Intestinal Disease

Digestive Diseases and Sciences

, 51:1063

First online:

Intestinal Damage in Strongyloidiasis: The Imbalance Between Cell Death and Proliferation

  • Ana Luiza Werneck-SilvaAffiliated withDepartment of Gastroenterology, School of Medicine, Laboratory of Investigation (LIM 07), University of São Paulo
  • , Eliana Parisi AlvaresAffiliated withDepartment of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São PauloAv Prof Lineu Prestes 1524 ICB I Email author 
  • , Patrícia GamaAffiliated withDepartment of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo
  • , Aderson Omar Mourão Cintra DamiãoAffiliated withDepartment of Gastroenterology, School of Medicine, Laboratory of Investigation (LIM 07), University of São Paulo
  • , Luciana Harumi OsakiAffiliated withDepartment of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo
  • , Daniela OgiasAffiliated withDepartment of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo
  • , Aytan Miranda SipahiAffiliated withDepartment of Gastroenterology, School of Medicine, Laboratory of Investigation (LIM 07), University of São Paulo

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Abstract

Strongyloidiasis is an endemic tropical parasitosis caused by Strongyloides stercoralis that also affects immigrants in nontropical countries. The nematode colonizes the duodenum and upper jejunum, inducing mucosal alterations. Because integrity is essential for a functional barrier, we aimed to study apoptosis and proliferation in the small bowel epithelium infected with S. stercoralis. We evaluated 23 patients and 17 controls. Apoptotic cells were detected by TUNEL and M30 immunolabelling, whereas proliferation was scored by Ki67 immunostaining and mitotic counting. Infection increased apoptotic indices in duodenum and jejunum (P < 0.001). Conversely, it decreased cell proliferation in both segments (P < 0.001). Our results showed that intestinal strongyloidiasis promotes an imbalance between cell death and proliferation. This is the first evidence of disruption of the epithelial kinetics with S. stercoralis infection, though the mechanisms remain unclear. Furthermore, our results support the idea that strongyloidiasis disturbs the mucosal integrity and can compromise the intestinal barrier.

Keywords

strongyloidiasis small intestine apoptosis cell proliferation