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SPECIFIC ISOTYPE IMMUNE RESPONSE IN THE DIAGNOSIS OF HUMAN SCHISTOSOMIASIS PATHOLOGY?

Since the few indirect markers available for assessing the development and the stage of intestinal schistosomiasis morbidity are weakly specific, endoscopy is still the only method able to detect severe forms of pathology. Therefore, we evaluated the isotype antibody response to the current schistosome antigen preparation (soluble egg antigens [SEA]) in 142 Senegalese patients infected with Schistosoma mansoni. They were stratified into three different stages of pathology according to ultrasonographic, endoscopic, and clinical parameters (stage 1 = no detectable pathology; stage 2 = moderate morbidity; stage 3 = severe forms of pathology). Only median specific IgG4, IgE, and IgA responses changed according to the stage of pathology. The IgA level was significantly higher in stages 2 and 3 compared with stage 1, and the IgE level was higher in stage 3 compared with stage 1. A high specific IgG4 level was observed only in stage 3 and was significantly different compared with stage 2. We show an association between the variability of the specific response to SEA and the degree of morbidity, and demonstrate that IgA and IgG4 responses could be combined markers to easily discriminate the different stages of pathology due to infection with S. mansoni.

Received December 15, 2003. Accepted for publication March 10, 2004.

Acknowledgments: We thank the population of Richard-Toll, Senegal for their participation in this study, and S. Pillet and E. Bassene for technical assistance. Special thanks are given to S. Guindo and S. Tine for their participation in the study.

Financial support: This work was supported by European Economic Community contract IC18CT970240 and IC18CT960041, French Ministry of Cooperation (FAC 88/CD/91-01), the European Special Program for Operational and Integrated Research, the Region Nord-Pas-de-Calais, the Institut Pasteur de Lille, and Institut National de la Santé et de la Recherche.

^* These authors contributed equally to this work.

Authors’ adresses: Philippe Bonnard, Département des Maladies Infectieuses et Tropicales, Hôpital Tenon, (Assistance Publique-Hôpitaux de Paris), 4 Rue de la Chine, 75020 Paris, France, Telephone: 33-1-56-01-74-21, Fax: 33-1-56-01-74-23, E-mail: philippe.bonnard{at}tnn.ap-hop-paris.fr. Franck Remoue, Epidémiologie et Prévention, Institut de Recherche pour le Développement, Unité de Recherche 24, Centre Institut de Recherche pour le Développement de Hann, Route des Pères Maristes, BP 1386, Dakar, Senegal and Institut National de la Santé et de la Recherche Médicale Unité 547, Institut Pasteur de Lille, 1 Rue du Professeur Calmette, 59019, Lille Cedex, France. Anne-Marie Schacht, Sylvie Deuffic-Burban, Jean-Pierre Dompnier, Andre Capron, and Gilles Riveau, Institut National de la Santé et de la Recherche Médicale Unité 547, Institut Pasteur de Lille, 1 Rue du Professeur Calmette, 59019, Lille Cedex, France. Eric Elguero, Institut de Recherche pour le Développement, Unité de Recherche 24, 911 Avenue d’Agropolis, BP 64501, 34394 Montepllier Cedex 5, France. Nicole Charrier, Michel Cassagnou, Mamadou Diop, and Abdoulaye Ly, European Special Program for Operational and Integrated Research, Région Médicale de Saint Louis, BP 394, Saint Louis, Senegal.