ABSTRACT
It is difficult to completely eradicate strongyloidiasis, a human intestinal nematode infection with Strongyloides stercoralis with drugs, especially in males. To find host factors involved in the response to treatment, patients infected with S. stercoralis were examined for S. stercoralis-specific antibody titers and the effect of treatment with albendazole on these titers were determined. The cure rate was slightly but not significantly lower in males than in females (P = 0.108). However, a significantly higher titer of S. stercoralis-specific IgG4 antibody was observed in males than in females (P = 0.0097), and the S. stercoralis-specific IgG4 antibody titer was significantly higher in the male non-cured group than in the cured group (P = 0.035). These results suggest that elevation of the S. stercoralis-specific IgG4 antibody titer is associated with resistance to treatment of S. stercoralis infection, especially in males.
Subject(s)
Anthelmintics/administration & dosage , Drug Resistance/immunology , Immunoglobulin G/biosynthesis , Strongyloides stercoralis/drug effects , Strongyloidiasis/immunology , Animals , Anthelmintics/pharmacology , Anthelmintics/therapeutic use , Antibodies, Helminth/biosynthesis , Antibodies, Helminth/blood , Female , Humans , Male , Sex Factors , Strongyloides stercoralis/immunology , Strongyloidiasis/drug therapy , Strongyloidiasis/parasitologyABSTRACT
The intermediate state of HTLV-1 infection, often found in individuals dually infected with Strongyloides stercoralis (S. stercoralis) and HTLV-1, is assumed to be a preleukemic state of adult T-cell leukemia (ATL). To investigate the effects of S. stercoralis superinfection on the natural history of HTLV-1 infection, we characterized peripheral blood samples of these individuals in Okinawa, Japan, an endemic area for both HTLV-1 and S. stercoralis and we studied effects of the parasite antigen on T-cells. The dually infected individuals showed a significantly higher provirus load and an increase in CD4(+)25(+) T cell population, with a significant, positive correlation. This increase was attributable to polyclonal expansion of HTLV-1-infected cells, as demonstrated by inverse-long PCR analysis of the integration sites. S. stercoralis antigen activated the IL-2 promoter in reporter gene assays, induced production of IL-2 by PBMC in vitro, and supported growth of IL-2 dependent cell lines immortalized by HTLV-1 infection or the transduction of Tax. Taken collectively, these results indicate that S. stercoralis infection induces polyclonal expansion of HTLV-1-infected cells by activating the IL-2/IL-2R system in dually infected carriers, an event which may be a precipitating factor for ATL and inflammatory diseases.
Subject(s)
CD4-Positive T-Lymphocytes/immunology , Human T-lymphotropic virus 1/isolation & purification , Interleukin-2/physiology , Strongyloides stercoralis/immunology , Strongyloidiasis/immunology , Animals , Antigens, Helminth/immunology , CD4-Positive T-Lymphocytes/virology , Carrier State , Cell Line , Cells, Cultured , Clone Cells , Female , HTLV-I Infections/immunology , HTLV-I Infections/virology , Humans , Immunophenotyping , Lymphocyte Activation , Male , Middle Aged , Proviruses/isolation & purification , Receptors, Interleukin-2/analysis , Receptors, Interleukin-2/physiology , T-Lymphocyte Subsets/classification , Viral LoadABSTRACT
O diagnostico parasitologico baseado no exame de fezes e muitas vezes dificil, principalmente nos casos de infeccoes cronicas ou leves pelo S. stercoralis. Mesmo utilizando o mais novo e sensivel metodo (cultura em placas de agar) e essencial examinar repetidamente as amostras fecais, para um diagnostico correto. E importante ressaltar tambem que o resultado negativo nao indica de modo inequivoco a ausencia da infeccao. Por outro lado, varios sorologicos recentementes desenvolvidos para estrongiloidiase tem provado a sua eficacia quando usados para complementar exames parasitologicos. Para demonstrar infeccao por Strongyloides desenvolvemos dois tipos de testes sorologicos - ELISA e GPAT - e, com base em nossos recentes estudos, apresentamos uma opiniao sobre sua possivel aplicacao para screening em massa, estudos epidemiologicos e avaliacao pos-tratamento de estrongiloidiases.
