The Liver in Brucellosis
ABSTRACT Brucellosis involves the liver in varying ways, ranging from benign subclinical increases in serum aminotransferase levels to ominous chronic suppurative disease. Data on histopathology of the liver in brucellosis are scarce and contradictory. We sought to determine the liver histologic patterns present in a series of brucellosis patients and review the existing knowledge about liver involvement in this worldwide, prevalent zoonotic infection.
Fourteen patients from 2 referral centers were retrospectively studied. They had brucellosis caused by Brucella melitensis and had undergone liver biopsy at the time of diagnosis.
All patients exhibited granuloma formation in the liver parenchyma and in the majority in portal spaces. Varying degrees of cellular infiltration of parenchymal tissue and portal spaces, giant cells in granulomas, parenchymal necroses, and Kupffer's cell hyperplasia were also noted. No significant epidemiological or clinical correlations with liver involvement were exhibited. Thus, liver involvement was not increased in men vs women, young vs old patients, or complicated vs uncomplicated disease.
The liver is involved in Brucella melitensis infection contrary to past beliefs. Different histologic patterns can be observed in liver involvement in brucellosis, the most common being granuloma formation. The pathogenetic role of brucellosis in development of liver fibrosis and cirrhosis remains limited and understudied.
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- "Intriguingly, there also have been speculations about a possible causal relationship between Brucella abortus infection and cirrhosis , which has not been definitively established . In spite of several histopathological descriptions of liver brucellosis, the cellular and molecular mechanisms underlying the hepatic lesions have not been addressed. "
ABSTRACT: Hepatic involvement is frequent in human brucellosis. While different histopathological lesions have been reported in these patients, the underlying cellular and molecular mechanisms have not been addressed. This study assessed whether Brucella abortus can infect a human hepatoma cell line and induce a proinflammatory response in these cells. The bacterium not only infected the human hepatoma cell line HepG2 but also exhibited intracellular replication. The infection induced hepatoma cells to secrete IL-8, and supernatants from Brucella-infected hepatoma cells were shown to induce the migration of human neutrophils. The infection also induced the expression of the intercellular adhesion molecule ICAM-1 on hepatoma cells, and the adhesion of neutrophils to these cells was significantly higher than to uninfected hepatoma cells. ICAM-1 expression was also induced by stimulation of hepatoma cells with supernatants from Brucella-infected neutrophils. While Brucella infection did not induce the expression of matrix metalloproteinases (MMPs) in hepatoma cells, it significantly induced MMP-9 in neutrophils. Hepatoma cell apoptosis was significantly induced by B. abortus infection and also by stimulation with supernatants from Brucella-infected neutrophils. The present study provides clues regarding potential mechanisms of tissue damage during liver brucellosis.Journal of Hepatology 07/2010; 53(1):145-54. DOI:10.1016/j.jhep.2010.02.028 · 10.40 Impact Factor
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- "S. L. Yingst and others almost no chance that a biopsy would be taken early in the course of infection because hepatic enlargement or changes notable on ultrasound are not reported to occur early in the course of exposure (Akritidis et al., 2007). Based on the limited information available, our data are consistent with reports of liver histology in human brucellosis, i.e. that parenchymal necrosis and lymphocytic infiltration are common. "
ABSTRACT: The US Centers for Disease Control and Prevention lists Brucella as a potential bioterrorism threat requiring enhanced diagnostic capacity and surveillance (http://emergency.cdc.gov/bioterrorism/). Successful treatment and management of patients after exposure to biological threat agents depends on accurate and timely diagnosis, but many biothreat agents present with similar, vague clinical signs--commonly referred to as 'flu-like illness'. Diagnosis of brucellosis is notoriously challenging, especially early in infection, and definitive diagnosis may require invasive methods, e.g. bone marrow biopsy. We studied the pathogenesis of Brucella suis aerosol infection in rhesus macaques in an effort to guide the diagnostic algorithm in case of possible intentional exposure of humans. Rhesus proved to be an excellent model for human brucellosis; the data showed that PCR DNA amplification testing of non-invasive diagnostic samples has the potential to definitively detect a point-source outbreak immediately and for several days after exposure.Journal of Medical Microbiology 03/2010; 59(Pt 6):724-30. DOI:10.1099/jmm.0.017285-0 · 2.27 Impact Factor
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ABSTRACT: Chip-on-chip MCM packaging combines the benefits of conventional MCM methods with conventional ASIC/commercial memory printed circuit board design methods. COC can reduce board space, increase performance, maintain a cost competitive position and offer an alternative to embedded SRAM and DRAM in the appropriate situations. We show that additional testing for known-good-die is minimal, functional to parametric memory yield is very high, COC module assembly is simple and straightforward, and final packaging is essentially identical to conventional ASIC packaging processesIC/Package Design Integration, 1998. Proceedings. 1998 IEEE Symposium on; 03/1998