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

• Published in: Revista da Sociedade Brasileira de Medicina Tropical Vol. 56; p. e0341
• Main Authors: Sousa, Mariana Silva, Meneses, Gdayllon Cavalcante, Dam, Govert Jan van, Corstjens, Paul Leo Albert Maria, Galvão, Rosangela Lima de Freitas, Pinheiro, Marta Cristhiany Cunha, Martins, Alice Maria Costa, Daher, Elizabeth de Francesco, Bezerra, Fernando Schemelzer de Moraes
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Medicina Tropical - SBMT 01-01-2023; Sociedade Brasileira de Medicina Tropical (SBMT)
• Subjects: Animals; Antigens, Helminth - urine; Brazil - epidemiology; Humans; Inflammation - drug therapy; Kidney disease; Lateral Flow Circulating Anodic Antigen (UCP-LF CAA) assay, biomarkers; Major; Podocytes - chemistry; Praziquantel - therapeutic use; Prevalence; Schistosoma mansoni; Schistosomiasis; Schistosomiasis mansoni - complications; Schistosomiasis mansoni - diagnosis; Schistosomiasis mansoni - drug therapy; TROPICAL MEDICINE; Up-Converting Phosphor Reporter Particle; Vascular Endothelial Growth Factor (VEGF); Vascular Endothelial Growth Factor A - therapeutic use; Brazil; Kidney disease; Up-Converting Phosphor Reporter Particle; Schistosomiasis; Vascular Endothelial Growth Factor (VEGF); Lateral Flow Circulating Anodic Antigen (UCP-LF CAA) assay, biomarkers
• ISSN: 0037-8682; 1678-9849; 1678-9849
• DOI: 10.1590/0037-8682-0341-2022

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.
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.
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.
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.