Schistosoma japonicum-associated morbidity and its mechanisms among children and young adults in the Philippines

摘要: This thesis presents results from a longitudinal study in Schistosoma japonicum infected children, adolescents and young adults, carried out the Philippines. The aim of this was to describe nutritional morbidity hepatic fibrosis context S. infection reinfection following treatment with praziquantel, evaluate potential immunological mechanisms involved these morbidities. In addition, immunomodulatory role puberty-associated hormone dehydroepiandrosterone sulphate (DHEAS) age-related decline evaluated. Following status as measured by Z-scores hemoglobin levels improved, whereas had an overall negative impact on status. Reinfection associated iron deficiency anemia high intensities only. Conversely, non-iron all intensities. Serum C-reactive protein (CRP) interleukin (IL)-6 showed dose-dependent positive association intensity reinfection, suggesting that schistosomiasis induces systemic inflammation. Taken together, 1) strengthen causal relationship between undernutrition anemia, 2) suggest is mediated, part, proinflammatory cytokines, particular IL-6, 3) inflammation central mechanism responsible for infection. Based findings, intervals highly endemic areas should not exceed one year order prevent rebound due reinfection. Furthermore, dietary supplementation be combined control strategies reduce areas. Independent age helminth infections, increased DHEAS were reduction inflammation-associated well reduced serum CRP, IL-1 IL-6. These findings support hypothesis increasing age, anti-inflammatory effects during pubertal development result decreased cytokine-mediated morbidity. Both presence severity japonicum-associated status, thereby leads anemia. Even individuals mild fibrosis, which generally considered clinically insignificant, compared those without fibrosis. finding stresses importance early recognition Persistent i.e. diagnosed at baseline remained present treatment, japonicum-specific IL-4, IL-5 IL-13. suggests pro-fibrotic T-helper 2 (Th2) cytokine responses, may also protect against play progression Therefore, Th2-boosting vaccine worsening investigated adverse effect. Males experienced higher prevalence greater both than females. risk among males directly production Th2 cytokines.