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Autoimmunity in human CE: Correlative with the fertility status of the CE cyst

E. A. EL Saftawy

E. A. EL Saftawy

  • Medical Parasitology Department, Faculty of Medicine, Cairo UniversityCairo, Egypt
  • Medical Parasitology Department, Faculty of Medicine, Armed Forces College of MedicineCairo, Egypt
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Saftawy, E. A. EL
, 
A. Abdelraouf

A. Abdelraouf

HBP Surgery Department NHTMRI. (National hepatology and tropical médecine Research Institute)Cairo, Egypt
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Abdelraouf, A.
, 
M. A. Elsalam

M. A. Elsalam

Egyptian Fellowship of GIT & Hepatology, Nasser Institute for Research and TreatmentCairo, Egypt
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Elsalam, M. A.
, 
P. Zakareya

P. Zakareya

Master’s degree of clinical pathology, Ain Shames UniversityCairo, Egypt
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Zakareya, P.
, 
A. Fouad

A. Fouad

Clinical Pathology Department, National Hepatology And Tropical Medicine Research InstituteCairo, Egypt
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Fouad, A.
, 
E. A. Albadawi

E. A. Albadawi

Department of Anatomy College of Medicine, Taibah UniversityTaibah, KSA
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Albadawi, E. A.
, 
A. H. S. Abobakr Ali

A. H. S. Abobakr Ali

Department of Anatomy, Faculty of Minia UniversityMinya, Egypt
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Abobakr Ali, A. H. S.
 and 
N. M. Amin

N. M. Amin

  • Medical Parasitology Department, Faculty of Medicine, Cairo UniversityCairo, Egypt
  • Master’s Degree of Clinical Pathology, Cairo UniversityCairo, Egypt
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Amin, N. M.
  
May 04, 2022
Autoimmunity in human CE: Correlative with the fertility status of the CE cyst's Cover Image
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Article Category: Research Article
Published Online: May 04, 2022
Page range: 1 - 17
Received: Sep 11, 2020
Accepted: Jan 27, 2022
DOI: https://doi.org/10.2478/helm-2022-0011
Keywords
© 2022 E. A. El Saftawy, A. Abdelraouf, M. A. Elsalam, P. Zakareya, A. Fouad, E. A. Albadawi, A. H. S. Abobakr Ali, N. M. Amin, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1

Show the structures of the fertile hydatid cysts removed from liver tissue. (A) Light microscopy of free evaginated hydatid protoscoleces in wet mount. (B,C) Determination of parasite viability using 0.1 % eosin dye-exclusion test showing viable and dead protoscoleces respectively. Note stalks are still joining protoscoleces to the germinal layer (red asterisk) in (C). (D) Developed brood capsules encompass protoscoleces. (E) Growing protoscoleces still attached to a piece of germinal layer from a fertile cystic echinococcosis are observed; note the cells with nuclei bigger than parasite cells within the germinal layer (arrows). (F) Laminated (L) layer adjacent to the adventitial layer (AL). (G) Adventitial layer encompasses mixed inflammatory cells (IC) with sinusoids (S) and collagen element. Scale bare, 50μm (A);100 μm (B-G).
Show the structures of the fertile hydatid cysts removed from liver tissue. (A) Light microscopy of free evaginated hydatid protoscoleces in wet mount. (B,C) Determination of parasite viability using 0.1 % eosin dye-exclusion test showing viable and dead protoscoleces respectively. Note stalks are still joining protoscoleces to the germinal layer (red asterisk) in (C). (D) Developed brood capsules encompass protoscoleces. (E) Growing protoscoleces still attached to a piece of germinal layer from a fertile cystic echinococcosis are observed; note the cells with nuclei bigger than parasite cells within the germinal layer (arrows). (F) Laminated (L) layer adjacent to the adventitial layer (AL). (G) Adventitial layer encompasses mixed inflammatory cells (IC) with sinusoids (S) and collagen element. Scale bare, 50μm (A);100 μm (B-G).

Fig. 2

Plasma concentrations of IL-17A (A), ANA-sera titres (B) and anti-CCP serological values (C) in cystic echinococcosis (CE) patients using ELISA test. Patients were assembled according to the fertility state of their infection, that is, fertile with high viability, fertile with low viability, or non-fertile cystic echinococcosis. Comparisons of the paired measurements within each group were performed using the non-parametric Wilcoxon signed rank test. All data are presented as means ± SD in the three independent groups.
Plasma concentrations of IL-17A (A), ANA-sera titres (B) and anti-CCP serological values (C) in cystic echinococcosis (CE) patients using ELISA test. Patients were assembled according to the fertility state of their infection, that is, fertile with high viability, fertile with low viability, or non-fertile cystic echinococcosis. Comparisons of the paired measurements within each group were performed using the non-parametric Wilcoxon signed rank test. All data are presented as means ± SD in the three independent groups.

Fig. 3

Photomicrography of IHC-stained hydatid slides for IL-17A obtained using Olympus, CX-23, USA microscopy. Fertile hydatid cyst with high viability: (A) frequent IL-17A immune reactive cells infiltrates marginal to AL. (B) immune reactive cells among the cellular territories of the parasite’s protoscoleces along the cuticle. Note the structural composition of a protoscoleces (black arrows) still attached to germinative membrane (G). Non-fertile hydatid cysts: (C,D) showing low immune-positive cell infiltration within fibrous elements.
Photomicrography of IHC-stained hydatid slides for IL-17A obtained using Olympus, CX-23, USA microscopy. Fertile hydatid cyst with high viability: (A) frequent IL-17A immune reactive cells infiltrates marginal to AL. (B) immune reactive cells among the cellular territories of the parasite’s protoscoleces along the cuticle. Note the structural composition of a protoscoleces (black arrows) still attached to germinative membrane (G). Non-fertile hydatid cysts: (C,D) showing low immune-positive cell infiltration within fibrous elements.

Fig. 4

Immunofluorescence photomicrographs of hydatid cysts. I-(a-g) the deposits of immune complexes showed a predominant dispersal in the cellular territories of the germinal layer. (a) The rod and ring distribution pattern of ANA. (b) Protoscoleces (P) attached with stalks (s) to the germinal layer (g). (c) Protoscoleces bounded by germinal layer, brood capsules (b). (d) Protoscoleces with chief distribution of immunecomplexes in the hooklet region (h) and moderate to faint existence in the suckers (sk.) and outer rim of the protoscolix. (e) Mononuclear immune cells infiltrating adventitial layer in homogenous ANA pattern. (f) Sinusoidal endothelium showing positive immune reactivity with apparent defenestration (white arrows). II (a-e) Representative images of positive controls in group-1(fertile cyst with high viability stained with Hoechst dye showing total nuclear counts). In II (f), the negative control, healthy Guinea pig’s liver stained for ANA. Scale bar in pixels.
Immunofluorescence photomicrographs of hydatid cysts. I-(a-g) the deposits of immune complexes showed a predominant dispersal in the cellular territories of the germinal layer. (a) The rod and ring distribution pattern of ANA. (b) Protoscoleces (P) attached with stalks (s) to the germinal layer (g). (c) Protoscoleces bounded by germinal layer, brood capsules (b). (d) Protoscoleces with chief distribution of immunecomplexes in the hooklet region (h) and moderate to faint existence in the suckers (sk.) and outer rim of the protoscolix. (e) Mononuclear immune cells infiltrating adventitial layer in homogenous ANA pattern. (f) Sinusoidal endothelium showing positive immune reactivity with apparent defenestration (white arrows). II (a-e) Representative images of positive controls in group-1(fertile cyst with high viability stained with Hoechst dye showing total nuclear counts). In II (f), the negative control, healthy Guinea pig’s liver stained for ANA. Scale bar in pixels.

Fig. 5

Immunohistochemistry study of the hepatic hydatid cyst adventitial layer (AL) for interleukin factor IL-17A and ANA immunofluorescence in the three independent groups of hydatidosis patients. The level of significance was adjusted by the non-parametric Kruskal-Wallis and Mann-Whitney tests. The significant differences between the examined groups are indicated (P < 0.01).
Immunohistochemistry study of the hepatic hydatid cyst adventitial layer (AL) for interleukin factor IL-17A and ANA immunofluorescence in the three independent groups of hydatidosis patients. The level of significance was adjusted by the non-parametric Kruskal-Wallis and Mann-Whitney tests. The significant differences between the examined groups are indicated (P < 0.01).

Fig. 6

Correlation between IL-17A immunohistochemical profile and ANA fluorescent intensities in the three independent groups of hydatidosis patients: IL-17A showed positive correlation with ANA in the three hydatid cyst groups. Open symbols and lines represent mean intensities of the tested specimens of each group.
Correlation between IL-17A immunohistochemical profile and ANA fluorescent intensities in the three independent groups of hydatidosis patients: IL-17A showed positive correlation with ANA in the three hydatid cyst groups. Open symbols and lines represent mean intensities of the tested specimens of each group.

Distribution of patients into three groups based on fertility rate of hydatid cysts in the current study_

No of group, n=63 Type of cysts Mean value ± SD of protoscoleces Mean value ± SD of brood capsules
Solitary cysts Multivesicular cysts
Group-1, n=22 13(59.0%) 13(59%) 1020.45± 479.22 18.82±9.28
Group-2, n=26 18(70%) 8(30%) 498.08 ± 232.16 18.65±8.78
Group-3, n=15 14(93%) 1(7%) 0 0

Mean±S_D_ plasma concentrations of ANA and anti-CCP antibodies in each of the three groups of cystic echinococcosis patients versus their infection- free controls

Category of patients Autoimmune- population Mean±SD of diseased group Mean±SD of control group p -value
Group-1 ANA 405.45±589.99 120.00±92.38 0.001
anti-CCP 14.14±7.71 11.32±6.52 0.109
Group- 2 ANA 158.46±171.76 27.12 ±88.31 0.063
anti-CCP 45.12 ±8.09 10.58 ±6.31 0.291
Group- 3 ANA 218.67 ± 206.67 37.73 ±23.72 0.084
anti-CCP 74.47 ± 14.59 12.60 ± 9.14 0.209

Spearman coefficient of IL-17A plasma levels with autoimmune populations_

Patient groups ANA autoimmune population sera titres Anti-CCP autoimmune population sera titres
Spearman rho-value p value Spearman rho-value p value
Group-1 -0.004- 0.984 -0.139- 0.538
Group-2 0.021 0.919 0.177 0.388
Group-3 0.257 0.355 0.460 0.084
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