الفهرس 
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Abstract
Human schistosomiasis is an important and widespread infection in the tropics; it gives rise to a complex of acute and chronic diseases with widely differing signs and symptoms (WHO, 1999). Based on the latest extrapolation, it is estimated that 652 million people live at risk of infection and that 200 million people are actually infected with schistosomiasis. It is believed that there are 120 million symptomatic cases of which 20 million are suffering from severe disease (Fenwick et al., 2007).
Schistosomiasis and many other decades-long infections are situations where endemic area residents become infected as children and retain their infection throughout their adolescence and well into their adult years. Setting in which these disease occurs provide situations, where many of the women bearing age are infected and are likely to expose their unborn and newborn children to both infection- related idiotypes and infection- related parasite antigens (King et al., 2000).
Our objectives are: (1) studying and identifying young children living in S. mansoni endemic area and already were born for mothers who were infected or not infected with S. mansoni during birth time and (2) Determination of the immune response of those individuals against schistosome antigens and related idiotypes.
Our population comprised 120 patients ranged from 14-20 years old and was living in Qalyubia governorate, an Egyptian S. mansoni endemic area with high intensity infection (Habib et al., 2000). These patients belong to mothers who were infected with schistosomiasis during the time of pregnancy. Eight unexposed, uninfected, healthy individuals were enrolled as a control. Demographic, clinical, ultrasonographic and serological examinations with special reference symptoms indicating infection with S. mansoni were
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performed. Also, parasitological identification of S. mansoni characteristic eggs in stool of patients was done using Kato-Katz analysis.
Groups of patient, belong to our study, were selected according to if their mothers were infected with S. mansoni or not during pregnancy time and classified according to parasitological examinations into four groups: Infected mother infected children group (IMIC) includes 23 patients, infected mother uninfected children group (IMUC) includes 23 patients, uninfected mother infected children group (UMIC) include 32 patients and uninfected mother uninfected children group (UMUC) include 42 patients.
PBMC from patient and healthy control groups were isolated and cultured in vitro against non parasitic antigens (PPD, PHA). Proliferation response of lymphocytes against PPD or PHA is the same in children come from infected or uninfected mothers and they were both similar to healthy control group, while IL-4, IL-5, IL-10, IFN- secretions against these antigens had no difference in children from infected or uninfected mothers nor healthy control.
Crude schistosome antigens (SAWA and SEA) and related SEA-idiotypes (Id) were cultured in vitro against PBMCs of different endemic groups and healthy controls.
Lymphocyte proliferation of IMIC subjects in response to SEA stimulation was significantly higher (p<0.05) than UMIC patients; no statistically significant difference between proliferations of IMUC and UMUC against SEA antigen. On the other hand, UMUC cells proliferation against SAWA have been increased significantly in comparison to IMUC.
Stimulation of PBMCs of different studied groups with SEA or Id revealed that Th1 cytokines (IL-2, IFN-) have no statistically significant different between IMIC and UMIC; IMUC and UMUC. Although IL-2 and IFN- secreted by the same cells as a result of SAWA stimulation have showed no significant difference between groups of children born to infected and non
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infected mothers, IL-2 was significantly high (p<0.01) in IMUC in compare to UMUC group.
Th2 cytokines (IL-4, IL-5 and IL-10) produced as a result of SAWA stimulation have no significant difference between IMIC and UMIC; IMUC and UMUC. Idiotypes stimulation for PBMCs have showed highly significance IL-5 production (p<0.001) in UMIC group in compare to IMIC group , on the other hand, PBMCs of IMUC group have secreted higher level of IL-5 (p<0.004) as a result of idiotypes stimulation, in compare to that secreted by UMUC. IL-4 and IL-10 have no difference in production between groups of children of infected and uninfected mother as a response of idiotypes stimulation for PBMCs. IL-10 is significant (p<0.04) as a result of SEA stimulation in UMUC group in comparison with IMUC, while there are no statistically significance difference in production of IL-4, IL-5 for both groups.
Cellular response showed that effect of mother infection in outcome of immune response of offspring in long term may be decline or lost, however may be other factors control that response in the children.
Humoral immune response for children against S. mansoni antigens was determined. IgG1, IgG2, IgG3, IgG4, IgM, IgE and IgA were measured in sera of children against SAWA and SEA by using ELSIA. Except that IgG4 against SEA was significantly elevated (p<0.05) in IMUC group in comparison with UMUC, no statistically significant difference were detected in different types of antibodies between groups of children of infected and uninfected mothers.
In conclusion, evaluation of impact of mother infection during time of pregnancy in outcome of the immune response of offspring in long term showed that children living in S. mansoni endemic area and born to infected mother have the same immune response against schistosome parasite in compare to children born to non infected mother.