Schistosomiasis pulmonary arterial hypertension
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | http://hdl.handle.net/1843/41458 |
Resumo: | Pulmonary arterial hypertension (PAH) is a disease of the lung blood vessels that results in right heart failure. PAH is thought to occur in about 5% to 10% of patients with hepatosplenic schistosomiasis, particularly due to S. mansoni. The lung blood vessel injury may result from a combination of embolization of eggs through portocaval shunts into the lungs causing localized Type 2 inflammatory response and vessel remodeling, triggering of autonomous pathology that becomes independent of the antigen, and high cardiac output as seen in portopulmonary hypertension. The condition is likely underdiagnosed as there is little systematic screening, and risk factors for developing PAH are not known. Screening is done by echocardiography, and formal diagnosis requires invasive right heart catheterization. Patients with Schistosoma-associated PAH show reduced functional capacity and can be treated with pulmonary vasodilators, which improves symptoms and may improve survival. There are animal models of this disease that might help in understanding disease pathogenesis and identify novel targets to screen and treatment. Pathogenic mechanisms include Type 2 immunity and activation and signaling in the TGF-β pathway. There are still major uncertainties regarding Schistosoma-associated PAH development, course and treatment. |
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2022-05-06T23:25:46Z2022-05-06T23:25:46Z202011313210.3389/fimmu.2020.6088831664-3224http://hdl.handle.net/1843/41458Pulmonary arterial hypertension (PAH) is a disease of the lung blood vessels that results in right heart failure. PAH is thought to occur in about 5% to 10% of patients with hepatosplenic schistosomiasis, particularly due to S. mansoni. The lung blood vessel injury may result from a combination of embolization of eggs through portocaval shunts into the lungs causing localized Type 2 inflammatory response and vessel remodeling, triggering of autonomous pathology that becomes independent of the antigen, and high cardiac output as seen in portopulmonary hypertension. The condition is likely underdiagnosed as there is little systematic screening, and risk factors for developing PAH are not known. Screening is done by echocardiography, and formal diagnosis requires invasive right heart catheterization. Patients with Schistosoma-associated PAH show reduced functional capacity and can be treated with pulmonary vasodilators, which improves symptoms and may improve survival. There are animal models of this disease that might help in understanding disease pathogenesis and identify novel targets to screen and treatment. Pathogenic mechanisms include Type 2 immunity and activation and signaling in the TGF-β pathway. There are still major uncertainties regarding Schistosoma-associated PAH development, course and treatment.A hipertensão arterial pulmonar (HAP) é uma doença dos vasos sanguíneos pulmonares que resulta em insuficiência cardíaca direita. Acredita-se que a HAP ocorra em cerca de 5% a 10% dos pacientes com esquistossomose hepatoesplênica, particularmente por S. mansoni. A lesão dos vasos sanguíneos pulmonares pode resultar de uma combinação de embolização de ovos por meio de derivações portocava para os pulmões, causando resposta inflamatória tipo 2 localizada e remodelação do vaso, desencadeando patologia autônoma que se torna independente do antígeno e alto débito cardíaco, como visto na hipertensão portopulmonar . A condição provavelmente é subdiagnosticada, pois há pouca triagem sistemática e os fatores de risco para o desenvolvimento de HAP não são conhecidos. A triagem é feita por ecocardiografia, e o diagnóstico formal requer cateterismo cardíaco direito invasivo. Pacientes com HAP associada ao Schistosoma apresentam redução da capacidade funcional e podem ser tratados com vasodilatadores pulmonares, o que melhora os sintomas e pode melhorar a sobrevida. Existem modelos animais desta doença que podem ajudar na compreensão da patogênese da doença e identificar novos alvos para triagem e tratamento. Mecanismos patogênicos incluem imunidade tipo 2 e ativação e sinalização na via de TGF-β. Ainda existem grandes incertezas em relação ao desenvolvimento, curso e tratamento da HAP associada ao Schistosoma.engUniversidade Federal de Minas GeraisUFMGBrasilMED - DEPARTAMENTO DE CLÍNICA MÉDICAFrontiers in immunologyEsquistossomoseHipertensão pulmonarDoença tropical negligenciadaTGF-betaHepatoesplênicaSchistosomiasis pulmonary arterial hypertensionHipertensão Arterial Pulmonar Esquistossomoseinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://www.frontiersin.org/articles/10.3389/fimmu.2020.608883/fullJean PierresibomanaMichael H. LeeCamila M. C. LoureiroSula MazimbaClaudia MickaelRudolf K. F. OliveiraJaquelina S. Ota-arakakiCamila Farnese RezendeLuciana Cristina Dos Santos SilvaEdford SinkalaHanan Yusuf AhmedAloma CampecheBrian B. GrahamRoberto J. Carvalho-filhoRicardo Amorim CorreaHelena DuaniVirginia Pacheco GuimaraesJoan F. HiltonBiruk KassaRahul Kumarapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/41458/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINAL2020_Schistosomiasis pulmonary arterial hypertension[.pdf2020_Schistosomiasis pulmonary arterial hypertension[.pdfapplication/pdf1271187https://repositorio.ufmg.br/bitstream/1843/41458/2/2020_Schistosomiasis%20pulmonary%20arterial%20hypertension%5b.pdfa557eedf77286d00b8ad2ca7eee8b7faMD521843/414582022-05-06 20:25:46.348oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2022-05-06T23:25:46Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Schistosomiasis pulmonary arterial hypertension |
dc.title.alternative.pt_BR.fl_str_mv |
Hipertensão Arterial Pulmonar Esquistossomose |
title |
Schistosomiasis pulmonary arterial hypertension |
spellingShingle |
Schistosomiasis pulmonary arterial hypertension Jean Pierresibomana Esquistossomose Hipertensão pulmonar Doença tropical negligenciada TGF-beta Hepatoesplênica |
title_short |
Schistosomiasis pulmonary arterial hypertension |
title_full |
Schistosomiasis pulmonary arterial hypertension |
title_fullStr |
Schistosomiasis pulmonary arterial hypertension |
title_full_unstemmed |
Schistosomiasis pulmonary arterial hypertension |
title_sort |
Schistosomiasis pulmonary arterial hypertension |
author |
Jean Pierresibomana |
author_facet |
Jean Pierresibomana Michael H. Lee Camila M. C. Loureiro Sula Mazimba Claudia Mickael Rudolf K. F. Oliveira Jaquelina S. Ota-arakaki Camila Farnese Rezende Luciana Cristina Dos Santos Silva Edford Sinkala Hanan Yusuf Ahmed Aloma Campeche Brian B. Graham Roberto J. Carvalho-filho Ricardo Amorim Correa Helena Duani Virginia Pacheco Guimaraes Joan F. Hilton Biruk Kassa Rahul Kumar |
author_role |
author |
author2 |
Michael H. Lee Camila M. C. Loureiro Sula Mazimba Claudia Mickael Rudolf K. F. Oliveira Jaquelina S. Ota-arakaki Camila Farnese Rezende Luciana Cristina Dos Santos Silva Edford Sinkala Hanan Yusuf Ahmed Aloma Campeche Brian B. Graham Roberto J. Carvalho-filho Ricardo Amorim Correa Helena Duani Virginia Pacheco Guimaraes Joan F. Hilton Biruk Kassa Rahul Kumar |
author2_role |
author author author author author author author author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Jean Pierresibomana Michael H. Lee Camila M. C. Loureiro Sula Mazimba Claudia Mickael Rudolf K. F. Oliveira Jaquelina S. Ota-arakaki Camila Farnese Rezende Luciana Cristina Dos Santos Silva Edford Sinkala Hanan Yusuf Ahmed Aloma Campeche Brian B. Graham Roberto J. Carvalho-filho Ricardo Amorim Correa Helena Duani Virginia Pacheco Guimaraes Joan F. Hilton Biruk Kassa Rahul Kumar |
dc.subject.other.pt_BR.fl_str_mv |
Esquistossomose Hipertensão pulmonar Doença tropical negligenciada TGF-beta Hepatoesplênica |
topic |
Esquistossomose Hipertensão pulmonar Doença tropical negligenciada TGF-beta Hepatoesplênica |
description |
Pulmonary arterial hypertension (PAH) is a disease of the lung blood vessels that results in right heart failure. PAH is thought to occur in about 5% to 10% of patients with hepatosplenic schistosomiasis, particularly due to S. mansoni. The lung blood vessel injury may result from a combination of embolization of eggs through portocaval shunts into the lungs causing localized Type 2 inflammatory response and vessel remodeling, triggering of autonomous pathology that becomes independent of the antigen, and high cardiac output as seen in portopulmonary hypertension. The condition is likely underdiagnosed as there is little systematic screening, and risk factors for developing PAH are not known. Screening is done by echocardiography, and formal diagnosis requires invasive right heart catheterization. Patients with Schistosoma-associated PAH show reduced functional capacity and can be treated with pulmonary vasodilators, which improves symptoms and may improve survival. There are animal models of this disease that might help in understanding disease pathogenesis and identify novel targets to screen and treatment. Pathogenic mechanisms include Type 2 immunity and activation and signaling in the TGF-β pathway. There are still major uncertainties regarding Schistosoma-associated PAH development, course and treatment. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020 |
dc.date.accessioned.fl_str_mv |
2022-05-06T23:25:46Z |
dc.date.available.fl_str_mv |
2022-05-06T23:25:46Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
format |
article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/41458 |
dc.identifier.doi.pt_BR.fl_str_mv |
10.3389/fimmu.2020.608883 |
dc.identifier.issn.pt_BR.fl_str_mv |
1664-3224 |
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10.3389/fimmu.2020.608883 1664-3224 |
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http://hdl.handle.net/1843/41458 |
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eng |
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eng |
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Frontiers in immunology |
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openAccess |
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Universidade Federal de Minas Gerais |
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UFMG |
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Brasil |
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MED - DEPARTAMENTO DE CLÍNICA MÉDICA |
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Universidade Federal de Minas Gerais |
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