02715nas a2200529   4500000000100000008004100001260001600042653001500058653001000073653000900083653002400092653002300116653001100139653002500150653002000175653001600195653002400211653001100235653001100246653002100257653001900278653001800297653003500315653002500350653002500375653002800400653002600428653000900454653001600463653002500479653001500504653002400519653001700543653001400560653001600574100001400590700002100604700001800625700001300643700002400656245016000680856007700840300001100917490000800928520123500936022001402171       2010                            d  c2010 Jul 0110aAdolescent10aAdult10aAged10aAntigens, Bacterial10aAntigens, Helminth10aBrazil10aCase-Control Studies10aCells, Cultured10aComorbidity10aDisease Progression10aFemale10aHumans10aInterferon-gamma10aInterleukin-1010aInterleukin-410aIntestinal Diseases, Parasitic10aLeprosy, lepromatous10aLeprosy, Tuberculoid10aLeukocytes, Mononuclear10aLymphocyte Activation10aMale10aMiddle Aged10aMycobacterium leprae10aPrevalence10aProspective Studies10aRisk Factors10aTh1 Cells10aYoung Adult1 aDiniz L M1 aMagalhães E F L1 aPereira F E L1 aDietze R1 aRibeiro-Rodrigues R00aPresence of intestinal helminths decreases T helper type 1 responses in tuberculoid leprosy patients and may increase the risk for multi-bacillary leprosy.  uhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2940159/pdf/cei0161-0142.pdf  a142-500 v1613 a<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>  a1365-2249