Human bilharzial ureters. II. Cellular dynamic against deposited eggs

The cellular dynamic against deposited Schistosoma haematobium eggs was studied in the submucosa and muscularis of the lower ureteral segments of Saudi patients with chronic urinary schistosomiasis. This dynamic activity was greatly affected by the damaged phase of the egg embryo. Freshly deposited eggs with "healthy" embryos were entirely surrounded by long cytoplasmic extensions of fibroblasts. Eggs with partially damaged embryos were surrounded by plasma cells which were focally adhered to spines of egg-shells and releasing their granular contents over their surface. Eggs with "dead" embryos, or empty egg-shells, were surrounded by actively mobile macrophages possessing numerous lysosomes, phagocytic vacuoles, and convoluted surface projections. After "peeling" off the outer and intermediate shell layers, macrophages invaded into eggs and fused together forming multinucleate giant macrophages. This study showed that the fibroblastic extensions acted as barriers between the parasite eggs or their products, and the host tissue; the plasma cell secretion over the egg surface may be involved in the migration of macrophages towards deposited eggs; and macrophages were the only dynamic cells responsible for the egg-shell invasion possibly for elimination.