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The study assessed changes in fasting serum gastrin level in early schistosomiasis and chronic fascioliasis in 52 patients. Forty patients had either schistosomiasis or fascioliasis alone. Twelve patients had combined infection with both parasitosis. Also, ten healthy parasite free individuals were selected as a control. All were clinically examined and subjected to stool analysis, liver function tests and sero-diagnosis for H. pylori. Serum gastrin was measured by radioimmunoassay and showed significant elevation in all patients (with schistosomiasis, fascioliasis or both parasites) compared to controls. A significantly higher serum gastrin level was detected among patients with combined infection relative to either with schistosomiasis or fascioliasis. Alkaline phosphatase activity increased significantly in all patients as compared to control. The activity of the enzyme had significant positive correlation with egg counts in patients with either parasite and with serum gastrin level in those with combined infection. The results were discussed.

IL-1 generation by mononuclear phagocytes, IL-4 production by Th2 lymphocytes and IgE levels in serum were measured in eight patients with acute fasciolosis and seven patients in the chronic stage of the disease before and after triclabendazole treatment. Results were compared with those of a control group of ten individuals. The monocytes and lymphocytes from patients with acute and chronic fasciolosis produced significantly lower levels of IL-1 and IL-4 respectively, particularly in the chronic phase of the disease, as compared to the control. A significant increase in IgE level in both acute and chronic fasciolosis was observed. The level was significantly higher in acute as compared to chronic cases. After treatment with triclabendazole IL-1, IL-4 and IgE levels moved towards the control indicating obvious improvement in the immunological responses of the patients.

Seventeen patients with established fasciolosis and ten normal controls were enrolled in the study. The Fasciola patients were divided according to infection intensity into two groups (four patients with high intensity and thirteen patients with low intensity) as assessed by egg counts coupled with ultrasonography for detection of worms in the biliary system. Aspartate and alanine aminotransferases (AST and ALT) levels were similar to those of the controls, within the accepted normal limits, before and after treatment denoting absence of hepatocellular injury. Total serum bile acids, individual bile acids: cholic acid (CA) and chenodeoxycholic acid (CDCA), gamma glutamyl transpeptidase (GGT) and serum alkaline phosphatase (SAP) were significantly higher among all patients as compared to the controls denoting a degree of cholestatic lesion in those patients. Patients with high infection intensity revealed higher parameters than those with low intensity. The difference was not significant. One month after treatment, there was a significant improvement in the cholestasis indicating parameters in all Fasciola cases compared to the pretreatment ones. This indicates the effective role of the drug on the hepatobiliary function. However, the levels were still different from the controls. In Fasciola infection, total and individual serum bile acids in conjunction with GGT and SAP evaluate the hepatobiliary status and detect any minor abnormalities especially in anicteric subjects. Studied after treatment, they can be useful indices for assessment of the improvement.

The three cytokines, IL-10 (Th2 product), IFN-gamma (Th1 product) and TNF-alpha work in concert. The present work was undertaken to study the level of these cytokines during the acute and chronic stages of human fascioliasis in an attempt to assess the involvement of Th1 and Th2 cells in regulation of the immune response in this disease. Sera of twenty six Fasciola patients were obtained and divided into two groups: twelve with acute and fourteen with chronic fascioliasis, sera of a control group were studied simultaneously. During the acute stage, a significant increase was observed in IL-10, IFN-gamma as well as TNF-alpha and specific antibody level. In the chronic phase, a significant increase of IL-10 level was observed. IFN-gamma showed a lower level as compared to the acute stage but TNF-alpha was still high. Accordingly, in fascioliasis in the early phase of infection B cells, macrophages, Th1 and Th2 cells were all activated. They cooperate in overcoming the parasite and work to the benefit of the host. With time and after maturation of the evading worms, Th2 action predominates. IL-10 (Th2 cytokine) which is antagonistic to IFN-gamma (Th1 product) and consequently to TNF-alpha limits the immunopathology that may be caused by the latter.

Prevention of human fascioliasis could depend on clearing of the leafy salads from the metacercariae. The present work evaluated the role of some chemicals in detaching and killing this infective stage. It was observed that washing in running water for 10 minutes detached only 50% of the metacercariae. Citric acid in the concentration of (10 ml/L) commercial vinegar (120 ml/L), liquid soap (12 ml/L) and KMnO4 (24 mg/L) detached all metacercariae after 10 minutes exposure. The use of vinegar and KMnO4 is recommended: the first is lethal to other parasites in the vegetables, the second destroyed the metacercariae. Vegetable leaves were not softened and remained fresh.

Ten adult patients with proven fasciolosis were enrolled in the study. Serum samples were obtained before and one month after successful treatment using a single oral dose of triclabendazole. It was observed that, serum triglycerides (TG) and very low density lipoproteins (VLDL-C) increased, while serum total cholesterol, high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) exhibited a significant decrease. These changes were due to the degenerative necrotic damage of the hepatocytes. One month after treatment, the serum level of total cholesterol, HDL-C and LDL-C gained normal values, indicating recovery of the liver and restoration of its functions in cholesterol synthesis and esterification, while TG and VLDL-C were still significantly higher than control values. This might indicate that hepatic triglyceride lipase requires a longer period to return to a normal level.

Neutrophil phagocytic function was studied in fifteen patients with chronic fasciolosis and five in the incubating phase of the disease. Results were compared with a control group. The chematactic index which is the ratio of directed to non directed migration, the (NBT) reduction test which estimates phagocytosis and the more recent and specific test the chemiluminescence which measures phagocytosis and intracellular killing were performed. The results showed that in fasciolosis chemotactic activity, NBT and chemiluminescence index were significantly increased as compared to controls. This increase was more prominent in the acute phase. In this stage, the immature parasites are in close contact with the liver tissue. With chronicity of infection, they reach the bile ducts and inflammation in the liver parenchyma subsides. At this stage a lower level of metabolites and antigens reach the tissues, while the majority pass with bile to the intestinal lumen. The indices returned to normal level after treatment of fasciolosis. This signifies disappearance of all stimuli responsible for activation of PMN phagocytes.

Acute human fascioliasis depends in its diagnosis on detecting specific antibodies in the sera of patients. It was observed that both somatic fraction I and crude E/S products of adult Fasciola gigantica worm gave sensitive and specific results. Using IgM ELISA, the cut off O.D was 0.6 and 0.3 nm. and the accuracy was 93% and 98% for the two antigens respectively. Determination of the molecular weight of these two antigens was undertaken by SDS-PAGE. The molecular weight of the somatic fraction I ranged from 17.5 to 43.9 kd, that of the crude E/S products ranged from 12.5 to 14.7 kd. These results were compored with those of previous works performed on antigens of F. hepatica.

The present work aimed at studying the effect of Ambrosia maritima (Damsissa) on the viability of Lymnaea snails. Lymnaea snails used in these trials were acclimatized to laboratory conditions before use in the toxicity test. The snails were exposed to various concentrations (100-3000 mg/l) of dry powdered Damsissa, Ambrosia maritima was lethal to Lymnaea snails at concentration of 3000 mg/L after one day and at 100 mg/l after 14 days.

Lymnaea snails in Abis II village were studied as regard their species, monthly distribution, density and infection rates in different water bodies. The trematode parasites in L. cailliaudi, the only species of Lymnaea in Abis II village were xiphidio in 40% of snails and Fasciola in 10%. Echinostome cercariae were detected from few snails outside Abis II village. The morphological characters of the different larval stages of the detected parasites were described.

This study included forty patients with incubating or open fascioliasis. All were subjected to repeated stool examination, serological and haematological study using IHAT in the former. Ultrasonography was done for upper abdomen stressing on gall bladder and assessing its function. Eighteen patients were diagnosed as incubating fascioliasis by positive IHAT, high eosinophilic count and negative stool examination for Fasciola eggs. No gall bladder changes could be detected by U.S. among those patients. Twenty two patients passed eggs in their stool were diagnosed as open Fasciola. Their gall bladder through U.S. revealed flukes in twelve of them. A weak gall bladder contractility was observed in 64% with open fascioliasis.