Decreased atopy in children infected with Schistosoma haematobium: a role for parasite-induced interleukin-10

Lancet. 2000 Nov 18;356(9243):1723-7. doi: 10.1016/S0140-6736(00)03206-2.


Background: Most of the effort directed at understanding the role infections have in preventing allergy has focused on bacteria and viruses and their ability to divert the immune system towards T-helper-1 responses and away from proallergic T-helper-2 responses. However, helminth infections, highly prevalent in large parts of the developing world, where allergy is uncommon, stimulate strong T-helper-2 responses. We investigated the influence of chronic helminth infections on the prevalence of atopy and aimed to understand the relation at a detailed immunological level.

Methods: 520 Gabonese schoolchildren were tested for skin reaction to house-dust mite and other allergens, for Schistosoma haematobium eggs in urine, and for microfilariae in blood samples. Total and mite-specific IgE antibodies were measured. A subsample selected on the basis of their skin test to house-dust mite received detailed immunological investigations.

Findings: Children with urinary schistosomiasis had a lower prevalence of a positive skin reaction to house-dust mite than those free of this infection (odds ratio 0.32 [95% CI 0.16-0.63]). The degree of sensitisation to house-dust mite could not explain this difference in skin-prick positivity. Schistosome-antigen-specific concentrations of interleukin-10 were significantly higher in infected children, and higher specific concentrations of this anti-inflammatory cytokine were negatively associated with the outcome of skin-test reactivity to mite (0.53 [0.30-0.96]). No association between polyclonal IgE antibodies and skin-test results was found.

Interpretation: The anti-inflammatory cytokine, interleukin-10, induced in chronic schistosomiasis, appears central to suppressing atopy in African children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Allergens / immunology
  • Animals
  • Antigens, Dermatophagoides
  • Child
  • Child, Preschool
  • Female
  • Gabon / epidemiology
  • Glycoproteins / immunology
  • Humans
  • Hypersensitivity, Immediate / epidemiology
  • Hypersensitivity, Immediate / immunology*
  • Immunoglobulin E / blood
  • Interleukin-10 / metabolism
  • Male
  • Mites / immunology
  • Prevalence
  • Schistosoma haematobium / isolation & purification*
  • Schistosoma haematobium / physiology
  • Schistosomiasis haematobia / immunology*
  • Schistosomiasis haematobia / metabolism
  • Skin Tests


  • Allergens
  • Antigens, Dermatophagoides
  • Glycoproteins
  • Interleukin-10
  • Immunoglobulin E