Tawfeek Gihan M, Alafifi Amal M, Azmy Maha F
Department of Parasitology, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt.
J Egypt Soc Parasitol. 2003 Aug;33(2):597-614.
Based sonographic examinations of 90 schistosomiasis mansoni, they were divided into five groups: lightly infected, heavily infected, intestinal, early hepatosplenic and periportal fibrosis. Using ELISA, the levels of circulating vascular endothelial growth factor (VEGF) and anti-soluble egg antigen (SEA) IgG4 were measured in their sera. Compared to normal controls, VEGF levels were significantly raised in all schistosomiasis patients groups except lightly infected and intestinal patients were insignificantly elevated. The level of VEGF correlated with disease progression from lightly infected to periportal fibrosis patients. It also correlated with sonographic indicators of portal hypertension; presence of portosystemic collaterals, portal vein dilatation and splenomegaly. Serum IgG4 was significantly raised in only periportal fibrosis and portal hypertension patients. The results provided evidence that circulating levels of VEGF can serve as a new indicator of progression of schistosomiasis mansoni reflecting angiogenesis that regulates the granuloma and fibrosis development in liver while IgG4 seemed to be an indicator of only fibrosis development. Both are potential sensitive markers for effectiveness of treatment in periportal fibrosis patients. The understanding of the key role of VEGF in schistosomiasis mansoni pathogenesis may provide a new pharmacological target.
基于对90例曼氏血吸虫病患者的超声检查，将他们分为五组：轻度感染组、重度感染组、肠道型、早期肝脾型和门静脉周围纤维化型。采用酶联免疫吸附测定法（ELISA）检测他们血清中循环血管内皮生长因子（VEGF）和抗可溶性虫卵抗原（SEA）IgG4的水平。与正常对照组相比，除轻度感染组外，所有血吸虫病患者组的VEGF水平均显著升高，而肠道型患者的VEGF水平升高不显著。VEGF水平与疾病从轻度感染到门静脉周围纤维化患者的进展相关。它还与门静脉高压的超声指标相关；存在门体侧支循环、门静脉扩张和脾肿大。仅门静脉周围纤维化和门静脉高压患者的血清IgG4显著升高。结果表明，VEGF的循环水平可作为曼氏血吸虫病进展的新指标，反映调节肝脏肉芽肿和纤维化发展的血管生成，而IgG4似乎只是纤维化发展的指标。两者都是门静脉周围纤维化患者治疗效果的潜在敏感标志物。对VEGF在曼氏血吸虫病发病机制中的关键作用的理解可能提供一个新的药理学靶点。
