Immune responses in children infected with the pinwormEnterobius vermicularisin central Greece

Abstract

Previous studies have suggested an immunomodulatory and even protective role for Enterobius vermicularis, the least pathogenic human intestinal helminth. Here, in a study using haematological and serological parameters, we tested a total of 215 children from central Greece, with a mean age of 8.39, of whom 105 (48.84%) were infected with E. vermicularis and 110 (51.16%) were matched healthy controls. In particular, we analysed eosinophil counts (EO), serum eosinophil cationic protein (ECP), total and specific serum immunoglobulin E (IgE) and the ECP/EO ratio. The atopic status and the potential occurrence of clinically expressed allergic diseases were both taken into account. Eosinophils, ECP and IgE were found to be higher in infected than in uninfected children, indicating a type-2 immune response activation during infection. Atopic infected children exhibited higher IgE levels compared to non-atopic ones. EO and ECP were found to be lower in atopic children who had a history of allergic disease than in those with no such history. The type-2 oriented immune response elicited against E. vermicularis could contribute to a balanced activation of the immune system in the examined children. Interestingly, although the atopic children showed a stronger activation, they did not exhibit any symptoms and, moreover, there seemed to be some indication of immunosuppression in those children with a positive history of allergic disease.

Eosinophils and Parasitic Infections

“…Although it is claimed that E. vermicularis is an almost harmless intestinal helminth and could play a role in educating the immune system, it can sometimes cause eosinophilia. 30 The relationship between trichostrongyliasis and different intensities of eosinophilia has been proven. 27,31 In the same vein, 3 out of 4 (75%) patients with trichostrongyliasis, in our study, had elevated eosinophilia.…”

Enterobiasis epidemiology and molecular characterization of Enterobius vermicularis in healthy children in north-eastern Poland

“…Although the parasitological study in children populations indicated that the prevalence has declined during the last decades, enterobiasis still remain common. Depending on the country the E. vermicularis infections rate ranges from 7.3 % (Greece) to 28 % (Sweden) in examined children populations (Patsantara et al, 2015, Değerli et al, 2009, Kang et al, 2006, Bøås et al, 2012, Herrström et al, 2001, Crotti & D'Annibale, 2006Remm, 2006). In Poland, nationwide parasitological studies (periodically repeated from 1988 to 2003) confi rmed the decreasing trend in the prevalence of E. vermicularis among 7-year-old children (from 21 % to 12.2 %) (Bitkowska et al, 2004).…”

Acidic mammalian chitinase tuning after enteric helminths eradication in inflammatory respiratory disease patients

“…Among the studied cohort, total IgE was high in the helminth‐infected patients only. According to many previous researches on geohelminth, Enterobius vermicularis , hookworms, Trichuris trichiura and Ascaris lumbricoides are powerful IgE inducers . They initiate a Th2‐skewed inflammatory response and B cells switch to IgE class production.…”

“…Another proof, for the possibility of allergic induction by some nematodes, is the termination of some clinical trials on the helominthic therapy in Brazil lately due to the development of generalized urticaria in the vaccinated volunteers despite the documented success of previous trials. The volunteers were from a hookworms’ endemic area and had a history of previous exposure to infections as proved by the prevaccination positivity to specific IgE . However, repeated exposure to the same antigens stimulates the regulatory T and B cells, alternatively activated macrophages, and IL‐10 and TGF‐ß production to counteract the allergic manifestation induced by the high IgE level in the circulation.…”

“…The volunteers were from a hookworms' endemic area and had a history of previous exposure to infections as proved by the prevaccination positivity to specific IgE. 52,59 However, repeated exposure to the same antigens stimulates the regulatory T and B cells, alternatively activated macrophages, and IL-10 and TGF-ß production to counteract the allergic manifestation induced by the high IgE level in the circulation.…”