The effect of maternal helminth infection on maternal and neonatal immune function and immunity to tuberculosis.

Dawit Gebreegziabiher,Rawleigh Howe,Girmay Desalegn,Kassu Desta,Markos Abebe,Pere-Joan Cardona

doi:10.1371/journal.pone.0093429

Dawit Gebreegziabiher, Rawleigh Howe + Show 4 more

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https://doi.org/10.1371/journal.pone.0093429

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Abstract

Background M. tuberculosis and helminth infection each affects one third of the world population. Helminth infections down regulate cell mediated immune responses and this may contribute to lower efficacy of BCG vaccination and higher prevalence of tuberculosis.ObjectiveTo determine the effect of maternal helminth infection on maternal and neonatal immune function and immunity to TB.MethodsIn this cross sectional study, eighty five pregnant women were screened for parasitic and latent TB infections using Kato-Katz and QFT-GIT tests, respectively. IFN-γ and IL-4 ELISpot on Cord blood Mononuclear Cells, and total IgE and TB specific IgG ELISA on cord blood plasma was performed to investigate the possible effect of maternal helminth and/or latent TB co-infection on maternal and neonatal immune function and immunity to TB.ResultThe prevalence of helminth infections in pregnant women was 27% (n = 23), with Schistosoma mansoni the most common helminth species observed (20% of women were infected). Among the total of 85 study participants 25.8% were QFT-GIT positive and 17% had an indeterminate result. The mean total IgE value of cord blood was significantly higher in helminth positive than negative women (0.76 vs 0.47, p = 0.042). Cross placental transfer of TB specific IgG was significantly higher in helminth positive (21.9±7.9) than negative (12.3±5.1), p = 0.002) Latent TB Infection positive participants. The IFN-γ response of CBMCs to ESAT-6/CFP-10 cocktail (50 vs 116, p = 0.018) and PPD (58 vs 123, p = 0.02) was significantly lower in helminth positive than negative participants. There was no significant difference in IL-4 response of CBMCs between helminth negative and positive participants.ConclusionsMaternal helminth infection had a significant association with the IFN-γ response of CBMCs, total IgE and cross placental transfer of TB specific IgG. Therefore, further studies should be conducted to determine the effect of these factors on neonatal immune response to BCG vaccination.

Highlights

Over one third of the human population is currently infected with M. tuberculosis, and a similar percentage with helminths, the majority of these infections are found in the developing countries [1,2,3]
Maternal helminth infection had a significant association with the IFN-c response of Cord Blood Mononuclear Cells (CBMCs), total IgE and cross placental transfer of TB specific IgG
Further studies should be conducted to determine the effect of these factors on neonatal immune response to BCG vaccination

Summary

Introduction

Over one third of the human population is currently infected with M. tuberculosis, and a similar percentage with helminths, the majority of these infections are found in the developing countries [1,2,3]. The major immune response during M. tuberculosis infection (both active and latent) is cell mediated. Studies conducted in developing countries indicated that women of childbearing age are frequently infected with one or more helminths [15,16]. This may be due to immunological and physiological changes during pregnancy which favors persistent infection [17,18]. Helminth infections down regulate cell mediated immune responses and this may contribute to lower efficacy of BCG vaccination and higher prevalence of tuberculosis

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