title: Strongyloides stercoralisInfection in Alcoholic Patients.
abstract: The course ofStrongyloides stercoralisinfection is usually asymptomatic with a low discharge of rhabditoid larva in feces. However, the deleterious effects of alcohol consumption seem to enhance the susceptibility to infection, as shown by a fivefold higher strongyloidiasis frequency in alcoholics than in nonalcoholics. Moreover, the association betweenS. stercoralisinfection and alcoholism presents a risk for hyperinfection and severe strongyloidiasis. There are several possible mechanisms for the disruption of the host-parasite equilibrium in ethanol-addicted patients with chronic strongyloidiasis. One explanation is that chronic ethanol intake stimulates the hypothalamic-pituitary-adrenal (HPA) axis to produce excessive levels of endogenous cortisol, which in turn can lead to a deficiency in type 2 T helper cells (Th2) protective response, and also to mimic the parasite hormone ecdysone, which promotes the transformation of rhabditiform larvae to filariform larvae, leading to autoinfection. Therefore, when untreated, alcoholic patients are continuously infected by this autoinfection mechanism. Thus, the early diagnosis of strongyloidiasis and treatment can prevent serious forms of hyperinfection in ethanol abusers.
authors.affiliation: Faculdade de Farmácia, Universidade Federal da Bahia, 40170115 Salvador, BA, Brazil.
authors.forename: Marcia C A
authors.identifier: 0000-0003-0477-5092
authors.initials: MC
authors.lastname: Teixeira
authors.affiliation: Faculdade de Farmácia, Universidade Federal da Bahia, 40170115 Salvador, BA, Brazil.
authors.forename: Flavia T F
authors.initials: FT
authors.lastname: Pacheco
authors.affiliation: Faculdade de Farmácia, Universidade Federal da Bahia, 40170115 Salvador, BA, Brazil.
authors.forename: Joelma N
authors.initials: JN
authors.lastname: Souza
authors.affiliation: Faculdade de Farmácia, Universidade Federal da Bahia, 40170115 Salvador, BA, Brazil.
authors.forename: Mônica L S
authors.initials: ML
authors.lastname: Silva
authors.affiliation: Faculdade de Farmácia, Universidade Federal da Bahia, 40170115 Salvador, BA, Brazil.
authors.forename: Elizabete J
authors.initials: EJ
authors.lastname: Inês
authors.affiliation: Faculdade de Farmácia, Universidade Federal da Bahia, 40170115 Salvador, BA, Brazil.
authors.forename: Neci M
authors.initials: NM
authors.lastname: Soares
mesh_terms: D000437:Alcoholism / Q000276:immunology / Q000378:metabolism / Q000469:parasitology / Q000473:pathology; D000818:Animals; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D010913:Pituitary-Adrenal System / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D012307:Risk Factors; D017171:Strongyloides stercoralis / Q000276:immunology / Q000378:metabolism; D013322:Strongyloidiasis / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D018418:Th2 Cells / Q000276:immunology / Q000378:metabolism / Q000473:pathology