Protective role of blood groups

Concentrations of IL-4, IL-5, IL-10 and IL-13 in the plasma

The cytokine network significantly influences homeostasis. There is no sophisticated analysis in describing physiological values of soluble cytokines in healthy individuals. ELISA method was used to determine soluble cytokines and costimulatory molecules simultaneously in the plasma of blood donors. During analysis of the values, a special approach was used which had median 0. A probability model for detectable levels occurrence for each interleukin was formulated with intervals of confidence. The results offered reference values for cytokine levels in plasma of a healthy individual. This study aims to outline antibody levels to schistosome infection levels and history, and human system cytokine. Plasma cytokines and anti-Schistosoma haematobium antibodies were measured by ELISA in the schistosome-endemic area and related to infection status and age. Egg-positive people had higher levels of specific antibodies. On the contrary, egg-negative individuals had significantly higher circulating IL-4, IL-10, and IL-13 that were detected with high frequency in all participants. Analyzing by age, IL-4 and IL-10 increased appreciably, due to increase in schistosome-specific antibodies. Even so, when age was combined with infection status, IL-5 increased with age in the egg-negative people while declined over time in egg-positive people. The elderly had significantly higher IL-5 and IL-4 levels than younger egg-negative people. Thus, a Th2-dominated suite of cytokine is evident in egg-negative individuals while a mixed Th1/Th2 systemic environment occurs in individuals with patent schistosome infection.

It is critical to identify and study new inflammatory markers, for use as possible targets for the growth of new pharmacological approaches. In determining how much a molecule is deregulated in a case of disease, there is a need for reference values to be measured in physiological conditions. Some of the molecules are supposed to be associated with the specific illness. IL-5 is known to be the primary cause for immunopathogenesis of celiac disease, for this reason, it has been considered as a useful therapeutic target. Other cytokines IL-4 and IL-13 showed more compound profiles, with a notable difference in the production in children of the age group (7-18 years), most likely caused by physiological changes that occur during adolescence. Same findings were described in other studies such as ( Howard, T. D., Whittaker, P. A., Zaiman, A. L., Koppelman, G. H., Xu, J., Hanley, M. T., & Bleecker, E. R., 2001) and (Terefe Ashenafi, Shimelis Techalew, Mengistu Mulugeta, Hailu Asrat, Erko & Berhanu,  2011)  Despite the fact that the results must be confirmed by further studies with larger cohorts of patients, recommendations were drawn to help in evaluating the levels of chemokines and cytokines in the serum of healthy subjects of different age, to better comprehend the production these molecules in physiological conditions.

Protective role of blood groups of individuals against schistosomiasis

From the study and analysis of data, blood group O grant a significant protection against schistosomiasis compared to blood group A and B. (D. Raman, T. Sobolik-Delmaire, & A. Richmond, 2011) results is consistent with the Zimbabwe study carried out in 1997, where there was outstandingly high intensity of S. haematobium infection and associated with organ pathology among the young children who belong to blood group A and microscopic among blood group O children. The outcome of disease in schistosomiasis is not well understood, but a reasonable explanation depends on the ability of young schistosomula to absorb blood group antigens of the host on their surfaces to mask antigenic sites and prevent the specific-parasite antibody from binding and resulting in higher chances of survival and developing a severe form of schistosomiasis. This may brief why the severity of schistosomiasis is more common in children with blood group A and B than blood group O.

Anaemia was linked with urinary schistosomiasis. S. haematobium-infected subjects had lower hemoglobin concentration compared to values and controls which were beneath the bottom limit of normal range while that of the checks was within the normal range. Lower hemoglobin concentration was noted among the subjects infected who had >50/10 ml than the ones that had less. Anaemia caused by Schistosoma haematobium is as a result of chronic blood loss as ova penetrate the urinary tract, and heavy infection is distinguished by red cell hemolysis and iron loss resulting in iron deficiency anemia. This study revealed that hemoglobin concentration was related to the power of disease. This is in line with the report of Deribew et al. (2013) who observed a notably negative relationship between hemoglobin and egg intensity. Elenwo and Okafor (2007) who disclosed that egg power was remarkably related to hemoglobin concentration and Friedman et al. (2005) who outlined that the risk of anemia correlate with intensity of infection.

Schistosome specific levels of IgE, IgG1, IgG4 and IgA in the plasma

Schistosomiasis prevails as one of the major public health concern in developing countries after Malaria., and rapid reinfection nurtured by continued exposure to contaminated water sources necessitates a vaccine to augment current mass treatment-based control strategies. Casanova, J. L. and Abel, L. (2007) argues that isotype-specific (immunoglobin A [lgA], lgE, lgG1, lgG4, and lgG) antibody responses were reported to soluble worm antigen preparation and the recombinant vaccine candidates rSj22, rSj67, and rSj97 from a schistosoma japonicum-infected contingent where schistosomiasis is endemic. Reinfection was closely monitored by stool sampling after every three months, and data up to the duration of one year were included in the analysis. In repeated-measures models, IgG4 responses to rSj67 as well as rSj97 and rSj22 were associated with markedly increased reinfection intensity. In contrast, individuals with detectable lgE responses to rSj97 had 26% lower intensity reinfection at 12 months of post-treatment compared to no responses after adjusting for gender, age, village, pretreatment, exposure, clustering by household and infection intensity. When stratified by lgE and lgG4 responder status, persons with lgE but not lgG4 responses to rSj97 had a 77% lower intensity of reinfection at 12 months compared to individual with lgG4 responses but not lgE responses, even after adjusting potential confounders. These data advance support paramyosin as a leading vaccine candidate for human schistosomiasis japonica and underscore the significance careful adjuvant selection to avoid the generation of blocking antibody responses.

Schistosoma mansoni infection may occur as either an acute infection in individuals who have currently visited an endemic area, with no recent contact with the parasite or as a long chronic disease, if not disrupted by specific chemotherapy. The acute phase is accompanied by symptoms such as a cough, fever, anorexia, diarrhea, arthralgias in combination with leukocytosis and eosinophilia, and high cellular immune response to schistosome antigens especially those that originate from the parasites eggs. In the constant stage, most patients living in endemic areas are asymptomatic, and their immune retaliation to egg antigens is regulated. A small number develop fibrosis of the liver, which may lead to a hepatosplenic form of the disease. The humoral response (lgG, lgM, and lgE) in critical patients to worm and egg antigens does not differ from the chronic stage. Nevertheless, a soaring level of lgG and lgM antibodies to KLH was discovered in acute patients. Acute patients express a considerably high in vitro cellular responsiveness than do chronic patients, mainly to egg antigens. They provide a mixed profile of Th1 and Th2 cytokines. Ultrasound investigation of the endemic population portrays a high heterogeneity between patients as regard the existence and power of periportal fibrosis, the majority of patients are asymptomatic, and their immune responses to schistosoma egg antigens (SEA) are modulated. In contrast, a high percentage of patients with incipient fibrosis (early stage of hepatosplenic) responded strongly to SEA. Patients with the advanced hepatosplenic disease were likely to be non-responders to SEA. Most of the chronic patients presented a Th2 profile with a small production of interferon-gamma (IFN-g). The strength of infection favors the production of interleukin (IL)-10. After adjusting for sex, age, and intensity of infection, a high correlation was observed between the production of IL-13 and the degree of fibrosis. Chronic asymptomatic patients and those with incipient fibrosis expressed very high levels of heterogeneity of their antibody responses. IgG response to soluble worm antigen preparation (SWAP) was distinct and significantly higher in hepatosplenic patients than in those asymptomatic or with incipient fibrosis. Degree of IgG4 to SEA was substantially higher from patients with incipient fibrosis as compared to uninfected and hepatosplenic groups. Polyclonal idiotypic antibodies and their fragments F(ab)2, directly stimulate in culture T cells of schistosomiasis patients in the presence of IL-1. Polyclonal idiotypic antibodies can modulate in vitro granuloma formation around SEA-polyacrylamide. The importance of idiotypes for protection or pathology in schistosomiasis is still not clear.

(Casanova, J. L., & Abel, L., 2007) discusses how to determine Schistosome specific levels of IgE, IgG1, IgG4 and IgA in the plasma and how it leads to the production of antibody. Schistosoma mansoni infected participants (97) were involved in this study. They were taken for a clinical check up. Then after the lgE concentration and lgG reactivity against Schistosoma mansoni adult worm antigen preparation and soluble egg antigens were evaluated by ELISA. The final tally from the study showed that continuous re-infection, low parasite burden, and signs of fibrosis were detected in more than 30% of the subjects. Schistosoma mansoni is the most spreading Schistosoma genus affecting the people as argued by (Van den Biggelaar, A. H., van Ree, R., Rodrigues, L.C., Lell, B., Deelder, A. M., Kremsner, P. G., & Yazdanbakhsh, M., 2000). The cause of this organism is hepatic schistosomiasis and intestinal. These have been recorded mostly in Sub-African countries whereby more than 100 million persons are said to have the infection. Other endemic areas are The Caribbean and South America including Brazil.

 In Schistosoma mansoni endemic areas the most infected persons experience mild clinical manifestation and are asymptomatic while the minority infected suffers from severe hepatosplenic schistosomiasis which is characterized by portal hypertension, gastrointestinal bleeding, periportal fibrosis and even occurrence of death at some time. (Kouriba, B., Chevillard, C., Bream, J. H., Argiro, L., Dessein, H., Arnaud, V. and Traore, H.A. (2005) and (Steinmann P, Keiser J, Bos R, Tanner M, Utzinger J., 2006) suggest that the murine model, Schistosoma egg deposited in the body calls for type-2 immune, which is associated with the IL-4, IL-13, IL-10 and IL-5 cytokines which moderate the type-1 immune response and the formation of granuloma.

In other experiment models, the type -2 cytokines, especially the IL-13, have been related to fibrosis its regulation may be more involved during severe pathology in human being during schistosomiasis. Another research suggested that S. mansoni infected individuals with acute fibrosis have raised levels of chemokines CCL3, IL-5, IL-13 and tumor necrosis factor (TNF)-alpha. On the contrary, there has been a very little investigation in regards to the knowledge of cytokines role during granuloma formation and their participation during disease severity and the antibody participation against the infection of Schistosoma mansoni. (Howard, T. D., Whittaker, P. A., Zaiman, A. L., Koppelman, G. H., Xu, J., Hanley, M.T & Bleecker, E. R., 2001) reports that in human beings, immunoepidemiologic studies have proved anti-schistosome lgE levels increases about resistance and reinfection, and an increase in the level of anti-schistosome lgG4 are also related to the increase in susceptibility and parasite.