parasitic arthritis

Objective

The objective of this study was to conduct a bibliographic analysis of current data regarding the impact of parasitic infestations on immune status and the progression of osteoarticular diseases within the context of parasitic infections.

Material and methods

This was a qualitative analytical study presented as a narrative literature review. Relevant primary sources published between 2016 and 2022 were identified and selected using data extraction and analysis methods.

Results and discussion

The concept of "parasitic therapy" has generated considerable interest among researchers, the public, and patients for whom standard treatments have been ineffective or offered limited results. Although studies exploring the role of parasitic infections in arthritis are less common than in other fields, animal models suggest that parasitic infections may alleviate joint inflammation. However, further research is needed across different forms of arthritis, including clinical data collection and double-blind, controlled clinical trials.

Conclusions

While only a few studies have demonstrated that parasitic infections may worsen preexisting diseases, the scientific consensus is that parasitic infections can create an immunoregulatory environment, reducing the severity of coexisting conditions. Finally, more rigorous animal studies are required to thoroughly investigate immunomodulatory mechanisms and potential side effects of parasitic infections in the presence of other diseases.

Introduction

The description of clinical manifestations of parasitic infestation includes joint damage manifested by arthralgia and arthritis, however, until today; the form of joint damage in parasitic infections is not clinically defined. The multitude of parasites creates a heterogeneous joint involvement, and the intensifying of specific manifestations would be an important premise in clinical diagnosis.

Objective

Assessment of immunological changes in the context of parasitosis and their ratio depending on the clinical variant of parasitic arthritis.

Material and methods

A group of 161 patients with parasitic arthritis was selected, established in two stages of compliance according to specific and serological criteria. The average age was 47.0±2.1 years, 72 men / 89 women. The average duration of joint syndrome was 50.4±15.6 months. The first group (97 patients) had parasitic arthritis of echinococcosis infestation, the 2nd (31 patients) – parasitic arthritis of Toxocara cannis and the 3rd (33 patients) had parasitic arthritis of Giardia lamblia infestation.

Results and discussion

IgA was increased above normal in all patients with parasitic arthritis (4.25±0.001; p < 0.001). IgM showed significant changes, depended on infestation agent (p < 0.05). Patients with normal IgG levels predominated, except for patients from the group with echinococcosis parasitic arthritis (p > 0.05). The amount of IgE exceeds normal values in Echinococcus parasitic arthritis (38.40 ng/ml), Toxocara canis (34.16 ng/ml), Giardia lamblia (45.06 ng/ml).

Conclusions

This suggests that the key aspects of immunity against parasites are mainly determined by the size of the harmful organisms that the immune system needs to combat. Macroorganism includes unique defense mechanisms that can be effective against multicellular helminths: high production of IgA and IgE and activation of key effector cells – eosinophils.

Introduction

Parasitic arthritis is associated with infestation of the patient's body of parasitic species of worms and protozoan microorganisms. Now it has been established that parasitic arthritis can be caused by almost any species of these creatures. The objective of the study was to research the clinical-evolutionary features of cases of parasitic infections associated with damage of the osteo-articular system in helminthic pathologies.

Materials and methods

161 patients were included in the study, which were divided into 3 groups of differentiated observation by the pathogen of infestation and the clinical variant of parasitic arthritis. The first group (97 patients) consisted of patients with parasitic arthritis associated with echinococcosis infestation, the 2nd (31 patients) – patients with parasitic arthritis associated with Toxocara canis and the 3rd (33 patients) included subjects with parasitic arthritis associated with of Giardia lamblia infestation.

Results and discussion

Echinococcosis was manifested more often by the axial (65.67%) and peripheral (31.34%) clinical forms, while the mixed form was being extremely rare (2.98%) (p < 0.001).The power of connection with the type of arthritis has reached the degree of statistical significance (p < 0.001). Parasitic arthritis due to Toxocara canis showed an overwhelming predominance of peripheral forms of joint syndrome (70.96%), with an insignificant share of axial (12.9%) and mixed form (16.13%) (p < 0.01), with a connection to the peripheral form of parasitic arthritis (p < 0.01). The clinically developed form of parasitosis caused by Giardia lamblia manifested a predominantly mixed joint syndrome (57.89%), confirming a predominantly peripheral impairment (36.84%) of the axial (5%) with a statistically significant difference (p < 0.05), as well as a connection for the mixed-peripheral form of parasitic arthritis (p < 0.05).

Conclusions

Parasitic arthritis is characterized by the diversity of clinical joint manifestations, which fall into 3 clinical variants: induced by infestation with Echinococcus, Toxocara canis and Giardia lamblia, among which giardiasis correlates with a more severe clinical course, followed by echinococcosis and toxocariasis. Despite a large number of painful and inflamed joints that are also associated with an advanced radiological stage of joint damage, parasitic arthritis is characterized by a comparatively diminished articular painful syndrome.