly elevated in the case population (P=.02 and P<.01, respectively), as was fecal lactoferrin (P=.01) and the T helper (Th)-2 cytokine IL-13 (P=.03). The counterregulatory cytokine IL-10 was exclusively elevated in the case population (P<.01). A Th1 cytokine response to infection was not detected. This triple cohort study demonstrates that malnourished children with acute cryptosporidiosis mount inflammatory, Th-2, and counterregulatory intestinal immune responses.
authors.affiliation: Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA. beth.kirkpatrick@vtmednet.org
authors.forename: Beth D
authors.initials: BD
authors.lastname: Kirkpatrick
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Daniels
authors.forename: Simone Sonia
authors.initials: SS
authors.lastname: Jean
authors.forename: Jean W
authors.initials: JW
authors.lastname: Pape
authors.forename: Christopher
authors.initials: C
authors.lastname: Karp
authors.forename: Benjamin
authors.initials: B
authors.lastname: Littenberg
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Fitzgerald
authors.forename: Howard M
authors.initials: HM
authors.lastname: Lederman
authors.forename: James P
authors.initials: JP
authors.lastname: Nataro
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Sears
mesh_terms: D000818:Animals; D001942:Breast Feeding; D015331:Cohort Studies; D003457:Cryptosporidiosis / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D016785:Cryptosporidium parvum; D003906:Developing Countries; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology / Q000276:immunology; D005243:Feces / Q000737:chemistry; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D007223:Infant; D016753:Interleukin-10 / Q000032:analysis; D018793:Interleukin-13 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D007422:Intestines / Q000276:immunology; D007781:Lactoferrin / Q000032:analysis; D009748:Nutrition Disorders / Q000150:complications* / Q000382:microbiology; D011446:Prospective Studies; D011506:Proteins / Q000032:analysis; D047990:TNF Receptor-Associated Factor 1; D014505:Urban Population; D014802:Vitamin A Deficiency / Q000150:complications
chemical_list: D018793:Interleukin-13; D016209:Interleukin-8; D011506:Proteins; D047990:TNF Receptor-Associated Factor 1; D016753:Interleukin-10; D007781:Lactoferrin