Modulation and Upregulation of IL-5 and Mastocytosis in Hepatosplenic Schistosomiasis with Asthma

Abstract

RATIONALE: This study highlights modulation of pro-inflammatory immune response in mansoni hepatosplenic schistosomiasis (MHSS) with asthma. METHODS: Based on the history, clinical exam., spirometry, urine and stool analysis for parasites; 100 patients (mean age 44±6 years) were enrolled in three groups, A: 50 MHSS with asthma, B: 25 MHSS without asthma and C: 25 non bilharzial cirrhotic liver as control. All were subjected to: 1-CBC for eosinophilia. 2-Liver function tests(SGOT, SGPT, Alk. Phosphatase,Serum bilirubin). 3-Total serum IgE. 4-ELISA assay for serum IL-5 , IL-12 and bilharzial antibody(Bilh.Ab.)titre. 5-Double immuno-histochemical staining for mast cells (MCT & MCTC)in liver and colonic biopsies. RESULTS: Both absolute eosinophilic count and serum IgE showed significant elevation in group A, followed by B with normal levels in C (P< 0.0001). Bilh.Ab.titre was significantly elevated in group B followed by A and normal in C (P<0.0001). IL-5 was significantly high in A and very low in B (P<0.0001),while IL-12 showed significant difference among groups (p<0.001) with inverse relationship to IL-5. Clonic mucosal mast cell concentrations (MCT & MCTC) were significantly increased in group A than B, with few detectable cells in C. Hepatic mastocytosis was significant in group A than B(P<0.0001), with dominant MCT Phenotype. CONCLUSIONS: MHSS is linked to Th1 - like response with involvement of pro-inflammatory cytokines in schistosomal hepatosplenic disease process resulting in low level of IL-5. Meanwhile, association with asthma could modulate the immune response with shift to Th2 side resulting in marked elevation of IL-5, eosinophilia and mastocytosis.