Immunopathogenesis of human gastrointestinal infection by Anisakis simplex

• Published in: Journal of allergy and clinical immunology Vol. 104; no. 3; pp. 637 - 643
• Main Authors: del Pozo, Victoria, Arrieta, Ignacio, Tuñon, Teresa, Cortegano, Isabel, Gomez, Belen, Cárdaba, Blanca, Gallardo, Soledad, Rojo, Marta, Renedo, Guadalupe, Palomino, Pilar, Tabar, Ana I., Lahoz, Carlos
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.09.1999; Elsevier
• Subjects: Abdominal Pain - blood; Abdominal Pain - immunology; Abdominal Pain - pathology; Adult; Aged; Aged, 80 and over; Animals; Anisakiasis; Anisakiasis - blood; Anisakiasis - diagnosis; Anisakiasis - immunology; Anisakiasis - pathology; Anisakis - immunology; Anisakis - pathogenicity; Anisakis simplex; Anisakis simplex allergy; Ascariasis; Biological and medical sciences; Blood Proteins - analysis; Blood Proteins - genetics; Cells, Cultured; Chemokines - genetics; cytokines; Cytokines - genetics; Diseases caused by nematodes; eosinophil cationic protein; Eosinophil Granule Proteins; eosinophil protein X; Eosinophil-Derived Neurotoxin; eosinophilic gastroenteritis; eosinophils; Eosinophils - immunology; Female; gastrointestinal tract infection; Helminthic diseases; Humans; Infectious diseases; Leukocytes, Mononuclear - cytology; Leukocytes, Mononuclear - immunology; Male; Medical sciences; Middle Aged; Nitric Oxide Synthase - genetics; Nitric Oxide Synthase Type II; Parasitic diseases; Ribonucleases; T H2 response; Th1 Cells - immunology; Th2 Cells - immunology; Anisakis simplex allergy; EG; ECP; Anisakiasis; T H2 response; eosinophils; iNOS; cytokines; MBP; PBL; EPX; eosinophilic gastroenteritis; Allergy; Pathogenesis; Gastroenteritis; Granulocyte; Larva migrans; Helper cell; T-Lymphocyte; Intestinal disease; Th2 lymphocyte; Nematoda; Gastric disease; Human; Immunopathology; Immune response; Anisakis simplex; Inflammation; Parasitosis; Helminthiasis; Cell subpopulation; Eosinophil; Infection; Nematode disease; Helmintha; Digestive diseases; Nemathelminthia; Invertebrata
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/S0091-6749(99)70336-2

Background: Anisakis simplex is a parasite of fish, and in the case of human infestation, it should be considered as a possible cause of gastrointestinal disease, especially in countries where raw or undercooked fish is a frequent food. Clinical features of anisakiasis may simulate acute abdominal pain, such as that found in patients with gastric ulcers, appendicitis, and Crohn’s disease. Furthermore, many cases of anisakiasis are diagnosed as eosinophilic gastroenteritis, which is a broad term for a specific disease. Objective: The purpose of this study was to investigate the immunopathogenesis of human gastrointestinal infestation by A simplex . Methods: Thirteen intestinal biopsy specimens from patients with anisakiasis were analyzed for the presence of messenger (m)RNA for different cytokines and inflammatory mediators by RT-PCR. Specific IgE, eosinophil cationic protein, eosinophil protein X, and tryptase levels were measured in each patient ́s serum. Also, cell cultures were set up with lymphocytes from some patients and stimulated in vitro with Anisakis and Ascaris antigens. Results: We performed immunologic phenotyping in 13 patients. All patients underwent biopsy after emergency surgery caused by episodes of acute abdominal pain. In all cases inflammatory infiltrate composed of eosinophils and lymphocytes was found in the intestinal wall. We demonstrated that after infestation, a T H2 -type immune response occurred. Also, major basic protein, nitric oxide, and eotaxin were found in the tissue, and eosinophil cationic protein and eosinophil protein X levels were elevated in sera. Conclusion: These data and in vitro lymphocyte cultures indicate that a T H2 mechanism plays an important role in the inflammatory infiltrate produced by the anchorage of parasites in the gastrointestinal wall. (J Allergy Clin Immunol 1999;104:637-43.)