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Intestinal nematode infections in children: the pathophysiological price paid

Published online by Cambridge University Press:  06 April 2009

E. S. Cooper ,
C. A. M. Whyte-Alleng ,
J. S. Finzi-Smith  and
T. T. MacDonald
E. S. Cooper
Affiliation:
Tropical Metabolism Research Unit, University of the West Indies, Mona, Kingston 7, Jamaica Parasite Epidemiology Research Group, Department of Biology, Imperial College, London SW7 2AZ, UK
C. A. M. Whyte-Alleng
Affiliation:
Department of Zoology, University of the West Indies (Jamaica)
J. S. Finzi-Smith
Affiliation:
Tropical Metabolism Research Unit, University of the West Indies, Mona, Kingston 7, Jamaica
T. T. MacDonald
Affiliation:
Department of Paediatric Gastroenterology, St Bartholomew's Hospital Medical College, London ECIA 7BE, UK
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Summary

The mechanism by which small animals such as rodents resist or eliminate nematode parasites requires mucosal in flammation as the final effector of the immune response. The resulting freedom from chronic infection may be worth the price of short-term illness. Putative vaccines which attempt to enhance the natural effect will have to take into account the inflammatory cost to the host. Human helminthiases involve a more stable equilibrium between host and parasite. The medical literature on hookworm disease and clinical ascariasis describes, for the former, some chronic inflammatory effects correlated with worm burden, but for the latter a less quantified or predictable set of detrimental effects. We describe a current, systematic study of the inflammatory response to whipworm infection, in which anaemia, growth retardation and intestinal leakiness are viewed as predictable consequences related to infection intensity. There is evidence for the absence of cell-mediated immunopathology. However, a specific, IgE-mediated local anaphylaxis may, at least partly, mediate the deleterious effects. Increased numbers of mucosal macrophages may also contribute to the chronic, systemic effects through their output of cytokines. Similar attempts to show the mechanisms of pathogenesis and quantify the effects of hookworm disease should be undertaken.

Keywords

mucosal inflammationlocal anaphylaxishelminthiaseshuman growth.
Type
Geohelminthiasis
Information
Parasitology , Volume 104 , Issue S1: Symposia of the British Society for Parasitology Volume 29:Human parasitic disease: the complementory roles of field and laboratory studies , June 1992 , pp. S91 - S103
Copyright
Copyright © Cambridge University Press 1992

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