Comparative clinical and ultrasound study of egg-negative and egg-positive individuals from Schistosoma mansoni low morbidity endemic areas, and hospitalized patients with hepatosplenic disease

Duzentos e vinte e três indivíduos de área endêmica de baixa morbidade para esquistossomose e nove pacientes hospitalizados com a forma hepatoesplênica foram submetidos ao exame de fezes e clínico e à ultra-sonografia do abdômen. De acordo com os resultado dos exames de fezes e do ultra-som eles foram agrupados do seguinte modo: G1 - 63 indivíduos sem ovos de Schistosoma mansoni nas fezes; G2 - 141 indivíduos apresentando ovos de Schistosoma mansoni nas fezes, sem ecogenicidade periportal. G3 — 19 indivíduos com ovos de Schistosoma mansoni nas fezes e ecogenicidade periportal entre 3-6mm.; G4 — 9 pacientes hepatesplênicos com ecogenicidade periportal > 6mm. Pelo exame físico do abdômen, a hepatomegalia na linha hemiclavicular direita foi constatada em G1, G2 E G3, respectivamente, em 11,1, 12,1 e 26,3%. Nos grupos G1, G2 e G3, houve espessamento periportal somente em esquistossomáticos (8,5%). Alterações patológicas leves em pacientes, as quais não puderam ser detectadas pelo exame clínico, foram evidenciadas no fígado pelo ultra-som e podem ser devidas à fibrose. O grau de fibrose periportal leve foi diminuído em 57,9% dos pacientes 12 meses após tratamento da esquistossomose com oxamniquine. Na ultra-sonografia, a média da medida do lobo esquerdo do fígado dos indivíduos de G3 foi maior que a de G1 e, a de G4 maior que a de G1 e G2. O tamanho médio do baço de G4 foi significativamente maior que o dos outros grupos e o de G3 foi maior que o de G1 e G2.

Colorimetric leukocyte adherence inhibition assay: a new auxiliary technique for the diagnosis of Schistosomiasis

We describe a modification of the leukocyte adherence inhibition assay (LAI) in which we propose the use of 3-(4,5-dimethylthiazole-2-yl)-2-5-diphenyltetrazolium bromide (MTT) dye which is taken up and reduced by mitochondria. The method was tested by screening peripheral blood leukocytes from Schistosoma mansoni-infected patients. Peripheral blood leuckocytes from patients (N=2) but not from the blood of normal subjects (N=10) failed to adhere to glass in the presence od soluble adult worm antigenic preparation (SWAP). The non-adherence index (NAI) values for schistosomiasis patients were in the range of 11.0 to 72.3 (mean ñ SEM = 29.3 ñ 4.3), whereas the values for normal subjects were -56.0 to +2.0(-25.9 ñ 7.6) and those for treated patients -59.6 to +4.0 (-19.3 ñ 5.8). Our results show that the colorimetric LAI assay can be used as an auxiliary test for the diagnosis of schistosomiasis

A microcalorimetric assay to measure the reactivity of antigen-stimulated mononuclear cells from Schistosoma mansoni infected patients

The reactivity of mononuclear cells (2 x 10**6/ml minimum Eagle's medium, MEM) from normal subjects and from Schistosoma mansoni-infected patients was evaluated by microcalorimetry. The results which are reported as heat production (mcal for 2 x 10**6 cells in 3600s), were 2,087 ñ 21.2 and 2,497.0 ñ 21.3 for mononuclear cells from infected patients (N = 8) under stimulation with S. mansoni soluble egg antigen (SEA) and soluble adult worm antigenic preparation (SWAP), respectively. The values for cells from normal subjects (N = 8) were 13.7 ñ 1.1 and 29.3 ñ 3.2 in the presence of the same antigens. Pre-treatment of mononuclear cells from patients with 1 mM aminophylline (a cAMP phospphodiesterase inhibitor) totally abolished heat production. Cell viability (> 95%) was not changed after the measurement. The microcalorimetric assay described here measures the cellular metabolic activity and we feed justified in suggesting this techinique as an auxiliary diagnosis of schistosomiasis. Given the sensitivity, precision and accuracy of this microcalorimetric assay, we feel it can be used for the diagnosis of disease conditions for which a reliable diagnostic method is required

Correlation between the lack of mononuclear cell cytotoxicity against schistosomula in vitro with schistosomiasis

A comparison was made of the reactivity of mononuclear cells from subjects and from S. mansoni-infected patients. The following parameters were evaluated: 1) ability of mononuclear cells to kill schistosoma in the presence of complement; 2) [3H]-inositol incorporation into phosphatidylinositol (PI) and the rate of inositolphosphates (IPx) released. Cells from normal subjects, but not from S. mansoni infected patients, were able to kill schistosomula in vitro. A decrease in inositolpolyphosphates (IPx) was observed for phytohemagglutinin (PHA)-stimulated mononuclear cells from infected patients when compared with mononuclear cells from normal subjects after 24 h of incubation. The results suggest that the reactivity of mononuclear cells from infected patients is altered under conditions of nonspecific stimulation with PHA when compared with normal cells