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      Human toxocariasis and atopy Translated title: Toxocarose humaine et atopie

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          To assess the possible influence of atopy on the clinical picture of human toxocariasis, a retrospective study was carried out using file records for patients who attended the Outpatient Clinic of Parasitology in Toulouse University Hospitals. A total of 106 file records for patients who had been diagnosed with common/covert toxocariasis were extracted from the database. Forty-nine patients (20 females and 29 males) were considered atopic since they exhibited a long (≥ 1 year) history of various allergic issues along with a titer ≥ 0.7 kIU/L for specific IgE against at least two out of nine mixes of common inhalant allergens. Fifty-seven patients (42 females and 15 males) were designated nonatopic on the basis of a negative result (<0.35 kIU/L) of the test for specific IgE. Demographic (age and sex), clinical (20 signs or symptoms) and laboratory (blood eosinophil count, eosinophil cationic protein, serum total IgE, and specific anti- Toxocara IgE) variables were investigated by bivariate analysis followed by multivariate regression analysis using “atopy” as the outcome variable. On the basis of our results, the clinical or laboratory picture of toxocaral disease was not affected by the presence of an atopic status.

          Translated abstract

          Pour évaluer la possible influence de l’atopie sur la présentation clinico-biologique de la toxocarose humaine, une étude rétrospective a été réalisée à partir des dossiers de patients vus à la Consultation du Service de Parasitologie-Mycologie du CHU de Toulouse. Cent-six dossiers de patients diagnostiqués comme ayant la forme commune de la toxocarose ont été extraits de la base de données. Quarante-neuf patients (20 femmes et 29 hommes) ont été considérés comme atopiques, eu égard à une longue (≥ 1 an) histoire de manifestations allergiques couplée à une recherche positive (≥ 0.7 kUI/L) des IgE spécifiques contre au moins deux parmi 9 mélanges de pneumallergènes communs. Cinquante-sept patients (42 femmes et 15 hommes) ont été classés non atopiques sur la base d’un résultat négatif (< 0.35 kUI/L) de la recherche d’IgE spécifiques. Les variables démographiques (âge et sexe), cliniques (20 signes ou symptômes) et biologiques (numération des éosinophiles sanguins, dosage des protéines cationiques des éosinophiles, des IgE totales et des IgE spécifiques anti- Toxocara) ont été l’objet d’une analyse statistique bivariée suivie par une régression logistique multivariée, en utilisant “atopie” comme variable à expliquer. Selon nos résultats, le tableau clinique et biologique de la toxocarose n’est pas modifié par la présence d’un état atopique.

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          Most cited references 44

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            Chronic intestinal helminth infections are associated with immune hyporesponsiveness and induction of a regulatory network.

            Helminth infections have been associated with protection against allergy and autoimmune diseases. We investigated the effects of chronic infections with Ascaris lumbricoides and Trichuris trichiura (measured twice over a 5-year period) on cytokine and antibody responses. We collected blood from 1,060 children aged 4 to 11 years living in a poor urban area of Brazil and measured Th1 (gamma interferon [IFN-gamma]) and Th2 (interleukin-5 [IL-5] and IL-13) cytokines and the regulatory cytokine IL-10 in unstimulated and stimulated (with mitogen or A. lumbricoides antigens) cultures of peripheral blood leukocytes and levels of total IgE and anti-A. lumbricoides IgG4 and IgE in serum. Intestinal helminth infections were associated with an increased proportion of children producing IL-5 in response to A. lumbricoides and producing IL-10 spontaneously, especially among coinfected and chronically infected children. Helminth infections were associated with a generalized suppression of cytokine responses to mitogen. Levels of total IgE and anti-A. lumbricoides IgG4 and IgE were especially elevated in chronically infected children. In conclusion, intestinal helminth infections were associated with a typical Th2 immune response profile and with the induction of immune hyporesponsiveness that was associated with greater frequencies of the production of spontaneous IL-10.
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              Th2 responses without atopy: immunoregulation in chronic helminth infections and reduced allergic disease.

              The immune response to helminth infections has long been known to share key features with the allergic response. In particular, both are typified by enhanced T helper 2 (Th2) responses with high levels of interleukin-4 (IL-4), IL-5 and IL-13, accompanied by eosinophilia and abundant IgE production. Paradoxically, the geographical distribution of helminth parasitism and allergic disease is complementary rather than coincident. Thus, the question arises does the Th2 response to parasites protect or pre-empt the host from developing Th2-linked allergic manifestations? It is suggested that downregulatory immune mechanisms, which dampen the anti-parasite response, might benefit the host by blocking progression to atopic reactions. This is of relevance in explaining how the "hygiene hypothesis" might operate immunologically and in the design of therapeutics.

                Author and article information

                EDP Sciences
                13 May 2020
                : 27
                : ( publisher-idID: parasite/2020/01 )
                [1 ] Service de Parasitologie Médicale, Faculté de Médecine, Université de Toulouse 31000 Toulouse France
                [2 ] Service de Parasitologie et Mycologie, Université de Toulouse, Centre Hospitalier Universitaire de Toulouse TSA 40031-31059 Toulouse cedex 9 France
                [3 ] PharmaDev, Faculté de Pharmacie, Université de Toulouse, IRD, UPS 31062 Toulouse cedex 9 France
                [4 ] Centre de Physiopathologie Toulouse-Purpan (CPTP), Université de Toulouse, INSERM, CNRS, UPS TSA 40031-31059 Toulouse cedex 9 France
                Author notes
                parasite200021 10.1051/parasite/2020029
                © J.-F. Magnaval et al., published by EDP Sciences, 2020

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 41, Pages: 8
                Research Article


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