Postoperative changes in serum cytokines profile and nitric oxide levels in patients with cystic echinococcosis

Abstract

Summary :The aim of the present study was to examine serum cytokines and nitric oxide (NO) levels in patients with cystic echinococcosis (CE). 28 patients with CE were studied and all underwent surgery. Serum levels of tumour necrosis factor-alpha (TNF-α), interleukin IL-1β, receptor of soluble IL-2R (sIL-2R), IL-6, IL-8, nitrate/nitrite, and C-reactive protein (CRP) were determined before and after induction of treatment. Data were compared with those obtained from 28 healthy volunteers. IL-6 was elevated in all CE patients (100 %). IL-8 was increased in 11/28 (39.3 %). Increased levels of IL-2R and TNF-α were found in a limited number of them particularly those showing cysts in the central area of the liver (5/28, 6/28). IL-1β level was not elevated in any patient except in secondary severe CE. CRP and nitrate/nitrite levels were also increased. A positive correlation between CRP and IL-6 (r = 0.74; p < 0.001) was found confirming the link between inflammation due to CE and activation of monocytes. All patients completely recovered and the levels of the studied parameters reverted to normal levels except one patient in whom severe recurrent disease occurred two years after the first operation. These results suggest that there are different immunoregulatory events and cytokines response during CE and may be in part related to slight monocytosis and in part to Th2 activation. IL-6, NO and CRP were unambiguously involved in the host parasite interaction and therefore may be useful markers in monitoring CE management and evaluating surgical stress. Résumé :

The intermediate host immune response in cystic echinococcosis

“…In particular, IgG4 and IgE have been associated with the presence of active infection or relapsing/unresponsive infection after treatment , while levels of IgG2 were associated with cyst activity in another study . High levels of pro‐ and anti‐inflammatory cytokines are also generally reported in sera of CE patients ; however, this is not a constant finding and association with cyst stages is not clear‐cut . Similarly, results of in vitro stimulation of PBMC from infected patients generally report a predominant Th1 response in patients with inactive infection and/or responding to therapy, but results are often not clear‐cut .…”

Echinococcosis

“…The production of IL-10 and IL-4 appears actively induced by the parasite to favor its establishment by downregulating both effector arms Haralabidis et al 1995). High levels of circulating pro-and anti-inflammatory cytokines and higher in vitro production of a predominant Th1 response in patients with inactive infection and/or who responded to therapy are also generally reported (Bayraktar et al 2005;Chandrasekhar and Parija 2009;Mezioug and TouilBoukoffa 2009;Refik et al 2005;Rigano et al 1999b;Shan et al 2011;TouilBoukoffa et al 1997TouilBoukoffa et al , 1998. However, results and association with cyst stages are often not clear-cut (Hernandez-Pomi et al 1997;Rigano et al 1995bRigano et al , 1999aRigano et al , 2001Rigano et al , 2004Piccoli et al 2012;Tamarozzi et al 2010;Torcal et al 1996).…”

Characterization of cellular and humoral immune responses to alkaline phosphatase from fertile hydatid cysts in the human peripheral blood

“…Studies have indicated that both type1 and type2 responses can be concurrently detected in the peripheral immunity during the chronic CE (Siracusano et al, ; W. Zhang et al, ). Type1 cytokines have been showed to direct effective immune reactions against the parasite (Mezioug & Touil‐Boukoffa, ; Refik, Mehmet, & Durmaz, ; Rigano, Profumo, Teggi, & Siracusano, ; Touil‐Boukoffa, Bauvois, Sancéau, Hamrioui, & Wietzerbin, ; Touil‐Boukoffa, Sancëau, Tayebi, & Wietzerbin, ), whereas type2 responses are associated with the host susceptibility and existence of a progressive disease (Rigano et al, , ). Moreover, IgG responses to the growing cyst are evidently dominated by IgG1 and IgG4 antibodies (W. Zhang et al, ).…”