Immunological and histochemical study of skin biopsies and arterial vessels in human schistosomal hepatic fibrosis in relation to atherogenesis

ABSTRACT

Clinical and postmortem evidence indicated that complicated atherosclerosis is less frequent in patients with schistosomal hepatic fibrosis [SHF]. Underlying mechanisms have been previously searched for, among which, abnormalities in blood coagulation, fibrinolysis, lipid metabolism, estrogen inactivation hemodynamics, dietary factors and immune mechanisms. As some workers have suggested that skin condition may reflect the state of the arterial wall in the domain of atherosclerosis, the present work aimed to extrapolate this view to SHF situation, besides trying to elucidate possible local tissue factors which would damp atherogenesis in this disease. For this 20 patients with SHF, five among them showing atherosclerosis; 10 patients with complicated atherosclerosis and 10 healthy volunteers, all males aged above 40 years included in the study. Besides clinical, electrocardiographic and function, blood lipids profile and skin biopsy for histochemical and immunofluorescent studies have been performed. Some of the patients have been subjected to amputation [lower limb] either for morbid conditions [foot gangrene] or accidents [in control group] and amputated limb arteries have been subjected to the same study. The results revealed that findings in the skin were concordant with those in the arterial wall, significant increased deposition of immunoglobulins and C3 with increased phospholipids and decreased cholesterol deposits in both tissues in patients with SHF without atherosclerosis, particularly in those with collaterals; while, the reverse was observed in patients with complicated atherosclerosis. These findings suggested the importance of the local immuno-metabolic interaction as a sharing mechanism of modulation of atherogenesis in schistosomal patients