Dataset Information

Strongyloides stercoralis Infection in Solid Organ Transplant Patients is Associated with Eosinophil Activation and Intestinal Inflammation: A Cross-sectional Study.

ABSTRACT:

Background

Strongyloidiasis can cause devastating morbidity and death in immunosuppressed patients. Identification of reliable biomarkers for strongyloidiasis in immunosuppressed patients is critical for the prevention of severe disease.

Methods

In this cross-sectional study of solid organ transplant (SOT) candidates and recipients, we quantified Strongyloides-specific IgG to the recombinant NIE and/or to a soluble extract of S. stercoralis somatic antigens ("crude antigen") using ELISAs. We also measured peripheral eosinophilia, four different eosinophil granule proteins, and intestinal fatty acid binding protein (IFABP).

Results

We evaluated serum biomarkers in 149 individuals; 77 (52%) pre-SOT and 72 (48%) post-SOT. Four percent (6/149) tested positive by NIE ELISA and 9.6% (11/114) by crude antigen ELISA (overall seropositivity of 9.4% [14/149]). Seropositive patients had higher absolute eosinophil counts (AECs) than seronegative patients (p=0.004). AEC was positively correlated to the levels of eosinophil granule proteins ECP and EPO (p<0.05), while IFABP was positively related to the two other eosinophil granule proteins (MBP and EDN; Spearman r=0.3090 and 0.3778, respectively, p<0.05; multivariate analyses slopes=0.70 and 2.83, respectively).

Conclusions

This study suggests that, in SOT patients, strongyloidiasis triggers both eosinophilia and eosinophil activation, the latter being associated with intestinal inflammation. These data provide insight into the pathogenesis of S. stercoralis infection in the immunocompromised population at high risk for severe strongyloidiasis syndromes.

SUBMITTER: Clark E

PROVIDER: S-EPMC7744999 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Publications

Strongyloides stercoralis Infection in Solid Organ Transplant Patients Is Associated With Eosinophil Activation and Intestinal Inflammation: A Cross-sectional Study.

Clark Eva E Pritchard Haley H Hemmige Vagish V Restrepo Alejandro A Bautista Karla K Damania Ashish A Ricciardi Alessandra A Nutman Thomas B TB Mejia Rojelio R

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20201201 10

<h4>Background</h4>Strongyloidiasis can cause devastating morbidity and death in immunosuppressed patients. Identification of reliable biomarkers for strongyloidiasis in immunosuppressed patients is critical for the prevention of severe disease.<h4>Methods</h4>In this cross-sectional study of solid organ transplant (SOT) candidates and recipients, we quantified Strongyloides-specific IgG to the recombinant NIE-Strongyloides antigen and/or to a soluble extract of S. stercoralis somatic antigens ( ...[more]

PMID: 32155244

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Project description:IntroductionStrongyloides stercoralis is an intestinal helminth ubiquitous in tropical and subtropical regions worldwide. It persists in the human host for a lifetime as a result of autoinfection and if undetected and untreated, can lead to increased morbidity and high mortality in immunocompromised individuals such as the transplant population. Transplant patients, including solid-organ and haematopoietic stem cell transplants (SOT and HSCT, respectively), are at a high risk of hyperinfection and disseminated strongyloidiasis. Unfortunately screening is often not systematically performed. Prevalence estimates of Strongyloides in this high-risk population is not well studied. Through this systematic review, we aim to summarise the descriptive evidence on Strongyloides prevalence in SOT and HSCT patients, including diagnostic and screening practices alongside the cases of hyperinfection, disseminated strongyloidiasis and the mortality rate in this population.Methods and analysesThrough the use of various online library databases, we will conduct a systematic review including relevant literature on the prevalence of Strongyloides in SOT and HSCT patients as well as studies assessing hyperinfection and disseminated strongyloidiasis in this patient population. The Population, Intervention, Comparison, Outcome and Study Design strategy and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be used to determine a final subset of studies for analysis. Quality assessment for case series and case reports will be determined by a modified quality assessment tool developed by the National Heart, Lung, and Blood Institute (NIH), and the CARE guidelines, respectively. We will provide a narrative synthesis of the findings pertaining to the primary and secondary outcomes of interest (prevalence of Strongyloides and mortality rate in transplant population, respectively) alongside the associated 95% CI. Estimates from individual studies will be pooled using a random effects model.Ethics and disseminationThis systematic review does not require formal ethical approval since no primary data will be collected. Findings will be disseminated through a peer-reviewed publication and relevant conferences.Prospero registration numberCRD42021269305.