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Allergic-type inflammatory reactions to Onchocerca volvulus microfilariae in the skin. The Figure shows effect of treatment with the microflaricidal drug diethylcarbamazine. Pretreatment skin biopsy (A) shows microfilariae in the dermis with few associated inflammatory cells. After treatment with a single dose of DEC, the dead microfilariae become the focus of an intense inflammatory reaction composed of eosinophilic abscesses in the superficial dermis (B). Clinical appearance of the skin after DEC treatment (C).
Source publication
To review the findings of recent human studies of the association between helminth parasite infections and allergy and discuss their potential relevance to public health.
Different helminth parasites may have different effects on allergy that may depend on the timing or intensity of the exposure or host genetic factors. Infections with Trichuris tr...
Contexts in source publication
Context 1
... example, during infections with the tissue helminth, Onchocerca volvulus, the skin may be populated by millions of larval microfilariae and these appear to elicit little in the way of a host inflammatory response (Figure 2A). This state of hyporesponsiveness may be reversed rapidly after the killing of microfilariae by chemotherapy -treated individuals may develop allergic-type reactions ( Figure 2C) that are associated with the development of eosinophilic abscesses in the superficial dermis ( Figure 2B) within hours after treatment. ...
Context 2
... example, during infections with the tissue helminth, Onchocerca volvulus, the skin may be populated by millions of larval microfilariae and these appear to elicit little in the way of a host inflammatory response (Figure 2A). This state of hyporesponsiveness may be reversed rapidly after the killing of microfilariae by chemotherapy -treated individuals may develop allergic-type reactions ( Figure 2C) that are associated with the development of eosinophilic abscesses in the superficial dermis ( Figure 2B) within hours after treatment. The onset and severity of these reactions are associated with the release of allergic mediators such as tryptase and eosinophil degranulation products into the peripheral circulation [16]. ...
Context 3
... example, during infections with the tissue helminth, Onchocerca volvulus, the skin may be populated by millions of larval microfilariae and these appear to elicit little in the way of a host inflammatory response (Figure 2A). This state of hyporesponsiveness may be reversed rapidly after the killing of microfilariae by chemotherapy -treated individuals may develop allergic-type reactions ( Figure 2C) that are associated with the development of eosinophilic abscesses in the superficial dermis ( Figure 2B) within hours after treatment. The onset and severity of these reactions are associated with the release of allergic mediators such as tryptase and eosinophil degranulation products into the peripheral circulation [16]. ...
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Abstract
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Citations
... Later, a 2022 metaanalysis found no overall association between helminth infections and allergic diseases, but A. lumbricoides infections were associated with an increased risk of bronchial hyperresponsiveness in children and atopy in adults [39]. Con-cerning eczema, epidemiological studies have found that the association with helminth infection varies from positive to negative [40]. Helminth infections were associated with decreased skin test reactivity in several epidemiological studies; on the other hand, studies evaluating anthelmintic treatment and atopy showed that anthelminthic therapy was associated with an increased incidence of skin reactivity to house dust mites [40]. ...
... Con-cerning eczema, epidemiological studies have found that the association with helminth infection varies from positive to negative [40]. Helminth infections were associated with decreased skin test reactivity in several epidemiological studies; on the other hand, studies evaluating anthelmintic treatment and atopy showed that anthelminthic therapy was associated with an increased incidence of skin reactivity to house dust mites [40]. Interestingly, yet another metaanalysis has shown that helminth infection is associated Wong/Chew with an increased gut bacterial diversity, which has been shown to regulate immune response, as discussed above [41]. ...
... Although a history of helminth infection was positively associated with atopy in our study, there is con icting epidemiological evidence for this relationship, which has been attributed to the genetic susceptibility of the host and type of parasite as well as the timing, duration and intensity of infection (71)(72)(73)(74)(75). A recent meta-analysis, which included 80 studies, revealed that Ascaris lumbricoides infections were associated with an increased risk of atopy among helminth-infected adults (76). ...
Background
The increasing prevalence of allergic diseases in Zimbabwe may be attributed to changing environmental exposure patterns. In this study, we sought to identify the most influential environmental and lifestyle factors that may explain the observed atopy in a rural community in Zimbabwe.
Methods
Using a cross-sectional study, information on a wide array of environmental and lifestyle exposures was self-reported by a sample of participants (children aged < 18 years and adults aged ≥ 18 years) in the Gwanda district, Zimbabwe. To consenting participants, we performed skin prick testing (SPT) at a local clinic in Gwanda district to identify atopic individuals. Variables with a p value < 0.25 from univariate analysis were included in backward-elimination multiple logistic regression analysis. Separate regression analyses were conducted for children (n = 108), adults (n = 388), and a subgroup of adults whoreported ever being employed in any potentially harmful occupation (n =153).
Results
Compared with boys, girls were more likely to be sensitised to at least one allergen (OR= 4.87, 95% CI=1.22-19.51). Among adults, the likelihood of sensitisation increased with increasing age (OR= 1.02, 95% CI=1.01-1.03) and with a history of bloody urine and/or schistosomiasis (OR=2.20, 95% CI=0.98-4.95). In the subgroup of adults whoreported ever being employed in any potentially harmful occupation, atopic sensitisation was associated with a history of tuberculosis (TB)(OR= 3.37, 95% CI=1.08-10.52) and a history of bloody urine and/or schistosomiasis (OR=4.36, 95% CI=1.40-13.65). Other notable, though not significant, factors were passive or parental smoking, alcohol consumption, indoor dampness and visible mould on walls.
Conclusion
Risk factors for atopy included age, sex, passive smoking, alcohol consumption, indoor dampness, visible mould, and history of TB, bloody urine or schistosomiasis. Exposure to harmful pollutants typically found in occupational settings coupled with a history of TB or helminth infection particularly increased the likelihood of atopy amongadults. Longitudinal studies to explore the temporal and causal relationships between these factors and allergic outcomes areessential. There is a need for early public health interventions to address environmental and lifestyle factors for the prevention and control of allergic diseases in African rural communities.
... Genetically determined predispositions, as well as external and internal triggering factors, are important for the development of atopy (Burbank et al., 2017;Murrison et al., 2019). Despite the lack of consensus on the relationship between parasitic and allergic diseases, today many authors consider that with their pathological mechanisms on the host organism, parasites induce the development of endogenous intoxication, sensitization, autoimmune reactions, and modulation of the immune response (Cooper, 2009;Minciullo et al., 2018;Fernandes et al., 2019;Maizels, 2020). Allergic reactions have been associated with infection from both intestinal and tissue parasites (Kolkhir et al., 2016). ...
In recent years, more and more publications reflect the relationship between clinically apparent allergy and infection with Blastocystis spp. or Toxocara spp. Our main goal is to examine allergy patients infected with Blastocystis sp. for the presence of anti-Toxocara IgG antibodies, intending to detect co-infection and its influence on the allergic condition of patients. For a period of 3 years (2020 – 2022), 1011 patients hos¬pitalized in the Allergology Clinic at the University Hospital, Pleven, were examined for intestinal protozoa and helminths. Fresh stool samples for microscopic parasitological examination were used. From persons infected with Blastocystis sp. venous blood was obtained for the determination of specific anti-Toxocara antibodies. Of the patients with allergic symptoms examined for intestinal helminths and protozoa, 40 were infected with Blastocystis sp. Out of them, seven (17.5%) were positive for anti-Toxocara IgG antibodies on the ELISA test, and Western blot confirms the diagnosis. All individuals with Blastocystis / Toxocara co-infection were established against the background of chronic urticaria, but no difference was found in the severity of clinical manifestations in comparison with those with only blastocystosis and those without evidence of parasitic infection. The data of our study, give us reason to consider that the establishment of parasitic infections in persons with skin allergic manifestations is not unusual, but in general, it is very difficult to determine whether they are the cause of the allergic condition or are a finding in the course of diagnostic clarification.
... Хоча, як показали пізніші дослідження, поширення алергічних реакцій може залежати від рівня ендемічності по гельмінтозам серед населення. Тому на сьогоднішній день, з покращенням санітарно-гігієнічних умов та зниженням рівня паразитарних інфекцій, особливо у містах, рівень алергічних захворювань підвищується [28,29,30]. У осіб з високим рівнем аскаридспецифічних IgE антитіл відзначаються підвищені рівні IgE-антитіл до кліщів домашнього пилу та більш тяжкий перебіг астми. ...
Даний огляд присвячено причинно-наслідковому зв’язку між кліщами домашнього пилу і розвитком алергічних захворювань у людини. Літературні дані фундаментальних досліджень, пов’язаних з підвищеною чутливістю до алергенів, опис безпосередньо самих алергенів, а також дані сучасних досліджень були використані в якості наукових інструментів. Наведено перелік факторів та тригерних чинників, що викликають або посилюють симптоми алергічних реакцій, зокрема респіраторних та атопічних форм алергій. Були описані методи діагностики та лікування захворювань, викликаних сенсибілізацією до алергенів кліщів домашнього пилу.
... For example, while high-risk strains of HPV are known to cause over 70% of cervical cancer, our results also suggest that HPV-16 and -18 can be "protective" for diseases such as "seborrheic dermatitis" and "other dermatitis". Indeed, viral infections that increase risk of one phenotype or disease can reduce risk for others [45][46][47][48] . More generally, the role of viral infection in shaping the human immune system and subsequent immune responses has been studied extensively. ...
There are many well-established relationships between pathogens and human disease, but far fewer when focusing on non-communicable diseases (NCDs). We leverage data from The UK Biobank and TriNetX to perform a systematic survey across 20 pathogens and 426 diseases, focused primarily on NCDs. To this end, we assess the association between disease status and infection history proxies. We identify 206 pathogen-disease pairs that replicate in both cohorts. We replicate many established relationships, including Helicobacter pylori with several gastroenterological diseases, and connections between Epstein-Barr virus with multiple sclerosis and lupus. Overall, our approach identified evidence of association for 15 of the pathogens and 96 distinct diseases, including a currently controversial link between human cytomegalovirus (CMV) and ulcerative colitis (UC). We validate this connection through two orthogonal analyses, revealing increased CMV gene expression in UC patients and enrichment for UC genetic risk signal near human genes that have altered expression upon CMV infection. Collectively, these results form a foundation for future investigations into mechanistic roles played by pathogens in disease.
... Subsequently, several studies from sub-Saharan Africa reported elevated levels of allergen-specific IgE associated with parasitic infection, but these did not translate into allergic symptoms [97,104]. This phenomenon can be associated with IgE cross-reactivity, where immunoglobulins targeting one epitope can identify similar epitopes in homologous molecules [105][106][107]. ...
The dynamically growing incidence of food allergies forces the scientific community to develop new methods for their diagnosis, differentiation, and effective treatment. Parasitoses appear much less frequently in the scientific literature, as well as among the presumed causes of numerous conditions. The similarity of inflammatory mechanisms in allergies and parasitosis necessitates a revision of current diagnostic standards. A lack of specificity and the coincidence of symptoms at an early stage of disease can lead to misdiagnosis. In this paper, we attempted to perform a comparative analysis of the similarities and differences in symptoms for these two types of diseases. We described the molecular mechanisms and metabolic pathways of food allergy and parasitosis. We presented the available research methods and directions of ongoing studies aimed at implementing precise medical techniques for differential diagnosis. We discussed the allergenic properties of certain parasite proteins, using the example of myofibrillar tropomyosins from the nematode Anisakis simplex. The literature in the fields of allergology and parasitology leads to the conclusion that it is reasonable to run parallel allergological and parasitological diagnostics in patients with non-specific symptoms. This approach will facilitate accurate and early diagnosis and implementation of effective therapy.
... [8][9][10][11]. Similar results have been reported for other parasites, such as Trichuris trichiura, hookworm and Schistosoma mansoni [12,13]. Moreover, there is evidence that some nematodes, such as D. immitis, can increase allergen hypersensitivity in humans [14,15]. ...
Background
Cats can be infected by Dirofilaria immitis, the causative agent of heartworm disease, characterized by respiratory signs, airway hyperreactivity, remodelling and inflammation. Allergy is a multifactorial pathology, and the role of a number of helminth parasites in the development of allergies in humans and other species has been demonstrated in many studies. The aim of the present study was to verify whether cats seropositive for D. immitis present hypersensitivity to some environmental allergens.
Methods
Blood samples were collected from 120 cats and tested for the presence of specific immunoglobulin G antibodies against D. immitis and for hypersensitivity to 20 allergens, using commercial allergen test kits.
Results
Of the 120 cats tested, 72 (60.0%) were seropositive for anti-D. immitis IgG and 55 (45.8%) showed clinical signs of heartworm disease of a respiratory nature. The results of testing with the allergen kits showed that 50.8% of cats were seropositive for ≥ 1 allergens, with the most common allergens being Dermatophagoides farinae (25.8%), Dermatophagoides pteronyssinus (20.0%), Malassezia (17.5%) and Ctenocephalides felis (14.2%). The prevalence of allergies was significantly higher—by almost threefold—in cats seropositive for D. immitis (68.1% vs. 25%). There were no significant differences between the prevalence of allergic cats and presence/absence of symptoms, and the results confirmed that symptoms were not a decisive factor for the presence of allergies. The risk for developing allergies was 6.3-fold higher in cats seropositive for D. immitis than in cats that were seronegative, confirming that seropositivity for D. immitis is a risk factor.
Conclusions
Cats with confirmed heartworm can develop serious respiratory signs, potentially leading to progression to permanent lung injury and predisposing cats to hyperresponsive airway disease. Previous studies have shown that seropositivity for D. immitis and Wolbachia is related to the presence of bronchoconstriction and bronchospasm in the affected cat. The results support the suspicion that contact with D. immitis may be a risk factor for the presence of allergies.
Graphical abstract
... Allergen extracts for ASIT are complex mixtures of proteins and non-protein compounds containing a large amount of impurities, therefore, side reactions, including an anaphylactic shock may occur [3]. The difficulty in the manufacture of allergen extracts is the need to standardize the composition of ASIT preparations, which varies from batch to batch. ...
IgE-mediated allergic reaction occurs in response to harmless environmental compounds, such as tree and grass pollen, fragments of household microorganisms, etc. To date, the only way to treat IgE-mediated allergy is allergen-specific immunotherapy (ASIT), which consists of a prolonged subcutaneous administration of allergen extracts or recombinant proteins. The long duration of the treatment, the cost and the risk of life-threatening adverse reactions are the main limiting factors for ASIT. The aim of this work was to develop allergen proteins encapsulated in chitosan-based microparticles that can be safely administered at high doses and in a rash protocol. The egg white allergen, Gal d 1 protein, was used as a model antigen. The protein was packed into core–shell type microparticles (MPs), in which the core was formed with succinyl chitosan conjugated to Gal d 1, subsequently coated with a shell formed by quaternized chitosan. The obtained core–shell MPs containing Gal d 1 in the core (Gal-MPs) were non-toxic to macrophage and fibroblast cell lines. At the same time, Gal-MPs were quickly engulfed by bone marrow-derived dendritic cells or RAW264.7 macrophage cells, as was visualized using flow cytometry and confocal microscopy. Encapsulated Gal d 1 was not recognized by Gal d 1-specific IgE in ELISA. Female BALB/c mice were immunized with Gal-MPs subcutaneously three times a week for 2 weeks. Immunization of mice resulted in IgG titers 1250 ± 200 without IgE production. Allergy in control and vaccinated mice was induced by low-dose Gal d 1 injections in the withers of mice. IgE was induced in control-sensitized but not in the vaccinated mice. Thus, preventive vaccination with the encapsulated allergens is safe and rapid; it significantly reduces the risk of IgE production induced by respiratory and oral allergens.
... Some of this immune regulation was suggested to occur in the presence of helminth infestations because the regulation of immune reaction might have been of evolutionary benefit to both the helminths and the host [3] . This immune modulation by gastrointestinal helminth infestations is believed to reduce allergic conditions [11] , likely due to the immune regulatory potential of helminths, which is used to suppress the host immune system to establish chronic infestation and have an indirect suppressive effect on host responses against allergens [12] . This was supported by the increase in host reactivity to allergens subsequent to antihelminth treatment for chronic helminthiasis [13] and by the increase in asthma seen in high-income countries as they transitioned from having high to low prevalence of helminthiasis [1] . ...
Background
The association between helminthiasis and asthma remains inconclusive but can only be investigated in counties where helminthiasis is transitioning from a high to low burden. We investigated this association using data from a childhood respiratory cohort in Sri Lanka.
Methods
A case-control study was nested within a population-based cohort of children aged 6-14 years from Sri Lanka. Stool samples of 190 children with asthma and 190 children without asthma were analysed to assess the burden of helminth infestation. Logistic regression models were fitted to investigate the association of gastrointestinal helminth species with asthma.
Results
Helminthiasis in children with and without asthma was 23·3% (n=44) and 15·3% (n=23), respectively. Those with asthma were more likely to have helminthiasis (OR 3·7; 95%CI 1·7, 7·7; p=0·001), particularly with Trichiuris trichura (OR 4·5; 95%CI 1·6, 12·3; p=0·004). Helminth eggs per gram of faeces were not associated with asthma (p>0·05).
Conclusions
Our findings demonstrate a positive association between Trichiuris trichura infestation and asthma and point to the need to fully characterise this association to understand the likely immunological mechanism that drives it. This association highlights an important public health intervention in countries where these infections are still prevalent, affecting 24% of the population globally.
... Toxocariasis could be risk factor for the inception of allergic diseases including asthma, or may accelerate pulmonary symptoms in asthmatic patients as well (Cooper 2008;Aghaei et al. 2018). Moreover, asthma is described in various studies as a toxocariasis-associated factor (Cooper 2009;Cadore et al. 2016). ...
Toxocariasis is an underestimated geohelminthic infection which shows respiratory changes concurrent with larval migration. The purpose of the present study was to detect Toxocara seropositivity in asthmatic and pneumonic children, and in turn to evaluate its association with the children clinical manifestations, laboratory test results, and sociodemographic risk factors. A total of 50 asthmatic, 50 pneumonic children and 50 healthy controls were subjected to stool analysis by direct wet mount and concentration techniques to exclude possible cross reactivity. Blood samples were collected for complete blood count and assessment of eosinophil count. Sera were examined for anti-Toxocara IgG antibodies, and measurement of total IgE level. Anti Toxocara IgG was detected in 27.3% (41/150) of the studied children. It was significantly higher in asthmatic group compared to controls (26%. p value = 0.033) and significantly highest in pneumonia group compared to both bronchial asthma group (46%. p value = 0.030) and control group (10%. p value = 0.001). There was a significant association between anti Toxocara IgG seroprevalence and each of eosinophilia, total IgE and both combined. Anti Toxocara IgG showed significant higher percentage in asthmatic children who recorded history of soil contact and pets contact as compared to control and pneumonic groups. Toxocara IgG seropositivity was highly associated with fever, cough, wheezes and dyspnea with statistical significance. Toxocara seropositivity has to be considered as a vital associated factor for asthmatic and pneumonic children, and eventually better to be considered in differential diagnosis by pediatricians. Further studies are still needed to explore the correlation between toxocariasis and different patient categories.
