Respiratory allergy symptoms and cytokine profiles in the presence of anti-Ascaris antibody in Giardia lamblia-infected children.

Anti-Ascaris lumbricoides (Asc) IgE and IgG can immunomodulate the allergy; however, the influence of these isotypes has not been investigated in the giardiasis and allergy. Therefore, the frequency of respiratory allergy (RA) symptoms in Giardia lamblia-infected children, with or without anti-Asc IgE, IgG1, or IgG4 and Th1, Th2/Treg, and Th17 cytokine production, was evaluated. We performed a case-control study with children aged 2-10 years old selected by questionnaire and stool exams to form the groups: infected or uninfected with RA (G-RA, n = 55; nG-RA, n = 43); infected and uninfected without RA (G-nRA, n = 59; nG-nRA, n = 54). We performed blood leukocyte counts and in vitro culture. Cytokine levels in the supernatants (CBA), serum total IgE and anti-Asc IgE (ImmunoCAP), IgG1, IgG4, and total IgA (ELISA) were measured. Infection was not associated with allergy. Infected children showed increased levels of anti-Asc IgG1, IL-2, IFN-γ, IL-4, and IL-10. There was a lower frequency of allergy-related symptoms in anti-Asc IgG1-positive children than IgG1-negative (OR = 0.38; CI = 0.17-0.90, p = 0.027) and few eosinophils in G-RA than in G-nRA and more in G-nRA than in nG-nRA, whereas TNF-α levels were higher in the G-RA than in the nG-nRA group. For infected and positive anti-Asc IgG1, there was higher TNF-α and IL-10 production than G/-IgG1. IL-10 levels were lower in nG/ + IgG1 than in infected or non-infected, and both were negative for anti-Asc IgG1. Th1/Th2/IL-10 profiles were stimulated in the infected patients, and in those with circulating anti-Asc IgG1, the TNF-α production was strengthened with a lower risk for respiratory allergy symptoms.

Therapeutic potential of toosendanin: Novel applications of an old ascaris repellent as a drug candidate.

Toosendanin (TSN), extracted from Melia. toosendan Sieb.et Zucc. and Melia. azedarach L., has been developed into an ascaris repellent in China. However, with the improvement of public health protection, the incidence of ascariasis has been reduced considerably, resulting in limited medical application of TSN. Therefore, it is questionable whether this old ascaris repellent can develop into a drug candidate. Modern studies have shown that TSN has strong pharmacological activities, including anti-tumor, anti-botulinum, anti-viral and anti-parasitic potentials. It also can regulate fat formation and improve inflammation. These researches indicate that TSN has great potential to be developed into a corresponding medical product. In order to better development and application of TSN, the availability, pharmacodynamics, pharmacokinetics and toxicology of TSN are summarized systematically. In addition, this review discusses shortcomings in the current researches and provides useful suggestions about how TSN developed into a drug candidate. Therefore, this paper illustrates the possibility of developing TSN as a medical product, aimed to provide directions for the clinical application and further research of TSN.

Non-potable water reuse and the public health risks from protozoa and helminths: a case study from a city with a semi-arid climate.

The study estimated the risk due to Cryptosporidium, Giardia, and Ascaris, associated with non-potable water reuse in the city of Jaipur, India. The study first determined the exposure dose of Cryptosporidium, Giardia, and Ascaris based on various wastewater treatment technologies for various scenarios of reuse for six wastewater treatment plants (WWTPs) in the city. The exposure scenarios considered were (1) garden irrigation; (2) working and lounging in the garden; and (3) consumption of crops irrigated with recycled water. The estimated annual risk of infection varied between 8.57 × 10-7 and 1.0 for protozoa and helminths, respectively. The order of treatment processes, in decreasing order of annual risk of infection, was found to be: moving-bed bioreactor (MBBR) technology > activated sludge process (ASP) technology > sequencing batch reactor (SBR) technology. The estimated annual risk was found to be in this order: Ascaris > Giardia > Cryptosporidium. The study also estimated the maximum allowable concentration (Cmax) of pathogen in the effluent for a benchmark value of annual infection of risk equal to 1:10,000, the acceptable level of risk used for drinking water. The estimated Cmax values were found to be 6.54 × 10-5, 1.37 × 10-5, and 2.89 × 10-6 (oo) cysts/mL for Cryptosporidium, Giardia, and Ascaris, respectively.

First molecular data on the human roundworm Ascaris lumbricoides species complex from the Bronze and Iron Age in Hallstatt, Austria.

Palaeoparasitological studies can provide valuable information on the emergence, distribution, and elimination of parasites during a particular time in the past. In the prehistoric salt mines of Hallstatt, located in the Austrian Alps, human faeces have been conserved in salt. The aim of this study was to recover ancient DNA of intestinal parasites from these coprolites. Altogether, 35 coprolites from the Hallstatt salt mines, dating back to the Bronze Age mining phase (1158-1063 BCE) and the Iron Age mining phase (750-662 BCE), respectively, were analysed by microscopy and molecular methods. In 91% of the coprolite samples, eggs of soil-transmitted helminths (STH), namely of Trichuris and/or Ascaris were detected by light microscopy. The Ascaris eggs were exceptionally well preserved. For further analysis, DNA was extracted from the palaeofaecal samples and species-specific primers targeting different genes were designed. While amplification of Trichuris DNA remained unsuccessful, sequence data of A. lumbricoides species complex were successfully obtained from 16 coprolites from three different genes, the mitochondrial cytochrome c oxidase subunit 1 gene (cox1), the mitochondrial cytochrome B gene (cytB) and the mitochondrial NADH dehydrogenase subunit 1 gene (nadh1). Importantly, these included two Ascaris sequences from a coprolite from the Bronze Age, which to the best of our knowledge are the first molecular data of this genus from this period.

Nematódeos de interesse médico veterinário em represa urbana no município de Catalão, no sudeste do estado de Goiás, Brasil / Nematodes of veterinary medical interest in an urban reservoir in the municipality of Catalão, southeastern Goiás State, Brazil

Objetivo: realizar análises parasitológicas em amostras de solo provenientes da represa da Bica situada no município de Catalão-GO. Métodos: a área do entorno da represa foi dividida em cinco parcelas, sendo realizadas coletas em dois pontos de cada parcela, superior e inferior. Foram realizadas quatro coletas em dias alternados, totalizando 40 amostras de, aproximadamente, 50g da camada superficial do solo, com profundidade máxima de cinco centímetros. As amostras foram processadas no Setor de Diagnóstico Parasitológico do Laboratório de Biologia Molecular da Universidade Federal de Catalão (UFCAT). Para as análises parasitológicas, foram utilizados cinco métodos encontrados na literatura, Rugai, Willis, Sedimentação espontânea, Ritchie e Ritchie modificado. Resultados: pelo método de Rugai, foi possível detectar larvas rabditoides do gênero Ancylostoma e Strongyloides. Utilizando o método de Ritchie modificado, foram encontrados ovos de Ascaris lumbricoidese Ancylostoma sp. Conclusão: a presença de formas evolutivas no solo da represa indica contaminação por dejetos animais e humanos, favorecendo o estabelecimento de ciclos biológicos das espécies encontradas e de outras diferentes zoonoses. Os dados obtidos demonstram a importância de sensibilizar a população de medidas de promoção da saúde, além de ações preventivas e programas de educação em saúde.

Objective: to conduct parasitological analyses in soil samples from the Bica reservoir located in the municipality of Catalão-GO. Methods: the area around the dam was divided into five plots, and samples were collected from two points in each plot, upper and lower. Four samples were collected on alternate days, totaling 40 samples of approximately 50g of topsoil, with a maximum depth of five centimeters. The samples were processed in the Parasitological Diagnostic Sector of the Molecular Biology Laboratory of the Federal University of Catalão (UFCAT). For the parasitological analyses, we used five methods found in the literature, Rugai, Willis, spontaneous sedimentation, Ritchie, and modified Ritchie. Results: by the Rugai method, it was possible to detect rhabditoid larvae of the genus Ancylostoma and Strongyloides. Using the modified Ritchie method, eggs of Ascaris lumbricoidesand Ancylostoma sp were found. Conclusion: the presence of evolutive forms in the soil of the reservoir indicates contamination by animal and human waste, favoring the establishment of biological cycles of the species found and of other different zoonoses. The data obtained demonstrated the importance of raising the population's awareness of health promotion measures besides preventive actions and health education programs.

Parasitological Assessment of Sewage Sludge Samples for Potential Agricultural Reuse in Tunisia.

Wastewater sludge represents an important resource for reuse in agriculture. However, potentially harmful pathogens are a main threat in this context. Thus, the aim of this study was to examine the presence of helminth ova and protozoan cysts in dried sewage sludge samples collected from ten wastewater treatment plants (WWTPs) located in eight governorates in Tunisia. Based on morphological criteria, protozoan cysts of Giardia spp., Entamoeba histolytica/dispar/moshkovskii, and Entamoeba coli, were detected in all dried sludge composite samples (N = 116) from the investigated WWTPs. The mean concentration ranged from 1.4 to 10.7 cysts per 100 g dry matter (DM). The identified helminth eggs were Ascaris spp., Strongyles, Taeniid eggs, Hymenolepis nana, Enterobius vermicularis, and hookworm species. Ascaris spp. and Taeniid eggs were detected in 56.9 and 74.1% of analyzed samples, respectively. The presence of Trichuris spp., Hymenolepis diminuta, and Toxocara spp. eggs in dried sewage sludge samples was low (0.9, 1.7, and 2.6%, respectively). The mean concentration of helminth eggs during the three-year study was less than 1 egg/100 g DM. All examined dried sewage sludge sample contents were below the WHO (2006) and US EPA (2003) recommendations, and thus, the sludge can potentially be reused in agriculture.

Ascaris exposure and its association with lung function, asthma, and DNA methylation in Northern Europe.

BACKGROUND: Ascaris infections, with a worldwide prevalence above 10%, can cause respiratory pathology. However, long-term effects on lung function in humans are largely unknown. OBJECTIVE: We investigated the associations of Ascaris exposure with lung function, asthma, and DNA methylation. METHODS: Serum Ascaris IgG antibodies were measured in 671 adults aged 18 to 47 years (46% women) from Aarhus, Bergen, and Tartu RHINESSA study centers. Seropositivity was defined as IgG above the 90th percentile. Linear and logistic regressions were used to analyze Ascaris seropositivity as associated with lung function and asthma, adjusted for age, height, and smoking and clustered by center. DNA methylation in blood was profiled by a commercial methylation assay. RESULTS: Ascaris seropositivity was associated with lower FEV1 (-247 mL; 95% CI, -460, -34) and higher odds for asthma (adjusted odds ratio, 5.84; 95% CI, 1.67, 20.37) among men but not women, also after further adjusting for house dust mite sensitivity, consistent across study centers. At a genome-wide level, Ascaris exposure was associated with 23 differentially methylated sites in men and 3 in women. We identified hypermethylation of the MYBPC1 gene, which can regulate airway muscle contraction. We also identified genes linked to asthma pathogenesis such as CRHR1 and GRK1, as well as a differentially methylated region in the PRSS22 gene linked to nematode infection. CONCLUSION: Ascaris exposure was associated with substantially lower lung function and increased asthma risk among men. Seropositive participants had sex-specific differences in DNA methylation compared to the unexposed, thus suggesting that exposure may lead to sex-specific epigenetic changes associated with lung pathology.

Evaluation of vegetables grown in dry mountainous regions for soil transmitted helminths contamination / Avaliação de vegetais para contaminação por helmintos transmitida pelo solo em quatro distritos da divisão de Malakand: noroeste do Paquistão

Infection caused by geo-helminth parasites are called geohelminthiasis are one of the global health problems. Vegetables eaten raw is the principal source of transmission of geo-helminth parasites. Pakistani people believe that eating raw vegetables are a significant source to get important vitamins and minerals. Based on the high incidence of pathogenic parasites and cultivating different vegetable types in the study areas, we conducted this study to evaluate the geo-helminth contamination of raw vegetables in northwest Khyber Pakhtunkhwa, Pakistan. This is a descriptive study comprised, 1942 samples of 25 various types of vegetables. The samples were examined in physiological saline solution using sedimentation and centrifugation methods. The findings were analyzed by Graph-Pad version 5. P value less than 0.05 (95% CI) was considered significant. Results showed that 16.5% (n=322) of all vegetables were contaminated with one or more type of geo-helminth parasites. Garlic was the highest (35%) and cauliflower the lowest (4%) contaminated samples respectively. Ascaris lumbricoides was the most common geo helminth found followed by hook worm species while Trichuris trichura was the least in all the vegetable samples. Leafy vegetables were highly contaminated 25.3% than vegetables with root parts 21.2% and fruity 9.09%. More than half of the contaminated vegetables were contaminated with single species of geo-helminth (P0.05) species of geo-helminth parasites. Education level of vendors and means of display were not significantly associated while types of vegetable used were significantly associated with the prevalence of parasites. The findings of this study provide evidence that consumption of raw [...].

As infecções causadas por parasitas geo-helmínticos são chamados de geohelmintíases e são um dos problemas de saúde globais. Os vegetais comidos crus são a principal fonte de transmissão dos parasitas geo-helmínticos. O povo paquistanês acredita que comer vegetais crus é uma fonte significativa para obter vitaminas e minerais importantes. Com base na alta incidência de parasitas patogênicos e no cultivo de diferentes tipos de vegetais nas áreas de estudo, conduzimos este estudo para avaliar a contaminação por geo-helmintos de vegetais crus no noroeste de Khyber Pakhtunkhwa, Paquistão. Trata-se de um estudo descritivo composto por 1942 amostras de 25 tipos diversos de vegetais. As amostras foram examinadas em solução salina fisiológica utilizando métodos de sedimentação e centrifugação. Os achados foram analisados pelo Graph-Pad versão 5. O valor de P menor que 0,05 (IC 95%) foi considerado significativo. Os resultados mostraram que 16,5% (n = 322) de todas as hortaliças estavam contaminadas com um ou mais tipos de parasitas geo-helmínticos. O alho foi a amostra mais contaminada (35%) e a couve-flor a menos (4%), respectivamente. Ascaris lumbricoides foi o geo-helmíntico mais comum encontrado, seguido por espécies de verme-anzol, enquanto Trichuris trichura foi o menos encontrado em todas as amostras de vegetais. Os vegetais folhosos foram altamente contaminados 25,3% do que os vegetais com partes de raiz 21,2% e frutados 9,09%. Mais da metade dos vegetais contaminados estavam contaminados com uma única espécie de geo-helmintos (P 0,05) espécies de parasitas geo-helmínticos. O nível de escolaridade dos vendedores e os meios de exibição não [...].

Prevalence of intestinal parasitic diseases in school children of rural areas of district Lower Dir, Pakistan / Prevalência de doenças parasitárias intestinais em escolares de áreas rurais do distrito de Lower Dir, Paquistão

Present study was conducted among school children to recognize the prevalence of IPIs in rural communities of district Dir Lower, Pakistan. A sum of 324 samples of stool were collected (210 boys and 114 girls). Used direct smear method and formol ether sedimentation concentration technique for processing the samples. The result shows that 82% (n=266) were found infected comprised 64.8% male and 35.1% females. Children of the age group 10 to 12 years were found extremely infected 94.2% while 4-6 year age group were having minimum ratio of infection 72%. Current study shows mono parasitism in 50.6% of the students while 22.2% were infected with 2 species and 7.40% were infected with three species of parasites. Seven species of intestinal parasites were reported include Ascaris lumbricoid in male (n=122) 58.0% and in female (n=65) 57.0% followed by Hook worm (n=88) 41.9% and (n=44) 38.5%; Tania saginata (n=44) 20.9% and (n=24) 21.0%; Entrobius vermicularis (n=32) 15.2% and (n=16) 14.0%; Trichuris trichura (n=25) 11.9% and (n=22) 19.2%; Hymenolepis nana (n=24) 11.4% and (n=18) 15.7% and Entameoba histolytica (n=16) 7.61% and (n=14) 12.2% in male and females respectively. The study indicates that most occurring intestinal parasite in the current study were Ascaris lumbricoides 58.0% (n=122) followed by hookworms 41.9% (n=88). Male students were more infected than females in the present study.

O presente estudo foi conduzido entre crianças em idade escolar para reconhecer a prevalência de IPIs em comunidades rurais do distrito de Dir Lower, Paquistão. Foram coletadas 324 amostras de fezes (210 meninos e 114 meninas). Método de esfregaço direto usado e técnica de concentração de sedimentação de formol éter para processar as amostras. O resultado mostra que 82% (n = 266) dos infectados eram 64,8% do sexo masculino e 35,1% do feminino. Crianças da faixa etária de 10 a 12 anos foram encontradas extremamente infectadas 94,2%, enquanto a faixa etária de 4 a 6 anos apresentava proporção mínima de infecção de 72%. O estudo atual mostra monoparasitismo em 50,6% dos alunos, enquanto 22,2% estavam infectados com 2 espécies e 7,40% estavam infectados com três espécies de parasitas. Sete espécies de parasitas intestinais foram relatadas incluindo Ascaris lumbricoid em machos (n = 122) 58,0% e em fêmeas (n = 65) 57,0% seguido por anzol (n = 88) 41,9% e (n = 44) 38,5%; Tania saginata (n = 44) 20,9% e (n = 24) 21,0%; Entrobius vermicularis (n = 32) 15,2% e (n = 16) 14,0%; Trichuris trichura (n = 25) 11,9% e (n = 22) 19,2%; Hymenolepis nana (n = 24) 11,4% e (n = 18) 15,7% e Entameoba histolytica (n = 16) 7,61% e (n = 14) 12,2% em homens e mulheres, respectivamente. O estudo indica que os parasitas intestinais que mais ocorreram no presente estudo foram Ascaris lumbricoides 58,0% (n = 122), seguidos por ancilóstomos 41,9% (n = 88). Estudantes do sexo masculino foram mais infectados do que do sexo feminino no presente estudo.

Live ascaris in urinary bladder: a case report.

INTRODUCTION: Ascaris in urinary bladder is an extremely rare phenomenon. It may occur after fistula formation between urinary and gastrointestinal tract or by retrograde migration of adult worm, and is associated with complications. CASE PRESENTATION: A 47-year-old Amhara woman from rural northwest Ethiopia presented with a complaint of difficulty to fully evacuate her bladder of 1 year duration. Ultrasonography showed thickened bladder wall with echo debris. There were also thickened bowel and fluid-filled loops of intestine adjacent to urinary bladder. On cystoscopy examination, there was live ascaris swimming inside the bladder. Enterovesical fistula was entertained and explorative laparotomy performed. Findings confirmed presence of iliovesical fistula. The fistula was divided and the continuity of the intestine restored. The inflammatory mass was subjected to histopathology study and turned out to be benign inflammatory reaction. She was also given antihelminthics. Postoperatively, her course was uneventful, and she was discharged cured. CONCLUSION: Though it is extremely rare to have urinary symptoms from ascariasis, it is important to have a high index of suspicion for all possibilities.

[Meckel's diverticulitis by ascaris in children: about a case]. / Diverticulite de Meckel d´origine ascaridienne chez l´enfant: à propos d´un cas.

We here report the case of a 4-year-old male child presenting with congenital umbilical bud that, recently, had begun to bleed. Physical examination showed pinkish umbilical bud with blood stains but without any fistula, measuring about 1,5 cm in diameter. Abdominal ultrasound was performed, which suggested urachal sinus. Surgery revealed umbilical bud communicating, in the abdominal portion, with hyperemic, inflammatory Meckel´s diverticulum placed 90 cm away from the ileocaecal angle in which many ascaris were detected. Anatomo-pathological examination of the surgical specimen showed diverticulitis. Thus, the diagnosis of Meckel´s diverticulitis by Ascaris was retained. Resection and anastomosis with bud excision were performed. The postoperative course was simple even after a 6-month follow-up period.

Ultrasonografía endoscópica para el diagnóstico de áscaris biliar: reporte de caso y revisión de la literatura / Endoscopic ultrasound for the diagnosis of biliary ascariasis: case report and literature review

Resumen Se presenta un caso de áscaris de la vía biliar (AB), cuya manifestación clínica fue ictericia obstructiva, acompañada de dolor abdominal causado por un cuadro de pancreatitis aguda. Inicialmente, se sospechó de etiología litiásica, por lo cual se realizaron estudios de imágenes diagnósticas y se evidenció la presencia de AB como hallazgo incidental, diagnosticado por ultrasonografía endoscópica biliopancreática (UEB), que fue confirmado y tratado mediante colangiopancreatografía retrógrada endoscópica (CPRE).

Abstract The following is a case of biliary ascariasis (BA), whose clinical presentation was obstructive jaundice, accompanied by abdominal pain due to acute pancreatitis. At first, clinical suspicion led to consider a stone etiology, for which diagnostic imaging studies were performed, evidencing BA as an incidental finding diagnosed by endoscopic biliopancreatic ultrasonography (EBU), which was confirmed and treated using endoscopic retrograde cholangiopancreatography (ERCP).

Cloning and identification of a new multifunctional Ascaris-type peptide from the hemolymph of Buthus martensii Karsch.

Only a few work have been done for peptides from non-venom gland tissues of venomous animals. Here, with the help of the whole body transcriptomic and the hemolymph proteomic data of the Chinese scorpion Buthus martensii Karsch, we identified the first Ascaris-type peptide BmHDP from scorpion hemolymph. The precursor of BmHDP has 80 residues, including a 16 residue signal peptide and a 64 residue mature peptide. The mature peptide has 10 conserved cysteines and adopts a conserved Ascaris-type fold. Using combined inclusion body refolding and biochemical identification strategies, recombinant BmHDP was obtained successfully. Protease inhibitory assays showed that BmHDP inhibited chymotrypsin apparently at a concentration of 8 nM. Patch-clamp experiments showed that BmHDP inhibited the Kv1.3 potassium channel apparently at a concentration of 1000 nM. Coagulation experiment assays showed that BmHDP inhibited intrinsic coagulation pathway apparently at a concentration of 500 nM. To the best of our knowledge, BmHDP is the first Ascaris-type peptide from scorpion hemolymph. Our work highlighted a functional link between scorpion non-venom gland peptides and venom gland toxin peptides, and suggested that scorpion hemolymph might be a new source of bioactive peptides.

IgE Levels to Ascaris and House Dust Mite Allergens Are Associated With Increased Histone Acetylation at Key Type-2 Immune Genes.

Background: Epigenetic changes in response to allergen exposure are still not well understood. The aim of this study was to evaluate histone acetylation levels in peripheral blood leukocytes from humans naturally infected by intestinal parasites and perennially exposed to house dust mites (HDM). Methods: Peripheral blood mononuclear cells (PBMCs) were isolated by gradient centrifugation from 20 infected and 21 non-infected individuals living in a rural/village in Colombia. Histone 3 acetylation (H3Ac) and histone 4 acetylation (H4Ac) levels were measured in six immune genes previously associated with helminth immunity by chromatin immunoprecipitation (ChIP)-quantitative PCR. Then we analyzed the association between histone acetylation levels with total parasite egg burden and IgE levels. Results: We found an inverse correlation between H4Ac levels in the IL13 gene and egg worm burden that remained significant after adjustment by age [-0.20 (-0.32 to -0.09), p < 0.0001]. Moreover, we found significant associations between H4Ac levels in IL4 [0.32 (0.05-0.60), p = 0.02] and CHI3L1 [0.29 (0.08-0.51), p = 0.008] with the IgE levels to Ascaris lumbricoides. In addition, the levels of specific IgE antibodies to HDM were associated with H4Ac levels in the gene TNFSF13B encoding the B cell activating factor (BAFF) [0.51 (0.26-0.76), p < 0.001]. All values are presented as beta (95% CI). Conclusion: Histone acetylation levels at key type-2 immune genes in humans were modified by nematode infection and HDM allergens and are associated with the intensity of the IgE response.

Helminths, polyparasitism, and the gut microbiome in the Philippines.

Polyparasitism, involving soil-transmitted helminths. and Schistosoma blood flukes, is common in low to middle income countries. These helminths impact on the gut environment and can cause changes to the gut microbiome composition. Here we examined the gut microbiome in individuals with polyparasitism from two human cohorts in the Philippines utilising DNA sequencing-based profiling. Multiple helminth species infections were high with 70.3% of study participants harbouring at least two parasite species, and 16% harbouring at least five species. Increased numbers of helminth co-infections, in particular with the gut-resident soil-transmitted helminths, were significantly associated with increased bacterial diversity; however no significant parasite-gut microbiome associations were evident for individuals infected only with Schistosoma japonicum. In general, a healthy gut is associated with high bacterial diversity, which in these human cohorts may be the result of helminth-mediated immune modulation, or due to changes in the gut environment caused by these parasitic helminths.

Allergen presensitization drives an eosinophil-dependent arrest in lung-specific helminth development.

This study investigates the relationship between helminth infection and allergic sensitization by assessing the influence of preexisting allergy on the outcome of helminth infections, rather than the more traditional approach in which the helminth infection precedes the onset of allergy. Here we used a murine model of house dust mite-induced (HDM-induced) allergic inflammation followed by Ascaris infection to demonstrate that allergic sensitization drives an eosinophil-rich pulmonary type 2 immune response (Th2 cells, M2 macrophages, type 2 innate lymphoid cells, IL-33, IL-4, IL-13, and mucus) that directly hinders larval development and reduces markedly the parasite burden in the lungs. This effect is dependent on the presence of eosinophils, as eosinophil-deficient mice were unable to limit parasite development or numbers. In vivo administration of neutralizing antibodies against CD4 prior to HDM sensitization significantly reduced eosinophils in the lungs, resulting in the reversal of the HDM-induced Ascaris larval killing. Our data suggest that HDM allergic sensitization drives a response that mimics a primary Ascaris infection, such that CD4+ Th2-mediated eosinophil-dependent helminth larval killing in the lung tissue occurs. This study provides insight into the mechanisms underlying tissue-specific responses that drive a protective response against the early stages of the helminths prior to their establishing long-lasting infections in the host.

Concurrent decreases in the prevalence of wheezing and Ascaris infection among 5-year-old children in rural Bangladesh and their regulatory T cell immunity after the implementation of a national deworming program.

INTRODUCTION: Epidemiological research on the prevalence of asthma and helminthic infections in various countries has led to the hypothesis that helminthic infections protect against asthma by suppressing the host's immune response. This study was conducted to elucidate whether decreased Ascaris infection following a national deworming program was associated with increased recurrent wheezing among rural Bangladeshi children and to test their anti-inflammatory immunity. METHODS: This nested case-control study was conducted from December 2015 to October 2016 in the rural service area of the International Centre for Diarrhoeal Disease Research, Bangladesh. Of the 1800 5-year old children randomly selected for the study, informed consent was obtained from the guardians of 1658 children. Data were collected using a semistructured questionnaire adopted from the International Study of Asthma and Allergies in Childhood and blood samples for the analysis of regulatory T (Treg) cell immune responses and the balance between Th1 and Th2 immunity in Ascaris infections. RESULTS: A total of 145 children were found to have wheezing, yielding a prevalence rate of 8.7%, which was significantly lower than the rate found in 2001 (16.2%, P < .001); Ascaris infection also decreased from 2001 to 2016. The 127 wheezing children who agreed to participate further were compared to 114 randomly selected never-wheezing children. Wheezing had a significant positive association with antibiotic use, history of pneumonia, parents' history of asthma, and Ascaris infection; children with Ascaris infection were twice as likely to have wheezing (adjusted odds ratio = 2.31, P = .053). Flow cytometry found no significant differences in the rates of Th1, Th2, and CD4 + CD25 + CD127low cells by the wheezing group. CONCLUSIONS: Ascaris infection had a positive rather than a negative association with wheezing and the rates of wheezing and Ascaris infections both decreased from 2001 to 2016. These findings undermines the hypothesis that such infections provide protection against asthma.

Parasitosis y antiparasitarios en niños / Parasitosis and antiparasitic treatment in children / Parasitoses e antiparasitários em crianças

Las parasitosis siguen siendo un grave problema de salud en pediatría, no tanto por la mortalidad que ocasionan sino por la morbilidad y sus secuelas en el crecimiento y desarrollo de los niños y en su desempeño en la vida adulta. Dentro de los parásitos de mayor prevalencia en los niños, están los que se transmiten por contacto con el suelo (geohelmintos o helmintos transmitidos por contacto con el suelo, HTS), dentro de los cuales, los de mayor prevalencia, son los áscaris, tricocéfalos y uncinarias. Como los parásitos intestinales no se reproducen en el organismo humano, su principal fuente de contagio se da a través del suelo que esté contaminado con materias fecales. Es por esta razón que los principales factores determinantes son: contaminación fecal del ambiente, agua contaminada, falta de excretas y malos hábitos higiénicos, especialmente en el lavado de manos. Sus manifestaciones clínicas son variables en intensidad y en signos, hay que tener presente que muchas de las personas parasitadas pueden estar asintomáticas durante mucho tiempo, pero siguen excretando huevos en las fecales, contaminando así el ambiente y perpetuando su prevalencia. Por esta razón, la Organización Mundial de la Salud (OMS) recomienda que en aquellas regiones o áreas donde la prevalencia de las geohelmintiasis sea igual o superior al 20% se debe hacer una desparasitación masiva y con una periodicidad acorde con la gravedad de esta prevalencia. En la actualidad se dispone de antiparasitarios efectivos, fáciles de suministrar (incluso por personal no médico). Los más comunes (albendazol y mebendazol) actúan inhibiendo la síntesis de adenosín trifosfato (ATP) necesario para su supervivencia. Como solamente se absorbe entre el 1% y el 5% del medicamento y su metabolismo es rápido, los efectos secundarios son leves y transitorios. Lo ideal es emplearlos en los pacientes que vivan en zonas de riesgo y en comunidades con una prevalencia igual o mayor al 20%, continuando con desparasitaciones periódicas de acuerdo al comportamiento de la prevalencia. Es evidente el impacto que se logra con la desparasitación periódica, tanto en el crecimiento y en el estado nutricional, como en el desempeño cognitivo, así como sus efectos en el campo social y ambiental.

Parasitosis continues to be a serious problem in pediatrics, not only because it is a cause of death, but because of the morbility and the long-term effects it has on growth and development in children and later on in their adult life. The most prevalent parasites in children include those transmitted by contact with the soil (geohelminths or soil-transmitted helminths, STH), amongst which the most common are the ascaris, trichocephalia, and uncinaria. Since intestinal parasites are not produced inside the human body, they are mainly contracted through soil contaminated with fecal matter. Thus, the principal determining factors include fecal contamination in the environment, contaminated water, improper excreta management, and poor personal hygiene, especially hand washing. Its clinical manifestations vary in intensity and in signs; also, many individuals with parasites may be asymptomatic for a long period of time, but their fecal matter contains eggs, thus, contaminating the environment and perpetuating its prevalence. Therefore, the World Health Organization (WHO) recommends that regions where geohelminthiasis prevalence is 20% or higher should be massively treated for parasites with a periodicity that is appropriate for the seriousness of the prevalence. Currently, there are effective antiparsitics available that are easy to administer (even by non-medical personnel). The most common medications (albendazole and mebendazole) inhibit the synthesis of adenosine triphosphate (ATP) needed for survival. Since only between 1 and 5% of the medication is absorbed and children's metabolism is fast, secondary effects are minor and transitory. It is recommended that they be used in patients that live in high-risk areas and in communities with a prevalence of 20% or higher, conducting periodic mass drug administration for parasite removal depending on the behavior of the prevalence. Regular parasite removal has an evident impact on growth, nutritional state, cognitive performance, as well as its effects on the social and environmental fields.

As parasitoses seguem sendo um grave problema de saúde em pediatria, não tanto pela mortalidade que ocasionam senão pela morbilidade e suas sequelas no crescimento e desenvolvimento das crianças e no seu desempenho na vida adulta. Dentro dos parasitos de maior prevalência nas crianças, estão os que se transmitem por contato com o solo (geohelmintos ou helmintos transmitidos por contato com o solo, HTS), dentro dos quais, os de maior prevalência, são os áscaris, tricéfalos e uncinárias. Como os parasitos intestinais não se reproduzem no organismo humano, sua principal fonte de contágio se dá através do solo que esteja contaminado com matérias fecais. É por esta razão que os principais fatores determinantes são: contaminação fecal do ambiente, água contaminada, falta de excretas e maus hábitos higiênicos, especialmente na lavagem das mãos. Suas manifestações clínicas são variáveis em intensidade e em signos, há que ter presente que muitas das pessoas parasitadas podem estar assintomáticas durante muito tempo, mas seguem excretando ovos nas fecais, contaminando assim o ambiente e perpetuando sua prevalência. Por esta razão, a Organização Mundial da Saúde (OMS) recomenda que naquelas regiões ou áreas onde a prevalência das geohelmintiase seja igual ou superior a 20% se deve fazer uma desparasitação massiva e com uma periodicidade acorde com a gravidade desta prevalência. Na atualidade se dispõe de antiparasitários efetivos, fáceis de subministrar (incluso por pessoal não médico). Os mais comuns (albendazol e mebendazol) atuam inibindo a síntese de adenosina trifosfato (ATP) necessário para sua supervivência. Como somente se absorbe entre 1% e 5% do medicamento e seu metabolismo é rápido, os efeitos secundários são leves e transitórios. O ideal é empregá-los nos pacientes que vivam em zonas de risco e em comunidades com uma prevalência igual ou maior a 20%, continuando com desparasitações periódicas de acordo ao comportamento da prevalência. É evidente o impacto que se consegue com a desparasitação periódica, tanto no crescimento e no estado nutricional, como no desempenho cognitivo, assim como seus efeitos no campo social e ambiental.