The pathogenesis of pulmonary schistosomiasis in Egypt with special reference to Ayerza's disease

Shaw, A. F. Bernard; Ghareeb, Allen

doi:10.1002/path.1700460302

Cited by 136 publications

(48 citation statements)

References 6 publications

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“…It is reported that 10-20% patients with the hepatosplenic form of schistosomiasis mansoni develop PAH (31)(32)(33). This is thought to be caused by the opening of portocaval collaterals, in response to an increase in portal pressure, which enables the eggs to be shunted into the lungs (2,6,34).…”

Section: Discussionmentioning

confidence: 99%

Hepatic Shunting of Eggs and Pulmonary Vascular Remodeling in Bmpr2^+/− Mice with Schistosomiasis

Crosby

Soon

Jones

et al. 2015

Am J Respir Crit Care Med

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Rationale: Schistosomiasis is a major cause of pulmonary arterial hypertension (PAH). Mutations in the bone morphogenetic protein type-II receptor (BMPR-II) are the commonest genetic cause of PAH.Objectives: To determine whether Bmpr2 1/2 mice are more susceptible to schistosomiasis-induced pulmonary vascular remodeling.Methods: Wild-type (WT) and Bmpr2 1/2 mice were infected percutaneously with Schistosoma mansoni. At 17 weeks postinfection, right ventricular systolic pressure and liver and lung egg counts were measured. Serum, lung and liver cytokine, pulmonary vascular remodeling, and liver histology were assessed.Measurements and Main Results: By 17 weeks postinfection, there was a significant increase in pulmonary vascular remodeling in infected mice. This was greater in Bmpr2 1/2 mice and was associated with an increase in egg deposition and cytokine expression, which induced pulmonary arterial smooth muscle cell proliferation, in the lungs of these mice. Interestingly, Bmpr2 1/2 mice demonstrated dilatation of the hepatic central vein at baseline and postinfection, compared with WT. Bmpr2 1/2 mice also showed significant dilatation of the liver sinusoids and an increase in inflammatory cells surrounding the central hepatic vein, compared with WT. This is consistent with an increase in the transhepatic passage of eggs.Conclusions: This study has shown that levels of BMPR-II expression modify the pulmonary vascular response to chronic schistosomiasis. The likely mechanism involves the increased passage of eggs to the lungs, caused by altered diameter of the hepatic veins and sinusoids in Bmpr2 1/2 mice. Genetically determined differences in the remodeling of hepatic vessels may represent a new risk factor for PAH associated with schistosomiasis.

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Section: Discussionmentioning

confidence: 99%

Hepatic Shunting of Eggs and Pulmonary Vascular Remodeling in Bmpr2^+/− Mice with Schistosomiasis

Crosby

Soon

Jones

et al. 2015

Am J Respir Crit Care Med

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“…4 Most of the cardiopulmonary manifestations of schistosomiasis are thought to be related to the hepatosplenic form of the disease, which is characterized by presinusoidal block by embolized worm eggs, producing portal hypertension and portosystemic shunting. Although S mansoni and S japonicum infections are the main agents involved in schistosomal portal hypertension, the association of pulmonary hypertension (PH) with infection by those species is not unexpected.…”

mentioning

confidence: 99%

“…However, reports exist of pulmonary involvement in infections by S hematobium 5 and by S mansoni without liver fibrosis. 4 PH corresponds to one of the possible clinical complications of schistosomiasis. 6 About 4% to 8% of patients with chronic schistosomiasis develop hepatosplenic disease 3,7 ; nevertheless, the incidence of PH in this subpopulation is controversial.…”

mentioning

confidence: 99%

Cardiopulmonary Manifestations of Hepatosplenic Schistosomiasis

Lapa

Dias²,

Jardim³

et al. 2009

Circulation

182

151

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Background -Schistosomiasis is a highly prevalent disease with Ͼ200 million infected people. Pulmonary hypertension is one of the pulmonary manifestations in this disease, particularly in its hepatosplenic presentation. The aim of this study was to determine the prevalence of pulmonary hypertension in schistosomiasis patients with the hepatosplenic form of the disease. Methods and Results -All patients with hepatosplenic schistosomiasis followed up at the gastroenterology department of our university hospital underwent echocardiographic evaluation to search for pulmonary hypertension. Patients presenting with systolic pulmonary artery pressure Ͼ40 mm Hg were further evaluated through right heart catheterization. Our study showed an 18.5% prevalence of patients with elevated systolic pulmonary artery pressure at echocardiography. Invasive hemodynamics confirmed the presence of pulmonary hypertension in 7.7% (95% confidence interval, 3.3 to 16.7) of patients, with a prevalence of precapillary (arterial) pulmonary hypertension of 4.6% (95% confidence interval, 1.5 to 12.7). Conclusions -Our study reinforces the role of echocardiography as a screening tool in the investigation of pulmonary hypertension, together with the need for invasive monitoring for a proper diagnosis. We conclude that hepatosplenic schistosomiasis may account for one of the most prevalent forms of pulmonary hypertension worldwide, justifying the development of further studies to evaluate the effect of specific pulmonary hypertension treatment in this particular form of the disease.

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“…Because the resistance is primarily in the venous effluent, the renal vascular bed proximal to the resistance is subjected to the battering action of a high blood pressure. This leads to renal arteriolar sclerosis, just as, for example, blockage of the pulmonary vascular bed with schistosome ova leads to pulmonary arteriolar sclerosis (30). As the renal arteriolar sclerosis develops, an increased resistance to blood flow is gradually set into the arterial influent.…”

Section: Discussionmentioning

confidence: 99%

The Intrarenal Pressure During Experimental Renal Hypertension

Swann

Prine

Moore

et al. 1952

Journal of Experimental Medicine

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The intrarenal interstitial pressure was measured during the course of experimental renal hypertension in dogs. In perinephritic hypertension, produced by wrapping the kidney in a cellophane bag, the intrarenal pressure rose slowly from the normal value of 25 mm. Hg to a final level of about 60 mm. Hg. Strong pressure pulsations were observed in the renal parenchyma during this type of hypertension. In the hypertension following partial occlusion of the renal artery, the intrarenal pressure remained approximately normal, except in malignant hypertension when it tended to decline to about 9 mm. Hg. The hypertension of perinephritis is interpreted as a consequence of renal ischemia, the high intrarenal pressure, produced by the constricting fibrotic hull, acting to reduce the effective perfusion pressure of the kidney. The two experimental hypertensions herein examined are considered as examples of influent resistance hypertensions and effluent resistance hypertensions, the former being due to renal arterial or arteriolar resistance and the latter due to renal venous resistance, specifically at the arcuate-interlobar junction. The application of this concept to renal hypertensive disease in man is discussed.

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The pathogenesis of pulmonary schistosomiasis in Egypt with special reference to Ayerza's disease

Cited by 136 publications

References 6 publications

Hepatic Shunting of Eggs and Pulmonary Vascular Remodeling in Bmpr2^+/− Mice with Schistosomiasis

Hepatic Shunting of Eggs and Pulmonary Vascular Remodeling in Bmpr2^+/− Mice with Schistosomiasis

Cardiopulmonary Manifestations of Hepatosplenic Schistosomiasis

The Intrarenal Pressure During Experimental Renal Hypertension

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The pathogenesis of pulmonary schistosomiasis in Egypt with special reference to Ayerza's disease

Cited by 136 publications

References 6 publications

Hepatic Shunting of Eggs and Pulmonary Vascular Remodeling in Bmpr2+/− Mice with Schistosomiasis

Hepatic Shunting of Eggs and Pulmonary Vascular Remodeling in Bmpr2+/− Mice with Schistosomiasis

Cardiopulmonary Manifestations of Hepatosplenic Schistosomiasis

The Intrarenal Pressure During Experimental Renal Hypertension

Contact Info

Product

Resources

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Hepatic Shunting of Eggs and Pulmonary Vascular Remodeling in Bmpr2^+/− Mice with Schistosomiasis

Hepatic Shunting of Eggs and Pulmonary Vascular Remodeling in Bmpr2^+/− Mice with Schistosomiasis