ABSTRACT
Distinct patterns of glomerular lesions, including membranoproliferative glomerulonephritis and focal segmental glomerulosclerosis, are associated with infection by Schistosoma mansoni or Schistosoma japonicum. Evidence suggests that immune complex deposition is the main mechanism underlying the different forms of schistosomal glomerulonephritis and that immune complex deposition may be intensified by portal hypertension. The relationship between focal segmental glomerulosclerosis and schistosomiasis remains poorly understood. A clinicopathologic classification of schistosomal glomerulopathies was proposed in 1992 by the African Association of Nephrology. In Brazil, mass treatment with oral medications has led to a decrease in the occurrence of schistosomal glomerulopathy. In a survey of renal biopsies performed in Salvador, Brazil, from 2003-2009, only 24 (4 percent) patients were identified as positive for S. mansoni infection. Among these patients, only one had the hepatosplenic form of the disease. Focal segmental glomerulosclerosis was found in seven patients and membranoproliferative glomerulonephritis was found in four patients. Although retrospective studies on the prevalence of renal diseases based on kidney biopsies may be influenced by many patient selection biases, a change in the distribution of glomerulopathies associated with nephrotic syndrome was observed along with a decline in the occurrence of severe forms of schistosomiasis.
Subject(s)
Humans , Glomerulonephritis, Membranoproliferative/parasitology , Glomerulosclerosis, Focal Segmental/parasitology , Schistosomiasis japonica/complications , Schistosomiasis mansoni/complications , Biopsy , Glomerulonephritis, Membranoproliferative/immunology , Glomerulonephritis, Membranoproliferative/pathology , Glomerulosclerosis, Focal Segmental/immunology , Glomerulosclerosis, Focal Segmental/pathology , Schistosomiasis japonica/immunology , Schistosomiasis japonica/pathology , Schistosomiasis mansoni/immunology , Schistosomiasis mansoni/pathologyABSTRACT
This study examined endogenous cannabinoid (ECB)-anandamide (AEA) and its cannabinoid receptors (CBR) in mice liver with the development of schistosoma japonicum. Mice were infected with schistosoma by means of pasting the cercaria onto their abdomens. Liver fibrosis was pathologically confirmed nine weeks after the infection. High performance liquid chromatography (HPLC) was employed to determine the concentration of AEA in the plasma of mice. Immunofluorescence was used to detect the expression of CBR1 and CBR2 in liver tissue. Morphological examination showed typical pathological changes, with worm tubercles of schistosoma deposited in the liver tissue, fibrosis around the worm tubercles and infiltration or soakage of inflammatory cells. Also, CBR1 and CBR2 were present in hepatocytes and hepatic sinusoids of the two groups, but they were obviously enhanced in the schistosoma-infected mice. However, the average optical density of CBR1 in the negative control and fibrosis group was 13.28+/-7.32 and 30.55+/-7.78, and CBR2 were 28.13+/-6.42 and 52.29+/-4.24 (P<0.05). The levels of AEA in the fibrosis group were significantly increased as compared with those of the control group. The concentrations of AEA were (0.37+/-0.07) and (5.67+/-1.34) ng/mL (P<0.05). It is concluded that the expression of endocannabinoids AEA and its cannabinoid receptor CBR were significantly increased in schistosoma-infected mice. Endogenous endocannabinoids may be involved in the development of schistosoma-induced liver fibrosis.
Subject(s)
Arachidonic Acids/metabolism , Endocannabinoids/metabolism , Liver Cirrhosis/etiology , Liver Cirrhosis/metabolism , Liver Cirrhosis/parasitology , Polyunsaturated Alkamides/metabolism , Random Allocation , Receptor, Cannabinoid, CB1/metabolism , Receptor, Cannabinoid, CB2/metabolism , Schistosomiasis japonica/complications , Schistosomiasis japonica/metabolismABSTRACT
Seven hundred and eighty-five individuals from an area endemic for Schistosoma japonicum had parasitological and physical examinations done. A morbidity questionnaire was also administered to each participant. Among those with S. japonicum infection, there was a significant increase in diarrhea, blood in the stool and weakness during the previous two weeks. The severity of the disease appears to be related to the history of schistosomiasis japonicum and these results give further justification for treatment of the infected individuals and those severe morbidity groups in community based chemotherapy programs designed to reduce morbidity in endemic areas.
Subject(s)
Adolescent , Adult , Age Distribution , Case-Control Studies , Child , Child, Preschool , China/epidemiology , Diarrhea/parasitology , Endemic Diseases , Female , Humans , Male , Middle Aged , Morbidity , Prevalence , Surveys and Questionnaires , Schistosomiasis japonica/complications , Severity of Illness Index , Sex DistributionABSTRACT
Forty-six school children with japonicum schistosomiasis living in a village at Napu Valley, Indonesia were treated with praziquantel at a dosage of 70 mg/kg in two divided doses in a day. The number of children with palpable liver dropped significantly from 95.6% before treatment to 58.7% after treatment. The size of the liver was reduced in the majority of cases with a virtual disappearance of cases with very large liver (10 cm). Post-treatment increase of the liver size was observed in all 8 cases with small pre-treatment livers (0.5-1 cm). In contrast to the changes of the size of the liver after treatment, the number of children with palpable spleens before and after treatment was not significantly altered.