Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Nov 28, 2026; 32(44): 122956
Published online Nov 28, 2026. doi: 10.3748/wjg.122956
Published online Nov 28, 2026. doi: 10.3748/wjg.122956
Clonorchis sinensis co-infection potentiates polymorphonuclear-myeloid-derived suppressor cells expansion and metabolic reprogramming in chronic hepatitis B patients
Jie-Ru Qiu, Hong-Bin Zhang, Mei Shang, Jue Xu, Yue-Chun Fu, Yuan Liao, Bo Hu, Hui-Min Dong, Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
Co-first authors: Jie-Ru Qiu and Hong-Bin Zhang.
Co-corresponding authors: Bo Hu and Hui-Min Dong.
Author contributions: Qiu JR and Zhang HB contributed equally to this work as co-first authors; Hu B, and Dong HM contributed equally to this work as co-corresponding authors; Qiu JR wrote the manuscript; Zhang HB performed the experiments; Shang M contributed to the analysis; Xu J and Fu YC collected clinical information; Liao Y, Hu B, and Dong HM designed and supervised the study. All authors approved the final version.
AI contribution statement: We used DeepSeek R1 and Baidu Scholar only for formatting and organizing the reference list. No AI tools were used for data analysis, interpretation, or any other scientific aspects of the study.
Supported by the National Natural Science Foundation of China, No. 81902082.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University (approval No. [2020]02-045-01).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at
Corresponding author: Hui-Min Dong, PhD, Researcher, Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Tianhe District, Guangzhou 510630, Guangdong Province, China. donghmin@mail.sysu.edu.cn
Received: May 7, 2026
Revised: August 3, 2026
Accepted: September 10, 2026
Published online: November 28, 2026
Processing time: 149 Days and 17.6 Hours
Revised: August 3, 2026
Accepted: September 10, 2026
Published online: November 28, 2026
Processing time: 149 Days and 17.6 Hours
Core Tip
Core Tip: Compared with hepatitis B virus mono-infected patients with normal liver enzyme levels, Clonorchis sinensis co-infection expands polymorphonuclear-myeloid-derived suppressor cells. This activates the arginine (Arg)-ornithine (Orn) axis, raising the Orn-to-Arg ratio. Consequently, interferon-γ production is suppressed. The Orn-to-Arg ratio outperforms standard liver enzyme levels for immune assessment. Screening for Clonorchis sinensis is warranted even in patients with well-controlled viremia.