Formas hepatosplênicas da esquistossomose mansônica no interior do Nordeste do Brasil

Interleukin 10 (IL-10) is an important anti-inflammatory cytokine that modulates severe periportal fibrosis (PPF). We hypothesized that genetic polymorphisms (-G1082A/-C819T/-C592A) of the IL-10 gene and classic factors (age, sex, alcohol, exposure, and specific treatment) are associated with the severity of PPF and that these polymorphisms influence IL-10 expression. In this cross-sectional study, we genotyped these polymorphisms within the IL-10 gene in 203 Brazilian subjects infected with Schistosoma mansoni, with different patterns of PPF. There was an association of protection between the ages of 41 and 60 years and advanced standard PPF. The -1082AA genotype was significantly associated with severity in PPF when compared with the -1082GG genotype. Similarly, when analyzed together, both the -1082GA+AA genotypes were significantly associated. The ACC and GTA haplotypes indicated a protective effect against PPF, while the ATA haplotype was significantly associated with PPF severity when compared with the GCC haplotype. There was no significant difference between average levels of IL-10 between clinical groups, and there was no association between average serum levels of IL-10 and (-G1082A) IL-10 polymorphism. Our results suggest that (-G1082A) IL-10 polymorphism and putative haplotypes are associated with PPF severity in the Brazilian population.

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Association of SNP (-G1082A)IL-10with Increase in Severity of Periportal Fibrosis in Schistosomiasis, in the Northeast of Brazil

Valença

Vieira²,

Gomes³

et al. 2014

Genetic Testing and Molecular Biomarkers

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Potential Role of the Chemokine Macrophage Inflammatory Protein 1α in Human and Experimental Schistosomiasis

Souza¹,

Roffê²,

Pinho³

et al. 2005

Infect Immun

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In human schistosomiasis, the concentrations of the chemokine macrophage inflammatory protein 1␣ (MIP-1␣/CCL3) is greater in the plasma of patients with clinical hepatosplenic disease. The objective of the present study was to confirm the ability of CCL3 to detect severe disease in patients classified by ultrasonography (US) and to evaluate the potential role of CCL3 in Schistosoma mansoni-infected mice. CCL3 was measured by enzyme-linked immunosorbent assay in the plasma of S. mansoni-infected patients. CCL3-deficient mice were infected with 25 cercariae, and various inflammatory and infectious indices were evaluated. The concentration of CCL3 was higher in the plasma of S. mansoni-infected than noninfected patients. Moreover, CCL3 was greater in those with US-defined hepatosplenic than with the intestinal form of the disease. In CCL3-deficient mice, the size of the granuloma and the liver eosinophil peroxidase activity and collagen content were diminished compared to wild-type mice. In CCL3-deficient mice, the worm burden after 14 weeks of infection, but not after 9 weeks, was consistently smaller. The in vitro response of mesenteric lymph node cells to antigen stimulation was characterized by lower levels of interleukin-4 (IL-4) and IL-10. CCL3 is a marker of disease severity in infected humans, and experimental studies in mice suggest that CCL3 may be a causative factor in the development of severe schistosomiasis.Schistosomiasis is one of the most prevalent helminth diseases in the world and is caused by blood flukes of the Schistosoma genus (36). In infected individuals, the granulomatous inflammation in response to egg deposition in the liver in the case of Schistosoma mansoni is the major pathological finding and accounts for most of the clinical symptoms. Worm oviposition at 5 to 6 weeks poses a strong Th2 bias in the immune response against infection (6) while also inhibiting the Th1 component (12,42). Nonetheless, the granulomatous response that is maximal during the first few weeks after initial oviposition is also subjected to immunomodulation. Apart from interleukin-10 (IL-10) (29), other factors may also be involved in this process. For example, recent literature suggests that, in animal models, the granulomatous response that occurs at chronic time points is dependent on the soluble form of the IL-13 receptor ␣2 (27). In patients, failure in modulating the response might lead to the development severe schistosomiasis later in life (15). Indeed, a direct consequence of the persistence of an exacerbated immune response appears to be the development of large granulomatous reactions associated with intense collagen deposition (20) and the development of hepatosplenic schistosomiasis. Therefore, there is much scientific interest in the understanding of the mechanisms and inflammatory mediators underlying egg-induced granulomatous response, with the ultimate goal of proposing strategies to modulate fibrosis. It is known, however, that prevention of granuloma formation may be dangerous, since lethality ...

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Esquistossomose hepatoesplênica cirúrgica: histopatologia hepatica e endoscopia digestiva alta em crianças comparadas a adultos

Brandt¹,

Domingues²,

Figuerêdo-Silva³

et al. 2000

Rev. Col. Bras. Cir.

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Objetivando melhor compreender a fisiopatologia da esquistossomose grave em adultos e crianças, avaliaram-se diferenças histopatológicas do fígado e do padrão de endoscopia digestiva entre esses pacientes. Vinte e um adultos e igual número de crianças foram incluídos no estudo. Todos foram submetidos a esplenectomia e ligadura da veia gástrica esquerda. Os achados histopatológicos foram avaliados em secções de biópsia hepática. Utilizou-se videoendoscópio para endoscopia digestiva. Nos adultos foram encontradas: 1 - fibrose de Symmers, grau I, em um paciente; grau II, em sete; e grau III, em treze; 2 - atividade inflamatória mínima em cinco; leve, em sete; moderada, em seis; e intensa, em um; ausência de atividade inflamatória, em dois; 3 - mínima granulomatose, em quatro pacientes; moderada, em dois; ausência de granulomas, em quinze; 4 - pigmento esquistossomótico mínimo, em quatro pacientes; moderada, em um; ausência, em dezesseis. Nas crianças, foram encontradas: 1 - fibrose de Symmers, grau I, em um paciente; grau II, em quatro e grau III, em dezesseis; 2 - atividade inflamatória mínima, em sete pacientes; leve, em quatorze; 3 - mínima granulomatose, em seis pacientes; leve, em cinco; moderada, em dois; ausência, em oito; 4 - pigmento esquistossomótico mínimo, em seis pacientes; leve, em três; moderada, em seis; ausência, em seis. Na endoscopia digestiva alta encontrou-se nos adultos: oito (38%) com varizes de médio calibre e treze (62%), de grosso calibre. Oito pacientes (38%) tiveram varizes de fórnix gástrico e cinco (24%), da cárdia. Gastropatia da hipertensão porta foi diagnosticada em dezesseis pacientes (76%). Com relação às crianças, quatro (19%) apresentaram varizes de fino calibre, oito (38%) de médio; e nove (43%) de grosso calibre. Três (14%) tiveram varizes gástricas, sendo duas no fórnix e uma no cárdia. Nove (43%) das crianças apresentavam gastropatia de hipertensão porta. Os achados evidenciaram uma histopatologia hepática similar nos dois grupos; entretanto, as repercussões hemodinâmicas da hipertensão porta foram mais importantes nos adultos, sem, no entanto, alcançar significação estatística.

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Formas hepatosplênicas da esquistossomose mansônica no interior do Nordeste do Brasil

Cited by 5 publications

References 9 publications

Association of SNP (-G1082A)IL-10with Increase in Severity of Periportal Fibrosis in Schistosomiasis, in the Northeast of Brazil

Association of SNP (-G1082A)IL-10with Increase in Severity of Periportal Fibrosis in Schistosomiasis, in the Northeast of Brazil

Potential Role of the Chemokine Macrophage Inflammatory Protein 1α in Human and Experimental Schistosomiasis

Esquistossomose hepatoesplênica cirúrgica: histopatologia hepatica e endoscopia digestiva alta em crianças comparadas a adultos

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