Detection of serum cytokines before and after pharmacological and surgical treatment in patients with cystic echinococcosis.

BACKGROUND: Human cystic echinococcosis (CE), caused by Echinococcus granulosus, is one of the most important and widespread parasitic zoonoses in the developing world. Postsurgical relapses or treatment failure is a frequent risk and a long-term clinical and serological follow-up is required to evaluate the success and failure of therapy. Therefore, the present study was aimed to identify the immunological markers that correlate with the effectiveness of pharmacological and surgical treatment. METHODS: The relation of serum cytokine levels and outcome of chemotherapy and surgery was evaluated in 50 patients with cystic echinococcosis (CE). Serum IL-4, IL- 10 and interferon-gamma (IFN-γ) concentrations were determined by ELISA before and after pharmacological and surgical treatment. RESULTS: The serum cytokine levels of IL-4, IL-10 and IFN-γ were elevated in significant proportion of patients during the active stage of disease. IL-4, IL-10 and IFN- γ were measurable in 41 (82%), 37 (74%) and 25 (50%) patients before the treatment. Clinical and radiological assessment of patients at 2 years, after the pharmacological and surgical treatment, showed that 48 of the 50 patients had responded to the treatment. IL-4 and IL-10 levels were decreased significantly (P<0.05) in these patients. Conversely, of the patients who did not respond had high levels of IL-4 and IL-10 and undetectable levels of IFN-γ. CONCLUSION: In conclusion, the results indicate that the serum IL-4 and IL-10 cytokines are useful immunological markers demonstrating the effectiveness of surgical and pharmacological treatment in the follow- up of patients with cystic echinococcosis.