Relationship between serum cytokines profiles and hepatic fibrosis in Schistosomiasis mansoni: an experimental study

Forty of eighty mice [10 each group] were infected with S. mansoni cercariae and sacrificed at 3 weeks [G-A], 6 weeks [G-B], 12 weeks [G-C] and 16 weeks [G-D] post infection [P.I]. The other forty mice were used as control groups of ten mice each. There were highly significant difference between egg counts after 12 weeks and 16 weeks of infection compared to 6 weeks P.I. The maximum egg count and mature eggs were in 6[th] week P.I while dead eggs reached the peak at 16[th] weeks P.I. Liver egg counts showed maximum followed by intestinal and then, stool egg counts. A highly significant differences in hydroxy-proline, TGF-Bland DL-4 of infected than in controls and their peak at 16 weeks P.I. A significant difference in the EFN-gamma in the infected than in controls with peak occurred at 6 weeks P.I. and declined after that reaching a low level at 16 weeks P.I. A highly significant positive correlation was between TGF-Bland IL4 and significant negative correlation between IFN- gamma and both IL4 and TGF-B1. A highly significant and significant negative correlation between TGF-B1 and egg count at 12 and 16 weeks P.I respectively. Negative correlation was between IL-4 and egg count at 16 weeks P.I. But, significant positive correlation was between IFN- gamma with the egg count at 16 weeks P.I. A significant negative correlation was between TGF-B1 and oogram at 6 and 16 weeks P.I, but highly significant positivity was between IFN- gamma and oogram at 16 weeks P.I. A significant negative correlation was between IL-4 and oogram at 16 weeks P.I. A significant positive correlation was between levels of hydroxyproline and TGF-B1 at 12 and 16 weeks P.I. Highly significant negative correlation between hydroxyproline and IFN- gamma was at 12 weeks P.I with significant and highly significant positive correlation between hydroxyproline and IL4 at 12 and 16 weeks-P.I

Recurrent abdominal pain in children does toxocariasis play a role?

Recurrent abdominal pain [RAP] of unexplained etiology is a relatively common pediatric problem. It is often referred to as functional abdominal pain with only 5-10% of the affected children have organic causes for their pains. Toxocariasis, a helminthic zoonosis, causes a spectrum of diseases in man: two major syndromes; visceral larva migrans [VLM], Ocular larva migrans [OLM] and a third more common condition, covert toxocariasis in which positive toxocara serology [both anti-toxocara excretory-secretory IgG and IgE] are associated with a number of systemic and localized symptoms and signs; notably recurrent abdominal pain. It has been implicated as a cause of RAP which might be otherwise interpreted as an idiopathic. Aim of this study is to assess the role of toxocariasis as a causative agent of unexplained recurrent abdominal pain in our children based on clinical, serological and therapeutic criteria. One hundred fifty children suffering from RAP were included in our prospective study. After detailed history, thorough clinical examination and relevant investigations, patients were divided into two groups: the first with organic RAP and the second with unexplained RAP. Patients in the second group were subjected to complete blood count, eosinophilic count, urine and stool analysis, ELISA serotesting for anti-Toxocara excretory- secretory [TES] IgG and IgE and were followed-up for three months. Seropositive [IgG] patients were treated with Albendazole and re-tested for specific antibodies at the end of our study. Out of 150 children with RAP, 26.6% [40 patients] showed definite organic causes with intestinal parasites, particularly Giardia lamblia, represented the most common etiology. Among the remaining 73.4% [110 patients] who were addressed as unexplained RAP, 21.8% [24 patients] were anti [TES] IgG positive. Almost half of them [13 patients] were seropositive for anti [TES] IgE also [covert toxocariasis]. Unexplained RAP was the sole presentation in 61% [8/13] of them and high blood esinophils [>5% of TBL] was a common finding 77% [10/13]. Anti [TES] IgE was positive in 92% of chemoresponsive patients and was negative in all non-respenders. Post treatment mean of anti [TES] IgE showed significant decrease [P <0.05] when compared to pre-treatment level [45 +/- 9.8 Vsl90 +/- 13.3] while no difference can be proved regarding anti [TES] IgG [1.22 +/- 0.35 Vs 1.28 +/- 0.32]. Covert Toxocariasis may be a hidden cause of unexplained RAP in children and should be enlisted in its differential diagnosis particularly if associated with eosinophilia. ELISA quantitative assay of anti TES IgE, not only provide a specific diagnostic indicator for covert Toxocariasis but is a useful tool in monitoring drug therapy as well

Pathological changes in mice vaccinated with swap, challenged and treated with praziquantel

Not only SWAP vaccinated mice and challenged with Schistosoma mansoni cercaria [100 +/- 20 / mouse] showed a significantly decrease in worm burden of perfused vaccinated mice compared with control non vaccinated infected mice, but also minimized the size and number of granuloma in different tissues [intestine, spleen and liver] compared with infected control. Praziquantel therapy showed a significant decrease in egg granuloma size and number in the intestine but the liver showed less significant decrease in egg granuloma size and number. This observation may aggravate hepatic fibrosis, especially if some worms are still viable and shift to the liver due to partial drug resistance and/or incomplete therapy. These data may guide and recommend follow up and repeat therapeutic dose to surely kill and prevent worms from shift to the liver. There is a synergism between drug therapy and vaccination, which showed marked decrease in egg granuloma size and number in the liver, while the intestine was nearly cured. Finally SWAP vaccinated mice showed a partial protection due to acquired immunity but the mice are still susceptible to infection with Schistosoma