Relationship between tumor necrosis factor-alpha (TNF) profile and urinary tract pathology in rural Nigerians with Schistosoma haematobium infection

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Background: Schistosomiasis is estimated to affect more than 200 million people especially in rural and agricultural areas. Schistosoma haematobium causes significant urinary tract diseases is due to delayed hypersensitivity and mediated by T cell dependent granulomatous responses to the schistosome eggs. Since tumor necrosis factor alpha (TNF) is elicited by Th 1 responses and implicated in granulomatous responses to the ova trapped in the bladder wall of Schistosoma haematobium infected persons, it is important to ascertain the relationship between intensity of infection and urinary tract pathology in our locality.Methodology: The urine samples from volunteers were subjected to parasitological investigations to ascertain the presence of S. haematobium ova in their urine. The TNF profile was ascertained using standard enzyme-linked immunosorbent assay (ELISA). The ultrasonographical investigation was carried out on the S. haematobium infected participants using transabdominal ultrasonography.Results: Nineteen out of 40 rural Nigerians infected with S. haematobium showed severe infection while the remaining 21 individuals had light infection. Males (26) were more severely infected than females (14). Children (30) were more infected than adults (10). The serum TNF concentration correlated positively with the intensity of infection (r2 = 0.97). Serum TNF was negatively correlated with the age of the volunteers (r2 = -0.36). The mean TNF concentration among subjects with heavy infection (535.7.4±415.5 pg⁄ml) was significantly higher than that among those with light infection (93.8±40.9pg⁄ml) at (χ2 = 341.0, p0.05). Also the concentration of TNF in the sera of children (448.2±140.2pg⁄ml) was significantly higher than that in adults (180.0±152.1 pg⁄ml) at (χ2 = 114.6, p0.05). The ultrasonographic investigation revealed eight types of urinary tract pathology, namely, abnormal wall thickness (70%), irregular bladder wall (55%), echogenic particles (75%), calcification (60%), pseudopolyp (12.5%), masses (10%), residual volume (30%) and hydroureter (7.5%) among 28 subjects. These participants with urinary tract pathology had relatively high serum TNF ranging from 190.6±15.6 pg⁄ml in abnormal wall thickness to 630.6±15.6 pg⁄ml among individuals with masses.Conclusion: The bladder and kidney pathology revealed in this investigation as well as the intensity of infection correlated with the levels of serum TNF among S. haematobium infected participants in Ihieve-Ogben, Nigeria. We observed an association between high level TNF with heavy infection and urinary tract pathology.
日本熱帯医学会の論文
2009-03-01

Relationship between tumor necrosis factor-alpha (TNF) profile and urinary tract pathology in rural Nigerians with Schistosoma haematobium infection

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