%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Wammes, L. J.
%A Hamid, F.
%A Wiria, A. E.
%A May, L.
%A Kaisar, M. M. M.
%A Prasetyani-Gieseler, M. A.
%A Djuardi, Y.
%A Wibowo, H.
%A Kruize, Y. C. M.
%A Verweij, J. J.
%A de Jong, S. E.
%A Tsonaka, R.
%A Houwing-Duistermaat, J. J.
%A Sartono, E.
%A Luty, Adrian
%A Supali, T.
%A Yazdanbakhsh, M.
%T Community deworming alleviates geohelminth-induced immune hyporesponsiveness
%D 2016
%L fdi:010068316
%G ENG
%J Proceedings of the National Academy of Sciences of the United States of America
%@ 0027-8424
%K helminths ; albendazole ; cytokine responses ; Indonesia ; deworming
%K INDONESIE ; FLORES ILE
%M ISI:000386608200061
%N 44
%P 12526-12531
%R 10.1073/pnas.1604570113
%U https://www.documentation.ird.fr/hor/fdi:010068316
%> https://www.documentation.ird.fr/intranet/publi/2016/11/010068316.pdf
%V 113
%W Horizon (IRD)
%X In cross-sectional studies, chronic helminth infections have been associated with immunological hyporesponsiveness that can affect responses to unrelated antigens. To study the immunological effects of deworming, we conducted a cluster-randomized, double-blind, placebo-controlled trial in Indonesia and assigned 954 households to receive albendazole or placebo once every 3 mo for 2 y. Helminth-specific and nonspecific whole-blood cytokine responses were assessed in 1,059 subjects of all ages, whereas phenotyping of regulatory molecules was undertaken in 121 school-aged children. All measurements were performed before and at 9 and 21 mo after initiation of treatment. Anthelmintic treatment resulted in significant increases in proinflammatory cytokine responses to Plasmodium falciparum-infected red blood cells (PfRBCs) and mitogen, with the largest effect on TNF responses to PfRBCs at 9 mo-estimate [95% confidence interval], 0.37 [0.21-0.53], P value over time (P-time) < 0.0001. Although the frequency of regulatory T cells did not change after treatment, there was a significant decline in the expression of the inhibitory molecule cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) on CD4(+) T cells of albendazole-treated individuals, -0.060 [-0.107 to -0.013] and -0.057 [-0.105 to -0.008] at 9 and 21 mo, respectively; P-time = 0.017. This trial shows the capacity of helminths to up-regulate inhibitory molecules and to suppress proinflammatory immune responses in humans. This could help to explain the inferior immunological responses to vaccines and lower prevalence of inflammatory diseases in low- compared with high-income countries.
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