Circulating Angiopoietin-like proteins in Strongyloides Stercoralis infection and reversal following treatment

Strongyloides stercoralis (Ss) is a parasitic infection affecting 50–100 million people globally, with significant immune and metabolic consequences, particularly in immunocompromised individuals. While Strongyloides infection is known to modulate the host immune system, the role of angiopoietin-like proteins (AGPTLs), which regulate inflammation and immune responses, has not been explored in this context. In this study, we investigated the systemic levels of AGPTL-2, -3, -4, -6, and -8 in 60 Ss-infected (Ss+) and 56 uninfected (Ss-) individuals. AGPTL levels were quantified using enzyme-linked immunosorbent assays (ELISA). We also assessed the effect of anthelmintic treatment on AGPTL levels in Ss+ individuals. Our results show that Ss+ individuals had significantly elevated levels of AGPTL-2, -3, -6, and -8 compared to Ss- individuals. After anthelmintic treatment, these elevated levels were significantly reduced. Principal component analysis (PCA) revealed distinct clustering of AGPTLs between Ss+ and Ss- groups, explaining 25.1% and 36.1% of the variance, respectively. Additionally, a positive correlation between AGPTL levels and IgG suggested an association with immune activation. These findings suggest that Strongyloides infection is associated with elevated AGPTL levels, which decrease following effective treatment. This highlights the potential role of AGPTLs as biomarkers for diagnosing and monitoring infection and treatment response. Further research is needed to better understand the mechanisms of AGPTL regulation in parasitic infections and their impact on immune modulation and metabolic alterations.Author summary: Strongyloides stercoralis is a parasitic worm that infects people mostly in tropical and subtropical regions, often without causing noticeable symptoms. However, in individuals with weakened immune systems, the infection can become severe and even life-threatening. Our study examined at a group of proteins in the body called angiopoietin-like proteins (AGPTLs), which help regulate inflammation and immune responses. These proteins had not been previously studied in people with Strongyloides infection. We compared the levels of AGPTLs in individuals with and without the infection and found that four of these proteins (AGPTL-2, 3, 6, and 8) were significantly higher in those infected. Following anthelmintic treatment, the levels of these proteins decreased. We also observed that higher levels of these proteins were linked to immune responses in the body, suggesting they may play a role in how the body responds to the parasite. Our results suggest that AGPTLs could be useful markers for identifying infection and tracking how well treatment works. They may also help us understand how parasitic infections affect the immune system and possibly protect against other conditions like diabetes.