Hepatosplenic schistosomiasis is characterised by high blood markers of translocation, inflammation and fibrosis.
Hepatosplenic schistosomiasis is characterised by high blood markers of translocation, inflammation and fibrosis.
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肝脾血吸虫病的特点是易位、炎症和纤维化的高血液标志物。
DOI：
10.1111/liv.12891
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Sinkala E
中科院分区：
文献类型：
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作者：
Sinkala E
背景与目的肝硬化是世界范围内门静脉高压的主要原因，但血吸虫病在热带地区占主导地位。在赞比亚流行区曼氏血吸虫的血清阳性率高达77%。门静脉高压症导致静脉曲张出血，这可能是致命的。细菌移位与肝硬化门静脉高压症有关，但在肝脾血吸虫病中几乎未被探索。肝活检通常用于评估纤维化，尽管它是侵入性的并且容易发生采样错误。我们的目的是调查易位，纤维化和炎症标志物的病例对照研究血吸虫病在大学教学医院，卢萨卡，Zambia.MethodsPatients食管静脉曲张，但阴性的人类免疫缺陷病毒，肝炎B和C病毒。血浆脂多糖结合蛋白被用作易位的标志物，而透明质酸和层粘连蛋白测量肝纤维化。测量血液中的炎症标志物。对照组为非特异性腹痛患者，他们进行了正常的endoscopy.ResultsMedian（四分位距）脂多糖结合蛋白升高患者[44.3 ng/ml（35.7，57.1）]相比，对照组[30.7 ng/ml（30.4，35.5），P< 0.0001]。与对照组[21.0 ng/ml（12.4，37.6），P< 0.0001]相比，患者组[111.6 ng/ml（39.1，240.3）]中的羟考酮较高，与对照组[0.9 μg/ml（0.7，1.2），P= 0.0015]相比，层粘连蛋白[2.2 μg/ml（1.0，3.7）]也较高。炎症标志物，除了C反应蛋白，升高patients.ConclusionsThese data表明，细菌易位有助于全身炎症在肝脾血吸虫病。升高的纤维化标志物表明它们可能有助于诊断和监测门静脉周围纤维化。
Background & AimsCirrhosis is the main cause of portal hypertension worldwide but schistosomiasis dominates in much of the tropics. The seroprevalence ofSchistosoma mansoniis up to 77% in endemic parts of Zambia. Morbidity is attributed to portal hypertension causing variceal bleeding which can be fatal. Bacterial translocation is associated with portal hypertension in cirrhosis but this is almost unexplored in hepatosplenic schistosomiasis. Liver biopsy is usually used to assess fibrosis although it is invasive and prone to sampling error. We aimed to investigate translocation, fibrosis and inflammatory makers in a case‐control study of schistosomiasis at the University Teaching Hospital, Lusaka, Zambia.MethodsPatients had oesophageal varices, but were negative for human immunodeficiency virus, hepatitis B and C viruses. Plasma lipopolysaccharide binding protein was used as a marker of translocation while hyaluronan and laminin measured liver fibrosis. Inflammatory markers were measured in blood. Controls were patients with non‐specific abdominal pain who had normal endoscopy.ResultsMedian (interquartile range) lipopolysaccharide binding protein was elevated in patients [44.3 ng/ml (35.7, 57.1)] compared to controls [30.7 ng/ml (30.4, 35.5),P< 0.0001]. Hyaluronan was higher in patients [111.6 ng/ml (39.1, 240.3)] compared to controls [21.0 ng/ml (12.4, 37.6),P< 0.0001] and so was laminin [2.2 μg/ml (1.0, 3.7)] compared to controls [0.9 μg/ml (0.7, 1.2),P= 0.0015]. Inflammatory markers, except C‐reactive protein, were elevated in patients.ConclusionsThese data suggest that the bacterial translocation contributes to systemic inflammation in hepatosplenic schistosomiasis. Elevated fibrotic markers suggest they may be useful in diagnosing and monitoring periportal fibrosis.