Intestinal Damage in Strongyloidiasis.pdfVIP

Digestive Diseases and Sciences, Vol. 51, No. 6 (June 2006), pp. 1063–1069 ( C? 2006) DOI: 10.1007/s10620-006-8010-2 Intestinal Damage in Strongyloidiasis: The Imbalance Between Cell Death and Proliferation ANA LUIZA WERNECK-SILVA, PhD,* ELIANA PARISI ALVARES, PhD,? PATRI?CIA GAMA, PhD,? ADERSON OMAR MOURA?O CINTRA DAMIA?O, PhD,* LUCIANA HARUMI OSAKI,? DANIELA OGIAS,? and AYTAN MIRANDA SIPAHI, PhD* Strongyloidiasis is an endemic tropical parasitosis caused by Strongyloides stercoralis that also af- fects immigrants in nontropical countries. The nematode colonizes the duodenum and upper jejunum, inducing mucosal alterations. Because integrity is essential for a functional barrier, we aimed to study apoptosis and proliferation in the small bowel epithelium infected with S. stercoralis. We evaluated 23 patients and 17 controls. Apoptotic cells were detected by TUNEL and M30 immunolabelling, whereas proliferation was scored by Ki67 immunostaining and mitotic counting. Infection increased apoptotic indices in duodenum and jejunum (P 0.001). Conversely, it decreased cell proliferation in both segments (P 0.001). Our results showed that intestinal strongyloidiasis promotes an im- balance between cell death and proliferation. This is the first evidence of disruption of the epithelial kinetics with S. stercoralis infection, though the mechanisms remain unclear. Furthermore, our re- sults support the idea that strongyloidiasis disturbs the mucosal integrity and can compromise the intestinal barrier. KEY WORDS: strongyloidiasis; small intestine; apoptosis; cell proliferation. The balance among cell proliferation, differentiation, and death maintains the dynamics of epithelial cell popula- tion in the small bowel mucosa. Apoptosis is considered especially important for the crypts in this segment of the intestine, because it is assumed to protect the proliferating pool against carcinogenesis (1). Adding to that, different studies report that senescent and damaged cells die by