Haematological and biochemical characteristics of the splenic effluent blood in schistosomal patients undergoing splenectomy / Características hematológica e bioquímica do sangue efluente esplênico em pacientes esquistossomáticos submetidos à esplenectomia

OBJECTIVE: To assess hematological and biochemical features of splenic effluent blood and their influence on the rise of hematological values after splenectomy. METHODS: we studied 20 patients undergoing surgical treatment for schistosomatic portal hypertension. We collected blood samples for CBC, coagulation, bilirubin and albumin in the splenic vein (perioperative) and peripheral blood (immediately pre and postoperative periods). RESULTS: the splenic blood showed higher values of red blood cells, hemoglobin, hematocrit, platelet count, total leukocytes, neutrophils, lymphocytes, monocytes, eosinophils and basophils, as well as reduction of laboratory coagulation parameters in relation to peripheral blood collected preoperatively. In the postoperative peripheral blood there was an increase in the overall leukocytes and in their neutrophil component, and decreased levels of basophils, eosinophils and lymphocytes. The other postoperative variables of complete blood count and coagulation tests were not different compared with the splenic blood. The albumin values were lower postoperatively when compared to preoperative and splenic blood. There were higher values of direct bilirubin in the postoperative period when compared with the preoperative and splenic blood. Postoperative indirect bilirubin was lower compared to its value in the splenic blood. CONCLUSION: hematological and biochemical values of splenic effluent blood are higher than those found in peripheral blood in the presence of schistosomal splenomegaly. However, the splenic blood effluent is not sufficient to raise the blood levels found after splenectomy. .

OBJETIVO: verificar valores hematológicos e bioquímicos do sangue efluído do baço e avaliar a sua influência na elevação dos valores hematológicos após esplenectomia. MÉTODOS: foram estudados 20 pacientes submetidos ao tratamento cirúrgico para hipertensão porta esquistossomática. Foram coletadas amostras sanguíneas para hemograma, coagulograma, bilirrubinas e albumina na veia esplênica (peroperatório) e no sangue periférico (pré e pós-operatórios imediatos). RESULTADOS: o sangue esplênico apresentou valores maiores de: hemácias, hemoglobina, hematócrito, contagem de plaquetas, global de leucócitos, neutrófilos, linfócitos, monócitos, eosinófilos e basófilos, bem como redução dos parâmetros laboratoriais da coagulação em relação ao sangue periférico colhido no pré-operatório. No sangue periférico pós-operatório, houve aumento do global de leucócitos e de seu componente neutrofílico, além de redução dos valores de basófilos, eosinófilos e linfócitos. As demais variáveis do hemograma e do coagulograma pós-operatórios não foram diferentes na comparação com o sangue esplênico. Os valores da albumina foram menores no pós-operatório em relação ao pré-operatório e sangue esplênico. Houve valores maiores para a bilirrubina direta pós-operatória em relação à pré-operatória e à do sangue esplênico. A bilirrubina indireta pós-operatória foi menor em relação ao seu valor no sangue esplênico. . CONCLUSÃO: os valores hematológicos e bioquímicos do sangue efluído do baço são superiores aos encontrados no sangue periférico ...

Células derivadas da medula óssea no reparo de lesões causadas por infecções parasitárias em camundongos quiméricos / Derived bone marrow cells to repair damage caused by parasitic infections in chimeric mice

A contribuição das células de medula óssea na regeneração de tecidos não hematopoiéticos tem sido intensamente investigada desde a descoberta de células-tronco multipotentes neste órgão. Estudos prévios tem demonstrado que células derivadas da medula óssea podem contribuir para a formação de novos hepatócitos e cardiomiócitos. No presente estudo avaliamos a participação endógena das células-tronco de medula óssea no processo de reparo de lesões teciduais na fase crônica da doença de Chagas e esquistossomose experimentalmente induzidas. Para isso, camundongos quiméricos de medula óssea foram gerados após irradiação com dose letal e posterior reconstituição com células de medula óssea provenientes de camundongos transgênicos para a proteína fluorescente verde (GFP)...

he contribution of bone marrow cells in non-hematopoietic tissue regeneration has been intensely investigated since the discovery of multipotent stem cells in this organ. Previous studies have shown that bone marrow derived cells may contribute to the formation of new hepatocytes and cardiomyocytes. In the present study, we evaluated the participation of endogenous bone marrow stem cells in the repair of tissue injury in experimentally induced chronic phases of Chagas disease and schistosomiasis. For this purpose, chimeric mice were generated from bone marrow after a lethal irradiation dose and subsequent reconstitution with bone marrow cells from green fluorescent protein (GFP) transgenic mice...

Lipid profile of subjects infected with Schistosoma haematobium in South-Western Nigeria

To determine the plasma concentrations of total cholesterol, triglycerides, high-density lipoprotein cholesterol [HDL-C] and low-density lipoprotein cholesterol [LDL-C] in Schistosoma haematobium- infected subjects and healthy persons. The plasma concentration of lipids and the fractions with the urine microscopy of one hundred [100] subjects who had evidence of Schistosomiasis, selected from 14C, a rural area in Osun State, Nigeria and one hundred [100] healthy controls selected randomly in Osogbo, an urban centre in Osun State, Nigeria were determined. The age of the subjects ranged between 7-13 years with mean +/- SD of 11.00 [ +/- 1.69] years and 10.5 [ +/- 2.01] years for test subjects and controls respectively. The mean plasma concentration of triglyceride, total cholesterol, high density lipoprotein cholesterol [HDL-C] and low density lipoprotein cholesterol [LDL-C] were significantly lower among S. haematobium-infected subjects than in controls irrespective of the age and sex [p<0.01]. Significantly lower plasma lipid levels found in infected subjects lend support to the hypothesis that schistosome eggs probably contribute to alteration of lipid profile through enhancing of LDL-uptake by macrophages

Correlation of biological serum markers with the degree of hepatic fibrosis and necroinflammatory activity in hepatitis C and schistosomiasis patients

Liver biopsy is the gold-standard method to stage fibrosis; however, it is an invasive procedure and is potentially dangerous. The main objective of this study was to evaluate biological markers, such as cytokines IL-13, IFN-ã, TNF-á and TGF-â, platelets, bilirubins (Bil), alanine aminotransferase (ALT) and aspartate aminotransferase (AST), total proteins, ã-glutamil transferase (ã-GT) and alkaline phosphatase (AP), that could be used to predict the severity of hepatic fibrosis in schistosomiasis and hepatitis C (HC) as isolated diseases or co-infections. The following patient groups were selected: HC (n = 39), HC/hepatosplenic schistosomiasis (HSS) (n = 19), HSS (n = 22) and a control group (n = 13). ANOVA and ROC curves were used for statistical analysis. P < 0.05 was considered significant. With HC patients we showed that TNF-á (p = 0.020) and AP (p = 0.005) could differentiate mild and severe fibrosis. With regard to necroinflammatory activity, AST (p = 0.002), ã-GT (p = 0.034) and AP (p = 0.001) were the best markers to differentiate mild and severe activity. In HC + HSS patients, total Bil (p = 0.008) was capable of differentiating between mild and severe fibrosis. In conclusion, our study was able to suggest biological markers that are non-invasive candidates to evaluate fibrosis and necroinflammatory activity in HC and HC + HSS.

Development of the rapid and simple elisa (whole blood-ELISA) using coconut water-tween as a wash solution for whole blood sample from Schistosoma japonicum-infected rabbit and human.

PBS-Tween as a wash solution, prepared with distilled water, is used in ELISA. In areas where schistosomiasis is endemic, however, distilled water is hard to come by. We have modified a WHOLE BLOOD-ELISA test to use coconut water-Tween as a wash solution, because coconut water is easy to come by and cheap in the tropics. We applied the test to whole blood samples from rabbits and humans infected with Schistosoma japonicum. This modified WHOLE BLOOD-ELISA was confirmed to be a rapid, simple, and cost-effective method.

Development of the rapid and simplified ELISA (WHOLE BLOOD-ELISA) using samples of Schistosoma japonicum-infected human whole blood.

An ELISA technique was developed using samples of Schistosoma japonicum-infected human whole blood based on the conventional ELISA. In this study, the following were demonstrated. 1) Whole blood samples could be used. 2) The volume of whole blood and conjugate could be reduced to 0.05 ml. 3) The incubation time was shortened to 5 minutes. 4) The optical density could be measured at 10 minutes after transferring the substrate and the volume was reduced to 0.1 ml. 5) It did not require a fixed temperature setting. 6) The operation time was as short as 20 to 30 minutes. 7) The optical density values were almost the same as the conventional ELISA and were not influenced by other common intestinal helminthic infections. 8) The observed variations from day to day including effects of sampling in stool examination were negated by the results of this ELISA technique. 9) Based on correlation with stool examination results, criteria can be formulated in which optical density values of 0.3 and above as positive, 0.1 to less than 0.3 as doubtful, and less than 0.1 as negative. Whenever an immunological field survey is necessary, before and after a selective or a mass treatment control program, this WHOLE BLOOD-ELISA, which was shown to be rapid and simple, is recommended.

Gammaglutamyl transpeptidase activity in patients with schistosomiasis

Schistosoma mansoni infestation may induce liver fibrosis and portal hypertension, with possible elevation of liver enzymes. Aim of the study: The aim of this study was to evaluate the serum gammaglutamyl transpeptidase [GGT] activity in a group of non- alcoholic and non-obese patients with hepatointestinal schistosomiasis. Patients and methods: Medical records of 174 patients diagnosed to have hepatointestinal schistosomiasis on the basis of clinical and laboratory data patients diagnosed to have hepatointestinal schistosomiasis on the basis of clinical and laboratory data were reviewed. Body mass index [BMI] was calculated for all patients. Direct stool smear and formol-ether concentration [FEC] methods and hematological and biochemical blood tests were performed. Other studies including abdominal ultrasonography, upper and lower gastrointestinal endoscopy was also performed when feasible. All [174] patients were adults with male to female ratio of 3.8:1. BMI was similar in both groups. Patients were divided into two groups: group 1 [57] with elevated GGT and group 2 [117] patients with normal GGT. Both groups had positive indirect hemagglutination test [IHA] for schistosomiasis. Other causes of liver disease were excluded. Group 1 had significant elevation of alanine aminotransferase [ALT], alkaline phosphatase [ALP] and reduction in platelets [P<0.001], low albumin and high globulin levels [P>0.01] compared to group 2. Abnormal ultrasonographic findings were more frequently encountered in group 1 [P<0.001]. The above data indicated that GGT elevation was most likely secondary to hepatobiliary involvement by Schistosoma mansoni and may indicate chronicity. There fore schistoromiasis has to be cousidered in our bcomunity when even GGT is elevated in non-Al coholi population Alcoholic pouplation

Significance of tumour markers in colorectal carcinoma associated with Schistosomiasis.

Schistosomiasis as well as Colorectal Carcinoma are equally prevalent in Egypt. However, the role of Schistosomiasis as a risk factor for Colorectal Carcinoma is not well established. Three tumour markers have been assessed in 69 patients with large bowel disease. They were classified into five groups. Group 1 (A) included 21 cases with Schistosomal hepatic fibrosis. Group 2 (B) included 6 cases of ulcerative colitis. Group 3 (C) included 10 cases of adenomatous polypi of which 12 cases had Schistosomiasis. Group 4 (D) consisted of 21 cases of colorectal carcinoma, 12 cases had schistosomiasis in association with colorectal carcinoma constituting group 5 (E). Elevated CEA was observed in benign tumours but showed non significant difference in G4 and G5. Significantly increased AFP levels were evident in G1, G4, and G5. Significant increase of B-HCG was observed only in G4 and G5 indicating its significance as diagnostic index in case of malignancy. It has been observed that Schistosomal hepatic fibrosis induced increased levels of some of the tumour markers. Therefore, the factor of Schistosomal hepatic fibrosis should be considered during the assessment of tumour markers in colorectal carcinoma cases.

Humoral and cell mediated immune responses against Schistosoma spindale in BALB/c mice.

(BALB/c mice were infected with cercariae of Schistosoma spindale by tail immersion technique and by dropping some cercariae from a pipet onto the outer surface of the pinna of the ears. Groups of mice were removed on Days 10, 20 and 30 and tested for humoral and cell mediated immune responses using either adult worm or cercarial antigen. On Day 50 the mice were sacrificed and the worm burden was determined for each mouse. This method resulted in an infectivity rate of 89.7%. There was a significant increase in antibody titer to the adult worm antigen while no significant increase was observed for cercarial antigen over the period of the study. Results obtained for cell mediated immunity were more dramatic. There was a significant increase in foot pad swelling for adult worm antigen compared to a significant decrease for cercarial antigen during the course of the infection.

Serum levels of interleukin 2 and 4 in children with chronic liver diseases

This study was performed on 50 children, classified as follows: 15 patients with chronic viral hepatitis, 15 patients with chronic schistosomal hepatitis and 20 apparently healthy children as a control group. All cases were diagnosed by laboratory investigations which included urine and stool analysis, liver function tests and hepatitis B surface antigen, in addition to abdominal ultrasound and liver biopsy to detect the pathological diagnosis. Cases and control groups were investigated for quantitative measurement of serum interleukin 2 and 4. As regard to interleukin 2 [IL2], there was statistically significant decrease [P < 0.001] in its level in chronic viral hepatitis in relation to control group while it was statistically high [P < 0.001] in chronic schistosomal hepatitis in relation to control group. The serum level of interleukin 4 [IL4] was found to be statistically significantly more increased [P < 0.05] in chronic schistosomal hepatitis than control group. It was also high in chronic viral hepatitis, but with an insignificant difference [P > 0.05]. On studying the variation of serum IL2 and lL4 among the two patients group, it was found that there is significant increase in IL2 level in schistosomal group in relation to the viral one [P <0.001] while no significant difference could be recorded between them in IL4 level. We concluded that the changes occurring in the level of interleukins in chronic hepatitis are considered as an immunological mechanism offered by the body against invasion with antigen [whether schistosome or virus B] and these laboratory tests can be applied in the field of diagnosis of such liver diseases

Iron, copper and alpha 1-antitrypsin deficiency in the liver of cirrhotic and schistosomotic patients

Há vários estudos sobre depósitos de ferro e cobre e deficiência de alfa 1-antitripsina (A1AT) no fígado em cirróticos, mas nenhum, segundo nossa pesquisa bibliográfica, em esquistossomóticos. Os autores pesquisaram a presença desses metais e a deficiência de A1AT no fígado de 72 cirróticos e 27 esquistossomóticos. Entre esses, cinco eram de forma hepatointestinal e 22 da hepatoesplênica. Entre os cirróticos, 44 eram alcoólatras e 28 näo-alcoólatras. O ferro foi detectado em 23(31,9%) dos cirróticos, dos quais 16(36,3%) eram alcoólatras e 7(25,0%) näo alcoólatras, diferença näo significante. Quanto aos graus, foram observados: 13 casos (56,5%) grau I; cinco casos (21,7%) grau II, e cinco (21,7%) grau III. O cobre foi detectado em 24 cirróticos (33,3%) dos quais 15(34,0%) eram alcoólatras e nove (32,1%) näo alcoólatras, diferença näo significante. A deficiência de A1AT foi observada em dois (2,8%) cirróticos, um dos quais era alcoólatra. HBsAg e HBcAg em tecido hepático foram detectados em cinco cirróticos (6,9%), dos quais três eram alcoólatras. A presença de ferro, e cobre e deficiência de A1AT foi observada em três cirróticos (12,5%) e a de ferro e deficiência de A1AT em dois cirróticos (2,8%). Os autores ressaltam que nenhum paciente esquistossomático apresentou ferro, cobre ou deficiência de A1AT no fígado e discutem aspectos relacionados com a eventual importância dos dados obtidos

Induction of intestinal lesions in rabbits with Koyan and Baling strains of Schistosoma malayensis Sp N.

Schistosoma malayensis Sp N is a putative new species of schistosome discovered in Peninsular Malaysia in 1973. This paper comprises the first report on the detailed gastrointestinal pathology present in rabbits infected with strains of the parasite. Two different strains of schistosome--the Baling and Koyan strains--from two different ecosystems were used to infect inbred rabbits and the resulting pathophysiology was studied. Our results showed that the Baling strain of S. malayensis was more virulent than the Koyan strain and produced nodular, segmental circumferential lesions and large bilharziomas measuring 1-7 cm in diameter in the distal jejunum, ileum and the ileo-caecal junction. The findings indicate that the Baling strain of S. malayensis was more pathogenic for rabbits as compared with the Koyan strain--in relation to the gross pathology of the gut and the tissue egg load. Earlier reports have shown that rabbits infected with S. japonicum induces significant intestinal lesions in rabbits (Cheever et al, 1980 a,b) but these animals are refractory to infection with S. mekongi (Byram and Lichtenberg, 1980). Our studies show that the two strains of S. malayensis adapted well in rabbits. It is also established that in rabbits, the virulence of the Baling strain of S. malayensis is greater than that of S. mekongi and approximates that of S. japonicum.

Serum lipids and apolipoproteins in bilharzial hepatic fibrosis and post-hepatitis cirrhosis

For all patients and controls serum total cholesterol [TC], serum triglycerides [TG], serum high density lipoprotein cholesterol [HDL-c] were estimated colorimetrically and also serum apolipoproteins [apo A, A1 and B] were assayed by immunodiffusion. BHF and PHC patients showed significant decreases in the mean values of serum TC, TG, HDL-c an apo A, A1 and B compared to controls. Also PHC patients showed significant decreases in serum levels of the same parameters compared to BHF patients. Although the serum levels of HDL-c and apo A1 were significantly decreased in both groups of patients, yet the mean value of apo A1/apo B ratio was higher in both groups compared to controls and the rise was statistically significant in BHF patients and insignificant in PHC patients. Also there was a significant reduction of the serum levels of HDL-c and apo A1 in PHC compared to BHF patients and comparison of the mean value of apo A1/apo B ratio in the two groups was found to be statistically insignificant

Avaliaçäo da funçäo hepática de síntese protéica na hepatopatia esquistossomótica compensada e na cirrose / Evaluation of the hepatic function of protein synthesis in compensated schistosomotic hepatopathy and cirrhosis

A funçäo hepática de síntese protéica foi avaliada por meio da determinaçäo da concentraçäo sérica de albumina, de transtiretina e da proteína de ligaçäo do retinol (PLR), em portadores de hepatopatia esquistossomótica compensada e em cirróticos. Verificou-se que: a) em hepatopatia crônica e estável a meia-vida biológica de uma proteína näo deve ser o fator determinante de sua concentraçäo sérica, pois a PLR (meia-vida de 12h) mostrou-se normal em doentes com hipoalbuminemia (meia-vida de 21 dias) e/ou hipotranstiretinemia (meia-vida de 2 dias); b) na hepatopatia esquistossomótica a hipoalbuminemia pode refletir, em alguns doentes, näo insuficiência de síntese, mas sim o grau de hiperglobulinemia; c) a determinaçäo simultânea da concentraçäo sérica de albumina e transtiretina é mais útil na avaliaçäo de hepatopatias crônicas do que a determinaçäo de uma ou outra isoladamente; d) a determinaçäo da PLR nada acrescenta às informaçöes já obtidas com a determinaçäo de albumina e transtiretina séricas