[The role of cytokines in giardiasis in children].

INTRODUCTION: Trophozoites of Giardia lamblia present in the upper gastro-intestinal tract may cause inflammation of the duodenal mucosa, impair secretory activity of goblet cells, damage the enterocytes, and in case of intestinal villi atrophy, they may induce the malabsorption syndrome. The increase in number of endothelial lymphocytes in the epithelium of the duodenal mucosa indicates the involvement of local immune processes. THE AIM of the study was to assess the concentrations of chosen cytokines in the gastric mucosa in children infested with Giardia lamblia, before and after treatment, with simultaneous morphological evaluation of the duodenal mucosa before treatment.
MATERIAL AND METHODS: The study included 12 children infested with Giardia lamblia and 15 children constituting controls. Giardiasis was diagnosed basing on the presence of trophozoites in the mucus taken from the duodenum during endoscopy (brush swab). In all patients, samples from the prepyloric section of the gastric and duodenal mucosa were examined histologically. In bioptates, concentrations of chosen cytokines were determined by ELISA method.
RESULTS: Histopathological examination of the gastric mucosa showed chronic antral gastritis in 8.3% and duodenal mucosa inflammation in 58.3%. Mean concentrations of cytokines determined in the antral mucosa before treatment equaled: IL-2 - 53.1; IL-4 -27.7; IL-5 -39.4; IL-8 - 41.4; IL-10 - 33.0; IFN-gamma - 60.3; TNF-alpha - 27.7 pq/mg of protein. Concentrations of mucosal cytokines, apart from IL-10 (82.7 pq/mg of protein), decreased due to targeted treatment with the simultaneous improvement of histopathological changes reported before treatment.
CONCLUSION: In children infested with Giardia lamblia, an increased local production of proinflammatory and proallergic cytokines was observed in the gastric mucosa.