Cryptosporidiosis stimulates an inflammatory intestinal response in malnourished Haitian children.
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.
Kirkpatrick
Beth D
BD
Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA. beth.kirkpatrick@vtmednet.org
Daniels
Michelle M
MM
Jean
Simone Sonia
SS
Pape
Jean W
JW
Karp
Christopher
C
Littenberg
Benjamin
B
Fitzgerald
Daniel W
DW
Lederman
Howard M
HM
Nataro
James P
JP
Sears
Cynthia L
CL
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
D018793:Interleukin-13; D016209:Interleukin-8; D011506:Proteins; D047990:TNF Receptor-Associated Factor 1; D016753:Interleukin-10; D007781:Lactoferrin