title: Schistosome infection intensity is inversely related to auto-reactive antibody levels.
abstract: In animal experimental models, parasitic helminth infections can protect the host from auto-immune diseases. We conducted a population-scale human study investigating the relationship between helminth parasitism and auto-reactive antibodies and the subsequent effect of anti-helminthic treatment on this relationship. Levels of antinuclear antibodies (ANA) and plasma IL-10 were measured by enzyme linked immunosorbent assay in 613 Zimbabweans (aged 2-86 years) naturally exposed to the blood fluke Schistosoma haematobium. ANA levels were related to schistosome infection intensity and systemic IL-10 levels. All participants were offered treatment with the anti-helminthic drug praziquantel and 102 treated schoolchildren (5-16 years) were followed up 6 months post-antihelminthic treatment. ANA levels were inversely associated with current infection intensity but were independent of host age, sex and HIV status. Furthermore, after allowing for the confounding effects of schistosome infection intensity, ANA levels were inversely associated with systemic levels of IL-10. ANA levels increased significantly 6 months after anti-helminthic treatment. Our study shows that ANA levels are attenuated in helminth-infected humans and that anti-helminthic treatment of helminth-infected people can significantly increase ANA levels. The implications of these findings are relevant for understanding both the aetiology of immune disorders mediated by auto-reactive antibodies and in predicting the long-term consequences of large-scale schistosomiasis control programs.
authors.affiliation: Ashworth Laboratories, School of Biological Sciences, Institute for Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom. f.mutapi@ed.ac.uk
authors.forename: Francisca
authors.initials: F
authors.lastname: Mutapi
authors.forename: Natsuko
authors.initials: N
authors.lastname: Imai
authors.forename: Norman
authors.initials: N
authors.lastname: Nausch
authors.forename: Claire D
authors.initials: CD
authors.lastname: Bourke
authors.forename: Nadine
authors.initials: N
authors.lastname: Rujeni
authors.forename: Kate M
authors.initials: KM
authors.lastname: Mitchell
authors.forename: Nicholas
authors.initials: N
authors.lastname: Midzi
authors.forename: Mark E J
authors.initials: ME
authors.lastname: Woolhouse
authors.forename: Rick M
authors.initials: RM
authors.lastname: Maizels
authors.forename: Takafira
authors.initials: T
authors.lastname: Mduluza
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D000974:Antibodies, Antinuclear / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011223:Praziquantel / Q000627:therapeutic use; D012548:Schistosoma haematobium / Q000276:immunology / Q000472:pathogenicity*; D012553:Schistosomiasis haematobia / Q000097:blood* / Q000188:drug therapy / Q000469:parasitology; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D000974:Antibodies, Antinuclear; D016753:Interleukin-10; D011223:Praziquantel