Effect of filarial infection on serum inflammatory and atherogenic biomarkers in coronary artery disease (CURES-121)

Abstract

Helminth infections can potentially confer protection against metabolic disorders, possibly through immunomodulation. In this study, the baseline prevalence of lymphatic filariasis (LF) among subjects without (N = 236) and with (N = 217) coronary artery disease (CAD) was examined as part of the Chennai Urban Rural Epidemiological Study (CURES). The prevalence of LF was not significantly different between CAD(-) and CAD(+) subjects. The LF antigen load and antibody levels indicated comparable levels of infection and exposure between the groups. Within the CAD group, LF(+) and LF(-) subjects had no significant difference in the intimal medial thickness and high-sensitivity C-reactive protein values. However, LF infection was associated with augmented levels of tumor necrosis factor-α and interleukin-6 among CAD(+) subjects. The LF infection had no effect on serum adipocytokine profile. In conclusion, unlike type-2 diabetes, there is no association between the prevalence of LF and CAD and also no evidence of protective immunomodulation of LF infection on CAD in the Asian Indian population.

Figure 1.

Flow chart depicting the various stages of sample selection during various phases of Chennai Urban Rural Epidemiological Study (CURES). In phase 1 of the urban component of CURES, 26,001 individuals from 46 wards representing 10 zones of Chennai were recruited based on a systematic random sampling technique and fasting blood glucose was determined. In phase 2, detailed studies of diabetic complications, including nephropathy, neuropathy, and retinopathy were performed, and in phase 3, every 10th individual in phase 1 was invited to participate in more detailed studies, including screening for coronary artery disease. All participants for this study were recruited from phase 3 of CURES.

Figure 2.

Serum cytokine levels in lymphatic filariasis (LF)-negative and LF-positive CAD subjects. Serum levels of tumor necrosis factor-α (TNF-α) (A), interleukin (IL)-6 (B), IL-1β (C), and IL-10 (D) are shown. Each dot represents an individual patient, with the geometric mean represented by the horizontal bars. P values were calculated by Mann-Whitney U test. P < 0.05 was considered significant.

Figure 3.

Serum adipocytokine levels in lymphatic filariasis (LF)-negative and LF-positive CAD subjects. Serum levels of Adiponectin (A), Adipsin (B), Leptin (C), Resistin (D), PAI-1 (E), and Visfatin (F) are shown. Each dot represents an individual patient, with the geometric mean represented by the horizontal bars. P values were calculated by Mann-Whitney U test. P < 0.05 was considered significant.