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Immunologic Profiles of Persons Recruited for a Randomized, Placebo-Controlled Clinical Trial of Hookworm Infection

Data from epidemiologic studies suggest that hookworm infections, in establishing an immunologic phenotype conducive to parasite survival, may protect against the development of allergic disease. We describe immunologic findings from a clinical study designed to investigate the safety of iatrogenic hookworm infection in participants with allergic rhinitis. The low, relatively safe level of hookworm infection used in this study was immunogenic, inducing eosinophilia and a significant specific IgG response. Importantly, no potentiation of IgE responses to the environmental allergens to which the participants were sensitized was seen. However, no evidence of systemic immune regulation was seen in infected participants. This finding may indicate that the level of infection or the frequency of infection may have to be altered in future trials to induce a therapeutically conducive immunologic phenotype.

Received May 5, 2009. Accepted for publication June 23, 2009.

Acknowledgments: We thank Dr. Rupert Quinnell, Professor John Lewis, and Dr. Kevin Mortimer for their critical appraisal of this manuscript.

Financial support: This work was supported by the Wellcome Trust (GR076306/Z/04/Z).

Disclosure: David Pritchard wishes to disclose that he is an inventor on a patent supporting the use of molecules derived from nematodes as immune modulatory agents. The study could be viewed as supportive of such intellectual property if any ensuing trial is successful. This statement is made in the interest of full disclosure and not because the author considers this to be a conflict of interest.

^* Address correspondence to Daniel Blount, Immune Modulation Research Group, Division of Molecular and Cellular Science, School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, United Kingdom. E-mail: daniel.blount{at}nottingham.ac.uk

Authors’ addresses: Daniel Blount, Doreen Hooi, Gary Telford, Alan Brown, and David Pritchard, Immune Modulation Research Group, Division of Molecular and Cellular Science, School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, UK, E-mail: daniel.blount{at}nottingham.ac.uk. Johanna Feary, Andrea Venn, and John Britton, Division of Epidemiology and Public Health, University of Nottingham, City Hospital, Nottingham NG5 1PB, UK.