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Zhang P, Wang BJ, Wang JZ, Xie XM, Tong QX. Association of CX3CL1 and CX3CR1 Expression with Liver Fibrosis in a Mouse Model of Schistosomiasis. Curr Med Sci 2021; 40:1121-1127. [PMID: 33428140 DOI: 10.1007/s11596-020-2294-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 07/13/2020] [Indexed: 10/22/2022]
Abstract
Immunopathological mechanisms of schistosomiasis, a debilitating parasitic disease, are still unclear. In this study, we investigated the involvement of CX3C chemokine ligand 1 (CX3CL1) and its sole receptor CX3CR1 in the development of liver fibrosis in schistosomiasis. The animal model of schistosomiasis was established by infection of C57BL/6 mice with Schistosoma japonicum cercariae; mice injected with carbon tetrachloride (CCl4) were used as positive control of liver injury. After 4 and 8 weeks, the degree of liver lesions was assessed by hematoxylin and eosin staining, serum levels of hyaluronic acid (HA) were analyzed by a chemiluminescence immunoassay, liver fibrosis was evaluated by immunohistochemistry analysis of α-smooth muscle actin (α-SMA) expression, and CX3CL1 and CX3CR1 expression in the liver was measured by immunohistochemistry and real-time PCR. The results showed that at 8 weeks after Schistosoma infection, serum HA levels were increased and α-SMA-expressing cells appeared in the liver, indicating fibrogenesis. CX3CL1- and CX3CR1-positive cells were observed in the outer layer of granulomas formed around Schistosoma eggs in liver tissues, which was consistent with the significant upregulation of hepatic CX3CL1 and CX3CR1 mRNA expression at 4 and 8 weeks post-infection. Furthermore, correlation analysis revealed positive association between CX3CL1 and CX3CR1 expression and serum HA levels at 8 weeks post-infection, indicating a link between fibrogenesis and the CX3CL1/CX3CR1 axis in schistosomiasis. In conclusion, our data suggest the involvement of CX3CL1 and CX3CR1 in the progression of liver fibrosis caused by Schistosoma infection.
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Affiliation(s)
- Pan Zhang
- Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Bao-Ju Wang
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jun-Zhong Wang
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xu-Mao Xie
- Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Qiao-Xiao Tong
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Figliuolo da Paz VR, Figueiredo-Vanzan D, dos Santos Pyrrho A. Interaction and involvement of cellular adhesion molecules in the pathogenesis of Schistosomiasis mansoni. Immunol Lett 2019; 206:11-18. [DOI: 10.1016/j.imlet.2018.11.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/20/2018] [Accepted: 11/25/2018] [Indexed: 12/11/2022]
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Ricard-Blum S, Baffet G, Théret N. Molecular and tissue alterations of collagens in fibrosis. Matrix Biol 2018; 68-69:122-149. [DOI: 10.1016/j.matbio.2018.02.004] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/02/2018] [Accepted: 02/02/2018] [Indexed: 02/07/2023]
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Barreto AVMS, Alecrim VM, Medeiros TBD, Domingues ALC, Lopes EP, Martins JRM, Nader HB, Diniz GTN, Montenegro SML, Morais CNLD. New index for the diagnosis of liver fibrosis in Schistosomiasis mansoni. Arq Gastroenterol 2017; 54:51-56. [PMID: 28079240 DOI: 10.1590/s0004-2803.2017v54n1-10] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 09/27/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND - Periportal fibrosis is the major pathological consequence of the Schistosoma mansoni infection. OBJECTIVE - To evaluate the accuracy of serum markers and to construct an index to assess fibrosis. METHODS - Patients (n=116) with schistosomiasis were evaluated by ultrasound scan and measurements of serum levels of aminotransferases, γ-glutamyl transferase, alkaline phosphatase, hyaluronic acid, cytokines and platelets. Ultrasound images were used to evaluate the fibrosis using Niamey's classification and identified 19 patients without periportal fibrosis (patterns A and B), 48 with mild to moderate fibrosis (C and D) and 49 with advanced fibrosis (E and F). RESULTS - Using multivariate analysis, a model was created, which involved alkaline phosphatase and platelets and could separate patients with different patterns of fibrosis. This index showed a better performance in separating patients without fibrosis from with advanced periportal fibrosis. The biological index showed an area under the ROC curve of 1.000. Using values below the lowest or above the highest cut-off point, the presence or absence of advanced fibrosis could be predicted in all patients. CONCLUSION - The index constructed can be used to separate patients with different patterns of periportal fibrosis, specially to predict advanced fibrosis in schistosomiasis patients.
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Affiliation(s)
| | | | | | | | - Edmundo Pessoa Lopes
- Departamento de Medicina Clínica, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - João Roberto Maciel Martins
- Departamento de Bioquímica, Disciplina de Biologia Molecular, Escola Paulista de Medicina, Universidade Federal de São Paulo, SP, Brasil
| | - Helena Bonciani Nader
- Departamento de Bioquímica, Disciplina de Biologia Molecular, Escola Paulista de Medicina, Universidade Federal de São Paulo, SP, Brasil
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Medeiros TB, Domingues ALC, Luna CF, Lopes EP. Correlation between platelet count and both liver fibrosis and spleen diameter in patients with schistosomiasis mansoni. Arq Gastroenterol 2014; 51:34-8. [PMID: 24760062 DOI: 10.1590/s0004-28032014000100008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Accepted: 11/05/2013] [Indexed: 01/14/2023]
Abstract
CONTEXT Studies have described the correlation between platelet count and the stages of fibrosis in chronic viral hepatitis, but few publications have studied this correlation in Schistosomiasis mansoni. OBJECTIVES Therefore, this study aimed to correlate platelet count with both the periportal fibrosis pattern and spleen diameter evaluated by ultrasound exam in patients with Schistosomiasis mansoni. METHODS Patients with Schistosomiasis mansoni were evaluated by abdominal ultrasound by a single examiner for the determination of periportal fibrosis pattern (Niamey classification) and spleen diameter. Platelet counts were performed in an automated cell counter. RESULTS One hundred eighty-seven patients with Schistosomiasis mansoni (mean age: 50.2 years) were included in the study, 114 of whom (61%) were women. Based on the Niamey classification, the ultrasound analysis revealed that 37, 64, 64 and 22 patients exhibited patterns C, D, E and F, respectively. In these four groups, the mean number of platelets was 264, 196, 127 and 103 x 109/L and mean spleen diameter was 9.2, 11.9, 14.9 and 16.2 centimeters, respectively. A reduction in platelet count was significantly associated with both the progression of the periportal fibrosis and the increase in spleen size. CONCLUSIONS Platelet count in patients with Schistosomiasis mansoni was inversely correlated with the severity of periportal fibrosis and spleen diameter.
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Affiliation(s)
- Tibério B Medeiros
- Gastroenterology Section, Department of Internal Medicine, Universidade Federal de Pernambuco - UFPE, Recife, PE, Brasil
| | - Ana Lucia C Domingues
- Gastroenterology Section, Department of Internal Medicine, Universidade Federal de Pernambuco - UFPE, Recife, PE, Brasil
| | - Carlos F Luna
- Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz - FIOCRUZ, Recife, PE, Brasil
| | - Edmundo P Lopes
- Gastroenterology Section, Department of Internal Medicine, Universidade Federal de Pernambuco - UFPE, Recife, PE, Brasil
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Olveda DU, Olveda RM, McManus DP, Cai P, Chau TNP, Lam AK, Li Y, Harn DA, Vinluan ML, Ross AGP. The chronic enteropathogenic disease schistosomiasis. Int J Infect Dis 2014; 28:193-203. [PMID: 25250908 DOI: 10.1016/j.ijid.2014.07.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 06/26/2014] [Accepted: 07/16/2014] [Indexed: 02/08/2023] Open
Abstract
Schistosomiasis is a chronic enteropathogenic disease caused by blood flukes of the genus Schistosoma. The disease afflicts approximately 240 million individuals globally, causing approximately 70 million disability-adjusted life years lost. Chronic infections with morbidity and mortality occur as a result of granuloma formation in the intestine, liver, or in the case of Schistosoma haematobium, the bladder. Various methods are utilized to diagnose and evaluate liver fibrosis due to schistosomiasis. Liver biopsy is still considered the gold standard, but it is invasive. Diagnostic imaging has proven to be an invaluable method in assessing hepatic morbidity in the hospital setting, but has practical limitations in the field. The potential of non-invasive biological markers, serum antibodies, cytokines, and circulating host microRNAs to diagnose hepatic fibrosis is presently undergoing evaluation. This review provides an update on the recent advances made with respect to gastrointestinal disease associated with chronic schistosomiasis.
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Affiliation(s)
- David U Olveda
- Department of Medical Sciences, Griffith Health Institute, Gold Coast, Australia
| | - Remigio M Olveda
- Department of Health, Research Institute for Tropical Medicine, Manila, The Philippines
| | - Donald P McManus
- Department of Molecular Parasitology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Pengfei Cai
- Department of Molecular Parasitology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Thao N P Chau
- Department of Public Health, Flinders University, Adelaide, Australia
| | - Alfred K Lam
- Department of Medical Sciences, Griffith Health Institute, Gold Coast, Australia
| | - Yuesheng Li
- Department of Molecular Parasitology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Donald A Harn
- Department of Infectious Diseases, University of Georgia, Georgia, USA
| | - Marilyn L Vinluan
- Department of Health, Research Institute for Tropical Medicine, Manila, The Philippines
| | - Allen G P Ross
- Department of Medical Sciences, Griffith Health Institute, Gold Coast, Australia.
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Domingues ALC, Medeiros TBD, Lopes EPDA. Ultrasound versus biological markers in the evaluation of periportal fibrosis in human Schistosoma mansoni. Mem Inst Oswaldo Cruz 2012; 106:802-7. [PMID: 22124551 DOI: 10.1590/s0074-02762011000700004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2011] [Accepted: 09/06/2011] [Indexed: 01/21/2023] Open
Abstract
In this paper, the authors review the literature and share their experience of the principal biological markers of fibrosis for the evaluation of periportal fibrosis (PPF) caused by mansoni schistosomiasis. These biological markers are compared to diagnostic ultrasound (US) scans as means of grading PPF. We also review procollagen type I and III, collagen type IV, laminin, hyaluronic acid (HA), immunoglobulin G, platelets, aspartate aminotransferase to platelet ratio index (APRI) and gamma-glutamyl transpeptidase as markers of the disease. Although there are several good markers for evaluating PPF and portal hypertension, such as HA, platelets or APRI, none can yet replace US. These markers may, however, be used to identify patients at greater risk of developing advanced disease in endemic areas and determine who will need further care and US studies.
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Silva CC, Domingues AL, Lopes EP, Morais CN, Santos RB, Luna CF, Nader HB, Martins JR. Schistosomiasis mansoni: ultrasound-evaluated hepatic fibrosis and serum concentrations of hyaluronic acid. Ann Trop Med Parasitol 2011; 105:233-9. [PMID: 21801502 DOI: 10.1179/136485911x12987676649629] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Schistosomiasis mansoni is a fibrogenic liver disease that constitutes a major health problem in north-eastern Brazil. Although one common manifestation of the disease, periportal fibrosis (PPF), can be assessed by ultrasonography by well-trained physicians, the necessary equipment and personnel are not always readily available. Serum markers, including hyaluronic acid (HA), have been used as alternative means of measuring fibrosis. Recently serum concentrations of HA have been evaluated in 77 Brazilians (61 cases of schistosomiasis mansoni and 16 healthy controls) and compared against the ultrasound-evaluated PPF in the same subjects. The HA was measured using a non-competitive fluorescence-based assay, while the PPF was explored using a portable ultrasound scanner (SSD-500; Aloka, Tokyo) and graded, as patterns A-F, according to the World Health Organization's 'Niamey protocol'. In general, the serum concentrations of HA were found to be positively correlated with the severity of the PPF. The mean concentration of HA in the sera of the 16 controls was significantly lower than that recorded in the schistosomiasis cases who showed PPF of patterns D or E (P<0·001 for each). The cases who showed pattern-C PPF also had significantly less HA in their sera than the cases with PPF of patterns D or E (P<0·001 for each), and the cases with pattern-D fibrosis had significantly lower HA concentrations in their sera than the cases with PPF of pattern E (P<0·001). In an analysis based on a receiver-operating-characteristic (ROC) curve, an HA concentration of 20·2 μg/litre of serum was identified as a threshold that could be used to distinguish moderate cases of PPF (i.e. patterns C or D) from the more advanced cases (i.e. patterns E or F), with a sensitivity of 60% and specificity of 65%. In conclusion, it appears that serum concentrations of hyaluronic acid could be used as markers for periportal fibrosis in patients with schistosomiasis mansoni.
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Affiliation(s)
- C C Silva
- Universidade Federal de Pernambuco, Rua Irmã Maria Davi 154, Recife, PE, Brazil
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Morais CNLD, Carvalho BDM, Melo WGD, Melo FLD, Lopes EPDA, Domingues ALC, Jucá N, Martins JRM, Diniz GTN, Montenegro SML. Correlation of biological serum markers with the degree of hepatic fibrosis and necroinflammatory activity in hepatitis C and schistosomiasis patients. Mem Inst Oswaldo Cruz 2010; 105:460-6. [DOI: 10.1590/s0074-02762010000400018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Accepted: 10/08/2009] [Indexed: 01/19/2023] Open
Affiliation(s)
| | | | | | | | | | | | - Norma Jucá
- Universidade Federal de Pernambuco, Brasil
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10
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Marinho CC, Bretas T, Voieta I, Queiroz LCD, Ruiz-Guevara R, Teixeira AL, Antunes CM, Prata A, Lambertucci JR. Serum hyaluronan and collagen IV as non-invasive markers of liver fibrosis in patients from an endemic area for schistosomiasis mansoni: a field-based study in Brazil. Mem Inst Oswaldo Cruz 2010; 105:471-8. [DOI: 10.1590/s0074-02762010000400020] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Accepted: 09/04/2009] [Indexed: 12/27/2022] Open
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Esterre P, Plichart C, Huin-Blondey MO, Nguyen LN. Soluble cellular adhesion molecules, selectins, VEGF and endothelin-1 in patients with Wuchereria bancrofti infection and association with clinical status. Parasite Immunol 2005; 27:9-16. [PMID: 15813718 DOI: 10.1111/j.1365-3024.2005.00732.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Lymphatic filariasis, a mosquito-transmitted disease commonly known as Bancroftian filariasis, is characterized by debilitating pathology linked to the progression of lymphoedema to a chronic state of elephantiasis. We performed longitudinal measurements of endothelial adhesion and angiogenic molecules in 63 Polynesian patients living in an hyperendemic focus of Wuchereria bancrofti. Decreased serum concentrations of soluble (s-) L selectin (CD62L) were noticed in sera of of patients with chronic conditions (hydrocele and elephantiasis). Chyluria was associated with increased vascular endothelial growth factor (VEGF) levels, whereas elephantiasis presented a high endothelin-1 (ET-1) profile. By contrast, increased serum concentrations of soluble intercellular (sICAM-1, CD54), but not of vascular cell (sVCAM-1, CD106), adhesion molecules were observed in sera of patients with bacterial lymphangitis used as controls. These trends are consistent with the increased permeability of vascular structures, a major clinical feature observed in acute lymphatic pathology (of bacterial or filarial origin), and of fundamental differences in the pathogenesis of hydrocele and elephantiasis. Using markers correlated with the clinical status (high ET-1 and VEGF levels for elephantiasis and chyluria, respectively; low CD62L levels for hydrocoele and elephantiasis) it should be possible to monitor disease progression in lymphatic filariasis.
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Affiliation(s)
- P Esterre
- Immunology Unit, Institut de Recherches Medicales Malarde, Papeete 98713 Tahiti (French Polynesia).
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Bezerra ASDA, D'Ippolito G, Caldana RP, Cecin AO, Szejnfeld J. Avaliação hepática e esplênica por ressonância magnética em pacientes portadores de esquistossomose mansônica crônica. Radiol Bras 2004. [DOI: 10.1590/s0100-39842004000500003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Avaliar, qualitativa e quantitativamente, as alterações morfológicas hepáticas e esplênicas por ressonância magnética (RM) em pacientes portadores de esquistossomose mansônica crônica, e a reprodutibilidade do método na avaliação hepatoesplênica destes pacientes. MATERIAIS E MÉTODOS: Realizou-se estudo prospectivo em 28 pacientes esquistossomóticos submetidos à RM de abdome superior. Os exames foram realizados em equipamento com alto campo (1,5 T), utilizando-se bobina de corpo e bomba injetora para a administração do contraste endovenoso, e interpretados por dois examinadores independentes, que avaliaram a presença de alterações morfológicas hepáticas e esplênicas. A concordância interobservador e intra-observador foram medidas pelo teste kappa e pelo teste do coeficiente de correlação intraclasses. RESULTADOS: As variáveis qualitativas e quantitativas apresentaram boa concordância interobservador e intra-observador (kapa > 0,65 e r > 0,66, respectivamente). A maior concordância interobservador foi obtida para o diâmetro ântero-posterior do baço (r = 0,98). Os observadores identificaram redução do lobo hepático direito, aumento do lobo hepático esquerdo e caudado associado a esplenomegalia em quase todos os pacientes, e alargamento de fissuras, heterogeneidade do parênquima hepático, irregularidade de contornos, vasos periféricos hepáticos e fibrose periportal em mais de 82% dos pacientes. CONCLUSÃO: As alterações morfológicas hepáticas caracterizam-se pela redução do lobo direito e aumento dos lobos caudado e esquerdo, e as esplênicas, pela presença de esplenomegalia e nódulos sideróticos. A RM apresenta elevada reprodutibilidade na avaliação dessas alterações em pacientes com esquistossomose mansônica crônica.
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Köpke-Aguiar LA, Martins JRM, Passerotti CC, Toledo CF, Nader HB, Borges DR. Serum hyaluronic acid as a comprehensive marker to assess severity of liver disease in schistosomiasis. Acta Trop 2002; 84:117-26. [PMID: 12429428 DOI: 10.1016/s0001-706x(02)00136-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Schistosomiasis mansoni is a non-cirrhotic fibrogenic disease model. The mild form shows normal liver function with slight or no liver fibrosis whereas in the periportal fibrosis form the manifestations of portal hypertension prevail over hepatocellular failure. We assessed serum hyaluronic acid as a marker of the course of the disease. We studied 24 patients presenting with pure chronic forms of schistosomiasis and seven with cirrhosis. In order to measure serum hyaluronic acid we developed a sandwich fluorescent ELISA-like assay. alpha2-Macroglobulin, prothrombin index, gamma-glutamyltransferase, platelets and ultrasound parameters were also assessed. The 20 micro g/l (ROC plot) hyaluronic acid level differentiated patients with the mild form (with no portal hypertension) from those with the severe form of schistosomiasis with 78% diagnostic efficacy. The 80 micro g/l cut-off value differentiated patients with the severe form of schistosomiasis from the cirrhotic group with similar diagnostic efficacy. alpha2-Macroglobulin provided no distinction between the groups studied. The hyaluronic acid serum concentration correlated positively with the splenic vein diameter (P=0.004) and marginally with alpha2-macroglobulin (P=0.059). Serum hyaluronic acid is a good marker for the initial phase of hepatic fibrosis and it was able to assess severity of liver disease in schistosomiasis.
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Affiliation(s)
- L A Köpke-Aguiar
- Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
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Li YS, Sleigh AC, Ross AG, Li Y, Williams GM, Tanner M, McManus DP. Two-year impact of praziquantel treatment for Schistosoma japonicum infection in China: re-infection, subclinical disease and fibrosis marker measurements. Trans R Soc Trop Med Hyg 2000; 94:191-7. [PMID: 10897367 DOI: 10.1016/s0035-9203(00)90274-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
We studied a community cohort of 193 individuals exposed to endemic Schistosoma japonicum infection in the Dongting Lake region of China to assess subclinical morbidity and the 2-year benefit of curative therapy (praziquantel) administered in 1996. Prevalence and intensity of S. japonicum infection before treatment were 28% and 192 eggs per gram faeces (epg), respectively. Two years after cure, 22% of the cohort were re-infected, but with a lighter intensity (67 epg). Sixty-four subjects (37%) showed significant improvement in ultrasound parenchyma images after treatment and 51 subjects (54%) showed significant improvement of periportal fibrosis. Left-lobe enlargement also reversed (P < 0.05) and splenomegaly reversed in 6 of 8 cases and developed in only 1. Two years post-treatment a dilated portal vein became less frequent, but the decline was not significant (16% vs 11%, P < 0.05). The serum levels of laminin and collagen IV associated with re-infection and intensity and hyaluronic acid levels correlated with ultrasound findings (P < 0.01). Overall, treatment induced a marked decrease in subclinical hepatosplenic morbidity attributable to S. japonicum although low-intensity re-infection after treatment remained relatively frequent. Stratified analysis and logistic models evaluated potential confounding factors for assessment of treatment effects on hepatic fibrosis. S. japonicum infection and moderate-heavy alcohol intake interacted: improvement in parenchymal morbidity was impeded among drinkers (P < 0.05). Chemotherapy focused on at-risk residents controls prevalent subclinical hepatic fibrosis but re-infection indicates the need for complementary control strategies.
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Affiliation(s)
- Y S Li
- Australian Centre for International and Tropical Health and Nutrition, Queensland Institute of Medical Research, Herston, Brisbane, Australia.
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Pascal M, Abdallahi OM, Elwali NE, Mergani A, Qurashi MA, Magzoub M, de Reggi M, Gharib B. Hyaluronate levels and markers of oxidative stress in the serum of Sudanese subjects at risk of infection with Schistosoma mansoni. Trans R Soc Trop Med Hyg 2000; 94:66-70. [PMID: 10748904 DOI: 10.1016/s0035-9203(00)90443-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We showed previously that infection by Schistosoma mansoni not only triggers the production of reactive oxygen species in mouse liver but also leads to the alteration of antioxidant defences. To determine whether such events occur in humans, we measured the serum markers of oxidative stress, i.e., lipid peroxides and protein carbonyl, as well as hyaluronate levels in subjects in the Managil area of the Sudan. Grades of fibrosis were determined by ultrasonographic examination. Two groups were used as controls, one Sudanese and the other European. We found that Sudanese subjects in the endemic area differed from the control groups, both Sudanese and European, insofar as they had higher levels of the serum metabolites measured. The latter increased with the grade of fibrosis. Moreover, protein carbonyl and hyaluronic acid levels correlated positively with lipid peroxide levels. These findings indicate that oxidative stress might contribute to S. mansoni-associated pathology in man. The serum markers considered in our study, obtained by relatively simple techniques, may provide a useful biochemical index for the identification of almost asymptomatic patients who, however, are at risk of developing severe schistosomiasis.
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Affiliation(s)
- M Pascal
- INSERM U399, Université Méditerranée, Marseille, France
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