Pro-Inflammatory Cytokines and C-Reactive Protein Are Associated With Undernutrition in the Context of Schistosoma Japonicum Infection

Abstract

Schistosomiasis is associated with undernutrition, but the mechanisms involved remain unknown. We analyzed baseline and follow-up data from a longitudinal treatment-reinfection study in N = 477 Schistosoma japonicum-infected subjects 7-20 years of age from Leyte, the Philippines. After baseline treatment with praziquantel, follow-up visits were scheduled every 3 months for 18 months; stool, venous blood, and anthropometric measurements were collected at each visit. Cytokine production by peripheral blood mononuclear cells (PBMCs) stimulated with specific S. japonicum antigens was measured once 4 weeks after treatment. After adjustment for confounders, S. japonicum intensity was associated with decreased serum albumin and Z-scores (all P < 0.05) and with increased serum C-reactive protein (CRP) and interleukin (IL)-6. CRP was associated with decreased albumin and Z-scores (all P < 0.01). Production of IL-1b and tumor necrosis factor (TNF)-alpha in response to worm antigen was associated with decreased albumin (both P < 0.005) and height-for-age Z-score (TNF-alpha only, P = 0.05). S. japonicum-associated undernutrition may, in part, result directly from inflammation.

Modeling the Effect of Chronic Schistosomiasis on Childhood Development and the Potential for Catch-Up Growth with Different Drug Treatment Strategies Promoted for Control of Endemic Schistosomiasis

“…Children's growth patterns exhibit different rates according to levels of bone maturity and sexual development. 44,57,72,73 Retardation in growth will continue if inflammation persists or quickly recurs, 74 but there is a potential for regaining a normal growth velocity. 75 Changes in environment and nutrient availability are not necessarily sufficient to reverse early growth impairment.…”

Impact of Polyparasitic Infections on Anemia and Undernutrition among Kenyan Children Living in a Schistosoma haematobium-Endemic Area

“…The underlying mechanisms for this process are not fully explored. 39 Parasite migration, persistence in the circulation, egg retention, and consequent inflammatory response by the host is a plausible mechanistic pathway; however, more research is needed in this area.…”

Maternal Schistosomiasis Japonica Is Associated with Maternal, Placental, and Fetal Inflammation

“…Only two observational studies have reported decreased birth weights in schistosome-infected women (41, 47), despite well-documented adverse pregnancy outcomes in animal models of schistosomiasis (3,17). Recently, a randomized controlled trial of praziquantel treatment during the second or third trimester of pregnancy did not detect a birth weight difference in Schistosoma mansoni-infected Ugandan women, although infection intensity was low in this population (37).In previous studies, we demonstrated that Schistosoma japonicum infection is associated with a systemic proinflammatory response that results in undernutrition and anemia in nonpregnant individuals (11,30). To examine the impact of schistosome infection during pregnancy, we conducted a longitudinal study of pregnant women (n ϭ 99) living in an area of S. japonicum endemicity in the Philippines.…”

“…In previous studies, we demonstrated that Schistosoma japonicum infection is associated with a systemic proinflammatory response that results in undernutrition and anemia in nonpregnant individuals (11,30). To examine the impact of schistosome infection during pregnancy, we conducted a longitudinal study of pregnant women (n ϭ 99) living in an area of S. japonicum endemicity in the Philippines.…”