Clive Shiff
Bloomberg School of Public Health
Associate Professor, Molecular Microbiology and Immunology

Chronic urinary schistosomiasis, the silent carcinogen: Developing biomarkers for its detection

Country: Ghana

Collaborators:
Robert Veltri, School of Medicine

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Project Abstract
Approximately 200 million people in endemic areas in Africa, Western Asia and the Middle East are infected with the parasite Schistosoma haematobium, the causative agent for urinary schistosomiasis. Squamous cell carcinoma (SCC) of the bladder is a complication of schistosomiasis. Biomarkers of SCC could identify those at risk of malignancy and provide new targets for therapy.

A collaborative research group including individuals from Johns Hopkins Hospital, Johns Hopkins Bloomberg School of Public Health and Noguchi Memorial Institute for Medical Research Ghana examined urine specimens from 528 volunteers in three endemic villages in Ghana. Forty two percent of adults had schistosome infection, 39% of individuals screened with ultrasonography exhibited severe bladder damage, 40% of urine specimens screened for presence of BLCA-4, an investigational marker for bladder cancer, revealed overexpression. Additionally nuclear morphometry or quantitative nuclear grade had 84% sensitivity to detect severe abnormal bladder pathology determined by ultrasound. However no correlations have been made with actual cancer cases.

Hypothesis: BLCA-4 and alterations in nuclear morphometry (QNG) have utility as biomarkers for presence of squamous cell carcinoma of the bladder and other unique differentially expressed protein biomarkers exist in SCC of the bladder.

Study Aims: We will collect urine specimens from volunteers in villages in the Densu River area, perform examination for presence of BLCA-4, assessment of QNG and discovery of new protein biomarkers for squamous cell bladder carcinoma.

Conclusion: The efficacy of BLCA-4 and QNG as biomarkers for early detection of SCC of the bladder is explored in this project.

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