Colchicine therapy for hepatic murine schistosomal fibrosis: image analysis and serological study.

Colchicine in a dose of 200 micrograms kg body weight/day (5 days/week) was administered to groups of Schistosoma mansoni infected mice 12 weeks post infection, either alone or following previous praziquantel therapy at the 8th week of infection. Certain groups received colchicine for 6 weeks and others received it for 10 weeks. Colchicine alone did not significantly change the light microscopic appearance of schistosomal liver fibrosis, or hepatic collagen content estimated histomorphometrically, and did not reduce the elevated IL-2 serum level. Colchicine induced hepatic injury consisted of intense inflammatory reaction in granuloma and portal tracts, hepatocytic degeneration, and elevation of serum AST and ALT levels. Colchicine seemed to postpone granulomatous reaction healing and collagen deposition rather than inhibiting collagen formation or degrading it. Colchicine inhibited proliferation of hepatocytes of infected mice by expanding G2-M phases of cell cycle, thus reduced Ag NOR count and raised cell ploidy and cyclic AMP serum level. Subsidence of schistosomal infection by praziquantel prior to colchicine therapy greatly reduced inflammatory cellular reaction, significantly diminished hepatic collagen deposition and serum IL-2 level, minimized the elevated nuclear ploidy and cyclic AMP serum level that followed colchicine therapy when administered alone.

Helicobacter pylori among Egyptian patients with chronic liver diseases. A comparative study.

The prevalence of Helicobacter pylori in Egyptian patients with different stages of liver diseases was compared to those with normal liver status. Eighty patients subjected to upper gastrointestinal endoscopy were enrolled. They were divided according to their liver status into two groups; the first patients with liver cirrhosis and the second who had no liver affection. Gall bladder diseases were excluded by abdominal ultrasound examinations. Endoscopic antral mucosal biopsies were used for H. pylori screening by both culture and urease test, and for histopathological examinations. Both groups were matched as regards age, sex, and socioeconomic conditions. Culture was positive in 42.2% and 40.7% of patients in both groups respectively (P > 0.05). Urease test showed positive results in 58% and 76.6% in both groups respectively (P > 0.05). Helicobacter pylori prevalence showed no significant differences between both studied groups as regards age, sex, or type of gastric lesions. Furthermore, liver status in patients with chronic liver diseases does not play a role in distribution of infection. The study shows the high prevalence of H. pylori among Egyptians and the absence of a relation between H. pylori and chronic liver diseases.

Evaluation of colchicine with or without praziquantel therapy in the control of hepatic fibrosis in murine schistosomiasis.

Colchicine alone or following praziquantel was given to mice infected with Schistosoma mansoni either 6 or 10 weeks post infection. Praziquantel increased body weight gain, histologically reduced number, diameter and cellularity of granuloma and improved liver function parameters. Early praziquantel therapy decreased hepatic collagen content as detected by the colorimetric method and the serum procollagen propeptide (PIIIP), while later treatment at the 10th week of infection increased hepatic collagen content and serum PIIIP. Colchicine therapy significantly decreased body weight gain with significant weight loss after early treatment. Colchicine did not change the histologic picture of schistosomal liver fibrosis; it induced a detectable hepatocytic injury recorded ultrastructurally and histologically with excitation of the inflammatory reaction in the granuloma and in portal tracts after early treatment. Excess pigmentation in macrophages and Kupffer cells, binucleation and large sized hepatocytic nuclei were evident after colchicine therapy. Colchicine increased hepatic collagen content microgram/mg protein, raised globulin and total serum protein and normalized the raised serum PIIIP of infected mice, but had no effect on PIIIP of normal mice. Early cessation of schistosomal infection evidently minimized the adverse effects of colchicine.

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.

Aminoterminal propeptide of type III procollagen: a marker of disease activity in schistosomal patients.

The serum concentration of aminoterminal propeptide of type III procollagen was measured in 44 Egyptian healthy controls and 29 patients with hepatosplenomegaly originating from endemic areas for schistosomiasis in Egypt. Patients were classified into two main groups according to the histopathological pattern of the liver biopsy: patients with active schistosomal liver fibrosis and patients with inactive schistosomal liver fibrosis. Serum aminoterminal propeptide of type III procollagen levels were elevated in most of patients with active fibrosis but not in those with inactive schistosomiasis. From the present work, it is suggested that aminoterminal propeptide of type III procollagen can be used as a marker for active fibrogenesis in patients with schistosomal liver fibrosis.

Effect of praziquantel on hepatic fibrosis in experimental Schistosomiasis mansoni.

The effect of specific chemotherapy on hepatic fibrosis was studied in Swiss albino mice infected with Schistosoma mansoni. The effect of treatment with praziquantel at 8, 12, and 20 weeks postinfection on fibrosis was assessed by determination of total hepatic collagen content, ratio of type III/I + III collagen, granuloma volume, and histopathological examination of liver section. Total collagen content was reduced in mice treated at the 8th week of infection compared to respective infected controls. The ratio of type III/I collagen was within normal limits. The decrease in collagen deposition was not observed when treatment was given 12 or 20 weeks postinfection. Early specific treatment of schistosomiasis may be important in the therapeutic approach to the control of morbidity in schistosomiasis.

Serum concentration of N-terminal procollagen peptide of collagen type III in schistosomal liver fibrosis.

The major cause of mortality in human schistosomiasis is the chronic granulomatous reaction of the liver tissue to Schistosoma mansoni eggs. Liver biopsy still provides the best evaluation of the degree of liver damage. However, liver biopsy does not provide an image of the dynamic process of fibrogenesis. Variations of concentrations of procollagen type III peptide in sera have been proposed to be significant markers of liver fibrosis. Thus, liver function tests in relation to histopathological diagnosis and procollagen type III peptide concentrations were studied in patients with schistosomiasis and revealed a high correlation between the serum procollagen type III peptide and the degree of fibrosis in liver tissue.

Study of some immunopharmacological properties of praziquantel in experimental schistosomiasis mansoni.

The immunopharmacological properties of praziquantel were studied in mice infected with Schistosoma mansoni. Hepatic granuloma measurement was the main parameter of assessment. Delayed foot pad swelling as an in vivo correlate for the delayed granulomatous hypersensitivity reaction was also determined. Fluorescent direct antigen-antibody reaction in the granuloma together with the immediate foot pad swelling were used to test for the humoral immune response. Praziquantel administered at seven weeks after infection in two dose regimens (3 X 250 mg kg-1 for three consecutive days and 3 X 83 mg kg-1 given four hourly within the same day was more or less equally effective in reducing the size of hepatic granuloma by 37-41% two weeks after treatment and by 81-85% one month after treatment. Delayed foot pad swelling using soluble egg antigen (SEA) was significantly suppressed one month after treatment by 53%. At nine weeks after infection the fluorescent antigen-antibody reaction in the granuloma was positive in the untreated controls, but at the same time (i.e. two weeks after treatment) it was negative in the praziquantel-treated mice. One month after treatment positivity was less compared to infected control mice. Reduction in worm burden, hepatic shift of the worms and the reduced number of ova per gram of tissue denoted the efficacy of the drug in its two dose regimens against the Egyptian strain of S. mansoni.

Collagen immunotyping in human liver: light and electron microscope study.

Types I, III, IV, and AB collagens have been extracted from human cirrhotic livers and specific antibodies have been raised in rabbits and purified. Histological immunofluorescent staining of collagen types in normal and fibrotic human livers reveals the respective distribution of the various collagens among the hepatic connective matrix and the modification of the normal pattern in fibrosis: types I and III appear to be the main components of the fibrotic connective matrix in enlarged portal spaces and of the Dissian reticulin framework; type IV collagen deposits are thickened around portal vessels and ducts and outline lobular capillarized sinusoids; type AB collagen appears as thin punctual deposits in portal and Dissian fibrotic connective matrix. Ultrastructural immunoperoxidase labeling of type I and III collagen makes it possible to identify the typical collagen fibers, using 65 nm periodicity, as type I collagen and the fibrillar associated network as type III collagen. Fibers of type I collagen are preferentially organized in large dense bundles in Dense Connective Matrix Organization (DCMO), since fibrillar type III collagen network is predominant in Loose Connective Matrix Organization (LCMO) surrounding vascular and biliary tracts.