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Soil-transmitted helminths and Mycobacterium tuberculosis frequently coincide geographically and it is hypothesized that gastrointestinal helminth infection may exacerbate tuberculosis (TB) disease by suppression of Th1 and Th17 responses. However, few studies have focused on latent TB infection (LTBI), which predominates globally. We performed a large observational study of healthy adults migrating from Nepal to the UK (n = 645). Individuals were screened for LTBI and gastrointestinal parasite infections. A significant negative association between hookworm and LTBI-positivity was seen (OR = 0.221; p = 0.039). Hookworm infection treatment did not affect LTBI conversions. Blood from individuals with hookworm had a significantly greater ability to control virulent mycobacterial growth in vitro than from those without, which was lost following hookworm treatment. There was a significant negative relationship between mycobacterial growth and eosinophil counts. Eosinophil-associated differential gene expression characterized the whole blood transcriptome of hookworm infection and correlated with improved mycobacterial control. These data provide a potential alternative explanation for the reduced prevalence of LTBI among individuals with hookworm infection, and possibly an anti-mycobacterial role for helminth-induced eosinophils.

Original publication

DOI

10.3389/fimmu.2018.02893

Type

Journal article

Journal

Frontiers in immunology

Publication Date

01/2018

Volume

9

Addresses

Nuffield Department of Medicine, The Jenner Institute, University of Oxford, Oxford, United Kingdom.

Keywords

Eosinophils, Feces, Animals, Humans, Ancylostomatoidea, Mycobacterium tuberculosis, Hookworm Infections, Risk Factors, Longitudinal Studies, Prospective Studies, Gene Expression Profiling, Adolescent, Nepal, Male, Young Adult, Latent Tuberculosis