Helminth infections and tuberculosis are two of the major health care problems worldwide and share a great deal of geographical overlap.

Strongyloides stercoralis/CDC
Strongyloides stercoralis/CDC

Helminth infections are known to influence T cell responses in latent tuberculosis (LTBI). A new study published in PLOS Neglected Tropical Diseases   whether helminth infections also modulate B cell responses in helminth-tuberculosis co-infection.

Researchers from the National Institutes of Health—NIRT—International Center for Excellence in Research, Chennai, India examined how Strongyloides stercoralis (Ss) infection influences B cell responses in latent tuberculosis infection (LTBI) in the context of co-infection.

We studied 132 individuals in Tamil Nadu, South India; 44 with LTBI and clinically asymptomatic S. stercoralis infection (hereafter LTBI/Ss), 44 with LTBI only (hereafter LTBI) and 44 with S. stercoralis infection alone (hereafter Ss). None had previous anthelmintic treatment nor HIV. Follow up was performed at 6 months following recruitment and treatment.

Those with LTBI were clinically asymptomatic with a positive QuantiFERON Gold-in-tube tests and normal chest radiographs. Active TB was excluded by sputum smear negativity. Ss infection was diagnosed by the presence of IgG antibodies to the recombinant NIE antigen as described previously. None of the study population had other intestinal helminths (based on stool microscopy). All LTBI/Ss and Ss individuals were treated with single doses of ivermectin (12mg) and albendazole (400 mg) and follow–up blood draws from LTBI/Ss individuals were obtained six months later. Treated individuals were Ss infection negative by stool microscopy at six months post–treatment. All LTBI alone individuals were anti- Ss-NIE negative and negative for other intestinal helminths.

In summary, the study has demonstrated clearly that Ss infections are associated with altered B cell responses and B cell subset numbers in the context of LTBI coinfection, the authors note. While the study does not prove causation, it does provide evidence of a significant association of Ss infection with modulation of B cell function.

They also suggest that treatment of helminth infection would make for a prudent first step in the conduct of TB vaccine trials in countries endemic for both TB and helminths.

Read the study at PLOS Neglected Tropical Diseases 

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