Host-Parasite Interactions in Individuals with Type 1 and 2 Diabetes Result in Higher Frequency of Ascaris lumbricoides and Giardia lamblia in Type 2 Diabetic Individuals.

Eleuza Rodrigues Machado,Daniela Carlos,Sinione Morais Rezende,Maria Jarlene Rodrigues Almeida,Maria Imaculada Muniz-Junqueira,Rodrigo Gurgel-Gonçalves,Thauana Cristina Silva,Maria Regina Fernandes De Oliveira,Leônia Rodrigues,Núbia Oliveira Matos

doi:10.1155/2018/4238435

Abstract

Host-parasite interactions in diabetic patients might influence diabetes complications and intestinal parasitosis. The aim was to investigate the occurrence of enteroparasites in individuals with diabetes types 1 and 2. A descriptive study was designed to estimate frequencies of parasites and to compare them in individuals with diabetes types 1 and 2 from two Health Centers and one hospital in the Federal District of Brazil. Patients were allocated to the study by convenience. Three fecal samples of 156 diabetic individuals (120 type 1 and 36 type 2) were analyzed using two parasitological methods. Enteroparasites or commensals frequency in diabetics was 64%. Diabetics infected with up to six species of intestinal parasites or commensals were found. Frequencies of Ascaris lumbricoides and Giardia lamblia were higher in individuals with type 2 diabetes. The lower frequency of A. lumbricoides found in type 1 diabetes may be related to a strong Th2 response to parasites. Autoimmune response developed in type 1 diabetic individuals characterized by the production of Th1 cytokines could explain low frequency of G. lamblia. High frequency of parasites found in type 2 diabetes emphasizes the importance of periodic parasitological examinations in these individuals.

Highlights

Intestinal parasites occur in marginalized, low-income, and resource-constrained regions of the world, with over one billion infected people in developing areas of Africa, Asia, and the Americas [1]
The development of diabetes has been linked to the loss of self-tolerance to beta cell autoantigens leading to the Th1-mediated destruction of insulin-producing beta cells
Helminths might inhibit type1 diabetes by disrupting the pathways leading to the Th1-mediated destruction of insulin-producing beta cells mediated by mechanisms related to the capacity of the host to mount a Th2 response to parasites

Summary

Introduction

Intestinal parasites occur in marginalized, low-income, and resource-constrained regions of the world, with over one billion infected people in developing areas of Africa, Asia, and the Americas [1]. The establishment of a regulatory network can Journal of Diabetes Research contribute to the control of overt immune responses to allow longer survival of the parasite while restricting inflammation that might otherwise lead to pathology [4]. These alterations in the host immune state might influence and be influenced by other concomitant diseases [5]. Helminths might inhibit type diabetes by disrupting the pathways leading to the Th1-mediated destruction of insulin-producing beta cells mediated by mechanisms related to the capacity of the host to mount a Th2 response to parasites. T1D accounts for 90% of diabetes in children and adolescents, usually presenting with a classic trio of symptoms such as polydypsia, polyphagia, and polyuria, alongside of overt hyperglycemia [6]

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