Canine gastrointestinal pythiosis: a case report in Brazilian Pantanal from a diagnostic approach / Pitiose gastrointestinal canina: relato de caso no Pantanal brasileiro a partir de uma abordagem diagnóstica

Pythiosis is caused by an aquatic fungus-like organism (Pythium insidiosum). It is considered an important public health issue as it can affect both animals and humans. This paper reports a case of gastrointestinal pythiosis in a dog. The patient was hospitalized for four days, during which the animal received supportive and symptomatic treatment. But the applied treatment was unsuccessful and the dog's clinical condition worsened, culminating in death. Complementary imaging tests such as radiography and ultrasonography, as well as hematological tests, were performed during the hospitalization period. The definitive diagnosis was reached in the postmortem as macroscopic and microscopic characteristics suggested the presence of intestinal granuloma and accentuated multifocal suppurative necrotic enteritis. Additionally, the histological evaluation revealed morphological structures compatible with P. insidiosum. Also, the results of nested PCR performed showed partial amplification (105 bp) of the ITS1 region of the ribosomal gene of P. insidiosum.(AU)

A pitiose é causada por um organismo aquático semelhante a um fungo (Pythium insidiosum) e considerada um importante problema de saúde pública, pois pode afetar animais e humanos. Este artigo relata um caso de pitiose gastrointestinal em um cão. O paciente ficou internado por quatro dias, período em que o animal recebeu tratamento de suporte e sintomático. No entanto, o tratamento aplicado não teve sucesso e o quadro clínico do cão piorou, culminando com a morte. Exames de imagem complementares, como radiografia e ultrassonografia, bem como exames hematológicos, foram realizados durante o período de internação. O diagnóstico definitivo foi feito na autópsia, pois as características macroscópicas e microscópicas sugeriam a presença de granuloma intestinal e acentuada enterite necrótica multifocal supurativa. Além disso, a avaliação histológica revelou estruturas morfológicas compatíveis com P. insidiosum. Além disso, a nested PCR foi realizada e mostrou amplificação parcial (105 pb) da região ITS1 do gene ribossomal de P. insidiosum.(AU)

Schistosoma mansoni granulomas in the skeletal striated muscles in the murine model of neuroschistosomiasis: histological findings

Schistosomiasis mansoni presents many clinical manifestations during migration of schistosomes in their hosts, including diarrhea, hepatomegaly, splenomegaly, liver abscesses, skinlesions, brain tumors and myeloradiculopathy. No lesions have been reported in skeletal striated muscles due to schistosomiasis mansoni in the literature. This short communication reports the histopathological findings on skeletal musculature in a murine model of neuroeschistosomiasis mansoni. Lesions were found in the tongue, masseter muscle, buccinator muscle, digastric muscle and temporalis muscle. Worm recovery was carried out to confirm the infection. We describe here, for the first time in the literature, injuries in the skeletal musculature due to Schistosoma mansoni nfection.

Demodicosis as treatment complication of amicrobial pustulosis of the folds

Abstract: Amicrobial pustulosis of the folds is a chronic relapsing neutrophilic dermatosis characterized by sterile pustules compromising skin folds, scalp, face and periorificial regions. It predominantly affects women. Demodicosis is an inflammatory disease associated with cutaneous overpopulation of the mite Demodex spp., the pathogenesis of which is not completely established, but is frequently related to local immunodeficiency. A case of a young woman with amicrobial pustulosis of the folds, and isolated worsening of facial lesions, is reported; investigation revealed overlapping demodicosis. There was complete regression of lesions with acaricide and cyclin treatment. This case warns of a poorly diagnosed but disfiguring and stigmatizing disease, often associated with underlying dermatoses or inadvertent treatments on the face.

Ameliorative Effect of Bone Marrow-Derived Stem Cells on Injured Liver of Mice Infected with Schistosoma mansoni

The technique of stem cells or hepatocytes transplantation has recently improved in order to bridge the time before whole-organ liver transplantation. In the present study, unfractionated bone marrow stem cells (BMSCs) were harvested from the tibial and femoral marrow compartments of male mice, which were cultured in Dulbecco's modified Eagle's medium (DMEM) with and without hepatocyte growth factor (HGF), and then transplanted into Schistosoma mansoni-infected female mice on their 8th week post-infection. Mice were sacrificed monthly until the third month of bone marrow transplantation, serum was collected, and albumin concentration, ALT, AST, and alkaline phosphatase (ALP) activities were assayed. On the other hand, immunohistopathological and immunohistochemical changes of granuloma size and number, collagen content, and cells expressing OV-6 were detected for identification of liver fibrosis. BMSCs were shown to differentiate into hepatocyte-like cells. Serum ALT, AST, and ALP were markedly reduced in the group of mice treated with BMSCs than in the untreated control group. Also, granuloma showed a marked decrease in size and number as compared to the BMSCs untreated group. Collagen content showed marked decrease after the third month of treatment with BMSCs. On the other hand, the expression of OV-6 increased detecting the presence of newly formed hepatocytes after BMSCs treatment. BMSCs with or without HGF infusion significantly enhanced hepatic regeneration in S. mansoni-induced fibrotic liver model and have pathologic and immunohistopathologic therapeutic effects. Also, this new therapeutic trend could generate new hepatocytes to improve the overall liver functions.

Rattus norvegicus como indicador de la circulación de Capillaria hepatica y Taenia taeniaeformis en la Plaza Minorista de Medellín, Colombia / Rattus norvegicus as an indicator of circulation of Capillaria hepatica and Taenia taeniaeformis on a groceries trade center of Medellín, Colombia

Introducción. Rattus norvegicus cumple un papel epidemiológico en el mantenimiento y dispersión de agentes zoonóticos bacterianos, virales y parasitarios de interés en salud pública. La presencia de infección por helmintos en especies Rattus cercanas a poblaciones expuestas en condiciones ambientales propicias, puede convertirse en un factor de riesgo de transmisión. Objetivo. Reportar la frecuencia de infección con Capillaria hepatica y formas larvarias de Taenia taeniaeformis en ratas silvestres (R. norvegicus) capturadas en una zona urbana de Medellín. Materiales y métodos. Se capturaron 254 ejemplares de R. norvegicus. Los hígados de 54 ejemplares que presentaron lesión hepática macroscópica durante la necropsia, fueron examinados por histopatología convencional. Resultados. La frecuencia de infección por C. hepatica fue de 20,1 % (51/254). Seis hígados fueron también positivos para larvas de T. taeniaeformis con una frecuencia de 2,4 % (6/254). Los hígados infestados con C. hepatica exhibían parásitos en el estadio adulto o juvenil y huevos ovalados con opérculos bipolares, asociados con hepatitis granulomatosa leve a moderada multifocal y acompañada por infiltrado leucocitario. Se observaron lesiones granulomatosas en resolución y fibrosis residual o calcificada que contenía huevos. Donde se encontraron cisticercos de T. taeniaeformis, el hallazgo más frecuente fueron quistes hepáticos que contenían larvas, y lesiones inflamatorias y fibróticas. Conclusión. Estos resultados indican que helmintos de potencial zoonótico circulan en R. norvegicus de ambientes urbanos. Debe investigarse la verdadera distribución de estos parásitos, para determinar el riesgo potencial que corren las poblaciones animales y humanas expuestas a adquirir este tipo de infecciones.

Introduction. Rattus norvegicus, the Norway rat, plays a pivotal role in the maintenance and spread of several zoonotic bacterial, viral and parasitic pathogens of public health interest. The presence of helminthic infections near susceptible human populations can, under appropriate environmental conditions, become a risk factor for their transmission. Objective. Frequencies of infection were reported for Capillaria hepatica and larval forms of Taenia taeniaeformis in wild rats (R. norvegicus) captured in an urban area. Materials and methods. Two hundred and fifty-four adult specimens of R. norvegicus were collected in an urban zone of Medellín, Colombia. The livers of 54 specimens that showed macroscopic hepatic lesions during necropsy were examined by conventional histopathology. Results. The frequency of infestation with C. hepatica was 20.1% (51/254). Six livers (2.4%) were also positive for larvae of T. taeniaeformis. Livers infested with C. hepatica exhibited adult or juvenile parasites and oval eggs with bipolar opercula, and were associated with mild to moderate multifocal granulomatous hepatitis with leucocyte infiltrate. Granulomatous lesions and calcified residual fibroses were found with eggs but without adult parasites. Those animals with cysticerci of T. taeniaeformis showed a high frequency of hepatic cysts containing larvae as well as inflammed and fibrotic lesions. Conclusion. Zoonotic helminths circulate at high frequency in R. norvegicus that occur in urban environments. Further research about the distribution of these parasites will determine the level of health threat they present for susceptible human and domestic animal populations.

Schistosoma mansoni granuloma in late evolutive phase, in a case of tumoral form in man / Granuloma equistossomótico em fase evolutiva tardia, em um caso de forma tumoral no homem

INTRODUCTION: Authors describe human schistosomal granuloma in late chronic phase, from the morphological and evolutionary viewpoints. METHODS: The study was based on a histological analysis of two fragments obtained from a surgical biopsy of peritoneum and large intestine of a 42-year-old patient, with a pseudotumoral form mimicking a peritoneal carcinomatosis associated to the schistosomiasis hepatointestinal form. RESULTS: Two hundred and three granulomas were identified in the pseudotumor and 27 in the intestinal biopsy, with similar morphological features, most in the late chronic phase, in fibrotic healing. A new structural classification was suggested for granulomas: zone 1 (internal), 2 (intermediate) and 3 (external). CONCLUSIONS: Regarding granuloma as a whole, we may conclude that fibrosis is likely to be controlled by different and independent mechanisms in the three zones of the granuloma. Lamellar fibrosis in zone 3 seems to be controlled by matrix mesenchymal cells (fibroblasts and myoepithelial cells) and by inflammatory exudate cells (lymphocytes, plasmocytes, neutrophils, eosinophils). Annular fibrosis in zone 2, comprising a dense fibrous connective tissue, with few cells in the advanced phase, would be controlled by epithelioid cells involving zone 1 in recent granulomas. In zone 1, replacing periovular necrosis, an initialy loose and tracery connective neoformation, housing stellate cells or with fusiform nuclei, a dense paucicellular nodular connctive tissue emerges, probably induced by fibroblasts. In several granulomas, one of the zones is missing and granuloma is represented by two of them: Z3 and Z2, Z3 and Z1 or Z2 and Z1 and, ultimately, by a scar.

INTRODUÇÃO: Os autores descrevem o granuloma esquistossomótico no homem, na fase crônica tardia, do ponto de vista morfológico e evolutivo. MÉTODOS: O estudo baseou-se na análise histológica de dois fragmentos obtidos de biópsia cirúrgica do peritônio e do intestino grosso de um paciente de 42 anos de idade, com a forma pseudotumoral mimetizando carcinomatose peritoneal associada à forma hepatointestinal da esquistossomose. RESULTADOS: Foram identificados 203 granulomas no pseudotumor e 27 na biópsia intestinal, com aspectos morfológicos semelhantes, a maioria na fase crônica tardia, em cura por fibrose. Foi sugerida nova classificação estrutural para os granulomas: zona 1 (interna), zona 2 (intermediária) e zona 3 (externa). CONCLUSÕES: Considerando o granuloma como um todo, concluímos que, provavelmente, a fibrose é comandada por mecanismos diferentes e independentes nas três zonas do granuloma. A fibrose lamelar na zona 3 parece ser comandada pelas células mesenquimais da matriz (fibroblastos e células mioepiteliais) e pelas células do exsudato inflamatório (linfócitos, plasmócitos, neutrófilos, eosinófilos). A fibrose anular na zona 2, composta por conjuntivo fibroso denso, pouco celular na fase avançada, seria comandada pelas células epitelioides que envolvem a zona 1 nos granulomas recentes. Na zona 1, substituindo a necrose periovular, a neoformação conjuntiva inicialmente frouxa, rendilhada, albergando células estreladas ou com núcleos fusiformes, surge um conjuntivo denso, paucicelular, nodular, provavelmente induzido pelos fibroblastos. Em muitos granulomas falta uma das zonas descritas e o granuloma é representado apenas por duas delas: Z3 e Z2, Z3 e Z1 ou Z2 e Z1 e, no final, por uma cicatriz.

Achados ultrassonográficos em toxocaríase ocular / Ultrasonographic findings in ocular toxocariasis

OBJETIVO: Avaliar achados ultrassonográficos nas três principais formas de apresentação da toxocaríase ocular (granulomas de periferia e polo posterior e endoftalmite crônica), em pacientes com diagnóstico confirmado de toxocaríase ocular. MÉTODOS: Foram analisados no estudo 11 pacientes (11 olhos), de forma prospectiva, com diagnóstico de toxocaríase forma ativa, com teste ELISA positivo. Os pacientes foram submetidos ao exame de ultrassonografia ocular (transdutor 10 MHz, técnica de contato). RESULTADOS: Na série de 11 pacientes, com idade média de 7,9 anos (variando de 2 a 17 anos), 73% homens, referiram contato prévio com cães (91%), e com solo (50%), sem referência à perversão do apetite. Na avaliação dos olhos comprometidos (11 olhos), o exame oftalmológico revelou a seguinte distribuição das três formas de toxocaríase ocular: 7 (63,6%), granuloma de polo posterior; 1 (9,1%), endoftalmite crônica; 2 (18,2%), granuloma periférico; e 1 (9,1%), quadro associado de granuloma de polo posterior e endoftalmite crônica. Acuidade visual comprometida: sem percepção luminosa (3 olhos, 27,3%); visão de vultos (4 olhos, 36,4%); contar dedos a 10 cm (1 olho, 9,1%); 20/200 (1 olho, 9,1%); 20/70 (1 olho, 9,1%); indeterminado (1 olho, 9,1%). Sorologia para Toxocara canis foi positiva (teste ELISA) em 100% dos casos. Oftalmoscopia foi difícil ou impossível em 64% dos casos devido à opacidade de meios. Características ultrassonográficas observadas: membranas vítreas com retina aplicada (100%); lesões de parede (granulomas) com refletividade alta (80%) ou média (20%). CONCLUSÃO: O achado ultrassonográfico mais consistente no olho portador de toxocaríase foi a presença de massa retiniana de alta refletividade, localizada no polo posterior ou periferia, que pode ser calcificada, e que apresenta como principal característica a aderência de membranas vítreas. Em combinação com a história, exame clínico e sorologia, a ultrassonografia pode ajudar no diagnóstico da toxocaríase ocular, principalmente nos casos com opacidade de meios.

PURPOSE: To evaluate ophthalmic ultrasound findings in the three presentation forms of ocular toxocariasis (peripheral or posterior pole granulomas and chronic endophthalmitis), in patients with confirmed diagnosis of ocular toxocariasis. METHODS: 11 patients (11 eyes) with clinical and confirmed diagnosis of active ocular toxocariasis, presented positive ELISA test, were analyzed, prospectively, in the study. The patients were submitted to an ocular ultrasound examination (10-MHz transducer, contact technique). RESULTS: In the series of 11 patients, mean age was 7.9 years-old (range from 2 to 17 y), 73% male, referring previous contact with dogs (91%), and with the soil (50%), no referral of appetite perversion. In the analyses of compromised eyes (11 eyes), the ophthalmoscopic examination revealed the following distribution of the 3 forms of ocular toxocariasis: 7 cases (63.6%), posterior pole granuloma; 1 (9.1%), chronic endophthalmitis; 2 (18.2%), peripheral granuloma; and 1 (9.1%), posterior pole granuloma associated with chronic endophthalmitis. Visual acuity impairment: no light perception (3 eyes, 27.3%); hand motion (4 eyes, 36.4%); counting fingers at 10 cm (1 eye, 9.1%); 20/200 (1 eye, 9.1%); 20/70 (1 eye, 9.1%); undefined (1 eye, 9.1%). Serology was positive to Toxocara canis (ELISA test) in 100% of the cases. Ophthalmoscopy was difficult or impossible in 64% of the cases due to the media opacity. Ultrasound findings noted were vitreous membranes with retinal attachment (100%); parietal lesions (granulomas) with high (80%) or medium (20%) reflectivity. CONCLUSION: The most consistent ultrasound finding in the eye with toxocariasis was a high-reflectivity retinal mass, located in posterior pole or periphery, which may be calcified, and which has as main characteristic the adherence of vitreous membranes. In addition to clinical history, systemic evaluation and serology, the ultrasound can help in the diagnosis of ocular toxocariasis, especially in media opacities.

Pharmacodynamics of mefloquine and praziquantel combination therapy in mice harbouring juvenile and adult Schistosoma mansoni

Praziquantel (PZQ) is currently the only drug widely used for the treatment of schistosomiasis, but the antimalarial drug mefloquine (Mef) possesses interesting antischistosomal properties. Combination therapy with these two drugs has been suggested as a strategy for transmission control, as PZQ is active against adult worms and Mef is active against schistosomula. To examine the efficacy of combination therapy, Schistosoma mansoni-reinfected mice were separated into seven groups: untreated (I), treated with PZQ in doses of 200 mg/kg (II) or 1,000 mg/kg (III), treated with Mef in doses of 200 mg/kg (IV) or 400 mg/kg (V); each dose was divided equally and given on two consecutive days. Group VI was treated with doses of PZQ + Mef as in groups II and IV, respectively, while group VII was treated with PZQ + Mef as in groups III and V, respectively. PZQ + Mef at the reduced doses of 200 mg/kg each enhanced the therapeutic efficacy over the reduced PZQ dose alone as shown by a very high reduction in the total numbers of mature worms (95 percent vs. 49 percent), immature worms (96 percent vs. 29 percent) and the complete eradication of immature females, mature females and immature eggs. The reduction in worm burden was associated with the healing of hepatic granulomatous lesions and the normalisation of all liver enzymes. Therefore, the use of Mef with PZQ is more effective than PZQ alone and should be considered for clinical trials in humans as a potential treatment regimen to prevent treatment failures in areas with high rates of schistosomiasis.

Histological and histomorphometric evaluation of the retina of mice infected with Schistosoma mansoni in its hepatosplenic form / Avaliação histológica e histomorfométrica da retina de camundongos infectados pelo Schistosoma mansoni na forma hepatoesplênica

PURPOSE: To evaluate retinal manifestations of Schistosomiasis mansoni in its hepatosplenic form in mice. METHODS: It was performed a study with two groups of mice; one of them was infected with 40 cercariae of Schistosoma mansoni. After 120 days of the infection, the eyes underwent a retinal microscopy study. The histology findings were reported. Histomorphometric analysis was also performed, including: thickness measurement of the retinal layer and the number of the ganglion layer cells. RESULTS: In one case a retinal granuloma was found. The analysis of the other histological sections demonstrated normal architecture of the retina. The mean thickness of the retinal layer between the two groups were similar (41.81±6.09µm versus 38.48±8.58µm - p=0.279); as well as the mean number of the ganglion layer cells (20.93±4.88 versus 20.64±4.10 - p=0.864). Disorganization of the retinal layers was not identified and the histomorphometric analysis revealed no significant difference between the two groups. CONCLUSION: The absence of findings in this study does not exclude that hemodynamic and autoregulation changes associated with hepatosplenic schistosomiasis could be correlated to retinal manifestations. It is necessary that other methods with a high parasite infection should be performed.

OBJETIVO: Avaliar as repercussões da esquistossomose mansônica na forma hepatoesplênica na retina de camundongos. MÉTODOS: Foi realizado estudo com dois grupos de camundongos, sendo um infectado com 40 cercárias do Schistosoma mansoni. Decorridos 120 dias da infecção, os olhos foram submetidos à análise microscópica da retina com descrição dos achados histológicos e realizada análise histomorfométrica com mensuração da espessura de segmento retiniano e do número de células da camada ganglionar. RESULTADOS: Em um caso foi encontrado um granuloma retiniano. Já a análise dos demais cortes histológicos demonstrou uma arquitetura normal da retina. A média da espessura dos segmentos retinianos entre os grupos de camundongos, controle e infectado, foi similar (41,81±6,09µm versus 38,48±8,58µm - p=0,279) assim como a média do número de células da camada ganglionar (20,93±4,88 versus 20,64±4,10 - p=0,864). : A estrutura da retina encontrava-se íntegra e a análise histomorfométrica não revelava diferença significante entre os dois grupos. CONCLUSÃO: A ausência de alterações, neste estudo, não afasta a possibilidade de que desequilíbrios hemodinâmicos e no mecanismo de autoregulação, em portadores da forma hepatoesplênica da esquistossomose, possam acarretar dano retiniano. Demanda, entretanto, que outras metodologias com indução da infecção com uma maior carga parasitária sejam realizadas.

Carbohydrates detection in the hepatic egg - granuloma system using lectin histochemistry

This study aims to evaluate the egg-granuloma system in hepatic tissues using lectin histochemistry in experimental Schistosomiasis. Eight Swiss mice were infected with a local strain of Schistosoma mansoni, being submitted forty days later to a perfusion after which slices of liver were prepared. The tissue samples were incubated with the following peroxidase conjugated lectins: Peanut agglutinin (PNA), Wheat Germ agglutinin (WGA), and Concanavalin A (Con A). All lectins recognized the glycoconjugates in the adult worm tegument. In the hepatic tissue, WGA presented the highest staining followed by PNA and Con A. The PNA presented the most intense staining of the egg-granuloma system while WGA stained the hepatic sinusoid cells and Con A bound preferentially the fibrosis rings of granuloma and the surrounding hepatic parenquima. WGA and PNA indicated the presence of residues of N-acetyl-glucosamine and galactose in the surface of Schistosoma mansoni eggs in the hepatic granulomas. In conclusion, using PNA, Con A and WGA our study presented different aspects of the egg-granuloma and Tegument of Schistosoma mansoni as well as indicated differences in the peri-ovular granulomas indicating alterations in the cellular mechanism of expression of surface carbohydrates during progression of the Schistosomiasis.

El objetivo del estudio fue evaluar el sistema de los huevos de los granulomas en los tejidos hepáticos, utilizando histoquímica de lectinas esquistosomiasis. Ocho ratones suizos experimentales fueron infectados con una cepa local de Schistosoma mansoni y luego a los cuarenta días fueron sometidos a la perfusión y se prepararon cortes de hígado. Las muestras de los tejidos fueron incubadas con las siguientes peroxidasas lectinas conjugadas: aglutinina de maní (PNA), aglutinina de germenn de trigo (WGA), Concanavalin A (Con A). Todas las lectinas reconocieron las glicoconjugadas en el tegumento del gusano adulto. El tejido hepático con WGA presentó mayor coloración seguido de PNA y Con A. El PNA presentó la más intensa tinción de los huevos mientras el granuloma del sistema WGA tiñó las células hepáticas sinusoides y las Con A estuvieron siempre presentes en los anillos de la fibrosis y alrededor de los granulomas hepáticos del parénquima. WGA y PNA indicaron la presencia de residuos de N - acetil - glucosamina y galactosa en la superficie de los huevos de Schistosoma mansoni en los granulomas hepáticos de esquistosomiasis.

Schistosomiasis haematobia: histopathological course determined by cystoscopy in a patient in whom praziquantel treatment failed / Esquistossomíase hematóbica: seguimento histopatológico determinado por cistoscopia em um paciente com falha terapêutica ao praziquantel

Schistosomiasis haematobia or urinary schistosomiasis is one of the main public health problems in Africa and the Middle East. A single dose of 40 mg praziquantel per kg body weight continues to be the treatment of choice for this infection. The aims of this follow-up were to study the post-treatment course of a patient infected with S. haematobium and not submitted to re-exposure, and to identify complications of the disease and/or therapeutic failure after praziquantel treatment by histopathological analysis. Treatments were repeated under medical supervision to ensure the correct use of the drug. In view of the suspicion of lesions in cystoscopy, the patient was submitted to bladder biopsy. The histopathological characteristics observed in biopsies obtained, after each treatment, indicated viability of parasite eggs and activity of granulomas.

A Esquistossomíase Hematóbica ou Esquistossomíase Urinária é um dos principais problemas de Saúde Pública na África e no Oriente Médio. Uma única dose de praziquantel 40 mg/kg de peso, continua sendo o tratamento de escolha para esta infecção. Os objetivos deste seguimento foram: avaliar o período pós-tratamento de um paciente infectado com Schistosoma haematobium e não submetido à re-exposição e, identificar as complicações da doença e/ou falha terapêutica, após o tratamento com praziquantel, por análise histopatológica de material obtido por biópsia vesical. O tratamento foi repetido sob supervisão médica para assegurar o uso correto do medicamento. Na presença de lesões suspeitas a cistoscopia, o paciente foi submetido a biópsia vesical. As características histopatológicas observadas nos materiais obtidos por biópsia, após cada tratamento, indicaram viabilidade de ovos e atividade dos granulomas.

A distribuição dos eosinófilos nas diferentes fases de evolução do granuloma hepático em camundongos infectados pelo Schistosoma mansoni / Distribution of eosinophils at different stages of hepatic granuloma evolution in mice infected with Schistosoma mansoni

No presente estudo, avaliou-se a distribuição dos eosinófilos nas diferentes fases da formação do granuloma hepático de camundongos infectados pelo Schistosoma mansoni. A partir dos resultados obtidos sugerimos uma nova classificação para a evolução do granuloma hepático em camundongos montada a partir de fases descritas por outros autores. Em cada fase há um padrão diferente de distribuição dos eosinófilos. Na fase necrótico-exudativa os eosinófilos encontram-se concentrados na periferia e no centro do granuloma e na área de necrose eles são escassos; na "produtiva" os eosinófilos estão ainda distribuídos de maneira difusa por todo o granuloma; na de cura por fibrose se concentram na periferia e no centro do granuloma. Os eosinófilos estavam em contato direto com os ovos em todos os estágios de evolução dos granulomas. Conclui-se então que a dinâmica dos eosinófilos possui papel importante na formação da reação granulomatosa do hospedeiro e resolução do processo inflamatório causado pelo ovo do parasita, além de acrescentar novos dados na classificação dos granulomas hepáticos.

In the present study, the distribution of eosinophils at different stages of the formation of hepatic granuloma in mice infected with Schistosoma mansoni was evaluated. From the results obtained, we suggest a new classification for the evolution of hepatic granuloma in mice, constructed from the phases described by other authors. In each phase, there is a different pattern of eosinophil distribution. In the exudative-necrotic phase, the eosinophils are concentrated in the periphery and center of the granuloma, and are scarce in the necrotic area; in the productive phase, the eosinophils are dispersed throughout the granuloma; and in the cure due to fibrosis phase, the eosinophils are concentrated in the periphery and center of the granuloma. Eosinophils were found in direct contact with the eggs at all stages of evolution of the granuloma. It was concluded that the dynamics of eosinophils have an important role in forming the granulomatous reaction of the host and in resolving the inflammatory process caused by the parasite egg, as well as adding new data regarding hepatic granuloma classification.

Flowcytometric analysis of T-lymphocytes and serum tumour necrosis factor alpha [TNF- alpha] levels in schistosoma mansoni patients

Analysis of T-lymphocytes by flowcytometry, estimation of serum TNF-alpha level by solid phase enzyme amplified sensitivity immunoassay [EASIA] and IHAT were done for chronic schistosomiasis mansoni patients without hepatic fibrosis, with hepatosplenomegaly and 20 healthy controls. The sensitivity and specificity of IHAT in schistosomiasis mansoni were 85% and 90% respectively. Chronic schistosomiasis mansoni patients showed increase in CD8% [27.3 +/- 5.3] and decrease in CD4% [44.2 +/- 4.68]. Hepatosplenomegaly cases showed increase in CD4% [46.5 +/- 4.1] and decrease in CD8% [23.2 +/- 2.18]. Serum level of TNF-alpha was significantly higher in cases with hepatosplenomegaly compared to either cases of chronic schistosomiasis mansoni or controls. No significant difference was between chronic schistosomiasis mansoni patients and controls. A correlation between hepatosplenomegaly and increase of CD4 and/or decrease of CD8 and significant high level of TNF-alpha indicated TNF-alpha role in granuloma formation

Four whole-istic aspects of schistosome granuloma biology: fractal arrangement, internal regulation, autopoietic component and closure

This paper centers on some whole-istic organizational and functional aspects of hepatic Schistosoma mansoni granuloma, which is an extremely complex system. First, it structurally develops a collagenic topology, originated bidirectionally from an inward and outward assembly of growth units. Inward growth appears to be originated from myofibroblasts derived from small portal vessel around intravascular entrapped eggs, while outward growth arises from hepatic stellate cells. The auto-assembly of the growth units defines the three-dimensional scaffold of the schistosome granulomas. The granuloma surface irregularity and its border presented fractal dimension equal to 1.58. Second, it is internally regulated by intricate networks of immuneneuroendocrine stimuli orchestrated by leptin and leptin receptors, substance P and Vasoactive intestinal peptide. Third, it can reach the population of ± 40,000 cells and presents an autopoietic component evidenced by internal proliferation (Ki-67+ Cells), and by expression of c-Kit+ Cells, leptin and leptin receptor (Ob-R), granulocyte-colony stimulating factor (G-CSF-R), and erythropoietin (Epo-R) receptors. Fourth, the granulomas cells are intimately connected by pan-cadherins, occludin and connexin-43, building a state of closing (granuloma closure). In conclusion, the granuloma is characterized by transitory stages in such a way that its organized structure emerges as a global property which is greater than the sum of actions of its individual cells and extracellular matrix components.

Histopathological study of Schistosoma mansoni infection in the murine model using the PC (Pará) and LILA (Maranhão) strains

Experimental models of Schistosoma mansoni infections in mammals have contributed greatly in understanding the pathology and pathogenesis of human infection. The absence of earlier reviews regarding specific strains of the Amazon region prompted research, which the main objective was to describe histopathological lesions in different phases of schistosomiasis in a murine model using PC (Pará) and LILA (Maranhão) S. mansoni strains. One hundred and eighty young female albino swiss mice (Mus musculus) were used and were randomly divided into five groups (PC-01, PC-02, LILA-01, LILA-02, and controls), according to the number of cercariae injected and the strain adopted. Animals were sacrificed in predetermined periods (35, 56, 112, 156, and 180 days) in an attempt to follow the evolution of the disease in the histological sections of their tissues at different phases of infection. Our findings were compatible with the data already described by others authors using different strains of S. mansoni, making it possible to identify some peculiarities, which are discussed in this work. In conclusion, the strains of parasite used did not modify the histopathological findings in the tissues of infected mice in any significant way when compared with the results of other studies using different strains.

Infecciones por amebas de vida libre. Comentarios históricos, taxonomía y nomenclatura, protozoología y cuadros anátomo-clínicos / Infections caused by free-living amebas: historical commentaries, taxonomy and nomenclature, protozoology and clinicopathologic features

Infections caused by free-living amebae constitute one of emergent opportunistic infections with greatest medical interest. Although infrequently, they have been described in almost all world, its diagnosis depends on a high index of suspicion, especially in morpho-pathologic and laboratory studies. Exciting historical features of infections due to free-living amebae, its taxonomy and the present nomenclature are briefly reviewed. An analysis of the protozoology of the most frequent agents is done and, based on the author's own experience and the published one, already established anatomo-clinical entities are described: the primary amebic meningoencephalitis, granulomatous amebic encephalitis, Acanthamoeba keratitis, cutaneous acanthamoebiasis, disseminated infection and other rare isolated locations.

Encefalitis amebiana granulomatosa por Balamuthia mandrillaris. Primer caso diagnosticado en Chile / Granulomatous amebic encephalitis caused by Balamuthia mandrillaris: first case diagnosed in Chile

Se presenta el caso de un lactante de sexo masculino de 7 meses de vida con una historia de varias semanas de evolución caracterizada por convulsiones, fiebre y cambios conductuales. Hospitalizado, la tomografía axial computada de cerebro mostró lesiones multifocales de algunos mm a 4 cm de diámetro, sin efecto de masa, y una biopsia de las mismas reveló una encefalitis necrotizante con arteritis necrótica fibrinoide. A pesar del tratamiento, las lesiones progresaron y el niño falleció. La necropsia demostró una extensa encefalitis necrotizante, multifocal, con arteritis necrótica fibrinoide, algunos signos de organización, y la presencia de elementos parasitarios con caracteres de trofozoitos y quistes de amebas de vida libre del género Acanthamoeba o Balamuthia. Además, se constató una hipoplasia- displasia del timo y signos de schok. Los elementos encontrados corresponden al cuadro descrito como encefalitis amebiana granulomatosa y el agente encontrado fue tipificado, (Centers for Disease Control and Prevention, Atlanta, USA) correspondiendo a la especie Balamuthia mandrillaris.

Meningoencefalitis granulomatosa por Balamuthia mandrillaris: Reporte de un caso y revisión de la literatura / Granulomatous amoebic meningoencephalitis by Balamuthia mandrillaris: case report and literature review

Durante los últimos años, otra ameba de vida libre, Balamuthia mandrillaris, ha sido identificada como agente etiológico de meningoencefalitis granulomatosa amebiana (MGA) en humanos. Presentamos el caso de una escolar de sexo femenino, inmunocompetente en quien se realizó el diagnóstico post mortem de MGA por este agente. Consultó por aparición de lesiones eritematosas e induradas que comprometían la zona centro-facial. En biopsia cutánea se evidenció una lesión granulomatosa con RPC positiva para secuencias génicas de Mycobacterium atípico, por lo que se inició tratamiento para micobacteriosis atípica extrapulmonar. Evolucionó con compromiso neurológico progresivo, falleciendo aproximadamente un año después de iniciar los síntomas. La necropsia reveló una MGA, cuyo estudio posterior demostró la presencia de B. mandrillaris. La infección por B. mandrillaris debe ser considerada en el diagnóstico diferencial de una enfermedad granulomatosa crónica que evoluciona con compromiso neurológico.

Does Cleome droserifolia have anti-schistosomiasis mansoni activity? / Cleome droserifolia tem atividade anti-esquistossomose mansônica?

The present study was undertaken to assess the effect of the crude extract of Cleome droserifolia (CD) leaves on experimentally infected mice with Schistosoma mansoni. Two groups of mice, showing a patent infection of S. mansoni, one of them was daily treated with an alcoholic extract of CD leaves (0.31 g kg-1 body weight, i.p.) for 21 days. The schistosomicidal activity of the CD extract was evaluated, three weeks post-treatment, on some parasitological and histopathological aspects including worm load, oogram pattern, faecal eggs releasing and granuloma formation. In addition, serum thyroid hormones levels (tri-iodothyronine; T3 and tetra-iodo-thyronin; T4), serum total protein contents and hepatic reduced glutathione (GSH) were evaluated. Treatment using CD extract resulted in a weak reduction in worm burden (32.46 percent) and affected the viability of both mature and immature eggs as indicated by the increase in the percentage of dead eggs and the decrease in the percentage of live ones. In addition, a week post-treatment, eggs elimination was observed in the stool of the infected-treated group which was low compared to the infected group. There was a suppressive effect of the extract on granuloma formation that could be due to the antioxidant effect of the extract. These data are confirmed by increasing hepatic GSH, serum total proteins and thyroid hormone levels in the infected-treated group as compared to the infected group. Treatment significantly enhanced b globulin fractions of the protein. Based on these assumptions, CD extract has beneficial effects on thyroid hormones status and anti-schistosomiasis activity. The beneficial effects of CD extract could be related to its direct effects on the parasite, and secondary to its effect on the antioxidant capacity of the host. The present study could emphasize the precise mechanism (s) of CD extract protection.

O presente estudo foi realizado para verificar o efeito do extrato cru de folhas de Cleome droserifolia (CD) em camundongos experimentalmente infectados com Schistosoma mansoni. Em dois grupos de camundongos mostrando infecção patente por S. mansoni, um deles foi tratado diariamente com extrato alcoólico de folhas de CD (0.31g kg-1 por peso corporal, i.p.) por 21 dias. A atividade esquistossomicida do extrato de CD foi avaliada, três semanas após o tratamento, em alguns aspectos parasitológicos e histopatológicos incluindo carga parasitária, padrão de oograma, eliminação fecal de ovos e formação de granuloma. Além disto, níveis séricos de hormônio tireoideano (tri-iodotironina: T3 e tetra-iodotironina: T4), conteúdo sérico total de proteínas e glutatione hepático reduzido (GSH) foram avaliados. Tratamento usando extrato de CD resultou em fraca redução da carga de vermes (32,46 por cento) e afetou a viabilidade de ovos maduros ou não, como indicado pelo aumento na porcentagem de ovos mortos e o descrécimo na porcentagem de ovos viáveis. Além disso, uma semana após o tratamento, a eliminação de ovos foi observada nas fezes do grupo infectado-tratado que foi baixa comparada ao grupo infectado. Houve efeito supressivo do extrato sobre a formação de granuloma que poderia ser devido ao efeito antioxidante do extrato. Estes dados são confirmados pelo aumento do GSH hepático, soro total de proteínas e níveis dos hormônios tireoideanos no grupo infecto-tratado quando comparado com o grupo infectado. O tratamento aumentou significativamente as frações beta-globulina da proteína. Baseado nestas afirmativas o extrato de CD tem efeitos benéficos sobre o nível dos hormônios tireoideanos e da atividade anti-esquistossomica. Os efeitos benéficos do extrato de CD poderiam estar relacionados com seu efeito direto sobre o parasita, e secundariamente por seus efeitos na capacidade anti-oxidante do hospedeiro. O presente trabalho poderia enfatizar o(s) mecanismo(s) preciso(s) desta proteção do extrato de CD.

Forma tumoral da esquistossomose mansoni cerebelar: relato de caso e medida dos granulomas / The tumoral form of cerebellar schistosomiasis: case report and measure of granulomas

Caso raro de forma tumoral da esquistossomose mansoni cerebelar diagnosticada pela biópsia, em um paciente de 15 anos, que apresentou sinais e sintomas neurológicos 60 dias antes da cirurgia. A tomografia computadorizada revelou lesão expansiva, hiperdensa, localizada no cerebelo, sugestiva de glioma. O exame histopatológico mostrou numerosos ovos de S. mansoni envolvidos por reação inflamatória granulomatosa na fase necrótico-exsudativa, confluentes, localizados principalmente na camada interna, granular, do cerebelo, formando pseudotumor no verme cerebelar e hemorragia recente na ponte. Foram medidas as áreas dos granulomas.