- 作者：Thais Mauad ; Geanette Pozzan ; Tatiana Lan莽as ; Maria J. Overbeek ; Rog茅rio Souza ; Carlos Jardim ; Marisa Dolhnikoff ; George Mello ; Ruy Camargo Pires-Neto ; Fabiola del Carlo Bernardi ; Katrien Gr眉nberg
- 关键词：Schistosomiasis ; Pulmonary hypertension ; Histopathology ; Inflammation ; Plexiform lesions ; Dendritic cell ; Idiopathic pulmonary arterial hypertension
- 刊名：Journal of Infection
- 出版年：January, 2014
- 年：2014
- 卷：68
- 期：1
- 页码：90-98
- 全文大小：1922 K
Summary
Objectives
Pulmonary hypertension is a lethal complication of chronic hepatosplenic schistosomiasis. Little is known of the underlying (immuno-)histopathological characteristics of lung vasculopathy.Methods
We characterized vasculopathy and inflammation in lung tissue of 10 patients with Schistosomiasis-associated PH (SCH-PH) in comparison to 22 idiopathic pulmonary arterial hypertension (IPAH) patients and 10 normal controls. SCH-PH cases were younger than controls.
Results
Plexiform lesions and/or angiomatoid lesions were found in 10/10 SCH-PH, and 19/22 IPAH patients (蠂2 p聽=聽0.22). Lung granulomas with Schistosoma eggs were found in 2/10 of SCH-PH cases. PAH cases had increased peri-arterial density of CD3+ T cells, chymase+ and tryptase+ mast cells when compared to controls (p聽鈮ぢ?.047). SCH-PH showed increased density of CD4+ cells when compared to controls (p聽=聽0.025), paralleled by an increased density of dendritic CD83+ cells when compared to both controls and IPAH patients (p聽鈮ぢ?.022).
Conclusion
Both SCH-PH and IPAH feature plexogenic arteriopathy and increased periarterial T cell and mast cell density. SCH-PH and IPAH differ only with respect to the density of dendritic CD83+ cells. These findings imply ongoing antigenic stimulation in SCH-PH, yet a pattern of pulmonary vasculopathy similar to IPAH, suggestive of a final common pathway in their pathogenesis of PAH.