الفهرس 
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Abstract
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P ascioiiasis is becoming a problem of increasing importance
in Egypt. The disease is more common than has hitherto believed. Recent outbreaks are reported in the vicinity of Alexandria and Behira governor ates.
The herein study is endeavored to throw light on the enzymatic activity levels of serum adenosine deaminase in Fascioia patients through studying the correlation between its activity and some liver function tests, as well as T-cell population and function.
The study was carried out on 35 subjects, aged between 15-35 years. They were divided into: Group /: ten normal subjects. Group 2: ten patients with incubating fascioliasis. Group 3: fifteen patients with established fascioliasis.
11 subjects of the studied groups were investigated by: I. Parasitoiogicai investigation: Urine examination to exclude Schistosoma haematobium, stool examination to detect established fascioliasis and exclude other parasitic infection and indirect haemagglutination test to acertain the diagnosis of incubating Fasciola cases.
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2. Biochemical investigation: determination of serum adenosine deaminase level and liver function tests (alkaline phosphatase, alanine aminotransferase, albumin and bilirubin). A .’■-•.
3. Immunological investigation: T-ceii count and function.
4. Hematological investigation: complete blood picture. Eosinophilia together with high anti-Fasciola antibody titre are useful adjunct in the diagnosis of incubating fascioliasis.
The study revealed that there was increase in enzymatic activity of adenosine deaminase, alkaline phosphatase and alanine aminotransferase, in case of incubating fascioliasis. This may be due to hepatocyte damage and necrosis of the liver around migrating tracks of Fasciola larvae.
In established fascioliasis, the level of serum adenosine deaminase remained high. This increased level may be as a result of liver regeneration process. The increased level of alkaline phosphatase may be attributed to the mechanical obstruction of bile ducts by th worms or hyperplasia of biliary epithelium as a result of toxic byproducts of the flukes. On the other hand, alanine aminotransferase regained the normal values.
The levels of albumin and bilirubin in the two Fasciola groups, were within the normal range.
In the present study, a reduced T-cell count was observed in both incubating and established Fasciola patients. The reduction
may be a true one as a sort of immuosuppression produced by the disease or a false reduction. Masking of T-cell receptors by circulating immune complexes may be the cause of false reduction.
In incubating fascioliasis, the depression of T-cell function may be due to the toxicity of the excretory/secretory products of the actively feeding liver flukes. On the other hand, the depression in case of established fascioliasis may be attributed to the immunosuppression associating this stage of infection.
In incubating fascioliasis, eosinophilia was shown as a characteristic feature of this stage of infection. Eosinophilia may be attributed to either stimulation of T-cell by larval antigens leading to release of lymphokines (IL-5) or laraval antigens itself work like lymphokines and consequently increase the eosinophilic proliferation. On the other hand, in established fasciloiasis eosinophilic count was more or less similar to normal values. This reduction may indicate that Fasciola iarvae are more antigenic than adult worms.