Influence of Parasitic Worm Infections on Allergy Diagnosis in Sub-Saharan Africa
Date
2017-09-01
Journal Title
Journal ISSN
Volume Title
Publisher
Springer Open
Abstract
Epidemiological studies from Sub-Saharan Africa
indicate that allergies are on the rise in this region especially in
urban compared to rural areas. This increase has been linked
to improved hygiene, lifestyle changes, and lower exposure to
pathogens in childhood. Reduced exposure to parasitic worm
(helminth) infections and allergy outcomes has been the focus
of a number of population studies over the years. Paradoxically,
there are parallels in the immune responses to helminths and to
allergies. Both conditions are associated with elevated levels of
immunoglobulin E, high numbers of T helper 2 cells, eosinophils,
and mast cells. These immune parallels have meant that
the diagnosis of allergies in parts of the world where helminths
are endemic can be hampered. The aim of this review is to
examine observations from population studies conducted in
Sub-Saharan Africa that demonstrate how helminth infections
influence the parameters used to diagnose allergy outcomes in
this region. We explore specifically how helminth infections
hinder the in vitro diagnosis of allergic sensitization, influence
the clinical manifestations of allergy, and also the effect of
anthelmintic treatment on allergy outcomes. Advancing our
understanding of how helminths influence allergy diagnosis is
imperative for the development of improved tools to assess,
diagnose, and treat allergic disorders in both helminthendemic
and non-endemic countries worldwide.
Description
Article
Keywords
Allergy diagnosis, Allergic inflammation, Helminths, IgE cross-reactivity, Immune hyporesponsiveness, Sub-Saharan Africa