Factors Associated with Resistance to Schistosoma mansoni Infection in an Endemic Area of Bahia, Brazil

Oliveira, Ricardo Riccio; Figueiredo, Joanemile P.; Cardoso, Luciana Santos; Jabar, Rafael L.; Souza, Robson P.; Wells, Martin T.; Carvalho, Edgar M.; Fitzgerald, Daniel W.; Barnes, Kathleen C.; Araújo, Maria Ilma; Glesby, Marshall J.

doi:10.4269/ajtmh.2012.11-0204

Cited by 25 publications

(36 citation statements)

References 57 publications

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“…An interesting finding was a negative standardized mean difference observed in the association between IgE levels and reinfection with schistosomes (Figure 5 and Figure S2) inferred from meta-analysis on 8 studies [23], [31], [39], [44], [48]–[51]. However, subgroup analyses of these associations with IgE levels against adult worm antigen (SWA) (Figure 5A) and egg antigen (SEA) (Figure 5B) were not statistically significant (For anti-SWA IgE, SMD = −0.06, 95% CI = −0.59–0.46, Z = 0.23, p = 0.82; for anti-SEA IgE, SMD = −0.03, 95% CI = −0.38–0.32, Z = 0.15, p = 0.88).…”

Section: Resultsmentioning

confidence: 93%

Host Determinants of Reinfection with Schistosomes in Humans: A Systematic Review and Meta-analysis

et al. 2014

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BackgroundSchistosomiasis is still a major public health burden in the tropics and subtropics. Although there is an effective chemotherapy (Praziquantel) for this disease, reinfection occurs rapidly after mass drug administration (MDA). Because the entire population do not get reinfected at the same rate, it is possible that host factors may play a dominant role in determining resistance or susceptibility to reinfection with schistosomes. Here, we systematically reviewed and meta-analyzed studies that reported associations between reinfection with the principal human-infecting species (S. mansoni, S. japonicum and S. haematobium) and host socio-demographic, epidemiological, immunological and genetic factors.Methodology/Principal FindingsPubMed, Scopus, Google Scholar, Cochrane Review Library and African Journals Online public databases were searched in October 2013 to retrieve studies assessing association of host factors with reinfection with schistosomes. Meta-analysis was performed to generate pooled odds ratios and standardized mean differences as overall effect estimates for dichotomous and continuous variables, respectively. Quality assessment of included studies, heterogeneity between studies and publication bias were also assessed. Out of the initial 2739 records, 109 studies were included in the analyses, of which only 32 studies with 37 data sets were eligible for quantitative data synthesis. Among several host factors identified, strong positive association was found with age and pre-treatment intensity, and only slightly for gender. These factors are major determinants of exposure and disease transmission. Significant positive association was found with anti-SWA IgG4 level, and a negative overall effect for association with IgE levels. This reconfirmed the concept that IgE/IgG4 balance is a major determinant of protective immunity against schistosomiasis. Other identified determinants were reported by a small number of studies to enable interpretation.ConclusionsOur data contribute to the understanding of host-parasite interaction as it affects reinfection, and is a potential tool to guide planning and tailoring of community interventions to target high-risk groups.

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Section: Resultsmentioning

confidence: 93%

Host Determinants of Reinfection with Schistosomes in Humans: A Systematic Review and Meta-analysis

et al. 2014

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“…Mechanistically, both high-and low-affinity IgE receptors on eosinophils and B cells (or in soluble form), respectively, are associated with protection against reinfection (70,116,117). In contrast, susceptibility to reinfection has been associated with IgG4, which may serve as a blocking antibody, inhibiting the action of IgE (111)(112)(113)(114)(115)118). Interestingly, the propensity of children and adults to produce IgG4 and IgE, respectively, matches their relative susceptibility to reinfection (119).…”

Section: Immunology Of Resistance To Reinfection In Humansmentioning

confidence: 99%

Immunology of human schistosomiasis

Colley

Secor

2014

Parasite Immunology

212

227

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There is a wealth of immunologic studies that have been carried out in experimental and human schistosomiasis that can be classified into three main areas: immunopathogenesis, resistance to reinfection and diagnostics. It is clear that the bulk of, if not all, morbidity due to human schistosomiasis results from immune-response-based inflammation against eggs lodged in the body, either as regulated chronic inflammation or resulting in fibrotic lesions. However, the exact nature of these responses, the antigens to which they are mounted and the mechanisms of the critical regulatory responses are still being sorted out. It is also becoming apparent that protective immunity against schistosomula as they develop into adult worms develops slowly and is hastened by the dying of adult worms, either naturally or when they are killed by praziquantel. However, as with anti-egg responses, the responsible immune mechanisms and inducing antigens are not clearly established, nor are any potential regulatory responses known. Finally, a wide variety of immune markers, both cellular and humoral, can be used to demonstrate exposure to schistosomes, and immunologic measurement of schistosome antigens can be used to detect, and thus diagnose, active infections. All three areas contribute to the public health response to human schistosome infections.

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“…The analysis revealed a significant proportion of studies showing an increase rather than decrease in anti‐WWA IgG4 (86% of observations reported increase) after treatment. Longitudinal and cross‐sectional population studies have demonstrated the association of both anti‐SEA IgG4 and anti‐WWA IgG4 with human susceptibility to re‐infection after treatment in schistosomiasis endemic areas . In particular, IgG4 has been suggested as a possible blocking antibody that inhibits the action of protective IgE in both S haematobium and S mansoni infections .…”

Section: Discussionmentioning

confidence: 99%

Population level changes in schistosome‐specific antibody levels following chemotherapy

Fukushige

Mutapi

Woolhouse

2018

Parasite Immunology

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Summary Aims Previous studies have reported that chemotherapy of schistosomiasis by praziquantel in humans boosts protective antibody responses against S mansoni and S haematobium. A number of studies have reported schistosome‐specific antibody levels before and after chemotherapy. Using these reports, a meta‐analysis was conducted to identify predictors of population level change in schistosome‐specific antibody levels after chemotherapy. Methods and results Following a systematic review, 92 observations from 26 articles published between 1988 and 2013 were included in this study. Observations were grouped by antigen type and antibody isotypes for the classification and regression tree (CART) analysis. The study showed that the change in antibody levels was variable: (a) between different human populations and (b) according to the parasite antigen and antibody isotypes. Thus, while anti‐worm responses predominantly increased after chemotherapy, anti‐egg responses decreased or did not show a significant trend. The change in antibody levels depended on a combination of age and infection intensity for anti‐egg IgA, IgM, IgG1, IgG2 and anti‐worm IgM and IgG. Conclusion The study results are consistent with praziquantel treatment boosting anti‐worm antibody responses. However, there is considerable heterogeneity in post‐treatment changes in specific antibody levels that is related to host age and pre‐treatment infection intensity.

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Factors Associated with Resistance to Schistosoma mansoni Infection in an Endemic Area of Bahia, Brazil

Cited by 25 publications

References 57 publications

Host Determinants of Reinfection with Schistosomes in Humans: A Systematic Review and Meta-analysis

Host Determinants of Reinfection with Schistosomes in Humans: A Systematic Review and Meta-analysis

Immunology of human schistosomiasis

Population level changes in schistosome‐specific antibody levels following chemotherapy

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