Volume 111, Issue 5 , Pages 947-951, May 2003
Schistosoma mansoni infection is associated with a reduced course of asthma1
Article Outline
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
No full text is available. To read the body of this article, please view the PDF online.
References
- . Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet. 1998;351:1225–1232
- Measles and atopy in Guinea-Bissau. Lancet. 1996;347:1792–1796
- . The inverse association between tuberculin responses and atopic disorder. Science. 1997;275:77–79
- . Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing. J Allergy Clin Immunol. 2001;107:129–134
- . Exposure to foodborne and orofecal microbes versus airborne viruses in relation to atopy and allergic asthma: epidemiological study. BJM. 2000;320:412–417
- . Endotoxin exposure in allergy and asthma: reconciling a paradox. J Allergy Clin Immunol. 2002;109:379–392
- . Asthma: an epidemic in the absence of infection?. Science. 1997;275:41–42
- . Reduced risk of hay fever and asthma among children of farmers. Clin Exp Allergy. 2000;30:187–193
- . Effect of antihelminthic treatment on the allergic reactivity of children in a tropical slum. J Allergy Clin Immunol. 1993;92:401–411
- Inverse association between skin response to aeroallergens and Schistosoma mansoni infection. Int Arch Allergy Immunol. 2000;123:145–148
- Decreased atopy in children infected with Schistosoma haematobium: a role for parasite-induced interleukin-10. Lancet. 2000;356:1723–1727
- . Prevalence of allergic diseases in patients with shistosomiasis mansoni. J Allergy Clin Immunol. 1997;100:142
- International study of asthma and allergies in childhood (ISAAC): Rationale and methods. Eur Respir J. 1995;8:483–491
- [abstract] Impairment of skin prick test response to house dust mite (HDM) antigens in Schistosoma mansoni infected subjects highly exposed to HDM allergens. J Allergy Clin Immunol. 2002;109:S139
- . Evaluation of Kato's quantitative method through the recovery of Schistosoma mansoni eggs added to human feces. J Parasitol. 1970;56:1032–1033
- . Coprological diagnosis of shistosomiasis. I. Evaluation of quantitative techniques. Rev Inst Med Trop Sao Paulo. 1968;10:295–298
- . Immunoanalysis of histamine through a novel chemical derivatization. J Allergy Clin Immunol. 1988;82:646–654
- . Association of asthma with serum IgE levels and skin-test reactivity to allergens. N Engl J Med. 1989;320:271–277
- . Early exposure to house-dust mite and cat allergens and development of childhood asthma: a cohort study. Lancet. 2000;356:1392–1397
- Relationship between helminthic infection and IgE response in atopic and nonatopic children in a tropical environment. J Allergy Clin Immunol. 1998;101:217–221
- . parasites and asthma/allergy: what is the relationship?. J Allergy Clin Immunol. 2000;105:205–210
- . Control of allergic reactivity in human filariasis. Predominant localization of blocking antibody to the IgG4 subclass. J Immunol. 1992;148:2731–2737
- . Evidence of a T helper type 2 activation in human schistosomiasis. Eur J Immunol. 1996;26:1399–1403
- . Cytokine control of parasite-specific anergy in human urinary schistosomiasis. IL-10 modulates lymphocyte reactivity. J Immunol. 1996;156:4715–4721
- . Lewis(x)-containing oligosaccharide attenuates schistosome egg antigen-induced immune depression in human schistosomiasis. Hum Immunol. 2000;61:225–232
- . Inhibition of IgE-induced activation of human mast cells by IL-10. Clin Exp Allergy. 2001;31:694–704
- . Mapping susceptibility genes for asthma and allergy. J Allergy Clin Immunol. 2000;105:S477–S481
- . Can intestinal helminthic infections (geohelminths) affect the development and expression of asthma and allergic disease?. Clin Exp Immunol. 2002;128:398–404
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
© 2003 Published by Elsevier Inc.
Volume 111, Issue 5 , Pages 947-951, May 2003
