RESUMEN
Serum levels of secretory immunoglobulin A [S-IgA] have not been thoroughly investigated in Schistosomiasis mansoni. The aim of the present work has been to assess if the relation of serum S-IgA to liver insult in alcoholic liver disease can be extrapolated on the situation of Schistosomiasis mansoni. For this, 112 male subjects in their third decade of life have been included in the present study, and followed up for 5 years. Among them, 27 patients with intestinal Schistosomiasis without hepatic affection at the time of inclusion in the study, five of them showed hepatic pathology later on during the follow-up period; 45 patients with intestinal Schistosomiasis complicated by hepatic fibrosis with preserved liver functions, 19 of these showed deterioration of liver functions of variable degrees later on during follow-up, and 40 matched healthy volunteers as a control group. All patients were subjected to egg count in stools using Kato technique; and passive hemagglutination test using Schistosoma mansoni soluble egg antigen; both patients and controls were subjected to liver function tests and quantitation of serum levels of S-IgA using a solid phase direct competition radioimmunoassay. The results of the present study revealed statistically significant differences in serum levels of serum S-IgA in groups and subgroups of patients with hepatic affection being higher than in those without it. These differences are more accentuated in those who developed impairment of liver functions. These findings were consistent even at the onset of the study and even in subgroups of patients who only later on developed these changes. The prognostic value of serum S-IgA, described for the first time in the context of Schistosomiasis mansoni, is further consolidated by the presence of significant moderate to strong linear correlation between S-IgA levels and most parameters of liver function with a concomitant absence of any correlation with egg count or passive hemagglutination titers. Cut off levels of serum S-IgA predicting development of hepatic affection and/or impairment of liver functions have been suggested