Abstract
In 20 patients with hepatic or hepatosplenic schistosomiasis and 82 individuals infected with S. mansoni, but without liver enlargement, serum parameters reflecting the fibrotic process and hemodynamic alterations as well as immunomodulation were examined. Included as controls were 35 age- and sex-matched healthy individuals from the study region in Northeast Brazil. Peripheral blood cholylglycine levels in patients with hepatomegaly, reflecting the spillover of portal blood into the systemic circulation, were elevated 12-fold over values of patients without liver involvement. Procollagen-III-peptide, a cleavage product of collagen synthesis, was elevated in patients with hepatomegaly (P<0.001) but normal in uncomplicated cases. Immunomodulation was assessed by in vivo delayed hypersensitivity to recall antigens and by serum Β 2-microglobulin and neopterin, substances released in the context of lymphocyte activation. Neopterin, predominantly a macrophage product, was elevated most strikingly in hepatomegalic cases (P< 0.001). The possible interrelation between altered immune responses and excess fibrogenesis is discussed.
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References
Andrade ZA, Bina JC (1983) A patología da forma hépatoesplenica da esquistossomose mansoni em sua forma avancada. Estudo de 232 necrópsias completas. Mem Inst Oswaldo Cruz 78(3): 285–305
Blagg W, Schloegel EL, Mansour MS, Khalaf GI (1955) A new concentration technique for the demonstration of protozoa and helminth ova in feces. Am J Trop Med Hyg 4:23–28
Bolarin DM (1984) Radioimmunoassay of serum conjugated cholic acid in hepatic murine schistosomiasis. Trans R Soc Trop Med Hyg 78:755–757
Bolarin DM, Savolaiinen ER, Kivirikko KI (1984) Three serum markers of collagen biosynthesis in Nigerians with cirrhosis and various infectious diseases. Eur J Clin Invest 14:90–95
Cheever AW (1968) A quantitative post mortem study of schistosomiasis mansoni in man. Am J Trop Med Hyg 17:38–64
Colley DG, Katz N, Rocha RS, Abrantes W, da Silva AL, Gazzinelli G (1983) Immune responses during human schistosomiasis mansoni. IX T-lymphocyte subset analysis by monoclonal antibodies in hepatosplenic disease. Scand J Immunol 17:297–302
Cresswell P, Springer T, Strominger JL (1974) Immunological identity of the small unit of HLA antigens and Β 2-microglobulin and its turnover on the cell membrane. Proc Natl Acad Sci USA 71:2123–2127
Dunn MA, Kamel R (1981) Hepatic schistosomiasis. Hepatology (6): 653–661
Feldmeier H, Büttner DW (1983) Immunodiagnosis of S. haematobium and S. mansoni in man. Application of crude extracts from adult worms and cercariae in the IHA and the ELISA. Zentralbl Bakteriol Parasitenkd Infektionskr Hyg Abt Orig Reihe A 255:413–421
Feldmeier H, Gastl GA, Poggensee U, Kortmann Daffalla AA, Peter HH (1985) Relationship between intensity of infection and immunomodulation in human schistosomiasis: I. Lymphocyte subpopulations and specific antibody responses. Clin Exp Immunol 60:225–233
Gigase PLJ (1982) Hepatosplenic human schistosomiasis; progress and problems. Acta Leiden 49:41–53
Grimaud JA, Borojevic R (1977) Chronic human schistosomiasis mansoni. Pathology of the Dissé's space. Lab Invest 36:268–273
Huber C, Troppmaier J, Fuchs D, Hausen A, Lang A, Niederwieser D, Reibnegger G, Swetly P, Wachter H, Margreiter R (1985) Immune response associated production of neopterin: release from macrophages under the control of lymphokines. Transplant Proc 17:582–585
Junqueira LCU, Montes GS, Toledo OMS, Joazeiro PP (1986) Morphological, histochemical and biochemical observations on the connective tissue matrix of in situ and isolated hepatic granulomas in experimental murine schistosomiasis. Ann Trop Med Parasitol 80(1):27–41
Kamal KA, Higashi GI (1982) Depression of in vivo and in vitro cell mediated immunity in schistosomiasis mansoni patients with splenomegaly. Abstract. Mol Biochem Parasitol 5(Suppl):34
Katz N, Chaves A, Pellegrino J (1972) A simple device for quantitative stool thick-smear technique in schistosomiasis mansoni. Rev Inst Med Trop Sao Paulo 14:397–400
Khalil SH, Khalil H Sr, Fahmi MH, Said M, el Sawy M, Nofal M, Amara F, Taky M, Brock J, Arab M (1985) Study of eosinophilia in relation to serum IgE level and cell mediated immunity to soluble egg antigen in human schistosomiasis mansoni. Allerg Immunol 31(2):105–108
Mackenjee MKR, Coovadia HM, Chutte CHJ (1984) Clinical recognition of mild hepatic schistosomiasis in an endemic area. Trans R Soc Trop Med Hyg 78:13–15
Mahmoud AAF (1984) Schistosomiasis. In: Warren KS, Mahmoud AAF (eds) Tropical and geographical medicine. McGraw-Hill, New York, pp 443–458
Parise ER, Summerfield JA, Hahn E, Wiedmann KH, Doenhoff MJB (1985) Basement membrane proteins and type III procollagen in murine schistosomiasis. Trans R Soc Trop Med Hyg 79:663–670
Rohde H, Langer I, Krieg T (1979) Radioimmunoassay for type III procollagen peptide and its application to human liver disease. Eur J Clin Invest 9:451–459
Rojkind M (1984) The blue glass and the predictive value of serum amino-terminal propeptide of type III procollagen as a marker of liver fibrosis. Hepatology 4:977–978
Schmutzhard E, Boonpucknavig V, Fuchs D, Hausen A, Lutz H, Reibnegger G, Wachter H (1984) Neopterin, a new parameter in malarial diseases. In: Wachter H, Curtius HC, Pfleiderer W (eds) Biochemical and clinical aspects of pteridines, vol 3. Walter de Gruyter, Berlin New York, pp 469–481
Symmers WC (1904) Note on a new form of liver cirrhosis due to the presence of the ova of Bilharzia haematobia. J Pathol Bacteriol 9:237–239
Todd CW, Goodgame RW, Colley DG (1980) Immune responses during human schistosomiasis mansoni: VII. Further analysis of the interactions between patient sera and lymphocytes during in vitro blastogenesis to schistosome antigen preparations. Am J Trop Med Hyg 29(5): 875–881
Warren KS (1984) The kinetics of hepatosplenic schistosomiasis. Semin Liver Dis 4:293–300
Wyler DJ, Wahl SM, Cheever AW, Wahl LM (1981) Fibroblast stimulation in schistosomiasis: I. Stimulation in vitro of fibroblasts by soluble products of egg granulomas. J Infect Dis 144(3):254–262
Wyler DJ, Stadecker MJ, Dinarello CA, O'Dea JF (1984) Fibroblast stimulation in schistosomiasis: V. Egg granuloma macrophages spontaneously secrete a fibroblast-stimulating factor. J Immunol 132(6):3142–3148
Zwingenberger K, Harms G, Feldmeier H, Müller O, Steiner A, Bienzle U (1988) Liver involvement in human schistosomiasis. Reversibility of biochemical and immunological alterations after specific chemotherapy. Acta Tropica (in press)
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Support received: The study was supported in part by Merck Germany, Merck do Brasil, Gesellschaft für Technische Zusammenarbeit (Grant no 76.2512.2) and Referat Entwicklungshilfe, Senator für Gesundheit und Soziales, Berlin, Federal Republic of Germany
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Zwingenberger, K., Feldmeier, H., Nogueira Queiroz, J.A. et al. Liver involvement in human schistosomiasis mansoni. Assessment by immunological and biochemical markers. Parasitol Res 74, 448–455 (1988). https://doi.org/10.1007/BF00535145
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DOI: https://doi.org/10.1007/BF00535145