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Strongyloides hyperinfection and hypogammaglobulinemia
Raymond C S Seet1, Lee Gong Lau, Paul Ananth Tambyah
1Department of Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074. raymond_seet@nus.edu.sg
Clinical and Diagnostic Laboratory Immunology
|May 10, 2005
Summary
Strongyloides hyperinfection can occur even with a strong antibody response in patients with hypogammaglobulinemia. Human IgG protects against initial infection but not against the autoinfective larvae causing hyperinfection.
Area of Science:
- Immunology
- Infectious Diseases
- Parasitology
Background:
- Generalized hypogammaglobulinemia, often seen in multiple myeloma and nephrotic syndrome, impairs immune function.
- Strongyloides stercoralis is a nematode parasite that can cause hyperinfection syndrome in immunocompromised individuals.
Observation:
- Two patients with hypogammaglobulinemia experienced Strongyloides hyperinfection despite a robust Strongyloides-specific immunoglobulin G (IgG) response.
- This contrasts with findings in animal models where IgG antibodies were protective.
Findings:
- Human IgG appears to confer immunity against infective-stage Strongyloides larvae.
- However, this immunity is insufficient to prevent autoinfective larvae from causing hyperinfection syndrome in humans.
Implications:
- Current understanding of Strongyloides immunity, particularly the role of IgG, may need revision for human infections.
- This highlights a critical gap in protective immunity against autoinfective Strongyloides larvae in immunocompromised patients.
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