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Kabir M, Alam M, Nayak U, Arju T, Hossain B, Tarannum R, Khatun A, White JA, Ma JZ, Haque R, Petri WA, Gilchrist CA. Nonsterile immunity to cryptosporidiosis in infants is associated with mucosal IgA against the sporozoite and protection from malnutrition. PLoS Pathog 2021; 17:e1009445. [PMID: 34181697 PMCID: PMC8270466 DOI: 10.1371/journal.ppat.1009445] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/09/2021] [Accepted: 05/16/2021] [Indexed: 01/08/2023] Open
Abstract
We conducted a longitudinal study of cryptosporidiosis from birth to three years of age in an urban slum of Dhaka Bangladesh. Fecal DNA was extracted from monthly surveillance samples and diarrheal stool samples collected from 392 infants from birth to three years. A pan-Cryptosporidium qPCR assay was used to identify sub-clinical and symptomatic cryptosporidiosis. Anthropometric measurements were collected quarterly to assess child nutritional status. 31% (121/392) of children experienced a single and 57% (222/392) multiple infections with Cryptosporidium. Repeat infections had a lower burden of parasites in the stool (Cq slope = -1.85; p<0.0001) and were more likely to be sub-clinical (Chi square test for trend; p = 0.01). Repeat infections were associated with the development of growth faltering (Pearson correlation = -0.18; p = 0.0004). High levels of fecal IgA antibodies against the Cryptosporidium Cp23 sporozoite protein at one year of life were associated with a delay in reinfection and amelioration of growth faltering through three years of life (HAZ IgA high responders -1.323 ± 0.932 versus HAZ -1.731 ± 0.984 p = 0.0001). We concluded that nonsterile immunity to cryptosporidiosis in young children was associated with high levels of mucosal IgA anti-Cp23 and protection from diarrhea and growth faltering. Trial Registration: NCT02764918.
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Affiliation(s)
- Mamun Kabir
- Emerging Infections and Parasitology Laboratory, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Mohakhali, Bangladesh
| | - Masud Alam
- Emerging Infections and Parasitology Laboratory, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Mohakhali, Bangladesh
| | - Uma Nayak
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, United States of America
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America
| | - Tuhinur Arju
- Emerging Infections and Parasitology Laboratory, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Mohakhali, Bangladesh
| | - Biplob Hossain
- Emerging Infections and Parasitology Laboratory, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Mohakhali, Bangladesh
| | - Rubaiya Tarannum
- Emerging Infections and Parasitology Laboratory, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Mohakhali, Bangladesh
| | - Amena Khatun
- Emerging Infections and Parasitology Laboratory, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Mohakhali, Bangladesh
| | - Jennifer A. White
- Department of Medicine, University of Virginia, Charlottesville, Virginia, United States of America
| | - Jennie Z. Ma
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Medicine, University of Virginia, Charlottesville, Virginia, United States of America
| | - Rashidul Haque
- Emerging Infections and Parasitology Laboratory, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Mohakhali, Bangladesh
| | - William A. Petri
- Department of Medicine, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Microbiology, Immunology and Cancer Biology, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Pathology, University of Virginia, Charlottesville, Virginia, United States of America
| | - Carol A. Gilchrist
- Department of Medicine, University of Virginia, Charlottesville, Virginia, United States of America
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