Immunomodulatory parasites and toll-like receptor-mediated tumour necrosis factor alpha responsiveness in wild mammals
© Jackson et al; licensee BioMed Central Ltd. 2009
Received: 14 November 2008
Accepted: 22 April 2009
Published: 22 April 2009
Immunological analyses of wild populations can increase our understanding of how vertebrate immune systems respond to 'natural' levels of exposure to diverse infections. A major recent advance in immunology has been the recognition of the central role of phylogenetically conserved toll-like receptors in triggering innate immunity and the subsequent recruitment of adaptive response programmes. We studied the cross-sectional associations between individual levels of systemic toll-like receptor-mediated tumour necrosis factor alpha responsiveness and macro- and microparasite infections in a natural wood mouse (Apodemus sylvaticus) population.
Amongst a diverse group of macroparasites, only levels of the nematode Heligmosomoides polygyrus and the louse Polyplax serrata were correlated (negatively) with innate immune responsiveness (measured by splenocyte tumour necrosis factor alpha responses to a panel of toll-like receptor agonists). Polyplax serrata infection explained a strikingly high proportion of the total variation in innate responses. Contrastingly, faecal oocyst count in microparasitic Eimeria spp. was positively associated with innate immune responsiveness, most significantly for the endosomal receptors TLR7 and TLR9.
Analogy with relevant laboratory models suggests the underlying causality for the observed patterns may be parasite-driven immunomodulatory effects on the host. A subset of immunomodulatory parasite species could thus have a key role in structuring other infections in natural vertebrate populations by affecting the 'upstream' innate mediators, like toll-like receptors, that are important in initiating immunity. Furthermore, the magnitude of the present result suggests that populations free from immunosuppressive parasites may exist at 'unnaturally' elevated levels of innate immune activation, perhaps leading to an increased risk of immunopathology.
Natural vertebrate populations are chronically exposed to multiple infections and experience a range of environmental stressors. The vertebrate immune system will have evolved in ancestral populations subject to these pressures. Given that our understanding of mammalian immunology is largely based on rodents reared under highly unnatural pathogen- and stress-free conditions, analysing immune responses in wild populations may give crucial insights into how the immune system functions in its natural context. There may be fundamental implications for how we understand immunological dysfunction observed in modern humans. Across recent generations, humans in developed countries, much like laboratory mouse strains, have been exposed to a very different profile of infections to that encountered by their ancestors. At the same time there is evidence of a continuing breakdown of immune regulation in humans in industrialised societies, manifested by increases in allergic  and autoimmune disorders . A putative functional link between reduced infection exposure and immune hyperactivity in human populations (the 'hygiene hypothesis') has long been proposed . A more recent refinement of this idea is that metazoan infections may lead to the healthy development of immunoregulatory networks due to their ability to stimulate expansions of regulatory T-cells . The evolutionary basis for this is that strong immunomodulatory stimuli from metazoan parasites have been a constant presence during vertebrate history, and that the immune system is now maladapted to a situation where these organisms are absent . This is consistent with the considerable evidence that helminth infections of humans stimulate immunosuppressive effects and increased T-regulatory activity [6–9]. However, support for the evolutionary role of parasite-induced immunoregulation would be strengthened if immune suppression by metazoan parasites could be shown to also be a general phenomenon in wild vertebrate populations. Studies in wildlife systems might also give greater insight into the range of parasitic organisms involved and the ecological context in which immunosuppression occurs.
The analysis of immune responses in wildlife has been hindered by a lack of specific reagents for the measurement of immunological molecules in non-model organisms . Here we take advantage of conservation in the murine pro-inflammatory signalling molecule tumour necrosis factor alpha (TNF-α) to develop a novel assay of innate toll-like receptor (TLR)-mediated immune responsiveness in a wild rodent population. TLRs are pattern-recognition receptors (PRRs) that detect conserved molecular patterns associated with certain types of pathogenic organism or with endogenous 'danger' signals . Currently, TLRs are thought to be the most important family of PRRs in initiating innate immunity and the activation of antigen presenting cells that trigger adaptive responses. Their central role in the immune system gives a number of potential advantages in assays which seek to provide an overall measure of immune function. As there is a diversity of TLRs  with differing ligand specificities, responses for a panel of different receptor-ligand combinations may give indications of immune responsiveness towards a broad range of infections. In addition to triggering and influencing the phenotypic trajectory of innate and adaptive immunity, TLR responses are also themselves influenced by signals from many other elements of the immune system, including signals from regulatory adaptive responses . The assay that we describe below may therefore offer a relatively holistic index of overall immune activation.
We used this assay of innate immune responses to analyse a cross-sectional natural population sample of the wood mouse, Apodemus sylvaticus, in the UK and test hypotheses of covariation between innate immune activation, parasitic infection and other host variables. On the basis of our results we suggest that a subset of metazoan parasites can have strong suppressive effects on innate immunity that over-ride effects due to individual body condition or reproductive status.
Details of toll-like receptors (TLRs) stimulated in cellular assays.
Site of expression
Fungal zymosan (10 μg/ml)
Heat-killed Listeria monocytogenes (0.6 × 108 cells/ml)
Escherichia coli K12 lipopolysaccharide (3 μg/ml)
Salmonella typhimurium flagellin (0.6 μg/ml)
Imiquimod (1.5 μg/ml)
Oligonucleotide ODN2006 (6 μg/ml)
Positive covariation amongst TLR-mediated responses
Parasite community structure
Associations between infection variables and TLR-mediated responses
General linear mixed model prediction of tumour necrosis factor alpha (pg/ml) responses in louse-free wood mice and wood mice in the heaviest louse infection category.
TLR2/heat-killed Listeria monocytogenes
Associations between host variables and TLR-mediated responses
In LMMs excluding parasite variables there was no significant relation of PC1 I to sex (F 1,82.2 = 0.74; P = 0.393), SVL (F 1,84.8 = 0.93; P = 0.337), or post-capture body weight (BW) (F 1,88.1 = 1.17; P = 0.283). A factor reflecting distinct life stages (LH) that would be expected to show differing hormonal backgrounds (juvenile male, non-reproductive adult male, reproductive adult male, imperforate juvenile female, non-pregnant non-lactating adult female, pregnant female) was also unrelated to PC1 I (F 4,79.8 = 0.43; P = 0.788). There was no relationship of PC1 I to residuals of BW (BW resid ) (F 1,82.6 = 0.09; P = 0.765) and liver weight (LW resid ) (F 1,83.8 = 1.50; P = 0.224) from regressions on SVL. No other significant associations were found between individual TLR variables and SVL, BW, BW resid , LW resid or LH. Whilst there was a marginally non-significant positive link between packed blood cell volume (PCV) and PC1 I (F 1,76.7 = 3.77, P = 0.056) this was principally due to a strong relation of PCV to TLR9-mediated responses (F 1,80.9 = 11.41; P = 0.001) but not responses mediated through other receptors (all P > 0.05).
Our analysis provides compelling evidence for strong negative associations between some members of the metazoan parasite community and the level of innate immune activation. These were detectable for the nematode H. polygyrus and, very strongly, for the louse P. serrata but not for other abundant community members. It has long been known from studies of the Heligmosomoides bakeri-Mus musculus laboratory model that H. bakeri can exert non-specific immunosuppressive effects [15, 16] that may enable other parasites to survive better in the face of host immunity . More recent studies show it to stimulate expansion of regulatory T-cell subsets [18–21]. Given that TLR-responsiveness can be influenced by regulatory signals from the adaptive immune system [13, 22, 23] and that some helminth products, including H. polygyrus products, also direct the maturation of dendritic cells (DCs) with muted pro-inflammatory properties and down-regulated TLR function [24–28], our current data are consistent with an H. polygyrus-dependent depression of innate immunity. Perhaps more surprising is the observation that louse infection is even more strongly associated with innate immune activation. The quantitative effect of this infection was large, with modelling results indicating that the highest levels of louse reproductive activity (>20 louse egg cases per host) were associated with approximately 50% reductions in TLR2 and TLR9-mediated TNF-α responses. This suggests that some ectoparasites that are in contact with the host immune system merely through feeding and attachment at the body surface may exert a stronger influence on the immunoregulatory environment in their host than endohelminth infections. Although P. serrata has not been a major focus of recent immunological research, older studies have reported it not only to generate protective immunity in M. musculus , but also to mediate in vivo suppressive effects on T-cell proliferation in some inbred strains of this host . Immunosuppressive effects are well documented in other ectoparasitic arthropods [31, 32]. For example, the Salp15 protein secreted in Ixodes scapularis saliva can interfere with DC function to reduce TLR-mediated pro-inflammatory cytokine release  and directly inhibit CD4+ T-cell activation . It might be predicted that P. serrata may also secrete substances into the host that interfere directly with innate immune function or, perhaps by analogy with gastrointestinal nematodes, stimulate expansions of regulatory T-cells. However, a further possibility is that unidentified microbial pathogens (perhaps members of the bacterial genus Bartonella?), for which lice might act as a vector, could be responsible for immunosuppressive effects.
Apart from Heligmosomoides and lice, no other common metazoan parasites appeared to be associated with variation in innate responsiveness. This may indicate that these species lack immunomodulatory properties in A. sylvaticus or occurred at levels too low for the detection of such effects. The cross-sectional study design may also have been unable to detect time-lagged correlations, depending on the relative dynamics of the parasite infrapopulations and immune processes. In the case of B. recurvum, S. lobata and C. hepaticum no experimental data on infection duration and immunology are available to assess this. Ixodes ticks, which are known to have immunomodulatory effects in laboratory models (loc. cit.), occurred at relatively low levels and the inherently transient nature of host-parasite contacts in these organisms could have compromised the detection of immunological influences. Syphacia spp. live and feed in the gut lumen at all stages in the life-cycle and perhaps have less contact with the immune system than nematodes that feed on tissues or have a histozoic phase in their life history. Despite this less intimate association, Syphacia obvelata is known to stimulate vigorous Th2 immune responses and down-regulate allergic responses  in M. musculus. As generation time (1 to 2 weeks) and adult lifespan are very short in Syphacia spp. [36, 37], instantaneous population size might not reflect the recent history of infection, compromising the ability to detect covariation between worm counts and immune effects.
In contrast to the metazoan parasites, there was a positive association between TLR-mediated TNF-α responses and the presence of microparasitic coccidian infections. This is consistent with a Th1 response and with the immunostimulatory effects reported for Eimeria spp. in rodent and avian laboratory models, in which primary infection is typically associated with the production of pro-inflammatory cytokines such as IL-6, TNF-α, IL-12 and IFN-γ [38–40]. Furthermore, a defined Eimeria antigen is known to up-regulate pro-inflammatory cytokine production in mice by a MyD88-dependent mechanism, consistent with the involvement of TLRs [41, 42].
The parallels between our present immuno-epidemiological results and the parasite-mediated immunosuppressive effects reported in relevant laboratory model studies are suggestive that the patterns we report above are due to parasite causal effects on host immunity. We considered the alternative possibility that stressed individuals in poor condition , or individuals in active reproductive states, might make a weaker immune response and therefore have more parasites. Under some circumstances nutritional status can affect immunity and resistance to parasites [44–47] (but see ). Glucocorticoids, produced in individuals experiencing high environmental stress, and sex hormones are sometimes [49, 50] associated with effects on immunity [44, 46]. However, we generally found no associations between the host status variables that we measured and TLR-mediated TNF-α responsiveness. There were no significant relationships with body size, or with indexes of general condition including BW residuals on body length, liver weight (LW) residuals on body length and PCV. This was with the exception of an isolated significant positive association between PCV and TLR9-mediated response. Nor was there any association of TLR-mediated responses with life history stage. It therefore seems unlikely that the causality for the patterns reported above was a tendency for weak or reproductively active animals to make weaker immune responses leading to higher infection levels. Whilst other authors have reported synergistic links between declining condition, infection and immunity in wild rodents [43, 51], our failure to link TLR-mediated TNF-α responses and condition may be due to relatively benign environmental conditions over the sampling period, or to a lack of sensitivity of our cross-sectional survey when compared with longitudinal or interventional studies. A further possibility is that inter-host variation, independent of the measures of condition that we utilised, may have caused the observed link between TNF-α responses and parasitism. Perhaps the most likely source of such variability would be genetic polymorphisms affecting the intensity of TLR-mediated responses. Whilst mutations in individual TLR genes have sometimes been reported to affect cytokine responsiveness and resistance to infection [52–57], the strong positive covariation amongst different TLR responses in our study population would more likely relate to polymorphism in mediators affecting shared MyD88-dependent signalling pathways [58, 59], or governing the expression of TNF-α . If genotypic variation in wild mammal populations underpinned key phenotypic variation in the innate immune response and this, in turn, determined susceptibility to parasitism, then pinpointing the loci involved would be of fundamental interest.
TLR-mediated responses represent attractive measurements for ecological studies in immunology because of their central importance in initiating innate and adaptive immunity and their modulation by signals from regulatory elements of the immune system . In practice, many individual A. sylvaticus produced measurable TLR-mediated TNF-α responses, and there was considerable variation in responsiveness between individuals. Viewed in the context of published experimental studies on infections in M. musculus, the present results in a natural A. sylvaticus population suggest that a subset of the metazoan parasite community may be important mediators of the level of innate immune activation. A systemic down-regulation of TLR activity by parasite-induced DC-driven Treg expansions seems a plausible mechanistic explanation for the current observations, although immunomodulation by other routes cannot be discounted. One other possibility might be modulated TLR function (tolerance ) induced by greater exposure to ligands during chronic infection states. Whatever the mechanism, the existence of parasite-driven effects on innate mediators that trigger immune responses against a spectrum of different infectious agents provides strong, albeit indirect, evidence that pathogen/parasite communities may be structured by cross-species effects on innate immune function. This is highly relevant to the current interest in the importance of interspecies interactions in pathogen community dynamics [17, 63]. The profound dampening of innate immune responsiveness associated with some metazoan parasite infections in A. sylvaticus also supports a view that modern parasite-free human and domesticated vertebrate populations may exist at levels of innate immune activation much greater than would have been typical during their recent evolutionary history. The operation of immune systems in this unnatural configuration may uncover maladaptations in control networks that were neutral in the historical context of high metazoan parasite exposure/high regulatory activity . Our results are consistent with recent observations that gastrointestinal nematodes have regulatory effects on adaptive responses in laboratory models  and exposed human populations . Importantly, we also make the novel observation that lice may be a strong source of immunoregulatory stimuli that is absent in many modern human populations.
Sampling was carried out in July–November 2007 at Cotgrave forest, an area of about 135ha of coniferous and mixed forestry plantation in Nottinghamshire, UK (+52.891, -1.041242). Mice were obtained by overnight trapping using variable numbers of Longworth traps assigned randomly amongst 80 permanently marked stations (1 or 0 traps/station). Stations were located at 20 m intervals along a 1600 m linear transect extending through the margins of contiguous forestry blocks. This protocol was intended to spread sampling effort evenly over a relatively large time and distance, so as not to place very high levels of mortality on the study population. Trapping rate was equivalent to 12.5 A. sylvaticus/km/month.
Traps baited with peanut butter were set overnight (17.00) and collected the following morning (08.00). Captured animals were returned to the laboratory, weighed (g) and housed in identical individual cages under a lighting regimen equivalent to the natural photoperiod at the time of capture. Each cage was floored with soft wood chippings and contained sufficient soft bedding for the animal to make a nest. Each animal had free access to water and a standard selection of foods that previous trials had shown A. sylvaticus specimens found palatable. Approximately half of each group of animals were processed between 09.00 and 12.00 on the next day (25 to 28 hours post-capture, 'day 1'). The remainder of the group were processed at the same time on the next day (49 to 52 hours post-capture, 'day 2'). Each animal was killed by an overdose of chloroform followed by exsanguination. SVL (mm) and BW were recorded prior to exsanguination. Each animal was then dissected in a Class 2 safety cabinet and the spleen was removed to RPMI 1640. Initial parasitological observations were made on surfaces within the body cavity (see below) and the gut was transferred to 70% ethanol for dissection and microscopic examination of gastrointestinal parasites at a later time. A blood sample was collected instantly on cardiac puncture in 100 μl heparinised microcapillary tubes and spun in a microhaematocrit centrifuge (Hawksley) for 3 minutes to provide an estimate of PCV ([height of cell column/total column height] × 100). LW (wet weight, g) and reproductive status were recorded. Carcasses were wrapped in white tissue, enclosed within a plastic bag and examined later for the presence of ectoparasites (within 24 hours).
We recorded all endoparasitic organisms detectable at the light microscope level in the faeces, within the lumen of the gut, within the peritoneal cavity, or visible on the surfaces of abdominal internal organs. Six metazoan parasite species occurred in the gut lumen: the cestode Skjrabinotaenia lobata, the digenean Brachylaemus recurvum and the nematodes Heligmosomoides polygyrus, Syphacia stroma, Heterakis spumosa and Aoncotheca annulosa. Individual counts were made for each of these species. For S. stroma, model analyses are presented for the number of established adult females worms as rapid development combined with retroinfection and/or autoinfection processes  may lead to great short-term fluctuation in the numbers of males and larvae present. Parallel analyses on total S. stroma counts suggest equivalent results (not shown). Another nematode, Calodium hepaticum (= Capillaria hepatica) occurred in the liver. Female burrows of this histozoic species are associated with prominent fibrotic reactions  to deposited eggs. Infection severity for C. hepaticum was graded according to the extent of fibrotic burrows in the liver (0: absent; 1: few fibrotic burrows in one hepatic lobe; 2: few fibrotic burrows in more than one lobe, or an extensive mass of fibrotic burrows in one lobe; 3: extensive masses of fibrotic burrows in more than one lobe). We also recorded infection with all ectoparasitic arthropods. Individual counts were made for the flea Ctenophthalmus nobilis, the tick Ixodes trianguliceps and laelapid mites. Infection with the louse Polyplax serrata was graded by the abundance of egg cases in the fur (0, absent; 1 <20; 2, >20). Infection with trombiculid mites was graded by the extent of the accompanying dermatitis (0, absent; 1, single local patch <5 mm in diameter). Faecal samples were examined by the McMaster flotation technique, allowing counts to be made for Eimeria spp. oocysts (minimum detection limit: 100 oocysts/g). Although Eimeria can occur in multi-species communities [67, 68], and variation in oocyst morphology was observed in the present study, it was not possible to unambiguously distinguish different taxa and Eimeria infection is analysed here as an overall FOC.
Immunological assay concept
TLRs are PRRs that detect pathogen-associated molecular patterns. They are of central importance in the induction of anti-pathogen immune responses, initially recognising an infection threat and mobilising inducible innate responses . TLR stimulation is also crucial in shaping how antigen presenting cells activate and polarise adaptive T-helper cell responses . Although TLRs may utilise more than one intracellular signalling pathway, all known human and mouse TLRs except TLR3 can signal via MyD88 resulting in the production of pro-inflammatory cytokines, including TNF-α . We use an ex vivo stimulatory assay to detect TNF-α cytokine production by splenocytes following TLR stimulation. Our underlying assumption is that the ex vivo response mediated by a particular receptor against a particular agonist reflects the relative strength of the response that would occur had the same receptor-ligand interaction taken place in vivo. To give a profile of responsiveness in TLRs with independent specificities directed against different pathogen molecular structures , we measured TNF-α production mediated by TLR2, TLR4, TLR5, TLR7 and TLR9 against defined agonists (Table 1).
Spleens were disaggregated through a 70 μm cell strainer into RPMI 1640. Following erythrocytic lysis (Sigma R7757), leucocytes were washed three times in RPMI 1640 and then cultured (37°C, 5% CO2) on 96 well plates at 2 × 106 cells/ml in RPMI 1640 supplemented with 24 mM NaHCO3, 10% heat-inactivated foetal calf serum, 2 mM L-glutamine, 100 u/ml penicillin, 100 μg/ml streptomycin and 60 μM monothioglycerol. Duplicate individual cultures (150 μl volume) were stimulated with one of six different TLR agonists (at the concentrations shown in Table 1) or left unstimulated as negative controls. Culture supernatants were collected after 24 hours and stored at -80°C. All receptor agonist reagents utilised were tested for functional induction of the target TLR and for endotoxin contamination by the manufacturer (InvivoGen, San Diego, CA, USA). Optimal agonist concentrations were determined by preliminary dose-response experiments on splenocyte cultures from Cotgrave A. sylvaticus.
TNF-α enzyme-linked immunosorbent assay
A. sylvaticus is related to the laboratory models M. musculus and Rattus norvegicus at the subfamily level (Murinae), with recent molecular analyses leaving phylogenetic relationships amongst the three taxa unresolved  or tentatively placing Apodemus spp. closest to Mus . Although the TNF-α gene and protein in A. sylvaticus has not been characterised, a comparison of TNF-α amino acid sequences in R. norvegicus (GenBank NP_036807.1) and M. musculus (NP_038721.1) indicated a similarity of 94%. As some possibility of cross-reactivity of antibody reagents might reasonably be expected at amino acid sequence similarities of >85%, and A. sylvaticus is unlikely to be much more diverged from M. musculus than R. norvegicus, we investigated the possibility that commercially available reagents for the detection of murine TNF-α might be applicable to A. sylvaticus. A standard anti-M. musculus TNF-α sandwich enzyme-linked immunosorbent assay (ELISA) (R&D, DY410) was identified in which the capture and detection antibody reagents were found to cross react with supernatants from A. sylvaticus splenocyte cultures subjected to a pro-inflammatory stimulus. Preliminary analyses (not shown) further confirmed that ELISA measurements in supernatants from splenocyte cultures exposed to a range of pro-inflammatory agents (HKLM, Escherichia coli K12 lipopolysaccharide, Salmonella typhimurium flagellin, FSL-1, imiquimod, ssRNA40, ODN2006; InvivoGen) increased in a dose-dependent manner. Duplicate supernatants for each assay condition in the main study (see above) were analysed on 96-well microplates (following manufacturer's instructions), with a seven-point recombinant mouse TNF-α (31 to 2000 pg/ml) standard curve run in duplicate on each plate. ELISA plate layout mirrored that of the culture plate, so that a single term for 'assay plate' could be included in statistical analyses to account for non-independence introduced into the data by the assaying procedures. Given that the ELISA antibody reagents are likely to have a differing affinity to M. musculus and A. sylvaticus TNF-α, the results we report above may be approximate estimates of A. sylvaticus TNF-α concentration, but should reflect relative variation between individuals. As few individuals showed detectable responses in control (unstimulated) cultures and these responses were low, data from the stimulatory conditions are analysed as the determined pg/ml readings rather than as an above-control value (analyses on data with control concentrations subtracted gave equivalent results, not shown).
Measures of host status
In addition to PCV, we also used residuals from regressions of BW and LW on SVL as derived measures of host condition. In each of these cases a linear regression was a good fit to the data. Individual hosts were classified in the following life history stage categories: 1, juvenile male (non-scrotal with undeveloped testes); 2, non-reproductive adult male (non-scrotal with small testes and non-expanded seminal vesicles); 3, reproductive adult male (scrotal with large testes and expanded seminal vesicles); 4, juvenile female (imperforate, pelvis closed); 5, non-pregnant, non-lactating adult female (perforate and/or pelvis open); 6, pregnant female.
Some missing values occurred for two study animals, so that all multivariate analyses and some analyses for individual TLR responses are based on N = 98 or 99. Where a logarithmic transformation is used, this is log10 (x +1). PCA on the correlation matrix was used to analyse correlational structure amongst log-transformed immunological variables. PCA of parasite data included either a log-transformed count variable or an ordinal categorical variable for each of the nine commonest species (prevalence ≥ 20%). The significance of the largest first component (PC1) extracted from PCAs was assessed by a previously described randomisation test . The strength and direction of the contributions of individual variables to a principal component relate to the magnitude and sign of variable coefficients on that component. Ranks-based correlation coefficients (Spearman's, r s ) were also used to assess pairwise associations between variables. Where there was a significant first component for a PCA, suggesting redundancy amongst the set of variables analysed, individual component (PC) scores were used to represent the main axis of shared variation in subsequent analyses. This is a standard data reduction technique, where the PC scores represent a composite variable derived as the sum of the products of individual observations and variable coefficients. PC1 score variables are designated PC1 I for the immunological analysis and PC1 P for the parasitological analysis. Analyses of reduced data were used to minimise the number of the main hypothesis tests (H0 = infection variables are unrelated to TLR-mediated responsiveness), which were then followed up by exhaustive post hoc testing of individual variables [72–74]. As part of the post hoc analysis we also investigated other components from PCAs with eigenvalues >1, but these results are not shown as they failed to reveal any significant relationships involving the immunological responses.
In order to model covariation of TLR-response variables with other TLR-response variables, or with parasite variables, in the context of confounder variables and correlations introduced by the immunological assaying structure we used residual maximum likelihood (REML) mixed models (fixed model: TLR response ~sex + SVL + season + trap group + variable of interest; random model: trap day/process day/assay plate). Sex (male/female) and season (summer/autumn) were included as factors with two levels and trap group as a factor with seven levels determined by the distribution of traps within contiguous forestry blocks. Significance of terms individually dropped from the full model was assessed by Wald tests. TLR variables with zero or few non-responders (TLR2, TLR9, TIR) were treated as continuous responses in REML LMMs. For some continuous individual TLR variables log-transformation produced significant improvements in model fit and, for consistency, all significance results, unless otherwise indicated, relate to models of log-transformed TNF-α (pg/ml). In all cases these showed satisfactory fit to the data by standard model diagnostics (see below). For predictions in LMMs, analyses were based on untransformed TNF-α concentrations and relate to averaged values for other variables included in the model. For highly skewed TLR responses with around 50% zero values (TLR4, 5 and 7), data were coded to binary form (responder/non-responder) and analysed using REML GLMMs specifying binomial errors (trial size = 1). When a skewed continuous parasite variable was used as an explanatory variable in a mixed model analysis, we routinely assessed the sensitivity of the outcome to log-transformation and ordinal categorisation of that variable. In order to model pairwise covariation amongst infection variables in the context of confounder variables, we used maximum likelihood GLMs. Depending on the distributions of the response variables, we either specified Poisson or negative binomial errors with a log link function, using an adjusted scale parameter where appropriate. Only data for common parasites (prevalence ≥ 20%) were analysed, the remaining species occurring at levels that might be considered negligible. Significance in GLMs was assessed by deleting terms  from a model containing all confounder variables (parasite variable 1 ~SVL + sex + season + trap group + parasite variable 2). Standard model diagnostics (residual distributions, residual versus fit plots, normal and half-normal plots) were used to assess the fit of GLMs, LMMs and GLMMs to the data. PCA was implemented in Minitab® 220.127.116.11 and linear models in GenStat® version 10.1.0.71.
Although elevated stress cannot be eliminated in studies where wild mammals are subject to handling and periods of captivity, there was no significant difference for any of the TLR-mediated response variables, including TIR, PC1 I and each of the individual TLR responses, between animals analysed 1 or 2 days post-capture (LMMs or GLMMs of the form: TLR variable ~SVL + sex + season + trap group + process time, random model = capture date/assay plate; P > 0.05). This suggests that any stress-related immunological variation had stabilised by the time the first animals were processed.
enzyme-linked immunosorbent assay
faecal oocyst count
generalised linear model
generalised linear mixed model
heat-killed Listeria monocytogenes
general linear mixed model
principal components analysis
packed blood cell volume
residual maximum likelihood
tumour necrosis factor alpha.
We are very grateful to Till Hill Ltd for allowing access to the study site, to Bob Liddle (School of Biology, University of Nottingham) for providing logistical support, to Daniel Bermejo for assistance with preliminary work, and to Mike Begon and Steve Paterson for reading the manuscript. We acknowledge funding from the Natural Environment Research Council to JEB (NE/E015131/1) and the European Commission to IMF (Marie Curie Early Stage Research Training).
- Kemp AS, Mullins RJ, Weiner JM: The allergy epidemic: what is the Australian response?. Med J Aust. 2006, 185: 226-227.PubMedGoogle Scholar
- Gale EAM: The rise of childhood type 1 diabetes in the 20th century. Diabetes. 2002, 51: 3353-3361. 10.2337/diabetes.51.12.3353.View ArticlePubMedGoogle Scholar
- Strachan D: Hay fever, hygiene and household size. BMJ. 1989, 299: 1259-1260. 10.1136/bmj.299.6710.1259.PubMed CentralView ArticlePubMedGoogle Scholar
- Maizels RM, Yazdanbakhsh M: Immune regulation by helminth parasites: cellular and molecular mechanisms. Nat Rev Immunol. 2003, 3: 733-744. 10.1038/nri1183.View ArticlePubMedGoogle Scholar
- Bradley JE, Jackson JA: Immunity, immunoregulation and the ecology of trichuriasis and ascariasis. Parasite Immunol. 2004, 26: 429-441. 10.1111/j.0141-9838.2004.00730.x.View ArticlePubMedGoogle Scholar
- McElroy MD, Elrefaei M, Jones N, Ssali F, Mugyenyi P, Barugahare B, Cao A: Coinfection with Schistosoma mansoni is associated with decreased HIV-specific cytolysis and increased IL-10 production. J Immunol. 2005, 174: 5119-5123.View ArticlePubMedGoogle Scholar
- Babu S, Blauvelt CP, Kumaraswami V, Nutman TB: Regulatory networks induced by live parasites impair both Th1 and Th2 pathways in patent lymphatic filariasis: implications for parasite persistence. J Immunol. 2006, 176: 3248-3256.View ArticlePubMedGoogle Scholar
- Mutapi F, Winborn G, Midzi N, Taylor M, Mduluza T, Maizels RM: Cytokine responses to Schistosoma haematobium in a Zimbabwean population: contrasting profiles for IFN-gamma, IL-4, IL-5 and IL-10 with age. BMC Infect Dis. 2007, 7: 139-10.1186/1471-2334-7-139.PubMed CentralView ArticlePubMedGoogle Scholar
- Turner JD, Jackson JA, Faulkner H, Behnke J, Else KJ, Kamgno J, Boussinesq M, Bradley JE: Intensity of intestinal infection with multiple worm species is related to regulatory cytokine output and immune hyporesponsiveness. J Infect Dis. 2008, 197: 1204-1212. 10.1086/586717.View ArticlePubMedGoogle Scholar
- Bradley JE, Jackson JA: Measuring immune system variation to help understand host-pathogen community dynamics. Parasitology. 2008, 135: 807-823. 10.1017/S0031182008000322.View ArticlePubMedGoogle Scholar
- Akira S, Uematsu S, Takeuchi O: Pathogen recognition and innate immunity. Cell. 2006, 124: 783-801. 10.1016/j.cell.2006.02.015.View ArticlePubMedGoogle Scholar
- Roach JC, Glusman G, Rowen L, Kaur A, Purcell MK, Smith KD, Hood LE, Aderem A: The evolution of vertebrate Toll-like receptors. Proc Natl Acad Sci USA. 2005, 102: 9577-9582. 10.1073/pnas.0502272102.PubMed CentralView ArticlePubMedGoogle Scholar
- Murphy TJ, Choileain NN, Zang Y, Mannick JA, Lederer JA: CD4+CD25+ regulatory T cells control innate immune reactivity after injury. J Immunol. 2005, 174: 2957-2963.View ArticlePubMedGoogle Scholar
- Behnke JM, Lewis JW, Zain SNM, Gilbert FS: Helminth infections in Apodemus sylvaticus in southern England: interactive effects of host age, sex and year on the prevalence and abundance of infections. J Helminthol. 1999, 73: 31-44.PubMedGoogle Scholar
- Behnke JM, Wakelin D, Wilson MM: Trichinella spiralis: delayed rejection in mice concurrently infected with Nematospiroides dubius. Exp Parasitol. 1978, 46: 121-130. 10.1016/0014-4894(78)90162-5.View ArticlePubMedGoogle Scholar
- Behnke JM, Hannah J, Pritchard DI: Nematospiroides dubius in the mouse – evidence that adult worms depress the expression of homologous immunity. Parasite Immunol. 1983, 5: 397-408. 10.1111/j.1365-3024.1983.tb00755.x.View ArticlePubMedGoogle Scholar
- Behnke JM, Gilbert FS, Abu-Madi MA, Lewis JW: Do the helminth parasites of wood mice interact?. J Anim Ecol. 2005, 74: 982-993. 10.1111/j.1365-2656.2005.00995.x.View ArticleGoogle Scholar
- Wilson MS, Taylor MD, Balic A, Finney CAM, Lamb JR, Maizels RM: Suppression of allergic airway inflammation by helminth-induced regulatory T cells. J Exp Med. 2005, 202: 1199-1212. 10.1084/jem.20042572.PubMed CentralView ArticlePubMedGoogle Scholar
- Metwali A, Setiawan T, Blum AM, Urban J, Elliott DE, Hang L, Weinstock JV: Induction of CD8+ regulatory T cells in the intestine by Heligmosomoides polygyrus infection. Am J Physiol Gastrointest Liver Physiol. 2006, 291: G253-G259. 10.1152/ajpgi.00409.2005.View ArticlePubMedGoogle Scholar
- Setiawan T, Metwali A, Blum AM, Ince MN, Urban JF, Elliott DE, Weinstock JV: Heligmosomoides polygyrus promotes regulatory T-cell cytokine production in the murine normal distal intestine. Infect Immun. 2007, 75: 4655-4663. 10.1128/IAI.00358-07.PubMed CentralView ArticlePubMedGoogle Scholar
- Finney CA, Taylor MD, Wilson MS, Maizels RM: Expansion and activation of CD4+CD25+ regulatory T cells in Heligmosomoides polygyrus infection. Eur J Immunol. 2007, 37: 1874-1886. 10.1002/eji.200636751.PubMed CentralView ArticlePubMedGoogle Scholar
- Dong Kim K, Zhao J, Auh S, Yang X, Du P, Tang H, Fu Y-X: Adaptive immune cells temper initial innate responses. Nat Med. 2007, 13: 1248-1252. 10.1038/nm1633.View ArticleGoogle Scholar
- Zhao J, Kim KD, Yang X, Auh S, Fu Y-X, Tang H: Hyper innate responses in neonates lead to increased morbidity and mortality after infection. Proc Natl Acad Sci USA. 2008, 105: 7528-7533. 10.1073/pnas.0800152105.PubMed CentralView ArticlePubMedGoogle Scholar
- Kane CM, Cervi L, Sun J, McKee AS, Masek KS, Shapira S, Hunter CA, Pearce EJ: Helminth antigens modulate TLR-initiated dendritic cell activation. J Immunol. 2004, 173: 7454-7461.View ArticlePubMedGoogle Scholar
- Jankovic D, Kullberg MC, Caspar P, Sher A: Parasite-induced Th2 polarization is associated with down-regulated dendritic cell responsiveness to Th1 stimuli and a transient delay in T lymphocyte cycling. J Immunol. 2004, 173: 2419-2427.View ArticlePubMedGoogle Scholar
- Segura M, Su Z, Piccirillo C, Stevenson MM: Impairment of dendritic cell function by excretory-secretory products: a potential mechanism for nematode-induced immunosuppression. Eur J Immunol. 2007, 37: 1887-1904. 10.1002/eji.200636553.View ArticlePubMedGoogle Scholar
- MacDonald AS, Maizels RM: Alarming dendritic cells for Th2 induction. J Exp Med. 2008, 205: 13-17. 10.1084/jem.20072665.PubMed CentralView ArticlePubMedGoogle Scholar
- Semnani RT, Venugopal PG, Leifer CA, Mostbock S, Sabzevari H, Nutman TB: Inhibition of TLR3 and TLR4 function and expression in human dendritic cells by helminth parasites. Blood. 2008, 112: 1290-1298. 10.1182/blood-2008-04-149856.PubMed CentralView ArticlePubMedGoogle Scholar
- Bell JF, Stewart SJ, Nelson WA: Transplant of acquired resistance to Polyplax serrata (Phthiraptera, Hoplopleuridae) in skin allografts to athymic mice. J Med Entomol. 1982, 19: 164-168.View ArticlePubMedGoogle Scholar
- Wikel SK: Immune responses to arthropods and their products. Annu Rev Entomol. 1982, 27: 21-48. 10.1146/annurev.en.27.010182.000321.View ArticlePubMedGoogle Scholar
- Baron RW, Weintraub J: Immunological responses to parasitic arthropods. Parasitol Today. 1987, 3: 77-82. 10.1016/0169-4758(87)90163-3.View ArticlePubMedGoogle Scholar
- Wikel SK, Bergman D: Tick-host immunology: Significant advances and challenging opportunities. Parasitol Today. 1997, 13: 383-389. 10.1016/S0169-4758(97)01126-5.View ArticlePubMedGoogle Scholar
- Hovius JWR, de Jong MAWP, den Dunnen J, Litjens M, Fikrig E, Poll van der T, Gringhuis SI, Geijtenbeek TBH: Salp15 binding to DC-SIGN inhibits cytokine expression by impairing both nucleosome remodeling and mRNA stabilization. PLoS Pathog. 2008, 4: e31-10.1371/journal.ppat.0040031.PubMed CentralView ArticlePubMedGoogle Scholar
- Anguita J, Ramamoorthi N, Hovius JWR, Das S, Thomas V, Persinski R, Conze D, Askenase PW, Rincón M, Kantor FS, Fikrig E: Salp15, an Ixodes scapularis salivary protein, inhibits CD4+ T cell activation. Immunity. 2002, 16: 849-859. 10.1016/S1074-7613(02)00325-4.View ArticlePubMedGoogle Scholar
- Michels C, Goyal P, Nieuwenhuizen N, Brombacher F: Infection with Syphacia obvelata (pinworm) induces protective Th2 immune responses and influences ovalbumin-induced allergic reactions. Infect Immun. 2006, 74: 5926-5932. 10.1128/IAI.00207-06.PubMed CentralView ArticlePubMedGoogle Scholar
- Chan KF: Life cycle studies on the nematode Syphacia obvelata. Am J Hyg. 1952, 56: 14-21.PubMedGoogle Scholar
- Lewis JW, D'Silva J: The life-cycle of Syphacia muris Yamaguti (Nematoda, Oxyuroidea) in the laboratory rat. J Helminthol. 1986, 60: 39-46.View ArticlePubMedGoogle Scholar
- Ovington KS, Alleva LM, Kerr EA: Cytokines and immunological control of Eimeria spp. Int J Parasitol. 1995, 25: 1331-1351. 10.1016/0020-7519(95)00069-E.View ArticlePubMedGoogle Scholar
- Lynagh GR, Bailey M, Kaiser P: Interleukin-6 is produced during both murine and avian Eimeria infections. Vet Immunol Immunopathol. 2000, 76: 89-102. 10.1016/S0165-2427(00)00203-8.View ArticlePubMedGoogle Scholar
- Lillehoj HS, Min W, Dalloul RA: Recent progress on the cytokine regulation of intestinal immune responses to Eimeria. Poult Sci. 2004, 83: 611-623.View ArticlePubMedGoogle Scholar
- Rosenberg BJD, Aylsworth CF, Dimitrov NV, Ho S-C, Judge JW, Kessel S, Quensen J, Ho Wong KP, Zlatkin I, Zlatkin T: Protein from intestinal Eimeria protozoan stimulates IL-12 release from dendritic cells, exhibits antitumor properties in vivo and is correlated with low intestinal tumorigenicity. Int J Cancer. 2005, 114: 756-765. 10.1002/ijc.20801.View ArticlePubMedGoogle Scholar
- Gowen BB, Smee DF, Wong M-H, Judge JW, Jung K-H, Bailey KW, Pace AM, Rosenberg B, Sidwell RW: Recombinant Eimeria protozoan protein elicits resistance to acute phlebovirus infection in mice but not hamsters. Antimicrob Agents Chemother. 2006, 50: 2023-2029. 10.1128/AAC.01473-05.PubMed CentralView ArticlePubMedGoogle Scholar
- Beldomenico PM, Telfer S, Gebert S, Lukomski L, Bennett M, Begon M: Poor condition and infection: a vicious circle in natural populations. Proc Biol Sci. 2008, 275: 1753-1759. 10.1098/rspb.2008.0147.PubMed CentralView ArticlePubMedGoogle Scholar
- Martin LB, Weil ZM, Nelson RJ: Refining approaches and diversifying directions in ecoimmunology. Integr Comp Biol. 2006, 46: 1030-1039. 10.1093/icb/icl039.View ArticlePubMedGoogle Scholar
- Ing R, Su Z, Scott ME, Koski KG: Suppressed T helper 2 immunity and prolonged survival of a nematode parasite in protein-malnourished mice. Proc Natl Acad Sci USA. 2000, 97: 7078-7083. 10.1073/pnas.97.13.7078.PubMed CentralView ArticlePubMedGoogle Scholar
- Martin LB, Weil ZM, Nelson RJ: Seasonal changes in vertebrate immune activity: mediation by physiological trade-offs. Philos Trans R Soc Lond B Biol Sci. 2008, 363: 321-339. 10.1098/rstb.2007.2142.PubMed CentralView ArticlePubMedGoogle Scholar
- Martin LB, Navara KJ, Bailey MT, Hutch CR, Powell ND, Sheridan JF, Nelson RJ: Food restriction compromises immune memory in deer mice (Peromyscus maniculatus) by reducing spleen-derived antibody-producing B cell numbers. Physiol Biochem Zool. 2008, 81: 366-372. 10.1086/587090.PubMed CentralView ArticlePubMedGoogle Scholar
- Hughes S, Kelly P: Interactions of malnutrition and immune impairment, with specific reference to immunity against parasites. Parasite Immunol. 2006, 28: 577-588.PubMed CentralPubMedGoogle Scholar
- Deviche P, Cortez L: Androgen control of immunocompetence in the male house finch, Carpodacus mexicanus Muller. J Exp Biol. 2005, 208: 1287-1295. 10.1242/jeb.01531.View ArticlePubMedGoogle Scholar
- Roberts ML, Buchanan KL, Hasselquist D, Evans MR: Effects of testosterone and corticosterone on immunocompetence in the zebra finch. Horm Behav. 2007, 51: 126-134. 10.1016/j.yhbeh.2006.09.004.View ArticlePubMedGoogle Scholar
- Pedersen AB, Greives TJ: The interaction of parasites and resources cause crashes in a wild mouse population. J Anim Ecol. 2008, 77: 370-377. 10.1111/j.1365-2656.2007.01321.x.View ArticlePubMedGoogle Scholar
- Bochud PY, Hersberger M, Taffe P, Bochud M, Stein CM, Rodrigues SD, Calandra T, Francioli P, Telenti A, Speck RF, Aderem A: Polymorphisms in Toll-like receptor 9 influence the clinical course of HIV-1 infection. AIDS. 2007, 21: 441-446. 10.1097/QAD.0b013e328012b8ac.View ArticlePubMedGoogle Scholar
- Ferwerda B, McCall MBB, Alonso S, Giamarellos-Bourboulis EJ, Mouktaroudi M, Izagirre N, Syafruddin D, Kibiki G, Cristea T, Hijmans A, Hamann L, Israel S, ElGhazali G, Troye-Blomberg M, Kumpf O, Maiga B, Dolo A, Doumbo O, Hermsen CC, Stalenhoef AFH, van Crevel R, Brunner HG, Oh D-Y, Schumann RR, de la Rúa C, Sauerwein R, Kullberg BJ, Ven van der AJAM, Meer van der JWM, Netea MG: TLR4 polymorphisms, infectious diseases, and evolutionary pressure during migration of modern humans. Proc Natl Acad Sci USA. 2007, 104: 16645-16650. 10.1073/pnas.0704828104.PubMed CentralView ArticlePubMedGoogle Scholar
- Carvalho A, Pasqualotto AC, Pitzurra L, Romani L, Denning DW, Rodrigues F: Polymorphisms in Toll-like receptor genes and susceptibility to pulmonary aspergillosis. J Infect Dis. 2008, 197: 618-621. 10.1086/526500.View ArticlePubMedGoogle Scholar
- Ferwerda B, McCall MB, Verheijen K, Kullberg BJ, Ven van der AJ, Meer Van der JW, Netea MG: Functional consequences of Toll-like receptor 4 polymorphisms. Mol Med. 2008, 14: 346-352. 10.2119/2007-00135.Ferwerda.PubMed CentralView ArticlePubMedGoogle Scholar
- Misch EA, Hawn TR: Toll-like receptor polymorphisms and susceptibility to human disease. Clin Sci. 2008, 114: 347-360. 10.1042/CS20070214.View ArticlePubMedGoogle Scholar
- Mrabet-Dahbi S, Dalpke AH, Niebuhr M, Frey M, Draing C, Brand S, Heeg K, Werfel T, Renz H: The Toll-like receptor 2 R753Q mutation modifies cytokine production and Toll-like receptor expression in atopic dermatitis. J Allergy Clin Immunol. 2008, 121: 1013-1019. 10.1016/j.jaci.2007.11.029.View ArticlePubMedGoogle Scholar
- Hawn TR, Dunstan SJ, Thwaites GE, Simmons CP, Thuong NT, Lan NT, Quy HT, Chau TT, Hieu NT, Rodrigues S, Janer M, Zhao LP, Hien TT, Farrar JJ, Aderem A: A polymorphism in Toll-Interleukin 1 receptor domain containing adaptor protein is associated with susceptibility to meningeal tuberculosis. J Infect Dis. 2006, 194: 1127-1134. 10.1086/507907.PubMed CentralView ArticlePubMedGoogle Scholar
- Khor CC, Chapman SJ, Vannberg FO, Dunne A, Murphy C, Ling EY, Frodsham aJ, Walley AJ, Kyrieleis O, Khan A, Aucan C, Segal S, Moore CE, Knox K, Campbell SJ, Lienhardt C, Scott A, Aaby P, Sow OY, Grignani RT, Sillah J, Sirugo G, Peshu N, Williams TN, Maitland K, Davies RJ, Kwiatkowski DP, Day NP, Yala D, Crook DW, Marsh K, Berkley JA, O'Neill LA, Hill AV: A Mal functional variant is associated with protection against invasive pneumococcal disease, bacteremia, malaria and tuberculosis. Nat Genet. 2007, 39: 523-528. 10.1038/ng1976.PubMed CentralView ArticlePubMedGoogle Scholar
- Bayley JP, Ottenhoff THM, Verweij CL: Is there a future for TNF promoter polymorphisms?. Genes Immun. 2004, 5: 315-329. 10.1038/sj.gene.6364055.View ArticlePubMedGoogle Scholar
- Mazzoni A, Segal DM: Controlling the Toll road to dendritic cell polarization. J Leukoc Biol. 2004, 75: 721-730. 10.1189/jlb.1003482.View ArticlePubMedGoogle Scholar
- Hayashi T, Gray CS, Chan M, Tawatao RI, Ronacher L, McGargill MA, Datta SK, Carson DA, Corr M: Prevention of autoimmune disease by induction of tolerance to Toll-like receptor 7. Proc Natl Acad Sci USA. 2009, 106: 2764-2769. 10.1073/pnas.0813037106.PubMed CentralView ArticlePubMedGoogle Scholar
- Graham AL: Ecological rules governing helminth microparasite coinfection. Proc Natl Acad Sci USA. 2008, 105: 566-570. 10.1073/pnas.0707221105.PubMed CentralView ArticlePubMedGoogle Scholar
- Cooke A, Tonks P, Jones FM, O'Shea H, Hutchings P, Fulford AJ, Dunne DW: Infection with Schistosoma mansoni prevents insulin dependent diabetes mellitus in non-obese diabetic mice. Parasite Immunol. 1999, 21: 169-176. 10.1046/j.1365-3024.1999.00213.x.View ArticlePubMedGoogle Scholar
- Anderson RC: Nematode Parasites of Vertebrates: Their Development and Transmission. 2000, Wallingford: CABIView ArticleGoogle Scholar
- Redrobe SP, Patterson-Kane JC: Calodium hepaticum (syn. Capillaria hepatica) in captive rodents in a zoological garden. J Comp Pathol. 2005, 133: 73-76. 10.1016/j.jcpa.2005.01.013.View ArticlePubMedGoogle Scholar
- Higgs S, Nowell F: A review of the species of Eimeria infecting hosts in the genus Apodemus. Syst Parasitol. 1991, 20: 203-209. 10.1007/BF00009784.View ArticleGoogle Scholar
- Higgs S, Nowell F: Population biology of Eimeria (Protozoa: Apicomplexa) in Apodemus sylvaticus: a capture/recapture study. Parasitology. 2000, 120: 355-363. 10.1017/S0031182099005545.View ArticlePubMedGoogle Scholar
- O'Neill LAJ, Bowie AG: The family of five: TIR-domain-containing adaptors in Toll-like receptor signalling. Nat Rev Immunol. 2007, 7: 353-364. 10.1038/nri2079.View ArticlePubMedGoogle Scholar
- Michaux JR, Chevret P, Filippucci MG, Macholan M: Phylogeny of the genus Apodemus with a special emphasis on the subgenus Sylvaemus using the nuclear IRBP gene and two mitochondrial markers: cytochrome b and 12S rRNA. Mol Phylogenet Evol. 2002, 23: 123-136. 10.1016/S1055-7903(02)00007-6.View ArticlePubMedGoogle Scholar
- Steppan SJ, Adkins RM, Spinks PQ, Hale C: Multigene phylogeny of the Old World mice, Murinae, reveals distinct geographic lineages and the declining utility of mitochondrial genes compared to nuclear genes. Mol Phylogenet Evol. 2005, 37: 370-388. 10.1016/j.ympev.2005.04.016.View ArticlePubMedGoogle Scholar
- Jackson JA, Turner JD, Rentoul L, Faulkner H, Behnke JM, Hoyle M, Grencis RK, Else KJ, Kamgno J, Boussinesq M, Bradley JE: T helper cell type 2 responsiveness predicts future susceptibility to gastrointestinal nematodes in humans. J Infect Dis. 2004, 190: 1804-1811. 10.1086/425014.View ArticlePubMedGoogle Scholar
- Turner JD, Faulkner H, Kamgno J, Cormont F, Van Snick J, Else KJ, Grencis RK, Behnke JM, Boussinesq M, Bradley JE: Th2 cytokines are associated with reduced worm burdens in a human intestinal helminth infection. J Infect Dis. 2003, 188: 1768-1775. 10.1086/379370.View ArticlePubMedGoogle Scholar
- Jackson JA, Turner JD, Kamal M, Wright V, Bickle Q, Else KJ, Ramsan M, Bradley JE: Gastrointestinal nematode infection is associated with variation in innate immune responsiveness. Microbes Infect. 2006, 8: 487-492. 10.1016/j.micinf.2005.07.025.View ArticlePubMedGoogle Scholar
- Crawley MJ: GLIM for Ecologists. 1993, Oxford: Blackwell ScienceGoogle Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.