Schistosomal glomerulopathy and changes in the distribution of histological patterns of glomerular diseases in Bahia, Brazil

dos-Santos, Washington L. C.; Sweet, Glória Maria Maranhão; Bahiense-Oliveira, Marilia; Rocha, Paulo Novis

doi:10.1590/s0074-02762011000700017

Cited by 20 publications

(14 citation statements)

References 19 publications

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“…Digestive anomalies are present in only 8–10% of Chagas disease patients and are characterized by a dilation of esophagus and/or colon (mega esophagus and/or mega colon) and also damage in the peripheral nerves. This might be due to either an increased antibody production and proliferative responses to peripheral myelin components72 or as a consequence of the damage due to deposits of ICs in the nerve tissue, as reported for other infectious diseases, such as filariasis and schistosomiasis74.…”

Section: Discussionmentioning

confidence: 88%

Immune complexes in chronic Chagas disease patients are formed by exovesicles from Trypanosoma cruzi carrying the conserved MASP N-terminal region

Lozano

Pablos

Longhi

et al. 2017

Sci Rep

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The exovesicles (EVs) are involved in pathologic host-parasite immune associations and have been recently used as biomarkers for diagnosis of infectious diseases. The release of EVs by Trypanosoma cruzi, the causative agent of Chagas disease, has recently been described, with different protein cargoes including the MASP multigene family of proteins MASPs are specific to this parasite and characterized by a conserved C-terminal (C-term) region and an N-terminal codifying for a signal peptide (SP). In this investigation, we identified immature MASP proteins containing the MASP SP in EVs secreted by the infective forms of the parasite. Those EVs are responsible for the formation of immune complexes (ICs) containing anti-MASP SP IgGs in patients with different (cardiac, digestive and asymptomatic) chronic Chagas disease manifestations. Moreover, purified EVs as well as the MASP SP inhibit the action of the complement system and also show a significant association with the humoral response in patients with digestive pathologies. These findings reveal a new route for the secretion of MASP proteins in T. cruzi, which uses EVs as vehicles for immature and misfolded proteins, forming circulating immune complexes. Such complexes could be used in the prognosis of digestive pathologies of clinical forms of Chagas disease.

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Section: Discussionmentioning

confidence: 88%

Immune complexes in chronic Chagas disease patients are formed by exovesicles from Trypanosoma cruzi carrying the conserved MASP N-terminal region

Lozano

Pablos

Longhi

et al. 2017

Sci Rep

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“…The immunological nature of glomerular involvement in schistosomiasis is well established [5] , [9] , [10] . The most frequently reported histological types are chronic membranoproliferative glomerulonephritis and focal segmental glomerulosclerosis, usually with nephrotic syndrome [11] , [12] , [13] , [14] . There are other important factors, in addition to parasite antigens, which seem to contribute to the pathogenesis of glomerular disease in schistosomiasis, such as the collateral circulation of the portal system due to the degree of hepatic involvement, the inefficiency of the hepatic macrophage system, the severity and duration of infestation, racial and genetic factors [13] , [15] .…”

Section: Introductionmentioning

confidence: 99%

Renal Function in Hepatosplenic Schistosomiasis – An Assessment of Renal Tubular Disorders

et al. 2014

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BackgroundRenal involvement in Schistosoma mansoni infection is not well studied. The aim of this study is to investigate the occurrence of renal abnormalities in patients with hepatosplenic schistosomiasis (HSS), especially renal tubular disorders.MethodsThis is a cross-sectional study with 20 consecutive patients with HSS followed in a medical center in Maceió, Alagoas, Brazil. Urinary acidification and concentration tests were performed using calcium chloride (CaCl2) after a 12-h period of water and food deprivation. The biomarker monocyte chemoattractant protein 1 (MCP-1) was quantified in urine. Fractional excretion of sodium (FENa+), transtubular potassium gradient (TTKG) and solute-free water reabsorption (TcH2O) were calculated. The HSS group was compared to a group of 17 healthy volunteers.ResultsPatients' mean age and gender were similar to controls. Urinary acidification deficit was found in 45% of HSS patients. Urinary osmolality was significantly lower in HSS patients (588±112 vs. 764±165 mOsm/kg, p = 0,001) after a 12-h period of water deprivation. TcH2O was lower in HSS patients (0.72±0.5 vs. 1.1±0.3, p = 0.04). Urinary concentration deficit was found in 85% of HSS patients. The values of MCP-1 were higher in HSS group than in control group (122±134 vs. 40±28 pg/mg-Cr, p = 0.01) and positively correlated with the values of microalbuminuria and proteinuria.ConclusionsHSS is associated with important kidney dysfunction. The main abnormalities found were urinary concentrating ability and incomplete distal acidification defect, demonstrating the occurrence of tubular dysfunction. There was also an increase in urinary MCP-1, which appears to be a more sensitive marker of renal damage than urinary albumin excretion rate.

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“…Studies from the 1970s demonstrated that membranoproliferative glomerulonephritis was the most prevalent type because of the high prevalence of schistosomiasis and other parasitic diseases. [7][8][9] More recent studies have shown an increase in the incidence of focal and segmental glomerulosclerosis, and this is currently the most prevalent form of glomerulonephritis in Brazil and other regions of the world. [10][11][12] So far, there have been few studies on the distribution of glomerular diseases in the northeastern region of Brazil.…”

Section: Introductionmentioning

confidence: 99%

Pattern, clinical features and response to corticoids of glomerular diseases in a Brazilian population. An analytical cross-sectional study

et al. 2014

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CONTEXT AND OBJECTIVE: Glomerular disease registries are increasing all around the world. The aim of this study was to evaluate the clinical characteristics and treatment response among patients with glomerular diseases followed up in a tertiary hospital in Brazil. DESIGN AND SETTING: Analytical cross-sectional study; tertiary-level public hospital. METHODS:This study included patients with glomerular diseases followed up at a tertiary hospital in Fortaleza, northeastern Brazil. Clinical and laboratory data on each patient were registered. The response to specific treatment was evaluated after 3, 6 and 12 months. RESULTS:The study included 168 patients of mean age 37 ± 14 years. The main clinical presentations were nephrotic proteinuria (67.3%) and renal insufficiency (17.9%). The mean proteinuria value decreased after the treatment began. Regarding 24-hour proteinuria on admission, there was no significant difference between patients with a good response and those with no response (7,448 ± 5,056 versus 6,448 ± 4,251 mg/24 h, P = 0.29). The glomerular disease with the highest remission rate was MCD (92%). Absence of interstitial fibrosis presented a strong correlation with remission (remission in patients without fibrosis = 83.4% versus 16.3% in those with fibrosis, P = 0.001).CONCLUSIONS: The present study found that the most frequent glomerular disease was FSGS, followed by MCD, MN and LN. The presence of interstitial fibrosis was a predictor of poor therapeutic response. Com relação à proteinúria de 24 horas na admissão, não houve diferença significativa entre os pacientes com boa resposta ao tratamento e aqueles sem resposta (7.448 ± 5.056 versus 6.448 ± 4.251 mg/24 h, P = 0,29). A doença com maior índice de remissão foi a DLM (92%). A ausência de fibrose intersticial apresentou forte correlação com a remissão (remissão em pacientes sem fibrose = 83,4% versus 16,3% naqueles com fibrose, P = 0,001). CONCLUSÕES: O presente estudo encontrou como glomerulopatia mais frequente a GESF, seguida da DLM, NM e NL. A presença de fibrose intersticial foi um preditor de pobre resposta terapêutica. RESUMO

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Schistosomal glomerulopathy and changes in the distribution of histological patterns of glomerular diseases in Bahia, Brazil

Cited by 20 publications

References 19 publications

Immune complexes in chronic Chagas disease patients are formed by exovesicles from Trypanosoma cruzi carrying the conserved MASP N-terminal region

Immune complexes in chronic Chagas disease patients are formed by exovesicles from Trypanosoma cruzi carrying the conserved MASP N-terminal region

Renal Function in Hepatosplenic Schistosomiasis – An Assessment of Renal Tubular Disorders

Pattern, clinical features and response to corticoids of glomerular diseases in a Brazilian population. An analytical cross-sectional study

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