Gavilanes Francisca, Fernandes Caio J C, Souza Rogerio
Pulmonary Department, Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Curr Opin Pulm Med. 2016 Sep;22(5):408-14. doi: 10.1097/MCP.0000000000000300.
Schistosomiasis is one of the most prevalent parasitic diseases in the world, being present in more than 70 countries. Pulmonary hypertension is one of the several chronic complications of schistosomiasis; particularly in developing countries, schistosomiasis-associated pulmonary arterial hypertension might represent one of the most prevalent causes of pulmonary arterial hypertension.
New epidemiological data reinforce the importance of schistosomiasis in the context of pulmonary hypertension; furthermore, the inflammatory components of the pathophysiology of pulmonary hypertension associated with schistosomiasis have been recently explored, opening the perspective of new targets to be explored. Clinical and hemodynamic features of this particular complication of schistosomiasis, and the role of targeted therapies in this setting, have been better described in recent years.
The importance of schistosomiasis-associated pulmonary hypertension is now recognized with better knowledge about its pathophysiology and management. Nevertheless, there is a need for better understanding the predisposal factors (genetic, environmental and so on) for the development of pulmonary hypertension in schistosomiasis as a way to prevent it from occurring. Furthermore, better control programs to decrease disease transmission are still missing, ensuring that we will have to face this devastating complication of schistosomiasis for a long future.
血吸虫病是世界上最流行的寄生虫病之一，在70多个国家存在。肺动脉高压是血吸虫病的几种慢性并发症之一；特别是在发展中国家，血吸虫病相关的肺动脉高压可能是肺动脉高压最常见的病因之一。
新的流行病学数据强化了血吸虫病在肺动脉高压背景下的重要性；此外，最近对血吸虫病相关肺动脉高压病理生理学中的炎症成分进行了探索，为探索新的靶点开辟了前景。近年来，对血吸虫病这一特殊并发症的临床和血流动力学特征以及靶向治疗在这种情况下的作用有了更好的描述。
随着对血吸虫病相关肺动脉高压病理生理学和管理的更好了解，其重要性现在得到了认可。然而，需要更好地了解血吸虫病中肺动脉高压发生的易感因素（遗传、环境等），以预防其发生。此外，仍然缺乏更好的控制疾病传播的项目，这确保了在很长一段时间内我们将不得不面对血吸虫病这一致命并发症。
