High serum laminin and type IV collagen levels in schistosomiasis mansoni

Abstract

BACKGROUND: Fibrosis is the process of excessive deposition of collagen and other extra cellular matrix components and large amounts of these components have been shown in periovular schistosomal granulomas, especially in the liver. Laminin and type IV collagen have been investigated in various hepatic disorders but their accuracy in fibrosis detection and in the evaluation of its progression in schistosomiasis have not been fully explained. AIM: To measure the serum levels of two markers of fibrosis, laminin and type IV collagen in schistosomiasis. PATIENTS AND METHODS: Sixty-four patients with different clinical forms of schistosomiasis mansoni: intestinal (group I), hepatointestinal (group II), compensated (group III) and decompensated hepatosplenic (group IV) and 18 healthy volunteers were included. RESULTS: Serum type IV collagen and laminin levels were significantly increased in patients compared to controls. At about clinical forms, serum type IV collagen was increased in groups II and IV, compared to controls and was significantly higher in group IV than in group I. Serum laminin was significantly increased in groups II, III and IV and was significantly higher in group IV than in group II. Serum type IV collagen was closely correlated with serum laminin in groups II and IV. CONCLUSIONS: Connective tissue marker levels did not correlate with periportal thickness. In schistosomiasis mansoni there is an increase of type IV collagen and laminin levels at the initial stage of the disease, as well as in advanced forms. We also suggest that these markers may be a useful predictor of disease progression.

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

“…Two independent groups in China found C-IV to be higher in subjects infected with Schistosoma japonicum (Guangjin et al 2002) and to correlate with re-infection after treatment of schistosomiasis japonica with praziquantel (Li et al 2000). Wyszomirska et al (2005Wyszomirska et al ( , 2006 investigated C-IV for the detection of schistosomiasis-related liver fibrosis in a tertiary care hospital in Brazil. patients had higher levels than controls.…”

Schistosomiasis mansoni: ultrasound-evaluated hepatic fibrosis and serum concentrations of hyaluronic acid

“…Many of the cases investigated in the present study had also had their spleens removed and it is possible that the splenectomies led to reductions in serum HA. In a study of patients with schistosomiasis mansoni in a tertiary-care hospital in Brazil, Wyszomirska et al (2005) observed post-splenectomy reductions in the serum concentrations of type-IV collagen. The measurement of PPF via serum markers, such as HA, would seem to have a wide application, especially in endemic areas where ultrasonography is difficult or impossible.…”

Ultrasound versus biological markers in the evaluation of periportal fibrosis in human Schistosoma mansoni

“…Finally, Wyszomirska et al (2005) showed a progressive increase of laminin in the initial stages of disease in hepatointestinal cases, as well as in advanced disease forms.…”

“…In the latter study, these researchers found that type IV collagen had a good specificity (over 90%) but poor sensitivity because more than half of those with severe liver involvement exhibited normal levels of type IV collagen. Wyszomirska et al (2005Wyszomirska et al ( , 2006 indicated a positive correlation between type IV collagen and advanced forms of the disease, with a significant reduction being observed in serum levels following splenectomy. These researchers did not observe a correlation to the grade of PPF when using US evaluation as gold-standard method.…”