Warren K S, Boros D L, Hang L M, Mahmoud A A
Am J Pathol. 1975 Aug;80(2):279-94.
Although Schistosoma japonicum egg granulomas are generally considered to be similar to those of S. mansoni (which are largely immunologic reactions of the delayed hypersensitivity type) there are suggestions that the histopathology and perhaps the etiology of the lesions are different. In mice with light S. japonicum infections, at 5 weeks after infection (2 weeks after egg production began), the livers contained 36,000 eggs each, but there was no reaction to the eggs, nor any evidence of hepatosplenic disease. By 6 weeks, large abscesses replete with cosinophils occurred around some of the eggs, and there was periportal inflammation consisting predominantly of plasma cells. From this time on, major lesions occurred mainly around large aggregates of eggs, and there was hepatosplenomegaly and portal hypertension. Living S. japonicum eggs injected into the pulmonary microvasculature of mice did not evoke significant granulomatous reactions on either primary or secondary exposure. Even when the eggs were injected into the lungs of infected animals, which had large granulomas around egg aggregates in the liver, little or no inflammatory reaction was seen around the eggs distributed singly throughout the pulmonary vessels. When the priming dose of eggs or soluble egg antigens was injected subcutaneously with or without complete Freund's adjuvant, significant granuloma formation occurred around eggs subsequently injected into the lungs. On the basis, therefore, of differences in the parasite factor (eggs) and host factors (histopathology and responses to routes of injection) it is suggested that the immunologic factors responsible for granuloma formation around S. mansoni and S. japonicum eggs may differ significantly.
虽然日本血吸虫卵肉芽肿通常被认为与曼氏血吸虫的卵肉芽肿相似(后者在很大程度上是迟发型超敏反应的免疫反应),但有迹象表明病变的组织病理学以及病因可能有所不同。在轻度感染日本血吸虫的小鼠中,感染后5周(开始产卵2周后),肝脏中每个含有36,000个卵,但对这些卵没有反应,也没有肝脾疾病的任何证据。到6周时,一些卵周围出现了充满嗜酸性粒细胞的大脓肿,并且有以浆细胞为主的门周炎症。从这时起,主要病变主要发生在大量虫卵聚集周围,并且出现肝脾肿大和门静脉高压。将活的日本血吸虫卵注入小鼠的肺微血管中,无论是初次还是再次接触,都不会引起明显的肉芽肿反应。即使将卵注入受感染动物的肺部,这些动物肝脏中的虫卵聚集周围有大的肉芽肿,但在单个分布于肺血管中的卵周围几乎看不到或没有炎症反应。当用或不用完全弗氏佐剂皮下注射致敏剂量的虫卵或可溶性虫卵抗原时,随后注入肺部的虫卵周围会出现明显的肉芽肿形成。因此,基于寄生虫因素(虫卵)和宿主因素(组织病理学以及对注射途径的反应)的差异,有人提出导致曼氏血吸虫和日本血吸虫卵周围肉芽肿形成的免疫因素可能有显著差异。