Abstract
BackgroundPathological changes due to infection with Schistosoma haematobium include cytokine-mediated urinary tract inflammation. The involved cytokines may be excreted in urine and their presence in urine may therefore reflect S. haematobium-related urinary tract pathology. The present study, for the first time, reports on the relationship between selected cytokines in urine and infection with S. haematobium in children from an area highly affected by this parasite.MethodsChildren aged 5–12 years from two primary schools in Tana Delta District of Kenya were examined for S. haematobium eggs using urine filtration technique, for haematuria using dipstix and for eosinophil cationic protein (ECP), IL-6, IFN- γ, TNF-α and IL-10 levels using ELISA, and for S. haematobium-related urinary tract pathology using ultrasonography. In addition, venous blood was examined for serum IL-6, IFN- γ, TNF-α and IL-10 levels using ELISA.ResultsThere was no significant correlation between urinary and serum levels of IL-6, IFN- γ, TNF-α or IL-10. There was no significant difference in geometric mean intensity (GMI) in any of the serum cytokines, or in urinary TNF-α or IFN-γ, between children with light and heavy S. haematobium infections. However, children with heavy S. haematobium infections had significantly higher GMI of urinary IL-6 (p < 0.001) and lower GMI of urinary IL-10 (p = 0.002) than children with light infections. There was also a significant positive correlation between urinary IL-6 and urinary ECP (p < 0.001) and a significant negative correlation between urinary IL-10 and urinary ECP (p = 0.012).ConclusionUrinary IL-6 was positively correlated to and IL-10 was negatively correlated to infection intensity and urinary tract inflammation in S. haematobium-infected children. Urinary IL-6 and IL-10 ELISA may be a useful non-invasive tool to complement the already available tools for studying S. haematobium-related urinary tract pathology in children.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2334-14-501) contains supplementary material, which is available to authorized users.
Highlights
Pathological changes due to infection with Schistosoma haematobium include cytokine-mediated urinary tract inflammation
It has been shown that a strong pro-inflammatory tumour necrosis factor (TNF)-α response relative to the anti-inflammatory interleukin (IL)-10 response is associated with increased ultrasound-detectable pathology in the urinary tracts of S. haematobium-infected children [5]
As the area is highly prevalent for S. haematobium and the sensitivity of the urine filtration technique is relatively low in individuals with low intensities [18,21] it was assumed that the 9 egg-negative children were infected but that the eggs were missed during microscopy
Summary
Pathological changes due to infection with Schistosoma haematobium include cytokine-mediated urinary tract inflammation. Most of the available information on pathogenesis in infected individuals is a result of studies using markers of morbidity such as egg counts, It has been shown that a strong pro-inflammatory tumour necrosis factor (TNF)-α response relative to the anti-inflammatory interleukin (IL)-10 response is associated with increased ultrasound-detectable pathology in the urinary tracts of S. haematobium-infected children [5]. Studies using peripheral blood mononuclear cell culture demonstrated a positive association between Th1 cytokines, such as TNF-α and urinary tract pathology in infected individuals [5,6]. Another study, using whole blood cultures from infected individuals, could not demonstrate a significant association between Th1 or Th2 cytokines and S. haematobium infection status or intensity [7]
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