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Reduced efficacy of treatment of strongyloidiasis in HTLV-I carriers related to enhanced expression of IFN-gamma and TGF-beta1.

Abstract
Strongyloidiasis, a human intestinal infection caused by Strongyloides stercoralis (S. stercoralis), is difficult to cure with drugs. In particular, a decrease of the efficacy of treatment has been reported in patients dually infected with S. stercoralis and human T-cell leukaemia virus type I (HTLV-I), both of which are endemic in Okinawa, Japan. However, the factors influencing this resistance remain unclear. In the present study, patients infected with S. stercoralis, with or without HTLV-I infection, were treated with albendazole, followed up for one year and separated into two groups, cured and non-cured. The cure rate of S. stercoralis was lower in HTLV-I carriers (P < 0.05). Serum levels of S. stercoralis-specific IgA, IgE, IgG, IgG1 and IgG4 antibodies were estimated, and a decrease of IgE (P < 0.05) and an increase of IgG4 (P < 0.05) were observed in the non-cured group, especially in HTLV-I carriers. RT-PCR of cytokines using peripheral blood mononuclear cells revealed that S. stercoralis patients with HTLV-I showed a high frequency of expression of IFN-gamma and TGF-beta1, whereas those without HTLV-I showed no expression of these cytokines. IFN-gamma- and TGF-beta1-positive HTLV-I carriers showed a decrease of IgE (P < 0.05), an increase of IgG4 (P < 0.01) and a lower cure rate (P < 0.01) compared with those who were negative for both cytokines. These results suggest that persistent infection with HTLV-I affected S. stercoralis-specific immunity and reduced therapeutic efficacy.
AuthorsM Satoh, H Toma, Y Sato, M Takara, Y Shiroma, S Kiyuna, K Hirayama
JournalClinical and experimental immunology (Clin Exp Immunol) Vol. 127 Issue 2 Pg. 354-9 (Feb 2002) ISSN: 0009-9104 [Print] England
PMID11876761 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Anthelmintics
  • Antibodies, Helminth
  • Immunoglobulin G
  • RNA, Messenger
  • Transforming Growth Factor beta
  • Immunoglobulin E
  • Interferon-gamma
  • Albendazole
Topics
  • Aged
  • Albendazole (therapeutic use)
  • Animals
  • Anthelmintics (therapeutic use)
  • Antibodies, Helminth (blood, immunology)
  • Feces (parasitology)
  • Female
  • Gene Expression Regulation
  • HTLV-I Infections (complications, drug therapy, immunology, metabolism)
  • Humans
  • Immunocompromised Host
  • Immunoglobulin E (blood, immunology)
  • Immunoglobulin G (blood, immunology)
  • Interferon-gamma (biosynthesis, genetics)
  • Intestinal Diseases, Parasitic (complications, drug therapy, immunology, metabolism, parasitology)
  • Male
  • Middle Aged
  • RNA, Messenger (biosynthesis)
  • Reverse Transcriptase Polymerase Chain Reaction
  • Strongyloides stercoralis (immunology, isolation & purification)
  • Strongyloidiasis (complications, drug therapy, immunology, metabolism)
  • Transforming Growth Factor beta (biosynthesis, genetics)
  • Treatment Failure

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