Urine biomarkers of schistosomiais and its associated bladder cancer

Abstract

Schistosomiasis (SCH) is the second only to malaria among the parasitic diseases affecting humans regarding the prevalence of infection worldwide. In this nonsystematic review, we summarize the existing data on commercially available and promising investigational urine markers for the detection of SCH and its associated bladder cancer (BC). We searched PubMed, Scopus and Cochran without time limits. We reviewed the recent literatures on urine-based markers for SCH and its associated BC. Many studies identified several urine biomarkers of Schistosoma haematobium and Schistosoma mansoni worms and their associated BC using automated, inexpensive, quantitative assays in urine. These markers may aid in early detection of bladder carcinoma and have the potential to reduce the number of follow-up cystoscopy, thus reducing healthcare costs and patient discomfort, at the same time. Nevertheless, clinical evidence is insufficient to warrant the substitution of the cystoscopic follow-up scheme by any of the currently available urine marker tests.

Keywords:

• bladder cancer
• miRNA
• schistosomiasis
• urinary biomarkers
• urine cytology

Financial and competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Key issues

• The WHO recognizes schistosomiasis (SCH) as one of the mostly persistent and prevalent tropical diseases that affects >1 billion people worldwide.

• SCH can result in many serious complications at adult age such as cirrhosis and cancer, for example, bladder, colorectal, cervical and liver cancer.

• Several urinary biomarkers of Schistosoma haematobium worms were identified like urinary estrogen metabolites, cytotoxic T-lymphocyte antigen 4 and urinary hemoglobin-derived peptides.

• In developing countries, squamous cell carcinoma is often associated with bladder infection by Schistosoma haematobium.

• Although cystoscopy aided by cytology is the mainstay for the diagnosis of bladder cancer (BC), they have many limitations that raise the needs to find a better method for BC surveillance.

• A number of markers that take advantage of exfoliated cells in the urine for detection of cell-surface antigens, nuclear morphology, or gene expression have been studied in BC.

• Although most of them remain investigational and are undergoing preclinical evaluation, few have undergone clinical trials and have been approved for clinical use.

• The nanoparticle-based assays have high potential for the detection of high-burden SCH infections and cancers.