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Gómez-Mateos M, Arrebola F, Navarro MC, Romero MC, González JM, Valero A. Acute Anisakiasis: Pharmacological Evaluation of Various Drugs in an Animal Model. Dig Dis Sci 2021; 66:105-113. [PMID: 32107679 DOI: 10.1007/s10620-020-06144-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 02/11/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The accidental ingestion of the third larval stage of Anisakis can cause acute clinical symptoms, which are relieved via extraction of the larvae. Although this is a highly effective technique, it can only be practiced when the larvae are found in accessible areas of the gastrointestinal tract, and therefore instead the condition has often been treated using various different drugs. AIMS This study evaluates the effectiveness of gastric acid secretion inhibitors (omeprazole and ranitidine), gastric mucosal protectants (sucralfate) and anthelmintics (mebendazole and flubendazole) in treating anisakiasis in Wistar rats. METHODS Rats were infected with Anisakis-type I larvae and administered the drugs via a gastric probe. Data were recorded regarding the number of live and dead larvae, their location both within the animal and in its feces, and the presence of gastrointestinal lesions. Additionally, gastric pH was measured and histology performed. RESULTS While rats in all experimental groups exhibited lesions; those treated with ranitidine and mebendazole showed significantly fewer lesions (50% and 35% of rats exhibited lesions, respectively). Histological examination of the gastric lesions revealed infection-induced changes, but no significant differences were observed between the treated and untreated rats. CONCLUSIONS Mebendazole was found to be most efficacious in preventing gastrointestinal lesions, followed by ranitidine, which was the most effective antacid of those studied. Both these drugs could thus be considered as part of the conservative management of anisakiasis.
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Affiliation(s)
- Magdalena Gómez-Mateos
- Department of Parasitology, Faculty of Pharmacy, University of Granada, Campus de Cartuja s/n, 18071, Granada, Spain.
| | - Francisco Arrebola
- Department of Histology, Faculty of Medicine, University of Granada, Avenida de la Investigación 11, 18071, Granada, Spain
| | - María Concepción Navarro
- Department of Pharmacology, Faculty of Pharmacy, University of Granada, Campus de Cartuja s/n, 18071, Granada, Spain
| | - María Carmen Romero
- Department of Parasitology, Faculty of Pharmacy, University of Granada, Campus de Cartuja s/n, 18071, Granada, Spain
| | - José María González
- Pharmacy Services, University Hospital San Cecilio of Granada, Calle Dr. Olóriz, 16, 18012, Granada, Spain
| | - Adela Valero
- Department of Parasitology, Faculty of Pharmacy, University of Granada, Campus de Cartuja s/n, 18071, Granada, Spain
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Kawashima K, Fujiwara T, Katakura K, Gunji N, Yokokawa A, Sakamoto A, Hikichi T, Kono K, Ohira H. Anisakiasis in the Small Intestine with Excessive Bleeding That Was Difficult to Diagnose Endoscopically. Intern Med 2019; 58:63-66. [PMID: 30146603 PMCID: PMC6367072 DOI: 10.2169/internalmedicine.1482-18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Anisakiasis involves the stomach in most cases and occurs rarely in the small intestine. Anisakiasis in the small intestine is associated with abdominal pain and obstruction and is rarely associated with intestinal bleeding. Unlike in the stomach, anisakiasis in the small intestine is difficult to diagnose anatomically. The patient in this case study developed hypovolemic shock due to excessive bleeding and underwent emergency surgery. With the recent increase in the consumption of raw fish around the world, this report provides an important finding of bleeding in the small intestine due to an unknown cause.
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Affiliation(s)
- Kazumasa Kawashima
- Department of Gastroenterology, Fukushima Medical University School Medicine, Japan
| | - Tatsuo Fujiwara
- Department of Gastroenterology, Fukushima Medical University School Medicine, Japan
| | - Kyoko Katakura
- Department of Gastroenterology, Fukushima Medical University School Medicine, Japan
| | - Naohiko Gunji
- Department of Gastroenterology, Fukushima Medical University School Medicine, Japan
| | - Aki Yokokawa
- Department of Gastroenterology, Fukushima Medical University School Medicine, Japan
| | - Ayumu Sakamoto
- Department of Gastrointestinal Surgery, Fukushima Medical University School Medicine, Japan
| | - Takuto Hikichi
- Department of Endoscopy, Fukushima Medical University Hospital, Japan
| | - Koji Kono
- Department of Gastrointestinal Surgery, Fukushima Medical University School Medicine, Japan
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School Medicine, Japan
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Guardone L, Armani A, Nucera D, Costanzo F, Mattiucci S, Bruschi F. Human anisakiasis in Italy: a retrospective epidemiological study over two decades. Parasite 2018; 25:41. [PMID: 30058531 PMCID: PMC6065268 DOI: 10.1051/parasite/2018034] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 06/12/2018] [Indexed: 12/24/2022] Open
Abstract
A retrospective analysis on human anisakiasis in Italy since its first description in 1996 was performed by conducting a literature search. Inclusion criteria based on the presence of a larva and on parasite identification were applied. Epidemiological data and clinical features were analysed. Particular attention was paid to the source of infection. In total, 73 cases were included in the analysis, while 34 were excluded. Cases were reported from eight Italian regions, most frequently Abruzzo, Apulia and Latium. The parasite was detected by endoscopy (51.4%) or laparotomy (48.6%). The site of infection was intestinal (42.5%), gastric (43.8%), oesophageal (1.4%) or ectopic (12.3%). Most of the parasites (71.0%) were identified as Anisakis sp. or A. simplex (s.l.). However, when molecular methods were used (21 cases), A. pegreffii was always identified. In most of the patients (65.7%), the source of infection was raw or undercooked anchovies, followed by "anchovies or sardines" (15.1%), generic "raw seafood" (15.1%), and sardines (1.4%). In only 2 cases (2.7%), the source was not available. This is the first systematic analysis of Italian cases of anisakiasis. The main conclusions derived from the results are: i) attention should be given to the history, in particular when raw marinated anchovies, proven to be the main source of human anisakiasis in Italy, are consumed; ii) in order to assess correct epidemiological data, a confirmed and specific etiological identification should always be sought.
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Affiliation(s)
- Lisa Guardone
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FishLab, Department of Veterinary Sciences, University of Pisa Via delle Piagge 2 56124
Pisa Italy
| | - Andrea Armani
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FishLab, Department of Veterinary Sciences, University of Pisa Via delle Piagge 2 56124
Pisa Italy
| | - Daniele Nucera
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Department of Agriculture, Forestry and Food Science, University of Turin Largo Braccini 2 10095
Grugliasco – Torino Italy
| | - Francesco Costanzo
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FishLab, Department of Veterinary Sciences, University of Pisa Via delle Piagge 2 56124
Pisa Italy
| | - Simonetta Mattiucci
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Department of Public Health and Infectious Diseases, Section of Parasitology, “Sapienza – University of Rome”, Laboratory affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti P.le Aldo Moro, 5 00185
Rome Italy
| | - Fabrizio Bruschi
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Department of Translational Research, N.T.M.S., School of Medicine, University of Pisa via Roma, 55 56126
Pisa Italy
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Zanelli M, Ragazzi M, Fiorino S, Foroni M, Cecinato P, Del Mar Jordana Sanchez M, Ascani S, De Marco L. An Italian case of intestinal anisakiasis with a presurgical diagnosis: Could this parasite represent an emerging disease? Pathol Res Pract 2017; 213:558-564. [PMID: 28325642 DOI: 10.1016/j.prp.2017.01.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/22/2017] [Accepted: 01/23/2017] [Indexed: 12/19/2022]
Abstract
Anisakiasis is a parasitic infection caused by the consumption of raw fish containing larvae of the Anisakis species. Since the first description in 1960 of a patient suffering from this pathogen, in the Netherlands, most of the cases have been reported in Japan, where consumption of raw fish is common, but the number of cases is increasing worldwide. The first case identified in Italy dates back to 1996 and a few cases have been reported since then. In Italy the intestinal form occurs almost as frequently as the gastric form, which is far more frequent in Japan. Intestinal Anisakiasis represents a diagnostic challenge as it is clinically misdiagnosed and most of the patients require surgery due to the occurrence of complications such as bowel occlusion or perforation. Practically no cases of the intestinal form are diagnosed preoperatively. We report the first case, to our knowledge, of intestinal Anisakiasis in which surgery was avoided, due to a prompt diagnosis suspected on intestinal biopsies. A literature review of Anisakiasis cases reported in Italy is also carried out.
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Affiliation(s)
- Magda Zanelli
- Anatomic Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Moira Ragazzi
- Anatomic Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy.
| | - Sirio Fiorino
- Unità Operativa Semplice Dipartimentale di Medicina Interna C, Ospedale Maggiore, Bologna, Italy
| | - Moira Foroni
- Anatomic Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Paolo Cecinato
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | | | - Stefano Ascani
- Institute of Pathology, Ospedale di Terni, University of Perugia, Perugia, Italy
| | - Loredana De Marco
- Anatomic Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
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Colombo F, Cattaneo P, Castelletti M, Bernardi C. Prevalence and Mean Intensity of Anisakidae Parasite in Seafood Caught in the Mediterranean Sea Focusing on Fish Species at Risk of Being Raw-consumed. A Meta Analysis and Systematic Review. Crit Rev Food Sci Nutr 2017; 56:1405-16. [PMID: 25807208 DOI: 10.1080/10408398.2012.755947] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the prevalence and mean intensity of anisakids in seafood caught in the Mediterranean Sea, focusing on fish species at risk of being raw-consumed. DESIGN Systematic review and meta-analysis of studies published from 1960-2012. STUDY SELECTION Main criteria for the inclusion of studies were as follows: Findings of anisakid larvae, in both muscles and viscera; fish species for human consumption caught in the Mediterranean Sea; prevalence and mean intensity data for each species; and sample size equal to or more than 40 fishes. RESULTS Twelve studies were identified. Among these, four studies considered the following three fish species that are often consumed raw or preserved lightly, or not cooked thoroughly: anchovy, pilchard, and Atlantic mackerel. DATA SYNTHESIS All pooled analyses were based on the random-effect model. Anisakids prevalence in fish muscle was 0.64% (P < 0.0001), in viscera it was 1.34% (P < 0.0001), and overall prevalence was 0.95% (P < 0.0001). Mean intensity in muscle was 2.31 (P = 0.0083), in viscera it was 1.55 (P = 0.0174), and overall it was 1.81 (P < 0.0005). Heterogeneity indices (I(2)) were significantly high with the exception of viscera mean intensity. CONCLUSIONS Anchovy, pilchard, and Atlantic mackerel have a low prevalence and mean intensity of anisakidae larvae in both viscera and muscles. Mean Intensity was also low.
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Affiliation(s)
- Fabio Colombo
- a Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare , Università Degli Studi di Milano , Milano , Italy
| | - Patrizia Cattaneo
- a Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare , Università Degli Studi di Milano , Milano , Italy
| | - Maddalena Castelletti
- a Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare , Università Degli Studi di Milano , Milano , Italy
| | - Cristian Bernardi
- a Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare , Università Degli Studi di Milano , Milano , Italy
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Valero A, Romero MC, Gómez-Mateos M, Hierro I, Navarro MC. Natural products: Perspectives in the pharmacological treatment of gastrointestinal anisakiasis. ASIAN PAC J TROP MED 2015; 8:612-7. [PMID: 26321513 DOI: 10.1016/j.apjtm.2015.07.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 06/20/2015] [Accepted: 07/15/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate the activity of different natural products against L3 larvae of Anisakis type I. METHODS Information on investigations into the activity of natural products against the L3 larvae of Anisakis simplex was collected from scientific journals, books, theses and reports via a library and electronic search (using Pubmed, Scopus, Medline, Web of Science and ScienceDirect). The search terms included: natural products, medicinal plants, essential oils, terpenic derivatives, Anisakis, antinematodal activity. RESULTS In the literature reviewed numerous papers were found concerning the in vitro and in vivo activity against Anisakis type I of various natural products (plant extracts, essential oils and their major components). Analysis of the results showed that in vitro tests the Melaleuca alternifolia essential oil and the ar-turmerone isolated from Curcuma longa displayed the greatest activity. In vivo, the most active compound was perillaldehyde, the main component of Perilla frutescens essential oil. CONCLUSIONS This study shows that some natural products exhibited promising antianisakis properties.
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Affiliation(s)
- A Valero
- Department of Parasitology, Faculty of Pharmacy, University of Granada, Spain
| | - M C Romero
- Department of Parasitology, Faculty of Pharmacy, University of Granada, Spain
| | - M Gómez-Mateos
- Department of Parasitology, Faculty of Pharmacy, University of Granada, Spain.
| | - I Hierro
- Department of Parasitology, Faculty of Pharmacy, University of Granada, Spain
| | - M C Navarro
- Department of Pharmacology, Faculty of Pharmacy, University of Granada, Spain
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Romero MC, Navarro MC, Martín-Sánchez J, Valero A. Peppermint (Mentha piperita) and albendazole against anisakiasis in an animal model. Trop Med Int Health 2014; 19:1430-6. [PMID: 25330410 DOI: 10.1111/tmi.12399] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Therapy against anisakiasis requires invasive techniques to extract L3 , and an effective drug against this nematode is needed. The aim of this study was to determine the efficacy of peppermint essential oil (EO) and its main components against the parasite in comparison to albendazole, a drug currently prescribed to treat anisakiasis. METHODS We conducted in vitro experiments and studied an experimental model simulating the human infection in Wistar rats. We used polymerase chain reaction restriction fragment length polymorphism to identify A. simplex s.s. and A. pegreffii and determine any differences in their pathogenicity and susceptibility to the treatments. RESULTS The in vitro and in vivo experiments both showed that the larvicidal activity of peppermint EO, menthol, menthone and menthyl acetate is higher than that of albendazole. Large stomach lesions were observed in 46.7% of the albendazole-treated rats, whereas no gastrointestinal lesions were detected in those treated with peppermint EO, menthol, menthyl acetate or menthone. CONCLUSIONS In this animal model, treatment with peppermint EO or its main components was more effective than was treatment with albendazole. Lesions were more frequently produced by A. simplex s.s. larvae than by A. pegreffii larvae.
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Affiliation(s)
- Ma Carmen Romero
- Department of Parasitology, University of Granada, Granada, Spain
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