Toxocara canis and T. cati are parasites of dogs and cats, respectively, that infect humans and cause human toxocariasis. Infection may cause asthma-like symptoms but is often asymptomatic and is associated with a marked eosinophilia. Previous epidemiological studies indicate that T. canis infection may be associated with the development of atopy and asthma.
To investigate possible associations between Toxocara spp. seropositivity and atopy and childhood wheezing in a population of children living in non-affluent areas of a large Latin American city.
The study was conducted in the city of Salvador, Brazil. Data on wheezing symptoms were collected by questionnaire, and atopy was measured by the presence of aeroallergen-specific IgE (sIgE). Skin prick test (SPT), total IgE and peripheral eosinophilia were measured. Toxocara seropositivity was determined by the presence of anti-Toxocara IgG antibodies, and intestinal helminth infections were determined by stool microscopy.
Children aged 4 to 11 years were studied, of whom 47% were seropositive for anti-Toxocara IgG; eosinophilia >4% occurred in 74.2% and >10% in 25.4%; 59.6% had elevated levels of total IgE; 36.8% had sIgE≥0.70 kU/L and 30.4% had SPT for at least one aeroallergen; 22.4% had current wheezing symptoms. Anti-Toxocara IgG was positively associated with elevated eosinophils counts, total IgE and the presence of specific IgE to aeroallergens but was inversely associated with skin prick test reactivity.
The prevalence of Toxocara seropositivity was high in the studied population of children living in conditions of poverty in urban Brazil. Toxocara infection, although associated with total IgE, sIgE and eosinophilia, may prevent the development of skin hypersensitivity to aeroallergens, possibly through increased polyclonal IgE and the induction of a modified Th2 immune reaction.
Toxocara canis and T. cati are roundworms found in dogs and cats, respectively, that can also infect humans and cause several clinical features, including asthma-like symptoms. Human infections with T. canis have been associated with an increased prevalence of atopy and asthma. In the present study, we investigated the associations between Toxocara seropositivity with eosinophilia, total IgE, specific IgE and skin prick test reactivity to aeroallergens, as well as atopic and non-atopic wheezing. Toxocara seropositivity was associated with elevated eosinophil counts and total and aeroallergen-specific IgE but was also associated with a decreased prevalence of skin prick test. Toxocara seropositivity was not associated with atopic wheezing. In conclusion, our data show that human toxocariasis, although associated with eosinophilia and raised levels of total and allergen-specific IgE, may play a role in the modulation of allergic effector responses in the skin.