Associations between helminth infection status and the composition and concentration of fecal bile acids in school-age children in Uganda

Over 1 billion people globally are infected with helminths, and understanding the impact of these infections on human health is crucial for further developing effective interventions. We investigated potential associations between helminth infection status and the abundance of fecal bile acids: a group of metabolites known to impact gut physiology and function and have immunomodulatory capabilities. Fecal samples were collected from school-age children in Uganda and used to determine helminth infection status (Kato-Katz technique) and to quantify the fecal bile acid pool (UPLC-MRM/MS). We found that helminth infection status was associated with changes to the fecal bile acid pool and that these differences were dependent on the biological sex of study participants. Females who were coinfected with schistosomes and hookworms had higher levels of unconjugated secondary bile acids than helminth-negative individuals. In males, no significant associations were detected between helminth infection status and levels of unconjugated secondary bile acids, however, there were reduced levels of some species of conjugated primary bile acids in schistosome-infected individuals compared to helminth-negative individuals. Further research into the specific mechanisms underlying these associations and the functional consequences of bile acid perturbations during helminth infection may provide valuable insights into the pathophysiology of helminth infections.