Immunological Profile in Individuals with Schistosomal Myeloradiculopathy.
BACKGROUND
Schistosomal myeloradiculopathy (SMR) is the most serious ectopic presentation of Schistosoma mansoni infection. The pathogenesis occurs mainly via the host inflammatory response to the eggs of the parasite that are stuck in the central nervous system, and the diagnosis is generally made by the exclusion of other neurological diseases.


OBJECTIVE
We aimed to evaluate the immune status of SMR patients and to identify a marker for SMR diagnosis.


METHODS
We enrolled 15 patients with a presumptive diagnosis of SMR, and the control groups included 17 patients with myelopathy associated with human T cell lymphotropic virus type 1 (HTLV-1) and 11 with other neurological disorders. The determination of soluble egg antigen-specific IgE and the levels of cytokines from Th1, Th2, Th17 and T-regulatory cell profiles and the chemokines MIP-1a and RANTES were measured in the cerebrospinal fluid (CSF) and serum using an ELISA technique.


RESULTS
We observed that SMR leads to an increase in IgE levels in the CSF compared to serum, and the levels of IL-13 and MIP-1α were significantly higher in the CSF and serum of the SMR patients than in the patients with HTLV-1-associated myelopathy. The levels of MIP-1α and RANTES were higher in the CSF than in the serum of the SMR group. The ratio between levels of IL-13, MIP-1α and RANTES over IL-10 was positive in the CSF of the SMR patients.


CONCLUSIONS
These results indicate that S. mansoni-specific IgE in the CSF is a promising marker for the diagnosis of SMR and that the cytokines and chemokines associated with the Th2 profile may be important factors in the immunopathogenesis of SMR.
Serviço de Imunologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.
Ramon de Almeida
RA
Kruschewsky
Luciana Santos
LS
Cardoso
Jamille Souza
JS
Fernandes
Robson da Paixão de
RD
Souza
Diego Mota
DM
Lopes
Otavio Augusto Moreno de
OA
Carvalho
Maria Ilma
MI
Araujo
D054405:Chemokine CCL3; D016207:Cytokines; D015368:Human T-lymphotropic virus 1; D006801:Humans; D016753:Interleukin-10; D020818:Neuroschistosomiasis
D054405:Chemokine CCL3; D016207:Cytokines; D016753:Interleukin-10