Inflammation during Schistosoma haematobium infection and anti-allergy in pre-school-aged children living in a rural endemic area in Zimbabwe.

BACKGROUND: Allergies and autoimmune disorders are less prevalent in areas where parasitic infections are abundant. The relationship between schistosomiasis, Chitinase 3-Like 1 protein (YKL-40), an inflammatory marker, and antinuclear antibodies (ANA), an allergy marker, was investigated in pre-school-aged children (1-5 years old) living in an area endemic to Schistosoma haematobium infection. METHODS: Cross-sectional study including 145 participants, 66 females and 79 males. S. haematobium infection was diagnosed using the urine filtration technique. Levels of YKL-40 and antinuclear antibodies concentrations were determined using enzyme-linked immunosorbent assay. RESULTS: The prevalence of S. haematobium infection was 21.4 % (n = 31) with 114 not infected, 18 with light and 13 with moderate infections. YKL-40 levels were higher in the S. haematobium-infected group than in the uninfected group (P = 0.038). However, S. haematobium infection intensity did not correlate with YKL-40 levels. ANA levels were significantly higher in uninfected children than in infected children (P = 0.028). There was a significant inverse relationship between ANA levels and schistosome infection intensity (r = -0.225, P = 0.016). The correlation between ANA levels and YKL-40 levels was not significant. CONCLUSION: Inflammatory marker in pre-school-aged children living in an area endemic for schistosomiasis indicate YKL-40 as a possible biomarker of S. haematobium infection in pre-school-aged children, warranting further investigations in a longitudinal study.  The study gives an insight into allergy as ANA levels were higher in schistosome-uninfected than infected participants, further studies on allergies are needed.

CONTEXTE: Les allergies et les troubles auto-immunes sont moins répandus dans les régions où les infections parasitaires sont abondantes. La relation entre la schistosomiase, la protéine Chitinase 3-Like 1 (YKL-40), un marqueur antiinflammatoire, et les anticorps antinucléaires (AAN), un marqueur d'allergie, a été étudiée chez des enfants d'âge préscolaire (1 à 5 ans) vivant dans une zone endémique pour l'infection à Schistosoma haematobium. MÉTHODES: Etude transversale portant sur 145 participants, 66 de sexe féminin et 79 de sexe masculin. L'infection à S. haematobium a été diagnostiquée à l'aide de la technique de filtration de l'urine. Les niveaux de YKL-40 et les concentrations d'AAN ont été déterminés en utilisant un dosage immunoenzymatique . RÉSULTATS: La prévalence de l'infection à S. haematobium était de 21,4% (n = 31) avec 114 non infectés, 18 avec des infections légères et 13 avec des infections modérées. Les niveaux de YKL-40 étaient plus élevés dans le groupe infecté par S. haematobium que dans le groupe non infecté (p = 0,038). Cependant, l'intensité de l'infection à S. haematobium ne corrélait pas avec les niveaux de YKL-40. Les niveaux d'AAN étaient significativement plus élevés chez les enfants non infectés que chez les infectés (p = 0,028). Il y avait une relation inverse significative entre les niveaux d'AAN et l'intensité de l'infection schistosomique (r = -0,225, p = 0,016). La corrélation entre les niveaux d'AAN et les niveaux de YKL-40 n'était pas significative. CONCLUSION: Les marqueurs d'inflammation et les marqueurs d'allergie chez les enfants d'âge préscolaire vivant dans une zone endémique pour la schistosomiase indiquent YKL-40 comme biomarqueur possible de l'infection par S. haematobium chez les enfants d'âge préscolaire, ce qui justifie des investigations supplémentaires dans une étude longitudinale. Comme les niveaux d'AAN étaient plus élevés chez les participants non infectés que chez ceux infectés par le schistosome, d'autres études sur les allergies sont nécessaires.

Elevation of C-reactive protein, P-selectin and Resistin as potential inflammatory biomarkers of urogenital Schistosomiasis exposure in preschool children.

BACKGROUND: Schistosomiasis is known to induce inflammatory immune responses. C-reactive protein (CRP), resistin and P-selectin are serological inflammatory markers that rise during the acute stages of infection. Here, we propose such inflammatory biomarkers have a potential for use in urogenital schistosomiasis diagnostic screening for exposure and infection in preschool-aged children. METHODS: As part of a larger study on urogenital schistosomiasis, 299 preschool children aged 1-5 years were included in this cross-sectional study. Parasitological diagnosis was conducted using urine filtration for Schistosoma haemtobium infection, and Kato Katz for S. mansoni infection. Serum levels of P-selectin, resistin, CRP, and antibodies against S. haematobium cercarial antigen preparation (CAP) and soluble worm antigen preparation (SWAP) were measured by ELISA. RESULTS: Of the 299 participants, 14% were egg positive for S. haematobium. Serology showed 46 and 9% of the participants to have been exposed to S. haematobium cercarial antigens and adult worm antigens, respectively. Levels of P-selectin were significantly higher in participants infected with S. haematobium (egg-positive) than in uninfected participants (p = 0.001). Levels of P-selectin were also higher in those exposed to cercarial antigen than in unexposed participants (p = 0.019). There was a positive correlation between P-selectin and infection intensity (r = 0.172; p = 0.002), as well as with IgM responses to CAP and SWAP (r = 0.183; p = 0.001); (r = 0.333; p < 0.0001) respectively. CRP significantly correlated with IgM responses to CAP (r = 0.133; p = 0.029) while resistin correlated with IgM responses to CAP and SWAP (r = 0.127; p = 0.016); (r = 0.197; p = 0.0004). CRP levels were higher in those exposed to cercarial and adult worm antigens than unexposed participants (p = 0.035); (p = 0.002) respectively, while resistin was higher in participants exposed to cercarial antigen than unexposed participants (p = 0.024). CONCLUSION: In this preschool population, P-selectin is significantly associated with urogenital schistosome infection and intensity; hence a potential biomarker for infection diagnosis and disease monitoring. The inflammatory biomarkers (P-selectin, Resistin and CRP) were significantly higher in participants exposed to cercarial antigens than unexposed individuals indicating an underlying inflammatory environment.