Volume 83, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Several animal studies have shown a protective effect of helminth infections against type-1 diabetes mellitus (T1DM). However, epidemiologic studies demonstrating this protective relationship with T1DM are largely lacking, although an inverse correlation between the prevalence of lymphatic filariasis (LF) and prevalence of allergies and autoimmunity has been shown. A cross-sectional study was undertaken in southern India to assess the baseline prevalence of seropositivity of LF among persons with T1DM (n = 200) and normal glucose tolerant (NGT) persons (n = 562). The prevalence of LF was 0% among persons with T1DM and 2.6% among NGT persons ( = 0.026). The percentage of persons who were positive for filarial antigen-specific IgG4 (but not antigen-specific IgG) was also significantly lower in persons with T1DM (2%) compared with NGT persons (28%) ( < 0.001). Thus, there appears to be a striking inverse relationship between the prevalence of LF and T1DM in southern India.


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  1. Eisenbarth GS, , 2007. Update in type 1 diabetes. J Clin Endocrinol Metab 92: 24032407.[Crossref]
  2. Faustman DL, Davis M, , 2009. The primacy of CD8 T lymphocytes in type 1 diabetes and implications for therapies. J Mol Med 87: 11731178.[Crossref]
  3. Knip M, Siljander H, , 2008. Autoimmune mechanisms in type 1 diabetes. Autoimmun Rev 7: 550557.[Crossref]
  4. Tisch R, Wang B, , 2008. Dysregulation of T cell peripheral tolerance in type 1 diabetes. Adv Immunol 100: 125149.[Crossref]
  5. Green A, , 2008. Descriptive epidemiology of type 1 diabetes in youth: incidence, mortality, prevalence, and secular trends. Endocr Res 33: 115.[Crossref]
  6. Sabin MA, Cameron FJ, Werther GA, , 2009. Type 1 diabetes: still the commonest form of diabetes in children. Aust Fam Physician 38: 695697.
  7. Cooper GS, Bynum ML, Somers EC, , 2009. Recent insights in the epidemiology of autoimmune diseases: improved prevalence estimates and understanding of clustering of diseases. J Autoimmun 33: 197207.[Crossref]
  8. Bergholdt R, , 2009. Understanding type 1 diabetes genetics: approaches for identification of susceptibility genes in multi-factorial diseases. Dan Med Bull 56: 139.
  9. Gillespie KM, , 2006. Type 1 diabetes: pathogenesis and prevention. CMAJ 175: 165170.[Crossref]
  10. Cooke A, , 2009. Review series on helminths, immune modulation and the hygiene hypothesis: how might infection modulate the onset of type 1 diabetes? Immunology 126: 1217.[Crossref]
  11. Cooke A, Tonks P, Jones FM, O'shea H, Hutchings P, Fulford AJ, Dunne DW, , 1999. Infection with Schistosoma mansoni prevents insulin dependent diabetes mellitus in non-obese diabetic mice. Parasite Immunol 21: 169176.[Crossref]
  12. Saunders KA, Raine T, Cooke A, Lawrence CE, , 2007. Inhibition of autoimmune type 1 diabetes by gastrointestinal helminth infection. Infect Immun 75: 397407.[Crossref]
  13. Liu Q, Sundar K, Mishra PK, Mousavi G, Liu Z, Gaydo A, Alem F, Lagunoff D, Bleich D, Gause WC, , 2009. Helminth infection can reduce insulitis and type 1 diabetes through CD25- and IL-10-independent mechanisms. Infect Immun 77: 53475358.[Crossref]
  14. Weinstock JV, Elliott DE, , 2009. Helminths and the IBD hygiene hypothesis. Inflamm Bowel Dis 15: 128133.[Crossref]
  15. Zaccone P, Fehervari Z, Phillips JM, Dunne DW, Cooke A, , 2006. Parasitic worms and inflammatory diseases. Parasite Immunol 28: 515523.[Crossref]
  16. Reddy A, Fried B, , 2009. An update on the use of helminths to treat Crohn's and other autoimmune diseases. Parasitol Res 104: 217221.[Crossref]
  17. Kuartei S, , 2005. Era of globalization, emerging and re-emerging diseases and the increasing burden of non-communicable diseases. Pac Health Dialog 12: 5.
  18. Allender S, Foster C, Hutchinson L, Arambepola C, , 2008. Quantification of urbanization in relation to chronic diseases in developing countries: a systematic review. J Urban Health 85: 938951.[Crossref]
  19. Aravindhan V, Mohan V, Surendar J, Muralidhara Rao M, Pavankumar N, Deepa M, Rajagopalan R, Kumaraswami V, Nutman TB, Babu S, , 2010. Decreased prevalence of lymphatic filariasis among diabetic subjects associated with a diminished pro-inflammatory cytokine response (CURES 83). PLoS Negl Trop Dis 4: e707.[Crossref]
  20. Fida S, Myers M, Mackay IR, Zimmet PZ, Mohan V, Deepa R, Rowley MJ, , 2001. Antibodies to diabetes-associated autoantigens in Indian patients with type 1 diabetes: prevalence of anti-ICA512/IA2 and anti-SOX13. Diabetes Res Clin Pract 52: 205211.[Crossref]
  21. Somannavar S, Lanthorn H, Pradeepa R, Narayanan V, Rema M, Mohan V, , 2008. Prevention awareness counselling and evaluation (PACE) diabetes project: a mega multi-pronged program for diabetes awareness and prevention in South India (PACE- 5). J Assoc Physicians India 56: 429435.
  22. Lal RB, Ottesen EA, , 1988. Enhanced diagnostic specificity in human filariasis by IgG4 antibody assessment. J Infect Dis 158: 10341037.[Crossref]
  23. Hubner MP, Stocker JT, Mitre E, , 2009. Inhibition of type 1 diabetes in filaria-infected non-obese diabetic mice is associated with a T helper type 2 shift and induction of FoxP3+ regulatory T cells. Immunology 127: 512522.[Crossref]
  24. Espinoza-Jimenez A, Rivera-Montoya I, Cardenas-Arreola R, Moran L, Terrazas LI, , 2010. Taenia crassiceps infection attenuates multiple low-dose streptozotocin-induced diabetes. J Biomed Biotechnol 850541.
  25. Imai S, Tezuka H, Fujita K, , 2001. A factor of inducing IgE from a filarial parasite prevents insulin-dependent diabetes mellitus in nonobese diabetic mice. Biochem Biophys Res Commun 286: 10511058.[Crossref]
  26. Yuvaraj J, Pani SP, Vanamail P, Ramaiah KD, Das PK, , 2008. Impact of seven rounds of mass administration of diethylcarbamazine and ivermectin on prevalence of chronic lymphatic filariasis in south India. Trop Med Int Health 13: 737742.[Crossref]
  27. Cooke A, , 2009. Infection and autoimmunity. Blood Cells Mol Dis 42: 105107.[Crossref]
  28. Mariappan T, Snehalatha KS, Vijaya KK, Krishnamoorthy K, , 2007. Socio economic factors as indicators of various risk groups for bancroftian filariasis, Cochin, Kerala, India. J Commun Dis 39: 197199.
  29. Metenou S, Dembele B, Konate S, Dolo H, Coulibaly SY, Coulibaly YI, Diallo AA, Soumaoro L, Coulibaly ME, Sanogo D, Doumbia SS, Traoré SF, Mahanty S, Klion A, Nutman TB, , 2010. At homeostasis filarial infections have expanded adaptive regulatory T cells but not classical Th2 cells. J Immunol 184: 53755382.[Crossref]
  30. Babu S, Blauvelt CP, Kumaraswami V, Nutman TB, , 2006. Regulatory networks induced by live parasites impair both Th1 and Th2 pathways in patent lymphatic filariasis: implications for parasite persistence. J Immunol 176: 32483256.[Crossref]
  31. Semnani RT, Law M, Kubofcik J, Nutman TB, , 2004. Filaria-induced immune evasion: suppression by the infective stage of Brugia malayi at the earliest host-parasite interface. J Immunol 172: 62296238.[Crossref]
  32. Babu S, Kumaraswami V, Nutman TB, , 2009. Alternatively activated and immunoregulatory monocytes in human filarial infections. J Infect Dis 199: 18271837.[Crossref]
  33. King CL, Mahanty S, Kumaraswami V, Abrams JS, Regunathan J, Jayaraman K, Ottesen EA, Nutman TB, , 1993. Cytokine control of parasite-specific anergy in human lymphatic filariasis: preferential induction of a regulatory T helper type 2 subset. J Clin Invest 92: 16671673.[Crossref]

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Supplementary Data

Supplementary Table 1

  • Received : 19 Jul 2010
  • Accepted : 31 Aug 2010

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