@article{9209,
  keywords = {Adolescent, Adult, Aged, Antigens, Bacterial, Antigens, Helminth, Brazil, Case-Control Studies, Cells, Cultured, Comorbidity, Disease Progression, Female, Humans, Interferon-gamma, Interleukin-10, Interleukin-4, Intestinal Diseases, Parasitic, Leprosy, lepromatous, Leprosy, Tuberculoid, Leukocytes, Mononuclear, Lymphocyte Activation, Male, Middle Aged, Mycobacterium leprae, Prevalence, Prospective Studies, Risk Factors, Th1 Cells, Young Adult},
  author = {Diniz L M and Magalhães E F L and Pereira F E L and Dietze R and Ribeiro-Rodrigues R},
  title = {Presence of intestinal helminths decreases T helper type 1 responses in tuberculoid leprosy patients and may increase the risk for multi-bacillary leprosy.},
  abstract = {<p>Resistance to intracellular pathogens such as Mycobacterium leprae is dependent upon an effective T helper type 1 (Th1)-type immune response. On the other hand, intestinal helminths are known to subvert the host's immune response towards to either a Th2-type immune response or a regulatory T cell up-regulation, which may affect the host's ability to mount an effective response to mycobacteria. Here, we report a significant association between intestinal helminth infections and lepromatous leprosy [odds ratio (OR), 10.88; confidence interval (CI) 95%: 4.02-29.4; P<0.001]. We also observed that the frequency of intestinal helminths correlated strongly with the mycobacterial index (r=0.982, P<0.01). Corroborating with our hypothesis, intracellular levels of interferon-gamma were decreased significantly in leprosy patients co-infected with intestinal helminths when compared to leprosy patients without worms. Conversely, lepromatous leprosy patients with intestinal worms produced higher levels of both interleukin (IL)-4 and IL-10. Our results suggest that a pre-existing infection by intestinal helminths may facilitate the establishment of M. leprae infection or its progression to more severe forms of leprosy.</p>},
  year = {2010},
  journal = {Clinical and experimental immunology},
  volume = {161},
  pages = {142-50},
  month = {2010 Jul 01},
  issn = {1365-2249},
  url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2940159/pdf/cei0161-0142.pdf},
  doi = {10.1111/j.1365-2249.2010.04164.x},
  language = {eng},
}