Specific liver autoreactivity in schistosomiasis mansoni

Area of Science:

• Immunology
• Hepatology
• Parasitology

Background:

• Autoimmune mechanisms are increasingly recognized in chronic liver diseases.
• Hepatosplenic schistosomiasis (HSS) is a severe manifestation of Schistosoma mansoni infection with complex pathophysiology.
• The role of autoimmunity in HSS pathogenesis remains incompletely understood.

Purpose of the Study:

• To investigate the potential involvement of autoimmune reactions in the development of hepatosplenic schistosomiasis (HSS).
• To screen patients with chronic Schistosoma mansoni infections for specific autoantibodies, including anti-hepatic asialoglycoprotein receptor (ASGP-R).

Main Methods:

• Screening of 234 patients with chronic Schistosoma mansoni infections for autoantibodies.
• Detection of antibodies against the GOR peptide and the liver-specific autoantigen, ASGP-R.
• Comparison of anti-ASGP-R seropositivity between HSS patients, hepatointestinal schistosomiasis patients, and autoimmune hepatitis patients.

Main Results:

• Anti-ASGP-R antibodies were detected in 27.4% of patients, at titres comparable to autoimmune hepatitis.
• Seropositivity for anti-ASGP-R was significantly higher in HSS patients (32.6%) compared to hepatointestinal schistosomiasis patients (4.5%).
• Anti-ASGP-R antibodies were significantly less frequent in HSS patients who had undergone splenectomy (5.8%) versus those who had not (54.8%).

Conclusions:

• Liver-specific autoreactivity, particularly against ASGP-R, may contribute to the pathogenesis of hepatosplenic schistosomiasis.
• The reduced prevalence of anti-ASGP-R antibodies after splenectomy suggests a role for autoreactivity in the disease process.
• These findings highlight a potential autoimmune component in HSS, distinct from non-organ-specific autoantibodies.