This study was planned to evaluate the in vitro production of
IL-1 beta and
IL-4 by peripheral blood mononuclear cells (PBMCs) and total
IgE in patients with
fascioliasis before and 3 months
after treatment with purified extract of
myrrh from Commiphora molmol tree (
Mirazid), to determine the role of these variables in immunopathogenesis of the disease in relation to this new
drug. The study was carried out in Departments of Tropical Medicine, Al-Azhar University Hospitals in the period from March 2002 to November 2003. A total of 35 patients with chronic
fascioliasis with age range from 9-45 years in addition to 10 healthy subjects with matched age and sex serving as controls were studied. Serum
IgE and in vitro
IL-1 and
IL-4 were estimated by
enzyme immuno-assay (ELISA) before and 3 months after
therapy. Results revealed significant increase in
IL-1 beta in patients before treatment than control (p<0.001) but it decreased significantly after
therapy (p<0.001) to reach the control level (p=0.16). In contrast,
IL-4 was significantly lower than control before
therapy (p=0.04) and increased significantly
after treatment (p<0.001) to reach normal levels as control (p=0.59). Total
IgE was significantly elevated in patients before treatment (p<0.001) and it did decrease significantly with treatment (p<0.001), although it remained significantly higher than the control level. In conclusion,
Mirazid is an effective fasciolicidal
drug.
IL-1 may be involved in disease immunopathogenesis and the depressed
IL-4 may be a phenomenon of parasite immune suppression. Complete decline of total
IgE is not an early criterion of cure.