1
|
Kumar R, Lee M, Kassa B, Fonseca Balladares D, Mickael C, Sanders L, Andruska A, Kumar M, Spiekerkoetter E, Bandeira A, Stenmark K, Tuder R, Graham B. Repetitive schistosoma exposure causes perivascular lung fibrosis and persistent pulmonary hypertension. Clin Sci (Lond) 2023; 137:617-631. [PMID: 37014925 PMCID: PMC10133871 DOI: 10.1042/cs20220642] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/23/2023] [Accepted: 04/04/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Pulmonary hypertension (PH) can occur as a complication of schistosomiasis. In humans, schistosomiasis-PH persists despite antihelminthic therapy and parasite eradication. We hypothesized that persistent disease arises as a consequence of exposure repetition. METHODS Following intraperitoneal sensitization, mice were experimentally exposed to Schistosoma eggs by intravenous injection, either once or three times repeatedly. The phenotype was characterized by right heart catheterization and tissue analysis. RESULTS Following intraperitoneal sensitization, a single intravenous Schistosoma egg exposure resulted in a PH phenotype that peaked at 7-14 days, followed by spontaneous resolution. Three sequential exposures resulted in a persistent PH phenotype. Inflammatory cytokines were not significantly different between mice exposed to one or three egg doses, but there was an increase in perivascular fibrosis in those who received three egg doses. Significant perivascular fibrosis was also observed in autopsy specimens from patients who died of this condition. CONCLUSIONS Repeatedly exposing mice to schistosomiasis causes a persistent PH phenotype, accompanied by perivascular fibrosis. Perivascular fibrosis may contribute to the persistent schistosomiasis-PH observed in humans with this disease.
Collapse
Affiliation(s)
- Rahul Kumar
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, U.S.A
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, California, U.S.A
| | - Michael H. Lee
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, U.S.A
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, California, U.S.A
| | - Biruk Kassa
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, U.S.A
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, California, U.S.A
| | - Dara C. Fonseca Balladares
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, U.S.A
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, California, U.S.A
| | - Claudia Mickael
- Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, U.S.A
| | - Linda Sanders
- Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, U.S.A
| | - Adam Andruska
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Stanford University, Palo Alto, CA, U.S.A
| | - Maya Kumar
- Department of Pediatrics, Division of Pulmonary Medicine, Stanford University, Palo Alto, CA, U.S.A
| | - Edda Spiekerkoetter
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Stanford University, Palo Alto, CA, U.S.A
| | - Angela Bandeira
- PROCAPE, Universidade de Pernambuco, Recife, Pernambuco, Brazil
| | - Kurt R. Stenmark
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, U.S.A
| | - Rubin M. Tuder
- Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, U.S.A
| | - Brian B Graham
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, U.S.A
- Lung Biology Center, Zuckerberg San Francisco General Hospital, San Francisco, California, U.S.A
| |
Collapse
|
2
|
Immune Cells in Pulmonary Arterial Hypertension. Heart Lung Circ 2022; 31:934-943. [PMID: 35361533 DOI: 10.1016/j.hlc.2022.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/24/2022] [Accepted: 02/13/2022] [Indexed: 12/11/2022]
Abstract
Pulmonary arterial hypertension (PAH) is a complex and serious cardiopulmonary disease; it is characterised by increased pulmonary arterial pressure and pulmonary vascular remodelling accompanied by disordered endothelial and smooth muscle cell proliferation within pulmonary arterioles and arteries. Although recent reports have suggested that dysregulated immunity and inflammation are key players in PAH pathogenesis, their roles in PAH progression remain unclear. Intriguingly, altered host immune cell distribution, number, and polarisation within the lung arterial vasculature have been linked to disease development. This review mainly focusses on the roles of different immune cells in PAH and discusses the underlying mechanisms.
Collapse
|
3
|
Stone JR. Diseases of small and medium-sized blood vessels. Cardiovasc Pathol 2022. [DOI: 10.1016/b978-0-12-822224-9.00020-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
|
4
|
Ferrari TCA, Albricker ACL, Gonçalves IM, Freire CMV. Schistosome-Associated Pulmonary Arterial Hypertension: A Review Emphasizing Pathogenesis. Front Cardiovasc Med 2021; 8:724254. [PMID: 34676250 PMCID: PMC8523797 DOI: 10.3389/fcvm.2021.724254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 09/13/2021] [Indexed: 12/21/2022] Open
Abstract
Schistosomiasis, especially due to Schistosoma mansoni, is a well-recognized cause of pulmonary arterial hypertension (PAH). The high prevalence of this helminthiasis makes schistosome-related PAH (Sch-PAH) one of the most common causes of this disorder worldwide. The pathogenic mechanisms underlying Sch-PAH remain largely unknown. Available evidence suggests that schistosome eggs reach the lung via portocaval shunts formed as a consequence of portal hypertension due to hepatosplenic schistosomiasis. Once deposited into the lungs, the eggs elicit an immune response resulting in periovular granuloma formation. Immune mediators drive transforming growth factor-β (TGF-β) release, which gives rise to pulmonary vascular inflammation with subsequent remodeling and development of angiomatoid and plexiform lesions. These mechanisms elicited by the eggs seem to become autonomous and the vascular lesions progress independently of the antigen. Portopulmonary hypertension, which pathogenesis is still uncertain, may also play a role in the genesis of Sch-PAH. Recently, there have been substantial advances in the diagnosis and treatment of PAH, but it remains a difficult condition to recognize and manage, and patients still die prematurely from right-heart failure. Echocardiography is used for screening, and the formal diagnosis requires right-heart catheterization. The experience in treating Sch-PAH is largely limited to the phosphodiesterase type 5 inhibitors, with evidence suggesting that these vasodilators improve symptoms and may also improve survival. Considering the great deal of uncertainty about Sch-PAH pathogenesis, course, and treatment, the aim of this review is to summarize current knowledge on this condition emphasizing its pathogenesis.
Collapse
Affiliation(s)
- Teresa Cristina Abreu Ferrari
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Cristina Lopes Albricker
- Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ina Morais Gonçalves
- Graduação em Medicina, Centro Universitário de Belo Horizonte, Belo Horizonte, Brazil
| | | |
Collapse
|
5
|
Pulmonary Vascular Diseases Associated with Infectious Disease-Schistosomiasis and Human Immunodeficiency Viruses. Clin Chest Med 2021; 42:71-80. [PMID: 33541618 DOI: 10.1016/j.ccm.2020.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A wide variety of infectious diseases are major contributors to the causation of pulmonary vascular disease and, consequently, pulmonary hypertension, especially in the developing world. Schistosomiasis and human immunodeficiency virus are the most common infections that are known to contribute to pulmonary hypertension worldwide. The resultant inflammation and immunologic milieu caused by infection are the main pathologic processes affecting the pulmonary vasculature.
Collapse
|
6
|
Reddy AK, Chakrabarty M, Liu Y, Cohen SH, Maniar AH. Case Report: Clonorchis sinensis Infection Associated with Eosinophilic Pneumonia: A Case Report and Review of the Literature. Am J Trop Med Hyg 2021; 104:2065-2068. [PMID: 33939634 DOI: 10.4269/ajtmh.20-0632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 01/10/2021] [Indexed: 11/07/2022] Open
Abstract
Clonorchis sinensis, a trematode prevalent in East Asia, causes hepatobiliary infection. Exposure typically occurs through ingestion of raw or undercooked fish containing the encysted larval form of the parasite. Extrahepatobiliary disease has not commonly been described. In this case report, we describe an unusual case of C. sinensis infection associated with eosinophilic pneumonia. A middle-aged man from China presented with subacute cough and was found to have a bilateral diffuse eosinophilic pneumonia with associated peripheral eosinophilia. Stool microscopy revealed C. sinensis eggs, and the patient improved after treatment with prednisone and praziquantel. Pulmonary clonorchiasis should be considered in patients with eosinophilic pneumonia from areas highly endemic for this pathogen.
Collapse
Affiliation(s)
- Archana K Reddy
- 1Division of Infectious Diseases, Department of Internal Medicine, University of California-Davis Health, Sacramento, California
| | - Melony Chakrabarty
- 1Division of Infectious Diseases, Department of Internal Medicine, University of California-Davis Health, Sacramento, California
| | - Ying Liu
- 2Department of Pathology and Laboratory Medicine, University of California-Davis Health, Sacramento, California
| | - Stuart H Cohen
- 1Division of Infectious Diseases, Department of Internal Medicine, University of California-Davis Health, Sacramento, California
| | - Archana H Maniar
- 1Division of Infectious Diseases, Department of Internal Medicine, University of California-Davis Health, Sacramento, California
| |
Collapse
|
7
|
Sibomana JP, Campeche A, Carvalho-Filho RJ, Correa RA, Duani H, Pacheco Guimaraes V, Hilton JF, Kassa B, Kumar R, Lee MH, Loureiro CMC, Mazimba S, Mickael C, Oliveira RKF, Ota-Arakaki JS, Rezende CF, Silva LCS, Sinkala E, Ahmed HY, Graham BB. Schistosomiasis Pulmonary Arterial Hypertension. Front Immunol 2020; 11:608883. [PMID: 33362796 PMCID: PMC7758287 DOI: 10.3389/fimmu.2020.608883] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/03/2020] [Indexed: 12/18/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) is a disease of the lung blood vessels that results in right heart failure. PAH is thought to occur in about 5% to 10% of patients with hepatosplenic schistosomiasis, particularly due to S. mansoni. The lung blood vessel injury may result from a combination of embolization of eggs through portocaval shunts into the lungs causing localized Type 2 inflammatory response and vessel remodeling, triggering of autonomous pathology that becomes independent of the antigen, and high cardiac output as seen in portopulmonary hypertension. The condition is likely underdiagnosed as there is little systematic screening, and risk factors for developing PAH are not known. Screening is done by echocardiography, and formal diagnosis requires invasive right heart catheterization. Patients with Schistosoma-associated PAH show reduced functional capacity and can be treated with pulmonary vasodilators, which improves symptoms and may improve survival. There are animal models of this disease that might help in understanding disease pathogenesis and identify novel targets to screen and treatment. Pathogenic mechanisms include Type 2 immunity and activation and signaling in the TGF-β pathway. There are still major uncertainties regarding Schistosoma-associated PAH development, course and treatment.
Collapse
Affiliation(s)
- Jean Pierre Sibomana
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Tikur Anbessa Specialized Hospital, College of Health Sciences, University of Addis Ababa, Addis Ababa, Ethiopia
- Department of Medicine, Butare University Teaching Hospital, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Aloma Campeche
- Division of Gastroenterology, Department of Medicine, Santa Casa Hospital, Salvador, Bahia, Brazil
| | - Roberto J. Carvalho-Filho
- Division of Gastroenterology, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Ricardo Amorim Correa
- Internal Medicine/Pulmonary Division, Medical School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Helena Duani
- Internal Medicine/Infectious Diseases Division, Medical School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Virginia Pacheco Guimaraes
- Pulmonary Department, Hospital Júlia Kubistchek, Fundação Hospitalar of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Joan F. Hilton
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
| | - Biruk Kassa
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Rahul Kumar
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | - Michael H. Lee
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| | | | - Sula Mazimba
- Division of Cardiology, Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Claudia Mickael
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Rudolf K. F. Oliveira
- Division of Respiratory Diseases, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Jaquelina S. Ota-Arakaki
- Division of Respiratory Diseases, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Camila Farnese Rezende
- Pulmonary Medicine, Hospital das Clinicas, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luciana C. S. Silva
- Internal Medicine Department, Medical School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Edford Sinkala
- Hepatology Clinic, Department of Medicine, University of Zambia Teaching Hospital, Lusaka, Zambia
| | - Hanan Yusuf Ahmed
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Tikur Anbessa Specialized Hospital, College of Health Sciences, University of Addis Ababa, Addis Ababa, Ethiopia
| | - Brian B. Graham
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA, United States
| |
Collapse
|
8
|
Hasby Saad MA, El-Anwar N. Bevacizumab as a potential anti-angiogenic therapy in schistosomiasis: A double-edged, but adjustable weapon. Parasite Immunol 2020; 42:e12724. [PMID: 32338371 DOI: 10.1111/pim.12724] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 04/09/2020] [Accepted: 04/17/2020] [Indexed: 11/30/2022]
Abstract
AIM Investigating the anti-angiogenic effect of bevacizumab on chronic schistosomiasis mansoni in a trial to hinder the Schistosome-induced angiogenesis and porto-systemic shunting complications. METHODS The immunohistochemical expression of CD34, VEGF-R1, PCNA and α-SMA (angiogenesis markers) was analysed in the lung, liver and gastrointestinal junctions of chronic S mansoni infected mice after intraperitoneal injection of bevacizumab. The effect of prolonged administration of bevacizumab with praziquantel was also assessed through parasitic load, protective index, granuloma and fibrous tissue evaluation. RESULTS A regression in the vascular activity and microvascular density was observed in the infected mice after receiving bevacizumab. They had a significantly less VEGF-R1, PCNA, CD-34 and α-SMA expression in comparison to the infected untreated mice. The least tissue egg count was reported in mice received bevacizumab for 6 weeks (Mean = 27 120). However, they had persistent liver granulomas, and massively amalgamated fibrosis. Interestingly, the least faecal egg and tissue worms counts (Mean = 112, 13.4), and the highest protection index (39.26) were reported in mice received bevacizumab for 3 weeks, with marked granuloma, and fibrous tissue resolution. CONCLUSIONS Bevacizumab has a promising protective effect against the Schistosoma-induced angiogenesis. As an adjuvant to praziquantel, it is important to adjust the appropriate duration of administration that achieves the best schistosomicidal effect without impeding granuloma and fibrous tissue resolution.
Collapse
Affiliation(s)
- Marwa A Hasby Saad
- Medical Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Gharbia Governorate, Egypt
| | - Noha El-Anwar
- Department of Pathology, Tanta University, Faculty of Medicine, Tanta, Egypt
| |
Collapse
|
9
|
Piscoya Roncal CG, Mendes AA, Muniz MT, de Oliveira SA, do Valle Neto LM, de Vasconcellos Piscoya NA, Góes GH, Sobral Filho DC, Gomberg-Maitland M. Schistosomiasis-associated pulmonary arterial hypertension: survival in endemic area in Brazil. IJC HEART & VASCULATURE 2019; 25:100373. [PMID: 31720370 PMCID: PMC6838530 DOI: 10.1016/j.ijcha.2019.100373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND The survival of schistosomiasis-associated pulmonary arterial hypertension (Sch-PAH) patients in endemic areas is unknown, but can be estimated using predictive equations. METHODS We retrospectively analyzed all consecutive patients diagnosed with Sch-PAH referred to the Pronto SocorroCardiologico de Pernambuco between 2004 and 2010 using specific therapy and measured laboratory, diagnostic imaging, and baseline hemodynamic parameters. Observed and predicted survivals according to the National Institutes of Health (NIH) and Pulmonary Hypertension Connection (PHC) registry equations were compared by the Kaplan-Meier method, log-rank test and Cox proportional hazards model. RESULTS Sixty-eight patients (47 [69.1%] women) observed for a mean of 3.1 years (range, 7-72 months), median survival was 74 months, and 42 (61.7%) survived. The sex and age distributions were similar for functional class I/II and III/IV patients. Hemodynamic abnormalities were severe: mean right atrial pressure, 12.6 ± 6.2 mmHg; mean pulmonary artery pressure, 60.3 ± 13.69 mmHg; pulmonary vascular resistance, 14.62 ± 7.04 Wood units; and cardiac index, 2.3 ± 0.8 L/min/m2. The usual idiopathic PAH predictors were not prognostic in Sch-PAH patients. The 1-, 3- and 5-year survival rates were 92.1%, 75.2%, and 50.8%, respectively, and those estimatedby the NIH and PHC registry equations were 68%, 45% and 32% (p = 0.001), and 93%, 79% and 68% (p = 0.340), respectively. CONCLUSIONS Sch-PAH patients in endemic areas have severe hemodynamic profiles and reduced long-term survivaldespite treatment. The PHC registry equation may be a useful tool to estimate survival in Sch-PAH.
Collapse
Affiliation(s)
| | - Adriano A. Mendes
- Pronto-Socorro Cardiologico de Pernambuco (PROCAPE/University of Pernambuco), Brazil
| | - Maria T.C. Muniz
- Biological Sciences Institute - University of Pernambuco, Brazil
| | - Sheilla A. de Oliveira
- Department of Immunology Aggeu Magalhaes Research Center, Federal University of Pernambuco, Brazil
| | | | | | - Gustavo H.B. Góes
- Pronto-Socorro Cardiologico de Pernambuco (PROCAPE/University of Pernambuco), Brazil
| | - Dario C. Sobral Filho
- Pronto-Socorro Cardiologico de Pernambuco (PROCAPE/University of Pernambuco), Brazil
| | | |
Collapse
|
10
|
Butrous G. Schistosome infection and its effect on pulmonary circulation. Glob Cardiol Sci Pract 2019; 2019:5. [PMID: 31024947 PMCID: PMC6472693 DOI: 10.21542/gcsp.2019.5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 12/17/2018] [Indexed: 02/06/2023] Open
Abstract
Schistosomiasis is the most common parasitic disease associated with pulmonary hypertension. It induces remodelling via complex inflammatory processes, which eventually produce the clinical manifestation of pulmonary hypertension. The pulmonary hypertension shows clinical signs and symptoms that are not distinguishable from other forms of pulmonary arterial hypertension.
Collapse
Affiliation(s)
- Ghazwan Butrous
- Professor of Cardiopulmonary Sciences, Medway School of Pharmacy, University of Kent, UK and University of Greenwich, Central Ave, Gillingham, Chatham ME4 4BF, Kent, UK
| |
Collapse
|
11
|
Chapman PA, Cribb TH, Flint M, Traub RJ, Blair D, Kyaw-Tanner MT, Mills PC. Spirorchiidiasis in marine turtles: the current state of knowledge. DISEASES OF AQUATIC ORGANISMS 2019; 133:217-245. [PMID: 31187736 DOI: 10.3354/dao03348] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Blood flukes of the family Spirorchiidae are important disease agents in marine turtles. The family is near cosmopolitan in distribution. Twenty-nine marine species across 10 genera are currently recognized, but taxonomic problems remain and it is likely that more species will be discovered. Spirorchiids infect the circulatory system, where they and their eggs cause a range of inflammatory lesions. Infection is sometimes implicated in the death of the turtle. In some regions, prevalence in stranded turtles is close to 100%. Knowledge of life cycles, important for control and epidemiological studies, has proven elusive until recently, when the first intermediate host identifications were made. Recent molecular studies of eggs and adult worms indicate that a considerable level of intrageneric and intraspecific diversity exists. The characterization of this diversity is likely to be of importance in exploring parasite taxonomy and ecology, unravelling life cycles, identifying the differential pathogenicity of genotypes and species, and developing antemortem diagnostic tools, all of which are major priorities for future spirorchiid research. Diagnosis to date has been reliant on copromicroscopy or necropsy, which both have significant limitations. The current lack of reliable antemortem diagnostic options is a roadblock to determining the true prevalence and epidemiology of spirorchiidiasis and the development of effective treatment regimes.
Collapse
Affiliation(s)
- Phoebe A Chapman
- Veterinary-Marine Animal Research, Teaching and Investigation, School of Veterinary Science, The University of Queensland, Gatton, Queensland 4343, Australia
| | | | | | | | | | | | | |
Collapse
|
12
|
Use of Computed Tomography - Digital Subtraction Angiography in differentiating pulmonary thrombosis and pulmonary artery dissection in a large pulmonary artery aneurysm. Respir Med Case Rep 2016; 18:24-6. [PMID: 27144113 PMCID: PMC4840406 DOI: 10.1016/j.rmcr.2016.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 02/22/2016] [Indexed: 11/26/2022] Open
Abstract
70 year-old female with chronic obstructive pulmonary disease (COPD) presented with typical symptoms of an exacerbation of COPD. Management of COPD resolved her wheezing, but ongoing hypoxia and retrospective history of atypical chest pain prompted exclusion of a pulmonary embolus. A CT Pulmonary Angiogram (CTPA) with standard 64-slice CT revealed an extensive non-occlusive defect in a grossly dilated right pulmonary artery. Presence of circumferential cuff of soft tissue within sub-segmental pulmonary artery branch raised the possibility of pulmonary artery dissection (PAD). Exclusion of PAD was important as it precluded full anticoagulation. A dynamic CT-digital subtraction angiography (CT-DSA) with the 320-slice multidetector CT (Aquilion-one Vision, Toshiba) did not reveal any intimal flap or contrast extension into the pulmonary arterial wall, suggesting it is unlikely to be PAD. The patient was started on full anticoagulation and reported improvement of symptoms with reduction in pulmonary thrombus burden on repeat CTPA at 4 weeks. To our knowledge, this is the first reported use of dynamic CT-DSA in ruling out PAD.
Collapse
|
13
|
Coron N, Le Govic Y, Kettani S, Pihet M, Hemery S, de Gentile L, Chabasse D. Early Detection of Schistosoma Egg-Induced Pulmonary Granulomas in a Returning Traveler. Am J Trop Med Hyg 2016; 94:611-4. [PMID: 26787142 DOI: 10.4269/ajtmh.15-0765] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 11/30/2015] [Indexed: 11/07/2022] Open
Abstract
We report the case of a French traveler who developed acute pulmonary schistosomiasis 2 months after visiting Benin. He presented with a 1-month history of fever, cough, and thoracic pain. Initial investigations revealed hypereosinophilia and multiple nodular lesions on chest computed tomography scan. Lung biopsies were performed 2 months later because of migrating chest infiltrates and increasing eosinophilia. Histological examination showed schistosomal egg-induced pulmonary granulomas with ova exhibiting a prominent terminal spine, resembling Schistosoma haematobium. However, egg shells were Ziehl-Neelsen positive, raising the possibility of a Schistosoma intercalatum or a Schistosoma guineensis infection. Moreover, involvement of highly infectious hybrid species cannot be excluded considering the atypical early pulmonary oviposition. This case is remarkable because of the rarity of pulmonary schistosomiasis, its peculiar clinical presentation and difficulties in making species identification. It also emphasizes the need to consider schistosomiasis diagnosis in all potentially exposed travelers with compatible symptoms.
Collapse
Affiliation(s)
- Noémie Coron
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Institut de Biologie en Santé, Angers, France; Groupe d'Etude des Interactions Hôte-Pathogène, L'UNAM Université, Université d'Angers, Angers, France; Laboratoire d'Anatomo-Cytopathologie, Centre de Pathologie de l'Ouest, Angers, France; Maison Médicale des Spécialistes, Village Santé Angers Loire, Trélazé, France
| | - Yohann Le Govic
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Institut de Biologie en Santé, Angers, France; Groupe d'Etude des Interactions Hôte-Pathogène, L'UNAM Université, Université d'Angers, Angers, France; Laboratoire d'Anatomo-Cytopathologie, Centre de Pathologie de l'Ouest, Angers, France; Maison Médicale des Spécialistes, Village Santé Angers Loire, Trélazé, France
| | - Sami Kettani
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Institut de Biologie en Santé, Angers, France; Groupe d'Etude des Interactions Hôte-Pathogène, L'UNAM Université, Université d'Angers, Angers, France; Laboratoire d'Anatomo-Cytopathologie, Centre de Pathologie de l'Ouest, Angers, France; Maison Médicale des Spécialistes, Village Santé Angers Loire, Trélazé, France
| | - Marc Pihet
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Institut de Biologie en Santé, Angers, France; Groupe d'Etude des Interactions Hôte-Pathogène, L'UNAM Université, Université d'Angers, Angers, France; Laboratoire d'Anatomo-Cytopathologie, Centre de Pathologie de l'Ouest, Angers, France; Maison Médicale des Spécialistes, Village Santé Angers Loire, Trélazé, France
| | - Sandrine Hemery
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Institut de Biologie en Santé, Angers, France; Groupe d'Etude des Interactions Hôte-Pathogène, L'UNAM Université, Université d'Angers, Angers, France; Laboratoire d'Anatomo-Cytopathologie, Centre de Pathologie de l'Ouest, Angers, France; Maison Médicale des Spécialistes, Village Santé Angers Loire, Trélazé, France
| | - Ludovic de Gentile
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Institut de Biologie en Santé, Angers, France; Groupe d'Etude des Interactions Hôte-Pathogène, L'UNAM Université, Université d'Angers, Angers, France; Laboratoire d'Anatomo-Cytopathologie, Centre de Pathologie de l'Ouest, Angers, France; Maison Médicale des Spécialistes, Village Santé Angers Loire, Trélazé, France
| | - Dominique Chabasse
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Institut de Biologie en Santé, Angers, France; Groupe d'Etude des Interactions Hôte-Pathogène, L'UNAM Université, Université d'Angers, Angers, France; Laboratoire d'Anatomo-Cytopathologie, Centre de Pathologie de l'Ouest, Angers, France; Maison Médicale des Spécialistes, Village Santé Angers Loire, Trélazé, France
| |
Collapse
|
14
|
|
15
|
Hoette S, Figueiredo C, Dias B, Alves JL, Gavilanes F, Prada LF, Jasinowodolinski D, Morinaga LTK, Jardim C, Fernandes CJC, Souza R. Pulmonary artery enlargement in schistosomiasis associated pulmonary arterial hypertension. BMC Pulm Med 2015; 15:118. [PMID: 26459359 PMCID: PMC4603807 DOI: 10.1186/s12890-015-0115-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 09/30/2015] [Indexed: 11/14/2022] Open
Abstract
Background Schistosomiasis associated pulmonary arterial hypertension (Sch-PAH) might represent the most prevalent form of PAH worldwide. In Sch-PAH, the presence of aneurismal dilation of the pulmonary artery has been described, although it is still a matter of debate whether on average the pulmonary artery is more enlarged in Sc-PAH than IPAH. Methods We retrospectively evaluated patients with IPAH (n = 25) and Sch-PAH (n = 22) who underwent computed tomography pulmonary angiogram and right heart catheterization. Results Sch-PAH patients were older and presented less severe hemodynamic profiles. Main pulmonary artery diameter (MPAD) was greater in Sch-PAH than IPAH (4.5 ± 1.8 vs 3.7 ± 1.1 cm, p = 0.018). For the same level of mean pulmonary artery pressure, the MPAD in Sch-PAH was 0.89 cm larger than in IPAH (Covariance model p = 0.02). Conclusion This study demonstrated that pulmonary artery enlargement is more pronounced in Sch-PAH than IPAH, independently of mean pulmonary artery pressure level, suggesting that this is more likely a feature of Sch-PAH.
Collapse
Affiliation(s)
- Susana Hoette
- Pulmonary Department - Heart Institute, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 44, Sao Paulo, 05403-000, Brazil.
| | - Claudia Figueiredo
- Pulmonary Department - Heart Institute, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 44, Sao Paulo, 05403-000, Brazil.
| | - Bruno Dias
- Pulmonary Department - Heart Institute, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 44, Sao Paulo, 05403-000, Brazil.
| | - Jose Leonidas Alves
- Pulmonary Department - Heart Institute, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 44, Sao Paulo, 05403-000, Brazil.
| | - Francisca Gavilanes
- Pulmonary Department - Heart Institute, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 44, Sao Paulo, 05403-000, Brazil.
| | - Luis Felipe Prada
- Pulmonary Department - Heart Institute, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 44, Sao Paulo, 05403-000, Brazil.
| | - Dany Jasinowodolinski
- Pulmonary Department - Heart Institute, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 44, Sao Paulo, 05403-000, Brazil.
| | - Luciana Tamie Kato Morinaga
- Pulmonary Department - Heart Institute, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 44, Sao Paulo, 05403-000, Brazil.
| | - Carlos Jardim
- Pulmonary Department - Heart Institute, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 44, Sao Paulo, 05403-000, Brazil.
| | - Caio Julio Cesar Fernandes
- Pulmonary Department - Heart Institute, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 44, Sao Paulo, 05403-000, Brazil.
| | - Rogério Souza
- Pulmonary Department - Heart Institute, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 44, Sao Paulo, 05403-000, Brazil.
| |
Collapse
|
16
|
Hilbe M, Robert N, Pospischil A, Gerspach C. Pulmonary Arterial Lesions in New World Camelids in Association With Dicrocoelium dendriticum and Fasciola hepatica Infection. Vet Pathol 2015; 52:1202-9. [DOI: 10.1177/0300985814564978] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In Switzerland, dicrocoeliasis is regarded as the most significant parasitic infection of llamas and alpacas. Fasciola hepatica infestation is also a problem but less common. The aim of the present retrospective study was to evaluate the lungs of New World camelids (NWCs) for evidence of arterial hypertension in association with liver changes due to liver fluke infestation. The lungs of 20 llamas and 20 alpacas with liver fluke infestation were histologically evaluated. The hematoxylin and eosin and van Gieson (VG)–elastica stains as well as immunohistology for the expression of α–smooth muscle actin (α-SMA) were used to visualize the structures of arterial walls. Parasitology of fecal matter (11 llamas and 17 alpacas) confirmed that most of these animals were infested with both Dicrocoelium dendriticum and other gastrointestinal parasites. In most cases (10/12 llamas, 4/6 alpacas), liver enzyme activity in serum was elevated. Histologically, arteries in the lungs of 9 of 20 llamas (45%) and 3 of 20 alpacas (15%) showed severe intimal and adventitial and slight to moderate medial thickening, which was confirmed with α-SMA and VG-elastica staining. All animals exhibited typical liver changes, such as fibrosis and biliary hyperplasia, in association with the presence of liver flukes. This study shows that liver flukes can induce proliferative changes in lung arteries in NWCs that resemble those seen with pulmonary arterial hypertension due to liver parasites in humans. However, the degree of liver fluke infestation was not correlated with the extent of liver damage, or with the amount of thoracic or abdominal effusion or pulmonary arterial changes.
Collapse
Affiliation(s)
- M. Hilbe
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
| | - N. Robert
- Institute of Animal Pathology, Vetsuisse Faculty, University of Berne, Berne, Switzerland
| | - A. Pospischil
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
| | - C. Gerspach
- Department of Farm Animals, Clinic of Ruminants, Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
| |
Collapse
|
17
|
Papamatheakis DG, Mocumbi AOH, Kim NH, Mandel J. Schistosomiasis-associated pulmonary hypertension. Pulm Circ 2015; 4:596-611. [PMID: 25610596 DOI: 10.1086/678507] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 07/13/2014] [Indexed: 01/26/2023] Open
Abstract
Schistosomiasis, a parasite-borne disease, is highly prevalent in Africa and Asia; it is estimated that close to 20 million people worldwide have a severe form of the disease. The chronic form can affect the gastrointestinal system and lead to hepatosplenic disease, and it may cause cardiopulmonary complications, including pulmonary hypertension. The exact pathogenesis of schistosomiasis-associated pulmonary hypertension (Sch-PH) remains unclear, although several mechanisms, including parasitic arterial embolization, pulmonary arteriopathy, and portopulmonary hypertension-like pathophysiology, have been suggested. The immunopathology of the disease is also unclear, although there are similarities with the immunology of idiopathic pulmonary arterial hypertension (PAH). Finally, the treatment of Sch-PH has not been well studied. There is some evidence on treating the underlying infection, with unclear effect on Sch-PH, and advanced PAH therapies are now being suggested, but more studies are needed to confirm their efficacy.
Collapse
Affiliation(s)
- Demosthenes G Papamatheakis
- Division of Pulmonary and Critical Care Medicine, University of California San Diego Health System, La Jolla, California, USA
| | - Ana Olga H Mocumbi
- Instituto Nacional de Saúde and Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Nick H Kim
- Division of Pulmonary and Critical Care Medicine, University of California San Diego Health System, La Jolla, California, USA
| | - Jess Mandel
- Division of Pulmonary and Critical Care Medicine, University of California San Diego Health System, La Jolla, California, USA
| |
Collapse
|
18
|
Park SH, Chen WC, Esmaeil N, Lucas B, Marsh LM, Reibman J, Grunig G. Interleukin 13- and interleukin 17A-induced pulmonary hypertension phenotype due to inhalation of antigen and fine particles from air pollution. Pulm Circ 2015; 4:654-68. [PMID: 25610601 DOI: 10.1086/678511] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 04/10/2014] [Indexed: 12/12/2022] Open
Abstract
Pulmonary hypertension has a marked detrimental effect on quality of life and life expectancy. In a mouse model of antigen-induced pulmonary arterial remodeling, we have recently shown that coexposure to urban ambient particulate matter (PM) significantly increased the thickening of the pulmonary arteries and also resulted in significantly increased right ventricular systolic pressures. Here we interrogate the mechanism and show that combined neutralization of interleukin 13 (IL-13) and IL-17A significantly ameliorated the increase in right ventricular systolic pressure, the circumferential muscularization of pulmonary arteries, and the molecular change in the right ventricle. Surprisingly, our data revealed a protective role of IL-17A for the antigen- and PM-induced severe thickening of pulmonary arteries. This protection was due to the inhibition of the effects of IL-13, which drove this response, and the expression of metalloelastase and resistin-like molecule α. However, the latter was redundant for the arterial thickening response. Anti-IL-13 exacerbated airway neutrophilia, which was due to a resulting excess effect of IL-17A, confirming concurrent cross inhibition of IL-13- and IL-17A-dependent responses in the lungs of animals exposed to antigen and PM. Our experiments also identified IL-13/IL-17A-independent molecular reprogramming in the lungs induced by exposure to antigen and PM, which indicates a risk for arterial remodeling and protection from arterial constriction. Our study points to IL-13- and IL-17A-coinduced inflammation as a new template for biomarkers and therapeutic targeting for the management of immune response-induced pulmonary hypertension.
Collapse
Affiliation(s)
- Sung-Hyun Park
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo, New York, USA
| | - Wen-Chi Chen
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo, New York, USA
| | - Nafiseh Esmaeil
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo, New York, USA ; Current affiliation: Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Benjamin Lucas
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo, New York, USA
| | - Leigh M Marsh
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Joan Reibman
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo, New York, USA ; Pulmonary Medicine, Department of Medicine, New York University School of Medicine, New York, New York, USA
| | - Gabriele Grunig
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo, New York, USA ; Pulmonary Medicine, Department of Medicine, New York University School of Medicine, New York, New York, USA
| |
Collapse
|
19
|
Craig JM, Scott AL. Helminths in the lungs. Parasite Immunol 2014; 36:463-74. [PMID: 25201409 DOI: 10.1111/pim.12102] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 01/21/2014] [Indexed: 12/21/2022]
Abstract
Parasitic helminths infect well over one billion people and typically cause chronic and recurrent infections that exert a considerable toll on human health and productivity. A significant number of important intestinal- and tissue-dwelling helminth parasites have evolved a scripted migration through select organ systems. Of specific interest here are the helminth parasites that interact with respiratory tissues and the pulmonary immune system. This review will consider the nature of the interactions between helminth parasites and the lung environment, as well as the consequences of these interactions on the evolution of parasitism and host immunity.
Collapse
Affiliation(s)
- J M Craig
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | |
Collapse
|
20
|
Mathew R. Pathogenesis of pulmonary hypertension: a case for caveolin-1 and cell membrane integrity. Am J Physiol Heart Circ Physiol 2013; 306:H15-25. [PMID: 24163076 DOI: 10.1152/ajpheart.00266.2013] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Pulmonary hypertension (PH) is a progressive disease with a high morbidity and mortality rate. Despite important advances in the field, the precise mechanisms leading to PH are not yet understood. Main features of PH are loss of vasodilatory response, the activation of proliferative and antiapoptotic pathways leading to pulmonary vascular remodeling and obstruction, elevated pressure and right ventricular hypertrophy, resulting in right ventricular failure and death. Experimental studies suggest that endothelial dysfunction may be the key underlying feature in PH. Caveolin-1, a major protein constituent of caveolae, interacts with several signaling molecules including the ones implicated in PH and modulates them. Disruption and progressive loss of endothelial caveolin-1 with reciprocal activation of proliferative pathways occur before the onset of PH, and the rescue of caveolin-1 inhibits proliferative pathways and attenuates PH. Extensive endothelial damage/loss occurs during the progression of the disease with subsequent enhanced expression of caveolin-1 in smooth muscle cells. This caveolin-1 in smooth muscle cells switches from being an antiproliferative factor to a proproliferative one and participates in cell proliferation and cell migration, possibly leading to irreversible PH. In contrast, the disruption of endothelial caveolin-1 is not observed in the hypoxia-induced PH, a reversible form of PH. However, proliferative pathways are activated in this model, indicating caveolin-1 dysfunction. Thus disruption or dysfunction of endothelial caveolin-1 leads to PH, and the status of caveolin-1 may determine the reversibility versus irreversibility of PH. This article reviews the role of caveolin-1 and cell membrane integrity in the pathogenesis and progression of PH.
Collapse
Affiliation(s)
- Rajamma Mathew
- Section of Pediatric Cardiology and Department of Physiology, Maria Fareri Children's Hospital/New York Medical College, Valhalla, New York
| |
Collapse
|
21
|
Kolosionek E, King J, Rollinson D, Schermuly RT, Grimminger F, Graham BB, Morrell N, Butrous G. Schistosomiasis causes remodeling of pulmonary vessels in the lung in a heterogeneous localized manner: Detailed study. Pulm Circ 2013; 3:356-62. [PMID: 24015336 PMCID: PMC3757830 DOI: 10.4103/2045-8932.114764] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Schistosomiasis is a global parasitic disease with high impact on public health in tropical areas. Schistosomiasis is a well-described cause of pulmonary arterial hypertension (PAH). The exact pathogenesis is still unclear, though inflammatory mechanisms are suspected. Another unknown is whether the changes in the pulmonary vasculature are generalized or localized. We studied 13 mice infected with cercariae for 12 weeks compared with 10 control mice. In our model, we observed that the liver was a target during infection and was enlarged more than two-fold after infection. However, right heart hypertrophy as measured by RV/(LV + S) ratio was not observed at this time point. Moreover, we noticed that 72% of the sampled lobes (92% of the lungs) harvested from these animals costained evidence of granulomatous changes, secondary to egg deposition. We systemically mapped the distribution of granulomatous lesions in right lung lobes (n = 43) of infected mice. We observed that the distribution of the granulomatous lesions was heterogeneous. Remodeled pulmonary vessels were seen in 26% of the lobes (46% of the lungs) and were observed only in close proximity to the granuloma. No remodeling was observed in the absence of granulomas. These findings support the view that pulmonary vascular remodeling is caused by the local presence of granulomas in PAH associated with schistosomiasis. The heterogeneous nature of the remodeling partly explains why many patients with schistosomiasis do not develop pulmonary hypertension.
Collapse
|
22
|
Effects of high-fat chow on heart tissue in acute and chronic experimental murine schistosomiasis mansoni. Parasitology 2012; 139:1462-70. [PMID: 23025901 DOI: 10.1017/s0031182012000807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study aimed to investigate myocardial injuries in mice infected with Schistosoma mansoni and fed a high-fat chow. Sections of myocardial tissue from S. mansoni-infected mice, and controls that had been killed 9 and 17 weeks post-infection, were stained with H&E and Picrosirius red. Histopathological examination, stereological design-based method (optical disector) and morphometry (vessels, cardiomyocytes and an amount of collagen) were used. Data were analysed using two-way ANOVA. Regardless of time of infection, myocardial tissue from the infected mice fed high-fat chow showed myocarditis characterized by a higher number of inflammatory foci, several areas displaying coagulation of cardiac fibres, a greater loss of cardiomyocytes and fibroblast proliferation than in the standard chow control. Comparing infected mice from acute and chronic infections, a higher cardiomyocyte hyperplasia (P < 0·0001) and higher amounts of collagen (P < 0·05) were observed than in standard chow control. In addition, all animals fed high-fat chow showed lower numerical density and total number of cardiomyocytes (P < 0·05), thicker vessel walls and narrowed luminal intramyocardial vessels (P > 0·05) than in the standard chow control. Altogether the data supported the view that a double burden has a synergistic deleterious effect on the myocardial tissue.
Collapse
|
23
|
Luan Y, Zhang X, Kong F, Cheng GH, Qi TG, Zhang ZH. Mesenchymal stem cell prevention of vascular remodeling in high flow-induced pulmonary hypertension through a paracrine mechanism. Int Immunopharmacol 2012; 14:432-7. [PMID: 22922316 DOI: 10.1016/j.intimp.2012.08.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 08/01/2012] [Accepted: 08/01/2012] [Indexed: 01/31/2023]
Abstract
UNLABELLED Pulmonary arterial hypertension (PAH) is characterized by functional and structural changes in the pulmonary vasculature, and despite the drug treatment that made significant progress, the prognosis of patients with advanced PH remains extremely poor. In the present study, we investigated the early effect of bone marrow mesenchymal stem cells (BMSCs) on experimental high blood flow-induced PAH model rats and discussed the mechanism. BMSCs were isolated, cultured from bone marrow of Sprague-Dawley (SD) rat. The animal model of PAH was created by surgical methods to produce a left-to-right shunt. Following the successful establishment of the PAH model, rats were randomly assigned to three groups (n=20 in each group): sham group (control), PAH group, and BMSC group (received a sublingual vein injection of 1-5 × 10(6) BMSCs). Two weeks after the administration, BMSCs significantly reduced the vascular remodeling, improved the hemodynamic data, and deceased the right ventricle weight ratio to left ventricular plus septal weight (RV/LV+S) (P<0.05). Real-time reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry analysis results indicated that the inflammation factors such as interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) were reduced (P<0.05); the expression of matrix metallo proteinase-9 (MMP-9) was lower (P<0.05); vascular endothelial growth factor (VEGF) was higher in BMSC group than those in PAH group (P<0.05). CONCLUSION Sublingual vein injection of BMSCs for 2 weeks, significantly improved the lung and heart injury caused by left-to-right shunt-induced PAH; decreased pulmonary vascular remodeling and inflammation; and enhanced angiogenesis.
Collapse
Affiliation(s)
- Yun Luan
- Central Research Laboratory, The Second Hospital of Shandong University, Jinan, China
| | | | | | | | | | | |
Collapse
|
24
|
Oliveira SDDS, Silva CLM. Schistosomiasis differentially affects vasoconstrictor responses: up-regulation of 5-HT receptor-mediated aorta contraction. Mem Inst Oswaldo Cruz 2011; 106:456-60. [DOI: 10.1590/s0074-02762011000400012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 05/03/2011] [Indexed: 11/22/2022] Open
|