Serum Soluble Fas in Patients with Schistosomal Cor pulmonale

Abstract

Background: Schistosomal cor pulmonale is considered an important pathological condition in endemic areas. Few recent studies have reported the role of apoptosis in pulmonary hypertension. Objectives: The aim of this study was to assess serum levels of soluble Fas (sFas), an inhibitor of apoptosis, in patients with schistosomal cor pulmonale as compared to patients with cor pulmonale due to chronic obstructive pulmonary disease (COPD) and normal subjects. Methods: Serum sFas was assessed in 15 men with schistosomal cor pulmonale (age 32 ± 10 years), 15 men with chronic cor pulmonale secondary to COPD and 20 healthy men, matched for age. Results: Serum levels of sFas were significantly higher in patients with schistosomal cor pulmonale (74 ± 80 U/ml) than in patients with cor pulmonale due to COPD (15 ± 10 U/ml) and normal subjects (19 ± 11 U/ml, p < 0.001 in both). In patients with schistosomal cor pulmonale, sFas was significantly higher in patients with mean pulmonary artery pressure >30 mm Hg as compared to patients with pressure ≤30 mm Hg (109 ± 97 vs. 34 ± 20 U/ml, p = 0.01). There was a significant correlation between serum sFas and the mean pulmonary artery pressure in patients with bilharzial cor pulmonale (r = 0.4, p < 0.01), but not in patients with COPD (r = 0.1, p = NS). Conclusions: Serum sFas levels are elevated in patients with schistosomal cor pulmonale and they are related to the severity of pulmonary hypertension. These findings suggest a role of apoptosis in schistosomal cor pulmonale.

Schistosome infection and its effect on pulmonary circulation

“…But until now there have been very few studies on the direct role of extrinsic apoptosis on schistosomiasis-induced pulmonary vascular disease. For example, soluble FAS is significantly higher in schistosomiasis pulmonary hypertension compared with those in patients with cor pulmonale resulting from chronic obstructive pulmonary disease 151 . Furthermore, soluble FAS (SFas) is shed from the cell surface through the action of certain enzymes like metalloproteinases 152 .…”

Pulmonary Vascular Disease in the Developing World

“…In patients with schistosomal pulmonary hypertension, serum levels of soluble Fas are significantly higher compared with patients with cor pulmonale resulting from chronic obstructive pulmonary disease. 40 This factor may contribute to the remodeling process of schistosomal pulmonary vascular disease.…”

Parasitic diseases of the respiratory tract

“…In the acute form of disease, patients present with shortness of breath, wheezing and dry cough associated with fever, myalgia, headache, hepatosplenomegaly and marked eosinophilia [60]. Salama et al [61] suggested that apoptosis of endothelial cells in the pulmonary vasculature also plays an important role in the pathogenesis of shistosomal cor pulmonale. Pulmonary involvement can occur in this phase, with ectopic migration of ova from the portal system to the pulmonary vascular bed.…”