High levels of IgG4 to Schistosoma mansoni egg antigens in individuals with periportal fibrosis.

Silveira, Alda Maria Soares; Bethony, Jeffrey M.; Gazzinelli, Andréa; Kloos, Helmut; Fraga, Lúcia Alves de Oliveira; Álvares, Maria Carolina Barbosa; Prata, Áluízio; Guerra, Henrique Leonardo; LoVerde, Philip T.; Corrêa-Oliveira, Rodrigo; Gazzinelli, Giovanni

doi:10.4269/ajtmh.2002.66.542

Cited by 26 publications

(30 citation statements)

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“…31–36 It has been argued that this characteristic infection curve reflects the inability of the immature immune system of children and teenagers to eliminate the parasite. 18,19,21 Evaluation of the IgE and IgG4 anti-SEA reactivity over time showed that after 2005 anti-SEA IgE reactivity was significantly increased for both infected and uninfected individuals. Webster et al 37 showed that higher IgE serum levels among individuals living in endemic areas are a consequence of persistent antigen exposure, which is consistent with our observation.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal analysis of antigen specific response in individuals with Schistosoma mansoni infection in an endemic area of Minas Gerais, Brazil

Matoso

Oliveira-Prado

Abreu

et al. 2013

Transactions of the Royal Society of Tropical Medicine and Hygi

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BackgroundImmunoepidemiologic studies have shown a relationship between IgE and IgG4 antibodies with age and with resistance and susceptibility to infection. It is believed that the IgE and IgG4 responses to soluble egg antigen (SEA) can be used for serological analysis of infection and post-treatment status. This study aimed to evaluate the association between Schistosoma mansoni infection and anti-SEA IgG4 and IgE reactivities, and determine whether these reactivities could be used as biomarkers of infection.MethodsBetween 2001 and 2009, a longitudinal study was performed in which parasitologic and blood specimens and socioeconomic and water-contact information were collected from 127 individuals. All patients positive for S. mansoni infection were treated.ResultsSchistosomiasis prevalence and the geometric mean of the egg count in 2001 were 59% and 61.05, respectively, decreasing to 26.8% and 8.78 in 2009. IgG4 anti-SEA reactivity in infected individuals was significantly higher than that in uninfected individuals at all time points. Analysis of receiver-operating characteristic (ROC) area showed that the IgG4 anti-SEA antibodies were able to predict infection by S. mansoni at each time point.ConclusionIgG4 anti-SEA reactivity can be used as a biomarker for immune monitoring of the presence of infection with S. mansoni in endemic areas.

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Section: Discussionmentioning

confidence: 99%

Longitudinal analysis of antigen specific response in individuals with Schistosoma mansoni infection in an endemic area of Minas Gerais, Brazil

Matoso

Oliveira-Prado

Abreu

et al. 2013

Transactions of the Royal Society of Tropical Medicine and Hygi

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“…The DRB1*0901 allele was also associated with susceptibility to PSHD (OR = 2.14, 95%CI = 1.31-3.48, P = 0.002). The possibility that the HLA-DRB1*0901 allele is primarily responsible for PSHD susceptibility is an interesting point to be considered because IgG4 elevation has been found in individuals with the HLA-DRB1*0901 allele [66] and is positively linked to several systemic fibrosis conditions [67] and schistosomiasis peri-portal fibrosis [68]. It is probable that patients with HLA-DRB1*0901 are prone to produce B cells for specific…”

Section: Discussionmentioning

confidence: 99%

Association of HLA and post-schistosomal hepatic disorder: A systematic review and meta-analysis

Huy

Hamada

Kikuchi

et al. 2011

Parasitology International

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Several human genetic variants, HLA antigens and alleles are reportedly linked to post-schistosomal hepatic disorder (PSHD), but the results from these reports are highly inconclusive. In order to estimate overall associations between human genetic variants, HLA antigens, HLA alleles and PSHD, we systematically reviewed and performed a meta-analysis of relevant studies in both post-schistosomal hepatic disorder and post-schistosomal non-hepatic disorder patients. PubMed, Scopus, Google Scholar, The HuGE Published Literature database, Cochrane Library, and manual search of reference lists of articles published before July 2009 were used to retrieve relevant studies. Two reviewers independently selected articles and extracted data on study characteristics and data regarding the association between genetic variants, HLA antigens, HLA alleles and PSHD in the form of 2×2 tables. A meta-analysis using fixed-effects or random-effects models to pooled odds ratios (OR) with corresponding 95% confidence intervals were calculated only if more than one study had investigated particular variation. We found 17 articles that met our eligibility criteria. Schistosoma mansoni and Schistosoma japonicum were reported as the species causing PSHD. Since human genetic variants were only investigated in one study, these markers were not assessed by meta-analysis. Thus, only HLA-genes (a total of 66 HLA markers) were conducted in the meta-analysis. Our meta-analysis showed that human leucocyte antigens HLA-DQB1*0201 (OR = 2.64, P = 0.018), DQB1*0303 (OR = 1.93, P = 0.008), and DRB1*0901 (OR = 2.14, P = 0.002) alleles and HLA-A1 (OR = 5.10, P = 0.001), A2 (OR = 2.17, P = 0.005), B5 (OR = 4.63, P = 0.001), B8 (OR = 2.99, P = 0.02), and B12 (OR = 5.49, P = 0.005) serotypes enhanced susceptibility to PSHD, whereas HLA-DQA1*0501 (OR = 0.29, P = <0.001) and DQB1*0301 (OR = 0.58, P = 0.007) 4 were protective factors against the disease. We further suggested that the DRB1*0901-DQB1*0201, DRB1*0901-DQB1*0303 and A1-B8 haplotypes enhanced susceptibility to PSHD, whereas DQA1*0501-DQB1*0301 linkage decreased the risk of PSHD. The result improved our understanding of the association between the HLA loci and PSHD with regard to pathogenic or protective T-cells and provided novel evidence that HLA alleles may influence disease severity.. 5

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“…Vale lembrar que os anticorpos contra os ovos e os vermes adultos, especialmente da classe IgG, cursam com níveis séricos mais elevados naqueles pacientes com EM que apresentam fibrose periportal e esplenomegalia (24) . Além disso, a carga parasitária encontra-se relacionada com a evolução para as diversas formas da EM.…”

Section: Discussionunclassified

“…Adicionalmente, no artigo sobre a fibrose na hepatite C, descreveu-se correlação da fibrose hepática não apenas com os níveis de IgG, mas também com os de IgA e com o nível sérico total das imunoglobulinas (24) . Já no estudo sobre a fibrose na hepatite B, observou-se correlação tanto com os níveis de IgG como com os de globulinas e com a contagem de plaquetas no sangue periférico, mas não foi detectada com os níveis de IgA (19) .…”

Section: Discussionunclassified

Níveis séricos de globulinas e a intensidade da fibrose hepática em pacientes com esquistossomose mansônica

Correia¹,

Domingues²,

Lopes³

et al. 2009

Arq. Gastroenterol.

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RESUMO -Contexto -Tem sido descrita correlação entre os níveis séricos de globulinas e o grau de fibrose hepática nas hepatites crônicas, mas não se encontram relatos na esquistossomose mansônica. Objetivo -Avaliar os níveis séricos de globulinas e de IgG, e a intensidade da fibrose periportal mensurada pela ultrassonografia em pacientes com esquistossomose mansônica. INTRODUÇÃONa esquistossomose mansônica (EM), em sua forma hepatoesplênica (EHE), a hipertensão portal ocorre tanto em função da fibrose periportal (Symmers) como pelo hiperfluxo proveniente da veia esplênica em consequência da grande esplenomegalia (13,17,25) . Descreve-se correlação entre a intensidade da fibrose periportal e os níveis de pressão na veia porta (18) .A biopsia hepática, a ultrassonografia (US) e, mais recentemente, marcadores biológicos e a elastografia transhepática (FibroScan ® ) vêm sendo utilizados para mensurar a fibrose que se desenvolve nas doenças crônicas do fígado (8,15,20,22) . Na EM, a biopsia hepática em cunha, realizada a céu aberto, é o método mais acurado para a mensuração da fibrose periportal, mas implica na realização de laparotomia. Já a biopsia por agulha nem sempre representa o verdadeiro quadro histopatológico, visto que a fibrose, apesar de ser difusa, varia de intensidade no parênquima hepático (6) .A US, através da identificação do aumento do lobo hepático esquerdo e redução do direito, do espessamento periportal, além da comprovação da grande esplenomegalia, constitui importante ferramenta na propedêutica da EM (4,7,19) . Em 1990, convenção da OMS realizada no Cairo classificou em três graus a fibrose periportal na EM, e outra convenção em 1996, em Niamey, propôs nova classificação baseada em seis padrões de A a F, que auxiliam na avaliação da morbidade (27,28) . As duas classificações apresentam grande precisão, mas requerem equipamentos sofisticados e examinadores qualificados, inferindo a necessidade de que métodos mais simples sejam implementados.Sabe-se que as células hepáticas estreladas, também chamadas células de Ito, são as principais mediadoras da fibrose hepática e quando ativadas, se transformam em células proliferativas e contráteis, constituindo a essência da resposta fibrótica à agressão hepática (3,9) . Estas células são ativadas pelo fator de necrose tumoral alfa (TNF-α), pelo fator de crescimento derivado das

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High levels of IgG4 to Schistosoma mansoni egg antigens in individuals with periportal fibrosis.

Cited by 26 publications

References 49 publications

Longitudinal analysis of antigen specific response in individuals with Schistosoma mansoni infection in an endemic area of Minas Gerais, Brazil

Longitudinal analysis of antigen specific response in individuals with Schistosoma mansoni infection in an endemic area of Minas Gerais, Brazil

Association of HLA and post-schistosomal hepatic disorder: A systematic review and meta-analysis

Níveis séricos de globulinas e a intensidade da fibrose hepática em pacientes com esquistossomose mansônica

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