Search

This paper centers on some whole-istic organizational and functional aspects of hepatic Schistosoma mansoni granuloma, which is an extremely complex system. First, it structurally develops a collagenic topology, originated bidirectionally from an inward and outward assembly of growth units. Inward growth appears to be originated from myofibroblasts derived from small portal vessel around intravascular entrapped eggs, while outward growth arises from hepatic stellate cells. The auto-assembly of the growth units defines the three-dimensional scaffold of the schistosome granulomas. The granuloma surface irregularity and its border presented fractal dimension equal to 1.58. Second, it is internally regulated by intricate networks of immuneneuroendocrine stimuli orchestrated by leptin and leptin receptors, substance P and Vasoactive intestinal peptide. Third, it can reach the population of +/- 40,000 cells and presents an autopoietic component evidenced by internal proliferation (Ki-67+ Cells), and by expression of c-Kit+ Cells, leptin and leptin receptor (Ob-R), granulocyte-colony stimulating factor (G-CSF-R), and erythropoietin (Epo-R) receptors. Fourth, the granulomas cells are intimately connected by pan-cadherins, occludin and connexin-43, building a state of closing (granuloma closure). In conclusion, the granuloma is characterized by transitory stages in such a way that its organized structure emerges as a global property which is greater than the sum of actions of its individual cells and extracellular matrix components.

Schistosoma mansoni is responsible for lesions that can alter the hemodinamic of the portal venous circulation, lung arterial and venous sistemic systems. Therefore, hemodinamic changes in the ocular circulation of mansonic schistosomotic patients with portal hypertension and hepatofugal venous blood flow is also probable. The purpose of this study was to determine the fluorescein contrast arrival time at the retina of young patients with the hepatosplenic form of schistosomiasis, clinically and surgically treated. The control group included 36 non schistosomotic patients, mean age of 17.3 years, and the case group was represented by 25 schistosomotic patients, mean age of 18.2 years, who were cared for at The University Hospital (Federal University of Pernambuco, Brazil), from 1990 to 2001. They underwent digital angiofluoresceinography and were evaluated for the contrast arrival time at the early retinal venous phase of the exam. Both groups were ophthalmologically examined at the same hospital (Altino Ventura Foundation, Recife, Brazil), using the same technique. There was retardation of the retinal contrast arrival time equal or more than 70 sec in the eyes of three schistosomotic patients (12%) and in none of the control group, however, the mean contrast arrival time between the two groups were not statistically different. These findings lend support to the hypothesis that there could be a delay of the eye venous blood flow drainage.

Aiming at investigating the changes on the lipidic constitution of hepatic lysosomal membranes at the initial phase of schistosomatic damage, mice have been infected with 30 cercarias and employed for essais in the 30th day of infection. The triacylglycerois decreased from 220 +/- 48 micrograms/mg of total proteins in the control mice, to 165 +/- 22 micrograms/mg in the infected ones. Similarly, the free cholesterol, also decreased from 539 +/- 80 to 396 +/- 54 micrograms/mg; the cholesterol esters from 270 +/- 35 to 216 +/- 36 micrograms/mg and the phosphatidylcholines from 44 +/- 5.7 to 31 +/- 4.9 micrograms/mg. The phosphatidylserines the phosphatidylethanolamines and the sphingomyelins increased, respectively from 58 +/- 9.7 to 60 +/- 8.5, from 72 +/- 7.8 to 111 +/- 15.7 and from 36 +/- 4.9 to 63 +/- 7.1 micrograms/mg. The free fatty acids showed no statistical significance on their variations. They varied from 1.7 +/- 0.25 microEq/g in the controls to 1.8 +/- 0.39 microEq/g in the infected animals. These results indicated that in the initial phase of hepatic schistosomiasis, before the formation of granulomas, important changes on the lipidic constitution of lysosomal membranes can be detected. It seems that they are provoked by the catabolic excreted by immature or adult worms of Schistosoma mansoni present in the portal vein system.