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Oroojalian F, Mohammadzadeh T, Ebrahimzadeh A, Alesheikh P, Shafiei R, Amani A. Black seed oil nanoemulsion containing albendazole against protoscoleces of Echinococcus granulosus: An in vivo study on C57BL/6 mice. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2025; 28:755-761. [PMID: 40343289 PMCID: PMC12057752 DOI: 10.22038/ijbms.2025.83014.17942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Accepted: 01/18/2025] [Indexed: 05/11/2025]
Abstract
Objectives Hydatid cysts are typically treated with albendazole. Nevertheless, this drug has side effects and limited bioavailability. In this study, we aimed to explore a nanoemulsion of black seed oil to enhance the therapeutic efficacy of albendazole in mice with hydatid cysts. Materials and Methods The size of the prepared nanoemulsions was characterized using a Zetasizer analyzer. Additionally, the stability of the nanoemulsions was assessed after 45 days. MTT assay was used to compare the cytotoxicity of free albendazole, nanoemulsion containing albendazole, and nanoemulsion without albendazole. Furthermore, infected mice were treated with these preparations, euthanized, and subjected to autopsy examination. Cysts obtained from mice were examined for histopathological features. Results ALB-NE (albendazole-loaded nanoemulsion) DLS results were obtained from black seed oil. Freshly prepared ALB-NE showed (d50 = 170 nm), PDI: 0.323, ALB-NE after 45 days storage at 25 ºC were (d50 = 92.4 nm), and ALB-NE after 45 days storage at 45 ºC revealed (d50 = 118 nm). The cytotoxicity of albendazole was reduced when loaded into the nanoemulsion. Moreover, the group treated with nanoemulsion containing albendazole showed a significant decrease in size and number of cysts compared to those receiving free albendazole or nanoemulsion without the drug. Additionally, after 60 days, the nanoemulsion containing albendazole showed 100% survival, while the survival rate was 50% for free albendazole, 75% for nanoemulsion without albendazole, and 37.5% for PBS. Conclusion The nanoemulsion containing albendazole can be a promising treatment for hydatid cysts.
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Affiliation(s)
- Fatemeh Oroojalian
- Natural Products and Medicinal Plants Research Center North Khorasan University of Medical Sciences, Bojnurd, Iran
- Department of Advanced Technologies, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Tahereh Mohammadzadeh
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Department of Parasitology and Mycology, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ailin Ebrahimzadeh
- Department of Advanced Technologies, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Peiman Alesheikh
- Natural Products and Medicinal Plants Research Center North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Reza Shafiei
- Vector-borne Diseases Research Center North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Amir Amani
- Natural Products and Medicinal Plants Research Center North Khorasan University of Medical Sciences, Bojnurd, Iran
- Department of Advanced Technologies, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
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Bazzi N, Baalbaki H, Njeim A, Hmede A, Chaaban M, Almokdad MA, Alhousseini A, Abou Sleiman G. Extrahepatic intraabdominal hydatid cyst: a case report. J Med Case Rep 2024; 18:399. [PMID: 39210392 PMCID: PMC11363457 DOI: 10.1186/s13256-024-04733-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/02/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Hydatid disease, also known as echinococcosis, is a zoonotic parasitic infection caused by the larvae of the Echinococcus tapeworm. It is endemic in various regions worldwide, particularly in rural areas of countries in southern South America, Central Asia, China, parts of Africa, the Mediterranean, and parts of the Middle East. The disease primarily affects the liver (60-70% of cases) and the lungs (10-25% of cases), but it can involve any organ, including the brain, bones, and rarely the pelvic region, as seen in our case report. Hydatid disease typically follows an asymptomatic course in the early stages of the primary infection and may remain so potentially for years or even permanently. If symptoms occur, they depend on various factors, such as the number, size, and location among other factors. Typically, hydatid disease presents with nonspecific symptoms. Common symptoms include abdominal pain, hepatomegaly, as well as anaphylaxis in case of cyst rupture. Extrahepatic intra-abdominal isolated hydatic cyst is a rare finding (6-11%). CASE PRESENTATION In our case, a 70 year-old Asian white male presented with right thigh pain radiating to the lower leg, which is an atypical presentation for an extrahepatic intraabdominal hydatid cyst. Primary intraabdominal hydatid cysts involving the pelvic region are relatively rare, and such cases pose diagnostic and management challenges. CONCLUSION This case report underscores the challenges in diagnosing and managing extrahepatic intraabdominal hydatid cysts, particularly in atypical presentations. A combination of clinical evaluation, serological studies, and imaging techniques facilitates accurate diagnosis.
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Affiliation(s)
- Nagham Bazzi
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | | | - Alain Njeim
- Medical Intern, Lebanese University, Beirut, Lebanon
| | - Ali Hmede
- Medical Intern, Lebanese University, Beirut, Lebanon
| | - Mohammad Chaaban
- General Surgery Resident PGY1, Lebanese University, Beirut, Lebanon
| | | | - Ali Alhousseini
- Department of Obstetrics and Gynecology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Gaby Abou Sleiman
- Head of General Surgery Department, St. Charles Hospital, Fayadiyeh, Lebanon
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Albalawi AE, Shater AF, Alanazi AD, Alsulami MN, Almohammed HI. High potency of linalool-zinc oxide nanocomposite as a new agent for cystic echinococcosis treatment. Antimicrob Agents Chemother 2024; 68:e0173423. [PMID: 38752808 PMCID: PMC11620505 DOI: 10.1128/aac.01734-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 04/15/2024] [Indexed: 12/07/2024] Open
Abstract
This current in vitro, ex vivo, and in vivo research aims to evaluate and analyze the linalool-zinc oxide nanocomposite (Lin-ZNP) for treating cystic echinococcosis. Lin-ZNP was synthesized using an ethanolic solution of polyvinyl alcohol. The protoscolicidal effects of Lin-ZNP were tested on hydatid cyst protoscoleces (PTS) in both in vitro and ex vivo by eosin exclusion test. The study also examined the impact on caspase-3 gene expression and the external structure of PTS. The in vivo effect was measured by examining hydatid cysts' quantity, dimensions, and weight in mice intraperitoneally infected with 0.5 mL of PTS solution containing 1,000 PTS. The antioxidant and inflammatory cytokine gene expression levels were examined using real-time PCR. Lin-ZNP significantly (P < 0.001) killed the PTS in both in vitro and ex vivo in a dose- and time-dependent manner. The treated PTS exhibited creases and protrusions as a result of bleb formation and upregulation in the gene expression of caspase-3. Upon treatment with Lin-ZNP, there was a significant (P < 0.001) reduction in the number, diameter, and weight of the hydatid cysts. Treatment with Lin-ZNP nanocomposite led to a significant increase in the expression of antioxidant genes and a notable decrease in oxidative stress markers, and the expression levels of IL-4 and IL-10. Lin-ZNP has the potential to act as a scolicidal agent and demonstrates promise in controlling hydatid cysts in a mouse model, attributed to its antioxidant and anti-inflammatory properties. However, additional studies in clinical trials are needed to confirm the use of Lin-ZNP for treating hydatidosis.
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Affiliation(s)
- Aishah E. Albalawi
- Department of Biology, Faculty of Science, University of Tabuk, Tabuk, Saudi Arabia
| | - Abdullah F. Shater
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
| | - Abdullah D. Alanazi
- Department of Biological Sciences, Faculty of Science and Humanities, Shaqra University, Ad-Dawadimi, Saudi Arabia
| | - Muslimah N. Alsulami
- Department of Biology, College of Science, University of Jeddah, Jeddah, Saudi Arabia
| | - Hamdan I. Almohammed
- Department of General Science, Deanship of Supportive Studies, Alasala University, Dammam, Saudi Arabia
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González-Porcile MC, Muniz-Lagos AC, Cucher MA, Mourglia-Ettlin G. Mouse model of secondary cystic echinococcosis. Methods Cell Biol 2024; 185:115-136. [PMID: 38556444 DOI: 10.1016/bs.mcb.2024.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Cystic echinococcosis (CE) is a parasitic zoonosis caused by the larval stage of the cestode Echinococcus granulosus sensu lato (s. l.), a genetic complex composed of five species: E. granulosus sensu stricto (s. s.), E. equinus, E. ortleppi, E. canadensis, and E. felidis. The parasite requires two mammalian hosts to complete its life cycle: a definitive host (mainly dogs) harboring the adult parasite in its intestines, and an intermediate host (mostly farm and wild ungulates) where hydatid cysts develop mainly in the liver and lungs. Humans are accidental intermediate hosts, being susceptible to either primary or secondary forms of CE; the first one due to the ingestion of oncospheres, and the second one because of the spillage of protoscoleces (PSC) contained within a primary cyst. Secondary CE is a serious medical problem, and can be modeled in immunocompetent mice (a non-natural intermediate host) through the intraperitoneal inoculation of viable PSC from E. granulosus s. l. This model is useful to study not only the immunobiology of CE, but also to test new chemotherapeutics or therapeutical protocols, to explore novel vaccine candidates, and to evaluate alternative diagnostic and/or follow-up tools. The mouse model of secondary CE involves two sequential stages: an early stage of parasite pre-encystment (PSC develop into hydatid cysts in the peritoneal cavity of mice), and a late or chronic stage of parasite post-encystment (already differentiated cysts slowly grow during the whole host lifespan). This model is a time-consuming infection, whose outcome depends on several factors like the parasite infective dose, the mouse strain, and the parasite species/genotype. Thus, such variables should always be adjusted according to the research objectives. Herein, the general materials and procedures needed to establish secondary CE in mice are described, as well as several useful tips and recommendations.
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Affiliation(s)
- María Clara González-Porcile
- Área Inmunología, Departamento de Biociencias (DEPBIO), Facultad de Química, Universidad de la República, Montevideo, Uruguay; Unidad Asociada de Inmunología, Instituto de Química Biológica (IQB), Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay; Laboratorio de Inmunología, Instituto de Higiene "Prof. Arnoldo Berta", Universidad de la República, Montevideo, Uruguay; Graduate Program in Biotechnology, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - Ana Clara Muniz-Lagos
- Área Inmunología, Departamento de Biociencias (DEPBIO), Facultad de Química, Universidad de la República, Montevideo, Uruguay; Unidad Asociada de Inmunología, Instituto de Química Biológica (IQB), Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay; Laboratorio de Inmunología, Instituto de Higiene "Prof. Arnoldo Berta", Universidad de la República, Montevideo, Uruguay; Graduate Program in Biotechnology, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - Marcela Alejandra Cucher
- Department of Microbiology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina; Institute of Research on Microbiology and Medical Parasitology (IMPaM, UBA-CONICET), University of Buenos Aires, Buenos Aires, Argentina
| | - Gustavo Mourglia-Ettlin
- Área Inmunología, Departamento de Biociencias (DEPBIO), Facultad de Química, Universidad de la República, Montevideo, Uruguay; Unidad Asociada de Inmunología, Instituto de Química Biológica (IQB), Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay; Laboratorio de Inmunología, Instituto de Higiene "Prof. Arnoldo Berta", Universidad de la República, Montevideo, Uruguay.
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Vantankhah A, Taqanaki PB, Rahmanian M, Ameri L, Atqiaee K, Mashhadi MP. A life-threatening encounter: an uncommon case of ruptured hydatid cyst presenting as anaphylactic shock and respiratory distress in a 12-year-old boy. Ann Med Surg (Lond) 2023; 85:5742-5747. [PMID: 37915699 PMCID: PMC10617809 DOI: 10.1097/ms9.0000000000001330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/10/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction and importance Although rare, the spontaneous rupture of a lung hydatid cyst or its perforation into the pleural cavity can give rise to an abrupt onset of symptoms, including cough, fever, hemoptysis (coughing up blood), and hypersensitivity reactions, and can ultimately lead to respiratory failure. Case presentation A 12-year-old boy was brought to the emergency room with a loss of consciousness. Symptoms included tachypnea, fever, low blood pressure, and overall respiratory distress. After resuscitation, a chest X-ray revealed a distinct, well-defined round opacity located in the lower region of the right lung, leading to mediastinal displacement. After confirmation of the disease, the child was hospitalized in the ICU care and consequently underwent surgery. Treatment was successful and there was no recurrence on the follow-up. Clinical discussion Studies have demonstrated that the right lower lobe of the lung is the most frequently affected area of the lung by hydatid cysts. Symptomatic and complicated hydatid cysts are a rare concept in children, and only a small percentage, are diagnosed in patients younger than 16 years. Surgery remains the preferred treatment for the majority of patients with pulmonary hydatid disease. It is important to note that combined surgery and chemotherapy represents the current gold standard in managing pulmonary hydatid cyst. Conclusion Although anaphylactic shock caused by a ruptured lung hydatid cyst is rare, it should be taken into consideration by physicians as a differential diagnosis in patients who also have respiratory symptoms, particularly in endemic areas.
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Affiliation(s)
| | | | - Mohsen Rahmanian
- School of Medicine, North Khorasan University of Medical Sciences, Bojnurd
| | | | - Khashayar Atqiaee
- Department of Pediatric Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
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Ghasemi AA, Mohammadzade H, Mohammadi R. Giant hydatid cyst of the brain: Intact cyst removal in 8-year-old child. Int J Surg Case Rep 2023; 106:108172. [PMID: 37086506 PMCID: PMC10154730 DOI: 10.1016/j.ijscr.2023.108172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/12/2023] [Accepted: 03/17/2023] [Indexed: 04/24/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Cystic echinococcosis (hydatidosis) in humans is an infectious disease caused by tapeworms of Echinococcus genus. Brain involvement is rare. The best treatment is surgery and intact cyst removal is mandatory to prevent recurrence and possible anaphylactic reaction. CASE PRESENTATION An 8-year-old girl presented with a 1-month history of malaise, headache and vomiting. On Physical examinations, she was disoriented with bilateral papilledema. Brain CT scan and MRI revealed a well-defined cystic mass in left temporo-parieto-occipital region with considerable midline shift without perilesional edema. The patient was diagnosed with brain hydatid cyst and underwent surgical excision of the cyst without rupture. CLINICAL DISCUSSION Surgery is the most important part of intracranial hydatid cyst treatment, and surgeons should make every effort to remove them in toto without spillage. We hence decided to perform surgery and necessary precautions to prevent rupture and dissemination of hydatid were taken during the surgery. CONCLUSION A neurosurgeon has to bear in mind brain hydatid cyst in the differential diagnosis of cystic cerebral lesions especially in children from rural areas. The hydrodissection technique is the gold standard for the surgical treatment of cerebral hydatid cyst disease. It can also be effectively applied to the treatment of giant cerebral hydatid cyst disease without rupturing the cyst.
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Affiliation(s)
- Amir Abbas Ghasemi
- Urmia University of Medical Sciences, Ershad BLVD, Imam Khomeini Hospital, Urmia, Iran.
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Jairus M, Jeff C, Jeffrey C, Marvelous S. Occurrence and Economic Impact of Cystic Echinococcosis in Cattle Slaughtered in the Matabeleland Region, Zimbabwe. Acta Trop 2023; 242:106918. [PMID: 37030490 DOI: 10.1016/j.actatropica.2023.106918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/09/2023] [Accepted: 03/31/2023] [Indexed: 04/10/2023]
Abstract
BACKGROUND Cystic echinococcosis is a neglected disease responsible for millions of infections in both animals and humans. The toll on the global economy is estimated to be in the billions of United States dollars. Although much effort has been made by public health authorities to curb the rise in new infections, the occurrence of cystic echinococcosis is still being noted, especially in low-income countries. This study was conducted in the Matabeleland region of Zimbabwe to determine the incidence of cystic echinococcosis in bovines. METHODS Meat inspection records from 2011 through 2021 kept at licensed abattoirs in the Matabeleland region were used to generate annual total figures of bovines slaughtered in the region, together with the corresponding number of organs condemned due to cystic echinococcosis. Descriptive statistics showing the overall incidence in each year, incidence per district, and cysts in infected organs were expressed as a percentage of the total number of cattle slaughtered per category. RESULTS Bulawayo had the highest occurrence of cystic echinococcosis (1.359%, 95% CI, 1.254-1.412), followed by Matabeleland South (0.914%, 95% CI, 0.886-0.929) and then Matabeleland North (0.848%, 95% CI 0.818-0.863) provinces. The Bulilima, Bulawayo, and Bubi districts had the highest occurrences of cystic echinococcosis at 1.749%, 1.358%, and 1.286%, respectively. The lung was the most frequently affected organ (n=7155; at 0.854 %; and 95% CI, 0.8334-0.874%, followed by the liver (0.053%; 95% CI, 0.048-0.058%). The total direct economic loss due to organ condemnation during the study period was US$ 24,812.43.
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Affiliation(s)
- Machakwa Jairus
- Directorate of Veterinary Services, Department of Veterinary Field Services, P.O Box CY 551 Causeway, Harare, Zimbabwe
| | - Chivheya Jeff
- Department of Veterinary Field Services, Veterinary Public Health, New CSC Complex, Corner Birkenhead and J Chinamano, Bulawayo, Zimbabwe; University of Edinburgh, Royal (Dick) School of Veterinary Studies, Old College, South Bridge, Edinburgh EH8 9YL, United Kingdom
| | - Chimbo Jeffrey
- Department of Veterinary Field Services, Veterinary Public Health, New CSC Complex, Corner Birkenhead and J Chinamano, Bulawayo, Zimbabwe
| | - Sungirai Marvelous
- Midlands State University, Department of Animal and Wildlife Sciences, P.Bag 9055, Gweru, Zimbabwe.
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Dastyar Haghighi S, Khudair Khalaf A, Mahmoudvand H, Adineh A, Maleki AM, Ghasemian Yadegari J. Antiparasitic Effects and Cellular Mechanisms of Formononetin (a Natural Isoflavone) Against Hydatid Cyst Protoscoleces. Jundishapur J Nat Pharm Prod 2023. [DOI: 10.5812/jjnpp-129302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Background: The chemical agents applied to reduce the complications of hydatid cyst surgery are not free of side effects. Formononetin (FMN), as a natural isoflavone, has been shown to have various therapeutic benefits. Objectives: We studied the in vitro and ex vivo protoscolicidal activity and cellular mechanisms of FMN against hydatid cyst protoscoleces. Methods: Formononetin at 75, 150, and 300 μg/mL was mixed with hydatid cyst protoscoleces (103/mL), and the viability was determined in 5 to 60 min through eosin staining assay. The effect of FMN on caspase-3 activity was tested through a commercial colorimetric protease kit. In addition, the penetrability of the plasma membrane of protoscoleces after exposure to FMN was also determined by the SYTOX assay. Results: Formononetin at 300 μg/mL completely destroyed hydatid cyst protoscoleces after 30 minutes. While at 150 μg/mL, after 60 minutes of contact, 100% of protoscoleces were eliminated. By ex vivo assay, FMN showed its antiparasitic effect for longer periods. Based on these results, FMN at 300 μg/mL concentration completely eliminated hydatid cyst protoscoleces after 60 minutes of exposure. While at a concentration of 150 μg/mL after 60 minutes, 89.6% of protoscoleces were destroyed. Formononetin noticeably increased (P < 0.001) the activity of caspase-3 and the permeability of protoscoleces dose-dependently. Conclusions: Formononetin as a natural product showed promising effects on the protoscoleces of hydatid cysts, indicating that it can be considered a valuable scolicidal agent. However, additional investigations are necessary to evaluate its efficacy in animal models and human subjects.
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Raziani Y, Cheraghipour K, Shakibaie M, Ghasemian Yadegari J, Mahmoudvand H. High potency of magnetic iron oxide nanoparticles covered by piroctone olamine against cystic echinococcosis. Biomed Pharmacother 2023; 161:114536. [PMID: 36940617 DOI: 10.1016/j.biopha.2023.114536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 03/22/2023] Open
Abstract
This study examined the synthesis of magnetic iron oxide nanoparticles coated with PO (FOMNPsP) and assessed their in vitro, ex vivo, and in vivo effects against cystic echinococcosis. The FOMNPsP was synthesized through the alkalization of iron ions in a deoxygenated form. In vitro and ex vivo protoscolicidal effects of FOMNPsP (100-400 μg/mL) were evaluated on hydatid cyst protoscoleces by the eosin exclusion test for 10-60 min. The effect of FOMNPsP on caspase-3 gene expression and exterior ultra-structural of protoscoleces was assessed by real-time PCR and scanning electron microscopy (SEM), respectively. In vivo effects were assessed by evaluating the number, size, and weight of hydatid cysts among infected mice. The FOMNPsP size was < 55 nm, and the most frequent particles were in the 15-20 nm range. In vitro and ex vivo assays revealed that the highest protoscolicidal effect was observed at 400 µg/mL with 100% lethality. After exposure of protoscoleces with FOMNPsP, the level of gene expression of caspase-3 was dose-dependently increased (p < 0.05). By SEM, the FOMNPsP-treated protoscoleces showed wrinkles and bulges resulting from the formation of blebs. FOMNPsP significantly decreased (p < 0.01) the mean number, size, and weight of the hydatid cyst. FOMNPsP revealed the potent protoscolicidal traits through disrupting the cell wall and apoptosis induction. The results also indicated the promising effect of FOMNPsP in controlling hydatid cysts in the animal model. Although FOMNPsP is safe for human normal cells, more investigations are required to clarify its toxicity and precise mechanisms of action.
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Affiliation(s)
- Yosra Raziani
- Nursing Department, Al-Mustaqbal University College, 51001 Hillah, Babylon, Iraq
| | - Koroush Cheraghipour
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mojtaba Shakibaie
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Javad Ghasemian Yadegari
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Hossein Mahmoudvand
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
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Sheves A, Fuxman Y, Gazer B, Shmueli M, Van Buren J, Ben-Shimol S, Assi Z. Treatment of Cystic Echinococcosis in Children: A Single Center Experience. Pediatr Infect Dis J 2023; 42:175-179. [PMID: 36729526 DOI: 10.1097/inf.0000000000003793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Cystic echinococcosis (CE) treatment is complicated, relying on cysts characteristics, host factors and possible treatment adverse events. We assessed childhood CE treatment characteristics. METHODS A retrospective cohort study, 2005-2021, which presents our experience with treating children with CE. We compared therapeutic interventions use in association with the location, size and number of cysts. Additionally, we assessed complications rate following those interventions. RESULTS Sixty six children had CE; 97% were Bedouins. Overall, 183 cysts were identified in 74 organs: liver (n = 47, 64%), lungs (n = 23, 31%), brain, para-ovarian, kidney and peritoneum (other-grouped, n = 4, 5%). Mean ± Standard deviation largest cyst size (per patient) was 6.6 ± 3.2 cm. Treatment with albendazole was administered to 94% of CE, while albendazole monotherapy was used in 27% (n = 18, including 4 cases with extra-hepatic cysts). Surgical interventions included drainage/puncture, aspiration, injection and reaspiration (PAIR; n = 20), mainly performed in hepatic-CE (40% vs. 4% in pulmonary-CE, and 0% in other-CE), excision and drainage (n = 34) and complete excision (n = 10), mainly done in other-CE (50% vs. 26% and 4% in pulmonary-CE and hepatic-CE, respectively). Larger cyst size was associated with complete excision compared with albendazole monotherapy. The number of cysts was not associated with the chosen intervention. Fever was recorded following 39% of surgical interventions. Local surgical complications were relatively rare. CONCLUSIONS Cysts location and size affected treatment choice among CE patients. Procedures with drainage had relatively higher rate of complications, including recurrence. Albendazole monotherapy may be a viable therapeutic option in selected CE cases.
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Affiliation(s)
- Asaf Sheves
- From the The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Pediatric Surgery, Soroka University Medical Center, Beer-Sheva, Israel
| | - Yulia Fuxman
- From the The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Pediatric Surgery, Soroka University Medical Center, Beer-Sheva, Israel
| | - Benny Gazer
- From the The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Pediatric Surgery, Soroka University Medical Center, Beer-Sheva, Israel
| | - Moshe Shmueli
- From the The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Jacob Van Buren
- Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Shalom Ben-Shimol
- From the The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel
| | - Zaki Assi
- From the The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Pediatric Surgery, Soroka University Medical Center, Beer-Sheva, Israel
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Mariki A, Barzin Z, Fasihi Harandi M, Karbasi Ravari K, Davoodi M, Mousavi SM, Rezakhani S, Nazeri M, Shabani M. Antigen B modulates anti-inflammatory cytokines in the EAE model of multiple sclerosis. Brain Behav 2023; 13:e2874. [PMID: 36582052 PMCID: PMC9927863 DOI: 10.1002/brb3.2874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/13/2021] [Accepted: 01/22/2022] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Multiple sclerosis (MS) is characterized by the destruction of the blood-brain barrier, loss of myelin sheath, and contribution of inflammatory interleukins such as TNF-alpha, interleukin-17, and interleukin-6. METHODS The current study investigated the effect of antigen B of hydatid cyst fluid on the reduction of anti-inflammatory cytokines and nerve conduction velocity in rats with experimental autoimmune encephalomyelitis (EAE)-induced MS. After isolation of antigen B from sterile cyst fluid, the rats were randomly divided into four groups: saline, EAE, EAE + teriflunomide (EAE + TF), and EAE + antigen B (EAE + AngB). The EAE model was induced using cow spinal cord homogenization, in combination with Freund's complete adjuvant. The serum concentration of cytokines including IL-1B and IL-17, IL-10, IL-6, and TNF-X was measured by the ELISA method, and real-time PCR was performed to study gene expression. Electrophysiological, behavioral, and neuropathological tests were also conducted. RESULTS Nerve conduction velocity and IL-10 concentration were increased in the antigen B group. The results of this study showed that antigen B reduced the inflammatory component of the EAE MS animal model by modulating the immune system compared to teriflunomide, which eventually led to a reduction in symptoms at the behavioral and electrophysiological level. CONCLUSIONS It seems that antigen B plays a critical role in regulating immunity and it can be used as a possible therapeutic agent to modulate the immune system in MS patients. It might be rational to consider hydatid cyst fluid antigen as a modifier in MS.
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Affiliation(s)
- Aliakbar Mariki
- Student Research Committee, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Zahra Barzin
- Department of Parasitology and Mycology, School of Medicine, Jiroft University of Medical Science, Jiroft, Kerman, Iran
| | - Majid Fasihi Harandi
- Research Center for Hydatid Disease in Iran, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Mahboubeh Davoodi
- Student Research Committee, Yasuj University of Medical sciences, Yasuj, Iran
| | - Seyed Mohammad Mousavi
- Research Center for Hydatid Disease in Iran, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Soheila Rezakhani
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Masoud Nazeri
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran.,Department of Anesthesiology, Friedrich-Alexander-University Erlangen-Nuremberg, University Hospital Erlangen, Krankenhausstraße, Germany
| | - Mohammad Shabani
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
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12
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Ghasemian Yadegari J, Khudair Khalaf A, Saadatmand M, Mahmoudvand H. Antiparasitic activity of Astragalus brachycalyx subsp. brachycalyx extract against hydatid cyst protoscoleces and its effect on induction of apoptosis: an in vitro and ex vivo study. JOURNAL OF HERBMED PHARMACOLOGY 2022. [DOI: 10.34172/jhp.2022.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: This study aims to evaluate in vitro and ex vivo antiparasitic activity of Astragalus brachycalyx subsp. brachycalyx. root chloroformic extract against hydatid cyst protoscoleces and its effect on induction of apoptosis. Methods: Various concentrations of the A. brachycalyx root chloroformic extract (56.25, 112.5, 225, and 450 mg/mL) were treated with hydatid cyst protoscoleces collected from the liver of infected sheep for 5-60minutes in vitro and ex vivo. Eosin exclusion test was also utilized to measure the mortality of protoscoleces. Moreover, the extract effect was assessed on apoptosis induction in hydatid cyst protoscoleces by caspase-3 activity measurement. Results: The mortality rate of protoscoleces in in vitro was 100% after being exposed to 450 and 225 mg/mL of A. brachycalyx extract for 20 and 30 minutes and in ex vivo for 30 and 60 minutes, respectively. Following 48 h treatment of protoscoleces, A. brachycalyx chloroformic extract at the doses of 56.25, 112.5, 225, and 450 mg/mL, dose-dependently motivated the caspase-3 enzyme ranging from 8.8% to 29.6% Conclusion: A. brachycalyx root chloroformic extract had a significant protoscolicidal effect; however, extra surveys are required to assess its efficacy and safety as a promising protoscolicidal agent in clinical settings.
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Affiliation(s)
- Javad Ghasemian Yadegari
- Department of Pharmacognosy, School of Pharmacy, Lorestan University of Medical Sciences, Khorramabad, Iran
| | | | - Massumeh Saadatmand
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Hossein Mahmoudvand
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
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13
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Dowgiałło-Gornowicz N, Botulińska A, Lech P. First-Ever Report of an Accidentally Found Echinococcal Cyst During Laparoscopic Sleeve Gastrectomy. Obes Surg 2022; 32:1356-1357. [DOI: 10.1007/s11695-021-05838-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 11/29/2021] [Accepted: 12/13/2021] [Indexed: 11/28/2022]
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Wu M, Yan C, Wang X, Liu Q, Liu Z, Song T. Automatic Classification of Hepatic Cystic Echinococcosis Using Ultrasound Images and Deep Learning. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:163-174. [PMID: 33710638 DOI: 10.1002/jum.15691] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND Hepatic cystic echinococcosis is the main form of hepatic echinococcosis, which is a life-threatening liver disease caused by parasites that requires a precise diagnosis and proper treatment. OBJECTIVE This study focuses on the automatic classification system of five different subtypes of hepatic cystic echinococcosis based on ultrasound images and deep learning algorithms. METHODS Three popular deep convolutional neural networks (VGG19, Inception-v3, and ResNet18) with and without pretrained weights were selected to test their performance on the classification task, and the experiments were followed by a 5-fold cross-validation process. RESULTS A total of 1820 abdominal ultrasound images covering five subtypes of hepatic cystic echinococcosis from 967 patients were used in the study. The classification accuracy for the models with pretrained weights (fine-tuning) ranged from 88.2 to 90.6%. The best accuracy of 90.6% was obtained by VGG19. For comparison, the models without pretrained weights (from scratch) achieved a lower accuracy, ranging from 69.4 to 75.1%. CONCLUSION Deep convolutional neural networks with pretrained weights are capable of recognizing different subtypes of hepatic cystic echinococcosis from ultrasound images, which are expected to be applied in the computer-aided diagnosis systems in future work.
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Affiliation(s)
- Miao Wu
- College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hang Zhou, China
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Chuanbo Yan
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Xiaorong Wang
- Ultrasonography Department, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Qian Liu
- Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Zhihua Liu
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Tao Song
- Ultrasonography Department, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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15
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Cystic Echinococcosis/Hydatid Cyst Coinfection with HIV: A Report from Shiraz, Iran. Can J Gastroenterol Hepatol 2021; 2021:8844104. [PMID: 33681092 PMCID: PMC7925034 DOI: 10.1155/2021/8844104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 01/02/2021] [Accepted: 01/18/2021] [Indexed: 12/28/2022] Open
Abstract
HIV coinfected with other parasitic diseases may cause a serious problem for the patients. A few case reports describing echinococcosis with human immunodeficiency virus (HIV) infection have been reported in the world; however, it has not been reported in Iran, so far. Here, the first case of liver hydatid cyst coinfected with HIV in Iran is reported. The patient is a 46-year-old female HIV-positive based on the laboratory report. Her clinical symptoms included abdominal pain, abdominal enlargement, and anorexia. Ultrasound showed three large hepatic hydatid cysts with hundreds of daughter cysts. Ultrasonography of the cyst revealed it as a CE2 stage according to the WHO classification. The patient went under complete anesthesia followed by complete cyst removal by surgery. Observation of the hydatid cyst fluid using eosin 0.1% revealed more than 70% viable protoscoleces. Histopathology examination, polymerase chain reaction (PCR), and viable protoscoleces confirmed the diagnosis of echinococcosis. The IgG ELISA test with native AgB for E. granulosus infection was also positive. mtDNA amplification using PCR and sequencing showed the cyst as E. granulosus sensu stricto genotype. Our observations show that huge, large, and high-pressure cysts with hundreds of daughter cysts are difficult to be completely removed, and drug treatment has not been able to reduce their size. Therefore, in HIV coinfection with hydatid cyst, surgery is preferable to other treatments.
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16
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Alyousif MS, Al-Abodi HR, Almohammed H, Alanazi AD, Mahmoudvand H, Shalamzari MH, Salimikia I. Chemical Composition, Apoptotic Activity, and Antiparasitic Effects of Ferula macrecolea Essential Oil against Echinococcus granulosus Protoscoleces. Molecules 2021; 26:molecules26040888. [PMID: 33567639 PMCID: PMC7914769 DOI: 10.3390/molecules26040888] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Today, the present protoscolicidals used to minimize the serious risks during hydatid cyst surgery are not completely safe and have various adverse side effects. The present study aimed to evaluate the chemical composition and apoptotic activity of Ferula macrecolea essential oil (FMEO) as well as its in vitro and ex vivo protoscolicidal effects against hydatid cyst protoscoleces. Methods: Gas chromatography/mass spectrometry (GC/MS) analysis was performed to determine the chemical composition of FMEO. Protoscoleces of hydatid cysts were collected from liver fertile hydatid cysts of infected sheep and were then treated with various concentrations of the essential oil (75, 150, and 300 µL/mL) for 5–60 min in vitro and ex vivo. Then, by using the eosin exclusion test, the viability of the protoscoleces was studied. The caspase-3-like activity of the FMEO-treated protoscoleces was also evaluated through the colorimetric protease assay Sigma Kit based on the manufacturer’s instructions. Results: According to GC/MS, the main constituents of the essential oil were terpinolene (77.72%), n-nonanal (4.47%), and linalool (4.35%), respectively. In vitro, the maximum protoscolicidal activity of FMEO was observed at the concentrations of 150 and 300 µL/mL, such that 100% of the protoscoleces were killed after 30 and 20 min of exposure, respectively. Based on the obtained findings, the results demonstrate that FMEO required a longer time to kill protoscoleces ex vivo; after 12 min of exposure to FMEO, only 13.4% of the protoscoleces remained alive. After 48 h of the treatment of protoscoleces, FMEO, in a dose-dependent manner and at doses of 75, 150, and 300 µL/mL, induced the activation of the caspase enzyme by 24.3, 35.3, and 48.3%, respectively. Conclusions: Our findings demonstrate the potent protoscolicidal effects of FMEO in vitro and ex vivo; however, further studies are required to assess the safety and the efficiency of FMEO as a promising scolicidal agent in a preclinical model and clinical setting.
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Affiliation(s)
- Mohamed S. Alyousif
- Department of Zoology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Hiba Riyadh Al-Abodi
- Department of Environment, College of Science, University of Al-Qadisiyah, Al-Diwaniyah 58001, Iraq;
| | - Hamdan Almohammed
- Department of Microbiology and Parasitology, Almaarefa University, Riyadh 11597, Saudi Arabia;
| | - Abdullah D. Alanazi
- Department of Biological Science, Faculty of Science and Humanities, Shaqra University, Ad-Dawadimi 11911, Saudi Arabia;
- Alghad International Colleges for Applied Medical Science, Tabuk 47913, Saudi Arabia
| | - Hossein Mahmoudvand
- Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad 6813833946, Iran;
| | | | - Iraj Salimikia
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad 6813833946, Iran
- Correspondence:
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17
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Moradi M, Rampisheh Z, Roozbehani M, Razmjou E. A retrospective study of hydatid cysts in patients undergoing liver and lung surgery in Tehran, Iran. Heliyon 2019; 5:e01897. [PMID: 31211265 PMCID: PMC6562322 DOI: 10.1016/j.heliyon.2019.e01897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/14/2019] [Accepted: 05/31/2019] [Indexed: 01/28/2023] Open
Abstract
Hydatid cyst, caused by larval stages of Echinococcus granulosus, is a zoonotic parasitic disease with public health importance. The disease is cosmopolitan and endemic in Iran. We conducted a retrospective study of the records of Milad Hospital, Tehran, Iran to establish the proportion of lung and liver surgical procedures that were performed for removal of hydatid cyst and to investigate the demography of the population undergoing lung and liver hydatid cyst surgery in this hospital. A retrospective cross-sectional study was conducted of records of 682 patients who underwent liver (n = 404) or lung (n = 278) surgery from April 2009 to March 2013. In 404 liver surgeries, 111 (27.5%) diagnoses of hydatid cyst were verified. Liver hydatid infection demonstrated a significant age-related difference (p < 0.05). Cysts were found in 64 of 217 females (29.5%) and 47 of 187 males (25.1%). While in both sexes, more cysts were found in liver, the liver/lung ratio in females was significantly higher than in males (p < 0.001). Hydatid cyst was verified in 59 (21.2%) of 278 lung surgeries: 27 of 105 females (25.7%) and 32 of 173 males (18.5%). There was a significant relationship between sex and organ site (p < 0.001) with the proportion of hydatid cysts in males occurring in lung higher than seen in females. In the five investigated years, approximately 25% of liver and lung surgeries conducted at Milad Hospital were related to hydatidosis. Increasing public awareness of principles of avoiding infection could reduce the risk of nearly a quarter of liver and lung surgeries and costs associated with the treatment of hydatid cysts.
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Affiliation(s)
- Maryam Moradi
- Department of Parasitology and Mycology, School of Medicine, International Campus, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Rampisheh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mona Roozbehani
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Razmjou
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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18
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Imam A, Khoury T, Weis D, Khalayleh H, Adeleh M, Khalaileh A. Laparoscopic cystectomy for pancreatic echinococcosis: A case report and literature review. Ann Hepatobiliary Pancreat Surg 2019; 23:87-90. [PMID: 30863816 PMCID: PMC6405372 DOI: 10.14701/ahbps.2019.23.1.87] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 07/21/2018] [Accepted: 07/26/2018] [Indexed: 01/17/2023] Open
Abstract
Cystic echinococcosis (CE) is a widely endemic helminthic disease caused by infection with the Echinococcus granulosus tapeworm. Following ingestion of eggs, hydatid cysts develop, most frequently in the liver and lungs, but occasionally in other organs. Infection of the pancreas by hydatid cysts is very rare, even in endemic areas. Most cases of pancreatic hydatid cysts reported in the literature were treated surgically using traditional open laparotomy. There are only few case reports describing laparoscopic treatment for this disease. Herein, we report on an eighteen-year-old female patient who was referred to our institution with a hydated pancreatic tail cyst. After a course of treatment with Albendazole, we successfully performed laparoscopic splenic-sparing distal pancreatectomy to remove the cyst with an uneventful intra- and post-operative course.
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Affiliation(s)
- Ashraf Imam
- Department of Surgery, Kaplan Medical Center, Rehovot, Israel
| | - Tawfik Khoury
- Department of Gastroenterology and Liver Diseases, Jerusalem, Israel
| | - Dani Weis
- Department of Surgery, Hadassah Medical Center, Jerusalem, Israel
| | - Harbi Khalayleh
- Department of Surgery, Kaplan Medical Center, Rehovot, Israel
| | - Muhammad Adeleh
- Department of Surgery, Hadassah Medical Center, Jerusalem, Israel
| | - Abed Khalaileh
- Department of Surgery, Hadassah Medical Center, Jerusalem, Israel
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19
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Bhutani N, Kajal P. Hepatic echinococcosis: A review. Ann Med Surg (Lond) 2018; 36:99-105. [PMID: 30450204 PMCID: PMC6226561 DOI: 10.1016/j.amsu.2018.10.032] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 10/24/2018] [Accepted: 10/26/2018] [Indexed: 12/28/2022] Open
Abstract
Cystic echinococcosis (CE) is a widely endemic helminthic disease caused by infection with metacestodes (larval stage) of the Echinococcus granulosus tapeworm and transmitted by dogs. E. granulosus are common parasites in certain parts of the world, and are present on every continent with the exception of Antarctica. As a result, a large number of people are affected by CE. In humans, the disease is characterized by slowly growing cyst commonly occurring in liver and lungs. Clinical features are mainly right upper quadrant pain, feeling of lump and enlarged tender liver. The cyst may be complicated by infection or rupture and may lead to anaphylactic reaction. The diagnosis depends on clinical suspicion. They appear in two ways as general (systemic) symptoms, and local symptoms based on the site and organ on which the larva settles. While cysts sometimes recover spontaneously, more severe clinical presentations are observed in immunosuppressed individuals. Ultrasonography supported by serology is the main diagnostic modality. The treatment varies from surgical intervention to minimally invasive treatments (percutaneous drainage) or medical therapies. Surgery is still the best treatment modality. Percutaneous drainage of the cyst is a good option in selected cases. New sensitive and specific diagnostic methods and effective therapeutic approaches against echinococcosis have been developed in the last 10 years.
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Affiliation(s)
| | - Pradeep Kajal
- Dept. of Paediatric Surgery, PGIMS Rohtak, Haryana, India
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20
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Mourglia-Ettlin G, Miles S, Velasco-De-Andrés M, Armiger-Borràs N, Cucher M, Dematteis S, Lozano F. The ectodomains of the lymphocyte scavenger receptors CD5 and CD6 interact with tegumental antigens from Echinococcus granulosus sensu lato and protect mice against secondary cystic echinococcosis. PLoS Negl Trop Dis 2018; 12:e0006891. [PMID: 30500820 PMCID: PMC6267981 DOI: 10.1371/journal.pntd.0006891] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/02/2018] [Indexed: 12/11/2022] Open
Abstract
Background Scavenger Receptors (SRs) from the host’s innate immune system are known to bind multiple ligands to promote the removal of non-self or altered-self targets. CD5 and CD6 are two highly homologous class I SRs mainly expressed on all T cells and the B1a cell subset, and involved in the fine tuning of activation and differentiation signals delivered by the antigen-specific receptors (TCR and BCR, respectively), to which they physically associate. Additionally, CD5 and CD6 have been shown to interact with and sense the presence of conserved pathogen-associated structures from bacteria, fungi and/or viruses. Methodology/Principal findings We report herein the interaction of CD5 and CD6 lymphocyte surface receptors with Echinococcus granulosus sensu lato (s.l.). Binding studies show that both soluble and membrane-bound forms of CD5 and CD6 bind to intact viable protoscoleces from E. granulosus s.l. through recognition of metaperiodate-resistant tegumental components. Proteomic analyses allowed identification of thioredoxin peroxidase for CD5, and peptidyl-prolyl cis-trans isomerase (cyclophilin) and endophilin B1 (antigen P-29) for CD6, as their potential interactors. Further in vitro assays demonstrate that membrane-bound or soluble CD5 and CD6 forms differentially modulate the pro- and anti-inflammatory cytokine release induced following peritoneal cells exposure to E. granulosus s.l. tegumental components. Importantly, prophylactic infusion of soluble CD5 or CD6 significantly ameliorated the infection outcome in the mouse model of secondary cystic echinococcosis. Conclusions/Significance Taken together, the results expand the pathogen binding properties of CD5 and CD6 and provide novel evidence for their therapeutic potential in human cystic echinococcosis. Scavenger Receptors (SRs) are constituents of host’s innate immune system able to sense and remove altered-self and/or pathogen components. Data on their interaction with helminth parasites is scarce. In this work, we describe that CD5 and CD6 -two lymphoid SRs previously reported to interact with conserved structures from bacteria, fungi and viruses- recognize tegumental components in the cestode parasite Echinococcus granulosus sensu lato (s.l.). Moreover, both receptors differentially modulate the cytokine release by host cells exposed to E. granulosus s.l. tegumental components. Importantly, the infusion of soluble forms of CD5 or CD6 improve infection outcomes in a murine model of secondary cystic echinococcosis. In summary, our results expand the pathogen binding properties of CD5 and CD6 and suggest their therapeutic potential against helminth infections.
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MESH Headings
- Animals
- Antigens, CD/genetics
- Antigens, CD/metabolism
- Antigens, Differentiation, T-Lymphocyte/genetics
- Antigens, Differentiation, T-Lymphocyte/metabolism
- CD5 Antigens/genetics
- CD5 Antigens/metabolism
- Echinococcosis/genetics
- Echinococcosis/metabolism
- Echinococcosis/parasitology
- Echinococcus granulosus/genetics
- Echinococcus granulosus/metabolism
- Female
- Helminth Proteins/genetics
- Helminth Proteins/metabolism
- Humans
- Mice
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Protein Binding
- Proteomics
- Receptors, Scavenger/genetics
- Receptors, Scavenger/metabolism
- T-Lymphocytes/metabolism
- T-Lymphocytes/parasitology
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Affiliation(s)
- Gustavo Mourglia-Ettlin
- Área Inmunología, Facultad de Química/Facultad de Ciencias, DEPBIO/IQB, Universidad de la República, Montevideo, Uruguay
- * E-mail: (GM-E); (FL)
| | - Sebastián Miles
- Área Inmunología, Facultad de Química/Facultad de Ciencias, DEPBIO/IQB, Universidad de la República, Montevideo, Uruguay
| | - María Velasco-De-Andrés
- Immunoreceptors del Sistema Innat i Adaptatiu, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Noelia Armiger-Borràs
- Immunoreceptors del Sistema Innat i Adaptatiu, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marcela Cucher
- Instituto de Investigaciones en Microbiología y Parasitología Médica, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Sylvia Dematteis
- Área Inmunología, Facultad de Química/Facultad de Ciencias, DEPBIO/IQB, Universidad de la República, Montevideo, Uruguay
| | - Francisco Lozano
- Immunoreceptors del Sistema Innat i Adaptatiu, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Servei d’Immunologia, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, Spain
- Departament de Biomedicina, Universitat de Barcelona, Barcelona, Spain
- * E-mail: (GM-E); (FL)
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Petrone L, Vanini V, Amicosante M, Corpolongo A, Gomez Morales MA, Ludovisi A, Ippolito G, Pozio E, Teggi A, Goletti D. A T-cell diagnostic test for cystic echinococcosis based on Antigen B peptides. Parasite Immunol 2018; 39. [PMID: 29171068 PMCID: PMC5846893 DOI: 10.1111/pim.12499] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 10/23/2017] [Indexed: 12/23/2022]
Abstract
Cystic echinococcosis (CE) immunodiagnosis is still imperfect. We recently set-up a whole-blood test based on the interleukin (IL)-4 response to the native Antigen B (AgB) of Echinococcus granulosus. However, AgB is encoded by a multigene family coding for five putative subunits. Therefore, the aims of this study were to analyse the IL-4 response to peptides spanning the immunodominant regions of the five AgB subunits and to evaluate the accuracy of this assay for CE diagnosis. Peptides corresponding to each subunit were combined into five pools. A pool containing all peptides was also used (total pool). IL-4 evaluated by enzyme-linked immunosorbent assay was significantly higher in patients with CE compared to those without (NO-CE subjects) when whole-blood was stimulated with AgB1 and with the total pool. Moreover, IL-4 levels in response to the total pool were significantly increased in patients with active cysts. Receiver Operator Curve analysis identified a cut-off point of 0.59 pg/mL predicting active cysts diagnosis with 71% sensitivity and 82% specificity in serology-positive CE patients. These data, if confirmed in a larger cohort, offer the opportunity to develop new diagnostic tools for CE based on a standardized source of AgB as the peptides.
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Affiliation(s)
- L Petrone
- Translational Research Unit, Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), Rome, Italy
| | - V Vanini
- Translational Research Unit, Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), Rome, Italy
| | - M Amicosante
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,ProxAgen Ltd, Sofia, Bulgaria
| | - A Corpolongo
- Clinical Department, National Institute for Infectious Diseases (INMI), Rome, Italy
| | - M A Gomez Morales
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - A Ludovisi
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - G Ippolito
- Scientific Direction, National Institute for Infectious Diseases (INMI), Rome, Italy
| | - E Pozio
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - A Teggi
- Department of Infectious and Tropical Diseases, Sant'Andrea Hospital University of Rome "Sapienza", Rome, Italy
| | - D Goletti
- Translational Research Unit, Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), Rome, Italy
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22
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Devi MA, Venumadhav T, Sukanya B, Manmada RT, Gopal P, Rammurti S. Role of Imaging in Diagnosis, Predicting Biological Activity and in Treatment Plan of Hydatid Disease. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/ojim.2018.83018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bakdik S, Arslan S, Oncu F, Tolu I, Eryilmaz MA. Percutaneous treatment of hepatic cystic echinococcosis: the success of alcohol as a single endocavitary agent in PAIR, catheterization, and modified catheterization techniques. Radiol Med 2017; 123:153-160. [PMID: 29030721 DOI: 10.1007/s11547-017-0820-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 09/28/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This retrospective study aims at demonstrating the success rate, effectiveness, and advantages of alcohol as a scolicidal and sclerosing agent for the percutaneous treatment of liver hydatid cysts. METHODS A total of 554 liver hydatid cysts obtained from 347 patients admitted between January 2008 and February 2016 were retrospectively investigated. Of these, 435 (78.5%), 91 (16.4%), and 28 (5%) were classified as Gharbi type 1, 2, and 3, respectively. Type 1 and 2 cysts were treated using PAIR (puncture, aspiration, injection, respiration) and single puncture catheterization methods; type 3 lesions were treated using a modified catheterization technique. Alcohol was used as a scolicidal and sclerosing agent in all procedures. RESULTS After excluding three lesions (0.5%) because of lack of parenchymal support during catheterization, 274 (49.7%), 250 (45.3%), and 27 (4.9%) of 551 lesions were treated with PAIR, single puncture catheterization, and modified catheterization techniques, respectively. Therefore, a 99.5% of technical success rate was obtained. Major complications in 2 patients (0.5%) and minor complications were observed in 36 patients (10.3%). Mean hospital stay was 1.55±2.3 days (range: 0-23 days). Patients were followed-up for mean 19.6 months (range: 6-83 months), during which recurrences were detected in 19 patients (5.4%). CONCLUSIONS The use of alcohol as a scolicidal and sclerosing agent during the percutaneous treatment of liver hydatid cysts is associated with a high success rate and low rates of recurrence and complications, and should be considered an important alternative to surgical procedures.
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Affiliation(s)
- Suleyman Bakdik
- Department of Radiology, Necmettin Erbakan University School of Medicine, Konya, Turkey
| | - Serdar Arslan
- Department of Radiology, University of Health Sciences, Konya Training and Research Hospital, Konya, Turkey.
| | - Fatih Oncu
- Department of Radiology, University of Health Sciences, Konya Training and Research Hospital, Konya, Turkey
| | - Ismet Tolu
- Department of Radiology, University of Health Sciences, Konya Training and Research Hospital, Konya, Turkey
| | - Mehmet Ali Eryilmaz
- Department of General Surgery, University of Health Sciences, Konya Training and Research Hospital, Konya, Turkey
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Patkowski W, Krasnodębski M, Grąt M, Masior Ł, Krawczyk M. Surgical treatment of hepatic Echinococcus granulosus. PRZEGLAD GASTROENTEROLOGICZNY 2017; 12:199-202. [PMID: 29123581 PMCID: PMC5672708 DOI: 10.5114/pg.2017.70473] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/29/2016] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Infections caused by metacestode stage of the Echinococcus granulosus in humans result in disease named cystic echinococcosis. AIM To present the outcomes of patients treated surgically for cystic echinococcosis of the liver. MATERIAL AND METHODS One hundred and nineteen patients treated in the period between 1989 and 2014 due to E. granulosus infection in the Department of General, Transplant, and Liver Surgery, Medical University of Warsaw were selected for this retrospective study. Diagnostic protocol included imaging examinations, i.e. ultrasonography and computed tomography of the abdomen. Blood samples where used to proceed sequential enzyme-linked immunosorbent assay (ELISA) using Em2plus antigen as well as polymerase chain reaction (PCR) to detect E. granulosus. RESULTS Surgery was the choice for treatment for almost all of the patients (98.3%). In 40 (34.2%) patients right hemihepatectomy, in 19 (16.2%) patients left hemihepatectomy, and in 21 (17.9%) patients bisegementectomy were performed. Postoperative complications occurred in 4 (3.4%) patients. In 3 patients biliary fistula requiring endoscopic treatment was observed, and 1 patient had subdiaphragmatic abscess successfully treated with drainage under ultrasound guidance. None of the patients died in the postoperative period, and the 1-, 5-, and 10-year survival rates were 100.0%, 90.9%, and 87.9%, respectively. CONCLUSIONS Surgical treatment of the symptomatic cystic echinococcosis is the modality of choice for E. granulosus infection of the liver. Despite substantial development of diagnostic methods and new management opportunities, echinococcal infection still presents a challenge for epidemiologists, pharmacologists, and clinicists.
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Affiliation(s)
- Waldemar Patkowski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Krasnodębski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał Grąt
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Łukasz Masior
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
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25
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26
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Zeghir-Bouteldja R, Polomé A, Bousbata S, Touil-Boukoffa C. Comparative proteome profiling of hydatid fluid from Algerian patients reveals cyst location-related variation in Echinococcus granulosus. Acta Trop 2017; 171:199-206. [PMID: 28412048 DOI: 10.1016/j.actatropica.2017.03.034] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Indexed: 12/22/2022]
Abstract
Human cystic echinococcosis, an endemic zoonosis in Algeria, is caused by larvae of the cestode Echinococcus granulosus. Parasitic modulation of the immune response allows E. granulosus to persist in intermediate hosts. Previous in vitro and in vivo immunological studies have shown differences in host immune responses according to the status and location of the hydatid cysts in the body. In this study, a proteomic analysis of human hydatid fluids was performed to identify the proteins in hydatid cyst fluids. Hydatid fluid was obtained after cystic surgical removal from three patients with these cysts. The study was conducted on fertile hydatid fluids from lungs, vertebra, and infertile paravertebral fluids. Comparisons of the protein compositions of these fluids revealed differences in their protein profiles. These differences are probably related to the cyst location and fertility status of the parasite. Notably, our analysis identified new proteins from the parasite and human host. The identification of host proteins in hydatid fluids indicates that the hydatid walls are permeable allowing a high protein exchange rate between the metacestode and the affected tissue. Interestingly, our study also revealed that parasite antigenic protein expression variations reflect the differences observed in host immunostimulation.
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Affiliation(s)
- Razika Zeghir-Bouteldja
- Laboratory of Cellular and Molecular Biology, Team 'Cytokines and NO Synthases' Faculty of Biological Science University of Sciences and Technology Houari Boumediene, USTHB, PB 32 El-Alia, Algiers 16111, Algeria; Department of Biological Science, Akli Mohand Oulhadj University, Bouira, Algeria.
| | - Andy Polomé
- Proteomic Platform, Microbiology Laboratory, Department of Molecular Biology, Université Libre de Bruxelles, Belgium.
| | - Sabrina Bousbata
- Proteomic Platform, Microbiology Laboratory, Department of Molecular Biology, Université Libre de Bruxelles, Belgium.
| | - Chafia Touil-Boukoffa
- Laboratory of Cellular and Molecular Biology, Team 'Cytokines and NO Synthases' Faculty of Biological Science University of Sciences and Technology Houari Boumediene, USTHB, PB 32 El-Alia, Algiers 16111, Algeria.
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Al-timimy QAH. WITHDRAWN: A rapidly progressive hydatid disease imitating metastatic malignancy: An unusual multi-organ presentation. Report of a case and review of literature. Respir Med Case Rep 2017. [DOI: 10.1016/j.rmcr.2016.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Ye J, Zhang Q, Xuan Y, Chen S, Ma L, Zhang Y, Zheng H. Factors Associated with Echinococcosis-Induced Perioperative Anaphylactic Shock. THE KOREAN JOURNAL OF PARASITOLOGY 2017; 54:769-775. [PMID: 28095662 PMCID: PMC5266365 DOI: 10.3347/kjp.2016.54.6.769] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/27/2016] [Accepted: 09/11/2016] [Indexed: 12/28/2022]
Abstract
This retrospective case-control study explored the factors associated with anaphylactic shock during surgery for cystic echinococcosis (CE) at the First Affiliated Hospital of Xinjiang Medical University between October 2008 and September 2013. Patients who suffered from anaphylactic shock (n=16) were age-matched 3:1 to patients who did not (n=43). Multivariate analysis suggested that IL-4 levels (odds ratio=1.096; 95% confidence interval=1.015–1.185; P=0.02) and cyst size (odds ratio=3.028, 95% confidence interval=1.259–7.283, P=0.013) were independently associated with CE-induced perioperative anaphylactic shock. Using the receiver operating characteristic (ROC) curves and a cut-off value of 415.7 ng/ml, IL-4 showed an area under the ROC (AUC) of 0.926, sensitivity of 75.0%, and specificity of 97.7%. Using a cut-off value of 7.8 cm, cyst size showed an AUC of 0.828, sensitivity of 81.3%, and specificity of 76.7%. In conclusion, results suggest that levels of IL-4 and cyst size were independently associated with echinococcosis-induced perioperative anaphylactic shock. These results could help identifying patients with echinococcosis at risk of anaphylactic shock in whom appropriate prophylaxis could be undertaken.
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Affiliation(s)
- Jianrong Ye
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China
| | - Qin Zhang
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China
| | - Yan Xuan
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China
| | - Siyu Chen
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China
| | - Long Ma
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China
| | - Yongqiang Zhang
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China
| | - Hong Zheng
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China
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Cystic Echinococcosis: A Case of Extrahepatic Intra-Abdominal Involvement. Case Rep Radiol 2017; 2017:8919546. [PMID: 28194292 PMCID: PMC5282424 DOI: 10.1155/2017/8919546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/04/2017] [Indexed: 11/18/2022] Open
Abstract
Hydatid disease, or echinococcal disease, is a parasitic infestation caused by the larval stage of the Echinococcus tapeworm and it primarily affects the liver and lung but involvement of other organs is also possible secondary to peritoneal seeding or hematogeneous dissemination. We describe a rare case of extensive abdominal disease, with lesions affecting the liver, peritoneum, and lesser omentum, requiring aggressive surgical intervention. Complementary diagnostic exams were crucial to reach the diagnosis and evaluate the extension of the disease.
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Abstract
Cystic and alveolar echinococcosis are severe chronic helminthic diseases caused by the cystic growth or the intrahepatic tumour-like growth of the metacestode of Echinococcus granulosus or Echinococcus multilocularis, respectively. Both parasites have evolved sophisticated strategies to escape host immune responses, mainly by manipulating and directing this immune response towards anergy and/or tolerance. Recent research studies have revealed a number of respective immunoregulatory mechanisms related to macrophages and dendritic cell as well as T cell activities (regulatory T cells, Tregs). A better understanding of this complex parasite-host relationship, and the elucidation of specific crucial events that lead to disease, represents targets towards the development of novel treatment strategies and options.
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Herrador Z, Siles-Lucas M, Aparicio P, Lopez-Velez R, Gherasim A, Garate T, Benito A. Cystic Echinococcosis Epidemiology in Spain Based on Hospitalization Records, 1997-2012. PLoS Negl Trop Dis 2016; 10:e0004942. [PMID: 27547975 PMCID: PMC4993502 DOI: 10.1371/journal.pntd.0004942] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/02/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cystic echinococcosis (CE) is a parasitic disease caused by the tapeworm Echinococcus granulosus. Although present throughout Europe, deficiencies in the official reporting of CE result in under-reporting and misreporting of this disease, which in turn is reflected in the wrong opinion that CE is not an important health problem. By using an alternative data source, this study aimed at describing the clinical and temporal-spatial characteristics of CE hospitalizations in Spain between 1997 and 2012. METHODOLOGY/PRINCIPAL FINDINGS We performed a retrospective descriptive study using the Hospitalization Minimum Data Set (CMBD in Spanish). All CMBD's hospital discharges with echinococcosis diagnosis placed in first diagnostic position were reviewed. Hospitalization rates were computed and clinical characteristics were described. Spatial and temporal distribution of hospital discharges was also assessed. Between 1997 and 2012, 14,010 hospitalizations with diagnosis of CE were recorded, 55% were men and 67% were aged over 45 years. Pediatric hospitalizations occurred during the whole study period. The 95.2% were discharged at home, and only 1.7% were exitus. The average cost was 8,439.11 €. The hospitalization rate per 100,000 per year showed a decreasing trend during the study period. All the autonomous communities registered discharges, even those considered as non-endemic. Maximum rates were reached by Extremadura, Castilla-Leon and Aragon. Comparison of the CMBD data and the official Compulsory Notifiable Diseases (CND) reports from 2005 to 2012 showed that official data were lower than registered hospitalization discharges. CONCLUSIONS Hospitalizations distribution was uneven by year and autonomous region. Although CE hospitalization rates have decreased considerably due to the success of control programs, it remains a public health problem due to its severity and economic impact. Therefore, it would be desirable to improve its oversight and surveillance, since officially reported data are underestimating the real burden of CE in Spain.
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Affiliation(s)
- Zaida Herrador
- National Centre for Tropical Medicine, Health Institute Carlos III (ISCIII in Spanish), Madrid, Spain
- Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain
| | - Mar Siles-Lucas
- Laboratory of Parasitology, Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA), Consejo Superior de Investigaciones Científicas (CSIC), Salamanca, Spain
| | - Pilar Aparicio
- National Centre for Tropical Medicine, Health Institute Carlos III (ISCIII in Spanish), Madrid, Spain
- Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain
| | - Rogelio Lopez-Velez
- Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain
- National Referral Centre for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Alin Gherasim
- National Centre of Epidemiology, Health Institute Carlos III (ISCIII), Madrid, Spain
| | - Teresa Garate
- Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain
- National Centre of Microbiology, Health Institute Carlos III (ISCIII), Madrid, Spain
| | - Agustín Benito
- National Centre for Tropical Medicine, Health Institute Carlos III (ISCIII in Spanish), Madrid, Spain
- Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain
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Pakala T, Molina M, Wu GY. Hepatic Echinococcal Cysts: A Review. J Clin Transl Hepatol 2016; 4:39-46. [PMID: 27047771 PMCID: PMC4807142 DOI: 10.14218/jcth.2015.00036] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/15/2015] [Accepted: 12/16/2015] [Indexed: 12/16/2022] Open
Abstract
Cystic echinococcosis (CE) is a widely endemic helminthic disease caused by infection with metacestodes (larval stage) of the Echinococcus granulosus tapeworm. E. granulosus are common parasites in certain parts of the world, and are present on every continent with the exception of Antarctica. As a result, a large number of people are affected by CE. The increased emigration of populations from endemic areas where prevalence rates are as high as 5-10% and the relatively quiescent clinical course of CE pose challenges for accurate and timely diagnoses. Upon infection with CE, cyst formation mainly occurs in the liver (70%). Diagnosis involves serum serologic testing for antibodies against hydatid antigens, but preferably with imaging by ultrasound or CT/MRI. Treatment methods include chemotherapy with benzimidazole carbamates and/or surgical approaches, including percutaneous aspiration injection and reaspiration. The success of these methods is influenced by the stage and location of hepatic cysts. However, CE can be clinically silent, and has a high risk for recurrence. It is important to consider the echinococcal parasite in the differential diagnosis of liver cystic lesions, especially in patients of foreign origin, and to perform appropriate long-term follow-ups. The aim of this review is to highlight the epidemiology, natural history, diagnostic methods, and treatment of liver disease caused by E. granulosus.
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Affiliation(s)
- Tina Pakala
- Department of Medicine, Division of Gastroenterology-Hepatology, University of Connecticut Health Center, Farmington, CT, USA
| | - Marco Molina
- Department of Radiology, University of Connecticut Health Center, Farmington, CT, USA
| | - George Y. Wu
- Department of Medicine, Division of Gastroenterology-Hepatology, University of Connecticut Health Center, Farmington, CT, USA
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Natural and induced antibodies contribute to differential susceptibility to secondary cystic echinococcosis of Balb/c and C57Bl/6 mice. Immunobiology 2016; 221:103-15. [DOI: 10.1016/j.imbio.2015.07.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 07/07/2015] [Accepted: 07/23/2015] [Indexed: 01/15/2023]
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Park SJ, Han SS, Anvarov K, Khajibaev A, Choi MH, Hong ST. Prevalence of Serum IgG Antibodies to Cystic Echinococcus Antigen among Patients in an Uzbekistan Emergency Hospital. THE KOREAN JOURNAL OF PARASITOLOGY 2015; 53:699-703. [PMID: 26797436 PMCID: PMC4725226 DOI: 10.3347/kjp.2015.53.6.699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 11/26/2015] [Accepted: 11/26/2015] [Indexed: 11/23/2022]
Abstract
Cystic echinococcosis (CE) is one of the most widespread zoonotic helminthiases, which can last an asymptomatic infection for several years. The purpose of this study was to demonstrate serum antibody prevalence of CE among asymptomatic people in Uzbekistan using ELISA. A total of 2,547 serum samples were collected, 66 from confirmed CE patients and 2,481 of patients with other diseases than CE at a hospital in Tashkent, Uzbekistan. The serum samples were screened for CE specific IgG antibodies by ELISA using cystic fluid antigen obtained from sheep. The serum antibody positive rate was 89.4% (59/66) in CE and 3.6% (89/2,481) in other disease patients. The present ELISA recognized 89.4% sensitivity and 96.4% specificity. The ELISA absorbance of positive samples was distributed 0.271-0.971 for CE and 0.273-0.887 for other disease patients. The other disease patients with high absorbance over 0.3 were 50 (2.0%) who were presumed to be active CE patients. The patients in their 40s showed the highest positive rate of 5.2% (P=0.181), and women were 4.4% while men were 3.1% positive (P=0.136). The data confirmed that there are many asymptomatic patients of CE in Tashkent. It is indicated that CE is an endemic disease of public health importance in Uzbekistan.
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Affiliation(s)
- Se Jin Park
- School of Life Sciences and Biotechnology, Korea University, Seoul 02841, Korea
| | - Sung Sik Han
- School of Life Sciences and Biotechnology, Korea University, Seoul 02841, Korea
| | - Khikmat Anvarov
- Department of Surgery, Republican Research Center for Emergency Medicine, Tashkent 100107, Uzbekistan
| | - Abdukhakim Khajibaev
- Department of Surgery, Republican Research Center for Emergency Medicine, Tashkent 100107, Uzbekistan
| | - Min-Ho Choi
- Department of Parasitology and Tropical Medicine, Institute of Endemic Diseases, Seoul National University, College of Medicine, Seoul 03080, Korea
| | - Sung-Tae Hong
- Department of Parasitology and Tropical Medicine, Institute of Endemic Diseases, Seoul National University, College of Medicine, Seoul 03080, Korea
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AZIZI H, KAZEMI B, BANDEHPOUR M, MOHEBALI M, KHAMESIPOUR A, ARYAEIPOUR M, ROKNI MB. Molecular Cloning and Expression an 8-kDa Subunit of Antigen B from G1 strain of Echinococcus granulosus. IRANIAN JOURNAL OF PUBLIC HEALTH 2015; 44:962-8. [PMID: 26576374 PMCID: PMC4645767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Echinococcosis or hydatidosis is a chronic, zoonotic worldwide infection caused by the larval stage of the dog taeniid tapeworm Echinococcus granulosus. Vaccination has been considered as one of the ways to prevent of hydatidosis in recent decades. The aim of this study was to construct a pcDNA3.1 eukaryotic expression vector containing the subunit 8-kDa antigen B (Hyd1) of E. granulosus (G1 strain) and investigate its capability to induce protein expression in mammalian cell line, as a basis toward developing a DNA vaccine against hydatidosis. METHODS The coding sequence of HydI was amplified by PCR with the specific PCR primers from pQE/HydI, and then was sub-cloned into pcDNA3.1 plasmid as expression vector. The pcHyd1 plasmid was digested by restriction enzymes and amplified with the specific PCR primers to confirm cloning of this gene in pcDNA3 plasmid. In last step, the sub-cloned gene was expressed in mammalian cell line (NIH 3T3 cells). RESULT The subunit 8-kDa antigen B (Hyd1) was successfully sub-cloned in pcDNA3.1 and Hyd1 protein was expressed in eukaryotic cell confirmed by SDS-PAGE and Western blot. CONCLUSION Recombinant plasmid of pcDNA3.1 was successfully constructed and express of recombinant Hyd1 protein was confirmed. That is promising step for forthcoming measures on providing vaccine against human and animal hydatidosis.
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Affiliation(s)
- Hakim AZIZI
- Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Iran
| | - Bahram KAZEMI
- Cellular and Molecular Biology Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Biotechnology Department, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding Authors: ,
| | - Mojgan BANDEHPOUR
- Cellular and Molecular Biology Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Biotechnology Department, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi MOHEBALI
- Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Iran, Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
| | - Ali KHAMESIPOUR
- Skin and Leprosy Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojgan ARYAEIPOUR
- Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Iran
| | - Mohammad Bagher ROKNI
- Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Iran, Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran,Corresponding Authors: ,
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Hammami A, Hellara O, Mnari W, Loussaief C, Bedioui F, Safer L, Golli M, Chakroun M, Saffar H. Unusual presentation of severely disseminated and rapidly progressive hydatic cyst: Malignant hydatidosis. World J Hepatol 2015; 7:633-637. [PMID: 25848488 PMCID: PMC4381187 DOI: 10.4254/wjh.v7.i3.633] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 12/29/2014] [Accepted: 01/09/2015] [Indexed: 02/06/2023] Open
Abstract
The infection caused by the tapeworm Echinococcus granulosus leads to the development of hydatic disease. It is the most frequent mediterranean parasitic infection that commonly affects the liver and rarely involves multiple organs. Herein, we report an exceptional and confusing presentation of hepatopulmonary and splenic hydatidosis due to Echinococcus granulosus that caused diagnostic problems occuring in a 70-year-old man, treated with chemotherapy, with favorable outcome. This was a very unusual case of disseminated hydatid cyst highlighting the interest of keeping a high level of clinical suspicion of this diagnosis every time we have a cystic lesion of the liver.
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Affiliation(s)
- Aya Hammami
- Aya Hammami, Olfa Hellara, Fethia Bedioui, Leila Safer, Hammouda Saffar, Department of Gastroenterology and Hepatology, University Hospital Fattouma Bourguiba, 5000 Monastir, Tunisia
| | - Olfa Hellara
- Aya Hammami, Olfa Hellara, Fethia Bedioui, Leila Safer, Hammouda Saffar, Department of Gastroenterology and Hepatology, University Hospital Fattouma Bourguiba, 5000 Monastir, Tunisia
| | - Walid Mnari
- Aya Hammami, Olfa Hellara, Fethia Bedioui, Leila Safer, Hammouda Saffar, Department of Gastroenterology and Hepatology, University Hospital Fattouma Bourguiba, 5000 Monastir, Tunisia
| | - Chaouki Loussaief
- Aya Hammami, Olfa Hellara, Fethia Bedioui, Leila Safer, Hammouda Saffar, Department of Gastroenterology and Hepatology, University Hospital Fattouma Bourguiba, 5000 Monastir, Tunisia
| | - Fethia Bedioui
- Aya Hammami, Olfa Hellara, Fethia Bedioui, Leila Safer, Hammouda Saffar, Department of Gastroenterology and Hepatology, University Hospital Fattouma Bourguiba, 5000 Monastir, Tunisia
| | - Leila Safer
- Aya Hammami, Olfa Hellara, Fethia Bedioui, Leila Safer, Hammouda Saffar, Department of Gastroenterology and Hepatology, University Hospital Fattouma Bourguiba, 5000 Monastir, Tunisia
| | - Mondher Golli
- Aya Hammami, Olfa Hellara, Fethia Bedioui, Leila Safer, Hammouda Saffar, Department of Gastroenterology and Hepatology, University Hospital Fattouma Bourguiba, 5000 Monastir, Tunisia
| | - Mohamed Chakroun
- Aya Hammami, Olfa Hellara, Fethia Bedioui, Leila Safer, Hammouda Saffar, Department of Gastroenterology and Hepatology, University Hospital Fattouma Bourguiba, 5000 Monastir, Tunisia
| | - Hammouda Saffar
- Aya Hammami, Olfa Hellara, Fethia Bedioui, Leila Safer, Hammouda Saffar, Department of Gastroenterology and Hepatology, University Hospital Fattouma Bourguiba, 5000 Monastir, Tunisia
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Brundu D, Piseddu T, Stegel G, Masu G, Ledda S, Masala G. Retrospective study of human cystic echinococcosis in Italy based on the analysis of hospital discharge records between 2001 and 2012. Acta Trop 2014; 140:91-6. [PMID: 25149351 DOI: 10.1016/j.actatropica.2014.08.011] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 08/07/2014] [Accepted: 08/10/2014] [Indexed: 12/28/2022]
Abstract
Cystic echinococcosis (CE) is an important zoonotic parasitic infection. The European Centre for Disease Control highlights that Italy lacks a surveillance system for CE. Due to the lack of official data, we analysed the Hospital Discharge Records (HDRs) drawn from the National Ministry of Health. The aim of this study was to analyse data from the HDRs with CE-related diagnoses in Italy from 2001 to 2012 to assess the current status and trend of disease epidemiology. A total of 16,550 HDRs related to the admission of 10,682 Italian patients were examined. The HDRs were analysed according to the patient's region and province code to evaluate the demographic and clinical characteristics of each case, together with the annual incidence rates of hospital cases (AIh) in administrative divisions in rural and urban areas. Lesions occurred frequently in the liver (83.6%) and lungs (8.4%). Patients ranged in age from 1 to 100 years (mean 59.8), and 57% were over 60 years old. The highest average AIh was registered in the Islands with 4.6/10(5) inhabitants (6.9/10(5) in Sardinia and 4.3/10(5) in Sicily), followed by the South with an average AIh of 1.9/10(5) inhabitants (5.4/10(5) inhabitants) and the Centre with an average AIh of 1.07/10(5) inhabitants (there was an AIh of 1.65/10(5) in Latium). The analysis for trend showed a statistically significant decrease in the AIh throughout the study period (e.g., in the Islands r(2)=0.98, p<0.001). An AIh over 2/10(5) inhabitants was observed in 31/110 provinces. Rural areas with comprehensive development problems had a relative risk of CE of 5.7 (95% CI, 5.3 to 6.9) compared to urban areas. The relative risk increased between areas where sheep breeding is widespread compared to those where it is less prevalent. This study shows a detailed picture of the geographic distribution and the epidemiological situation of CE in Italy, indicating that CE continues to be a significant public health problem in Italy. The retrospective study of HDRs is useful for the evaluation of the status of disease epidemiology; however, a surveillance system is needed to report confirmed cases of human CE.
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IL-4 specific-response in whole blood associates with human Cystic Echinococcosis and cyst activity. J Infect 2014; 70:299-306. [PMID: 25444973 DOI: 10.1016/j.jinf.2014.10.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 09/15/2014] [Accepted: 10/17/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Human Cystic Echinococcosis (CE) is estimated in 2-3 million global cases. CE diagnosis and clinical management are based on imaging and serology, which lacks sensitivity and does not provide cyst stage information. This study aimed to evaluate tools for improving diagnosis by analysing the Interleukin (IL)-4-response to Antigen B (AgB) of Echinococcus granulosus. METHODS Whole blood (WB) and peripheral blood mononuclear cells were stimulated with AgB. IL-4 levels were measured by enzyme-linked immunosorbent assay. RESULTS WB 1-day stimulation resulted the best experimental condition for evaluating AgB IL-4-response. IL-4 levels were significantly higher in CE patients than healthy donors (p ≤ 0.0001). A ROC analysis showed significant area under the curve (AUC) results (AUC, 0.85; p = 0.0001) identifying an IL-4 level cut-off point ≥0.39 pg/mL which predicted CE with 71.4% sensitivity and 93.3% specificity. Moreover, we found that IL-4 levels were significantly increased in patients with active cysts compared to those with inactive cysts (p ≤ 0.0001). ROC analysis showed significant AUC results (0.94; p = 0.0001) with a cut-off point of 4.6 pg/mL which predicted active cysts with 84.6% sensitivity and 92% specificity. CONCLUSIONS We found immunological correlates associated with CE and biological cyst activity.
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Pagnozzi D, Biosa G, Addis MF, Mastrandrea S, Masala G, Uzzau S. An easy and efficient method for native and immunoreactive Echinococcus granulosus antigen 5 enrichment from hydatid cyst fluid. PLoS One 2014; 9:e104962. [PMID: 25119821 PMCID: PMC4132071 DOI: 10.1371/journal.pone.0104962] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 07/15/2014] [Indexed: 12/30/2022] Open
Abstract
Background Currently, the serodiagnosis of cystic echinococcosis relies mostly on crude Echinococcus granulosus hydatid cyst fluid as the antigen. Consequently, available immunodiagnostic tests lack standardization of the target antigen and, in turn, this is reflected on poor sensitivity and specificity of the serological diagnosis. Methodology/Principal Findings Here, a chromatographic method enabling the generation of highly enriched Antigen 5 (Ag5) is described. The procedure is very easy, efficient and reproducible, since different hydatid cyst fluid (HCF) sources produced very similar chromatograms, notwithstanding the clearly evident and extreme heterogeneity of the starting material. In addition, the performance of the antigen preparation in immunological assays was preliminarily assessed by western immunoblotting and ELISA on a limited panel of cystic echinococcosis patients and healthy controls. Following western immunoblotting and ELISA experiments, a high reactivity of patient sera was seen, with unambiguous and highly specific results. Conclusions/Significance The methods and results reported open interesting perspectives for the development of sensitive diagnostic tools to enable the timely and unambiguous detection of cystic echinococcosis antibodies in patient sera.
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Affiliation(s)
- Daniela Pagnozzi
- Porto Conte Ricerche Srl, Tramariglio, Alghero, Sassari, Italy
- * E-mail:
| | - Grazia Biosa
- Porto Conte Ricerche Srl, Tramariglio, Alghero, Sassari, Italy
| | | | - Scilla Mastrandrea
- Centro Nazionale di Riferimento per l’Echinococcosi, IZS “G. Pegreffi”, Sassari, Italy
- Unità Operativa Complessa di Malattie Infettive, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Giovanna Masala
- Centro Nazionale di Riferimento per l’Echinococcosi, IZS “G. Pegreffi”, Sassari, Italy
| | - Sergio Uzzau
- Porto Conte Ricerche Srl, Tramariglio, Alghero, Sassari, Italy
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Pilaca A, Vyshka G, Pepa A, Shytaj K, Shtjefni V, Boçari A, Beqiri A, Kraja D. A Neglected Zoonosis in Albania: why Echinococcosis is Becoming a Surgeon's Exclusivity? Mediterr J Hematol Infect Dis 2014; 6:e2014013. [PMID: 24678390 PMCID: PMC3965721 DOI: 10.4084/mjhid.2014.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 02/07/2014] [Indexed: 02/08/2023] Open
Abstract
Echinococcosis is an endemic zoonosis in the Mediterranean area, with Albania interested actually to a level that is becoming a public health concern. Authors describe preliminary data from the only tertiary (university) medical facility of Albania, positioned in the capital of the country (Tirana), with 333 new cases diagnosed and treated during the period 2005 - 2011. Out of all these 333 new cases an impressive majority of 91% had a surgical treatment right from the first admission, rendering the disease almost a surgical exclusivity. Even more, 80% of all patients from the study group were hospitalized straightforwardly in surgical wards, with options of surgical intervention's percentages outrunning figures from other sources and authors of the same geographical area. Such a situation, together with a very important level of patients' origin from highly urbanized areas such as those of the capital, suggest the necessity of well-organized interventions, among which might be the mandatory notification of all human cases with Echinococcus infection.
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Affiliation(s)
- Arben Pilaca
- Service of Infective Diseases, University Hospital Centre “Mother Theresa”, Tirana, Albania
| | - Gentian Vyshka
- Biomedical and Experimental Department, Faculty of Medicine, University of Tirana, Albania
| | - Arben Pepa
- Obstetrical and Gynecological Hospital, Tirana, Albania
| | - Kastriot Shytaj
- Faculty of Medical and Technical Sciences, University of Medicine in Tirana, Albania
| | | | - Arben Boçari
- Faculty of Veterinary Medicine, Agricultural University of Tirana, Albania
| | - Arben Beqiri
- Service of Surgery, University Hospital Centre “Mother Theresa”, Tirana, Albania
| | - Dhimitër Kraja
- Service of Infective Diseases, University Hospital Centre “Mother Theresa”, Tirana, Albania
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Cystic echinococcosis in a single tertiary care center in Rome, Italy. BIOMED RESEARCH INTERNATIONAL 2013; 2013:978146. [PMID: 24151631 PMCID: PMC3789360 DOI: 10.1155/2013/978146] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 06/26/2013] [Accepted: 07/29/2013] [Indexed: 12/28/2022]
Abstract
Background. Cystic echinococcosis (CE) is a chronic, clinically complex, and neglected disease. Its prevalence in Italy, a country of medium to high endemicity, remains poorly defined, as notification has long ceased to be mandatory. Methods. We set up a retrospective cohort study involving all CE patients followed at our institute between January 2005 and December 2012. Demographical and clinical features were recorded and analyzed. Results. CE was found in 28 patients (64.3%), mostly Italians from the central regions (50%), followed by subjects from the islands (33.3%) and Southern Italy (16.7%). Their median age was 45 years (IQR: 38.5–66.5), with Eastern Europeans being significantly younger (28 years, IQR: 19–39) than other patients (P ≤ 0.0001). A total of 149 cysts, mostly with hepatic localization (96%), were described. Based on the WHO classification, the cysts were mainly small (80.5%) and active (CE1 (73.8%); CE2 (7.4%)). Active cysts were more common in Eastern Europeans (85.7%) than Italians (66.7%). Conclusion. Our data confirm CE occurrence in Italy. We emphasize the importance to have a national CE registry, opportunely recently introduced. This is essential to assess CE prevalence in this country, implement appropriate control measures, and improve patient management.
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Zait H, Achir I, Guerchani MK, Hamrioui B. [Epidemiological profile of 290 cases of human cystic echinococcosis diagnosed in the Mustapha University Hospital (Algiers) from 2006 to 2011]. ACTA ACUST UNITED AC 2013; 61:193-8. [PMID: 23578521 DOI: 10.1016/j.patbio.2013.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Accepted: 03/01/2013] [Indexed: 10/27/2022]
Abstract
THE AIM OF THE STUDY This study reports a series of 290 cases of hydatidosis confirmed by the surgery and/or the imagery with a positive immuno-diagnosis collected between 1st January 2006 and 31 March 2011 at parasitology-mycology laboratory of hospital university center of Mustapha of Algiers. Our aim is to specify, through the listed cases, the epidemiological aspects of this affection and compared with those obtained in two previous Algerian epidemiological investigations carried out, between 1963-1964 and 1966-1975. PATIENTS AND METHODS It is a retrospective (2006-2008) and prospective (2008-2011) study. The parasitological diagnosis was carried out by the direct macroscopic and/or microscopic identification of the parasite and indirect diagnosis based on four techniques: passive hemagglutination, Elisa IgG "Echinococcus granulosus", Western Blot IgG "Echinococcus" and electrophoresis. RESULTS The study shows that this affection is still prerogative of the young adult. It bring out also in this study that the child of school age (ten years), in particular the boy, pays a heavy tribute. At the child, the preferential pulmonary seat of the hydatic disease is not devoid of risk. At adult, this parasitic disease mainly affect the active woman. CONCLUSION Generally, the epidemiological and clinical characteristics join the endemic countries data and confirmed the row of our country among them. The transmission seems as strong as in the past, in spite of a much better social educational level.
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Affiliation(s)
- H Zait
- Laboratoire de parasitologie-mycologie, CHU Mustapha, place du 1(er) Mai, CP 16000 Alger, Algérie.
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Moghadam ZK, Ghaffarifar F, Khalilpour A, Abdul Aziz F, Saadatnia G, Noordin R. IgG4 detection of Echinococcus granulosus paramyosin is a useful diagnostic test for human hydatidosis. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2013; 20:501-5. [PMID: 23365208 PMCID: PMC3623400 DOI: 10.1128/cvi.00019-13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 01/25/2013] [Indexed: 12/28/2022]
Abstract
Hydatidosis is a public health problem in many parts of the world, and improvement in diagnosis of the disease is still being pursued. Protoscoleces of Echinococcus granulosus were isolated from hydatid cysts collected from naturally infected sheep slaughtered in abattoirs in Iran. Sonicated extract of protoscolex was subjected to two-dimensional gel electrophoresis and Western blot analysis. Primary antibodies were from serum samples from 130 hydatidosis patients, 38 individuals infected with other parasitic infections, and 30 healthy people, whereas peroxidase (HRP)-conjugated anti-human IgG and IgG4 were used as secondary antibodies. The recombinant form of the identified protein was produced and tested for its sensitivity and specificity for the detection of human hydatidosis. An antigenic band of ∼60 kDa was found to be sensitive (82%) and specific (100%) for the detection of hydatidosis when probed with anti-human IgG4-HRP, while the sensitivity and specificity were 33 and 100%, respectively, with anti-human IgG-HRP. By mass spectrometry, the band was identified as protoscolex tegument paramyosin. The sensitivity and specificity of full-length paramyosin-recombinant protein in IgG4 blots were found to be 86 and 98%, respectively. In conclusion, IgG4 detection of Echinococcus granulosus paramyosin was found to be useful for the diagnosis of human hydatidosis.
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Affiliation(s)
- Zohreh Kazemi Moghadam
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Penang, Malaysia
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Wahlers K, Menezes CN, Wong ML, Zeyhle E, Ahmed ME, Ocaido M, Stijnis C, Romig T, Kern P, Grobusch MP. Cystic echinococcosis in sub-Saharan Africa. THE LANCET. INFECTIOUS DISEASES 2013; 12:871-80. [PMID: 23099081 DOI: 10.1016/s1473-3099(12)70155-x] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cystic echinococcosis is regarded as endemic in sub-Saharan Africa; however, for most countries only scarce data, if any, exist. For most of the continent, information about burden of disease is not available; neither are data for the animal hosts involved in the lifecycle of the parasite, thus making introduction of preventive measures difficult. Available evidence suggests that several species or strains within the Echinococcus granulosus complex are prevalent in sub-Saharan Africa and that these strains might be associated with varying virulence and host preference. Treatment strategies (chemotherapy, percutaneous radiological techniques, but mainly surgery) predominantly target active disease. Prevention strategies encompass anthelmintic treatment of dogs, slaughter hygiene, surveillance, and health-educational measures. Existing data are suggestive of unusual clinical presentations of cystic echinococcosis in some parts of the continent, for which the causes are speculative.
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Affiliation(s)
- Kerstin Wahlers
- First Department of Internal Medicine, Hospital of University of Cologne, Cologne, Germany
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Li Y, Zheng H, Gu M, Cao X, Wen H, Liu Z, Liu T. Comparisons of serum total IgE, IgG, and IgG1 levels in patients with and without echinococcosis-induced anaphylactic shock. Am J Trop Med Hyg 2012; 87:104-8. [PMID: 22764299 DOI: 10.4269/ajtmh.2012.11-0694] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We investigated serum total immunoglobulin E (IgE), IgG, and IgG1 levels in patients with and without echinococcosis-induced anaphylactic shock. This was a case-control study of 11 patients with echinococcosis-induced anaphylactic shock and 22 echinococcosis patients with cyst rupture but without anaphylactic shock. Blood was collected before surgery (T0), at the time of cyst rupture (T1), and shock (Tx), 1 h (T2), 1 day (T3), and 1 week (T4) after cyst rupture. Serum IgE, IgG, and IgG1 were determined by enzyme-linked immunosorbent assay. Serum IgE, IgG, and IgG1 levels were significantly higher in patients who developed anaphylactic shock at all time points. Increased pre-surgical IgG and IgG1 levels were identified to be a significant risk factors for developing anaphylactic shock. The results showed that a serum IgG concentration of 312.25 μg/mL could be used as a cut-off point to predict whether an echinococcosis patient would develop anaphylactic shock.
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Affiliation(s)
- Yimei Li
- Department of Pain Medicine, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China.
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The topological structure and function of Echinococcus granulosus lactate dehydrogenase, a tegumental transmembrane protein. Mol Biochem Parasitol 2012; 184:109-17. [DOI: 10.1016/j.molbiopara.2012.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Revised: 04/09/2012] [Accepted: 04/10/2012] [Indexed: 01/22/2023]
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Siracusano A, Delunardo F, Teggi A, Ortona E. Host-parasite relationship in cystic echinococcosis: an evolving story. Clin Dev Immunol 2011; 2012:639362. [PMID: 22110535 PMCID: PMC3206507 DOI: 10.1155/2012/639362] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 09/27/2011] [Indexed: 01/29/2023]
Abstract
The larval stage of Echinococcus granulosus causes cystic echinococcosis, a neglected infectious disease that constitutes a major public health problem in developing countries. Despite being under constant barrage by the immune system, E. granulosus modulates antiparasite immune responses and persists in the human hosts with detectable humoral and cellular responses against the parasite. In vitro and in vivo immunological approaches, together with molecular biology and immunoproteomic technologies, provided us exciting insights into the mechanisms involved in the initiation of E. granulosus infection and the consequent induction and regulation of the immune response. Although the last decade has clarified many aspects of host-parasite relationship in human cystic echinococcosis, establishing the full mechanisms that cause the disease requires more studies. Here, we review some of the recent developments and discuss new avenues in this evolving story of E. granulosus infection in man.
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Affiliation(s)
- Alessandra Siracusano
- Dipartimento di Malattie Infettive, Parassitarie e Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy.
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MOURGLIA-ETTLIN G, AMEZCUA-VESELY MC, FRAGA R, BAZ A, MERINO MC, GRUPPI A, DEMATTEIS S. Echinococcus granulosus glycoconjugates induce peritoneal B cell differentiation into antibody-secreting cells and cytokine production. Parasite Immunol 2011; 33:621-31. [DOI: 10.1111/j.1365-3024.2011.01326.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Early peritoneal immune response during Echinococcus granulosus establishment displays a biphasic behavior. PLoS Negl Trop Dis 2011; 5:e1293. [PMID: 21912714 PMCID: PMC3166041 DOI: 10.1371/journal.pntd.0001293] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Accepted: 07/14/2011] [Indexed: 12/31/2022] Open
Abstract
Background Cystic echinococcosis is a worldwide distributed helminth zoonosis caused by the larval stage of Echinococcus granulosus. Human secondary cystic echinococcosis is caused by dissemination of protoscoleces after accidental rupture of fertile cysts and is due to protoscoleces ability to develop into new metacestodes. In the experimental model of secondary cystic echinococcosis mice react against protoscoleces producing inefficient immune responses, allowing parasites to develop into cysts. Although the chronic phase of infection has been analyzed in depth, early immune responses at the site of infection establishment, e.g., peritoneal cavity, have not been well studied. Because during early stages of infection parasites are thought to be more susceptible to immune attack, this work focused on the study of cellular and molecular events triggered early in the peritoneal cavity of infected mice. Principal Findings Data obtained showed disparate behaviors among subpopulations within the peritoneal lymphoid compartment. Regarding B cells, there is an active molecular process of plasma cell differentiation accompanied by significant local production of specific IgM and IgG2b antibodies. In addition, peritoneal NK cells showed a rapid increase with a significant percentage of activated cells. Peritoneal T cells showed a substantial increase, with predominance in CD4+ T lymphocytes. There was also a local increase in Treg cells. Finally, cytokine response showed local biphasic kinetics: an early predominant induction of Th1-type cytokines (IFN-γ, IL-2 and IL-15), followed by a shift toward a Th2-type profile (IL-4, IL-5, IL-6, IL-10 and IL-13). Conclusions Results reported here open new ways to investigate the involvement of immune effectors players in E. granulosus establishment, and also in the sequential promotion of Th1- toward Th2-type responses in experimental secondary cystic echinococcosis. These data would be relevant for designing rational therapies based on stimulation of effective responses and blockade of evasion mechanisms. Cystic echinococcosis is a zoonotic disease caused by the larval stage of the cestode Echinococcus granulosus and shows a cosmopolitan distribution with a worldwide prevalence of roughly 6 million infected people. Human cystic echinococcosis can develop in two types of infection. Primary infection occurs by ingestion of oncospheres, while secondary infection is caused by dissemination of protoscoleces after accidental rupture of fertile cysts. Murine experimental secondary infection in Balb/c mice is the current model to study E. granulosus-host interaction. Secondary infection can be divided into two stages: an early stage in which protoscoleces develop into hydatid cysts (infection establishment) and a later stage in which already differentiated cysts grow and eventually become fertile cysts (chronic infection). During infection establishment parasites are more susceptible to immune attack, thus our study focused on the immunological phenomena triggered early in the peritoneal cavity of experimentally infected mice. Our results suggest that early and local Th2-type responses are permissive for infection establishment.
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Vacirca D, Perdicchio M, Campisi E, Delunardo F, Ortona E, Margutti P, Teggi A, Gottstein B, Siracusano A. Favourable prognostic value of antibodies anti-HSP20 in patients with cystic echinococcosis: a differential immunoproteomic approach. Parasite Immunol 2011; 33:193-8. [PMID: 21306401 DOI: 10.1111/j.1365-3024.2010.01264.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Seeking biomarkers reflecting disease development in cystic echinococcosis (CE), we used a proteomic approach linked to immunological characterisation for the identification of respective antigens. Two-dimensional gel electrophoresis (2-DE) of sheep hydatid fluid, followed by immunoblot analysis (IB) with sera from patients with distinct phases of disease, enabled us to identify by mass spectrometry heat shock protein 20 (HSP20) as a potential marker of active CE. Using IB, antibodies specific to the 34 kDa band of HSP20 were detected in sera from 61/95 (64%) patients with CE, but not in sera from healthy subjects. IB revealed anti-HSP20 antibodies in a higher percentage of sera from patients with active disease than in sera from patients with inactive disease (81 vs. 24%; P = 10(-4)). These primary results were confirmed in a long-term follow-up study after pharmacological and surgical treatment. Herewith anti-HSP20 antibody levels significantly decreased over the course of treatment in sera from patients with cured disease, relative to sera from patients with progressive disease (P = 0·017). Thus, during CE, a comprehensive strategy of proteomic identification combined with immunological validation represents a promising approach for the identification of biomarkers useful for the prognostic assessment of treatment of CE patients.
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Affiliation(s)
- D Vacirca
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy
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