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Abebe W, Asmare Z, Wondmagegn A, Awoke M, Adgo A. Status of selected biochemical and coagulation profiles and platelet count in malaria and malaria-Schistosoma mansoni co-infection among patients attending at Dembiya selected Health Institutions, Northwest Ethiopia. Sci Rep 2024; 14:6135. [PMID: 38480873 PMCID: PMC10937987 DOI: 10.1038/s41598-024-56529-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/07/2024] [Indexed: 03/17/2024] Open
Abstract
Malaria and schistosomiasis are infectious diseases that cause coagulation disorders, biochemical abnormalities, and thrombocytopenia. Malaria and Schistosoma mansoni co-infection cause exacerbations of health consequences and co-morbidities.This study aimed to compare the effect of malaria and Schistosoma mansoni co-infection and malaria infection on selected biochemical and coagulation profiles, and platelet count. An institutional-based comparative cross-sectional study was conducted from March 30 to August 10, 2022. A total of 70 individuals were enrolled in the study using a convenient sampling technique. Wet mount and Kato Katz techniques were conducted to detect Schistosoma mansoni in a stool sample. Blood films were prepared for the detection of plasmodium. The data was coded and entered into EpiData version 3.1 before being analyzed with SPSS version 25. An independent t test was used during data analysis. A P-value of less than 0.05 was considered statistically significant. The mean [SD] of alanine aminotransferase, aspartate aminotransferase, creatinine, total bilirubin, and direct bilirubin in the co-infected was higher than in malaria infected participants. However, the mean of total protein and glucose in co-infected was lower than in the malaria infected participants. The mean of prothrombin time, international normalization ratio, and activated partial thromboplastin time in co-infected was significantly higher, while the platelet count was lower compared to malaria infected participants. Biochemical and coagulation profiles, and platelet count status in co-infection were changed compared to malaria infected participants. Therefore, biochemical and coagulation profiles and platelet count tests should be used to monitor and manage co-infection related complications and to reduce co-infection associated morbidity and mortality.
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Affiliation(s)
- Wagaw Abebe
- Department of Medical Laboratory Sciences, College of Health Sciences, Woldia University, Woldia, Ethiopia.
| | - Zelalem Asmare
- Department of Medical Laboratory Sciences, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Addis Wondmagegn
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Mulat Awoke
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Aderajew Adgo
- Department of Biotechnology, College of Natural and Computational Science, Woldia University, Woldia, Ethiopia
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Kołodziej P, Szostakowska B, Lass A, Sulima M, Sikorska K, Kocki J, Krupski W, Starownik D, Bojar P, Szumiło J, Kasztelan-Szczerbińska B, Cichoż-Lach H, Bogucki J, Szymańska M, Fota-Markowska H, Bogucka-Kocka A. Chronic intestinal schistosomiasis caused by co-infection with Schistosoma intercalatum and Schistosoma mansoni. Lancet Infect Dis 2024; 24:e196-e205. [PMID: 37783223 DOI: 10.1016/s1473-3099(23)00486-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/23/2023] [Accepted: 07/19/2023] [Indexed: 10/04/2023]
Abstract
The Grand Round concerns a 24-year-old man from Zimbabwe who was studying and living in Poland. The patient had been complaining of abdominal pain, fatigue, alternating diarrhoea and constipation, and presence of blood in his stool for 3 years. The patient had the following diagnostic tests: colonoscopy, CT scan, histopathology, and parasitological and molecular tests. Results of the examinations showed that the cause of the patient's complaints was chronic intestinal schistosomiasis due to the co-infection with Schistosoma intercalatum and Schistosoma mansoni. The patient had two cycles of praziquantel therapy (Biltricide) and responded well to the treatment. In the Grand Round, we describe full diagnostics as well as clinical and therapeutic management in the patient with S intercalatum and S mansoni co-infection. This case allows us to draw attention to cases of forgotten chronic tropical diseases (including rare ones) in patients from regions with a high endemic index staying in non-endemic regions of the world for a long time. Co-infection with S intercalatum and S mansoni should be considered as a very rare clinical case.
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Affiliation(s)
- Przemysław Kołodziej
- Department of Biology and Genetics, Medical University of Lublin, Lublin, Poland.
| | - Beata Szostakowska
- Department of Tropical Parasitology, Medical University of Gdańsk, Gdańsk, Poland.
| | - Anna Lass
- Department of Tropical Parasitology, Medical University of Gdańsk, Gdańsk, Poland
| | - Małgorzata Sulima
- Division of Tropical and Parasitic Diseases, Medical University of Gdańsk, Gdańsk, Poland
| | - Katarzyna Sikorska
- Division of Tropical and Parasitic Diseases, Medical University of Gdańsk, Gdańsk, Poland
| | - Janusz Kocki
- Department of Clinical Genetics, Medical University of Lublin, Lublin, Poland
| | - Witold Krupski
- Department of Medical Radiology, Medical University of Lublin, Lublin, Poland
| | - Dorota Starownik
- Independent Public Clinical Hospital No. 4 in Lublin, Medical University of Lublin, Lublin, Poland
| | - Paweł Bojar
- Department of Pathomorphology, Beskid Oncology Centre-John Paul II Memorial City Hospital in Bielsko-Biala, Bielsko-Biała, Poland
| | - Justyna Szumiło
- Department of Clinical Pathomorphology, Medical University of Lublin, Lublin, Poland
| | | | - Halina Cichoż-Lach
- Department of Gastroenterology with Endoscopy Unit, Medical University of Lublin, Lublin, Poland
| | - Jacek Bogucki
- Department of Organic Chemistry, Medical University of Lublin, Lublin, Poland
| | - Magdalena Szymańska
- Department of Biology and Genetics, Medical University of Lublin, Lublin, Poland
| | | | - Anna Bogucka-Kocka
- Department of Biology and Genetics, Medical University of Lublin, Lublin, Poland
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Colt S, Miller CD, Edielu A, Webb EL, Mawa PA, Wu HW, Nakyesige R, Muheki E, Kabatereine N, Bustinduy AL, Friedman JF. Relationships Between Schistosoma mansoni Infection Intensity and Nutritional Status and Anemia Among Preschool-aged Children in Uganda. Clin Infect Dis 2024; 78:90-93. [PMID: 37585653 PMCID: PMC10810701 DOI: 10.1093/cid/ciad470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/18/2023] Open
Abstract
In a cross-sectional analysis of 354 Ugandan children (age 12-48 months) infected with Schistosoma mansoni, we assessed relationships between infection intensity and nutritional morbidities. Higher intensity was associated with an increased risk for anemia (RR = 1.05, 95% confidence interval [CI] 1.01-1.10) yet not associated with risk for underweight, stunting, or wasting.
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Affiliation(s)
- Susannah Colt
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Cole D Miller
- University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Andrew Edielu
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Emily L Webb
- Medical Research Council International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Patrice A Mawa
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
| | - Hannah W Wu
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Racheal Nakyesige
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Edridah Muheki
- Vector Control Division, Ministry of Health, Kampala, Uganda
| | | | - Amaya L Bustinduy
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jennifer F Friedman
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Macháček T, Fuchs CD, Winkelmann F, Frank M, Scharnagl H, Stojakovic T, Sombetzki M, Trauner M. Bsep/Abcb11 knockout ameliorates Schistosoma mansoni liver pathology by reducing parasite fecundity. Liver Int 2023; 43:2469-2478. [PMID: 37641872 PMCID: PMC10947390 DOI: 10.1111/liv.15710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 07/21/2023] [Accepted: 08/11/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND AND AIMS Schistosoma mansoni infection is one of the worldwide leading causes of liver fibrosis and portal hypertension. The objective of this study was to evaluate whether polyhydroxylated bile acids (BAs), known to protect mice from the development of acquired cholestatic liver injury, counteract S. mansoni-induced inflammation and fibrosis. METHODS Adult FVB/N wild type (WT) and Abcb11/Bsep-/- mice were infected with either 25 or 50 S. mansoni cercariae. Eight weeks post infection, effects on liver histology, serum biochemistry, gene expression profile of proinflammatory cytokines and fibrotic markers, hepatic hydroxyproline content and FACS analysis were performed. RESULTS Bsep-/- mice infected with S. mansoni showed significantly less hepatic inflammation and tendentially less fibrosis compared to infected WT mice. Despite elevated alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase levels in infected Bsep-/- mice, inflammatory cells such as M2 macrophages and Mac-2/galectin-3+ cells were reduced in these animals. Accordingly, mRNA-expression levels of anti-inflammatory cytokines (IL-4 and IL-13) were increased in Bsep-/- mice upon infection. Furthermore, infected Bsep-/- mice exhibited decreased hepatic egg load and parasite fecundity, consequently affecting the worm reproduction rate. This outcome could arise from elevated serum BA levels and lower blood pH in Bsep-/- mice. CONCLUSIONS The loss of Bsep and the resulting changes in bile acid composition and blood pH are associated with the reduction of parasite fecundity, thus attenuating the development of S. mansoni-induced hepatic inflammation and fibrosis.
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Affiliation(s)
- Tomáš Macháček
- Division of Tropical Medicine and Infectious DiseasesCenter of Internal Medicine IIRostock University Medical CenterRostockGermany
- Department of ParasitologyFaculty of ScienceCharles UniversityPragueCzechia
| | - Claudia D. Fuchs
- Hans Popper Laboratory of Molecular HepatologyDivision of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria
| | - Franziska Winkelmann
- Division of Tropical Medicine and Infectious DiseasesCenter of Internal Medicine IIRostock University Medical CenterRostockGermany
| | - Marcus Frank
- Medical Biology and Electron Microscopy CenterUniversity Medical Center RostockRostockGermany
- Department LifeLight and MatterUniversity of RostockRostockGermany
| | - Hubert Scharnagl
- Clinical Institute of Medical and Chemical Laboratory DiagnosticsMedical University of GrazGrazAustria
| | - Tatjana Stojakovic
- Clinical Institute of Medical and Chemical Laboratory DiagnosticsUniversity Hospital GrazGrazAustria
| | - Martina Sombetzki
- Division of Tropical Medicine and Infectious DiseasesCenter of Internal Medicine IIRostock University Medical CenterRostockGermany
| | - Michael Trauner
- Hans Popper Laboratory of Molecular HepatologyDivision of Gastroenterology and HepatologyDepartment of Internal Medicine IIIMedical University of ViennaViennaAustria
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Rissmann M, Veldhuis Kroeze EJB, Tielens AGM, Rockx B, van Hellemond JJ. Influence of a chronic Schistosoma mansoni infection on the outcomes of a SARS-CoV-2 infection in the hamster model. J Infect 2023; 87:273-276. [PMID: 37419283 DOI: 10.1016/j.jinf.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 07/09/2023]
Affiliation(s)
- Melanie Rissmann
- Department of Viroscience, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | | | - Aloysius G M Tielens
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Barry Rockx
- Department of Viroscience, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
| | - Jaap J van Hellemond
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
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Gruninger SK, Rasamoelina T, Rakotoarivelo RA, Razafindrakoto AR, Rasolojaona ZT, Rakotozafy RM, Soloniaina PR, Rakotozandrindrainy N, Rausche P, Doumbia CO, Jaeger A, Zerbo A, von Thien H, Klein P, van Dam G, Tannich E, Schwarz NG, Lorenz E, May J, Rakotozandrindrainy R, Fusco D. Prevalence and risk distribution of schistosomiasis among adults in Madagascar: a cross-sectional study. Infect Dis Poverty 2023; 12:44. [PMID: 37098581 PMCID: PMC10127445 DOI: 10.1186/s40249-023-01094-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/09/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The goal to eliminate the parasitic disease of poverty schistosomiasis as a public health problem is aligned with the 2030 United Nations agenda for sustainable development goals, including universal health coverage (UHC). Current control strategies focus on school-aged children, systematically neglecting adults. We aimed at providing evidence for the need of shifting the paradigm of schistosomiasis control programs from targeted to generalized approaches as key element for both the elimination of schistosomiasis as a public health problem and the promotion of UHC. METHODS In a cross-sectional study performed between March 2020 and January 2021 at three primary health care centers in Andina, Tsiroanomandidy and Ankazomborona in Madagascar, we determined prevalence and risk factors for schistosomiasis by a semi-quantitative PCR assay from specimens collected from 1482 adult participants. Univariable and multivariable logistic regression were performed to evaluate odd ratios. RESULTS The highest prevalence of S. mansoni, S. haematobium and co-infection of both species was 59.5%, 61.3% and 3.3%, in Andina and Ankazomborona respectively. Higher prevalence was observed among males (52.4%) and main contributors to the family income (68.1%). Not working as a farmer and higher age were found to be protective factors for infection. CONCLUSIONS Our findings provide evidence that adults are a high-risk group for schistosomiasis. Our data suggests that, for ensuring basic health as a human right, current public health strategies for schistosomiasis prevention and control need to be re-addressed towards more context specific, holistic and integrated approaches.
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Affiliation(s)
- Sarah Katharina Gruninger
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | | | - Rivo Andry Rakotoarivelo
- Department of Infectious Diseases, University of Fianarantsoa Andrainjato, 301, Fianarantsoa, Madagascar
| | | | | | - Rodson Morin Rakotozafy
- Department of Microbiology and Parasitology, University of Antananarivo, 101, Antananarivo, Madagascar
| | | | - Njary Rakotozandrindrainy
- Department of Microbiology and Parasitology, University of Antananarivo, 101, Antananarivo, Madagascar
| | - Pia Rausche
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Cheick Oumar Doumbia
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
- University Clinical Research Centre (UCRC), University of Sciences Technics and Technologies of Bamako (USTTB), Bamako, Mali
| | - Anna Jaeger
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Alexandre Zerbo
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Heidrun von Thien
- German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
- Department of Parasitology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Philipp Klein
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Govert van Dam
- Department of Parasitology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Egbert Tannich
- National Reference Centre for Tropical Pathogens (NRC), Hamburg, Germany
| | - Norbert Georg Schwarz
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Eva Lorenz
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jürgen May
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
- Department of Tropical Medicine I, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - Daniela Fusco
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
- German Centre for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany.
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Medrano-Garcia S, Morales-Cano D, Barreira B, Vera-Zambrano A, Kumar R, Kosanovic D, Schermuly RT, Graham BB, Perez-Vizcaino F, Mathie A, Savai R, Pullamseti S, Butrous G, Fernández-Malavé E, Cogolludo A. HIV and Schistosoma Co-Exposure Leads to Exacerbated Pulmonary Endothelial Remodeling and Dysfunction Associated with Altered Cytokine Landscape. Cells 2022; 11:cells11152414. [PMID: 35954255 PMCID: PMC9368261 DOI: 10.3390/cells11152414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/19/2022] [Accepted: 07/27/2022] [Indexed: 11/27/2022] Open
Abstract
HIV and Schistosoma infections have been individually associated with pulmonary vascular disease. Co-infection with these pathogens is very common in tropical areas, with an estimate of six million people co-infected worldwide. However, the effects of HIV and Schistosoma co-exposure on the pulmonary vasculature and its impact on the development of pulmonary vascular disease are largely unknown. Here, we have approached these questions by using a non-infectious animal model based on lung embolization of Schistosoma mansoni eggs in HIV-1 transgenic (HIV) mice. Schistosome-exposed HIV mice but not wild-type (Wt) counterparts showed augmented pulmonary arterial pressure associated with markedly suppressed endothelial-dependent vasodilation, increased endothelial remodeling and vessel obliterations, formation of plexiform-like lesions and a higher degree of perivascular fibrosis. In contrast, medial wall muscularization was similarly increased in both types of mice. Moreover, HIV mice displayed an impaired immune response to parasite eggs in the lung, as suggested by decreased pulmonary leukocyte infiltration, small-sized granulomas, and augmented residual egg burden. Notably, vascular changes in co-exposed mice were associated with increased expression of proinflammatory and profibrotic cytokines, including IFN-γ and IL-17A in CD4+ and γδ T cells and IL-13 in myeloid cells. Collectively, our study shows for the first time that combined pulmonary persistence of HIV proteins and Schistosoma eggs, as it may occur in co-infected people, alters the cytokine landscape and targets the vascular endothelium for aggravated pulmonary vascular pathology. Furthermore, it provides an experimental model for the understanding of pulmonary vascular disease associated with HIV and Schistosoma co-morbidity.
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Affiliation(s)
- Sandra Medrano-Garcia
- Max Planck Institute for Heart and Lung Research, Member of the German Center for Lung Research (DZL), Member of the Cardio-Pulmonary Institute (CPI), 61231 Bad Nauheim, Germany
- Institute for Lung Health (ILH), Justus Liebig University, 35305 Giessen, Germany
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28040 Madrid, Spain
| | - Daniel Morales-Cano
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid and Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación Biomédica en Red Enfermedades Respiratorias, 28040 Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28040 Madrid, Spain
- Correspondence: (D.M.-C.); (A.C.); Tel.: +34-913947120 (A.C.)
| | - Bianca Barreira
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid and Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación Biomédica en Red Enfermedades Respiratorias, 28040 Madrid, Spain
| | - Alba Vera-Zambrano
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid and Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación Biomédica en Red Enfermedades Respiratorias, 28040 Madrid, Spain
| | - Rahul Kumar
- Department of Medicine, University of California, San Francisco, CA 94143, USA
| | - Djuro Kosanovic
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Ralph Theo Schermuly
- Department of internal Medicine, Justus-Liebig University, Member of the German Center for Lung Research (DZL), 35305 Giessen, Germany
| | - Brian B. Graham
- Department of Medicine, University of California, San Francisco, CA 94143, USA
| | - Francisco Perez-Vizcaino
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid and Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación Biomédica en Red Enfermedades Respiratorias, 28040 Madrid, Spain
| | - Alistair Mathie
- Medway School of Pharmacy, University of Kent and University of Greenwich, Chatham ME4 4BF, UK
| | - Rajkumar Savai
- Max Planck Institute for Heart and Lung Research, Member of the German Center for Lung Research (DZL), Member of the Cardio-Pulmonary Institute (CPI), 61231 Bad Nauheim, Germany
- Institute for Lung Health (ILH), Justus Liebig University, 35305 Giessen, Germany
- Department of internal Medicine, Justus-Liebig University, Member of the German Center for Lung Research (DZL), 35305 Giessen, Germany
| | - Soni Pullamseti
- Max Planck Institute for Heart and Lung Research, Member of the German Center for Lung Research (DZL), Member of the Cardio-Pulmonary Institute (CPI), 61231 Bad Nauheim, Germany
- Institute for Lung Health (ILH), Justus Liebig University, 35305 Giessen, Germany
- Department of internal Medicine, Justus-Liebig University, Member of the German Center for Lung Research (DZL), 35305 Giessen, Germany
| | - Ghazwan Butrous
- Medway School of Pharmacy, University of Kent and University of Greenwich, Chatham ME4 4BF, UK
| | - Edgar Fernández-Malavé
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28040 Madrid, Spain
| | - Angel Cogolludo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid and Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación Biomédica en Red Enfermedades Respiratorias, 28040 Madrid, Spain
- Correspondence: (D.M.-C.); (A.C.); Tel.: +34-913947120 (A.C.)
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Sang HC, Mwinzi PNM, Odiere MR, Onkanga I, Rawago F, Pillay P, Kjetland EF. Absence of lower genital tract lesions among women of reproductive age infected with Schistosoma mansoni: A cross-sectional study using a colposcope in Western Kenya. PLoS Negl Trop Dis 2022; 16:e0010473. [PMID: 35802746 PMCID: PMC9299320 DOI: 10.1371/journal.pntd.0010473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/20/2022] [Accepted: 05/06/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Female genital schistosomiasis (FGS) constitutes four different lesions known to be caused by Schistosoma haematobium ova deposited in the genital tract. Schistosoma mansoni ova may also be found in the genital tract. However, it is not known if S. mansoni causes lower genital tract lesions characteristic of FGS.
Methodology
This study was conducted in 8 villages along the shores of Lake Victoria, western Kenya. Stool and urine samples, collected from women of reproductive age on three consecutive days, were analysed for S. mansoni and S. haematobium infection. S. mansoni positive and S. haematobium negative willing participants, aged 18–50 years were invited to answer a questionnaire (demographics, symptoms), undergo a gynaecological examination and cytology specimen collection by an FGS expert.
Principal findings
Gynaecologic investigations were conducted in 147 S. mansoni-positive women who had a mean infection intensity of 253.3 epg (95% CI: 194.8–311.9 epg). Nearly 90% of them used Lake Victoria as their main water source. None were found to have cervicovaginal grainy sandy patches or rubbery papules. Homogenous yellow patches were found in 12/147 (8.2%) women. Women with homogenous yellow patches were significantly older (47 years) than the rest (34 years, p = 0.001). No association was found between intensity of S. mansoni infection and homogenous yellow patches (p = 0.70) or abnormal blood vessels (p = 0.14). S. mansoni infection intensity was not associated with genital itch, bloody or malodorous vaginal discharge.
Conclusion
S. mansoni infection was neither associated with lower genital tract lesions nor symptoms typically found in women with FGS.
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Affiliation(s)
- Huldah C. Sang
- Neglected Tropical Diseases Unit, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Pauline N. M. Mwinzi
- Neglected Tropical Diseases Unit, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Maurice R. Odiere
- Neglected Tropical Diseases Unit, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Isaac Onkanga
- Neglected Tropical Diseases Unit, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Fredrick Rawago
- Neglected Tropical Diseases Unit, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Pavitra Pillay
- Department of Biomedical and Clinical Technology, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Eyrun Floerecke Kjetland
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases Ullevaal, Oslo University Hospital, Oslo, Norway
- Discipline of Public Health, Nelson Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- * E-mail:
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9
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Dos Reis LFC, Cerdeira CD, Gagliano GS, de Figueiredo ABT, Ferreira JH, Castro AP, Souza RLM, Marques MJ. Alternate-day fasting, a high-sucrose/caloric diet and praziquantel treatment influence biochemical and behavioral parameters during Schistosoma mansoni infection in male BALB/c mice. Exp Parasitol 2022; 240:108316. [PMID: 35787384 DOI: 10.1016/j.exppara.2022.108316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/12/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022]
Abstract
Schistosoma mansoni-induced granulomas result in severe damage to the host's liver, as well as neurological and metabolic disorders. We evaluated the biochemical and behavioral changes during schistosomiasis under three diet protocols: ad libitum (AL), alternate-day fasting (ADF) and a high-sucrose/caloric diet (HSD). Healthy male BALB/c mice were divided into noninfected, matched infected and infected/treated [praziquantel (PZQ)] groups. Caloric intake and energy efficiency coefficients associated with diets were measured. Behavioral (exploratory and locomotor) and biochemical (glucose, triglycerides, total cholesterol, AST, ALT, ALP, and γ-GT) tests and histological analysis were performed. Fifteen weeks postinfection, HSD and PZQ promoted weight gain, with higher caloric consumption than ADF (p < 0.05), reflecting serum glucose levels and lipid profiles. HSD and PZQ prevented liver dysfunction (AST and ALT) and significantly prevented increases in granuloma area (p < 0.05). HSD and PZQ also significantly improved mouse physical performance in exploratory and locomotor behavior (p < 0.05), reversing the impaired motivation caused by infection. These findings showed that ADF worsened the course of S. mansoni infection, while HSD and PZQ, even with synergistic effects, prevented and/or attenuated biochemical and behavioral impairment from infection.
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Affiliation(s)
- Luis F C Dos Reis
- Department of Structural Biology, Institute of Biomedical Sciences, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais (MG), Brazil
| | - Cláudio D Cerdeira
- Department of Biochemistry, Institute of Biomedical Sciences, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais (MG), Brazil.
| | - Guilherme S Gagliano
- Department of Microbiology and Immunology, Institute of Biomedical Sciences, UNIFAL-MG, Alfenas, Minas Gerais (MG), Brazil
| | - Ana B T de Figueiredo
- Department of Pathology and Parasitology, Institute of Biomedical Sciences, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais (MG), Brazil
| | - Juliana H Ferreira
- Department of Physiology, University of Sao Paulo, São Paulo (SP), Brazil
| | - Aline P Castro
- Department of Pathology and Parasitology, Institute of Biomedical Sciences, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais (MG), Brazil
| | - Raquel L M Souza
- Department of Pathology and Parasitology, Institute of Biomedical Sciences, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais (MG), Brazil
| | - Marcos J Marques
- Department of Pathology and Parasitology, Institute of Biomedical Sciences, Federal University of Alfenas (UNIFAL-MG), Alfenas, Minas Gerais (MG), Brazil
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Nigo MM, Odermatt P, Nigo DW, Salieb-Beugelaar GB, Battegay M, Hunziker PR. Morbidity associated with Schistosoma mansoni infection in north-eastern Democratic Republic of the Congo. PLoS Negl Trop Dis 2021; 15:e0009375. [PMID: 34855763 PMCID: PMC8638987 DOI: 10.1371/journal.pntd.0009375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 04/09/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Reducing morbidity is the main target of schistosomiasis control efforts, yet only rarely do control programmes assess morbidity linked to Schistosoma sp. infection. In the Democratic Republic of Congo (DRC), and particularly in north-eastern Ituri Province, little is known about morbidity associated with Schistosoma mansoni infection. For this reason, we aimed to assess intestinal and hepatosplenic morbidity associated with S. mansoni infection in Ituri Province. METHODS/PRINCIPAL FINDINGS In 2017, we conducted a cross-sectional study in 13 villages in Ituri Province, DRC. S. mansoni infection was assessed with a Kato-Katz stool test (2 smears) and a point-of-care circulating cathodic antigen (POC-CCA) urine test. A questionnaire was used to obtain demographic data and information about experienced intestinal morbidity. Each participant underwent an abdominal ultrasonography examination to diagnose hepatosplenic morbidity. Of the 586 study participants, 76.6% tested positive for S. mansoni. Intestinal morbidity reported in the two preceding weeks was very frequent, and included abdominal pain (52.7%), diarrhoea (23.4%) and blood in the stool (21.5%). Hepatosplenic morbidity consisted of abnormal liver parenchyma patterns (42.8%), hepatomegaly (26.5%) and splenomegaly (25.3%). Liver pathology (adjusted odds ratio [aOR] 1.20, 95% confidence interval [CI] 1.06-1.37, p = 0.005) was positively and significantly associated with S. mansoni infection. Hepatomegaly (aOR 1.52, 95% CI 0.99-2.32, p = 0.053) and splenomegaly (aOR 1.12, 95% CI 0.73-1.72, p = 0.619) were positively but not significantly associated with S. mansoni infection at the individual level. At the village level, S. mansoni prevalence was positively associated with the prevalence of hepatomegaly and splenomegaly. High-intensity S. mansoni infections were associated with diarrhoea, blood in the stool, hepatomegaly, splenomegaly, and liver parenchyma (C, D, E and F pathology patterns). Four study participants were diagnosed with ascites and five reported hematemesis. CONCLUSIONS/SIGNIFICANCE Our study documents a high burden of intestinal and hepatosplenic morbidity associated with S. mansoni infection status in Ituri Province. The findings call for targeted interventions to address both S. mansoni infection and related morbidity.
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Affiliation(s)
- Maurice M. Nigo
- Nanomedicine Translation Group, Medical Intensive Care Clinic, University Hospital Basel University of Basel, Basel, Switzerland
- CLINAM—European Foundation for Clinical Nanomedicine, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Institut Supérieur des Techniques Médicales (ISTM) Nyankunde, Democratic Republic of Congo
| | - Peter Odermatt
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - David Wully Nigo
- Centre Hospitalier, Ingbokolo Town, Democratic Republic of Congo
| | - Georgette B. Salieb-Beugelaar
- Nanomedicine Translation Group, Medical Intensive Care Clinic, University Hospital Basel University of Basel, Basel, Switzerland
- CLINAM—European Foundation for Clinical Nanomedicine, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Manuel Battegay
- University of Basel, Basel, Switzerland
- Department of Infectiology & Hospital Hygiene, University Hospital Basel, Basel, Switzerland
| | - Patrick R. Hunziker
- Nanomedicine Translation Group, Medical Intensive Care Clinic, University Hospital Basel University of Basel, Basel, Switzerland
- CLINAM—European Foundation for Clinical Nanomedicine, Basel, Switzerland
- University of Basel, Basel, Switzerland
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11
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Ahmed AFM, El-Sayad MH, Ali HS, El-Taweel HA. Impact of Coinfection with Schistosoma mansoni on the Antibody Response to Helicobacter pylori. Acta Parasitol 2021; 66:857-862. [PMID: 33598776 DOI: 10.1007/s11686-020-00330-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/15/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE In many tropical areas, the coinfection of Schistosoma spp. and other pathogens is frequent. The impact of schistosomiasis on other infections has been demonstrated for several organisms. Infection with the widely spread bacterium, Helicobacter pylori, has been linked to ulcers and tumors of the digestive system with the humoral immune response playing possible modulatory roles. The present study investigated the impact of patent S. mansoni infection on the antibody response to H. pylori. METHODS A total of 100 participants from a schistosomiasis endemic area in Egypt were enrolled in the study. Based on the detection of S. mansoni eggs and H. pylori coproantigen in fecal samples, they were equally divided into four groups: schistosomiasis, concomitant S. mansoni and H. pylori infection, H. pylori infection alone, and healthy controls. Anti-H. pylori IgG and IgA were determined in serum samples using ELISA. RESULTS A significantly lower IgA seropositivity rate and significantly lower IgG levels were found in patients with concomitant schistosomiasis (Gp2) compared to those infected only with H. pylori (Gp1). CONCLUSIONS Concomitant S. mansoni infection with light to moderate intensity alters serological responses to H. pylori. In schistosomiasis endemic areas, the routine examination for H. pylori infection should, therefore, rely on coproantigen level rather than antibody levels. Further studies should investigate histopathological changes and other immunological parameters in coinfection.
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Affiliation(s)
- Ashraf Fawzy Mosa Ahmed
- Parasitology Department, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
| | - Mona Hassan El-Sayad
- Parasitology Department, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
| | - Hala Shehata Ali
- Parasitology Department, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
| | - Hend Aly El-Taweel
- Parasitology Department, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt.
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12
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Gleeson SE, Zhang X, Azar MM. Recurrent Hematochezia in a Returning Traveler. JAMA 2021; 325:1558-1559. [PMID: 33666646 DOI: 10.1001/jama.2021.0368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Shana E Gleeson
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Xuchen Zhang
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Marwan M Azar
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
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13
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Nigo MM, Odermatt P, Nigo DW, Salieb-Beugelaar GB, Battegay M, Hunziker PR. Patients with severe schistosomiasis mansoni in Ituri Province, Democratic Republic of the Congo. Infect Dis Poverty 2021; 10:39. [PMID: 33762007 PMCID: PMC7992822 DOI: 10.1186/s40249-021-00815-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 03/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Severe hepatosplenic complications arise in patients with chronic Schistosoma mansoni infection after heavy exposure to disease agents in endemic areas. These complications are rarely reported and, hence, underestimated. CASE PRESENTATION We report on eight patients with severe morbidity associated with S. mansoni infection in Ituri Province, northeastern Democratic Republic of Congo (DRC). The patients were identified during a community-based survey in 2017; one patient was seen at the district hospital. After taking the patients' history, a clinical examination and an abdominal ultrasonographical examination were performed. S. mansoni infection was diagnosed in fecal (Kato-Katz technique) and urine (point-of-case circulating cathodic antigen test) samples. These eight patients with severe intestinal and hepatosplenic complications were identified from four villages with high S. mansoni infection prevalence and related morbidity. The patients' ages ranged from 19 to 57 years; four patients were women. Three patients reported hematemesis. Two patients were severely anemic. All patients reported non-specific abdominal symptoms, such as diarrhea (six patients), abdominal pain (seven patients), and blood in the stool (five patients), as well as weight loss (two patients). Abdominal ultrasonography revealed ascites in four patients. All patients had portal hypertension with hepatomegaly (seven patients) or splenomegaly (five patients). Of the six patients with a discernable liver parenchyma pattern, five displayed pattern F and three patient displayed pattern E. Liver parenchyma was not visible for two patients with severe ascites. An S. mansoni infection was confirmed in six patients, with infection intensity ranging from light to heavy. All S. mansoni positive patients were treated with praziquantel (40 mg/kg body weight) and referred to the district hospital for follow-up. One patient with severe ascites died two weeks after we saw her. Due to security and accessibility reasons, the villages could not be visited again and the patients were lost to follow-up. CONCLUSIONS Our observations of patients with severe schistosomiasis document the severe degree of endemicity of S. mansoni in the province and suggest an urgent need for adequate schistosomiasis control measures that target vulnerable population groups and address severe complications.
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Affiliation(s)
- Maurice M Nigo
- Nanomedicine Translation Group, Intensive Care Unit, University Hospital Basel University of Basel, Petersgraben 4, 4031, Basel, Switzerland.
- CLINAM-European Foundation for Clinical Nanomedicine, Alemannengasse 12, P.O. Box, 4016, Basel, Switzerland.
- University of Basel, Petersplatz 1, Basel, Switzerland.
- Institut Supérieur Des Techniques Médicales (ISTM) Nyankunde, BP 55, Bunia, Democratic Republic of Congo.
| | - Peter Odermatt
- University of Basel, Petersplatz 1, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002, Basel, Switzerland
| | | | - Georgette B Salieb-Beugelaar
- Nanomedicine Translation Group, Intensive Care Unit, University Hospital Basel University of Basel, Petersgraben 4, 4031, Basel, Switzerland
- CLINAM-European Foundation for Clinical Nanomedicine, Alemannengasse 12, P.O. Box, 4016, Basel, Switzerland
- University of Basel, Petersplatz 1, Basel, Switzerland
| | - Manuel Battegay
- University of Basel, Petersplatz 1, Basel, Switzerland
- Department of Infectiology and Hospital Hygiene, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Patrick R Hunziker
- Nanomedicine Translation Group, Intensive Care Unit, University Hospital Basel University of Basel, Petersgraben 4, 4031, Basel, Switzerland
- CLINAM-European Foundation for Clinical Nanomedicine, Alemannengasse 12, P.O. Box, 4016, Basel, Switzerland
- University of Basel, Petersplatz 1, Basel, Switzerland
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McLaughlin TA, Nizam A, Hayara FO, Ouma GS, Campbell A, Khayumbi J, Ongalo J, Ouma SG, Shah NS, Altman JD, Kaushal D, Rengarajan J, Ernst JD, Blumberg HM, Waller LA, Gandhi NR, Day CL, Benkeser D. Schistosoma mansoni Infection Is Associated With a Higher Probability of Tuberculosis Disease in HIV-Infected Adults in Kenya. J Acquir Immune Defic Syndr 2021; 86:157-163. [PMID: 33074856 PMCID: PMC8284023 DOI: 10.1097/qai.0000000000002536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/28/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Helminth infections can modulate immunity to Mycobacterium tuberculosis (Mtb). However, the effect of helminths, including Schistosoma mansoni (SM), on Mtb infection outcomes is less clear. Furthermore, HIV is a known risk factor for tuberculosis (TB) disease and has been implicated in SM pathogenesis. Therefore, it is important to evaluate whether HIV modifies the association between SM and Mtb infection. SETTING HIV-infected and HIV-uninfected adults were enrolled in Kisumu County, Kenya, between 2014 and 2017 and categorized into 3 groups based on Mtb infection status: Mtb-uninfected healthy controls, latent TB infection (LTBI), and active TB disease. Participants were subsequently evaluated for infection with SM. METHODS We used targeted minimum loss estimation and super learning to estimate a covariate-adjusted association between SM and Mtb infection outcomes, defined as the probability of being Mtb-uninfected healthy controls, LTBI, or TB. HIV status was evaluated as an effect modifier of this association. RESULTS SM was not associated with differences in baseline demographic or clinical features of participants in this study, nor with additional parasitic infections. Covariate-adjusted analyses indicated that infection with SM was associated with a 4% higher estimated proportion of active TB cases in HIV-uninfected individuals and a 14% higher estimated proportion of active TB cases in HIV-infected individuals. There were no differences in estimated proportions of LTBI cases. CONCLUSIONS We provide evidence that SM infection is associated with a higher probability of active TB disease, particularly in HIV-infected individuals.
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Affiliation(s)
| | - Azhar Nizam
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | | | - Gregory Sadat Ouma
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Angela Campbell
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Jeremiah Khayumbi
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Joshua Ongalo
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Samuel Gurrion Ouma
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - N. Sarita Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - John D. Altman
- Emory Vaccine Center, Emory University, Atlanta, GA USA
- Department of Microbiology & Immunology, Emory University School of Medicine, Atlanta, GA USA
| | - Deepak Kaushal
- Southwest National Primate Research Center, Texas Biomedical Research Center, San Antonio, TX
| | - Jyothi Rengarajan
- Emory Vaccine Center, Emory University, Atlanta, GA USA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA USA
| | - Joel D. Ernst
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, CA USA
| | - Henry M. Blumberg
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA USA
| | - Lance A. Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Neel R. Gandhi
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA USA
| | - Cheryl L. Day
- Emory Vaccine Center, Emory University, Atlanta, GA USA
- Department of Microbiology & Immunology, Emory University School of Medicine, Atlanta, GA USA
| | - David Benkeser
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA USA
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Neves PD, Bridi RA, Ramalho JA, Jorge LB, Watanabe EH, Watanabe A, Yu L, Woronik V, Pinheiro RB, Testagrossa LA, Cavalcante LB, Malheiros DM, Dias CB, Onuchic LF. Schistosoma mansoni infection as a trigger to collapsing glomerulopathy in a patient with high-risk APOL1 genotype. PLoS Negl Trop Dis 2020; 14:e0008582. [PMID: 33119586 PMCID: PMC7595310 DOI: 10.1371/journal.pntd.0008582] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Schistosoma mansoni schistosomiasis (SM) remains a public health problem in Brazil. Renal involvement is classically manifested as a glomerulopathy, most often membranoproliferative glomerulonephritis or focal and segmental glomerulosclerosis. We report a case of collapsing glomerulopathy (CG) associated with SM and high-risk APOL1 genotype (HRG). Case report A 35-year-old male was admitted for hypertension and an eight-month history of lower-limb edema, foamy urine, and increased abdominal girth. He had a recent diagnosis of hepatosplenic SM, treated with praziquantel, without clinical improvement. Laboratory tests revealed serum creatinine 1.89mg/dL, blood urea nitrogen (BUN) 24mg/dL, albumin 1.9g/dL, cholesterol 531mg/dL, low-density lipoprotein 426mg/dL, platelets 115000/mm3, normal C3/C4, antinuclear antibody (ANA), rheumatoid factor (RF), and antineutrophil cytoplasmic antibodies (ANCA), negative serologies for hepatitis C virus (HCV) and human immunodeficiency virus (HIV), HBsAg negative and AntiHBc IgG positive, no hematuria or leukocyturia, 24 hour proteinuria 6.56g and negative serum and urinary immunofixation. Kidney biopsy established the diagnosis of CG. A treatment with prednisone was started without therapeutic response, progressing to end-stage kidney disease 19 months later. Molecular genetics investigation revealed an HRG. Conclusions This is the first report of CG associated with SM in the setting of an HRG. This case highlights the two-hit model as a mechanism for CG pathogenesis, where the high-risk APOL1 genotype exerts a susceptibility role and SM infection serves as a trigger to CG. Schistosomiasis mansoni is still a public health problem in Brazil and renal involvement is described. In such cases, a glomerulopathy is the typical manifestation, most often membranoproliferative glomerulonephritis. In the current article, we report a patient with a recent diagnosis of hepatosplenic SM who was admitted for nephrotic syndrome associated with reduced renal function and hypertension. Kidney biopsy established the diagnosis of collapsing glomerulopathy (CG) and molecular genetics investigation identified a high-risk APOL1 genotype (HRG). Of note, HRG has been associated with increased risk to develop CG, and a two-hit model has been proposed for the genesis of this glomerulopathy. According to this model, a HRG represents the increased-susceptibility component, while an infection or other environmental factors could act as triggers for the development of CG. Based on those data and model, our case raises SM infection as a new trigger for this severe form of glomerulopathy. This is the first description of a case of CG associated with SM in a patient with an HRG. This case corroborates the interactive role between genetic and environmental factors in the pathogenesis of CG but also identifies SM infection as an additional trigger for its development.
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Affiliation(s)
- Precil D. Neves
- Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil
- Division of Molecular Medicine, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Ramaiane A. Bridi
- Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Janaína A. Ramalho
- Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Lectícia B. Jorge
- Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Elieser H. Watanabe
- Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil
- Division of Molecular Medicine, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Andreia Watanabe
- Division of Molecular Medicine, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Luis Yu
- Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Viktoria Woronik
- Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Rafaela B. Pinheiro
- Division of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil
| | | | - Lívia B. Cavalcante
- Division of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Denise M. Malheiros
- Division of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Cristiane B. Dias
- Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Luiz F. Onuchic
- Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil
- Division of Molecular Medicine, University of São Paulo School of Medicine, São Paulo, Brazil
- * E-mail:
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16
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Bochner AF, Baeten JM, Secor WE, van Dam GJ, Szpiro AA, Njenga SM, Corstjens PLAM, Newsam A, Mugo NR, Celum C, Mujugira A, McClelland RS, Barnabas RV. Associations between schistosomiasis and HIV-1 acquisition risk in four prospective cohorts: a nested case-control analysis. J Int AIDS Soc 2020; 23:e25534. [PMID: 32585078 PMCID: PMC7316390 DOI: 10.1002/jia2.25534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 04/08/2020] [Accepted: 05/04/2020] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Globally, schistosomes infect approximately 200 million people, with 90% of infections in sub-Saharan Africa. Schistosomiasis is hypothesized to increase HIV-1 acquisition risk, and multiple cross-sectional studies reported strong associations. We evaluated this hypothesis within four large prospective cohorts. METHODS We conducted nested case-control analyses within three longitudinal cohorts of heterosexual HIV-1 serodiscordant couples and one female sex worker (FSW) cohort from Kenya and Uganda. The serodiscordant couples studies were conducted between 2004 and 2012 while the FSW cohort analysis included participant follow-up from 1993 to 2014. Cases HIV-1 seroconverted during prospective follow-up; three controls were selected per case. The presence of circulating anodic antigen in archived serum, collected prior to HIV-1 seroconversion, identified participants with active schistosomiasis; immunoblots determined the schistosome species. Data from serodiscordant couples cohorts were pooled, while the FSW cohort was analysed separately to permit appropriate confounder adjustment. RESULTS We included 245 HIV-1 seroconverters and 713 controls from the serodiscordant couples cohorts and 330 HIV-1 seroconverters and 962 controls from the FSW cohort. The prevalence of active schistosomiasis was 20% among serodiscordant couples and 22% among FSWs. We found no association between schistosomiasis and HIV-1 acquisition risk among males (adjusted odds ratio (aOR) = 0.99, 95% CI 0.59 to 1.67) or females (aOR = 1.21, 95% CI 0.64 to 2.30) in serodiscordant couples. Similarly, in the FSW cohort we detected no association (adjusted incidence rate ratio (aIRR) = 1.11, 95% CI 0.83 to 1.50). Exploring schistosome species-specific effects, there was no statistically significant association between HIV-1 acquisition risk and Schistosoma mansoni (serodiscordant couples: aOR = 0.90, 95% CI 0.56 to 1.44; FSW: aIRR = 0.83, 95% CI 0.53 to 1.20) or Schistosoma haematobium (serodiscordant couples: aOR = 1.06, 95% CI 0.46 to 2.40; FSW: aIRR = 1.64, 95% CI 0.93 to 2.87) infection. CONCLUSIONS Schistosomiasis was not a strong risk factor for HIV-1 acquisition in these four prospective studies. S. mansoni was responsible for the majority of schistosomiasis in these cohorts, and our results do not support the hypothesis that S. mansoni infection is associated with increased HIV-1 acquisition risk. S. haematobium infection was associated with a point estimate of elevated HIV-1 risk in the FSW cohort that was not statistically significant, and there was no trend towards a positive association in the serodiscordant couples cohorts.
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Affiliation(s)
- Aaron F Bochner
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
| | - Jared M Baeten
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
- School of MedicineUniversity of WashingtonSeattleWAUSA
| | - W Evan Secor
- Division of Parasitic Diseases and MalariaCenter for Global HealthCenters for Disease Control and PreventionAtlantaGAUSA
| | - Govert J van Dam
- Department of ParasitologyLeiden University Medical CenterLeidenthe Netherlands
| | - Adam A Szpiro
- Department of BiostatisticsUniversity of WashingtonSeattleWAUSA
| | | | - Paul L A M Corstjens
- Department of Cell and Chemical BiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Austin Newsam
- Division of Parasitic Diseases and MalariaCenter for Global HealthCenters for Disease Control and PreventionAtlantaGAUSA
| | - Nelly R Mugo
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
- Kenya Medical Research InstituteNairobiKenya
| | - Connie Celum
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
- School of MedicineUniversity of WashingtonSeattleWAUSA
| | - Andrew Mujugira
- Infectious Diseases InstituteCollege of Health SciencesMakerere UniversityKampalaUganda
| | - R Scott McClelland
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
- School of MedicineUniversity of WashingtonSeattleWAUSA
| | - Ruanne V Barnabas
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
- School of MedicineUniversity of WashingtonSeattleWAUSA
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Sui M, Tang W, Wu C, Yang J, Liu H, Huang C, Hu X, Xia D, Yang Y. Delayed esophagopleural fistula after endoscopic injection sclerotherapy for esophageal varices: A case report. Medicine (Baltimore) 2020; 99:e18806. [PMID: 32011485 PMCID: PMC7220033 DOI: 10.1097/md.0000000000018806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Esophagopleural fistula (EPF) is a rare critical life-threatening condition that features high misdiagnosis rate. Although various surgical and conservative techniques have been developed for the treatment of EPF, the mortality rate of EPF remains high. PATIENT CONCERNS An 81-year-old man with hepatic cirrhosis caused by schistosomiasis was admitted with upper gastrointestinal bleeding. DIAGNOSES Upper endoscopy revealed bleeding large esophageal varices, and endoscopic injection sclerotherapy (EIS) was performed. Two weeks after the EIS was performed, the patient developed pyrexia, left-sided pleuritic chest pain. Air and pleural effusion were showed in the left pleural cavity by high-resolution computed tomography (HRCT), and a linear fistulous communication was noticed from the distal esophagus. These findings were consistent with hepatic cirrhosis, esophageal varices, upper gastrointestinal bleeding, and esophagopleural fistula. INTERVENTIONS The patient was intensively treated with endoscopic self-expandable metallic stent (covered-SEMS) implantation and comprehensive treatments (including thoracic closed drainage, antibiotics, nasojejunal nutrition, and antacids). OUTCOMES The patient was completely cured without recurrence during a 6 months of follow-up by comprehensive conservative treatments. LESSONS This case indicates that pleural effusion with food residue is a specific finding in EPF. Thorax CT exhibited high sensitivity for the diagnosis of EPF. Endoscopic self-expandable metallic stent implantation and comprehensive conservative treatments may be preferable for the severe liver disease with EPF.
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Cai P, Mu Y, Olveda RM, Ross AG, Olveda DU, McManus DP. Circulating miRNAs as footprints for liver fibrosis grading in schistosomiasis. EBioMedicine 2018; 37:334-343. [PMID: 30482723 PMCID: PMC6286190 DOI: 10.1016/j.ebiom.2018.10.048] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 10/03/2018] [Accepted: 10/18/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Chronic infection with Schistosoma japonicum or S. mansoni results in hepatic fibrosis of the human host. Staging fibrosis is crucial for the prognosis and to determine the rapid need of treatment in patients with schistosomiasis. METHODS To establish whether there is a correlation between circulating microRNA (miRNA) level and fibrosis progression in schistosomiasis, ten miRNAs were selected to assess their potential in grading schistosomiasis liver fibrosis. This was done firstly in two mouse strains (C57BL/6 and BALB/c) to determine the temporal expression profiles in serum over the course of S. japonicum infection, and then within a cohort of 163 schistosomiasis japonica patients with different grades of liver fibrosis. FINDING Four miRNAs (miR-150-5p, let-7a-5p, let-7d-5p and miR-146a-5p) were able to distinguish patients with mild versus severe fibrosis. The level of serum miR-150-5p showed the most promising potential for grading hepatic fibrosis in schistosomiasis. The diagnostic performance of miR-150-5p in discriminating mild from severe fibrosis is comparable with that of the ELF test and serum HA level. In addition, the serum levels of the four miRNAs rebounded in infected C57BL/6 mice, after 6 months post treatment, following the regression of liver fibrosis, thereby providing further support for the utility of these miRNAs in grading schistosomal hepatic fibrosis. INTERPRETATION Circulating miRNAs can be a supplementary tool for assessing hepatic fibrosis in human schistosomiasis. FUND: National Health and Medical Research Council (NHMRC) of Australia (APP1102926, APP1037304 and APP1098244).
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Affiliation(s)
- Pengfei Cai
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
| | - Yi Mu
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Remigio M Olveda
- Department of Health, Research Institute for Tropical Medicine, Manila, Philippines
| | - Allen G Ross
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; icddr b, Dhaka, Bangladesh
| | - David U Olveda
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Donald P McManus
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
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Valice EM, Wiegand RE, Mwinzi PNM, Karanja DMS, Williamson JM, Ochola E, Samuels A, Verani JR, Leon JS, Secor WE, Montgomery SP. Relative Contribution of Schistosomiasis and Malaria to Anemia in Western Kenya. Am J Trop Med Hyg 2018; 99:713-715. [PMID: 29988002 PMCID: PMC6169184 DOI: 10.4269/ajtmh.18-0069] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/04/2018] [Indexed: 02/04/2023] Open
Abstract
Because anemia is one of the markers of morbidity associated with schistosomiasis, it has been proposed as a potential measure to evaluate the impact of control programs. However, anemia is also a common consequence of malaria, and schistosomiasis and malaria are often co-endemic. To estimate the attributable fraction of anemia due to Schistosoma mansoni and Plasmodium falciparum infections, we applied a log-binomial model to four studies measuring these parameters of a combined 5,849 children in western Kenya. In our studies, malaria contributed 23.3%, schistosomiasis contributed 6.6%, and co-infection contributed 27.6% of the anemia. We conclude that in areas where S. mansoni and P. falciparum are co-endemic, the contribution of schistosomiasis to anemia is masked by anemia resulting from malaria, thus limiting anemia as a useful measure for schistosomiasis control programs in these settings.
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Affiliation(s)
- Emily M. Valice
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ryan E. Wiegand
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Pauline N. M. Mwinzi
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Diana M. S. Karanja
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - John M. Williamson
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth Ochola
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Aaron Samuels
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer R. Verani
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Juan S. Leon
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - W. Evan Secor
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan P. Montgomery
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
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Abstract
Case reports and pathology series suggest associations of female genital schistosomiasis (Schistosoma haematobium) with infertility and ectopic pregnancy. Differential geographic distribution of infertility is not explained by analyses of known risk factors. In this cross-sectional multilevel semi-ecologic study, interpolated prevalence maps for S. haematobium and Schistosoma mansoni in East Africa were created using data from two open-access Neglected Tropical Diseases Databases. Prevalence was extracted to georeferenced survey sample points for Demographic and Health Surveys for Ethiopia, Kenya, Tanzania, and Uganda for 2000 and 2010. Exploratory spatial analyses showed that infertility was not spatially random and mapped the clustering of infertility and its co-location with schistosomiasis. Multilevel logistic regression analysis demonstrated that women living in high compared with absent S. haematobium locations had significantly higher odds of infertility (2000 odds ratio [OR] = 1.5 [confidence interval95 = 1.3, 1.8]; 2010 OR = 1.2 [1.1, 1.5]). Women in high S. haematobium compared with high S. mansoni locations had significantly higher odds of infertility (2000 OR 1.4 [1.1, 1.9]; 2010 OR 1.4 [1.1, 1.8]). Living in high compared with absent S. mansoni locations did not affect the odds of infertility. Infertility appears to be associated spatially with S. haematobium.
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Affiliation(s)
- Patricia A. Woodall
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Michael R. Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
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Moriyasu T, Nakamura R, Deloer S, Senba M, Kubo M, Inoue M, Culleton R, Hamano S. Schistosoma mansoni infection suppresses the growth of Plasmodium yoelii parasites in the liver and reduces gametocyte infectivity to mosquitoes. PLoS Negl Trop Dis 2018; 12:e0006197. [PMID: 29373600 PMCID: PMC5802944 DOI: 10.1371/journal.pntd.0006197] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 02/07/2018] [Accepted: 12/28/2017] [Indexed: 11/19/2022] Open
Abstract
Malaria and schistosomiasis are major parasitic diseases causing morbidity and mortality in the tropics. Epidemiological surveys have revealed coinfection rates of up to 30% among children in Sub-Saharan Africa. To investigate the impact of coinfection of these two parasites on disease epidemiology and pathology, we carried out coinfection studies using Plasmodium yoelii and Schistosoma mansoni in mice. Malaria parasite growth in the liver following sporozoite inoculation is significantly inhibited in mice infected with S. mansoni, so that when low numbers of sporozoites are inoculated, there is a large reduction in the percentage of mice that go on to develop blood stage malaria. Furthermore, gametocyte infectivity is much reduced in mice with S. mansoni infections. These results have profound implications for understanding the interactions between Plasmodium and Schistosoma species, and have implications for the control of malaria in schistosome endemic areas. Malaria and schistosomiasis are parasitic infectious diseases that cause severe morbidity and mortality in the tropics. Chronic schistosomiasis causes malnutrition and impaired intellectual development to children while malaria can cause fatal acute infections. Since coinfection of these two parasites is common in the tropics, many studies of both epidemiology and coinfection in animal models have been performed in order to reveal interactions between them. Previous animal studies on the interactions between Plasmodium and Schistosoma parasites have focused on the blood stage pathology of the malaria infection, and have consistently shown that parasitaemia can be enhanced in the presence of the helminth. In contrast, we focused on liver immunopathology in mice during coinfection between with Schistosoma and Plasmodium. We show that S. mansoni infection inhibits Plasmodium parasite growth in the liver resulting in a large reduction in the percentage of mice that go on to develop blood stage malaria following inoculation of low numbers of sporozoites. We also demonstrate that gametocyte infectivity is much reduced in mice with S. mansoni infections. Our results imply that S. mansoni infection can reduce malaria transmission both from mosquitoes to mice, and from mice to mosquitoes.
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Affiliation(s)
- Taeko Moriyasu
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Risa Nakamura
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Sharmina Deloer
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Masachika Senba
- Pathology Unit, Department of Pathology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Masato Kubo
- Laboratory for Cytokine Regulation, Research Center for Integrative Medical Science (IMS), RIKEN Yokohama Institute, Yokohama, Japan
- Division of Molecular Pathology, Research Institute for Biomedical Science, Tokyo University of Science, Noda, Japan
| | - Megumi Inoue
- Malaria Unit, Department of Pathology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Richard Culleton
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Malaria Unit, Department of Pathology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- * E-mail: (RC); (SH)
| | - Shinjiro Hamano
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- * E-mail: (RC); (SH)
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Marti AI, Colombe S, Masikini PJ, Kalluvya SE, Smart LR, Wajanga BM, Jaka H, Peck RN, Downs JA. Increased hepatotoxicity among HIV-infected adults co-infected with Schistosoma mansoni in Tanzania: A cross-sectional study. PLoS Negl Trop Dis 2017; 11:e0005867. [PMID: 28817570 PMCID: PMC5574610 DOI: 10.1371/journal.pntd.0005867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 08/29/2017] [Accepted: 08/10/2017] [Indexed: 12/05/2022] Open
Abstract
Introduction Little is known about hepatotoxicity in patients with schistosome and HIV co-infections. Several studies have reported increased liver enzymes and bilirubin levels associated with schistosome infection. We investigated whether HIV-infected adults on antiretroviral therapy who had S. mansoni co-infection had a higher prevalence of hepatotoxicity than those without. Methodology/Principal findings We determined the presence and grade of hepatotoxicity among 305 HIV-infected outpatients who had been on medium-term (3–6 months) and long-term (>36 months) antiretroviral therapy in a region of northwest Tanzania where S. mansoni is hyperendemic. We used the AIDS Clinical Trial Group definition to define mild to moderate hepatotoxicity as alanine aminotransferase, alanine aminotransferase, and/or bilirubin elevations of grade 1 or 2, and severe hepatotoxicity as any elevation of grade 3 or 4. We determined schistosome infection status using the serum circulating cathodic antigen rapid test and used logistic regression to determine factors associated with hepatotoxicity. The prevalence of mild-moderate and severe hepatotoxicity was 29.6% (45/152) and 2.0% (3/152) in patients on medium-term antiretroviral therapy and 19.6% (30/153) and 3.3% (5/153) in the patients on long-term antiretroviral therapy. S. mansoni infection was significantly associated with hepatotoxicity on univariable analysis and after controlling for other factors associated with hepatotoxicity including hepatitis B or C and anti-tuberculosis medication use (adjusted odds ratio = 3.0 [1.6–5.8], p = 0.001). Conclusions/Significance Our work demonstrates a strong association between S. mansoni infection and hepatotoxicity among HIV-infected patients on antiretroviral therapy. Our study highlights the importance of schistosome screening and treatment for patients starting antiretroviral therapy in schistosome-endemic settings. Additional studies to determine the effects of schistosome-HIV co-infections are warranted. Schistosoma sp. are parasitic worms that infect at least 218 million people worldwide. Over 90% of these individuals live in Africa, where HIV infection is also endemic. Schistosome worms lay eggs that damage the gastrointestinal and genitourinary tracts, causing extensive morbidity and mortality. Patients who have HIV and Schistosoma mansoni co-infections are at risk for damage to the liver due to both the effects of the schistosome parasite and the side-effects of antiretroviral therapy. However, little is known about the additional liver effects of schistosome infection in patients already taking antiretroviral therapy. Therefore, we conducted a study in northwest Tanzania, where our prior work has shown that approximately one-third of HIV-infected patients also have schistosome infections, to investigate the effect of co-infection with Schistosoma mansoni on liver damage in patients taking antiretroviral therapy. We studied 305 HIV-infected outpatients on medium and long-term antiretroviral therapy and determined both liver damage and S.mansoni infection in those patients. We found that among patients on antiretroviral therapy, those with HIV-schistosome co-infection were 3 times more likely to have liver damage than those with HIV infection alone. Our work shows the importance of screening and treating for Schistosoma mansoni to decrease the risk of liver damage in patients infected with HIV.
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Affiliation(s)
- Amon I. Marti
- Catholic University of Health and Allied Sciences and Bugando Medical Centre, Mwanza, Tanzania
| | - Soledad Colombe
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York, United States of America
- * E-mail:
| | - Peter J. Masikini
- Catholic University of Health and Allied Sciences and Bugando Medical Centre, Mwanza, Tanzania
| | - Samuel E. Kalluvya
- Catholic University of Health and Allied Sciences and Bugando Medical Centre, Mwanza, Tanzania
| | - Luke R. Smart
- Catholic University of Health and Allied Sciences and Bugando Medical Centre, Mwanza, Tanzania
| | - Bahati M. Wajanga
- Catholic University of Health and Allied Sciences and Bugando Medical Centre, Mwanza, Tanzania
| | - Hyasinta Jaka
- Catholic University of Health and Allied Sciences and Bugando Medical Centre, Mwanza, Tanzania
| | - Robert N. Peck
- Catholic University of Health and Allied Sciences and Bugando Medical Centre, Mwanza, Tanzania
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York, United States of America
| | - Jennifer A. Downs
- Catholic University of Health and Allied Sciences and Bugando Medical Centre, Mwanza, Tanzania
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, New York, United States of America
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Gouveia LR, Santos JC, Silva RD, Batista AD, Domingues ALC, Lopes EPDA, Silva RO. Diagnosis of coinfection by schistosomiasis and viral hepatitis B or C using 1H NMR-based metabonomics. PLoS One 2017; 12:e0182196. [PMID: 28763497 PMCID: PMC5538707 DOI: 10.1371/journal.pone.0182196] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/13/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Diagnosis of liver involvement due to schistosomiasis in asymptomatic patients from endemic areas previously diagnosed with chronic hepatitis B (HBV) or C (HCV) and periportal fibrosis is challenging. H-1 Nuclear Magnetic Resonance (NMR)-based metabonomics strategy is a powerful tool for providing a profile of endogenous metabolites of low molecular weight in biofluids in a non-invasive way. The aim of this study was to diagnose periportal fibrosis due to schistosomiasis mansoni in patients with chronic HBV or HCV infection through NMR-based metabonomics models. METHODOLOGY/PRINCIPAL FINDINGS The study included 40 patients divided into two groups: (i) 18 coinfected patients with schistosomiasis mansoni and HBV or HCV; and (ii) 22 HBV or HCV monoinfected patients. The serum samples were analyzed through H-1 NMR spectroscopy and the models were based on Principal Component Analysis (PCA) and Partial Least Squares-Discriminant Analysis (PLS-DA). Ultrasonography examination was used to ascertain the diagnosis of periportal fibrosis. Exploratory analysis showed a clear separation between coinfected and monoinfected samples. The supervised model built from PLS-DA showed accuracy, R2 and Q2 values equal to 100%, 98.1% and 97.5%, respectively. According to the variable importance in the projection plot, lactate serum levels were higher in the coinfected group, while the signals attributed to HDL serum cholesterol were more intense in the monoinfected group. CONCLUSIONS/SIGNIFICANCE The metabonomics models constructed in this study are promising as an alternative tool for diagnosis of periportal fibrosis by schistosomiasis in patients with chronic HBV or HCV infection from endemic areas for Schistosoma mansoni.
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Affiliation(s)
- Liana Ribeiro Gouveia
- Postgraduate Program in Chemistry, Fundamental Chemistry Department, Center for Exact and Natural Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Joelma Carvalho Santos
- Postgraduate Program in Tropical Medicine, Center for Health Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Ronaldo Dionísio Silva
- Postgraduate Program in Chemistry, Fundamental Chemistry Department, Center for Exact and Natural Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Andrea Dória Batista
- Postgraduate Program in Tropical Medicine, Center for Health Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Department of Internal Medicine, Hospital das Clínicas, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Ana Lúcia Coutinho Domingues
- Postgraduate Program in Tropical Medicine, Center for Health Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Edmundo Pessoa de Almeida Lopes
- Postgraduate Program in Tropical Medicine, Center for Health Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Department of Internal Medicine, Hospital das Clínicas, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Ricardo Oliveira Silva
- Postgraduate Program in Chemistry, Fundamental Chemistry Department, Center for Exact and Natural Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
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Ocama P, Opio KC, Seremba E, Ajal P, Apica BS, Aginya EO. The burden, pattern and factors that contribute to periportal fibrosis in HIV-infected patients in an S. mansoni endemic rural Uganda. Afr Health Sci 2017; 17:301-307. [PMID: 29062323 DOI: 10.4314/ahs.v17i2.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Both Human Immunodeficiency Virus (HIV) and S.mansoni infections are common in Uganda and can cause liver disease. No study has determined co-infection significance in Uganda. We carried out a study on the burden, pattern and factors that contribute to peri-portal fibrosis (PPF) in HIV infected patients attending a Primary healthcare setting at Pakwach. METHODOLOGY We conducted a cross-sectional study in the HIV clinic at Pakwach health centre IV. Data on demographics, contact with the Nile, CD4+ cell count, ART and alcohol use were collected. Urinary Circulating Cathodic Antigen (CCA), was done for S. Mansoni detection. Liver scan was done for presence and pattern of PPF. HBsAg testing was performed on all participants. Data was analyzed using Stata Version 10. RESULTS We enrolled 299 patients, median age 39 years (IQR 16), most were female, 210 (73%). Overall, 206 (68.9%) had PPF, majority 191 (92.7%) had pattern c, either alone (63 participants) or in combination with pattern d (128 participants). Age of 30-50 years was significantly associated with PPF (OR 2.28 p-value-0.003). CONCLUSION We found high prevalence of S. mansoni and PPF in the HIV infected population and age was a significant factor for PPF. We recommend all HIV infected patients be examined routinely for S. mansoni infection for early anti-schistosomal treatment.
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Affiliation(s)
- Ponsiano Ocama
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Emmanuel Seremba
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Paul Ajal
- Pakwach Health Centre IV, Pakwach, Nebbi District, Uganda
| | - Betty Stephanie Apica
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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Gonçalves-Macedo L, Domingues ALC, Lopes EP, Luna CF, Mota VG, Becker MMDC, Markman-Filho B. Pulmonary shunts in severe hepatosplenic schistosomiasis: Diagnosis by contrast echocardiography and their relationship with abdominal ultrasound findings. PLoS Negl Trop Dis 2017; 11:e0005417. [PMID: 28369056 PMCID: PMC5391128 DOI: 10.1371/journal.pntd.0005417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 04/13/2017] [Accepted: 02/16/2017] [Indexed: 12/31/2022] Open
Abstract
Background Schistosomiasis is endemic to several parts of the world. Among the species that affect humans, Schistosoma mansoni is one of the most common causes of illness. In regions where schistosomiasis mansoni is endemic, reinfection is responsible for the emergence of hepatosplenic schistosomiasis (HSS) with portal hypertension in about 10% of infected individuals. Regardless of its etiology, portal hypertension may bring about the formation of arteriovenous fistulas and pulmonary vascular dilation, thus constituting a pulmonary shunt and its presence has been associated with the occurrence of neurological complications. The objective of this study was to identify pulmonary shunt using TTCE in patients with HSS and esophageal varices, and to compare the abdominal ultrasound and endoscopy findings among patients with and without pulmonary shunt. Methodology/Principal findings In this case series, a total of 461 patients with schistosomiasis mansoni were prospectively evaluated using abdominal ultrasound and endoscopy and 71 presented with HSS with esophageal varices. Fifty seven patients remained in the final analysis. The mean age of the patients was 55 ± 14 years, and 65% were female. Pulmonary shunts were observed in 19 (33.3%) patients. On comparing the groups with and without pulmonary shunt, no significant differences were observed in relation to the abdominal ultrasound and endoscopic findings. When comparing the two subgroups with pulmonary shunts (grade 1 vs grades 2 and 3), it was observed that the subgroup with shunt grades 2 and 3 presented with a significantly higher frequency of an enlarged splenic vein diameter (>0.9 cm), and an advanced pattern of periportal hepatic fibrosis (P = 0.041 and P = 0.005, respectively). None of the patients with pulmonary shunts had severe neurological complications. Conclusions/Significance Our findings suggest that in HSS with esophageal varices the pulmonary shunts may be present in higher grades and that in this condition it was associated with ultrasound findings compatible with advanced HSS. Among the species of Schistosoma that infect humans Schistosoma mansoni is one of the most common causes of illness. In the areas where schistosomiasis mansoni is endemic, around 10% of infected individuals develop hepatosplenic schistosomiasis (HSS) with portal hypertension. Portal hypertension may promotes an imbalance in the hepatic production of vasoactive substances, which may act on the lungs promoting the formation of arteriovenous fistulas and pulmonary vascular dilation, a condition that is called a pulmonary shunt. When the pulmonary shunt is of higher grades, small thrombus or septic emboli that would normally be filtered through the pulmonary capillaries reach the left heart and the systemic circulation, which can lead to neurological complications. We found pulmonary shunts in patients with HSS and esophageal varices and we also found that patients with higher grades of pulmonary shunts presented with a significantly higher frequency of advanced periportal fibrosis and an enlarged splenic vein diameter. No neurological complications were observed. Our findings suggest that pulmonary shunts may be present in patients with HSS and esophageal varices. The abdominal ultrasound findings compatible with advanced HSS could be used as screening to investigate pulmonary shunt.
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Affiliation(s)
- Liana Gonçalves-Macedo
- Graduate Program in Tropical Medicine, Universidade Federal de Pernambuco, Recife, Brazil
- * E-mail:
| | - Ana Lucia Coutinho Domingues
- Department of Clinical Medicine, Universidade Federal de Pernambuco, Recife, Brazil
- Center for Gastroenterology and Hepatology, Universidade Federal de Pernambuco, Recife, Brazil
| | - Edmundo Pessoa Lopes
- Department of Clinical Medicine, Universidade Federal de Pernambuco, Recife, Brazil
- Center for Gastroenterology and Hepatology, Universidade Federal de Pernambuco, Recife, Brazil
| | - Carlos Feitosa Luna
- Laboratory of Quantitative Health Methods, Fundação Oswaldo Cruz (Fiocruz), Recife, Brazil
| | - Vitor Gomes Mota
- Department of Clinical Medicine, Universidade Federal de Pernambuco, Recife, Brazil
- Center for Cardiology and Echocardiography, Universidade Federal de Pernambuco, Recife, Brazil
| | - Mônica Moraes de Chaves Becker
- Department of Clinical Medicine, Universidade Federal de Pernambuco, Recife, Brazil
- Center for Cardiology and Echocardiography, Universidade Federal de Pernambuco, Recife, Brazil
| | - Brivaldo Markman-Filho
- Department of Clinical Medicine, Universidade Federal de Pernambuco, Recife, Brazil
- Center for Cardiology and Echocardiography, Universidade Federal de Pernambuco, Recife, Brazil
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Ahmed NS, Mahmoud SF, El-Samman MK, Khalifa RMA. HISTOPATHOLOGICAL ANALYSIS OF SCHISTOSOMIASIS IN THE GASTROINTESTINAL TRACT WITH FIRST RECORD OF SCHISTOSOMAL APPENDICITIS FROM SOHAG, UPPER EGYPT. J Egypt Soc Parasitol 2017; 47:13-18. [PMID: 30157328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Schistosomiasis is a chronic granulomatous inflammation that affects many systems in the body including the gastrointestinal tract. Appendiceal schistosomiasis is also described and can be a precursor lesion of schistosomal appendicitis. The present study was done to make a retrospective analysis of histopathological changes in the gastrointestinal tract affected by Sckistosoma mansoni among patients attending Sohag University Hospital, Sohag Governorate between June 2013 and June 2016. A total of 150 colon and 30 appendix specimens were collected through out the period from male infected pa- tients aged between 35-50 years and suffering from abdominal pain and dysentery. Histopathological examination of the tissue biopsies was performed. 5p tissue sections were prepared and examined microscopically. Ten specimens were documented to have intestinal schistosomiasis, nine of the colon 9/150 (6%) were diagnosed as chronic schistosomal colitis and one of the appendix 1/30 (3.3%) as chronic schistosomal appendicitis. Microphotographs of the tissue sections were prepared for histopathological observations. Histopathological examination of all specimens revealed degenerated pinkish and calcified bluish bilharzial eggs in the submucosa and even musculosa with surrounding granulomatous reaction. Bilharzial polyps of the colon were detected in two specimens (20%) and bilharzial worms within venules of the muscle layer in two specimens (20%). During the present study, S. mansoni was documented as a not uncommon cause of chronic colitis and for the first time from Sohag as a cause of chronic appendicitis. All specimens did not show any malignant or premalignant cells.
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Dos Santos VM. Caput Medusae due to portal hypertension in schistosomiasis mansoni. Rev Gastroenterol Peru 2017; 37:94-95. [PMID: 28489845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A 62-year-old Brazilian man who lived in endemic areas of tropical diseases had an episode of hematemesis associated with portal hypertension. He used to swim in natural ponds during childhood and developed the hepatosplenic form of schistossomiasis with moderate ascites, in addition to the characteristic features of abdominal Caput Medusae. The aim of the report is highlight the role of chronic liver disease and schistossomiasis.
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Kinung’hi S, Magnussen P, Kaatano G, Olsen A. Infection with Schistosoma mansoni has an Effect on Quality of Life, but not on Physical Fitness in Schoolchildren in Mwanza Region, North-Western Tanzania: A Cross-Sectional Study. PLoS Negl Trop Dis 2016; 10:e0005257. [PMID: 28027317 PMCID: PMC5222294 DOI: 10.1371/journal.pntd.0005257] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 01/09/2017] [Accepted: 12/14/2016] [Indexed: 01/19/2023] Open
Abstract
Background Infection with Schistosoma mansoni negatively impact children’s physical health and may influence their general well-being. The aim of this study was to investigate the effect of S. mansoni infections on a panel of morbidity indicators with emphasis on quality of life (PedsQL; measured in four different dimensions) and physical fitness (measured as VO2 max) among 572 schoolchildren aged 7–8 years. Methodology/Principal findings Prevalence of S. mansoni infections was 58.7%, with an arithmetic mean (95% CI) among positives of 207.3 (169.2–245.4) eggs per gram (epg). Most infections were light (56.5%), while 16.4% had heavy infections. Girls had significantly higher arithmetic mean intensities (95% CI) than boys (247.4 (189.2–305.6) vs. 153.2 (110.6–195.8); P = 0.004). A total of 30.1% were anaemic with no sex difference. Stunting and wasting was found in less than 10% of the population. There was no association between S. mansoni prevalence or intensities and the following parameters: anthropometry, anaemia, liver or spleen pathology in neither univariable nor multivariable linear regression analyses. However, in univariable analyses children with S. mansoni infection had a significantly lower score in emotional PedsQL (95% CI) than uninfected (77.3 (74.5–80.1) vs. 82.7 (79.9–85.5); P = 0.033) and infected children had a higher VO2 max (95% CI) compared to uninfected (51.4 (51.0–51.8) vs. 50.8 (50.3–51.3); P = 0.042). In multivariable linear regression analyses, age, S. mansoni infection, haemoglobin and VO2 max were significant predictors for emotional PedsQL while significant predictors for VO2 max were physical PedsQL, height, age and haemoglobin. S. mansoni infection was thus not retained in the multivariable regression analyses on VO2 max. Conclusions/Significance Of the measured morbidity parameters, S. mansoni infection had a significant effect on the emotional dimension of quality of life, but not on physical fitness. If PedsQL should be a useful tool to measure schistosome related morbidity, more in depth studies are needed in order to refine the tool so it focuses more on aspects of quality of life that may be affected by schistosome infections. Millions of school-age children in Tanzania are infected with Schistosoma mansoni which have an impact on their physical health by reducing growth and fitness, causing anaemia and liver and spleen pathology. Apart from these measurable physical parameters, self-rating of well-being by administration of quality of life questionnaires has been proposed for measuring schistosome related morbidity. A total of 572 schoolchildren aged 7–8 years were examined for S. mansoni infection, anaemia, malnutrition and liver/spleen enlargement. Furthermore, the children participated in a 20 metres shuttle run fitness test and answered a quality of life questionnaire for children. While there was no association between S. mansoni prevalence or intensities and anaemia, malnutrition, fitness or organ enlargement, S. mansoni infected children had a significantly lower self-perceived emotional quality of life. Thus, infected children were more often scared, sad, angry or worried about their future compared to their uninfected peers. More in depth studies are needed in order to refine the questionnaire so it focuses more on aspects of quality of life that may be affected by schistosome infections.
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Affiliation(s)
- Safari Kinung’hi
- National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
| | - Pascal Magnussen
- Parasitology and Aquatic Diseases, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Centre for Medical Parasitology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Godfrey Kaatano
- National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
| | - Annette Olsen
- Parasitology and Aquatic Diseases, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
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Dkhil MA, Khalil MF, Bauomy AA, Diab MS, Al-Quraishy S. Efficacy of Gold Nanoparticles against Nephrotoxicity Induced by Schistosoma mansoni Infection in Mice. Biomed Environ Sci 2016; 29:773-781. [PMID: 27998383 DOI: 10.3967/bes2016.104] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 11/02/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE In this study, the ameliorative effects of gold nanoparticles (gold NP) on the renal tissue damage in Schistosoma mansoni (S. mansoni)-infected mice was investigated. METHODS High-resolution transmission electron microscopy was used for the characterization of NP. The gold NP at concentrations of 250, 500, and 1000 μg/kg body weight were inoculated into S. mansoni-infected mice. RESULTS The parasite caused alterations in the histological architecture. Furthermore, it induced a significant reduction in the renal glutathione levels; however, the levels of nitric oxide and malondialdehyde were significantly elevated. The parasite also managed to downregulate KIM-1, NGAL, MCP-1, and TGF-β mRNA expression in infected animals. Notably, gold NP treatment in mice reduced the extent of histological impairment and renal oxidative damage. Gold NP were able to regulate gene expression impaired by S. Mansoni infection. CONCLUSION The curative effect of gold NP against renal toxicity in S. mansoni-infected mice is associated with their role as free radical scavengers.
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Affiliation(s)
- Mohamed A Dkhil
- Department of Zoology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; Department of Zoology and Entomology, Faculty of Science, Helwan University, Cairo 11795, Eg
| | - Mona F Khalil
- Department of Zoology and Entomology, Faculty of Science, Helwan University, Cairo 11795, Eg
| | - Amira A Bauomy
- Department of Zoology and Entomology, Faculty of Science, Helwan University, Cairo 11795, Egypt; Department of Laboratory Sciences, College of Science & Arts, Al-Rass, Qassim University, AL-Qaseam 51921, Saudi Arabia
| | - Marwa Sm Diab
- Molecular Drug Evaluation Department, National Organization for Drug Control & Research (NODCAR), Giza 12553, Egypt
| | - Saleh Al-Quraishy
- Department of Zoology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
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Tan TJ, Ng VW, Lim KR. "Right Iliac Fossa Pain": More Than Meets the Eye. Ann Acad Med Singap 2016; 45:527-529. [PMID: 27922149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Tien Jin Tan
- Department of Radiology, Changi General Hospital, Singapore
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Wouthuyzen-Bakker M, Vorm PA, Koning KJ, van der Werf TS. An unexpected pulmonary bystander. Neth J Med 2016; 74:40-42. [PMID: 26819361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 30-year-old man from Eritrea was admitted with a pulmonary bacterial abscess. Unexpectedly, histopathology of the resected lobe also revealed an infection with Schistosoma mansoni with surrounding granulomatous tissue and fibrosis. Patients from endemic areas are often asymptomatic with blood eosinophilia being the only diagnostic clue. Early recognition is important as ongoing fibrosing inflammation may result in organ damage.
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Affiliation(s)
- M Wouthuyzen-Bakker
- Department of Internal Medicine÷Infectious Diseases, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, the Netherlands
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Aziz IA, Yacoub M, Rashid L, Solieman A. Malondialdehyde; Lipid peroxidation plasma biomarker correlated with hepatic fibrosis in human Schistosoma mansoni infection. Acta Parasitol 2015; 60:735-42. [PMID: 26408599 DOI: 10.1515/ap-2015-0105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 06/01/2015] [Indexed: 02/06/2023]
Abstract
Schistosomiasis is a debilitating parasitic disease, affects large number of host species. Currently affects 250-300 million people in tropic areas. Schistosoma pathogenic impact is hepatic periportal fibrosis; the parasite-induced inflammatory cellular activation promotes oxidative stress, resulting in lipid peroxidation (LPO), with subsequent increase in inflammatory mediators as malondialdehyde (MDA). This study was set up to reveal possible contribution of lipid peroxidation byproducts MDA in hepatic pathophysiology. Results displayed that MDA don't tend to change in relation with either age, nor hepatic transaminases AST & ALT, while exhibited a significant increase in MDA levels in human schistosomiasis versus control group P<0.0001 (Mn. ± St.dev. 7.77 ± 3.59, 1.21 ± 0.28 nmol/ml) respectively. Moreover; MDA plasma levels in Schistosoma infected group correlated significantly with two hepatic fibrosis parameters; (a) ultrasonography graded periportal fibrosis P< 0.0001. Levels of MDA in hepatic fibrosis grades 0, I, II, III in Schistosoma infected group were (Mn. ± St.dev. 2.8 ± 0.64, 4.3 ± 1.2, 9.3 ± 1.6 and 10.8 ± 1.3 nmol/ml) respectively, (b) serum Hyaluronic acid (HA) P<0.0001 (spearman r = 0.77) as a reliable hepatic fibrosis marker. This implies a considerable role of LPO byproducts in schistosomiasis pathogenicity, and proposing malondialdehyde as a biomarker for schistosomiasis morbidity.
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Krauth SJ, Musard C, Traoré SI, Zinsstag J, Achi LY, N'Goran EK, Utzinger J. Access to, and use of, water by populations living in a schistosomiasis and fascioliasis co-endemic area of northern Côte d'Ivoire. Acta Trop 2015; 149:179-85. [PMID: 26004285 DOI: 10.1016/j.actatropica.2015.05.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 05/18/2015] [Accepted: 05/20/2015] [Indexed: 12/29/2022]
Abstract
Water is an essential element of life, but it can also be a source of disease. Apart from direct consumption of unsafe water, direct contact and indirect consumption puts people at risk of many different types of pathogens. Employing a mixed methods approach, consisting of questionnaires and direct observations, we assessed access to, and use of, different water sources by the participants of the district des Savanes in northern Côte d'Ivoire. The use of water sources was put in relation to the potential risk of acquiring schistosomiasis and fascioliasis. Overall, 489 people aged 8 to 82 years participated. While all participants had access to safe water, 63% were in direct contact with unimproved water and 31% directly consumed unsafe water. More than a third of the people who otherwise reported using only improved water for all activities came in contact with unimproved water through crossing open water when going to their workplace, school or other destinations. Self-reported blood in urine - a marker for Schistosoma haematobium with reasonable sensitivity and specificity - was reported by 6% (n=30), self-reported blood in stool - an unspecific marker for Schistosoma mansoni - was reported by 7% (n=35), while blood co-occurring in both urine and stool was reported by another 10% (n=48) of participants. Accessing unimproved water for any activity (including crossing) was associated with higher odds of reporting blood in urine and/or blood in stool (odds ratio: 1.90; 95% confidence interval: 1.07-3.36). Our results have important rami-fications for intervention programmes targeting neglected tropical diseases, and emphasize the need for a wider supply of safe water to rural populations, since the water supply at the workplace needs to be considered as well next to the water supply at home. Crossing of open water sources is an important risk factor for sustained transmission of schistosomiasis.
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Affiliation(s)
- Stefanie J Krauth
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Capucine Musard
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Department of Environmental Systems Science, ETH Zurich, Zurich, Switzerland
| | - Seïdinan I Traoré
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Laboratoire Regional d'Appui au Développement Agricole de Korhogo, Korhogo, Côte d'Ivoire
| | - Jakob Zinsstag
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Louise Y Achi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Ecole de Spécialisation en Elevage de Bingerville, Bingerville, Côte d'Ivoire
| | - Eliézer K N'Goran
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
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Martins GLP, Bernardes JPG, Rovella MS, Andrade RG, Viana PCC, Herman P, Cerri GG, Menezes MR. Radiofrequency ablation for treatment of hypersplenism: A feasible therapeutic option. World J Gastroenterol 2015; 21:6391-6397. [PMID: 26034376 PMCID: PMC4445118 DOI: 10.3748/wjg.v21.i20.6391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/06/2014] [Accepted: 02/05/2015] [Indexed: 02/06/2023] Open
Abstract
We present a case of a patient with hypersplenism secondary to portal hypertension due to hepato-splenic schistosomiasis, which was accompanied by severe and refractory thrombocytopenia. We performed spleen ablation and measured the total spleen and ablated volumes with contrast-enhanced computed tomography and volumetry. No major complications occurred, thrombocytopenia was resolved, and platelet levels remained stable, which allowed for early treatment of the patient’s underlying disease. Previous work has shown that splenic radiofrequency ablation is an attractive alternative treatment for hypersplenism induced by liver cirrhosis. We aimed to contribute to the currently sparse literature evaluating the role of radiofrequency ablation (RFA) in the management of hypersplenism. We conclude that splenic RFA appears to be a viable and promising option for the treatment of hypersplenism.
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Durieux-Paillard S. [Migration and infectious diseases: there are more than Ebola]. Rev Med Suisse 2014; 10:2292-2293. [PMID: 25562985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Mekonnen Z, Meka S, Zeynudin A, Suleman S. Schistosoma mansoni infection and undernutrition among school age children in Fincha'a sugar estate, rural part of West Ethiopia. BMC Res Notes 2014; 7:763. [PMID: 25348748 PMCID: PMC4216851 DOI: 10.1186/1756-0500-7-763] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 10/14/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parasitic infection like schistosomiasis is known to exert a negative effect on nutritional status of school-aged children. However, studies associating parasitic infections with undernutrition are scarce. Thus, this study was primarily to document the association between Schistosoma mansoni infection and undernutrition among school-aged children in a rural setting of Fincha'a Sugar Estate, Ethiopia. METHODS A cross-sectional study was conducted on a total of 453 school-aged children (5-18 years). Stool specimen was collected and examined using the standard Kato-katz technique. Children's height-for-Age Z-score (HAZ) and Body mass index-for-Age Z- score (BAZ) was determined. Z-Scores for each nutritional index were compared with the WHO child growth standards reference values. Children were considered stunted or wasted as HAZ or BAZ falls below -2 standard deviations, respectively. RESULT The overall prevalence of Schistosoma mansoni infection was 53.2%. Out of the total school children examined, 11.5% and 13.2% were stunted and wasted, respectively. Multivariate logistic regression analysis was done to determine the relationship between Schistosoma mansoni infection and nutritional status controlling for other factors. Accordingly, stunting was not significantly associated while wasting was negatively associated with Schistosoma mansoni infection. Paternal occupation was the best predictor of stunting and wasting such that, unemployed fathers have 4.28 (95% CI; 2.13, 8.63) (p < 0.001) and 3.83, 95% CI; 1.89, 7.79) (p < 0.001) chance of having stunted and wasted children, respectively. CONCLUSION Schistosoma mansoni infection is highly prevalent in the study area. The high prevalence of wasting, and moderate level of stunting among study subjects in this study area indicate that they are affected by both infection and undernutrition. Therefore, regular preventive chemotherapy against S. mansoni and other control measures are recommended. Moreover, possibilities of synchronized nutritional rehabilitation and creation of employment opportunities to the families should be looked for.
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Affiliation(s)
- Zeleke Mekonnen
- />Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
| | - Selima Meka
- />Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
| | - Ahmed Zeynudin
- />Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
| | - Sultan Suleman
- />Department of Pharmacy, College of Public Health and Medical Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
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Algahtani HA, Aldarmahi AA, Al-Rabia MW, Baeesa SS. Acute paraplegia caused by Schistosoma mansoni. Neurosciences (Riyadh) 2014; 19:47-51. [PMID: 24419450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Schistosomiasis affects over 200 million people worldwide. Involvement of the CNS is a rare occurrence. We report 2 young males who presented with rapidly progressing paraparesis associated with urinary incontinence. In both cases, MRI of the spine demonstrated a diffusely enhancing mass at the conus medullaris with extensive spinal cord edema. Laboratory investigations revealed mild peripheral eosinophilia and abnormal, but non-specific, CSF analysis. In one patient, the diagnosis was made based on a rising schistosomal titer with a positive rectal biopsy. In the other patient, spinal cord biopsy revealed a granuloma. Both cases were caused by Schistosoma mansoni and patients were treated with praziquantel and steroid therapy. They both made a remarkable neurological recovery. We emphasize that a high index of suspicion should be raised in the differential diagnosis of transverse myelitis in endemic areas.
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Affiliation(s)
- Hussein A Algahtani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, PO Box 12723, Jeddah 21483, Kingdom of Saudi Arabia. Tel. +966 (12) 6240000 Ext. 21298/22070. Fax. +966 (12) 6240000 Ext. 22765. E-mail:
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Meurs L, Mbow M, Boon N, van den Broeck F, Vereecken K, Dièye TN, Abatih E, Huyse T, Mboup S, Polman K. Micro-geographical heterogeneity in Schistosoma mansoni and S. haematobium infection and morbidity in a co-endemic community in northern Senegal. PLoS Negl Trop Dis 2013; 7:e2608. [PMID: 24386499 PMCID: PMC3873272 DOI: 10.1371/journal.pntd.0002608] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 11/13/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Schistosoma mansoni and S. haematobium are co-endemic in many areas in Africa. Yet, little is known about the micro-geographical distribution of these two infections or associated disease within such foci. Such knowledge could give important insights into the drivers of infection and disease and as such better tailor schistosomiasis control and elimination efforts. METHODOLOGY In a co-endemic farming community in northern Senegal (346 children (0-19 y) and 253 adults (20-85 y); n = 599 in total), we studied the spatial distribution of S. mansoni and S. haematobium single and mixed infections (by microscopy), S. mansoni-specific hepatic fibrosis, S. haematobium-specific urinary tract morbidity (by ultrasound) and water contact behavior (by questionnaire). The Kulldorff's scan statistic was used to detect spatial clusters of infection and morbidity, adjusted for the spatial distribution of gender and age. PRINCIPAL FINDINGS Schistosoma mansoni and S. haematobium infection densities clustered in different sections of the community (p = 0.002 and p = 0.023, respectively), possibly related to heterogeneities in the use of different water contact sites. While the distribution of urinary tract morbidity was homogeneous, a strong geospatial cluster was found for severe hepatic fibrosis (p = 0.001). Particularly those people living adjacent to the most frequently used water contact site were more at risk for more advanced morbidity (RR = 6.3; p = 0.043). CONCLUSIONS/SIGNIFICANCE Schistosoma infection and associated disease showed important micro-geographical heterogeneities with divergent patterns for S. mansoni and S. haematobium in this Senegalese community. Further in depth investigations are needed to confirm and explain our observations. The present study indicates that local geospatial patterns should be taken into account in both research and control of schistosomiasis. The observed extreme focality of schistosomiasis even at community level, suggests that current strategies may not suffice to move from morbidity control to elimination of schistosomiasis, and calls for less uniform measures at a finer scale.
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Affiliation(s)
- Lynn Meurs
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Moustapha Mbow
- Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Bacteriology and Virology, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Senegal
| | - Nele Boon
- Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium
| | - Frederik van den Broeck
- Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium
| | | | - Tandakha Ndiaye Dièye
- Laboratory of Bacteriology and Virology, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Senegal
| | | | - Tine Huyse
- Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium
| | - Souleymane Mboup
- Laboratory of Bacteriology and Virology, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Senegal
| | - Katja Polman
- Institute of Tropical Medicine, Antwerp, Belgium
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Layland LE, Straubinger K, Ritter M, Loffredo-Verde E, Garn H, Sparwasser T, Prazeres da Costa C. Schistosoma mansoni-mediated suppression of allergic airway inflammation requires patency and Foxp3+ Treg cells. PLoS Negl Trop Dis 2013; 7:e2379. [PMID: 23967364 PMCID: PMC3744427 DOI: 10.1371/journal.pntd.0002379] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 07/05/2013] [Indexed: 12/13/2022] Open
Abstract
The continual rise of asthma in industrialised countries stands in strong contrast to the situation in developing lands. According to the modified Hygiene Hypothesis, helminths play a major role in suppressing bystander immune responses to allergens, and both epidemiological and experimental studies suggest that the tropical parasitic trematode Schistosoma mansoni elicits such effects. The focus of this study was to investigate which developmental stages of schistosome infection confer suppression of allergic airway inflammation (AAI) using ovalbumin (OVA) as a model allergen. Moreover, we assessed the functional role and localization of infection-induced CD4+Foxp3+ regulatory T cells (Treg) in mediating such suppressive effects. Therefore, AAI was elicited using OVA/adjuvant sensitizations with subsequent OVA aerosolic challenge and was induced during various stages of infection, as well as after successful anti-helminthic treatment with praziquantel. The role of Treg was determined by specifically depleting Treg in a genetically modified mouse model (DEREG) during schistosome infection. Alterations in AAI were determined by cell infiltration levels into the bronchial system, OVA-specific IgE and Th2 type responses, airway hyper-sensitivity and lung pathology. Our results demonstrate that schistosome infection leads to a suppression of OVA-induced AAI when mice are challenged during the patent phase of infection: production of eggs by fecund female worms. Moreover, this ameliorating effect does not persist after anti-helminthic treatment, and depletion of Treg reverts suppression, resulting in aggravated AAI responses. This is most likely due to a delayed reconstitution of Treg in infected-depleted animals which have strong ongoing immune responses. In summary, we conclude that schistosome-mediated suppression of AAI requires the presence of viable eggs and infection-driven Treg cells. These data provide evidence that helminth derived products could be incorporated into treatment strategies that specifically target suppression of immune responses in AAI by inducing Treg cells. Infections with schistosomes, such as S. mansoni, S. japonicum and S. haematobium, are considered a major public health concern. Morbidity arises through granulomatous responses to eggs that become trapped in infected tissues. Interestingly, schistosomes belong to the group of helminths that have been shown to reduce allergy or autoimmunity. Indeed, the evidence provided by epidemiological surveys and experimental animal models has been so overwhelming that such helminths are now included in the Hygiene Hypothesis. However, since helminths provoke immunological responses that are similar to those seen in allergy (increased eosinophilia and IgE) it is suggested that additional mechanisms dampen such allergic responses. Helminth-induced regulatory T cells (Treg) are considered a component of these modulatory networks. Using an allergic airway inflammation model, we have elucidated that schistosome-mediated protection requires patency, that is, active egg production from fecund female worms. In addition, protection was shown to be mediated by infection-induced Treg. Interestingly, in endemic countries it is usually individuals with strong patent infections that show reduced allergic prevalence. Thus, further research into the immunomodulatory capacity of schistosome-egg derived factors may elucidate novel drug candidates or enhance treatment strategies to reduce allergic responses on the cellular level.
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Affiliation(s)
- Laura E. Layland
- Institute of Medical Microbiology, Immunology and Hygiene (MIH), Technische Universität München, Munich, Germany
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Clinic Bonn, Bonn, Germany
| | - Kathrin Straubinger
- Institute of Medical Microbiology, Immunology and Hygiene (MIH), Technische Universität München, Munich, Germany
| | - Manuel Ritter
- Institute of Medical Microbiology, Immunology and Hygiene (MIH), Technische Universität München, Munich, Germany
| | - Eva Loffredo-Verde
- Institute of Medical Microbiology, Immunology and Hygiene (MIH), Technische Universität München, Munich, Germany
| | - Holger Garn
- Institute of Laboratory Medicine and Pathobiochemistry, Medical Faculty, Philipps-University Marburg, Marburg, Germany
| | - Tim Sparwasser
- Institut für Infektionsimmunologie TWINCORE - Zentrum für Experimentelle und Klinische Infektionsforschung GmbH, Hannover, Germany
| | - Clarissa Prazeres da Costa
- Institute of Medical Microbiology, Immunology and Hygiene (MIH), Technische Universität München, Munich, Germany
- * E-mail:
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Leite LAC, Pimenta Filho AA, da Fonseca CSM, dos Santos BS, Ferreira RDCDS, Montenegro SML, Lopes EP, Domingues ALC, Owen JS, Lima VLDM. Hemostatic dysfunction is increased in patients with hepatosplenic schistosomiasis mansoni and advanced periportal fibrosis. PLoS Negl Trop Dis 2013; 7:e2314. [PMID: 23875049 PMCID: PMC3715409 DOI: 10.1371/journal.pntd.0002314] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 06/03/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Schistosomiasis mansoni is an endemic parasitic disease and a public health problem in Northeast Brazil. In some patients, hepatic abnormalities lead to periportal fibrosis and result in the most severe clinical form, hepatosplenic schistosomiasis. This study aimed to evaluate whether abnormal blood coagulation and liver function tests in patients with hepatosplenic schistosomiasis (n = 55) correlate with the severity of their periportal fibrosis. METHODOLOGY/PRINCIPAL FINDINGS Blood samples were used for liver function tests, hemogram and prothrombin time (International Normalized Ratio, INR). The blood coagulation factors (II, VII, VIII, IX and X), protein C and antithrombin IIa (ATIIa), plasminogen activator inhibitor 1 (PAI-1) and D-dimer were measured by photometry or enzyme linked immunosorbent assay. Hyperfibrinolysis was defined on the basis of PAI-1 levels and a D-dimer concentration greater than a standard cut-off of 483 ng/mL. Standard liver function tests were all abnormal in the patient group compared to healthy controls (n = 29), including raised serum transaminases (p<0.001) and lower levels of albumin (p = 0.0156). Platelet counts were 50% lower in patients, while for coagulation factors there was a 40% increase in the INR (p<0.001) and reduced levels of Factor VII and protein C in patients compared to the controls (both p<0.001). Additionally, patients with more advanced fibrosis (n = 38) had lower levels of protein C compared to those with only central fibrosis (p = 0.0124). The concentration of plasma PAI-1 in patients was one-third that of the control group (p<0.001), and D-dimer levels 2.2 times higher (p<0.001) with 13 of the 55 patients having levels above the cut-off. CONCLUSION/SIGNIFICANCE This study confirms that hemostatic abnormalities are associated with reduced liver function and increased liver fibrosis. Of note was the finding that a quarter of patients with hepatosplenic schistosomiasis and advanced periportal fibrosis have hyperfibrinolysis, as judged by excessive levels of D-dimer, which may predispose them to gastrointestinal bleeding.
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Affiliation(s)
- Luiz Arthur Calheiros Leite
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | - Adenor Almeida Pimenta Filho
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | | | - Bianka Santana dos Santos
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | | | | | - Edmundo Pessoa Lopes
- Departamento de Medicina Clínica, Centro de Ciências da Saúde, Hospital das Clinicas, UFPE, Recife, Brazil
| | | | - James Stuart Owen
- Division of Medicine, University College London Medical School, Royal Free Campus, London, United Kingdom
| | - Vera Lúcia de Menezes Lima
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
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Paunovic B, El-Fanek H, Fiedler P, Appel C, Edwards L. Colonic schistosomiasis and associated cecal neuroma. Conn Med 2013; 77:339-342. [PMID: 23923251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Schistosomiasis remains a major health threat in many resource-poor countries and is being seen with increasing frequency in developed countries among immigrants and tourists who have a history of freshwater exposure in endemic areas. We report a case ofa 56-year-old male with no significant past medical history, who presented for a routine screening colonoscopy, which revealed two polyps in the cecum, and multiple petechiae in the rectum. Histologic evaluation showed presence of Schistosoma mansoni eggs. One of the polyps, where eggs were also present, was diagnosed as neuroma/ Schwann cell hamartoma. This is the first reported casewhere colonic schistosomiasis is associatedwith cecal neuroma.
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Affiliation(s)
- Brankica Paunovic
- Department of Pathologyand Laboratory Medicine, Danbury Hospital, Danbury, USA.
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Farias LP, Rodrigues D, Cunna V, Rofatto HK, Faquim-Mauro EL, Leite LCC. Schistosoma mansoni venom allergen like proteins present differential allergic responses in a murine model of airway inflammation. PLoS Negl Trop Dis 2012; 6:e1510. [PMID: 22347513 PMCID: PMC3274501 DOI: 10.1371/journal.pntd.0001510] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 12/19/2011] [Indexed: 12/27/2022] Open
Abstract
Background The Schistosoma mansoniVenom-Allergen-Like proteins (SmVALs) are members of the SCP/TAPS (Sperm-coating protein/Tpx-1/Ag5/PR-1/Sc7) protein superfamily, which may be important in the host-pathogen interaction. Some of these molecules were suggested by us and others as potential immunomodulators and vaccine candidates, due to their functional classification, expression profile and predicted localization. From a vaccine perspective, one of the concerns is the potential allergic effect of these molecules. Methodology/Principal Findings Herein, we characterized the putative secreted proteins SmVAL4 and SmVAL26 and explored the mouse model of airway inflammation to investigate their potential allergenic properties. The respective recombinant proteins were obtained in the Pichia pastoris system and the purified proteins used to produce specific antibodies. SmVAL4 protein was revealed to be present only in the cercarial stage, increasing from 0–6 h in the secretions of newly transformed schistosomulum. SmVAL26 was identified only in the egg stage, mainly in the hatched eggs' fluid and also in the secretions of cultured eggs. Concerning the investigation of the allergic properties of these proteins in the mouse model of airway inflammation, SmVAL4 induced a significant increase in total cells in the bronchoalveolar lavage fluid, mostly due to an increase in eosinophils and macrophages, which correlated with increases in IgG1, IgE and IL-5, characterizing a typical allergic airway inflammation response. High titers of anaphylactic IgG1 were revealed by the Passive Cutaneous Anaphylactic (PCA) hypersensitivity assay. Additionally, in a more conventional protocol of immunization for vaccine trials, rSmVAL4 still induced high levels of IgG1 and IgE. Conclusions Our results suggest that members of the SmVAL family do present allergic properties; however, this varies significantly and therefore should be considered in the design of a schistosomiasis vaccine. Additionally, the murine model of airway inflammation proved to be useful in the investigation of allergic properties of potential vaccine candidates. The Schistosoma mansoni Venom Allergen Like proteins (SmVALs) have been identified in the Transcriptome and Post-Genomic studies as targets for immune interventions. Two secreted members of the family were obtained as recombinant proteins in the native conformation. Antibodies produced against them showed that SmVAL4 was present mostly in cercarial secretions and SmVAL26 in egg secretions and that only the native SmVAL4 contained carbohydrate moieties. Due to concerns with potential allergic characteristics of this class of molecules, we have explored the mouse model of airway inflammation in order to investigate these properties in a more confined system. Sensitization and challenge with rSmVAL4, but not rSmVAL26, induced extensive migration of cells to the lungs, mostly eosinophils and macrophages; moreover, immunological parameters were also characteristic of an allergic inflammatory response. Our results showed that the allergic potential of this class of proteins can be variable and that the vaccine candidates should be characterized; the mouse model of airway inflammation can be useful to evaluate these properties.
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Affiliation(s)
| | - Dunia Rodrigues
- Centro de Biotecnologia, Instituto Butantan, São Paulo, São Paulo, Brasil
| | - Vinicius Cunna
- Centro de Biotecnologia, Instituto Butantan, São Paulo, São Paulo, Brasil
| | | | | | - Luciana C. C. Leite
- Centro de Biotecnologia, Instituto Butantan, São Paulo, São Paulo, Brasil
- * E-mail:
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Herranz Bachiller MT, Diez Redondo P, Gil Simon P, Lorenzo Pelayo S. [An unusual cause of rectal bleeding in our environment: intestinal schistosomiasis]. Gastroenterol Hepatol 2011; 34:717-8. [PMID: 21944228 DOI: 10.1016/j.gastrohep.2011.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 05/31/2011] [Accepted: 06/02/2011] [Indexed: 11/30/2022]
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Crosby A, Jones FM, Kolosionek E, Southwood M, Purvis I, Soon E, Butrous G, Dunne DE, Morrell NW. Praziquantel reverses pulmonary hypertension and vascular remodeling in murine schistosomiasis. Am J Respir Crit Care Med 2011; 184:467-73. [PMID: 21659614 DOI: 10.1164/rccm.201101-0146oc] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Schistosomiasis is the most common worldwide cause of pulmonary arterial hypertension. The anti-schistosome drug praziquantel has been shown to reverse the liver fibrosis associated with Schistosoma mansoni in mice. OBJECTIVES We sought to determine whether praziquantel reverses established pulmonary vascular remodeling and pulmonary hypertension in a mouse model of S. mansoni. METHODS Mice were infected percutaneously with S. mansoni. At 17 weeks after infection mice were either killed or received two doses of praziquantel or vehicle by oral gavage. Treated mice were studied at 25 weeks after infection. MEASUREMENTS AND MAIN RESULTS Vehicle-treated mice demonstrated significant increases in right ventricular systolic pressures (RVSP) and right ventricular hypertrophy (RVH) at 25 weeks, accompanied by pulmonary vascular remodeling. The degree of vascular remodeling correlated with proximity to granulomas. The elevation of RVSP and RVH at 25 weeks was dependent on the presence of eggs in the lung. Praziquantel eliminated the production of eggs in feces and led to clearance of eggs from the lung and to a lesser extent from liver. Praziquantel prevented the rise in RVSP and RVH seen in vehicle-treated mice and reversed established pulmonary vascular remodeling. Praziquantel significantly reduced lung mRNA expression of IL-13, IL-8, and IL-4, but did not reduce serum cytokine levels. CONCLUSIONS The development of pulmonary hypertension associated with S. mansoni infection can be prevented by praziquantel, and established vascular remodeling can be reversed. The mechanism involves clearance of lung eggs and reduced local expression of lung cytokines.
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Affiliation(s)
- Alexi Crosby
- Department of Medicine, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Hills Road, Cambridge, United Kingdom
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Hessien MH, El-Sharkawi IM, El-Barbary AA, El-Beltagy DM, Snyder N. Non-invasive index of liver fibrosis induced by alcohol, thioacetamide and Schistosomal infection in mice. BMC Gastroenterol 2010; 10:53. [PMID: 20515488 PMCID: PMC2894747 DOI: 10.1186/1471-230x-10-53] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Accepted: 06/01/2010] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Non invasive approaches will likely be increasing utilized to assess liver fibrosis. This work provides a new non invasive index to predict liver fibrosis induced in mice. METHODS Fibrosis was generated by thioacetamide (TAA), chronic intake of ethanol, or infection with S. mansoni in 240 mice. Both progression and regression of fibrosis (after treatment with silymarin and/or praziquantel) were monitored. The following methods were employed: (i) The METAVIR system was utilized to grade and stage liver inflammation and fibosis; (ii) Determination of hepatic hydroxyproline and collagen; and (iii) Derivation of a new hepatic fibrosis index from the induced changes, and its prospective validation in a group of 70 mice. RESULTS The index is composed of 4 serum variable including total proteins, gamma-GT, bilirubin and reduced glutathione (GSH), measured in diseased, treated and normal mice. These parameters were highly correlated with both the histological stage and the grade. They were combined in a logarithmic formula, which non-invasively scores the severity of liver fibrosis through a range (0 to 2), starting with healthy liver (corresponding to stage 0) to advanced fibrosis (corresponding stage 3).Receiver operating characteristic curves (ROC) for the accuracy of the index to predict the histological stages demonstrated that the areas under the curve (AUC) were 0.954, 0.979 and 0.99 for index values corresponding to histological stages 1, 2 and 3, respectively. Also, the index was correlated with stage and grade, (0.947 and 0.859, respectively). The cut off values that cover the range between stages 0-1, 1-2 and 2-3 are 0.4, 1.12 and 1.79, respectively. The results in the validation group confirmed the accuracy of the test. The AUROC was 0.869 and there was good correlation with the stage of fibrosis and grade of inflammation. CONCLUSION The index fulfils the basic criteria of non-invasive marker of liver fibrosis since it is liver-specific, easy to implement, reliable, and inexpensive. It proved to be accurate in discriminating precirrhotic stages.
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Affiliation(s)
- Mohamed H Hessien
- Department of Chemistry, Faculty of Science, Tanta University, Tanta 31111, Egypt
| | | | - Ahmed A El-Barbary
- Department of Chemistry, Faculty of Science, Tanta University, Tanta 31111, Egypt
| | - Doha M El-Beltagy
- Department of Chemistry, Faculty of Science, Tanta University, Tanta 31111, Egypt
| | - Ned Snyder
- Division of Gastroenterology at the University of Texas Medical Branch (UTMB) in Galveston, TX: 77555, USA
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Fairweather M, Burt BM, VanderLaan PA, Brunker PAR, Bafford AC, Ashley SW. Acute hemorrhage from small bowel diverticula harboring strongyloidiasis and schistosomiasis. Am Surg 2010; 76:539-541. [PMID: 20506887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Braz MM, Ramalho FS, Cardoso RL, Zucoloto S, Costa RS, Ramalho LNZ. Slight activation of nuclear factor kappa-B is associated with increased hepatic stellate cell apoptosis in human schistosomal fibrosis. Acta Trop 2010; 113:66-71. [PMID: 19781518 DOI: 10.1016/j.actatropica.2009.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2009] [Revised: 09/10/2009] [Accepted: 09/15/2009] [Indexed: 01/14/2023]
Abstract
To investigate the relationship between NF-kappaB activation and hepatic stellate cell (HSC) apoptosis in hepatosplenic schistosomiasis, hepatic biopsies from patients with Schistosoma mansoni-induced periportal fibrosis, hepatitis C virus-induced cirrhosis, and normal liver were submitted to alpha-smooth muscle actin (alpha-SMA) and NF-kappaB p65 immunohistochemistry, as well as to NF-kappaB Southwestern histochemistry and TUNEL assay. The numbers of alpha-SMA-positive cells and NF-kappaB- and NF-kappaB p65-positive HSC nuclei were reduced in schistosomal fibrosis relative to liver cirrhosis. In addition, increased HSC NF-kappaB p65 and TUNEL labeling was observed in schistosomiasis when compared to cirrhosis.These results suggest a possible relationship between the slight activation of the NF-kappaB complex and the increase of apoptotic HSC number in schistosome-induced fibrosis, taking place to a reduced HSC number in schistosomiasis in relation to liver cirrhosis. Therefore, the NF-kappaB pathway may constitute an important down-regulatory mechanism in the pathogenesis of human schistosomiasis mansoni, although further studies are needed to refine the understanding of this process.
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Affiliation(s)
- Mariana M Braz
- Department of Pathology and Legal Medicine of Faculty of Medicine of Ribeirão Preto, University of São Paulo, Av Bandeirantes, 3900, 14049-900 Ribeirão Preto, SP, Brazil
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