The effect of polyparasite infections on cytokine and chemokine responses as well as the effect of antiparasite treatment was studied in children without parasite infection (the G0 group), in children singly infected with Schistosoma haematobium (the G1 group), and in children multiply infected with S. haematobium/Schistosoma mansoni, Entamoeba histolytica/Entamoeba dispar, and Necator americanus (the G3+ group). Linear regression analysis disclosed a significant risk for coinfection with hookworm and Schistosoma species. Polyparasite infections detected in 23% of children before treatment were present in 5% at 15 months after treatment. Chemokine responses to S. mansoni adult worm antigen (SmAg) diminished after treatment for macrophage inflammatory chemokine (MIP)-1alpha/chemokine (C-C motif) ligand (CCL)-3 (among G3+ children, by a factor of 200 [95% confidence interval {CI}, 33-1111]) and for MIP-1beta/CCL-4 (among G3+ children, by a factor of 26 [95% CI, 6-117]) but were enhanced for thymus- and activation-regulated chemokine/CCL-17 (among G3+ children, by a factor of 10 [95% CI, 3-32]) (P < .001 for all). In response to E. histolytica antigen, interleukin (IL)-13 levels increased after treatment among G1 children by a factor of 138 (95% CI, 12-1569) and among G3+ children by a factor of 21 (95% CI, 7-64) (P < .001 for both). Cellular production of interferon (IFN)-gamma in response to SmAg decreased 4 weeks after treatment among G3+ children, whereas T helper cell type 2 (Th2) IL-13 production was enhanced among G1 and G3+ children. In summary, polyparasite infections with S. haematobium/S. mansoni, E. histolytica/E. dispar, and N. americanus generated prominent proinflammatory cytokine and chemokine responses, and, after antihelminth treatment, the inflammatory chemokine response lessened as the Th2 responsiveness in coinfected children increased.

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The cytostatic drugs Vincristine (VCR), Navelbine (NAV), and Methotrexate (MTX) were evaluated for their growth inhibitory potential against metacestodes of Echinococcus multilocularis (Em) by in vitro and in vivo assays. In vitro cultures of E. multilocularis were exposed to IC 90, IC 80, and IC 5 concentrations of VCR, NAV, or MTX for 1 week, then parasite tissue cultures were kept for 1 week without drug exposure in vitro, and thereafter, metacestode tissues were injected intra-peritoneally into Meriones unguiculatus. Metacestode growth was monitored for several months post-infection (p.i.) by body weight control, magnetic resonance imaging (MRI), and autopsy at 5 months p.i. Weight monitoring of infected M. unguiculatus did not provide conclusive evidence for Em-metacestode growth, while MRI could detect growing Em-metacestode in the MTX-treated group at 8 weeks (p.i.), whereas metacestodes exposed to VCR and NAV were at 17 weeks (p.i.) detectable. MRI disclosed progressive and massive growth of Em-metacestode in the VCR- and MTX-exposed groups, while the NAV-pretreated Em-metacestodes' volume did not exceed 4 cm(3). At autopsy, Em-metacestodes of less than 4 cm(3) were found in infected M. unguiculatus, which was not detected by MRI. In summary, the cytostatic drugs Methotrexate, Navelbine, and Vincristine--as applied in the present work--did not show parasitocidal or clear parasitostatic effects on metacestodes of E. multilocularis. While parasite growth in vivo was inhibited in NAV- and VCR-pretreated Em-metacestodes, MTX pretreatment seemed to enhance parasite proliferation. Magnetic resonance imaging appears suitable to monitor in vivo the effects of drugs on growth progression and regression only of larger Em-metacestode tissues.

Cytokine and chemokine response profiles were studied in newborns, 10-yr-old children and post partum mothers. All study groups were repeatedly exposed to Entamoeba histolytica, Onchocerca volvulus and Plasmodium falciparum infections as indicated by their Immunoglobulin (IgG) responses to parasite-specific antigens. As key indicators for regulatory and pro-inflammatory cytokine and chemokine responses, Interferon (IFN)gamma and regulatory IL-10 were investigated, along with the chemokines MIP-1 alpha/CCL3, MIP-1 beta/CCL4, MDC/CCL22 and TARC/CCL17. Entamoeba histolytica antigens (EhAg) strongly activated pro-inflammatory MIP-1 alpha/CCL3 and MIP-1 beta/CCL4 responses of similar magnitude in mothers, children and neonates alike. Plasmodium falciparum antigens (PfAg) enhanced MIP-1 alpha/CCL3, MIP-1 beta/CCL4 and MDC/CCL22 production in neonates, but did not trigger these chemokines in mothers or 10-yr-old children. Onchocerca volvulus antigens (OvAg) activated IFN-gamma and TARC/CCL17 production in mothers but not in neonates and children. Crude IL-10 production [i.e., without subtracting spontaneous cellular release (baseline)] was highest in mothers and somewhat lower in neonates, while the lowest IL-10 amounts of all were released by peripheral blood mononuclear cells from 10-yr-old children. In summary, strong inflammatory chemokine responses to plasmodia and ameba antigens in newborns and 10-yr-old children suggest that adequately balanced immune regulatory mechanisms may not have developed yet in these age groups and that repeated exposure to parasite infections and immune maturation during childhood is required to generate similar cytokine and chemokine profiles as in adults.

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