Effect of Chemotherapy with Praziquantel on the Production of Cytokines and Morbidity Associated with Schistosomiasis Mansoni

Abstract

The objective of the present study was to test the hypothesis that treatment of schistosomiasis mansoni with praziquantel can alter significantly the immune response of patients and generate a reversal of the level of fibrosis. Peripheral blood mononuclear cell (PBMC) samples were collected from, and abdominal ultrasound examinations conducted on, volunteers infected with Schistosoma mansoni and living in an area where the disease is endemic, both prior to and one year after treatment with praziquantel. Subjects were classified into groups according to the level of pathology (i.e., absent, incipient, moderate, or severe fibrosis). PBMCs were stimulated with schistosome soluble egg antigens (SEA), and the levels of production of the cytokines gamma interferon (IFN-␥), tumor necrosis factor alpha, transforming growth factor ␤, and interleukin-4 (IL-4), IL-10, and IL-13 were determined. The chemotherapy was effective in reducing morbidity, particularly for individuals presenting with severe fibrosis. When levels of cytokine production in posttreatment PBMC cultures stimulated by SEA were categorized as low or high, significant differences in the distribution of IL-13 levels between groups presenting with or not presenting with fibrosis were established. Comparison of pre-and posttreatment SEA-induced cytokine levels in individuals who had experienced no change in the grade of fibrosis following chemotherapy revealed that the level of IFN-␥ decreased in subjects with fibrosis whereas that of IL-10 decreased in individuals with and without fibrosis. The data suggest that chemotherapy is effective in reducing the morbidity of the disease and that the level of IL-13 may be a useful indicator of the persistence of fibrosis following treatment.

Efficacy and Safety of Arachidonic Acid for Treatment of Schistosoma mansoni-Infected Children in Menoufiya, Egypt

“…30 Therapy of S. mansoni-infected children with PZQ decreased the levels of circulating IL-10 and IFN-γ and the amounts of IFN-γ released in whole-blood cultures stimulated in vitro with rSG3PDH, giving support to the hypothesis that treatment of schistosomiasis mansoni with PZQ can significantly alter the immune response of patients. 49 Treatment with ARA alone or combined with PZQ was more effective than PZQ in altering the immune responses of children toward reducing production of IL-10 and IFN-γ as early as 3 days after the end of treatment, consistent with the observational studies showing that higher ARA consumption was associated with lower levels of inflammatory markers. 50 More importantly, ARA-associated significant decreases of the levels of the immunosuppressive IL-10 and the Th1 cytokine IFN-γ may enhance development and polarization of Th2-related immune responses to parasite antigens, which could lead to a prognosis of resistance to reinfection with schistosomes.…”

Praziquantel Facilitates IFN-γ-Producing CD8+ T Cells (Tc1) and IL-17-Producing CD8+ T Cells (Tc17) Responses to DNA Vaccination in Mice

“…PZQ was previously shown in schistosomiasis patients to significantly alter immune responses [25], [26], [36]. However, it was not explored as an immune adjuvant until its recent demonstration as an augmenting effect on cellular responses to DNA vaccination [27].…”

Can Early Diagnosis of Varices, Regular Praziquantel, and Reduction of Hepatitis Coinfection Reduce Mortality among Patients Attended for Periportal Fibrosis in Northwestern Tanzania? A Case-Control Study

“…So apart from biannual PZQ, screening and treatment for active S. mansoni infection are advocated on routine bases. Giving PZQ is shown to reverse PPF and potentially reduces mortality [36,37]. Routine screening for hepatitis B coinfection also is suggested by findings in this study.…”