IgG isotypes in Schistosomiasis patients before and after praziquantel

ABSTRACT

This work evaluated circulating anti-SWAP IgG1 and IgG4 in patients with active S. Mansoni infection before and after PZQ and its correlation to clinical, laboratory and sonographic data. The main complaints were abdominal discomfort, pain, tensmus and bleeding per rectum, which decreased progressively after PZQ. The results indicated that anti-SWAP IgG1 and IgG4 were significantly higher in patients than controls. The results also showed a progressive significant decrease in the level of circulating anti-SWAP IgG1 after treatment, a decrease of IgG4 three months after treatment and a decrease in the egg count after therapy. But, no significant difference in IgG1 or IgG4 was noticed between male and female patients before and after treatment. There was no significant difference in IgG1 or IgG4 in patients having GIT manifestation and organomegalic patients and/or asymptomatic patients. Also, there was no significant difference in IgG1 or IgG4 between patients with grade 0, grade I and grade II periportal fibrosis. The sensitivity of ELISA IgG1 was 73.3% and specificity was 80%, while of ELISA IgG4 was 80%. Enlarged liver and/or spleen, periportal fibrosis and dilated PV detected by ultrasonography were more among patients than controls. There was no significant difference in hematological parameters and liver function tests between patients and control groups. The study showed that ELISA is sensitive and specific for IgG1 and IgG4. Anti- SWAP IgG1 and IgG4 are useful means in diagnosis and cure and consider as parameters for evaluating cure. Follow up of anti-schistosomal IgG1 and IgG4 is useful for assessment of treatment