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. 2023 Feb 20:56:e0341.
doi: 10.1590/0037-8682-0341-2022. eCollection 2023.

Subclinical signs of podocyte injury associated with Circulating Anodic Antigen (CAA) in Schistosoma mansoni-infected patients in Brazil

Mariana Silva Sousa  1   2 , Gdayllon Cavalcante Meneses  2 , Govert Jan van Dam  3 , Paul Leo Albert Maria Corstjens  4 , Rosangela Lima de Freitas Galvão  1   5 , Marta Cristhiany Cunha Pinheiro  1 , Alice Maria Costa Martins  6 , Elizabeth de Francesco Daher  2 , Fernando Schemelzer de Moraes Bezerra  1   2   5
Affiliations

Subclinical signs of podocyte injury associated with Circulating Anodic Antigen (CAA) in Schistosoma mansoni-infected patients in Brazil

Mariana Silva Sousa et al. Rev Soc Bras Med Trop. .

Abstract

Background: The long-term effects of schistosomiasis on the glomerulus may contribute to the development of chronic kidney disease. This study aimed to investigate baseline Schistosoma mansoni-Circulating Anodic Antigen (CAA) levels and their association with kidney biomarkers related to podocyte injury and inflammation in long-term follow-up after praziquantel (PZQ) treatment.

Methods: Schistosoma infection was diagnosed by detecting CAA in urine using a quantitative assay based on lateral flow using luminescent up-converting phosphor reporter particles. A cutoff threshold of 0.1 pg/mL CAA was used to diagnose Schistosoma infection (baseline) in a low-prevalence area in Ceará, Northeast, Brazil. Two groups were included: CAA-positive and CAA-negative individuals, both of which received a single dose of PZQ at baseline. Urinary samples from 55 individuals were evaluated before (baseline) and at 1, 2, and 3 years after PZQ treatment. At all time points, kidney biomarkers were quantified in urine and adjusted for urinary creatinine levels.

Results: CAA-positive patients had increased baseline albuminuria and proteinuria and showed greater associations between kidney biomarkers. CAA levels correlated only with Vascular Endothelial Growth Factor (VEGF) (podocyte injury) levels. Increasing trends were observed for malondialdehyde (oxidative stress), monocyte chemoattractant protein-1 (inflammation marker), and VEGF. In the follow-up analysis, no relevant differences were observed in kidney biomarkers between the groups and different periods.

Conclusions: S. mansoni-infected individuals presented subclinical signs of glomerular damage that may reflect podocyte injury. However, no causal effect on long-term renal function was observed after PZQ treatment.

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Conflict of interest statement

Conflict of Interest: The authors declare that there is no conflict of interest related to this research.

Figures

FIGURE 1:
FIGURE 1:. Matrix scatter plots of the baseline renal parameters in CAA-negative and CAA-positive groups. The green squares represent a significant correlation (p <0.05). VEGF: Vascular Endothelial Growth Factor; MDA: Malondialdehyde; MCP-1: Monocyte Chemoattractant Protein-1.
FIGURE 2:
FIGURE 2:. The levels of renal parameters at post-treatment prospective follow-up in CAA-positive and CAA-negative groups. The four cross-sectional study time points are shown: baseline (T = 0) and 1, 2, and 3 years after treatment. Albuminuria; MDA: Malonaldehyde; MCP-1: Monocyte Chemoattractant Protein-1, Proteinuria; VEGF: Vascular Endothelial Growth Factor.
See this image and copyright information in PMC

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