Analysis of Complex Patterns of Human Exposure and Immunity to Schistosomiasis mansoni The Influence of Age, Sex, Ethnicity and IgE 英文参考文献.docVIP

AnalysisofComplexPatternsofHumanExposureand ImmunitytoSchistosomiasismansoni:TheInfluenceof Age,Sex,EthnicityandIgE AngelaPinotdeMoira1*,AnthonyJ.C.Fulford1,2,NarcisB.Kabatereine3,JohnH.Ouma4,MarkBooth1,5, DavidW.Dunne1 1Department of Pathology, University of Cambridge, Cambridge, United Kingdom, 2MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, London, United Kingdom, 3Vector Control Division, Ministry of Health, Kampala, Uganda, 4Kenya Methodist University, Meru, Kenya, 5Wolfson Research Institute,DurhamUniversityQueen’sCampus,StocktononTees,UnitedKingdom Abstract Background:NumerousfactorsmayinfluenceSchistosomainfectionintensityandprevalencewithinendemiccommunities, including exposure-related factors such as local environment and behaviour, and factors relating to susceptibility to infection suchas immunology andgenetics. Whileanimal studies performed in thelaboratory canbe tightly controlled, humanpopulationsarehighlyheterogeneous,varyingaccordingtodemographiccharacteristics,geneticbackgroundand exposure to infection. The heterogeneous nature of human water contact behaviour in particular makes it difficult to distinguish between a lack of cercarial exposure and reduced susceptibility to infection as the cause for low levels of infectioninthefield. Methods and Principal Findings: In this study we investigate risk factors for Schistosoma mansoni infection in a rural Ugandan fishing community receiving treatment as part of a multi-disciplinary longitudinal reinfection study. More specifically,weexaminetheinfluencethatage,sexandethnicbackgroundhaveonsusceptibilitytoreinfectionafteranti- helminthdrugtreatment,butuseindividualestimatesofcercarialexposureandmultivariablemethodsinanattemptto removenoisecreatedbyenvironmentalandbehaviouralheterogeneities.Wetheninvestigatewhetherschistosome-specific IgEimmuneresponsescouldaccountforanyremainingvariationsinsusceptibilitytoreinfection.Ourfindingssuggestthat observed ethnic- and sex-rela