Abstract
BackgroundCurrently there are few studies characterising the nature and aetiology of human schistosome-related inflammatory processes. The aim of this study was to determine the relationship between Chitinase 3-like 1 (CHI3L1), also known as YKL-40, a molecule associated with inflammatory processes, and schistosome infection, morbidity and systemic cytokine levels.MethodsSerological levels of CHI3L1 and a panel of cytokines (IFN-y, IL-4/5/6/9/10/13 and 17) were measured in two Zimbabwean populations resident in a high and low schistosome infection area. CHI3L1 levels were related to schistosome infection, haematuria status and cytokine levels after allowing for confounding variables. The effect of antihelminthic treatment with praziquantel on CHI3L1 levels was determined in 246 participants 6 weeks post-treatment.ResultsCHI3L1 levels increased with age in both areas but were significantly higher in the high infection areas compared to the low infection area. CHI3L1 levels were also higher in infected compared to uninfected individuals with this difference being significant in the youngest age group. Curative antihelminthic treatment resulted in a significant decrease in CHI3L1 levels. Of the cytokines, only IL-10 and IL-17 had a significant association with CHI3L1 levels, and this association was negative.ConclusionsSerum CHI3L1 levels differ between infected and uninfected people before and after antihelminthic treatment. The greatest difference occurs in the youngest age group, in keeping with the period when schistosome-related pathological processes are initiated. Following from previous studies in non-infectious diseases showing that CHI3L1 is a biomarker for the inflammatory process, this study suggests that the potential for CHI3L1 as a biomarker for schistosome-related pathology should be explored further.
Highlights
Urogenital schistosomiasis, caused by the blood fluke Schistosoma haematobium, is one of the world’s most prevalent human parasitic diseases
We showed that Chitinase 3-like 1 (CHI3L1) is elevated in schistosomiasis infected individuals over uninfected individuals, with the strongest association seen in the youngest age group who have a shorter history of schistosome infection
CHI3L1 levels were higher in infected vs. uninfected people, after allowing for the confounding effects of age and residential area, with this difference being significant in the youngest age group (Table 2, Figure 2)
Summary
Urogenital schistosomiasis, caused by the blood fluke Schistosoma haematobium, is one of the world’s most prevalent human parasitic diseases. Immunopathology commences with the laying of eggs in the blood vessels at the site of infection where they cause damage to the bladder walls and genital tissues in the form of lesions in blood vessels and tissues leading to the common symptom of haematuria Antigens secreted by these eggs induce a Th2 response, involving secretion of interleukin-4 (IL-4), IL-5 and IL-13 [3,4] and the eventual development of granulomas [5,6]. In young children infected with S. haematobium egg deposition is associated with more acute inflammatory symptoms, visible haematuria, anaemia and a high egg output in what is known as the active stage of disease [7] This progresses with age to an inactive stage characterised by a drop in urine egg counts as fewer eggs are excreted but more become trapped and calcified in tissues. The aim of this study was to determine the relationship between Chitinase 3-like 1 (CHI3L1), known as YKL-40, a molecule associated with inflammatory processes, and schistosome infection, morbidity and systemic cytokine levels
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