Immunology of a unique biological structure: the Echinococcus laminated layer

Echinococcus granulosus-Induced Liver Damage Through Ferroptosis in Rat Model

(1) Background: Cystic echinococcosis (CE) is an Echinococcus granulosus-induced worldwide parasitic zoonosis and is a recognized public health and socio-economic concern. The liver is the major target organ for CE's infective form protoscolex (PSCs), which causes serious liver damage and endangers the host's life. Reports show that PSC infection causes liver cell Fe2+ metabolism disorder and abnormal deposition of Fe2+ in liver cells and results in liver cell death. However, whether PSC-induced liver cell death is associated with ferroptosis remains to be clarified. (2) Methods: Using both an in vivo rat model and an in vitro co-culture of PSCs and the cell system, we studied the histopathological progress of PSCs infection and the cytopathogenesis of PSC-induced cell death in the liver. Hepatic-injury-related ferroptosis signaling pathways were identified by proteomics analysis at various stages of PSCs infection, and physiological and the biochemical indexes and expression of pathway proteins related to hepatic ferroptosis were studied. Ferrostatin-1, a ferroptosis inhibitor, was employed for in vivo interference with early protoscolices infection in rats, and the effects of the inhibition of hepatocyte ferroptosis on hepatocyte injury and the generation of fibrotic cysts were investigated. Additionally, PSCs were exposed to in vitro co-culture with BRL, a rat hepatocyte line, to clarify the direct influences of PSCs on BRL ferroptosis. (3) Results: The results of our in vivo studies revealed that PSCs infection induced Fe2+ enrichment in liver cells surrounding the PSCs cysts, cellular oxidation, and liver tissue damage along with the prolongation of PSCs parasitism. The results of our in vitro studies verified the ability of PSCs to directly induce ferroptosis, the formation of fibrotic cysts, and alteration of the iron metabolism of liver cells. The analysis of KEGG signaling pathways revealed that ferroptosis- and ROS-related pathways were significantly induced with PSCs infection. Using Ferrostatin-1 effectively blocked ferroptosis, reversed Fe2+ content, reduced liver cell oxidation, and reduced PSC-induced fibrosis cysts. (4) Conclusions: Our study reveals the histopathological progress of PSC infection and the cytopathogenesis of PSC-induced ferroptosis. Ferrostatin-1 effectively blocked PSCs infection and PSC-induced cell death in vivo and in vitro. Accordingly, the inhibition of PSC-induced hepatocyte ferroptosis may be an effective method in the control of Echinococcus granulosus infection and should be seriously considered in clinical studies.

Echinococcus granulosus' laminated layer immunomodulates nitric oxide, cytokines, and MMPs in PBMC from rheumatoid arthritis patients

Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease that affects the joints. Treatments are symptomatic and can induce side effects in some patients. In this sense and based on previous studies, our aim was to investigate the ex vivo immunoregulatory effect of the laminated layer (LL) during rheumatoid arthritis. LL is the outside layer of parasitic cyst of the helminth Echinococcus granulosus.Our main objective was to study the effect of LL on nitric oxide (NO) and cytokines production, matrix metalloproteinases (MMPs) activities, inducible NO synthase (iNOS) and nuclear factor κappa B (NF-κB) expression. In this context, cultures of peripheral blood mononuclear cells (PBMC) from Algerian RA patients in active (ARA) and inactive (IRA) stage of the disease were stimulated with LL extract (50, 100, 150μg/mL). However, PBMC from ARA patients were stimulated with methotrexate (MTX; 0.5μg/mL) and biological disease modifying anti-rheumatic drugs (bDMARDs): anti-TNFα (10μg/mL), anti-IL6 (10μg/mL), anti-CD20 (10μg/mL), alone or combined with LL (50μg/mL).Our results showed that LL reduced NO, TNF-α, and IL-17A production, MMP9/2 activities, and iNOS/NF-κB expression in PBMC from ARA patients. Concomitantly, LL increases IL-10 and TGF-β1 production in the same cultures. Interestingly, the decrease in NO production induced by bDMARDs was greater in association with LL.Collectively, our findings indicate a strong immunoregulatory effect of LL on NO, MMPs, and cytokines. LL probably acts through the NF-κB pathway. The development of biodrugs derived from LL of E. granulosus could be a potential candidate to modulate inflammation during RA.

Laminated Layer Extract from Echinococcus Granulosus cyst Attenuates Ocular Damages and Inflammatory Responses in an Experimental Autoimmune Uveitis Model

PURPOSE

Since extract of the laminated layer (LL) from E. granulosus showed immuno-modulatory effects in vitro and in vivo, we sought to determine its effect on the onset, development, and evolution of experimental auto-immune uveitis (EAU). The latter is a model of some human diseases with ocular inflammation that can cause blindness.

METHODS

E. granulosus LL extract was either injected before EAU induction for the pretreated group or later for treated group. Ocular exploration was made by retinal histological and immunohistological (CD86, CD4, CD8) analysis. Myeloperoxidase (MPO), Superoxide dismutase (SOD), Catalase enzymatic activities (CAT), and Malondialdehyde (MDA), Nitric oxide (NO), Urea, and TNF-α levels were measured in plasma.

RESULTS

LL injection attenuated retinal histological damage and reduced cells infiltration. Also, LL decreased systemic inflammatory and oxidative markers as well as TNF-α production and increased antioxidant parameters.

CONCLUSIONS

Interestingly, we observed a protective effect of E. granulosus LL extract during EAU. LL appears to ameliorate retinal damage by down-regulating inflammatory responses. Our results support LL immunomodulatory effects during autoimmune diseases and offer a promising prospect for helminthic therapy during autoimmune uveitis.

Management of Pathologic Hip Fracture Secondary to Musculoskeletal Echinococcosis: A Case Report

A 50-year-old female from Uzbekistan presented to our emergency department with severe right hip pain and loss of ambulation. Her history included multiple hepatic echinococcal cyst resections. After a fall, she underwent a proximal femur open reduction and internal fixation (ORIF) and revision in Uzbekistan, which revealed broken screws and cystic lesions. Subsequent treatment included hardware removal, proximal femur replacement, and antiparasitic therapy, leading to significant improvement. This case highlights the need for considering rare pathologies in atypical orthopedic presentations and demonstrates the effectiveness of integrating detailed history, careful diagnostics, and coordinated care to manage challenging conditions.

Mucins Shed from the Laminated Layer in Cystic Echinococcosis Are Captured by Kupffer Cells via the Lectin Receptor Clec4F

Cystic echinococcosis is caused by the larval stages (hydatids) of cestode parasites belonging to the species cluster Echinococcus granulosus sensu lato, with E. granulosus sensu stricto being the main infecting species. Hydatids are bladderlike structures that attain large sizes within various internal organs of livestock ungulates and humans. Hydatids are protected by the massive acellular laminated layer (LL), composed mainly of mucins. Parasite growth requires LL turnover, and abundant LL-derived particles are found at infection sites in infected humans, raising the question of how LL materials are dealt with by the hosts. In this article, we show that E. granulosus sensu stricto LL mucins injected into mice are taken up by Kupffer cells, the liver macrophages exposed to the vascular space. This uptake is largely dependent on the intact mucin glycans and on Clec4F, a C-type lectin receptor which, in rodents, is selectively expressed in Kupffer cells. This uptake mechanism operates on mucins injected both in soluble form intravenously (i.v.) and in particulate form intraperitoneally (i.p.). In mice harboring intraperitoneal infections by the same species, LL mucins were found essentially only at the infection site and in the liver, where they were taken up by Kupffer cells via Clec4F. Therefore, shed LL materials circulate in the host, and Kupffer cells can act as a sink for these materials, even when the parasite grows in sites other than the liver.