Extracellular matrix degradation in parasitic diseases.

1. Fibrosis is an important manifestation of several parasitic diseases, but is not irreversible. A marked degree of extracellular matrix degradation can occur after cure of parasitism. Patients with the hepatosplenic form of schistosomiasis undergo considerable resorption of portal fibrosis months or years after curative treatment as demonstrated by ultrasonography and pathological examination. 2. Studies of the post-treatment degradation of extracellular matrix in schistosomal periovular granulomas have demonstrated two forms of collagen degradation: in hepatic granulomas formed during early infection a rapid process occurs, with the extracellular breakdown of fibers and internalization of collagen fragments, whereas during late infection, degradation is slow and is accompanied by focal electrondense and/or lytic changes. 3. Extensive extracellular matrix degradation and resorption occurring after curative treatment was recently described in the liver of a man with advanced visceral leishmaniasis and in the heart of mice with chronic Chagas' disease.