The Journal of Allergy and Clinical Immunology
Volume 111, Issue 5 , Pages 947-951, May 2003

Schistosoma mansoni infection is associated with a reduced course of asthma1

    MD
  • Manoel Medeiros Jr

      Affiliations

    • Servico de Immunologia do Hospital Universitário Prof Edgar Santos, Salvador, Bahia, Brazil
    • Corresponding Author InformationReprint requests: Manoel Medeiros, Jr, MD, Serviço de Imunologia, Hospital Universitário Prof Edgar Santos. Rua João das Botas, s/n-5° andar-Canela, CEP 40110.160 Salvador-Bahia, Brazil.
  • , MD
  • Joanemile P. Figueiredo

      Affiliations

    • Servico de Immunologia do Hospital Universitário Prof Edgar Santos, Salvador, Bahia, Brazil
  • , MD
  • Maria C. Almeida

      Affiliations

    • Servico de Immunologia do Hospital Universitário Prof Edgar Santos, Salvador, Bahia, Brazil
  • , MD
  • Maria Analia Matos

      Affiliations

    • Servico de Immunologia do Hospital Universitário Prof Edgar Santos, Salvador, Bahia, Brazil
  • , MD, PhD
  • Maria I. Araújo

      Affiliations

    • Servico de Immunologia do Hospital Universitário Prof Edgar Santos, Salvador, Bahia, Brazil
    • Escola Baiana de Medicina e Saude Publica, Salvador, Bahia, Brazil
  • , MD, PhD
  • Alvaro A. Cruz

      Affiliations

    • Servico de Immunologia do Hospital Universitário Prof Edgar Santos, Salvador, Bahia, Brazil
  • , MD, PhD
  • Ajax M. Atta

      Affiliations

    • Departmento de Analises Clinicas e Toxicologicas, Universidade Federal da Bahia, Salvador, Bahia, Brazil
  • , MD, PhD
  • Marco Antonio V. Rego

      Affiliations

    • Instituto de Saude Coletiva, Salvador, Bahia, Brazil
  • , MD, PhD
  • Amélia R. de Jesus

      Affiliations

    • Servico de Immunologia do Hospital Universitário Prof Edgar Santos, Salvador, Bahia, Brazil
  • , MD, PhD
  • Ernesto A. Taketomi

      Affiliations

    • Departamento de Immunologia, Microbiologia e Parasitologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil
  • , MD, PhD
  • Edgar M. Carvalho

      Affiliations

    • Servico de Immunologia do Hospital Universitário Prof Edgar Santos, Salvador, Bahia, Brazil
    • Escola Baiana de Medicina e Saude Publica, Salvador, Bahia, Brazil

Received 17 August 2002; received in revised form 5 January 2003; accepted 10 January 2003.

Background:

Helminthic infections decrease skin reactivity to indoor allergens, but data on whether they influence asthma severity are lacking.

Objective:

This study evaluated the course of asthma in patients with and without Schistosoma mansoni infection.

Methods:

Asthmatic subjects were enrolled from 3 low-socioeconomic areas: a rural area endemic for schistosomiasis (group 1) in addition to a rural area (group 2) and a slum area (group 3), both of which were not endemic for schistosomiasis. A questionnaire on the basis of the International Study of Asthma and Allergies in Childhood study was applied in these 3 areas, and from each area, 21 age- and sex-matched asthmatic subjects were selected for a prospective 1-year study. Pulmonary function tests, skin prick tests with indoor allergens, stool examinations, and serum evaluations were performed in these subjects. Every 3 months, the subjects were evaluated for asthma exacerbation through physical examination, and a questionnaire regarding asthma symptoms and use of antiasthma medicine was administered.

Results:

The prevalence of S mansoni infection was greater in group 1 compared with in groups 2 and 3 (P<.0001), whereas the frequency of other helminth and protozoa infections was similar among the 3 groups. The frequency of positive skin test responses to indoor allergens was less (19.0%) in group 1 subjects relative to those in group 2 (76.2%) and group 3 (57.1%; P<.001). The frequencies of symptoms, use of antiasthma drugs, and pulmonary abnormal findings at physical examination were less in group 1 subjects than in group 2 and 3 subjects (P=.0001).

Conclusion:

Our results suggest that S mansoni infection is associated with a milder course of asthma.

Key words: Asthma, skin prick test, dust mites, helminths, Schistosoma mansoni, IL-10, IgE

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1 Supported by the Fundação de Apoio a Pesquisa do Estado da Bahia (FAPESB) and Conselho Nacional de Pesquisa (CNPq) through Instituto de Investigação em Imunologia (iii). Edgar M. Carvalho is Senior Investigator of CNPq.

PII: S0091-6749(03)80119-7

doi:10.1067/mai.2003.1381

The Journal of Allergy and Clinical Immunology
Volume 111, Issue 5 , Pages 947-951, May 2003