Anti-parasitic Treatment Modulates TH2 Response in Concomitant Asthma and Parasitic Infestation
Sunday, March 4, 2018
South Hall A2 (Convention Center)
El-Desouki E. Fouda, MD FAAAAI, Abd El-Aleem M. Ahmed, Mona H. Alrays, MD
RATIONALE: There are close parallels between allergic inflammation caused by host immune responses to environmental allergens and that caused by parasitic antigens. We evaluated TH2 response and anti-parasitic treatment effect on allergic asthma with concomitant parasitic infestation.

METHODS: Based on history, clinical examination, stool and urine analysis for ova, spirometry and blood absolute eosinophils (BAE); eighty subjects were enrolled as: 25 patients with allergic asthma (Group I), 25 with parasitic infestations (Group II) and 30 asthmatics with concomitant parasites (Group III).

Before and after anti-parasitic treatment for 3 courses, all groups were subjected to: -Total serum IgE (TsIgE). -Skin Prick Test (SPT) for soluble Ascaris and Schistosoma worms’ antigens and common house hold environment allergens. -Serum and sputum Tryptase Immuocap assay and sputum cytology.

RESULTS: All groups demonstrated highly significant elevation of TsIgE (738.5± 214.8, 1517.6±932.6, 2494.3±1411.2 IU/mL), serum tryptase (24±7.7, 43.3±21.8, 59.8±22.9 µg/L), sputum tryptase (14.8±5.5, 21.5±11.6, 32.8±12 µg/L), BAE (610.8±136.5, 913.2±348, 1189.2±405.6 eosinophils) and sputum eosinophil % (16.1±5.9, 68.4±12.7, 61.1±23.2) respectively, with highest values in group III (p>0.000). Anti-parasitic treatment was most effective in group III with significant reduction of these values: TsIgE (393.3±198.6 IU/mL), serum tryptase (13.8±5.6 µg/L), sputum tryptase (5.8±3.8 µg/L), BAE (332.0±178.9 eosinophils) and sputum eosinophil % (5.2±5.99) with p>0.000. After treatment, parasites wheal diameter of SPT was significantly decreased while that of environmental allergens increased and FEV1 was also improved from 48.1±1.17 to 59.1±1.4, p>0.001.

CONCLUSIONS: Anti-parasitic treatment reduces TH2 response in asthma with parasitic infestation resulting in improved asthma and allowing more SPT reactivity to non-parasitic allergens.