Intestinal helminth infestation is associated with increased bronchial responsiveness in children

Non‐atopic asthma is the predominant phenotype in non‐affluent parts of Latin America. We recently reported that infestation with Ascaris lumbricoides increased the risk of non‐atopic asthma in less affluent areas of Brazil but the mechanism is unclear. The present study was conducted to determine w...

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Published in:	Pediatric pulmonology Vol. 43; no. 7; pp. 662 - 665
Main Authors:	da Silva, Emerson R., Sly, Peter D., de Pereira, Marilyn U., Pinto, Leonardo A., Jones, Marcus H., Pitrez, Paulo M., Stein, Renato T.
Format:	Journal Article
Language:	English
Published:	Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-07-2008 Wiley-Liss
Subjects:	Animals Ascariasis - complications Ascariasis - immunology Ascaris lumbricoides - immunology Ascaris lumbricoides - isolation & purification asthma Asthma - immunology Asthma - parasitology Biological and medical sciences Brazil Bronchial Hyperreactivity - immunology Bronchial Hyperreactivity - parasitology bronchial hyperresponsiveness Bronchial Provocation Tests Child children Chronic obstructive pulmonary disease, asthma Female General aspects helminthes Humans Male Medical sciences Pneumology Brazil Human Lung disease Pediatrics Respiratory disease Gut Bronchus helminthes Asthma Association children Bronchus disease Obstructive pulmonary disease bronchial hyperresponsiveness Child Pneumology
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Summary:	Non‐atopic asthma is the predominant phenotype in non‐affluent parts of Latin America. We recently reported that infestation with Ascaris lumbricoides increased the risk of non‐atopic asthma in less affluent areas of Brazil but the mechanism is unclear. The present study was conducted to determine whether helminth infestation is associated with heightened bronchial responsiveness (BHR), a common finding in asthma. A random sample of 50 asthmatic and 50 non‐asthmatic controls (mean age 10.1 years) were selected from a larger cohort (n = 1,011) without knowledge of their helminth infestation status. Three stool samples were collected from each child on different days and each sample was analyzed by the Kato‐Katz method for quantitative determination of helminth eggs. Bronchial provocation tests were performed with inhaled 4.5% hypertonic saline using the ISAAC Phase II standardized protocol. There was no difference between the prevalence of positive BHR in the asthmatics (20.4%) compared with the controls (14.6%) (P = 1.0). Helminth infestation was detected in 24.0% of children, with A. lumbricoides being the most common. Children with high load infestation (≥100 eggs/g) were five times more likely to have BHR than children with low load or no infestation. Despite the small sample size the results of the present study suggest that the link between high load helminth infestation and non‐atopic asthma may be mediated via heightened bronchial responsiveness, possibly due to an inflammatory response to the pulmonary phase of the helminth life cycle. Pediatr Pulmonol. 2008; 43:662–665. © 2008 Wiley‐Liss, Inc.
Bibliography:	ark:/67375/WNG-1892094D-6 istex:2E39165D920CD5488A5D0A8FDFF849E3CCF8A492 ArticleID:PPUL20833 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	8755-6863 1099-0496
DOI:	10.1002/ppul.20833