title: Association between Strongyloides stercoralis infection and cortisol secretion in alcoholic patients.
abstract: A higher prevalence of Strongyloides stercoralis infections has been reported in alcoholic patients compared to nonalcoholic patients living in the same area. Excessive alcohol consumption increases the levels of endogenous corticosteroids that subsequently enhance the fecundity of S. stercoralis parthenogenetic females. These corticosteroids also enhance the transformation of rhabditiform larvae into infective filariform larvae by mimicking the effect of the ecdysteroid hormones produced by the parasite, thus leading to autoinfection. In addition, alterations in the intestinal barrier and host immune response contribute to the development of hyperinfection and severe strongyloidiasis in alcoholic patients. The aim of this study was to evaluate the frequency of S. stercoralis infections in alcoholic patients and to determine the association between S. stercoralis infection and endogenous cortisol levels. The frequency of infection was evaluated in 332 alcoholic and 92 nonalcoholic patients. The parasitological diagnosis was carried out by agar plate culture, the modified Baermann-Moraes method and spontaneous sedimentation. The immunological diagnosis was performed using an ELISA with anti-S. stercoralis IgG. The cortisol levels were measured in serum samples by ELISA. The frequency of S. stercoralis infection in alcoholic patients was 23.5% (78/332), while in nonalcoholic patients, it was 5.4% (5/92) (p<0.05). The cortisol levels were higher in alcoholic than in nonalcoholic patients (p<0.05). However, among the alcoholic patients, the cortisol levels did not differ between S. stercoralis-infected and uninfected patients (p>0.05). As demonstrated in this work, 81.3% (26/32) of patients with a high parasite load, considered as more than 11 larvae per gram of feces, presented serum cortisol levels above the normal reference value (24 mg/dL). High endogenous cortisol levels in alcoholic patients were not associated to susceptibility to S. stercoralis infection, however once infected, this may lead to a high parasite load.
authors.affiliation: Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
authors.forename: Mônica L S
authors.initials: ML
authors.lastname: Silva
authors.affiliation: Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
authors.forename: Elizabete de J
authors.initials: Ede J
authors.lastname: Inês
authors.affiliation: Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
authors.forename: Alex Bruno da S
authors.initials: AB
authors.lastname: Souza
authors.affiliation: Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
authors.forename: Victória Maria dos S
authors.initials: VM
authors.lastname: Dias
authors.affiliation: Obras Sociais Irmã Dulce, Salvador, Bahia, Brazil.
authors.forename: Cléa M
authors.initials: CM
authors.lastname: Guimarães
authors.affiliation: Obras Sociais Irmã Dulce, Salvador, Bahia, Brazil.
authors.forename: Edimacia R
authors.initials: ER
authors.lastname: Menezes
authors.affiliation: Obras Sociais Irmã Dulce, Salvador, Bahia, Brazil.
authors.forename: Larissa G
authors.initials: LG
authors.lastname: Barbosa
authors.affiliation: Obras Sociais Irmã Dulce, Salvador, Bahia, Brazil.
authors.forename: Maria Del Carmen M
authors.initials: Mdel C
authors.lastname: Alves
authors.affiliation: Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
authors.forename: Márcia Cristina A
authors.initials: MC
authors.lastname: Teixeira
authors.affiliation: Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia, Brazil. Electronic address: necisoares@gmail.com.
authors.forename: Neci M
authors.initials: NM
authors.lastname: Soares
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000097:blood / Q000453:epidemiology*; D000562:Amebiasis / Q000453:epidemiology*; D000818:Animals; D000909:Antibodies, Helminth / Q000276:immunology; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D060085:Coinfection / Q000453:epidemiology*; D015897:Comorbidity; D004709:Endolimax; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000469:parasitology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism*; D007814:Larva; D008297:Male; D008875:Middle Aged; D059208:Parasite Load; D015995:Prevalence; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000097:blood / Q000453:epidemiology* / Q000276:immunology
chemical_list: D000909:Antibodies, Helminth; D006854:Hydrocortisone
keywords: Alcoholism; Cortisol; Diagnosis; Strongyloides stercoralis