This paper centers on some whole-istic organizational and functional
aspects of hepatic Schistosoma mansoni granuloma, which is an
extremely complex system. First, it structurally develops a collagenic
topology, originated bidirectionally from an inward and outward
assembly of growth units. Inward growth appears to be originated from
myofibroblasts derived from small portal vessel around intravascular
entrapped eggs, while outward growth arises from hepatic stellate
cells. The auto-assembly of the growth units defines the
three-dimensional scaffold of the schistosome granulomas. The granuloma
surface irregularity and its border presented fractal dimension equal
to 1.58. Second, it is internally regulated by intricate networks of
immuneneuroendocrine stimuli orchestrated by leptin and leptin
receptors, substance P and Vasoactive intestinal peptide. Third, it can
reach the population of ± 40,000 cells and presents an autopoietic
component evidenced by internal proliferation (Ki-67+cells), and by
expression of c-Kit+cells, leptin and leptin receptor (Ob-R),
granulocyte-colony stimulating factor (G-CSF-R), and erythropoietin
(Epo-R) receptors. Fourth, the granulomas cells are intimately
connected by pan-cadherins, occludin and connexin-43, building a state
of closing (granuloma closure). In conclusion, the granuloma is
characterized by transitory stages in such a way that its organized
structure emerges as a global property which is greater than the sum of
actions of its individual cells and extracellular matrix components