Validity of urine-CCA cassette test and indirect haem-agglutination assay (IHA) in the detection of schistosomiasis-mansoni infection relative to microscopic examination

Impact of -20 C° cryopreservation on serum factors from schistosomiasis patients at different storage durations: insights into serum bio-banking

It is indefinite for research applications if prolonged freeze-stored serum from Schistosoma-infected patients is useful. We assessed - 20 °C freezing as a rapid and inexpensive method. A longitudinal cohort study with staggered follow-up periods evaluated the impact of cryopreservation on serum residues from 24 Schistosoma-infected Egyptian patients. Fresh serums were collected in March 2022 and assessed by the indirect haemagglutination test for Schistosoma immunoglobulin titrations and calorimetric assays for ALT, AST, total serum protein, Na+, K+, Ca++, and Mg++ (baseline values). Sera were then frozen and categorized into 4 groups (6 patients each) according to freezing duration; 3 months (group-1), 6 months (group-2), 9 months (group-3), and 12 months (group-4). Re-evaluation was performed on the Schistosoma immunoglobulin recovery rates and all other serum chemical factors. Baseline assessment showed increased mean values of Schistosoma immunoglobulins, ALT, AST, and proteins; yet, Ca++, Na+, and K+ were reduced. Mg++ showed normal values. Compared with the baselines, - 20 °C freezing showed significant deviations and increased percentage change in Schistosoma immunoglobulin titers, ALT, AST, K+, and Na+ at different time intervals of archiving (p-value ≤ 0.05). Evaluating serum factors interactions post-thawing revealed that AST correlated positively with ALT and Mg++ sera levels whereas Ca++ negatively correlated with Na+ and Schistosoma antibody titer. Analyzing baselines revealed that the parasite alters levels of immunoglobulin, ALT, AST, proteins, Ca++, Na+, and K+. - 20 °C cryopreservation did not guarantee the stability of all tK+hese serum parameters. In addition, some serum factors appeared to interact together. Assessing the efficacy of - 20 °C freezing on the next-generation sequencing is recommended.

Comparison of tissue biomarkers between non-schistosoma and schistosoma-associated urothelial carcinoma

BACKGROUND

High-grade urothelial carcinoma either non-Schistosoma (NS-UBC) or Schistosoma (S-UBC)-associated is the tenth cause of death worldwide and represents a serious therapeutic problem.

AIM

Evaluation of the immmunohistochemical expression of tumor necrosis factor-alpha (TNFα), epidermal growth factor receptor (EGFR), programmed cell death protein-1 (PDL1), estrogen receptor-alpha (ERα) and UroplakinIII, in the high-grade in NS-UBC and S-UBC as potential prognostic and therapeutic targets analyzed through estimation of area percentage, optical density and international pathological scoring system for each marker.

MATERIAL AND METHODS

Sixty high grade urothelial carcinoma cases were enrolled in the study (30 cases of NS-UBC and 30 cases of S-UBC). The cases were immunohistochemically-assessed for TNFα, EGFR, PDL1, ERα and Uroplakin III expression. In S-UBC, parasite load was also evaluated for correlation with the immunohistochemical markers' expression in S-UBC.

RESULTS

The area percentage of immune-expression of TNFα and EGFR was higher in S-UBC compared to NS-UBC. On the other hand, the NS-UBC displayed statistically-higher expression of PDL1 and uroplakinIII (p-value <0.001). ERα revealed higher, yet, non-significant expressions in S-UBC compared to NS-UBC (p-value =0.459). PDL1 expression showed the most superior record regarding area percentage (64.6± 34.5). Regarding optical density, TNF-α showed the highest transmittance expression (2.4 ± 0.9). EGFR positively correlated with PDL1 in S-UBC (r= 0.578, p-value =0.001) whereas in NS-UBC, TNFα and PDL1 (r=0.382, p-value=0.037) had positive correlation. Schistosoma eggs in tissues oppose uroplakin III expression and trigger immunomodulation via PDL1.

CONCLUSION

Due to lower UroplakinIII expression, S-UBC is supposed to have a poorer prognosis. Hormonal therapy is not hypothesized due to a very minimal ERα expression in both NS-UBC and S-UBC. Regarding immunotherapy, anti-TNF-α is suggested for S-UBC whilst in NS-UBC, blockading PDL1 might be useful. Targeted EGFR therapy seems to carry emphasized outcomes in S-UBC. Correlations encourage combined immune therapy in NS-UBC; nevertheless, in S-UBC, combined anti-EGFR and PDL1 seem to be of benefit.