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INTERLEUKIN-8, TUMOR NECROSIS FACTOR-, AND LACTOFERRIN IN IMMUNOCOMPETENT HOSTS WITH EXPERIMENTAL AND BRAZILIAN CHILDREN WITH ACQUIRED CRYPTOSPORIDIOSIS

To examine the importance of intestinal inflammation in the diagnosis and pathogenesis of human cryptosporidiosis, stools of healthy adult volunteers before and after experimental infection were tested for fecal lactoferrin, interleukin-8 (IL-8), and tumor necrosis factor- (TNF-). Stool samples of Brazilian children with well-defined Cryptosporidium infection, with or without diarrhea, were also tested for IL-8 and TNF-. Only one of the 14 volunteers challenged with Cryptosporidium had increased fecal lactoferrin. However, of 17 stool specimens from children with only Cryptosporidium infection from a previous study, 12 had mild to moderately elevated lactoferrin despite negative work-up for inflammatory enteritides. One of 10 adult volunteers who developed diarrhea with experimental cryptosporidiosis and three of 11 children with cryptosporidiosis and diarrhea had detectable fecal IL-8. The level of TNF- was increased only in one of 14 volunteers and in none of the children. Although considered relatively non-inflammatory, cryptosporidiosis is often associated with mild inflammation, especially in children in an endemic area.

Received June 11, 2001. Accepted for publication January 31, 2002.

Acknowledgments: We thank Dr. Robert Newman, who reported the original studies of children in Brazil with cryptosporidiosis, for critically reviewing the manuscript. We also thank Yatta Jacob and Chrissie Bradshaw for their technical assistance.

Financial support: This work was supported in part by NIH grant TMRC #2 P50 AI 30639 (UVa Subcontract #00/01.UBF.4), ICIDR grant #UO1 AI26512, USEPA-CR824759 (Volunteer studies), NIH General Clinical Research Center Grant M01-RR-02558 (where volunteers are challenged and monitored), grant RO1 AI-41735, and Fogarty Center International Training and Research in Emerging Infectious Diseases (ITREID) Fellowship Grant 5 D43 TW00909 (Joint funding-FIC/NIAID/NIDR).

Authors’ addresses: Cirle S. Alcantara, University of the Philippines-National Institute of Health, Pedro Gil Street, Room 101, Emita, Manila 1000, The Philippines, Telephone/Fax: 63-2-526-4266. Chang-Hun Yang, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of DongGuk College of Medicine, Kyungju, Korea, Fax: 82-56-1770-8500. Theodore S. Steiner, Infectious Diseases Division, University of British Columbia, Vancouver, British Columbia V5Z 3J5, Canada, Fax: 604-875-4013. Leah J. Barrett and Richard L. Guerrant, Division of Geographic and International Medicine, University of Virginia School of Medicine, Box 801379, Charlottesville VA 22908, Telephone: 434-924-5242, Fax: 434-977-5323, E-mail: rlg9a{at}virginia.edu. Aldo A. M. Lima, Clinical Research Unit, Federal University of Ceará, Fortaleza, Brazil, Fax: 55-85-281-5212. Cynthia L. Chappell, Center for Infectious Disease, University of Texas School of Public Health, Houston, TX 77030, Fax: 713-500-9364. Pablo C. Okhuysen, Division of Infectious Diseases, University of Texas-Houston Medical School, Houston, TX 77030, Fax: 713-500-5495. A. Clinton White, Jr., Infectious Diseases Section, Department of Medicine, Baylor College of Medicine, Houston, TX 7730, Fax: 713-798-6802.

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