Annals of Tropical Medicine & Parasitology
ISSN: 0003-4983 (Print) 1364-8594 (Online) Journal homepage: http://www.tandfonline.com/loi/ypgh19
Immunological studies in giardiasis S. R. Naik, L. Kumar, S. Naik, S. Sehgal, N. R. Rau & V. K. Vlnayak To cite this article: S. R. Naik, L. Kumar, S. Naik, S. Sehgal, N. R. Rau & V. K. Vlnayak (1979) Immunological studies in giardiasis, Annals of Tropical Medicine & Parasitology, 73:3, 291-292, DOI: 10.1080/00034983.1979.11687259 To link to this article: http://dx.doi.org/10.1080/00034983.1979.11687259
Published online: 23 Jun 2016.
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Date: 17 August 2017, At: 03:50
Annals of Tropical Medicine and Parasitology, Vol. 73, No. 3 (1979)
Downloaded by [Australian Catholic University] at 03:50 17 August 2017
Immunological studies in giardiasis Giardia Lamblia infection seems common in immunodeficient patients (Ament and Rubin, 1972) indicating an immunological basis for susceptibility to this infection. However, symptomatic giardiasis patients do show specific humoral antibody (Ridley and Ridley, 1976; Vinayak et al., 1978) as well as increased intraepithelial lymphocytic infiltration in jejunal biopsies, suggesting a local immunological phenomenon (Wright and Tomkins, 1977). Zinneman and Kaplan (1972) observed low jejunal juice IgA in ten giardiasis patients who did not apparently have an immunological problem, and so we investigated humoral and cellular immune function in a small group of Giardia patients not suspected of immune deficiency. Ten patients were examined-six males and four females aged 22-40 years; the ten healthy controls included seven males and three females, aged 13-36 years. They were matched with respect to age (t = 0·08, P>0·05). Cellular immune function was tested by intradermal tests for types I and IV sensitivities. Type I was investigated for nine commonly occurring antigens: Helminthosporium, Curvularia, Alternaria, wheat dust, house dust, Cassia saimia, Ailanthus excelsa, Chenopodium and Saccharum. Type IV sensitivity was examined with the aid of tuberculin (PPD, one unit injected, read after 72 hours) and phytohaemagglutinin (PHA17, Wellcome, England, 2 pl in 50 pi of normal saline, read after 24 hours). The nitroblue-tetrazolium (NBT) test (Quie et al., 1967) was carried out on seven controls and four patients. Unstimulated saliva was collected by pasteur pipette and IgA estimated using 7S standard antiserum (Mancini et al., 1965). Serum IgG, IgA and IgM were estimated using standard commercial antisera. T and B lymphocyte subpopulations were estimated by rosetting techniques (Papamichail et al., 1972) and their percentages and absolute values determined. The results of the type I skin tests showed no positive~ among the 88 controls, while five out of 78 tests were positive in the Giardia patients (X 2 = 3·83, 0·1 >P>0·05). Among the type IV reactions, PHA was positive in eight out of ten controls and in four out of seven patients (X 2 = 0·22, P>O·l); PPD was positive in two out of ten controls and five out of nine patients (X 2 = 1·27, P>0·1), so that there were no significant differences between the two groups with respect to these reactions. Similarly no significant differences were observed between the two groups with respect to serum IgG, IgA and IgM or salivary IgA (Table). The mean percentages forT 1ymphocytes were 63·6±9·3% in the controls and 54·4± 7·7% in the Giardia patients (t = 0·4, P>0·05), with absolute cell counts of 1303± 511 in the controls and 1025±367/mm3 in the patients (t = 0·66, P>0·05). The figures for B cells were: controls 21·3±4·4%, 419±151/mm3 , patients 22±6·5%, 393±207fmm3 TABLE
Serum immunoglobulin and salivary lgA levels (international unitsfml) in giardiasis patients and in controls Patients
Controls Range Serum lgG Serum lgA Serum lgM Salivary lgA
560-1630 66-270 108-372 5·4-20
Mean±SD
Range
Mean±SD
P value
821 ±353 141±81 210±97 9·5±4·4
590-960 70-225 120-276 5-16
826±164 160±64 198±51 8±3·9
NS*
*Ns
0003-4983f79f030291 +02 $01.00/0
=
NS NS NS
not significant.
© 1979 Liverpool School of Tropical Medicine
Downloaded by [Australian Catholic University] at 03:50 17 August 2017
292
IMMUNOLOGICAL STUDIES IN GIARDIASIS
(t = 0·28 and 0·3 respectively. P>0·05). There was therefore again no significant difference between the two groups. The NBT test was positive in the seven controls and four patients tested. The finding of normal immune functions in Giardia patients supports the results ofJones and Brown (1974) of similar serum and intestinal immunoglobulins in a series of patients and controls, but they do contrast with the general impression of the association between immunodeficiency and giardiasis (Ament and Rubin, 1972). It appears that this association is seldom observed when giardiasis rather than immunodeficiency is studied although it is likely that immunodeficient patients might have a greater frequency of G. lamblia infection. Since a specific humoral response occurs in giardiasis (Ridley and Ridley, 1976; Vinayak et al., 1978), it may be of interest to examine cell-mediated immune status in response to specific Giardia antigen. S. R. NAIK L. KuMAR S. NAIK
s.
Received 29 September 1978
SEHGAL
N. R. RAu V. K. VINAYAK Departments of Medicine, Pathology & Experimental Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
REFERENCES AMENT, M. E. & RuBIN, C. E. (1972). Gastroenterology, 62,216-226. JONES, E. G. & BROWN, W. R. (1974). American Journal rif Digestive Diseases, 19, 791-796. MANCINI, G., CARBONARA, A. 0. & HEREMANs,J. F. (1965). International Journal of Immuno-chemistry, 2, 235-
254. PAPAMICHAIL, M., HoLBRow, E.J., KEITH, H. I. & CuRREY, H. L. F. (1972). Lancet, 2, 6~6. Qum, P. G., WHITE, J. G., HoLMEs, B. & Gooo, R. A. (1967). Journal of Clinical Investigations, 46, 668-679. RIDLEY, M. J. & RIDLEY, D. S. (1976). Journal of Clinical Pathology, 29, 30-34. VINAYAK, V. K.,.JAIN, P. & NAIK, S. R. (1978) Annals of Tropical Medicine and Parasitology, 72, 581-582. WRIGHT, S. G. & ToMKINS, A. M. (1977). Clinical and Experimental Immunology, 29, 408-412. ZINNEMAN, H. H. & KAPLAN, D. A. (1972). AmericanJoumal rif Digestive Diseases, 19, 793-797.
ISSN: 0003-4983 (Print) 1364-8594 (Online) Journal homepage: http://www.tandfonline.com/loi/ypgh19
Immunological studies in giardiasis S. R. Naik, L. Kumar, S. Naik, S. Sehgal, N. R. Rau & V. K. Vlnayak To cite this article: S. R. Naik, L. Kumar, S. Naik, S. Sehgal, N. R. Rau & V. K. Vlnayak (1979) Immunological studies in giardiasis, Annals of Tropical Medicine & Parasitology, 73:3, 291-292, DOI: 10.1080/00034983.1979.11687259 To link to this article: http://dx.doi.org/10.1080/00034983.1979.11687259
Published online: 23 Jun 2016.
Submit your article to this journal
View related articles
Citing articles: 5 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ypgh19 Download by: [Australian Catholic University]
Date: 17 August 2017, At: 03:50
Annals of Tropical Medicine and Parasitology, Vol. 73, No. 3 (1979)
Downloaded by [Australian Catholic University] at 03:50 17 August 2017
Immunological studies in giardiasis Giardia Lamblia infection seems common in immunodeficient patients (Ament and Rubin, 1972) indicating an immunological basis for susceptibility to this infection. However, symptomatic giardiasis patients do show specific humoral antibody (Ridley and Ridley, 1976; Vinayak et al., 1978) as well as increased intraepithelial lymphocytic infiltration in jejunal biopsies, suggesting a local immunological phenomenon (Wright and Tomkins, 1977). Zinneman and Kaplan (1972) observed low jejunal juice IgA in ten giardiasis patients who did not apparently have an immunological problem, and so we investigated humoral and cellular immune function in a small group of Giardia patients not suspected of immune deficiency. Ten patients were examined-six males and four females aged 22-40 years; the ten healthy controls included seven males and three females, aged 13-36 years. They were matched with respect to age (t = 0·08, P>0·05). Cellular immune function was tested by intradermal tests for types I and IV sensitivities. Type I was investigated for nine commonly occurring antigens: Helminthosporium, Curvularia, Alternaria, wheat dust, house dust, Cassia saimia, Ailanthus excelsa, Chenopodium and Saccharum. Type IV sensitivity was examined with the aid of tuberculin (PPD, one unit injected, read after 72 hours) and phytohaemagglutinin (PHA17, Wellcome, England, 2 pl in 50 pi of normal saline, read after 24 hours). The nitroblue-tetrazolium (NBT) test (Quie et al., 1967) was carried out on seven controls and four patients. Unstimulated saliva was collected by pasteur pipette and IgA estimated using 7S standard antiserum (Mancini et al., 1965). Serum IgG, IgA and IgM were estimated using standard commercial antisera. T and B lymphocyte subpopulations were estimated by rosetting techniques (Papamichail et al., 1972) and their percentages and absolute values determined. The results of the type I skin tests showed no positive~ among the 88 controls, while five out of 78 tests were positive in the Giardia patients (X 2 = 3·83, 0·1 >P>0·05). Among the type IV reactions, PHA was positive in eight out of ten controls and in four out of seven patients (X 2 = 0·22, P>O·l); PPD was positive in two out of ten controls and five out of nine patients (X 2 = 1·27, P>0·1), so that there were no significant differences between the two groups with respect to these reactions. Similarly no significant differences were observed between the two groups with respect to serum IgG, IgA and IgM or salivary IgA (Table). The mean percentages forT 1ymphocytes were 63·6±9·3% in the controls and 54·4± 7·7% in the Giardia patients (t = 0·4, P>0·05), with absolute cell counts of 1303± 511 in the controls and 1025±367/mm3 in the patients (t = 0·66, P>0·05). The figures for B cells were: controls 21·3±4·4%, 419±151/mm3 , patients 22±6·5%, 393±207fmm3 TABLE
Serum immunoglobulin and salivary lgA levels (international unitsfml) in giardiasis patients and in controls Patients
Controls Range Serum lgG Serum lgA Serum lgM Salivary lgA
560-1630 66-270 108-372 5·4-20
Mean±SD
Range
Mean±SD
P value
821 ±353 141±81 210±97 9·5±4·4
590-960 70-225 120-276 5-16
826±164 160±64 198±51 8±3·9
NS*
*Ns
0003-4983f79f030291 +02 $01.00/0
=
NS NS NS
not significant.
© 1979 Liverpool School of Tropical Medicine
Downloaded by [Australian Catholic University] at 03:50 17 August 2017
292
IMMUNOLOGICAL STUDIES IN GIARDIASIS
(t = 0·28 and 0·3 respectively. P>0·05). There was therefore again no significant difference between the two groups. The NBT test was positive in the seven controls and four patients tested. The finding of normal immune functions in Giardia patients supports the results ofJones and Brown (1974) of similar serum and intestinal immunoglobulins in a series of patients and controls, but they do contrast with the general impression of the association between immunodeficiency and giardiasis (Ament and Rubin, 1972). It appears that this association is seldom observed when giardiasis rather than immunodeficiency is studied although it is likely that immunodeficient patients might have a greater frequency of G. lamblia infection. Since a specific humoral response occurs in giardiasis (Ridley and Ridley, 1976; Vinayak et al., 1978), it may be of interest to examine cell-mediated immune status in response to specific Giardia antigen. S. R. NAIK L. KuMAR S. NAIK
s.
Received 29 September 1978
SEHGAL
N. R. RAu V. K. VINAYAK Departments of Medicine, Pathology & Experimental Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
REFERENCES AMENT, M. E. & RuBIN, C. E. (1972). Gastroenterology, 62,216-226. JONES, E. G. & BROWN, W. R. (1974). American Journal rif Digestive Diseases, 19, 791-796. MANCINI, G., CARBONARA, A. 0. & HEREMANs,J. F. (1965). International Journal of Immuno-chemistry, 2, 235-
254. PAPAMICHAIL, M., HoLBRow, E.J., KEITH, H. I. & CuRREY, H. L. F. (1972). Lancet, 2, 6~6. Qum, P. G., WHITE, J. G., HoLMEs, B. & Gooo, R. A. (1967). Journal of Clinical Investigations, 46, 668-679. RIDLEY, M. J. & RIDLEY, D. S. (1976). Journal of Clinical Pathology, 29, 30-34. VINAYAK, V. K.,.JAIN, P. & NAIK, S. R. (1978) Annals of Tropical Medicine and Parasitology, 72, 581-582. WRIGHT, S. G. & ToMKINS, A. M. (1977). Clinical and Experimental Immunology, 29, 408-412. ZINNEMAN, H. H. & KAPLAN, D. A. (1972). AmericanJoumal rif Digestive Diseases, 19, 793-797.
