Angiopoietins as biomarkers of schistosomiasis severity: a cross-sectional study

Schistosomiasis, a parasitic disease caused by Schistosoma species, remains highly prevalent in tropical regions, where it contributes significantly to hepatic and vascular complications. Despite the well-established role of parasitic eggs in driving inflammation and organ damage, the specific vascular mechanisms remain poorly understood. Given the role of angiogenesis and vascular remodelling in tissue repair, the angiopoietins (ANGs) could be promising biomarkers to evaluate disease progression. This study aims to explore the relationship between ANG levels with parasitic load in patients with schistosomiasis. In this cross-sectional study, 126 schistosomiasis patients were stratified into three groups based on parasitic egg burden: negative, low, and moderate/high. Demographic, clinical, and laboratory data were collected, and serum ANGs were quantified via enzyme-linked immunosorbent assays. Parasitic load was assessed through stool examination, quantifying the number of Schistosoma eggs per gram of faeces. Additional clinical parameters, including liver abnormalities and blood chemistry, were evaluated. The ANG-2 levels and the ANG-2/ANG-1 ratio were significantly elevated in patients with higher egg burdens, particularly in the moderate/high group. The ANG-2/ANG-1 ratio was notably higher in patients with hepatosplenic schistosomiasis. While systemic blood pressure and oxygen saturation showed no significant differences between groups, patients with elevated triglycerides had lower ANG-2 levels. Elevated ANG-2 levels and an increased ANG-2/ANG-1 ratio correlate with higher parasitic burdens, reinforcing their potential as biomarkers for disease severity. These findings underscore the role of egg-induced inflammation in schistosomiasis pathophysiology and suggest that ANGs could aid in early diagnosis and treatment decisions, particularly in populations with high parasitic loads.