EFFECT OF ANTHELMINTIC TREATMENT ON THE ALLERGIC REACTIVITY OF CHILDREN IN A TROPICAL SLUM
EFFECT OF ANTHELMINTIC TREATMENT ON THE ALLERGIC REACTIVITY OF CHILDREN IN A TROPICAL SLUM
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DOI：
10.1016/0091-6749(93)90119-z
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发表时间：
1993-09-01
影响因子：
14.2
通讯作者：
ALVAREZ, N
中科院分区：
文献类型：
--
作者：
LYNCH, NR;HAGEL, I;ALVAREZ, N
众所周知，蠕虫感染可引起IgE合成的多克隆刺激，其依赖于白细胞介素-4（IL-4）的产生，并且已表明这可调节热带人群中过敏反应性的表达。我们评估了定期驱虫治疗的效果，为期22个月，在委内瑞拉的加拉加斯，那里的蠕虫是地方病的贫民窟地区的儿童过敏反应的某些方面。治疗（Oxantel-噻嘧啶; Quantrel）有效消除了肠道蠕虫感染，并导致初始升高的总血清IgE水平显著降低。血清中可检测到IL-4，治疗后也观察到IL-4显著降低。与此相反，立即过敏性皮肤试验反应性和血清特异性IgE抗体对环境过敏原显着增加，在治疗的儿童。在同一贫民窟接受评估但拒绝治疗的一组儿童中，蠕虫感染大幅增加，这与委内瑞拉社会经济状况在我们研究期间的严重恶化有关。这些儿童的总IgE水平显著升高，皮试反应性和特异性IgE水平降低，这说明了这一点。Prausnitz-Kustner被动转移试验的应用和特异性IgE抗体水平的分析表明，蠕虫寄生虫对IgE合成的多克隆刺激导致肥大细胞Fc受体饱和和特异性IgE抗体合成的抑制。这种对过敏反应的抑制作用可通过驱虫治疗逆转。
It is well known that helminthic infection can cause a polyclonal stimulation of the synthesis of IgE, which is dependent on interleukin-4 (IL-4) production, and it has been suggested that this can modulate the expression of allergic reactivity in tropical populations. We evaluated the effect of regular anthelmintic treatment, for a period of 22 months, on certain aspects of the allergic reactivity of children in a slum area of Caracas, Venezuela, where helminths are endemic. The treatment (Oxantel-Pyrantel,; Quantrel) effectively eliminated intestinal helminthic infection and resulted in a significant decrease in the initially elevated total serum IgE levels. IL-4 was detectable in the serum, and a significant reduction in IL-4 was also observed after treatment. In contrast, both the immediate-hypersensitivity skin-test reactivity and serum levels of specific IgE antibody against environmental allergens were markedly increased in the treated children. In a group of children who were also evaluated in the same slum, but who declined treatment, a substantial increase in helminthic infection occurred, which was related to an acute deterioration of the socioeconomic conditions of Venezuela over the course of our study period. This was paralleled by a considerable increase in total IgE levels in these children and a decrease in the skin-test reactivities and specific IgE levels. The application of Prausnitz-Kustner passive transfer tests and analysis of specific IgE antibody levels indicated that the polyclonal stimulation of IgE synthesis by helminthic parasites results in mast cell Fcepsilon receptor saturation and suppression of specific IgE antibody synthesis. This inhibition of allergic reactivity is reversible by anthelmintic treatment.