Pro-inflammatory cytokines and C-reactive protein are associated with undernutrition in the context of Schistosoma japonicum infection
Coutinho, H.M.; Leenstra, T.; Acosta, L.P.; Su, L.; Jarilla, B.; Jiz, M.A.; Langdon, G.C.; Olveda, R.M.; McGarvey, S.T.; Kurtis, J.D.; Friedman, J.F.
American Journal of Tropical Medicine and Hygiene 75(4): 720-726
2006
ISSN/ISBN: 0002-9637 PMID: 17038701 Document Number: 604784
Schistosomiasis is associated with undernutrition, but the mechanisms involved remain unknown. We analyzed baseline and follow-up data from a longitudinal treatment-reinfection study in N=477 Schistosoma japonicum-infected subjects 7-20 years of age from Leyte, the Philippines. After baseline treatment with praziquantel, follow-up visits were scheduled every 3 months for 18 months; stool, venous blood, and anthropometric measurements were collected at each visit. Cytokine production by peripheral blood mononuclear cells (PBMCs) stimulated with specific S. japonicum antigens was measured once 4 weeks after treatment. After adjustment for confounders, S. japonicum intensity was associated with decreased serum albumin and Z-scores (all P<0.05) and with increased serum C-reactive protein (CRP) and interleukin (IL)-6. CRP was associated with decreased albumin and Z-scores (all P<0.01). Production of IL-1b and tumor necrosis factor (TNF)- alpha in response to worm antigen was associated with decreased albumin (both P<0.005) and height-for-age Z-score (TNF- alpha only, P=0.05). S. japonicum-associated undernutrition may, in part, result directly from inflammation.