• 1

    Feld JJ, Heathcote EJ, 2003. Epidemiology of autoimmune liver disease. J Gastroenterol Hepatol 18 :1118–1128.

  • 2

    Parikh-Patel A, Gold EB, Worman H, Krivy KE, Gershwin ME, 2001. Risk factors for primary biliary cirrhosis in a cohort of patients from the United States. Hepatology 33 :16–21.

    • Search Google Scholar
    • Export Citation
  • 3

    Bach JF, 2002. The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med 347 :911–920.

  • 4

    Weinstock JV, Summers RW, Elliott DE, Qadir K, Urban JF Jr, Thompson R, 2002. The possible link between de-worming and the emergence of immunological disease. J Lab Clin Med 139 :334–338.

    • Search Google Scholar
    • Export Citation
  • 5

    Fox JG, Beck P, Dangler CA, Whary MT, Wang TC, Ning shi H, Nagleranderson C, 2000. Concurrent enteric helminth infection modulates inflammation and gastric immune responses and reduces helicobacter-induced gastric atrophy. Nat Med 6 :536–542.

    • Search Google Scholar
    • Export Citation
  • 6

    La Flamme AC, Ruddenklau K, Backstrom BT, 2003. Schistosomiasis decreases central nervous system inflammation and alters the progression of experimental autoimmune encephalomyelitis. Infect Immun 71 :4996–5004.

    • Search Google Scholar
    • Export Citation
  • 7

    Summers R, Elliott D, Qadir K, Urban JF Jr, Thompson R, Weinstock JV, 2003. Trichuris suis appears safe and effective in the treatment of inflammatory bowel disease: a possible example of Th2 conditioning of the mucosal immune response. Am J Gastroenterol 98 :2034–2041.

    • Search Google Scholar
    • Export Citation
  • 8

    McKay DM, 2006. The beneficial helminth parasite? Parasitology 132 :1–12.

  • 9

    Yazdanbakhsh M, Kremsner PG, van Ree R, 2002. Allergy, parasites, and the hygiene hypothesis. Science 296 :490–494.

  • 10

    Zaha O, Hirata T, Kinjo F, Saito A, 2000. Strongyloidiasis—progress in diagnosis and treatment. Intern Med 39 :695–700.

  • 11

    Hirata T, Uchima N, Kishimoto K, Zaha O, Kinjo N, Hokama A, Sakugawa H, Kinjo F, Fujita J, 2006. Impairment of host immune response against Strongyloides stercoralis by human T cell lymphotropic virus type 1 infection. Am J Trop Med Hyg 74 :246–249.

    • Search Google Scholar
    • Export Citation
  • 12

    Hegab MH, Zamzam SM, Khater NM, Tawfeek DM, Abdel-Rahman HM, 2003. Opportunistic intestinal parasites among children with chronic liver disease. J Egypt Soc Parasitol 33 :969–977.

    • Search Google Scholar
    • Export Citation
  • 13

    Gaburri D, Gaburri AK, Hubner E, Lopes MH, Ribeiro AM, de Paulo GA, Pace FH, Gaburri PD, Ornellas AT, Ferreira JO, Chebli JM, Ferreira LE, de Souza AF, 1997. Intestinal parasitosis and hepatic cirrhosis. Arq Gastroenterol 34 :7–12.

    • Search Google Scholar
    • Export Citation
  • 14

    de Oliveira LC, Ribeiro CT, Mendes Dde M, Oliveira TC, Costa-Cruz JM, 2002. Frequency of Strongyloides stercoralis infection in alcoholics. Mem Inst Oswaldo Cruz 97 :119–121.

    • Search Google Scholar
    • Export Citation
  • 15

    Arakaki T, Iwanaga M, Kinjo F, Saito A, Asato R, Ikeshiro T, 1990. Efficacy of agar-plate culture in detection of Strongyloides stercoralis infection. J Parasitol 76 :425–428.

    • Search Google Scholar
    • Export Citation
  • 16

    Alvarez F, Berg PA, Bianchi FB, Bianchi L, Burroughs AK, Cancado EL, Chapman RW, Cooksley WGE, Czaja AJ, Desmet VJ, Donaldson PT, Eddleston ALWF, Fainboim L, Heathcote J, Homberg JC, Hoofnagle JH, Kakumu S, Krawitt EL, Mackay IR, MacSween RNM, Maddrey WC, Manns MP, McFarlane IG, Meyer zum B̈uschenfelde KH, Mieli-Vergani G, Nakanuma Y, Nishioka M, Penner E, Porta G, Portmann BC, Reed WD, Rodes J, Schalm SW, Scheuer PJ, Schrumpf E, Seki T, Toda G, Tsuji T, Tygstrup N, Vergani D, Zeniya M, 1999. International autoimmune hepatitis group report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol 31 :929–938.

    • Search Google Scholar
    • Export Citation
  • 17

    Asato R, Nakasone T, Yoshida C, Arakaki T, Ikeshiro T, Murakami H, Sakiyama H, 1992. Current status of Strongyloides infection in Okinawa, Japan. Jpn J Trop Med Hyg 20 :169–173.

    • Search Google Scholar
    • Export Citation
  • 18

    Hayashi J, Kishihara Y, Yoshimura E, Furusyo N, Yamaji K, Kawakami Y, Murakami H, Kashiwagi S, 1997. Correlation between human T cell lymphotropic virus type-1 and Strongyloides stercoralis infections and serum immunoglobulin E responses in residents of Okinawa, Japan. Am J Trop Med Hyg 56 :71–75.

    • Search Google Scholar
    • Export Citation
  • 19

    Elliott DE, Urban JF Jr, Argo CK, Weinstock JV, 2000. Does the failure to acquire helminthic parasites predispose to Crohn’s disease? FASEB J 14 :1848–1855.

    • Search Google Scholar
    • Export Citation
  • 20

    Hunter MM, McKay DM, 2004. Review article: Helminths as therapeutic agents for inflammatory bowel disease. Aliment Pharmacol Ther 19 :167–177.

    • Search Google Scholar
    • Export Citation
  • 21

    Zaccone P, Fehervari Z, Jones FM, Sidobre S, Kronenberg M, Dunne DW, Cooke A, 2003. Schistosoma mansoni antigens modulate the activity of the innate immune response and prevent onset of type 1 diabetes. Eur J Immunol 33 :1439–1449.

    • Search Google Scholar
    • Export Citation
  • 22

    Sewell D, Qing Z, Reinke E, Elliot D, Weinstock J, Sandor M, Fabry Z, 2003. Immunomodulation of experimental autoimmune encephalomyelitis by helminth ova immunization. Int Immunol 15 :59–69.

    • Search Google Scholar
    • Export Citation
  • 23

    Yazdanbakhsh M, van den Biggelaar A, Maizels RM, 2001. Th2 responses without atopy: immunoregulation in chronic helminth infections and reduced allergic disease. Trends Immunol 22 :372–377.

    • Search Google Scholar
    • Export Citation
  • 24

    Porto AF, Neva FA, Bittencourt H, Lisboa W, Thompson R, Alcantara L, Carvalho EM, 2001. HTLV-1 decreases Th2 type of immune response in patients with strongyloidiasis. Parasite Immunol 23 :503–507.

    • Search Google Scholar
    • Export Citation
  • 25

    Mosmann TR, Sad S, 1996. The expanding universe of T-cell subsets: Th1, Th2 and more. Immunol Today 17 :138–146.

  • 26

    Doetze A, Satoguina J, Burchard G, Rau T, Loliger C, Fleischer B, Hoerauf A, 2000. Antigen-specific cellular hyporesponsiveness in a chronic human helminth infection is mediated by T(h)3/T(r)1-type cytokines IL-10 and transforming growth factor-beta but not by a T(h)1 to T(h)2 shift. Int Immunol 12 :623–630.

    • Search Google Scholar
    • Export Citation
  • 27

    Harada K, Van de Water J, Leung PS, Coppel RL, Ansari A, Nakanuma Y, Gershwin ME, 1997. In situ nucleic acid hybridization of cytokines in primary biliary cirrhosis: predominance of the Th1 subset. Hepatology 25 :791–796.

    • Search Google Scholar
    • Export Citation
  • 28

    Nagano T, Yamamoto K, Matsumoto S, Okamoto R, Tagashira M, Ibuki N, Matsumura S, Yabushita K, Okano N, Tsuji T, 1999. Cytokine profile in the liver of primary biliary cirrhosis. J Clin Immunol 19 :422–427.

    • Search Google Scholar
    • Export Citation
  • 29

    Martinez OM, Villanueva JC, Gershwin ME, Krams SM, 1995. Cytokine patterns and cytotoxic mediators in primary biliary cirrhosis. Hepatology 21 :113–119.

    • Search Google Scholar
    • Export Citation
  • 30

    Shindo M, Mullin GE, Braun-Elwert L, Bergasa NV, Jones EA, James SP, 1996. Cytokine mRNA expression in the liver of patients with primary biliary cirrhosis (PBC) and chronic hepatitis B (CHB). Clin Exp Immunol 105 :254–259.

    • Search Google Scholar
    • Export Citation
  • 31

    Gershwin ME, Ansari AA, Mackay IR, Nakanuma Y, Nishio A, Rowley MJ, Coppel RL, 2000. Primary biliary cirrhosis: An orchestrated immune response against epithelial cells. Immunol Rev 174 :210–225.

    • Search Google Scholar
    • Export Citation
  • 32

    Longhi MS, Ma Y, Bogdanos DP, Cheeseman P, Mieli-Vergani G, Vergani D, 2004. Impairment of CD4(+)CD25(+) regulatory T-cells in autoimmune liver disease. J Hepatol 41 :31–37.

    • Search Google Scholar
    • Export Citation
 
 
 

 

 
 
 

 

 

 

 

 

 

AN INVERSE RELATIONSHIP BETWEEN AUTOIMMUNE LIVER DISEASES AND STRONGYLOIDES STERCORALIS INFECTION

View More View Less
  • 1 Division of Control and Prevention of Infectious Diseases, Department of Medicine and Therapeutics, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan; Department of Internal Medicine, Heartlife Hospital, Okinawa, Japan; Department of Internal Medicine, Nakagami Hospital, Okinawa, Japan; Department of Endoscopy, Ryukyu University Hospital, Okinawa, Japan

A case-control study was undertaken to describe the prevalence of Strongyloides stercoralis infection among patients with autoimmune liver diseases, such as primary biliary cirrhosis (PBC), autoimmune hepatitis (AIH), and primary sclerosing cholangitis (PSC). This study covered 4,117 patients who were admitted to hospitals in Okinawa, Japan, between 1988 and 2006. During this period, 538 patients had the following chronic liver diseases: PBC, AIH, PSC, chronic viral hepatitis group, and alcoholic liver disease. The other 3,579 patients who were hospitalized and underwent parasitologic tests served as controls. The frequency of S. stercoralis infection in the autoimmune liver diseases group (1.0%) was lower than that found in the control group (7.0%; P = 0.0063). None of the female patients with PBC born before 1955 had S. stercoralis infection, which was also statistically significant (P = 0.045). We hypothesized that immunomodulation by S. stercoralis infection may lower the incidence of autoimmune liver disease.

Author Notes

Reprint requests: Hajime Aoyama, Control and Prevention of Infectious Diseases, Department of Medicine and Therapeutics, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, Telephone: 81-98-895-1144, Fax: 81-98-895-1414, E-mail: haaoyama-gi@umin.ac.jp.
Save