Human Schistosomiasis Is Associated with Endotoxemia and Toll-Like Receptor 2- and 4-Bearing B Cells

Daniel Onguru Vector Biology and Control Research Centre, Kenya Medical Research Institute, Kisian, Kenya; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts

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YanMei Liang Vector Biology and Control Research Centre, Kenya Medical Research Institute, Kisian, Kenya; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts

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Qyana Griffith Vector Biology and Control Research Centre, Kenya Medical Research Institute, Kisian, Kenya; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts

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Barbara Nikolajczyk Vector Biology and Control Research Centre, Kenya Medical Research Institute, Kisian, Kenya; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts

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Pauline Mwinzi Vector Biology and Control Research Centre, Kenya Medical Research Institute, Kisian, Kenya; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts

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Lisa Ganley-Leal Vector Biology and Control Research Centre, Kenya Medical Research Institute, Kisian, Kenya; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts

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Schistosomiasis is caused by parasitic trematodes. Individuals can accumulate hundreds of intravascular worms, which secrete a myriad of antigenic molecules into the bloodstream. Some of these molecules suppress immunity to microbial Toll-like receptor (TLR) ligands, such as lipopolysaccharides, which may increase host susceptibility to coinfecting pathogens. We show that schistosomiasis is associated with extremely high levels of endotoxemia as well as high mobility group 1, an endogenous inflammatory TLR ligand, in the absence of other coinfected pathogens. Circulating B cells express surface TLR2 and TLR4, reflecting systemic exposure to microbial ligands. Bacterial translocation may occur with schistosomal egg movement from the vascular to the gut and other routes, such as the skin during infection. Our report suggests that immunosuppressive schistosome antigens may have evolved to curb inflammatory responses to the high antigenic burden of translocated bacteria products and endogenous TLR ligands that arise during parasite exposure and inflammation.

Author Notes

*Address correspondence to Lisa Ganley-Leal, Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA 02118. E-mail: lisa.ganleyleal@bmc.org
†These authors contributed equally.

Financial support: This study was supported with funding from National Institute of Allergy and Infectious Diseases Grant A1074843 (to L.G.-L.) and Wellcome Trust Grant 08360 (to P.M.).

Authors' addresses: Daniel Onguru and Pauline Mwiniz, Vector Biology and Control Research Centre, Kenya Medical Research Institute, Kisumu, Kenya, E-mails: danonguru@yahoo.com and pmwinzi@kisian.mimcom.net. YanMei Liang, Qyana Griffith, and Lisa Ganley-Leal, Division of Infectious Diseases, Boston University School of Medicine, Boston, MA, E-mails: yanmei.liang@bmc.org, qyana@bu.edu, and Lisa.GanleyLeal@bmc.org. Barbara Nikolajczyk, Department of Microbiology, Boston University School of Medicine, Boston, MA, E-mail: bnikol@bu.edu.

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