A RISK OF VISCERAL LEISHMANIASIS IN CASE OF HELMINTHS CO-INFECTION IN ENDEMIC REGIONS.

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R. M. D. A. Sambamurthy Chandrasekaran, “A RISK OF VISCERAL LEISHMANIASIS IN CASE OF HELMINTHS CO-INFECTION IN ENDEMIC REGIONS”., ijmhs, vol. 2, no. 4, Oct. 2013.
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Abstract

People in the endemic region are more prone to helminth infections due to the poor hygienic conditions and their genetic susceptibility may be a factor for Leishmania infection. The acute worm infections may not cause fatal outcome to host but it may facilitates the infection of other intracellular pathogens which cause higher rate of morbidity. In case of Leishmania donovani infection, helminth infections mainly elicit Th2 type protective host immune response characterized by secretion of IL-4, IL-13, IL-5, IL-9 and IL-10, which may suppress the Th1 protective host immune response. Pre-immune polarized (Th2/Th1) individuals due to the helminth infections and their recovery from infection after treatment may have higher levels of serum IL-4 and IL-13 are highly susceptible for visceral leishmaniasis in endemic regions. These Th2 type cytokines, IL-4, IL-13 and IL-10 have immunosuppressive activity, help in the parasite survival by inhibiting the macrophage induced IFN-γ production and oxidative burst mechanism, thereby enhancing disease progression in chronic visceral leishmaniasis. In addition, IL-5 dependent eosinophilia in helminth infections may cause inflammation in visceral organs leading to tissue damage hence these individuals might be susceptible for parasite attack. Therefore, we hypothesize that the Th2 type cytokine milieu of helminth infection might be increase rate of susceptibility to VL occurrence in endemic regions.

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