Eosinophilia in Ascaris suum-reinfected mice

The secondary response of eosinophilia has been studied in mice infected with A. suum. In mice infected orally with 1000 A. suum eggs, larvae disappeared from the body within two weeks after infection. The number of peripheral blood eosinophils decreased to the pre-infection level within eight weeks. A typical secondary response of IgG antibody production to egg antigen was found after reinfection with 1000 eggs. The number of peripheral blood eosinophils increased more rapidly after reinfection than after the primary infection. However, the peak number of eosinophils after reinfection was similar to that after primary infection, and the long-lasting characteristics of eosinophilia after reinfection did not differ from those after primary infection. These results suggest that the secondary response of eosinophilia is characterized by a rapid increase in the number of eosinophils in A. suum-reinfected mice.     

Seroprevalence of toxocariasis among healthy people with eosinophilia

The aim of this study is to determine the Toxocara seropositive rate among healthy people with eosinophilia. A total of 97 people residing in Seoul who were healthy and whose blood eosinophilia was over 10%, as shown by regular health check-ups in 2004, were subjected to this study. Their sera were tested by immunoblotting and ELISA with the antigen of larval Toxocara canis excretory-secretory (ES) protein. Sixty-five sera were band-positive (67.0%). The seropositve control sera were positive to band sizes of 66 kDa, 56 kDa, 32 kDa, and 13 kDa. In ELISA, 63 sera (65.0%) were positive to T. canis ES protein. There was no significant correlation between the IgG ELISA titer and the level of eosinophilia (r = 0.156, P = 0.156). As there were insufficient data to determine whether there were cross-reactions with other helminthic infections, or whether atopy occurred, further studies are required to verify the cause of the seropositive reactions against T. canis ES antigen. Toxocariasis seropositivity is suggested to be the major cause of eosinophilia, since the Toxocara seroprevalence among Korean rural adults was shown to be approximately 5%.     

The effect of cyclosporin A on Angiostrongylus cantonensis infection and eosinophilia in mice

Male BALB/c mice were infected with Angiostrongylus cantonensis and at various times p.i. treated with cyclosporin A (CsA) either for 5 days continuously or intermittently, or for 12–16 days on alternate days. They were monitored for peripheral blood eosinophilia and at necropsy examined for CSF and bone marrow eosinophilia, and worm recovery. CsA treatment provoked a transient inhibition of peripheral blood eosinophilia in all groups examined, followed by rebounding eosinophilia. There was no significant difference in bone marrow and CSF eosinophilia between CsA- and vehicle-treated groups. Mice treated with CsA on alternate days yielded lower intracranial worm recovery with small-sized worms at days 7, 21 and 30 p.i. than vehicle-treated groups did. No significant reduction in worm recovery was noted in mice treated for 5 days either continuously or intermittently, although worms, especially female ones, harvested from groups treated with CsA from days — 1 to 3 or from days 13 to 17 were significantly smaller than those from vehicle-treated groups. CsA-treatment suppressed blastogenic responses of spleen cells against Con A or worm antigen at days 7 and 21 p.i. In vitro treatment of the 3rd stage larvae with CsA did not adversely influence survival of A. cantonensis in mice. These data indicate that CsA exerts antiparasitic effects against A. cantonensis in mice.     

Treatment of human acute schistosomiasis with oxamniquine induces an increase in interferon-gamma response to Schistosoma mansoni antigens

Patients with acute schistosomiasis were studied before and after oxamniquine treatment. They had been exposed to cercariae 5 to 9 weeks before, and presented compatible clinical manifestations, eosinophilia, and high levels of total IgE. Interferon-gamma (IFN-gamma) and interleukin-4 were measured by ELISA in whole blood samples under soluble egg antigen or soluble adult worm preparation stimulation. After treatment, the reduction of leukocytosis and eosinophilia were not significant, but total IgE levels decreased significantly, in contrast to IFN-gamma levels that were significantly increased. The oxamniquine treatment of acute schistosomiasis patients is followed by an improvement of a Th1 response in vitro. If this response has a protective aspect is unknown, and some investigations need to be realized.     

Cytokine mediated apoptosis of granulocyte eosinophils in expressed blood eosiniphilia

Programmed cell death induced by recombinant cytokines (IL-5, IL-3 and eotaxin) of eosinophils isolated from patients with expressed blood eosinophilia (malignant diseases of the blood system, opisthorchosis) has been examined. It was demonstrated that an initially low level of spontaneous apoptosis is registered in all surveyed patients. r-IL-5, r-IL-3 and r-eotaxin treatment of eosinophils isolated from the peripheral blood of opisthorchosis patients and cultivated in vitro suppressed apoptosis. However, eosinophils isolated from patients with malignant diseases associated with expressed blood eosinophilia were insensitive to the cytokines.     

Meningitis patients with Angiostrongylus cantonensis may present without eosinophilia in the cerebrospinal fluid in northern Vietnam

BackgroundEosinophilic meningitis (EM) is a rare clinical syndrome caused by both infectious and noninfectious diseases. In tropical pacific countries, Angiostrongylus cantonensis is the most common cause. However, the EM definition varies in the literature, and its relation to parasitic meningitis (PM) remains unclear.Methodology/Principal findingsAdult and adolescent patients of 13 years old or above with suspected central nervous system (CNS) infections with abnormal CSF findings were prospectively enrolled at a tertiary referral hospital in Hanoi, Vietnam from June 2012 to May 2014. Patients with EM or suspected PM (EM/PM) were defined by the presence of either ≥10% eosinophils or an absolute eosinophil cell counts of ≥10/mm³ in the CSF or blood eosinophilia (>16% of WBCs) without CSF eosinophils. In total 679 patients were enrolled: 7 (1.03%) had ≥10% CSF eosinophilia, 20 (2.95%) had ≥10/mm³ CSF eosinophilia, and 7 (1.03%) had >16% blood eosinophilia. The patients with ≥10% CSF eosinophilia were significantly younger (p = 0.017), had a lower body temperature (p = 0.036) than patients with ≥10/mm³ CSF eosinophilia among whom bacterial pathogens were detected in 72.2% (13/18) of those who were tested by culture and/or PCR. In contrast, the characteristics of the patients with >16% blood eosinophilia resembled those of patients with ≥10% CSF eosinophilia. We further conducted serological tests and real-time PCR to identify A. cantonensis. Serology or real-time PCR was positive in 3 (42.8%) patients with ≥10% CSF eosinophilia and 6 (85.7%) patients with >16% blood eosinophilia without CSF eosinophils but none of patients with ≥10/mm³ CSF eosinophilia.ConclusionsThe etiology of PM in northern Vietnam is A. cantonensis. The eosinophil percentage is a more reliable predictor of parasitic EM than absolute eosinophil count in the CSF. Patients with PM may present with a high percentage of eosinophils in the peripheral blood but not in the CSF.     

Eosinophil responses of permissive and nonpermissive hosts to the young adult worms of Angiostrongylus cantonensis

Blood and bone marrow eosinophilia was assessed in nonpermissive (guinea pigs) and permissive (rats) hosts following the pulmonary arterial transfers of live or dead young adult worms of Angiostrongylus cantonensis. Guinea pigs showed a marked eosinophilic response to live worms but only a slight response to dead worms. Neither IgE nor haemagglutinating antibodies correlated with the induction of this eosinophilia. In contrast, the rat responded to neither form of the young adult worm. When the guinea pig and the rat were injected with whole worm extract (WWE) of the young adult worms either by an osmotic mini-pump connected to the jugular vein or by intermittent intravenous injections, the former animal showed blood eosinophilia but the latter failed to do so. Guinea pigs also developed blood eosinophilia after continuous exposure to the excretory and secretory products of the young adult worms, administered by the mini-pump. Eosinophil responses to WWE could be induced both in athymic CD-1 (ICR) nude mice and in its heterozygous litter mates, suggesting that T cell-independent mechanism(s) could be involved in the induction of blood eosinophilia in the nonpermissive, mouse host. These data clearly indicate that the eosinophilia-inducing factor(s) and the mechanism of eosinophilia are different in permissive and nonpermissive hosts.     

Eosinophilia in murine trichinellosis

In both primary and secondary infections using 3 different strains of mice (DBA/1, B10 X D2, and C3H/HeJ), 2 peaks of peripheral blood eosinophilia were noted. Depending upon the strain, the first of the biphasic peaks in primary infections occurred between days 5 and 9, and the second peak occurred between days 16 and 22. The relative heights of the peak varied with the strain. In secondary infections, the initial peak was lower and the larger second peak occurred earlier. Methyridine treatment to eliminate adults prior to release of newborn larvae altered neither the course of eosinophilia in primary infection nor the biphasic distribution of eosinophilia. These studies demonstrate that the adult worm is responsible for inducing eosinophilia in murine infections, that 2 peaks of eosinophilia exist in primary and secondary infections, and that eosinophilia in secondary infections is an anamnestic response.     

Eosinophilia in the cerebrospinal fluid of children with shunts implanted for the treatment of internal hydrocephalus

Cerebrospinal fluid (CSF) eosinophilia was observed in 26 of 404 children after the implantation of shunts for the treatment of internal hydrocephalus. High levels of 65% and 78% were recorded in two cases, which are reported in detail. In the remaining 24 cases, CSF eosinophilia ranging between 1% and 3% was found. None of the cases with CSF eosinophilia had blood eosinophilia. The cases indicate that a reaction to the material used for the shunt should be considered along with possible parasitic infestations in patients with such findings.     

The influence of Mesocestoides corti on subsequent Angiostrongylus cantonensis infections in mice.

The influence of Mesocestoides corti on subsequent Angiostrongylus cantonensis infection in mice (C57BL/6 and BALB/c) was assessed. Both strains of mice infected with M. corti demonstrated a peak blood eosinophilia at around 3 weeks post-infection (p.i.). C57BL/6 and BALB/c mice primarily infected with M. corti were given A. cantonensis infection 18 days later, but pre-existing M. corti infection did not affect the recovery of intracranial worms of A. cantonensis at day 21 p.i. BALB/c mice with mixed parasite infections showed low morbidity and mortality as compared with mice singly infected with A. cantonensis and some mice demonstrated a pulmonary migration of intracranial worms. In C57BL/6 mice, intracranial worms were killed and thus all mice survived. C57BL/6 mice with mixed parasite infections failed to resist A. cantonensis reinfection. The blastogenic responses of spleen cells against A. cantonensis antigen were lower in BALB/c than in C57BL/6 mice and mixed parasite infections also resulted in less blastogenic responses against both concanavalin A and A. cantonensis antigen than monoinfection. The recovery of M. corti biomass was significantly higher in mice with mixed parasite infections than mice with monoinfection with M. corti. These data suggest a distinct difference in response to A. cantonensis infection between C57BL/6 and BALB/c mice, and the induction of immunosuppression in both mouse strains following M. corti infection. Blood eosinophilia provoked by M. corti infection is not directly associated with the killing of worms in subsequent A. cantonensis infection.     

Eosinophilia in murine ancylostomiasis.

Eosinophil changes in the peripheral blood of singly and repeated infected mice were studied during murine ancylostomiasis. In singly infected animals, eosinophils began to rise on 1st day, reached a peak on 4th day and progressively declined from 9th to 30th day. In repeatedly infected animals, peak eosinophilia was observed during 3rd week of post infection and sustained upto 30th day with a slight decrease. These studies demonstrate that eosinophilia is induced due to antigen-antibody reactions in the host system and eosinophilia in helminthic infections is amnestic response.     

A Third Locus for Eosinophilia on Chromosome 1 of the MES Rats.

Matsumoto Eosinophilia Shinshu (MES) is a rat strain that spontaneously develops eosinophilia and eosinophil-related inflammatory lesions in many organs. In a previous study, we performed chromosomal mapping of the gene for eosinophilia in MES rats using backcross progeny and found that the major locus for eosinophilia was located on chromosome 19. In addition, another quantitative trait locus showing suggestive linkage for blood eosinophil count was found on chromosome 2. In this study, we examined additional marker loci in the backcross progeny and discovered that a third locus for eosinophilia was also located on chromosome 1. These data reinforce the notion that eosinophilia in MES rats is a rather complex genetic trait. However, these results will form the basis for identifying the candidate genes for eosinophilia.     

Association of blood eosinophilia with the expression of resistance in Romney lambs to nematodes.

The dynamics of blood eosinophilia was studied in Romney lambs dosed twice weekly with 5000 infective larvae of Trichostrongylus colubriformis. A marked rise in blood eosinophil counts of the dosed lambs coincided with the start of the decline of faecal egg counts (FEC). Eosinophilia was also studied in grazing Romney lambs from a breeding programme, based on selection for high or low FEC. Comparison of the sire groups suggested that the magnitude of the eosinophil response was under genetic control. The significant negative correlations between blood eosinophil counts and FECs confirmed the association between eosinophilia and the expression of resistance in Romney lambs to nematodes. However, comparison of the mean blood eosinophil counts and FECs for both the ram and ewe lambs of the resistance sire groups suggested that the association of eosinophilia and resistance may be greater for some sire groups than others.     

Toxocariasis and ingestion of raw cow liver in patients with eosinophilia

Ingestion of raw animal liver has been suggested as a possible mode of infection of human toxocariasis. We evaluated the relationship between toxocariasis and the ingestion of raw meat in patients with eosinophilia of unknown etiology. The study population consisted of 120 patients presenting with peripheral blood eosinophilia (>500 cells/microliter or >10% of the white blood cell count). They were divided into 2 groups: 104 seropositive patients based on a Toxocara excretory-secretory IgG ELISA and 16 seronegative patients. While 25.0% of seronegative patients had a recent history of eating raw cow liver, 87.5% of seropositive patients had this history. Multivariate statistical analysis showed that a recent history of eating raw cow liver was related to an increased risk of toxocariasis. Collectively, it is proposed that raw cow liver is a significant infection source of toxocariasis in the patients with eosinophilia of unknown etiology.     

Early stage-specific immune responses in primary experimental human hookworm infection

To determine the cellular immune response during different stages of hookworm infection, we infected two human volunteers with Necator americanus and followed their immune responses against stage-specific, crude antigen extracts through larval migration, pre-patency, and early patency. After chemotherapy, the volunteers were followed for an additional 6 months. Low-dose N. americanus infection resulted in mild clinical signs and peripheral blood eosinophilia occurred during the estimated time of arrival of juvenile worms in the intestine. After an initial rise in proliferative responses against larval and adult worm antigens, the cellular reactivity decreased until the end of pre-patency, rose again during patency, and dropped after chemotherapy. Before infection and during the course of infection, elevated concentrations of TNF-alpha were detected in supernatants of peripheral blood mononuclear cells (PBMC) stimulated in vitro with third-stage (L3) or adult worm excretory-secretory (ES) antigens, which dropped off after chemotherapy. After stimulation with L3 antigen, elevated concentrations of CCL17 were detected in supernatants during pre-patency and patency. Interestingly, a prominent rise in IL-10 secretion was detected in ES antigen-stimulated PBMC cultures during late pre-patency. During reinfection studies in endemic areas, such distinct cytokine and chemokine profiles might be additional markers to better classify egg-negative patients.     

IL-5 drives eosinophils from bone marrow to blood and tissues in a guinea-pig model of visceral larva migrans syndrome

This study was undertaken to evaluate the role of IL-5 in eosinophil migration and in the maintenance of eosinophilia in a guinea-pig model of visceral larva migrans syndrome. The results show that the infection of animals with Toxocara canis induced an early increase in serum IL-5 levels that might be essential for eosinophil differentiation and proliferation and for the development of eosinophilia. When infected guinea-pigs were treated with mAb anti-IL-5 (TRFK-5) given at the same time or 1 or 3 days after infection, there was a high percentage of reduction of eosinophil counts 18 days after infection. However, when the mAb was administered during the peak of eosinophilia, there was high inhibition in blood, no inhibition in bronchoalveolar lavage fluid (BALF) or peritoneum and an increase in eosinophil numbers in bone marrow. Thus, a basic level of IL-5 may be essential to drive eosinophils from bone marrow to blood and tissues, and for the maintenance of eosinophilia in infected animals. We may also conclude that when eosinophils have already migrated to the lungs, TRFK-5 has no power to inhibit eosinophilia, which is also under control of local lung cells producing IL-5. In this way, only one later TRFK-5 treatment may not be sufficient to modify the lung parenchyma microenvironment, since T. canis antigens had already stimulated some cell populations to produce IL-5.     

Drug-specific T cells derived from patients with drug-induced allergic hepatitis.

Drug-induced allergic hepatitis is a tissue-specific inflammatory disease caused by hypersensitivity to a particular drug. Although the frequency of drug-induced allergic hepatitis appears to increase in proportion to the medicine, the mechanism by which tissue specificity is determined is still to be elucidated. In this study, we established CD4+ T cell clones specific for particular drugs from patients with drug-induced allergic hepatitis accompanied with mild blood eosinophilia and analyzed the possible role of liver protein as a directing factor of liver-specific inflammatory reactions. All CD4+ T cell clones obtained from two patients with this disease proliferated in response to a combination of the particular drug plus liver specific protein (LSP), which consists of over 30 proteins. Some T cell clones were responsive to an antigenic conformation consisting of the 200-kDa glycoprotein (partly purified LSP), a component of LSP, plus the causal drug. In contrast, all CD4+ T cell clones from a patient with simple drug-induced eosinophilia responded to the causal drug in the absence of LSP and partly purified LSP. These data suggested that LSP or partly purified LSP of the appropriate Ag is the target that leads to liver-specific inflammation in drug-induced allergic hepatitis. Furthermore, T cell lines derived from patients with drug-induced allergic hepatitis and simple drug-induced eosinophilia produced large amounts of IL-5 after the appropriate antigenic stimulation, whereas CD4+ T cell clones from donors with a normal amount of peripheral blood eosinophils secreted a much less IL-5. Taken together, these results indicate that overproduction of IL-5 by the allergen-sensitized T cells may result in blood eosinophilia.     

Transfusional Mansonella perstans microfilariasis

Mansonella perstans filariasis is widely distributed across the center of Africa and equatorial America. We describe a case of post-transfusional M. perstans microfilariasis in a young child, affected with severe Plasmodium falciparum malaria, admitted in Goundi Hospital in South of Chad. A decrease of M. perstans microfilariasis in the patient's blood was observed, with no subsequent development of either clinical symptoms or eosinophilia. We suggest that, in endemic areas, transfused M. perstans microfilariae may be cleared from the blood over relatively short periods of time. It is likely that only adult worms are responsible for symptoms and eosinophilia, whereas microfilariae in the bloodstream are unable to give clinical manifestations.     

Induction of blood eosinophilia by pulmonary embolization of antigen-coated particles: the relationship to cell-mediated immunity.

A method of immunization has been described which consists of the i. v. injection into rats of large latex particles coated with human gamma-globulin (HGG). The coated particles embolize the pulmonary capillary bed and induce blood eosinophilia, which correlated strongly with the development of lymphocyte responsiveness to HGG in vitro. Sequential histologic studies of the lungs including ultrastructural analysis suggest a delayed hypersensitivity reaction to the coated particles. These studies support the concept that the induction of blood eosinophilia may be mediated by T lymphocytes.     

Clinical characteristics that distinguish eosinophilic organ infiltration from metastatic nodule development in cancer patients with eosinophilia

ABSTRACT: BACKGROUND: When new space-occupying lesions are observed together with peripheral blood eosinophilia in patients diagnosed with cancer, the possibility of eosinophilic organ involvement should be differentiated from metastasis of primary cancer, since a misdiagnosis could lead to unnecessary chemotherapy. The aim of this study is to identify the clinical characteristics of eosinophilic organ involvement that distinguish it from distant metastasis in patients with primary cancer. METHODS: The medical records of 43 cancer patients who developed hepatic or pulmonary nodules with peripheral blood eosinophilia between January 2005 and February 2010 in the Asan Medical Center (Seoul) were reviewed. Eosinophilic infiltration and distant metastasis were identified on the basis of pathological findings and radiological features. Fisher's exact test, chi2 test or Mann-Whitney test were used for statistical analysis. RESULTS: In total, 33 patients (76 %) were diagnosed with eosinophilic infiltration, 5 (12 %) with cancer metastasis and 5 (12 %) had undetermined diagnoses. Compared to the patients with metastases, the patients with eosinophilic infiltration were significantly more likely to have serology indicating a parasitic infection, a history of eating raw food, high serum levels of total IgE, normal liver function, normal C-reactive protein levels, a normal erythrocyte sedimentation rate, and fewer and smaller nodules. The most common underlying malignancy in the eosinophilic organ infiltration group was stomach cancer. Physicians tended to neglect the eosinophilia in patients with a history of cancer. CONCLUSIONS: Several clinical characteristics of eosinophilic organ infiltration distinguish it from cancer metastasis. Physicians should make greater efforts to determine the causes of organ involvement with peripheral blood eosinophilia, especially in cancer patients.