BIOCHEMICAL INDICES IN PATIENTS WITH SCHISTOSOMA HAEMATOBIUM INFESTATION

Abstract

Schistosomiasis is a major health problem in Egypt. Despite active control program, it is estimated that over one third of the population or from 17 to 20 million people are infested. Infestation with this parasite increases the relative risk of bladder cancer among schistosomal patients which is about 6 times that in normal population among Egyptians. Because of the geographical coincidence of bladder cancer and endemic schistosomiasis, a causal relation has long been speculated to exist between them. This association determines a distinct clinicopathologic entity, quite different from that experienced in the Western World. Despite recent advances in diagnostic and therapeutic techniques, there is no evidence indicating a significant decrease in the incidence of bladder cancer. Therefore, the aim of many investigating teams is to early define malignant transformation in inflammatory schistosomal bladder lesions, together with better understanding the pathophysiology of the disease, at the molecular level. The present work was designed to determine the role of tumor suppressor gene (p53), proliferative markers (TPA and Cathepsin D), fibronectin, p2 microglobulin, cytokines (IL-2, IL-10, IFN-y and TNF-a), immunoglobulins and urinary parameters (GST, hydroxyproline / creatinine ratio, TPA and P-glucuronidase) in the various grades of schistosomal infestation. The study was conducted on a total of 80 subjects, 60 schistosomal patients and 20 healthy control. The patients were classified into 4 groups accordmg to the proposed ultrasonography score based on the urinary bladder morbidity seen in schistosomal patients :