The Impact of Schistosomiasis Co-infections on Immune Responses in Leprosy Pubblico
Kochlefl, Laura (Spring 2020)
Published
Abstract
Leprosy is an ancient neglected tropical disease caused by Mycobacterium leprae. India and Brazil carry the highest burden of disease, much of which is concentrated in hyperendemic areas with more than 40 new cases per 100,000 people annually. Helminth co-infections, like schistosomiasis, can cause immune dysregulation and may contribute to disease transmission. This paper analyses data from a case-control study performed in municipalities Governador Valadares and Mantena in the state of Minas Gerais, Brazil. A total of 79 leprosy patients and 178 healthy adults were recruited and administered questionnaires. Schistosomiasis was diagnosed from stool samples using Keto Katz methods. Levels of Th1 cytokines IFN-γ and TNF-α, Th2 cytokines IL-4 and IL-10, and Th17 cytokine IL-17 were assessed from blood samples using a cytometric bead array and stimulated with M. leprae. Descriptive, one-way ANOVA and ANCOVA analyses were performed. Significant differences were detected in levels of IFN-γ, and TNF-α between the four groups when controlling for age, sex, and vitamin D deficiency. Less IFN-γ was detected in leprosy patients with schistosomiasis co-infections, while TNF-α was found to be increased in this group. Levels of IL-10 were found to be higher in leprosy patients with schistosomiasis co-infections while no difference was found in IL-4 levels between groups. Average levels of IL-17 were found to be lower in individuals with schistosomiasis co-infections. These results support the theory that schistosomiasis co-infections upregulate the Th2 immune response, and downregulate the protective Th1 immune response to M. leprae, potentially making individuals more susceptible to disease. These findings suggest individuals living in areas endemic for schistosomiasis and leprosy may be at a higher risk for leprosy and open up the potential for new avenues to be explored in transmission control efforts.
Table of Contents
I. Introduction................................................................ 1
II. Literature Review........................................................ 3
III. Manuscript………………………………………………….…… 14
IV. Tables and Figures……………………………………………… 28
V. Public Health Implications and Recommendations…...... 32
VI. References……………………………………………………….. 36
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