Female genital schistosomiasis as an evidence of a neglected cause for reproductive ill-health: a retrospective histopathological study from Tanzania

BACKGROUND: Schistosomiasis affects the reproductive health of women. Described sequelae are ectopic pregnancy, infertility, abortion, and cervical lesions and symptoms mimicking cervical cancer and STIs. There are indications that cervical schistosomiasis lesions could become co-factors for viral infection such as HIV and HPV. METHODS: In a retrospective descriptive histopathological study clinical specimens sent between 1999 and 2005 to the pathology department of a consultant hospital in Tanzania were reviewed to analyse the occurrence and features of schistosomiasis in female genital organs. RESULTS: During the study period, schistosomiasis was histopathologically diagnosed in 423 specimens from different organs (0.7% of all specimens examined in the study period), out of those 40% were specimens from female and male organs. The specimens were sent from 24 hospitals in 13 regions of mainland Tanzania. Female genital schistosomiasis was diagnosed in 125 specimens from 111 patients. The main symptoms reported were bleeding disorders (48%), ulcer (17%), tumor (20%), lower abdominal pain (11%) and infertility (7%). The majority of cases with genital schistosomiasis were diagnosed in cervical tissue (71 cases). The confirmation of cervical cancer was specifically requested for 53 women, but the diagnosis could only be verified for 13 patients (25%), in 40 cases only severe cervical schistosomiasis was diagnosed. Vulval/labial schistosomiasis was seen in specimens from young women. Infertility was reported in four patients with schistosomiasis of the Fallopian tubes. CONCLUSION: Genital schistosomiasis adds to the disease burden of women in all age groups. Pathological consequences due to the involvement of different genital organs can be damaging for the affected women. Clinical unawareness of genital schistosomiasis can lead to misdiagnosis and therefore false and ineffective therapy. In endemic areas cervical schistosomiasis should be considered as differential diagnosis of cancer

Stress, ageing and their influence on functional, cellular and molecular aspects of the immune system

The immune response is essential for keeping an organism healthy and for defending it from different types of pathogens. It is a complex system that consists of a large number of components performing different functions. The adequate and controlled interaction between these components is necessary for a robust and strong immune response. There are, however, many factors that interfere with the way the immune response functions. Stress and ageing now consistently appear in the literature as factors that act upon the immune system in the way that is often damaging. This review focuses on the role of stress and ageing in altering the robustness of the immune response first separately, and then simultaneously, discussing the effects that emerge from their interplay. The special focus is on the psychological stress and the impact that it has at different levels, from the whole system to the individual molecules, resulting in consequences for physical health

Building the primary cilium membrane

Ciliogenesis involves coordinated assembly of a microtubule- based axoneme from the mother centriole and vesicular membrane transport and fusion forming a ciliary membrane around the developing axoneme. We, and others have reported that a Rab11-Rab8 cascade functions in ciliogenesis. Using live high-resolution fluorescence microscopy imaging we show that ciliary membrane assembly proceeds following Rabin8 (a Rab8 activator) binding to Rab11 membranes. Rabin8 transport via Rab11 vesicles to the centrosome is observed resulting in localized activation of Rab8 and leads to initiation of ciliary membrane assembly. Using proteomics approaches, we have discovered that Rabin8 binds to the TRAPPII tethering complex and find that this interaction is important for Rabin8 centrosomal targeting during ciliogenesis. Our work suggests that Rabin8 membrane transport is a highly regulated process controlled by serum-dependent and serum-independent signaling. Interestingly, following ciliogenesis Rabin8 centrosomal localization is lost resulting in reduced Rab8 activation at the ciliary membrane. This finding along with a previous report describing Rabin8 association with Bardet-Biedl syndrome (BBS) proteins has led us to hypothesize that regulation of centrosomal Rabin8 levels is important for establishing the length of primary cilium, an important factor in ciliary signaling. Finally, we describe the discovery of additional factors associated with the Rab11-Rab8 trafficking pathway that function in organizing membrane structure during ciliogenesis