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Infection and Immunity, May 2008, p. 2212-2218, Vol. 76, No. 5
0019-9567/08/$08.00+0     doi:10.1128/IAI.01433-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Hepatosplenomegaly Is Associated with Low Regulatory and Th2 Responses to Schistosome Antigens in Childhood Schistosomiasis and Malaria Coinfection{triangledown}

Shona Wilson,1* Frances M. Jones,1 Joseph K. Mwatha,2 Gachuhi Kimani,2 Mark Booth,1 H. Curtis Kariuki,3 Birgitte J. Vennervald,4 John H. Ouma,5 Eric Muchiri,3 and David W. Dunne1

Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QP, United Kingdom,1 Kenya Medical Research Institute, Nairobi, Kenya,2 Division of Vector Borne Diseases, Kenyan Ministry of Health, PO Box 54840 Nairobi, Kenya,3 DBL—Institute for Health Research and Development, Jægersborg Alle 1D, 2920 Charlottenlund, Denmark,4 Maseno University, Kisumu, Kenya5

Received 25 October 2007/ Returned for modification 27 November 2007/ Accepted 6 February 2008

Hepatosplenomegaly among Kenyan schoolchildren has been shown to be exacerbated where there is transmission of both Schistosoma mansoni and Plasmodium falciparum. This highly prevalent and chronic morbidity often occurs in the absence of ultrasound-detectable periportal fibrosis and may be due to immunological inflammation. For a cohort of school-age children, whole-blood cultures were stimulated with S. mansoni soluble egg antigen (SEA) or soluble worm antigen (SWA). Responses to SWA were found to be predominantly Th2 cytokines; however, they were not significantly associated with either hepatosplenomegaly or infection with S. mansoni or P. falciparum. In comparison, SEA-specific Th2 cytokine responses were low, and the levels were negatively correlated with S. mansoni infection intensities and were lower among children who were coinfected with P. falciparum. Tumor necrosis factor alpha levels in response to stimulation with SEA were high, and a negative association between presentation with hepatomegaly and the levels of the regulatory cytokines interleukin-6 and transforming growth factor β1 suggests that a possible mechanism for childhood hepatomegaly in areas where both malaria and schistosomiasis are endemic is poor regulation of an inflammatory response to schistosome eggs.

* Corresponding author. Mailing address: Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QP, United Kingdom. Phone: 44-1223333332. Fax: 44-1223333741. E-mail: sw320{at}cam.ac.uk

{triangledown} Published ahead of print on 19 February 2008.

Editor: J. F. Urban, Jr.

Infection and Immunity, May 2008, p. 2212-2218, Vol. 76, No. 5
0019-9567/08/$08.00+0     doi:10.1128/IAI.01433-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Mouk, E. M. O., Mwinzi, P. N. M., Black, C. L., Carter, J. M., Ng'ang'a, Z. W., Gicheru, M. M., Secor, W. E., Karanja, D. M. S., Colley, D. G. (2009). Childhood Coinfections with Plasmodium falciparum and Schistosoma mansoni Result in Lower Percentages of Activated T Cells and T Regulatory Memory Cells than Schistosomiasis Only. Am J Trop Med Hyg 80: 475-478 [Abstract] [Full Text]  


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