Histological assessment of tissue repair after treatment of human schistosomiasis.

Schistosomiasis is one of the main health problems hindering socio-economic development in Egypt. It affects millions at an early age, diminishing productivity and exerting a significant socio-economic impact. Schistosomiasis endemicity in Egypt varies in different areas. Schistosoma mansoni, with a prevalence generally ranging between 20 to 40%, has replaced Schistosoma haematobium in the Nile Delta, and the latter is now localized to upper Egypt with low endemicity levels (5-10%). The pathology of schistosomiasis consists essentially of a series of chronic inflammatory lesions produced in and around blood vessels by eggs or their products and sometimes by dead adult worms. If the ova continued to be deposited in sufficient numbers and over several years, they would ultimately lead to progressive fibrosis of the portal tracts and urinary bladder, or may be carried in blood and become trapped in the lungs, gastro-intestinal and genital tracts with only occasional association with other organs. The etiology of human pipe-stem fibrosis is still not understood. The host immune response and frequency of exposure and the time of re-infection interval appear to be involved in the overall process of fibrosis. Additional factors are probably involved in the human disease as genetic host susceptibility, malnutrition, repeated infections and repeated treatment, mixed infections including hepatitis, tuberculosis and typhoid. Reversibility of the fibrosis might be related to the proportion of the collagen types present. Immuno-histopathological demonstration of various types of collagen confirms the importance of time for administration of the treatment and period of follow-up. According to previous studies, the timing for treatment affects the reversibility of liver fibrosis emphasizing the importance of early treatment of schistosomiasis to prevent complications.

Serological diagnosis of extraintestinal Sarcocystosis.

The present study was carried out on eighty patients attending Zagazig University Hospitals. Forty cases suffered idiopathic cardiac diseases (28 with cardiomyopathy, 8 with myocarditis & 4 with valvular lesions) and forty cases suffered idiopathic rheumatic diseases (30 with musculoskeletal complaints and 10 with myositis). Sera were investigated by enzyme-linked immunosorbent assay (ELISA) and indirect fluorescent antibody technique (IFAT) using Sarcocystis fusiformis antigen in order to detect the role of Sarcocystis in initiation of these diseases. Twenty positive toxoplasmic sera and sera from twenty normal individuals were considered as control group. The sera of the investigated cases were tested against Toxoplasma gondii antigen to exclude it as one of the causative agents of these idiopathic lesions. No statistical difference was found between IFAT and ELISA in diagnosis of sarcocystosis (P < 0.05). Also, there was no cross reaction between Sarcocystis and Toxoplasma. This study showed that Sarcocystis can be considered as one of the possible causes of some idiopathic diseases.

Effect of praziquantel on the distribution of interstitial collagen types I and III and basement membrane collagen types IV and V in murine hepatic schistosomiasis.

The effect of specific chemotherapy (praziquantel) on liver function tests and on the distribution of collagen types I, III, IV and V was studied by indirect immunofluorescence in Swiss albino mice infected with Schistosoma mansoni. Treatment was started at 7 and 12 weeks after infection. Groups of treated and non-treated mice were killed 14 and 20 weeks after infection. Reduction in the amount of collagen and improvement of liver function were observed, especially when treatment was initiated early (7 weeks after infection), while collagen type III almost disappeared during the period of observation (13 weeks after treatment). The results indicate the importance of early specific treatment for schistosomiasis.