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Multi-disciplinary studies of human schistosomiasis in Uganda, Kenya and Mali: new perspectives on morbidity, immunity, treatment and control

Periodic Report Summary - MUSTSCHISTUKEMA (Multi-disciplinary studies of human schistosomiasis in Uganda, Kenya and Mali: new perspectives on morbidity, immunity, treatment and control)

The overall objective of the project was to contribute to an increased knowledge about the effect of praziquantel on schistosomiasis related morbidity, the mechanisms behind this effect both regarding the regulation of host immune responses as well as the effect on the parasite with the overall aim of improving the strategies for morbidity control.

The project conducted a Nuclear magnetic resonance (NMR) based metabonomics study based on urine samples collected from individuals at five time-points from the Ugandan cohort before and after (one or two times) chemotherapy with praziquantel. Using supervised multivariate statistical analysis of the recorded one-dimensional (1D) NMR spectra, we were able to discriminate infected from uninfected individuals in two age groups (children and adults) based on differences in their urinary profiles. The potential molecular markers of S. mansoni infection were found to be primarily linked to changes in gut microflora, energy metabolism and liver function. These findings are in agreement with data from earlier studies on S. mansoni infection in experimental animals and thus provide corroborating evidence for the existence of metabolic response specific for this infection.

The project has the following near future impact: An increased knowledge about the long term effect of treatment may have implication for future treatment strategies and it may ultimately reduce the number of tablets necessary to obtain a certain reduction in schistosomiasis related disease in affected communities. This can make morbidity control more sustainable.

The knowledge about the modulating and boosting effect of PZQ on immune responses and the implications for development of resistance may be of value in design of future vaccines and vaccine strategies. The use of the newest and most advanced MS and NMR technology in identification of parasite or host products related to morbidity may identify biomolecules suitable for use in future morbidity diagnosis. This part of the project is highly innovative and is therefore likely to reinforce competitiveness.

The second level of impact is when research results are transformed into strategies for disease control. A close contact is established with the control programmes and this will facilitate the transformation of the research findings into strategies for control. It is plausible that some of the results generated will change the current policies.

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