Mechanisms involved in the anaemia of schistosomiasis

Woodruff, A. W.

doi:10.1016/0035-9203(72)90055-7

Cited by 25 publications

(9 citation statements)

References 16 publications

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“…The mechanisms underlying S. japonicum associated anemia are likely multi-factorial [77] including, blood loss in the stool as eggs extravasate through the bowel wall, adult worm ingestion of host red blood cells [78], pro-inflammatory cytokine activity mediating anemia of inflammation whereby bio-available forms of iron are shunted to less bio-available storage forms (ferritin) [79],[80],[81], auto-immune hemolysis [82],[83], and sequestration of red blood cells in an enlarged spleen [84],[85]. High intensity trichuris infection affects iron status through blood loss in the stool, particularly if dysentery syndrome is present.…”

Section: Discussionmentioning

confidence: 99%

The Synergistic Effect of Concomitant Schistosomiasis, Hookworm, and Trichuris Infections on Children's Anemia Burden

et al. 2008

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ObjectiveTo estimate the degree of synergism between helminth species in their combined effects on anemia.MethodsQuantitative egg counts using the Kato–Katz method were determined for Ascaris lumbricoides, hookworm, Trichuris trichiura, and Schistosoma japonicum in 507 school-age children from helminth-endemic villages in The Philippines. Infection intensity was defined in three categories: uninfected, low, or moderate/high (M+). Anemia was defined as hemoglobin <11 g/dL. Logistic regression models were used to estimate odds ratios (OR), 95% confidence intervals (CI), and synergy index for pairs of concurrent infections.ResultsM+ co-infection of hookworm and S. japonicum (OR = 13.2, 95% CI: 3.82–45.5) and of hookworm and T. trichiura (OR = 5.34, 95% CI: 1.76–16.2) were associated with higher odds of anemia relative to children without respective M+ co-infections. For co-infections of hookworm and S. japonicum and of T. trichiura and hookworm, the estimated indices of synergy were 2.9 (95% CI: 1.1–4.6) and 1.4 (95% CI: 0.9–2.0), respectively.ConclusionCo-infections of hookworm and either S. japonicum or T. trichiura were associated with higher levels of anemia than would be expected if the effects of these species had only independent effects on anemia. This suggests that integrated anti-helminthic treatment programs with simultaneous deworming for S. japonicum and some geohelminths could yield a greater than additive benefit for reducing anemia in helminth-endemic regions.

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Section: Discussionmentioning

confidence: 99%

The Synergistic Effect of Concomitant Schistosomiasis, Hookworm, and Trichuris Infections on Children's Anemia Burden

et al. 2008

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“…This example illustrates that if anemia may be related to blood consumption or loss, immune defenses are also involved. Other pathogeneses of anemia are reported in humans infected by Schistosoma japonicum or in mice infected by Trypanosoma brucei , both being related to immune-mediated hemolysis (36, 37). …”

Section: Lessons From Empirical and Theoretical Studiesmentioning

confidence: 99%

The impact of multiple infections on wild animal hosts: a review

Bordes

Morand

2011

Infection Ecology & Epidemiology

140

138

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Field parasitological studies consistently demonstrate the reality of polyparasitism in natural systems. However, only recently, studies from ecological and evolutionary fields have emphasised a broad spectrum of potential multiple infections-related impacts. The main goal of our review is to reunify the different approaches on the impacts of polyparasitism, not only from laboratory or human medical studies but also from field or theoretical studies. We put forward that ecological and epidemiological determinants to explain the level of polyparasitism, which regularly affects not only host body condition, survival or reproduction but also host metabolism, genetics or immune investment. Despite inherent limitations of all these studies, multiple infections should be considered more systematically in wildlife to better appreciate the importance of parasite diversity in wildlife, cumulative effects of parasitism on the ecology and evolution of their hosts.

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“…Anemia in the setting of acute/ chronic inflammation is mediated by (i) decreased erythropoietin production and/or responsiveness of erythrocyte precursors in the bone marrow, (ii) a decreased erythrocyte life span, and (iii) shunting of bioavailable iron to storage forms and, possibly, a reduced uptake of dietary iron in the gut (19). In addition to anemia associated with inflammation, schistosomiasis may re-sult in anemia secondary to increased sequestration of erythrocytes and/or increased hemolysis in the spleens of individuals with schistosomiasis-associated splenomegaly (5,14,36).…”

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confidence: 99%

Schistosoma japonicum Reinfection after Praziquantel Treatment Causes Anemia Associated with Inflammation

et al. 2006

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There is a relationship between schistosomiasis and anemia, although the magnitude and exact mechanisms involved are unclear. In a cohort of 580 Schistosoma japonicum-infected 7-to 30-year-old patients from Leyte, The Philippines, we evaluated the impact of reinfection with S. japonicum after treatment with praziquantel on the mean hemoglobin level, iron-deficiency (IDA) and non-iron-deficiency anemia (NIDA), and inflammatory markers. All participants were treated at baseline and followed up every 3 months for a total of 18 months. At each follow-up, participants provided stools to quantify reinfection and venous blood samples for hemograms and measures of iron status and inflammation. After 18 months, reinfection with S. japonicum was associated with a lower mean hemoglobin level (؊0.39 g/dl; 95% confidence interval [95% CI], ؊0.63 to ؊0.16) and 1.70 (95% CI, 1.10 to 2.61) times higher odds of all-cause anemia than those without reinfection. Reinfection was associated with IDA for high reinfection intensities only. Conversely, reinfection was associated with NIDA for all infection intensities. Reinfection was associated with serum interleukin-6 responses (P < 0.01), and these responses were associated with NIDA (P ‫؍‬ 0.019) but not with IDA (P ‫؍‬ 0.29). Our results provide strong evidence for the causal relationship between S. japonicum infection and anemia. Rapidly reinfected individuals did not have the positive treatment effect on hemoglobin seen in nonreinfected individuals. The principle mechanism involved in S. japonicum-associated anemia is that of proinflammatory cytokine-mediated anemia, with iron deficiency playing a role in high-intensity infections. Based on the proposed mechanism, anemia is unlikely to be ameliorated by iron therapy alone.

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Mechanisms involved in the anaemia of schistosomiasis

Cited by 25 publications

References 16 publications

The Synergistic Effect of Concomitant Schistosomiasis, Hookworm, and Trichuris Infections on Children's Anemia Burden

The Synergistic Effect of Concomitant Schistosomiasis, Hookworm, and Trichuris Infections on Children's Anemia Burden

The impact of multiple infections on wild animal hosts: a review

Schistosoma japonicum Reinfection after Praziquantel Treatment Causes Anemia Associated with Inflammation

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