The hepatosplenic form of schistosomiasis mansoni sometimes induces bleeding in oesophageal varices that requires surgical treatment. Although splenectomy is often necessary these patients rarely present with septic events, a finding that may be related to changes in the immunological system. To investigate the immunological profiles of patients with schistosomiasis, we studied the B- and T-lymphocyte counts and the immunoglobulin A, G and M (IgA, IgG and IgM) levels in patients treated surgically and in those who were not operated on. Patients who underwent distal splenorenal shunt, preserving the spleen, showed significantly increased T-lymphocyte counts compared with healthy controls. The IgM and IgG levels were significantly increased compared with the healthy controls in patients submitted to partial and total splenectomy, respectively. The IgM level also tended to increase in patients who were not operated on compared with the controls. These results suggest that chronic schistosomiasis may influence the immune system.

Immune Profiles in Hepatosplenic Schistosomiasis Mansoni after Surgical Treatments

Schistosomiasis mansoni has a particular immunological pattern. Its hepatosplenic form develops sometimes to esophageal and gastric varices, hemorrhages that require surgical treatment. Despite of splenectomy frequently being required, these patients rarely present with septic events. These findings may be related to changes in the immunological system. In order to investigate the immunological pattern of patients with schistosomiasis, we studied the B- and T- lymphocytes and immunoglobulins - IgM, IgA and IgG - in operated and non-operated patients. Distal splenorenal shunts were related to increased T-lymphocytes. IgM and IgA were increased in patients submitted to subtotal and total splenectomy. The IgM was also increased in non-operated patients. These results suggest that chronic schistosomiasis may affect the immune system and protect patients even after total splenectomy.

Aspectos imunológicos da esquistossomose mansoni hepatoesplênica após cirurgia terapêutica Immune profiles in hepatosplenic schistosomiasis mansoni after therapeutic surgery

The amount of immunoglobulins serum and the cutaneous sensitivity to specific antigen in 19 patients with intestinal schistosomiasis were determined, as an attempt to study the incidence of delayed and imediate type of hypersensitivity. The tests were performed before and thirty, sixty and ninety days after treatment with aminonitrotiazol. The immunoglobulin levels before treatment were found to be 1,893 ± 472, 186 ± 74 and 91 ± 26 mg%, respectively for IgG, IgA and IgM; ninety days after treatment the level for IgG became normal (1,266 ± 389 mg%) and a slight increase of IgA (270 ± 89 mg%) and IgM (111 ± 31 mg%) was observed. The patients were intradermally tested with schistosomin and with anti IgE serum. The tests before treatment gave the following resulta: 1.22 ± 0.36 cm2 for schistosomin and 1.04 ± 0.25 cm2 for anti IgE. Ninety days afterwards a slight increase of the reactions was observed and the results respectively were 1.42 ± 0.65 cm2 and 1.15 ± 0.32 cm2. The studies for delayed hypersenstivity indicated that 35% of patients showed an area of induration larger than 0.5 cm2, 48 hours after the intradermal injection with schistosomin, and 71% developed positive reaction when challenged with dinitrofluorobenzene

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Ana Zélia Almendra Correia Lima

Papers

Estudo imunológico da esquistossomose mansoni intestinal antes e após tratamento com aminonitrotiazol