{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T06:19:00Z","timestamp":1770445140103,"version":"3.49.0"},"reference-count":49,"publisher":"BMJ","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Urology Department, Mayo clinic, Rochester, MN","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2025,7,27]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Schistosomiasis remains endemic in various parts of the world, and insights into pathogen immunobiology are mainly based on experimental models, while studies on human tissues are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We explored the role of immune checkpoint pathway by evaluating the immunohistochemical expression of programmed death-ligand 1 (PD-L1) in a retrospective cohort of patients with bilharzial cystitis. Inflammation severity by conventional histology and staining intensity by immunohistochemistry were assigned three-tier scores (0\/1+\/2+), and a cut-off for staining percentage was set at 5%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>38 biopsies from 31 patients were considered adequate for evaluation, and positive staining was detected in 80.6% of patients (34 biopsies). High expressors (22.6%) showed strong positive membranous staining (score 2+) with high staining density (more than 5% of inflammatory cells). Low expressors (58.1%) showed mild\/moderate staining (score 1+) predominantly in less than 5% of the cells (91.6%) or expressed restricted cytoplasmic staining (6\/31). All high expressors showed severe inflammation (score 2+) (p&lt;0.001), and viable ova were only observed in these cases. Calcified ova were associated with mild\/moderate inflammation or absent\/minimal inflammation, correlating with low expressors or non-expressors (19.4%), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Schistosomal granuloma exhibits upregulated PD-L1 expression proportional to inflammation severity and pathogen viability, highlighting a critical immune checkpoint engagement in disease pathology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jcp-2025-210271","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T09:20:52Z","timestamp":1755163252000},"page":"jcp-2025-210271","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["PD-L1 expression in schistosomal granuloma: an immunohistochemical study in urinary bladder schistosomiasis"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6990-8154","authenticated-orcid":false,"given":"Rofyda E","family":"Elhalaby","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA"},{"name":"Department of Pathology, Faculty of Medicine, Tanta University, Gharbia, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wael O","family":"Zeina","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liza","family":"Nessim","sequence":"additional","affiliation":[{"name":"Elia Anis Ramsis Lab, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed E","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noura N","family":"Kamel","sequence":"additional","affiliation":[{"name":"Elia Anis Ramsis Lab, Cairo, Egypt"},{"name":"Department of Pathology, National Research Institute, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shady E","family":"Anis","sequence":"additional","affiliation":[{"name":"Elia Anis Ramsis Lab, Cairo, Egypt"},{"name":"Department of Anatomic Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haidong","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Urology, Mayo Clinic, Rochester, Minnesota, USA"},{"name":"Department of Immunology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C","family":"Cheville","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Mayo 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Roles of PD-1\/PD-L1 pathway: signaling, cancer, and beyond. In: Xu J , ed. Regulation of cancer immune checkpoints: molecular and cellular mechanisms and therapy. 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