Plasma protein response in children with trichuris dysentry syndrome - abstract

ABSTRACT

In Trichuris Dysentry Syndrome (TDS), we have elsewhere shown an IgE-mediated mucosal mast cell inflammatory response and infiltration of the colonic lamina propria by macrophages with evidence of the cellular production to TNF O. There is an increased concentration of this cytokine in the systemic circulation both this and the correlation of finger-clubbing with worm load are evidence of an inflammatory response which is systemic as well as local to the intestine. We therefore assayed the plasmas of 53 TDS children, 16 "disease control" (DC) and 20 "normal control" (NC) children for plasma protein changes. DC children were Trichuris negative patients who had clinical indications for colonoscopy, mainly chronic diarrhoea; NC were trichuris-negative asymptomatic children of similar background to the TDS patients who were subjected to venepuncture and non-invasive tests of intestinal permeability and intestinal protein clearance (normal). There was a significant increase (p<0.05) in the means of C-Reactive protein (CRP) and antitrypsin in the TDS compared with the NC group. The mean increase in the DC group was significantly differernt from the NC. The reduction in the mean albumin concentration in TDS compared with NC children was not quite significant (p=0.05). Caeruloplasmin showed a significant difference only between the DC and NC children (p < 0.05). The other plasma proteins assayed, transferrin and fibrinogen, showed no significant difference in their means among the three groups. These changes in plasma protein concentrations are indicative of a generalized sytemic response to Trichuris trichuria and correspond to a continuous, mile "acute phase response" to this chronic infection (AU)