Specific liver autoreactivity in schistosomiasis mansoni

Abstract

To investigate the possible involvement of autoimmune mechanisms in the development of hepatosplenic schistosomiasis (HSS), 234 patients with chronic Schistosoma mansoni infections were screened for a wide range of non-organ-specific autoantibodies as well as for antibodies reacting with the GOR peptide and with a liver-specific autoantigen, the hepatic asialoglycoprotein receptor (ASGP-R). Thirty-five (15·0%) were seropositive for antinuclear, smooth muscle or gastric parietal cell antibodies at low titres (≤1:80), and 15 176 (8·5%) had anti-GOR, all of whom had concomitant hepatitis C viral (HCV) infections. Anti-ASGP-R was found in 64 (27·4%) of the 234 patients at titres similar to those found in 18 untreated auto-immune hepatitis patients studied concurrently. Anti-ASGP-R seropositivity occurred significantly ( P < 0·005) more frequently in patients with HSS ( 62 190 , 32·6%) than in those with hepatointestinal schistosomiasis ( 2 44 , 4·5%), but did not correlate with severity of liver disease or with the presence of the non-organ-specific autoantibodies. Anti-ASGP-R was found significantly ( P ⪡ 0·0005) less frequently in HSS patients who had had a splenectomy for portal hypertension ( 5 86 , 5·8%) than in those who had not had a splenectomy ( 57 104 , 54·8%). The findings suggest that liver-specific autoreactivity may play a role in the development of HSS.