Eosinophil activation status, cytokines and liver fibrosis in Schistosoma mansoni infected patients

We have been investigating whether human eosinophils play an important role in schistosomiasis mansoni morbidity. Our main focus has been on the activation-related cell surface markers (CD23/CD69/CD25/HLA-DR/CD28/CD80) and the detection of TNF-alpha, IL-4 and IL-5 in peripheral blood eosinophils from chronic Schistosoma mansoni-infected patients. Our studies compare both, intestinal (INT) and individuals with periportal fibrosis (FIB). Our major findings, point to distinct profile of activation-related surface markers on eosinophils as the hallmark of disease morbidity during chronic S. mansoni infection. Up-regulation of several activation-related markers was observed on eosinophils from FIB group, but not INT, which include early activation markers, such as CD69 and CD23. INT displayed a distinct profile, with up-regulation of molecules related to the late activation (CD25, HLA-DR, CD28 and CD80). These results suggest that some immunoregulatory events may take place controlling the early eosinophil activation in the INT group. Higher levels of eosinophil-derived cytokines were observed in FIB, regardless the antigen stimulation in vitro. A mixed cytokine pattern, characterized by positive correlation between TNF-alpha, IL-4 and IL-5 was observed in both INT and FIB. However, lack of correlation between the cytokine expression and the eosinophil activation status points out that even those FIB patients presenting minor increment on eosinophil activation displayed higher levels of cytokine-positive eosinophils. Indeed, the positive association between lymphocyte-derived IL-10 and the eosinophils cytokine profile was observed exclusively in INT further emphasize our hypothesis that immunoregulatory events take place controlling disease morbidity in human schistosomiasis. The impaired IL-10-driven immunoregulatory function may play an important role on the establishment of pathology in patients bearing periportal fibrosis.