Intestinal parasites infection: protective effect in rheumatoid arthritis? / Parasitoses intestinais: efeito protetor na artrite reumatoide?

Abstract Rheumatoid arthritis (RA) is a systemic autoimmune inflammatory disease, with a progressive course, characterized by chronic synovitis that may evolve with deformities and functional disability, and whose early treatment minimizes joint damage. Its etiopathogenesis is not fully elucidated but comprises immunologic responses mediated by T helper cells (Th1). An apparent minor severity of RA in patients from regions with lower income could be associated with a higher prevalence of gut parasites, especially helminths. Strictly, a shift in the immune response toward the predominance of T helper cells (Th2), due to the chronic exposure to helminths, could modulate negatively the inflammation in RA patients, resulting in lower severity/joint injury. The interaction between the immunological responses of parasitic helminths in rheumatoid arthritis patients is the purpose of this paper.

Resumo A artrite reumatoide (AR) é uma doença inflamatória autoimune, sistêmica, de curso progressivo, caracterizada por exuberante sinovite crônica, que pode gerar deformidades e incapacidade funcional, cujo tratamento precoce minimiza o dano às juntas. Sua etiopatogenia ainda não está completamente elucidada, mas compreende respostas imunológicas com a participação de células T auxiliares (Th1). Uma aparente menor gravidade da AR em pacientes de regiões com menor renda poderia estar associada a maior prevalência de parasitoses intestinais, especialmente as helmintíases. A rigor, um desvio na resposta imune para o predomínio de células T auxiliares (Th2), decorrente da exposição crônica a helmintos, modularia negativamente a inflamação em doentes com AR, e levaria a menor gravidade e dano articular. A revisão de aspectos da influência da reposta imunológica nas parasitoses intestinais, especialmente as helmintíases, em pacientes com artrite reumatoide é o objetivo desse trabalho.

Human muscle sarcocystosis in relation to non specific rheumatic diseases and rheumatoid arthritis

Human muscle sarcocystosis is a parasitic infestation acquired by ingestion of the sporocysts of the sarcocystis species. Sarcocystis antibodies were said to be encountered in patients with connective or mixed connective tissue disorders. Parasitological etiology of musculoskeletal disorders may help to modify the line of treatment of these patients. This study was performed on 22 non specific rheumatic patients, 21 rheumatoid arthritic [RA] patients and 10 apparently healthy persons as controls. Using the sarcocystis fusiformis antigen [Ag.], serum samples of the patients were tested for the presence of sarcocystis species antibodies using the Westren Blot technique. Of the 22 patients of the first group, 14 were positive [63.7%], of the 21 patients of the second group 5 were positive [23.8%]. They deducted several band ranges from 15-116 KD. Most of these samples had eosinophilia ranging from 7-20%. None of the control group serum reacted against sarcocystis Ag. Statistically the difference between the two groups was significant [P <0.04]. Sarcocystis infection may be an important cause of the non specific rheumatic diseases associated with myositis. Diagnosis and treatment of such a frequent infestation in carefully chosen cases would relieve them from prolonged intake of antirheumatics and their side effects

Study of gamma-interferon in schhistosomiasis mansoni, autoimmune diseases and schistosomal arthhropathy

IFN-gamma, aTh1 cytokine, was quantitatively estimated using EASIA in the sera of patients with different stages of Schistosomiasis mansoni autoimmune diseases and schistosomal arthropathy. Level of IFN-gamma was significantly elevated in all the test groups compared to the control group. The highest level of IFN-gamma observed was in RA and SLE with insignificant statistical difference between them. Cases with early S. mansoni infection showed significant higher level of IFN-gamma compared to hepatosplenic schistosomiasis with and without ascites. A significant statistical difference concerning IFN-gamma level was observed when comparing RA and SLE to different stages of S. mansoni infection and schistosomal arthropathy. This study concluded that IFN-gamma estimation in sera of patients having joint complaint could be a good marker for differentiation between autoimmune collagen induced arthritis and schistosomiasis induced arthropathy