TY - JOUR
T1 - Diagnosis of female genital schistosomiasis by indirect disease markers
T2 - Determination of eosinophil cationic protein, neopterin and IgA in vaginal fluid and swab eluates
AU - Poggensee, Gabriele
AU - Reimert, Claus Michael
AU - Nilsson, Lars Ake
AU - Jamaly, Shabbar
AU - Sjastad, Aimee
AU - Roald, Borghild
AU - Kjetland, Eyrun Floerecke
AU - Helling-Giese, Gertrud
AU - Richter, Joachim
AU - Chitsulo, Lester
AU - Kumwenda, Newton
AU - Gundersen, Svein Gunnar
AU - Krantz, Ingela
AU - Feldmeier, Hermann
N1 - Funding Information:
This investigation was supported by a Director's Initiative Grant from the UNDP/WB/WHO Special Programme for Research and Training in Tropical Diseases (TDR) and the Danish Medical Research Council. It also received support from the Kongregation der Franziskanerinnen, Salzkotten, Germany, and from the Research Forum and the Department of Infectious Diseases, Ullevaal Hospital, and Norwegian Lions International. We are indebted to the Mangochi District Hospital staff under the directorship of Dr. V. van Oosterzee and Dr. F. van der Velde. Special thanks go to Ms. R. Maziyauya, Mr. Kalua, Mr. A. Mazombe, Mr. E. Chikadza and Mrs. R. Gibson for their kind cooperation. Leisegang Feinmechanik-Optik GmbH & Co. provided an excellent photocolposcope.
PY - 1996/12/30
Y1 - 1996/12/30
N2 - Based on assumptions about the pathophysiology of egg-related lesions in the lower reproductive tract, putative indirect disease markers were investigated in vaginal fluids from 54 Malawi adolescent girls and women infected with S. haematobium. These women received a careful gynecological examination during which biopsies were taken from the cervix, and, if present, also from suspicious lesions in the vagina and the vulva. If the biopsies, either in wet crushed preparations or in histological sections, contained eggs the patients were considered to have female genital schistosomiasis (FGS; n = 33). The remainder (n = 21) were classified as having urinary schistosomiasis only. Eosinophil cationic protein (ECP), a cytotoxic granule protein of eosinophils, neopterin, a second messenger molecule generated during the activation of macrophages, and IgA as an indicator of local B-cell activation were quantitatively determined in vaginal fluid. To clarify the origin of ECP, this protein was also looked for in histological sections by an immunohistochemical method. In order to explore whether such disease markers can be detected after absorption to a tampon-like material, ECP and IgA were also assessed after elution from a non-porous, polypropylene fibre web impregnated with vaginal fluid. The concentration of ECP in vaginal fluid and the degree of immunohistochemical staining in histological sections were significantly higher in patients with FGS than in women with urinary schistosomiasis only. The amount of ECP detected in histological sections correlated to the number of eggs/mm2 of compressed genital tissue (rho = 0.36, P = 0.02), and the concentration of ECP in vaginal fluid correlated to the concentration of neopterin as well as to that of IgA (rho = 0.52, P = 0.004 and rho = 0.37, P = 0.02, respectively). Median neopterin concentration in vaginal fluid was also higher in the FGS group, but the difference was not statistically significant. ECP could also be detected in eluates from impregnated fibre webs, but the concentration was approximately one power of 10 less than in the original vaginal fluid. These results demonstrate that indicators of immunological mechanisms related to the egg-granuloma might be useful as indirect disease markers for women with FGS if assessed in vaginal washings or swab eluates.
AB - Based on assumptions about the pathophysiology of egg-related lesions in the lower reproductive tract, putative indirect disease markers were investigated in vaginal fluids from 54 Malawi adolescent girls and women infected with S. haematobium. These women received a careful gynecological examination during which biopsies were taken from the cervix, and, if present, also from suspicious lesions in the vagina and the vulva. If the biopsies, either in wet crushed preparations or in histological sections, contained eggs the patients were considered to have female genital schistosomiasis (FGS; n = 33). The remainder (n = 21) were classified as having urinary schistosomiasis only. Eosinophil cationic protein (ECP), a cytotoxic granule protein of eosinophils, neopterin, a second messenger molecule generated during the activation of macrophages, and IgA as an indicator of local B-cell activation were quantitatively determined in vaginal fluid. To clarify the origin of ECP, this protein was also looked for in histological sections by an immunohistochemical method. In order to explore whether such disease markers can be detected after absorption to a tampon-like material, ECP and IgA were also assessed after elution from a non-porous, polypropylene fibre web impregnated with vaginal fluid. The concentration of ECP in vaginal fluid and the degree of immunohistochemical staining in histological sections were significantly higher in patients with FGS than in women with urinary schistosomiasis only. The amount of ECP detected in histological sections correlated to the number of eggs/mm2 of compressed genital tissue (rho = 0.36, P = 0.02), and the concentration of ECP in vaginal fluid correlated to the concentration of neopterin as well as to that of IgA (rho = 0.52, P = 0.004 and rho = 0.37, P = 0.02, respectively). Median neopterin concentration in vaginal fluid was also higher in the FGS group, but the difference was not statistically significant. ECP could also be detected in eluates from impregnated fibre webs, but the concentration was approximately one power of 10 less than in the original vaginal fluid. These results demonstrate that indicators of immunological mechanisms related to the egg-granuloma might be useful as indirect disease markers for women with FGS if assessed in vaginal washings or swab eluates.
KW - diagnosis
KW - eosinophil cationic protein
KW - female genital schistosomiasis
KW - immunohistochemistry
KW - indirect disease markers
KW - neopterin
KW - vaginal fluid iga
KW - women
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U2 - 10.1016/S0001-706X(96)00028-9
DO - 10.1016/S0001-706X(96)00028-9
M3 - Article
C2 - 9028411
AN - SCOPUS:0030607737
SN - 0001-706X
VL - 62
SP - 269
EP - 280
JO - Acta Tropica
JF - Acta Tropica
IS - 4
ER -