This study is a search for the genetic susceptibility of Egyptians to complications of Schistosoma haematobium infestation, especially bladder cancer, and how useful is the determination of IL-2, IL-10, TNF-a and IFN-g as cellular markers of host immune response against this cancer. Thirty-one patients with carcinoma in schistosomal bladders as well as 92 normal Egyptian controls were studied. All patients and controls were typed for HLA-A, B, C and DR antigens using the microlymphocytotoxicity test, and the levels of cytokines (IL-2, IL-10, TNF-a and INF-g) were determined as markers of host cellular immunity by ELISA technique. HLA-A2+A28, CW4 and DR5 antigens were found to be negatively associated with the disease. As for the antigens with positive associations, HLA-B15, B16, BW4, CW7, DR1, DR3, DR4, DQ1, DQ2 and DQ7 had significantly increased frequency in-patients with bladder carcinoma. These findings might support the genetic control of the disease or the presence of an immune response and/or immune suppression genes which are in linkage disequilibrium with these HLA antigens and they control the susceptibility to, and pathological sequences of the disease. As regard to cytokines, TNF-a and IL-10 were significantly increased while IL-2 and IFN-g were significantly decreased in comparison to controls (P< 0.001). On the other hand, IL-10 was significantly increased while IL-2 was significantly decreased when the early stages of malignancy were compared with advanced stages of this malignancy. So, IL-10 increase tends to diminish the formation of cell mediated immunity causing a state of immunosuppression characteristic of the malignant disease.

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