Influence of helminth infections on the clinical course of and immune response to Leishmania braziliensis cutaneous leishmaniasis

Seth O'Neal, Luiz Henrique Guimarães, Paulo R. Machado, Leda Alcântara, Daniel J. Morgan, Sara Passos, Marshall J. Glesby, Edgar M. Carvalho

Research output: Contribution to journalArticle

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Abstract

Background. Helminth infections influence the clinical outcome of and immune response to certain immune-mediated diseases. Methods. We conducted a cohort study of 120 patients to examine the role that intestinal helminth infection plays in the clinical course of and immune response to cutaneous leishmaniasis (CL) treated with pentavalent antimony. Results. Patients coinfected with Leishmania braziliensis and helminths took longer to heal (relative hazard for healing, 0.47 [95% confidence interval, 0.26-0.85]; P = .01) than patients with CL without helminths, with 70% of coinfected patients being cured at 90 days, compared with 92% of helminth-free patients. Coinfected patients had an immune response shifted toward the T helper 2 type, with increased total immunoglobulin E levels (P <.06) and a tendency toward increased interleukin-5 levels, compared with helminth-free patients with CL. Conclusions. Helminths influence both the clinical outcome and the immune response of patients with CL. These results may have clinical implications for the care of patients with CL caused by Leishmania braziliensis, because screening for and treatment of helminths may improve responses to treatment and possibly reduce the risk of progression to mucosal disease.

Original languageEnglish (US)
Pages (from-to)142-148
Number of pages7
JournalJournal of Infectious Diseases
Volume195
Issue number1
DOIs
StatePublished - Jan 1 2007

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Leishmania braziliensis
Cutaneous Leishmaniasis
Helminths
Infection
Antimony
Immune System Diseases
Interleukin-5
Immunoglobulin E
Patient Care
Cohort Studies
Confidence Intervals

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

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Influence of helminth infections on the clinical course of and immune response to Leishmania braziliensis cutaneous leishmaniasis. / O'Neal, Seth; Guimarães, Luiz Henrique; Machado, Paulo R.; Alcântara, Leda; Morgan, Daniel J.; Passos, Sara; Glesby, Marshall J.; Carvalho, Edgar M.

In: Journal of Infectious Diseases, Vol. 195, No. 1, 01.01.2007, p. 142-148.

Research output: Contribution to journalArticle

O'Neal, S, Guimarães, LH, Machado, PR, Alcântara, L, Morgan, DJ, Passos, S, Glesby, MJ & Carvalho, EM 2007, 'Influence of helminth infections on the clinical course of and immune response to Leishmania braziliensis cutaneous leishmaniasis', Journal of Infectious Diseases, vol. 195, no. 1, pp. 142-148. https://doi.org/10.1086/509808
O'Neal, Seth ; Guimarães, Luiz Henrique ; Machado, Paulo R. ; Alcântara, Leda ; Morgan, Daniel J. ; Passos, Sara ; Glesby, Marshall J. ; Carvalho, Edgar M. / Influence of helminth infections on the clinical course of and immune response to Leishmania braziliensis cutaneous leishmaniasis. In: Journal of Infectious Diseases. 2007 ; Vol. 195, No. 1. pp. 142-148.
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abstract = "Background. Helminth infections influence the clinical outcome of and immune response to certain immune-mediated diseases. Methods. We conducted a cohort study of 120 patients to examine the role that intestinal helminth infection plays in the clinical course of and immune response to cutaneous leishmaniasis (CL) treated with pentavalent antimony. Results. Patients coinfected with Leishmania braziliensis and helminths took longer to heal (relative hazard for healing, 0.47 [95{\%} confidence interval, 0.26-0.85]; P = .01) than patients with CL without helminths, with 70{\%} of coinfected patients being cured at 90 days, compared with 92{\%} of helminth-free patients. Coinfected patients had an immune response shifted toward the T helper 2 type, with increased total immunoglobulin E levels (P <.06) and a tendency toward increased interleukin-5 levels, compared with helminth-free patients with CL. Conclusions. Helminths influence both the clinical outcome and the immune response of patients with CL. These results may have clinical implications for the care of patients with CL caused by Leishmania braziliensis, because screening for and treatment of helminths may improve responses to treatment and possibly reduce the risk of progression to mucosal disease.",
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