5th Annual BMRP Investigator Meeting - Abstract

Exploring the Relationship between Crohn’s Disease and Hookworm Infestation in a Hitherto Low Prevalence Area for Crohn’s Disease

Balakrishnan S. Ramakrishna^1,a, Kabeerdoss Jayakanthan¹, Srinivasan Pugazhendhi¹, Subramanian Venkataraman², Alok Srivastava³, James Lewis⁴, Jeffrey Bethony⁵ and Henry J. Binder<sup>6

1</sup>Departments of Gastrointestinal Sciences and ³Hematology, Christian Medical College (Vellore, India); ²St. George’s Medical School, University of London (United Kingdom); ⁴Department of Internal Medicine, University of Pennsylvania (Philadelphia, U.S.A.); ⁵Department of Microbiology, George Washington University, (Washington DC, U.S.A.) and ⁶Department of Internal Medicine, Yale University School of Medicine (New Haven, Connecticut, U.S.A.)

Helminth infections induce a Th2 type immune response in the human host and down-regulate Th1 cytokines including tumor necrosis factor a and interferon g.  This study explored the possibility that the increasing incidence of Crohn’s disease in a hitherto low prevalence area of India was related to a decreasing prevalence of hookworm infection in a hitherto high prevalence area.  We use a case control format to measure fecal hookworm carriage and T cell responses to extracted and recombinant hookworm antigens. Patients with Crohn’s disease with appropriate controls are being studied in Vellore, Tamil Nadu, India.  Recruitment of subjects is ongoing, but initial results show a trend towards reduced hookworm infection in Crohn’s disease with lower, but presently not significant, shifts in T cell populations on exposure to hookworm antigen compared to matched control subjects. Hookworm infection may have a protective effect against the development of Crohn’s disease in otherwise predisposed individuals.

^aPrincipal Investigator