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Aye NN, Maraming P, Tippayawat P, Daduang S, Techasen A, Sithithaworn P, Rujanakraikarn R, Jearanaikoon N, Phatthanakun R, Supruangnet R, Photongkam P, Daduang J. Synthesis and Characterization of a Novel All-in-One Graphene Oxide-Nafion Polymer Bioconjugate for Application in Electrochemical Biosensing of the Opisthorchis viverrini Antigen. ACS OMEGA 2025; 10:13621-13633. [PMID: 40224412 PMCID: PMC11983171 DOI: 10.1021/acsomega.5c00633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2025] [Revised: 02/19/2025] [Accepted: 03/18/2025] [Indexed: 04/15/2025]
Abstract
Bioconjugates in electrochemical biosensors can significantly enhance the detection process and sensitivity. In this study, we synthesized a monoclonal antibody-conjugated nanocomposite of graphene oxide and Nafion (GO-Nf-mAb) for application in an electrochemical biosensor as a novel all-in-one bioreceptor. The incorporation of Nafion (Nf) improved the stability, dispersity, and antibody immobilization on the GO surface, thereby increasing the sensitivity of the biosensor. The impact of Nafion on GO stability and antibody conjugation was thoroughly investigated and compared to that of Nafion-free conjugation via various characterization techniques, including X-ray photoelectron spectroscopy (XPS) and synchrotron radiation near-edge X-ray absorption fine structure. The presence of Nafion during monoclonal antibody (mAb) conjugation resulted in an increased peak intensity of the NH2 band in XPS analysis and the highest intensity of C=O groups in O-K edge analysis, indicating a greater yield of the antibody. This innovative electrochemical biosensor exhibited a low detection limit of 1.68 ng mL-1 in spiked urine, a wide linear range, and high reproducibility, outperforming conventional detection methods for Opisthorchis viverrini (OV) antigen detection. Our developed electrochemical biosensor introduces a novel and straightforward fabrication process using an all-in-one bioconjugate that serves as a bioreceptor, transducer, and blocking reagent simultaneously. Overall, this study offers a new insight on Nafion application in bioconjugation, and the GO-Nf-mAb conjugate-based electrochemical biosensor promises high sensitivity and a hassle-free immobilization process for OV antigen quantification.
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Affiliation(s)
- Nang Noon
Shean Aye
- Biomedical
Sciences Program, Graduate School, Khon
Kaen University, Khon Kaen 40002, Thailand
- Centre
for
Research and Development of Medical Diagnostic Laboratories, Faculty
of Associated Medical Sciences, Khon Kaen
University, Khon Kaen 40002, Thailand
| | - Pornsuda Maraming
- Centre
for
Research and Development of Medical Diagnostic Laboratories, Faculty
of Associated Medical Sciences, Khon Kaen
University, Khon Kaen 40002, Thailand
| | - Patcharaporn Tippayawat
- Centre
for
Research and Development of Medical Diagnostic Laboratories, Faculty
of Associated Medical Sciences, Khon Kaen
University, Khon Kaen 40002, Thailand
| | - Sakda Daduang
- Division
of Pharmacognosy and Toxicology, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Anchalee Techasen
- Centre
for
Research and Development of Medical Diagnostic Laboratories, Faculty
of Associated Medical Sciences, Khon Kaen
University, Khon Kaen 40002, Thailand
- Cholangiocarcinoma
Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Paiboon Sithithaworn
- Cholangiocarcinoma
Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand
- Department
of Parasitology, Faculty of Medicine, Khon
Kaen University, Khon Kaen 40002, Thailand
| | - Roengrut Rujanakraikarn
- Synchrotron
Light Research Institute (Public Organization), Nakhon Ratchasima 30000, Thailand
| | - Nichada Jearanaikoon
- Synchrotron
Light Research Institute (Public Organization), Nakhon Ratchasima 30000, Thailand
| | - Rungrueang Phatthanakun
- Synchrotron
Light Research Institute (Public Organization), Nakhon Ratchasima 30000, Thailand
| | | | - Pat Photongkam
- Synchrotron
Light Research Institute (Public Organization), Nakhon Ratchasima 30000, Thailand
| | - Jureerut Daduang
- Centre
for
Research and Development of Medical Diagnostic Laboratories, Faculty
of Associated Medical Sciences, Khon Kaen
University, Khon Kaen 40002, Thailand
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2
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Wongphutorn P, Kopolrat KY, Worasith C, Eamudomkarn C, Hongsrichan N, Pitaksakulrat O, Sithithaworn J, Tippayawat P, Techasen A, Noordin R, Crellen T, Sithithaworn P. Diagnostic value of urinary and serum IgG antibodies in evaluating drug treatment response in strongyloidiasis assessed by fecal examination and digital droplet PCR. PLoS One 2024; 19:e0306732. [PMID: 39625913 PMCID: PMC11614296 DOI: 10.1371/journal.pone.0306732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 11/13/2024] [Indexed: 12/06/2024] Open
Abstract
Detection of Strogyloides-specific IgG antibodies in urine and serum has been used in diagnostic and epidemiological studies on strongyloidiasis. However, the usefulness of these assays in assessing responses to anthelmintic treatment is unclear. Thus, we evaluated the diagnostic performance and temporal profiles of Strongyloides-specific IgG antibodies in a cohort of participants at baseline and post-treatment. The participants were prospectively screened for baseline parasitic infections by fecal examination [agar plate culture technique (APCT) and formalin-ethyl acetate concentration technique (FECT)] and digital droplet polymerase reaction (ddPCR) for Strongyloides stercoralis. At each sampling point, Strongyloides-specific IgG in urine and serum were measured by an in-house S. ratti-based enzyme-linked immunosorbent assay (ELISA). At baseline, 169 of 351 participants (48.1%) had S. stercoralis infection by the combined fecal examination and ddPCR. The diagnostic sensitivities of IgG in urine and serum were 91.1% and 88.2%, respectively. The participants were given treatment with a single oral dose of ivermectin (IVM, 200 μg/kg) and were followed up by fecal and immunological diagnosis at 3 to 18 months post-treatment. The cure rate of IVM treatment evaluated by APCT and ddPCR was 88.3% at three months post-treatment. The profiles of IgG in urine in the curative treatment group showed a significant trend of decline with time post-treatment (Kruskal-Wallis test = 113.4-212.6, p value < 0.0001) and the lowest levels were seen 12 months post-treatment. The treatment response (> 50% reduction in urinary IgG antibody units) was 100%, and conversion from positive to negative results was 65.4%. The treatment response and conversion to negative assessed by serum IgG-ELISA were similar to those by urine IgG-ELISA. The results from this long-term diagnostic study highlight the utility of urinary IgG and serum IgG for screening and monitoring treatment outcomes in strongyloidiasis.
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Affiliation(s)
- Phattharaphon Wongphutorn
- Biomedical Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
| | - Kulthida Y. Kopolrat
- Faculty of Public Health, Kasetsart University Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
| | - Chanika Worasith
- Department of Adult Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
| | - Chatanun Eamudomkarn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nuttanan Hongsrichan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Opal Pitaksakulrat
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jiraporn Sithithaworn
- Department of Medical Technology, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Patcharaporn Tippayawat
- Department of Medical Technology, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Anchalee Techasen
- Department of Medical Technology, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Rahmah Noordin
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan, Kuala Lumpur, Malaysia
| | - Thomas Crellen
- School of Biodiversity One Health and Veterinary Medicine, Graham Kerr Building, University of Glasgow, Glasgow, United Kingdom
| | - Paiboon Sithithaworn
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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3
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Qian MB, Keiser J, Utzinger J, Zhou XN. Clonorchiasis and opisthorchiasis: epidemiology, transmission, clinical features, morbidity, diagnosis, treatment, and control. Clin Microbiol Rev 2024; 37:e0000923. [PMID: 38169283 PMCID: PMC10938900 DOI: 10.1128/cmr.00009-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/18/2023] [Indexed: 01/05/2024] Open
Abstract
Clonorchis sinensis, Opisthorchis viverrini, and Opisthorchis felineus are important liver flukes that cause a considerable public health burden in eastern Asia, southeastern Asia, and eastern Europe, respectively. The life cycles are complex, involving humans, animal reservoirs, and two kinds of intermediate hosts. An interplay of biological, cultural, ecological, economic, and social factors drives transmission. Chronic infections are associated with liver and biliary complications, most importantly cholangiocarcinoma. With regard to diagnosis, stool microscopy is widely used in epidemiologic surveys and for individual diagnosis. Immunologic techniques are employed for screening purposes, and molecular techniques facilitate species differentiation in reference laboratories. The mainstay of control is preventive chemotherapy with praziquantel, usually combined with behavioral change through information, education and communication, and environmental control. Tribendimidine, a drug registered in the People's Republic of China for soil-transmitted helminth infections, shows potential against both C. sinensis and O. viverrini and, hence, warrants further clinical development. Novel control approaches include fish vaccine and biological control. Considerable advances have been made using multi-omics which may trigger the development of new interventions. Pressing research needs include mapping the current distribution, disentangling the transmission, accurately estimating the disease burden, and developing new diagnostic and treatment tools, which would aid to optimize control and elimination measures.
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Affiliation(s)
- Men-Bao Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, People’s Republic of China
- NHC Key Laboratory of Parasite and Vector Biology, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, People’s Republic of China
- NHC Key Laboratory of Parasite and Vector Biology, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
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4
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Saijuntha W, Sithithaworn P, Wangboon C, Andrews RH, Petney TN. Liver Flukes: Clonorchis and Opisthorchis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1454:239-284. [PMID: 39008268 DOI: 10.1007/978-3-031-60121-7_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Clonorchis sinensis, Opisthorchis viverrini and O. felineus are liver flukes of human and animal pathogens occurring across much of Europe and Asia. Nevertheless, they are often underestimated compared to other, better known neglected diseases in spite of the fact that many millions of people are infected and hundreds of millions are at risk. This is possibly because of the chronic nature of the infection and disease and that it takes several decades prior to a life-threatening pathology to develop. Several studies in the past decade have provided more information on the molecular biology of the liver flukes which clearly lead to better understanding of parasite biology, systematics and population genetics. Clonorchiasis and opisthorchiasis are characterized by a chronic infection that induces hepatobiliary inflammation, especially periductal fibrosis, which can be detected by ultrasonography. These chronic inflammations eventually lead to cholangiocarcinoma (CCA), a usually fatal bile duct cancer that develops in some infected individuals. In Thailand alone, opisthorchiasis-associated CCA kills up to 20,000 people every year and is therefore of substantial public health importance. Its socioeconomic impacts on impoverished families and communities are considerable. To reduce hepatobiliary morbidity and CCA, the primary intervention measures focus on control and elimination of the liver fluke. Accurate diagnosis of liver fluke infections in both human and other mammalian, snail and fish intermediate hosts is important for achieving these goals. While the short-term goal of liver fluke control can be achieved by praziquantel chemotherapy, a comprehensive health education package targeting school children is believed to be more beneficial for a long-term goal/solution. It is recommended that transdisciplinary research or multisectoral control approach including one health and/or eco health intervention strategy should be applied to combat the liver flukes and hence contribute to reduction of CCA in endemic areas.
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Affiliation(s)
| | - Paiboon Sithithaworn
- Department of Parasitology and Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
| | - Chompunoot Wangboon
- School of Preclinical Sciences, Institute of Science, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Ross H Andrews
- CASCAP, Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Trevor N Petney
- CASCAP, Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Paleontology and Evolution, State Museum of Natural History, Karlsruhe, Germany
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5
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Tan S, Machrumnizar M. Fish and Food-Fatale: Food-borne Trematode Opisthorchis viverrini and Cholangiocarcinoma. Helminthologia 2023; 60:287-299. [PMID: 38222491 PMCID: PMC10787637 DOI: 10.2478/helm-2023-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/20/2023] [Indexed: 01/16/2024] Open
Abstract
Neglected Tropical Diseases (NTDs) are a group of communicable diseases with a long history with human beings. NTDs are the proxy of poverty since they affect those in low-income and extreme-poverty populations, as those populations lack access to proper health care, clean water, sanitary conditions, and hygiene. NTDs create losses for a nation that come from the health and the economic sectors as well since the costs of diagnosis, prevention, and treatment strain the national purse strings. One of the 20 different forms of NTDs on the list is food-borne trematodes, comprises of Fasciola, Paragonimus, Clonorchis, and Opisthorchis. Currently, it is estimated that food-borne trematodes can cause a devastating effect on mortality and morbidity. All of them are zoonotic, as humans become infected by ingestion of a second intermediate host, such as freshwater snails, fish, or water vegetables. Opisthorchis viverrini, one of the food-borne trematodes that can be found mostly in South East Asia regions, especially in the Mekong basin, is regarded as a group 1 carcinogen leading to cholangiocarcinoma (CCA). This study aims to present the updated review of Opisthorchis viverrini and CCA.
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Affiliation(s)
- S. Tan
- Department of Parasitology, Faculty of Medicine, Universitas Trisakti, Jakarta11440, Indonesia
- Tropical Diseases and Public Health Research Centre, Faculty of Medicine, Universitas Trisakti, Jakarta11440, Indonesia
| | - M. Machrumnizar
- Department of Parasitology, Faculty of Medicine, Universitas Trisakti, Jakarta11440, Indonesia
- Tropical Diseases and Public Health Research Centre, Faculty of Medicine, Universitas Trisakti, Jakarta11440, Indonesia
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6
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Worasith C, Sithithaworn J, Wongphutorn P, Homwong C, Khongsukwiwat K, Techasen A, Kopolrat KY, Loilome W, Namwat N, Thinkamrop B, Tawarungruang C, Titapun A, Laha T, Andrews RH, Taylor-Robinson SD, Sithithaworn P. Accuracy of a new rapid diagnostic test for urinary antigen detection and assessment of drug treatment in opisthorchiasis. Infect Dis Poverty 2023; 12:102. [PMID: 37990282 PMCID: PMC10662682 DOI: 10.1186/s40249-023-01162-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/15/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Screening for opisthorchiasis, a parasitic worm infection affecting many millions of people in Southeast Asia, has traditionally relied on faecal egg examination such as the formalin-ethyl acetate concentration technique (FECT) and Kato-Katz method. Although the urinary enzyme-linked immunosorbent assay (ELISA) has been used more recently, we developed a urinary antigen-based rapid diagnostic test (RDT) to simplify diagnosis and as a point-of-care testing (POCT) and field applications for surveillance and control of opisthorchiasis. METHODS A urinary Opisthorchis viverrini (OV)-RDT was developed using immunochromatographic methodology with a specific monoclonal antibody against OV. The diagnostic performance of the urinary OV-RDT was compared to that of quantitative faecal FECT and urinary antigen ELISA (n = 493). Cross-reactivities of urinary OV-RDT with other helminthiases coexisted with O. viverrini were determined (n = 96). A field trial in the application of urinary OV-RDT was compared with urinary antigen ELISA at baseline screening and assessment of drug treatment outcomes in opisthorchiasis (n = 1629). The McNemar chi-square, Kruskal-Wallis and Cohen's kappa coefficient (κ-value) tests were used for statistical analyses. RESULTS Urinary OV-RDT had sensitivity of 94.2% and specificity of 93.2%, compared to faecal FECT. Urinary OV-RDT had high diagnostic agreement (Kappa = 0.842-0.874, P < 0.001) and quantitative correlation with urinary antigen ELISA (Kruskal-Wallis tests = 316.2, P < 0.0001) and faecal FECT (Kruskal-Wallis tests = 362.3, P < 0.0001). The positive rates by OV-RDT, ELISA and FECT were 48.9%, 52.5% and 49.3%, respectively. Cross-reactions of urinary OV-RDT with other helminthiases were few (2%). Field trials of urinary OV-RDT yielded comparable prevalence of O. viverrini between urinary OV-RDT (53.2%) and urinary antigen ELISA (54.0%). OV screening showed high diagnostic agreement (kappa > 0.8, P < 0.0001) between urinary OV-RDT and urinary antigen ELISA. The cure rates of opisthorchiasis at 1 month post-praziquantel treatment determined by urinary OV-RDT (86.6%) and urinary antigen ELISA (80.5%) were similar (P > 0.05). CONCLUSIONS The urinary OV-RDT test has high potential as a new tool for screening and evaluating treatment outcomes in opisthorchiasis. The ease of sample collection and simplicity of urinary OV-RDT may facilitate mass screening, control and elimination of opisthorchiasis, thereby contributing to a reduction in the disease burden in Southeast Asia.
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Affiliation(s)
- Chanika Worasith
- Department of Adult Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
| | - Jiraporn Sithithaworn
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Phattharaphon Wongphutorn
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Biomedical Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand
| | - Chutima Homwong
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
| | | | - Anchalee Techasen
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Kulthida Y Kopolrat
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Faculty of Public Health, Kasetsart University Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
| | - Watcharin Loilome
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Systems Biosciences and Computational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Khon Kaen University Phenome Centre, Khon Kaen University, Khon Kaen, Thailand
| | - Nisana Namwat
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Systems Biosciences and Computational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Khon Kaen University Phenome Centre, Khon Kaen University, Khon Kaen, Thailand
| | - Bandit Thinkamrop
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Chaiwat Tawarungruang
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Attapol Titapun
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Thewarach Laha
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ross H Andrews
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
- Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Simon D Taylor-Robinson
- Division of Digestive Health, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Paiboon Sithithaworn
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
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7
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Liau MYQ, Toh EQ, Shelat VG. Opisthorchis viverrini-Current Understanding of the Neglected Hepatobiliary Parasite. Pathogens 2023; 12:795. [PMID: 37375485 PMCID: PMC10301378 DOI: 10.3390/pathogens12060795] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 05/28/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Opisthorchiasis due to Opisthorchis viverrini infection continues to be a significant public healthcare concern in various subregions of Southeast Asia, particularly in Thailand, Laos, Cambodia, Myanmar, and Vietnam. The main mode of transmission is via consumption of raw or undercooked fish, which is deeply embedded in the culture and tradition of the people living near the Mekong River. After ingestion, the flukes migrate to the bile ducts, potentially causing many hepatobiliary complications, including cholangitis, cholecystitis, cholelithiasis, advanced periductal fibrosis and cholangiocarcinoma. Several mechanisms of opisthorchiasis-associated cholangiocarcinogenesis have been proposed and elucidated in the past decade, providing insight and potential drug targets to prevent the development of the sinister complication. The gold standard for diagnosing opisthorchiasis is still via stool microscopy, but the advent of novel serological, antigen, and molecular tests shows promise as more convenient, alternative diagnostic methods. The mainstay of treatment of opisthorchiasis is praziquantel, while treatment of opisthorchiasis-associated cholangiocarcinoma depends on its anatomic subtype and resectability. Thus far, the most successful fluke control programme is the Lawa model based in Thailand, which raised awareness, incorporated education, and frequent surveillance of intermediate hosts to reduce transmission of opisthorchiasis. Development of vaccines using tetraspanins shows promise and is currently ongoing.
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Affiliation(s)
- Matthias Yi Quan Liau
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore
| | - En Qi Toh
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore 308232, Singapore
| | - Vishalkumar Girishchandra Shelat
- Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
- Surgical Science Training Centre, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
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8
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Worasith C, Wongphutorn P, Kopolrat KY, Homwong C, Techasen A, Thanan R, Wangboon C, Eamudomkarn C, Sithithaworn J, Crellen T, Sithithaworn P. Long-term Persistence of Opisthorchis viverrini Antigen in Urine: A Prospective Study in Northeast Thailand. Am J Trop Med Hyg 2023; 108:356-358. [PMID: 36572008 PMCID: PMC9896324 DOI: 10.4269/ajtmh.22-0478] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/10/2022] [Indexed: 12/27/2022] Open
Abstract
Antigen detected in urine for the diagnosis of opisthorchiasis has a low daily variation; however, the longer term variability in antigen concentrations is unknown. In this study, we prospectively monitored Opisthorchis viverrini antigen concentrations for 30 consecutive days and at subsequent monthly intervals in a cohort of opisthorchiasis-positive individuals. On the basis of the monoclonal antibody-based ELISA, the profiles of antigen-positive rate and antigen concentration exhibited no significant change over 30 days with a mean proportion positive of 87.1% (range 73.7%-100%), and the average antigen concentration was 29.7 ± 2.2 ng/mL (mean ± SE). The urine antigen concentration at baseline was similar to the subsequent measurements at 2, 4, 6, and 10 months in the follow-up study (P > 0.05). The consistency and low daily and long-term fluctuation of O. viverrini antigen in urine demonstrates the reliability of urine assay for diagnosis of opisthorchiasis.
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Affiliation(s)
- Chanika Worasith
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Thailand;,Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
| | - Phattharaphon Wongphutorn
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand;,Biomedical Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand
| | - Kulthida Y. Kopolrat
- Faculty of Public Health, Kasetsart University Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
| | - Chutima Homwong
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
| | - Anchalee Techasen
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand;,Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Raynoo Thanan
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chompunoot Wangboon
- School of Preclinical Science, Institute of Science, Suranaree University of Technology, Nakhon Rachasima, Thailand
| | - Chatanun Eamudomkarn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Thailand;,Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
| | | | - Thomas Crellen
- School of Biodiversity, One Health and Veterinary Medicine, Glasgow, United Kingdom;,Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Paiboon Sithithaworn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Thailand;,Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand;,Address correspondence to Paiboon Sithithaworn, Department of Parasitology, Faculty of Medicine, Khon Kaen University, 123 Mitraparb Road, Khon Kaen 40002, Thailand. E-mail:
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Khuntikeo N, Thinkhamrop B, Crellen T, Eamudomkarn C, Petney TN, Andrews RH, Sithithaworn P. Epidemiology and Control of Opisthorchis viverrini Infection: Implications for Cholangiocarcinoma Prevention. Recent Results Cancer Res 2023; 219:27-52. [PMID: 37660330 DOI: 10.1007/978-3-031-35166-2_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
It is known that Opisthorchis viverrini (OV) is the most significant risk factor for the development of cholangiocarcinoma (CCA); hence, it is also known as carcinogenic parasite. Effective control and elimination of OV infection should significantly reduce O. viverrini-related CCA. This chapter includes details of the three recently developed innovative tools, namely the Isan cohort database software, an OV-RDT for screening of O. viverrini, and an ultrasound telecommunication system. Past and current control programs, i.e., education, medication, and sanitation were discussed and stressed the need for a comprehensive control program which encompasses primary, secondary, and tertiary patient care programs for confirmation and management of suspected CCA cases. The approach of mathematical modeling for control of OV and CCA was also briefly described. Additionally, we highlighted the current progress toward control of OV and CCA in Thailand and potential for expansion into nearby countries in Southeast Asia.
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Affiliation(s)
- Narong Khuntikeo
- Department of Surgery, Faculty of Medicine, Khon Kaen University and Cholangiocarcinoma Research Institute, Khon Kaen, Thailand
| | - Bandit Thinkhamrop
- Faculty of Public Health, Khon Kaen University and Cholangiocarcinoma Research Institute, Khon Kaen, Thailand
| | - Thomas Crellen
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, G12 8QQ, Glasgow, United Kingdom
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, OX3 7LF, London, UK
| | - Chatanun Eamudomkarn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Trevor N Petney
- Evolution and Paleontology, State Museum of Natural History Karlsruhe, Erbprinzenstrasse 13, 76133, Karlsruhe, Germany
| | - Ross H Andrews
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK
| | - Paiboon Sithithaworn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University and Cholangiocarcinoma Research Institute, Khon Kaen, Thailand.
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Effects of day-to-day variation of Opisthorchis viverrini antigen in urine on the accuracy of diagnosing opisthorchiasis in Northeast Thailand. PLoS One 2022; 17:e0271553. [PMID: 35853022 PMCID: PMC9295949 DOI: 10.1371/journal.pone.0271553] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/04/2022] [Indexed: 11/23/2022] Open
Abstract
Antigen detection in urine using an enzyme-linked immunosorbent assay (ELISA) is more sensitive than fecal examination for diagnosis of opisthorchiasis and for assessment of the effects of drug treatment. It is not known whether day-to-day variation of urine composition, including levels of Opisthorchis viverrini antigen, influences the urine assay. We investigated this topic with the cooperation of participants from two localities in Northeast Thailand. Project participants were screened for parasite infections for three consecutive days using the quantitative formalin-ethyl acetate concentration technique (FECT) to detect O. viverrini eggs and the urine ELISA for detection of O. viverrini antigen. A subset of participants (n = 801) with matched fecal and urine samples were analyzed for comparison of inter-day prevalence estimates and the performance of the urine assay compared against FECT for diagnosis of opisthorchiasis. The daily prevalence measured by the urine assay ranged between 29.0%-30.2% while those by FECT ranged between 11.9%-20.2%. The cumulative three-day prevalence estimate determined by the urine antigen assay was 30.3%, which was significantly higher than that by FECT (20.2%, p < 0.05). A significant positive correlation was found between the concentration of antigen in urine and fecal egg counts (p < 0.001). Overall, the urine assay had better diagnostic performance for opisthorchiasis than fecal examination by FECT. The high sensitivity plus negligible daily variation of O. viverrini antigen in urine indicates the utility of the urine assay for diagnosis, as well as population screening, of opisthorchiasis.
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Songserm N, Namwong W, Woradet S, Sripa B, Ali A. Public health interventions for preventing re-infection of Opisthorchis viverrini: application of the self-efficacy theory and group process in high-prevalent areas of Thailand. Trop Med Int Health 2021; 26:962-972. [PMID: 33938094 DOI: 10.1111/tmi.13598] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To study the effectiveness of public health interventions in preventing Opisthorchis viverrini (OV) re-infection in high-prevalence areas of Thailand. METHODS 68 people from Sisaket, the province with the second-highest prevalence in Thailand, who tested positive for OV eggs in faeces and took praziquantel before the start of the study, participated. 34 participants were allocated to the experimental group, which received a 12-week public health intervention based on the self-efficacy theory and group process between July and October 2018. The control group received the usual services. Data were collected using a questionnaire with a reliability of 0.84. Faecal examinations using the formalin-ether concentration technique were conducted before and after the experiment. The re-infection rate was analysed after the experimental 12 weeks and after one year. Descriptive and inferential statistics, including paired t-test and independent t-test, were employed for data analysis. RESULTS After the experiment, the mean scores of knowledge, perceived self-efficacy, self-efficacy expectation and OV prevention behaviour of the experimental group were significantly higher than before the experiment and also higher than scores of the control group (P < 0.05). CONCLUSION The public health intervention is useful. It educated the experimental group about OV, perceived self-efficacy and self-efficacy expectation in changing behaviour to prevent OV re-infection. As a result, no re-infections were observed after the 12-week intervention nor at the one-year follow-up. Public health benefits will be evident if the results are extended to other high-prevalence areas.
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Affiliation(s)
- Nopparat Songserm
- Faculty of Public Health, Ubon Ratchathani Rajabhat University, Ubon Ratchathani, Thailand
| | - Worawut Namwong
- Hua Chang Sub-District Health Promoting Hospital, Uthumphon Phisai District, Sisaket, Thailand
| | | | - Banchob Sripa
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,WHO Collaborating Centre for Research and Control of Opisthorchiasis (Southeast Asian Liver Fluke Disease)/Tropical Disease Research Center (TDRC), Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Akhtar Ali
- Department of Biological Science, The University of Tulsa, Tulsa, OK, USA
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Crellen T, Sithithaworn P, Pitaksakulrat O, Khuntikeo N, Medley GF, Hollingsworth TD. Towards Evidence-based Control of Opisthorchis viverrini. Trends Parasitol 2021; 37:370-380. [PMID: 33516657 DOI: 10.1016/j.pt.2020.12.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/18/2020] [Accepted: 12/25/2020] [Indexed: 01/21/2023]
Abstract
Transmission of the carcinogenic liver fluke Opisthorchis viverrini is ongoing across Southeast Asia. Endemic countries within the region are in different stages of achieving control. However, evidence on which interventions are the most effective for reducing parasite transmission, and the resulting liver cancer, is currently lacking. Quantitative modelling can be used to evaluate different control measures against O. viverrini and assist the design of clinical trials. In this article we evaluate the epidemiological parameters that underpin models of O. viverrini and the data necessary for their estimation, with the aim of developing evidence-based strategies for parasite control at a national or regional level.
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Affiliation(s)
- Thomas Crellen
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Paiboon Sithithaworn
- Department of Parasitology, Khon Kaen University, Khon Kaen 40002, Thailand; Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Opal Pitaksakulrat
- Department of Parasitology, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Narong Khuntikeo
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand; Department of Surgery, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Graham F Medley
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - T Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
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