AN INVERSE RELATIONSHIP BETWEEN AUTOIMMUNE LIVER DISEASES AND STRONGYLOIDES STERCORALIS INFECTION

HAJIME AOYAMA 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

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TETSUO HIRATA 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

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HIROSHI SAKUGAWA 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

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TAKAKO WATANABE 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

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SATORU MIYAGI 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

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TATSUJI MAESHIRO 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

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TAKAYUKI CHINEN 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

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MARIKO KAWANE 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

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OSAMU ZAHA 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

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TOMOKUNI NAKAYOSHI 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

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FUKUNORI KINJO 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

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JIRO FUJITA 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

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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.
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