Elevation of C-reactive protein, P-selectin and Resistin as potential inflammatory biomarkers of urogenital Schistosomiasis exposure in preschool children

Theresa N Chimponda,Derick N M Osakunor,Cremance Tshuma,Arthur Vengesai,Francisca Mutapi,Eyoh Enwono,Caroline Mushayi,Seth Amanfo,Takafira Mduluza,Janice Murray

doi:10.1186/s12879-019-4690-z

Abstract

BackgroundSchistosomiasis is known to induce inflammatory immune responses. C-reactive protein (CRP), resistin and P-selectin are serological inflammatory markers that rise during the acute stages of infection. Here, we propose such inflammatory biomarkers have a potential for use in urogenital schistosomiasis diagnostic screening for exposure and infection in preschool-aged children.MethodsAs part of a larger study on urogenital schistosomiasis, 299 preschool children aged 1–5 years were included in this cross-sectional study. Parasitological diagnosis was conducted using urine filtration for Schistosoma haemtobium infection, and Kato Katz for S. mansoni infection. Serum levels of P-selectin, resistin, CRP, and antibodies against S. haematobium cercarial antigen preparation (CAP) and soluble worm antigen preparation (SWAP) were measured by ELISA.ResultsOf the 299 participants, 14% were egg positive for S. haematobium. Serology showed 46 and 9% of the participants to have been exposed to S. haematobium cercarial antigens and adult worm antigens, respectively. Levels of P-selectin were significantly higher in participants infected with S. haematobium (egg-positive) than in uninfected participants (p = 0.001). Levels of P-selectin were also higher in those exposed to cercarial antigen than in unexposed participants (p = 0.019). There was a positive correlation between P-selectin and infection intensity (r = 0.172; p = 0.002), as well as with IgM responses to CAP and SWAP (r = 0.183; p = 0.001); (r = 0.333; p < 0.0001) respectively. CRP significantly correlated with IgM responses to CAP (r = 0.133; p = 0.029) while resistin correlated with IgM responses to CAP and SWAP (r = 0.127; p = 0.016); (r = 0.197; p = 0.0004). CRP levels were higher in those exposed to cercarial and adult worm antigens than unexposed participants (p = 0.035); (p = 0.002) respectively, while resistin was higher in participants exposed to cercarial antigen than unexposed participants (p = 0.024).ConclusionIn this preschool population, P-selectin is significantly associated with urogenital schistosome infection and intensity; hence a potential biomarker for infection diagnosis and disease monitoring. The inflammatory biomarkers (P-selectin, Resistin and CRP) were significantly higher in participants exposed to cercarial antigens than unexposed individuals indicating an underlying inflammatory environment.

Highlights

Schistosomiasis is known to induce inflammatory immune responses
Study area and population The study was conducted in 299 preschool children (≤5 years of age) as part of a larger longitudinal study investigating the immunological responses of paediatrics at first infection with schistosomiasis, in the Shamva district of the Mashonaland Central Province of Zimbabwe
S. haematobium and S. mansoni diagnosis Urine sample was collected from each participant on three consecutive days and a stool specimen collected on a single day from each participant

Summary

Introduction

C-reactive protein (CRP), resistin and P-selectin are serological inflammatory markers that rise during the acute stages of infection We propose such inflammatory biomarkers have a potential for use in urogenital schistosomiasis diagnostic screening for exposure and infection in preschool-aged children. The biomarkers can possibly predict disease outcome [16] and can be useful for the detection of possible infection in population groups that rarely acquire heavy infection; especially preschool-aged children during the early years when they first get exposed and infected Inflammatory markers such as C-Reactive Protein (CRP), fibrinogen, may be used to detect acute inflammation which can be indicative of a particular disease or can be used as a marker of response to treatment [32]. Measuring inflammatory markers in schistosomiasis is important, as there is a persistent acute phase response, which is caused by chronic infection [5]

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