Angiopoietinas e sua associação com carga parasitária e formas clínicas em pacientes com esquistossomose residentes em uma área de alta endemicidade no Nordeste brasileiro

Abstract

Schistosomiasis is a parasitic disease caused by blood flukes of the genus Schistosoma, whose severe manifestations are associated with inflammatory and vascular responses. Several biomarkers have been investigated in inflammatory and vascular conditions, including angiopoietins, a family of angiogenic growth factors. In this context, the aim of this study was to evaluate the relationship between parasite burden and angiopoietin levels(ANG1 and ANG2) in individuals infected with Schistosoma mansoni, as well as to assess the association of these biomarkers with disease severity and related clinical manifestations. The study was conducted in two endemic areas in the state of Sergipe, Brazil, between August 2022 and April 2023, involving 126 volunteers from Quilombo Patioba (Japaratuba) and Colônia Miranda (São Cristóvão). The methodology included the collection of blood samples to analyze ANG1 and ANG2 levels, along with clinical and laboratory tests to assess liver function and parasite burden. Schistosomiasis was diagnosed using the Kato-Katz method, and participants were stratified according to the intensity of infection. Endothelial function was evaluated by measuring endothelial biomarkers and traditional biochemical markers. The results revealed a positivity rate for schistosomiasis of 33.62% in Quilombo Patioba and 25.67% in Colônia Miranda, both higher than state and national averages. Moderate/high infection rates were more frequent in Quilombo Patioba (18.61%) compared to Colônia Miranda (14.3%). Analysis of ANG2 levels and the ANG2/ANG1 ratio showed a significant correlation with parasite burden and the hepatosplenic form of the disease. ANG2 levels and the ANG2/ANG1 ratio were higher in groups with moderate and high parasite burden, as well as in the hepatosplenic form of schistosomiasis. Individuals with more severe forms of the disease showed a higher prevalence of palpable liver and ultrasonographic alterations, corroborating previous studies linking parasite burden to progressive liver damage. No significant changes were observed in systemic blood pressure or oxygen saturation, suggesting that, in the studied population, the primary disease-related alterations were associated with hepatic and portal. These findings indicate that ANG2 and the ANG2/ANG1 ratio could serve as useful biomarkers for assessing disease severity and detecting early vascular inflammation. Further investigations are necessary to elucidate the exact mechanisms involved and to explore the application of these biomarkers in therapeutic interventions.