Effects of Praziquantel Treatment on the Levels of Total Bile Acids and the Basement Membrane Formation in Schistosomiasis: Correlations with the Severity of the Disease

The pathological effects of schistosomiasis are due to immune responses of the host to
the eggs of the parasite leading to intestinal and hepatic granulomatous disease and
hepatic fibrosis. Therefore, biochemical serum analyses concomitant with
haematological, microscopical, ultrasonographical and clinical examinations were
performed on 45 Schistosoma infested patients and on 15 matched healthy controls.
According to the development of the liver damage, as was reflected by Child Pugh’s
score, the patients were classified into 3 groups, containing 15 patients’ each. The
patients of group I were suffering from simple intestinal bilharzial infestation and
those of the group II and group III were bilharzially infested patients with Child A
and Child B, respectively. The patients were treated with triple doses of praziquantel
(PZQ) and the levels of total bile acids, laminin P1 (LP1), liver function tests (LFTs)
and blood picture were evaluated before and after 6 months of the treatment. Also,
the presence of schistosomal antibodies, its ova in stool or positivity of rectal snip for
such ova, before treatment, were used as diagnostic tools of bilharzial infestation. At
the same time, the clinical and ultrasonographical parameters were evaluated and
their correlations with the previous parameters were calculated. It was found that,
Schistosoma infestation caused damage to the liver with subsequent elevations in the
mean values of total bile acids (TBA), the basement membrane component (LP1) and
the parameters of LFTs due to presence of periporal fibrosis. After PZQ’s treatment,
the levels of the previous parameters were retuned back into levels reaching those of
the control group. In conclusion, PZQ treatment can cause spontaneous resolution of
liver fibrosis. In addition, the levels of total bile acids and LP1 can reflect the severity
of liver damage and the susceptibility to PZQ’s treatment. Moreover, one can not
neglect the role of LP1 in the regulation of inflammation in schistosomiasis.