Impact of Enterobius vermicularis infection and mebendazole treatment on intestinal microbiota and host immune response

Objectives: Previous association studies on Enterobiasis and risk of developing chronic inflammatory diseases revealed contradictory results1-3. We aimed to investigate whether Enterobius infection could influence our intestinal immune response and shift the microbiota to a composition that is beneficial to the host. Methods: Stool specimens were collected from 109 school-aged children either infected or uninfected with Enterobius vermicularis. Fecal samples were collected again in 65 subjects 2 weeks after taking 100 mg mebendazol. Gut microbiome composition was measured via 16S rRNA-sequencing. Intestinal cytokine and sIgA levels were detected by ELISA. Results: Enterobious exposure increased the intestinal microbial diversity. Mebendazole treatment further enriched the relative abundance of the probiotic bacteria Bifidobacterium longum and Streptococcus thermophilus. Moreover, pinworm infection significantly decreased intestinal sIgA levels, while the amounts of IL-1s and IL-4 remained unchanged. Of note, stool IL-4 was negatively associated with the abundance of Alistipes, which was found to be increased after Enterobius infection. Mebendazole increased sIgA level in subjects with higher proportions of gut Streptococcus and Collinsella after treatment. Conclusion: Childhood exposure to Enterobiasis and mebendazole could be beneficial in terms of enrichment of intestinal probiotic species. The impact of mebendazole treatment on sIgA restoration is dependent on host microbiome composition.