Background: Schistosomiasis remains an important cause of
parasitic morbidity and mortality worldwide. In countries where
schistosomiasis is endemic, a high prevalence of combined
Schistosomiasis mansoni and chronic hepatitis C and chronic
hepatitis B co-infection has been described. The immunopathogenesis
of human schistosomiasis with or without chronic
hepatitis remains controversial. Aim of the work: Is to evaluate
the immunopathogenic role of Th1 cytokine (IL-2) and Th2
cytokine (IL-4) in patients with different stages of hepatointestinal
schistosomiasis with or without chronic hepatitis. Methods: The
study included 60 Egyptian patients with different stages of
hepatointestinal schistosomiasis. They include 40 patients with
hepatosplenic schistosomiasis (divided into 4 subgroups according
to stage of hepatosplenic schistosomiasis), 10 patients with
schistosoma mansoni and chronic hepatitis C and 10 patients
with schistosoma mansoni and chronic hepatitis B co-infection,
In addition to, 10 healthy controls. IL-2 and Il-4 was measured
by competitive enzyme immunoassay (EIA) which measures the
natural and recombinant forms of the cytokines. Results:
Compared to control group, patients with hepatosplenic schistosomiasis
showed significant increase in serum IL-2 from stage
1 (P< 0.05) to stage 4 (P< 0.001). Moreover, both groups with
combined schistosomiasis and chronic hepatitis C and chronic
hepatitis B showed significant increase in the IL-2 (P< 0.05 for
both). Furthermore, decompensated schistosomiasis showed
highly significant increase in the IL-2 versus compensated schistosomiasis
(P< 0.001). Also, compared to control group, patients
with hepatosplenic schistosomiasis showed significant increase
in serum IL-4, that decreased from stage 1 (P< 0.001)) to nonsignificant
increase in stage 4 (P> 0.05). In addition, chronic HCV
with schistosomiasis showed significant increase in the IL-4 (P<
0.05) and chronic HBV with schistosomiasis showing significant
increase in the IL-4 (P< 0.001). Moreover, compensated schistosomiasis
showed significant increase in the IL-4 (P< 0.001)
versus decompensated schistosomiasis. Conclusion: Patients
with chronic schistosomiasis present a mixed profile of Th1 and
Th2 cytokines. The Th1 (IL-2) was increased with the progression
of the hepatosplenic schistosomiasis from stage 1(hepatomegaly)
to the stage 4. However, The Th2 (IL-4) was elevated in the first
stage of hepstosplenic schistosomiasis and then decreased with
progression of the disease. In patients with combined schistosomiasis
and chronic hepatitis the Th2 (IL-4) is the predominant
cytokine versusTh1 (IL-2).