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Sadeghi S, Ghiasi F, Aria A, Momenzadeh M, Nasri E, Reisizadeh Mobarakeh S. Multiple Hydatid Cysts in Rare Locations Treated with Albendazole: A Case Report. Adv Biomed Res 2023; 12:179. [PMID: 37694250 PMCID: PMC10492604 DOI: 10.4103/abr.abr_400_22] [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: 11/23/2022] [Revised: 12/21/2022] [Accepted: 01/04/2023] [Indexed: 09/12/2023] Open
Abstract
Hydatid cyst is a common disease between humans and animals. Foods that are contaminated with eggs of echinococcal species are the cause of hydatid disease. Although this parasite affects different organs, the liver and lungs are very susceptible but the cardiac hydatid disease is very rare. We report the case of a 33-year-old man admitted because of chest pain. Echocardiography had shown suspected round cyst in the myocardium. More diagnostic managements had demonstrated cystic lesion in the liver, spleen and lungs. There were also multiple cystic lesions in both lungs. He refused surgery and was taken to medical therapy. Myocardial involvement by hydatid cysts occurs very rarely. The main treatment approach for cardiac hydatid disease in patients should be surgery. The alternative treatment was done to those who refused surgical removal, adjuvant therapy such as albendazole for at least 1-6 months. Because myocardial involvement by hydatid cysts is uncommon, we decided to report this rare case.
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Affiliation(s)
- Somayeh Sadeghi
- Acquired Immunodeficiency Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Internal Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzin Ghiasi
- Acquired Immunodeficiency Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Internal Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Aria
- Department of Internal Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Momenzadeh
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan, Iran
| | - Elahe Nasri
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shadi Reisizadeh Mobarakeh
- Department of Internal Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Gottstein B, Deplazes P. Alveolar echinococcosis: what triggers emergence in North America, Central Europe and Asia? Curr Opin Infect Dis 2021; 34:440-446. [PMID: 34524197 DOI: 10.1097/qco.0000000000000765] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Infection with the larval (metacestode) stage of Echinococcus multilocularis causes alveolar echinococcosis (AE), a serious hepatic disorder. The parasite has increased its infection extensity in wildlife and domestic dogs, mainly due to urbanization and spatial extension of wildlife hosts in Europe, Asia as well as North America, resulting in emerging infection risk for humans. RECENT FINDINGS In hyperendemic areas such as Kyrgyzstan and China, ecological and socioeconomic changes have been associated with the unpredictable increase of AE cases. In North America, the appearance of the European-like genotype is of concern. In Europe, the annual increase of human case numbers reached a plateau even in hyperendemic situations. Therefore, we conclude that most of the exposed individuals are resistant to parasite invasion and/or to disease development. Thus, AE develops in a few healthy individuals, but preferentially in immunosuppressed patients. SUMMARY In the future, improved diagnostic strategies will allow more precise estimations of transmission routes including the role of food, water and direct dog contact, which should yield improved public health recommendations. Finally, understanding protective innate and acquired immune mechanisms as well as parasite-driven immune-evasion processes will be essential to develop curative therapies in nonoperable patients and, futuristically, appropriate vaccines.
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Affiliation(s)
- Bruno Gottstein
- Institute of Infectious Diseases, Faculty of Medicine, University of Bern, Bern
| | - Peter Deplazes
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Zurich, Zurich, Switzerland
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3
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Label-free detection of echinococcosis and liver cirrhosis based on serum Raman spectroscopy combined with multivariate analysis. Photodiagnosis Photodyn Ther 2020; 33:102164. [PMID: 33373744 DOI: 10.1016/j.pdpdt.2020.102164] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/11/2020] [Accepted: 12/18/2020] [Indexed: 11/21/2022]
Abstract
In this paper, we investigated the feasibility of using serum Raman spectroscopy and multivariate analysis method to discriminate echinococcosis and liver cirrhosis from healthy volunteers. Raman spectra of serum samples from echinococcosis, liver cirrhosis, and healthy volunteers were recorded under 532 nm excitation. The normalized mean Raman spectra revealed specific biomolecular differences associated with the disease, mainly manifested as the contents of β carotene in the serum of patients with echinococcosis and liver cirrhosis were lower than those of healthy people. Furthermore, principal components analysis (PCA), combined with linear discriminant analysis (LDA), was adopted to distinguish patients with echinococcosis, liver cirrhosis, and healthy volunteers. The overall diagnostic accuracy based on the PCA-LDA algorithm was 87.7 %. The diagnostic sensitivities to healthy volunteers, patients with echinococcosis, and liver cirrhosis were 92.5 %, 81.5 %, and 89.1 %, and the specificities were 93.2 %, 96.1 %, and 92.4 %, respectively. This exploratory work demonstrated that serum Raman spectroscopy technology combined with PCA-LDA diagnostic algorithm has great potential for the non-invasive identification of echinococcosis and liver cirrhosis.
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Zeng X, Yang X, Yang P, Luo H, Wang W, Yan L. Individualized biliary reconstruction techniques in autotransplantation for end-stage hepatic alveolar echinococcosis. HPB (Oxford) 2020; 22:578-587. [PMID: 31471064 DOI: 10.1016/j.hpb.2019.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 06/02/2019] [Accepted: 08/06/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Biliary reconstruction in ex vivo liver resection followed by autotransplantation (ERAT) for end-stage hepatic alveolar echinococcosis (HAE) remains the most challenging step, we present our experience with this complex procedure. METHODS A retrospective data analysis of 55 patients with end-stage HAE underwent ERAT, the biliary reconstruction techniques and short- and long-term outcomes were discussed. RESULTS All autografts were derived from the left lateral section after extensive ex vivo liver resection, multiple bile ducts were observed in 52 (94.5%) patients, and forty-four (80.0%) cases required ductoplasty. Biliary reconstruction was achieved with duct-to-duct anastomosis in 32 (58.2%) patients, Roux-en-Y hepaticojejunostomy (RYHJ) in 14 (25.5%) patients, and a combination of the two methods in 9 (16.4%) patients. Twenty (36.4%) patients had multiple anastomoses. Biliary leakage occurred in 8 (14.5%) patients postoperatively. Three (5.5%) patients died of liver failure, cerebral hemorrhage and intraabdominal bleeding. During a median of 31 months followed-up time, 3 (5.5%) patients developed anastomotic stricture, 1 of whom was treated by repeat RYHJ, while the others were managed with stenting. CONCLUSIONS With a well-designed plan and precise anastomosis, complex biliary reconstruction in ERAT can be performed with few biliary complications by a professional team.
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Affiliation(s)
- Xintao Zeng
- Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China; Department of Hepatobiliary Surgery, Mianyang Central Hospital, Sichuan, Mianyang, China
| | - Xianwei Yang
- Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Pei Yang
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, Sichuan, Mianyang, China
| | - Hua Luo
- Department of Hepatobiliary Surgery, Mianyang Central Hospital, Sichuan, Mianyang, China
| | - Wentao Wang
- Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Lunan Yan
- Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
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Wen H, Vuitton L, Tuxun T, Li J, Vuitton DA, Zhang W, McManus DP. Echinococcosis: Advances in the 21st Century. Clin Microbiol Rev 2019; 32:e00075-18. [PMID: 30760475 PMCID: PMC6431127 DOI: 10.1128/cmr.00075-18] [Citation(s) in RCA: 512] [Impact Index Per Article: 102.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Echinococcosis is a zoonosis caused by cestodes of the genus Echinococcus (family Taeniidae). This serious and near-cosmopolitan disease continues to be a significant public health issue, with western China being the area of highest endemicity for both the cystic (CE) and alveolar (AE) forms of echinococcosis. Considerable advances have been made in the 21st century on the genetics, genomics, and molecular epidemiology of the causative parasites, on diagnostic tools, and on treatment techniques and control strategies, including the development and deployment of vaccines. In terms of surgery, new procedures have superseded traditional techniques, and total cystectomy in CE, ex vivo resection with autotransplantation in AE, and percutaneous and perendoscopic procedures in both diseases have improved treatment efficacy and the quality of life of patients. In this review, we summarize recent progress on the biology, epidemiology, diagnosis, management, control, and prevention of CE and AE. Currently there is no alternative drug to albendazole to treat echinococcosis, and new compounds are required urgently. Recently acquired genomic and proteomic information can provide a platform for improving diagnosis and for finding new drug and vaccine targets, with direct impact in the future on the control of echinococcosis, which continues to be a global challenge.
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Affiliation(s)
- Hao Wen
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia and WHO Collaborating Centre for Prevention and Care Management of Echinococcosis, Urumqi, China
| | - Lucine Vuitton
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis and French National Centre for Echinococcosis, University Bourgogne Franche-Comte and University Hospital, Besançon, France
| | - Tuerhongjiang Tuxun
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Jun Li
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia and WHO Collaborating Centre for Prevention and Care Management of Echinococcosis, Urumqi, China
- Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Dominique A Vuitton
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis and French National Centre for Echinococcosis, University Bourgogne Franche-Comte and University Hospital, Besançon, France
| | - Wenbao Zhang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia and WHO Collaborating Centre for Prevention and Care Management of Echinococcosis, Urumqi, China
- Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Donald P McManus
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
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Kern P, Menezes da Silva A, Akhan O, Müllhaupt B, Vizcaychipi KA, Budke C, Vuitton DA. The Echinococcoses: Diagnosis, Clinical Management and Burden of Disease. ADVANCES IN PARASITOLOGY 2017; 96:259-369. [PMID: 28212790 DOI: 10.1016/bs.apar.2016.09.006] [Citation(s) in RCA: 273] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The echinococcoses are chronic, parasitic diseases that are acquired after ingestion of infective taeniid tapeworm eggs from certain species of the genus Echinococcus. Cystic echinococcosis (CE) occurs worldwide, whereas, alveolar echinococcosis (AE) is restricted to the northern hemisphere, and neotropical echinococcosis (NE) has only been identified in Central and South America. Clinical manifestations and disease courses vary profoundly for the different species of Echinococcus. CE presents as small to large cysts, and has commonly been referred to as 'hydatid disease', or 'hydatidosis'. A structured stage-specific approach to CE management, based on the World Health Organization (WHO) ultrasound classification of liver cysts, is now recommended. Management options include percutaneous sterilization techniques, surgery, drug treatment, a 'watch-and-wait' approach or combinations thereof. In contrast, clinical manifestations associated with AE resemble those of a 'malignant', silently-progressing liver disease, with local tissue infiltration and metastases. Structured care is important for AE management and includes WHO staging, drug therapy and long-term follow-up for at least a decade. NE presents as polycystic or unicystic disease. Clinical characteristics resemble those of AE, and management needs to be structured accordingly. However, to date, only a few hundreds of cases have been reported in the literature. The echinococcoses are often expensive and complicated to treat, and prospective clinical studies are needed to better inform case management decisions.
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Affiliation(s)
- P Kern
- University Hospital of Ulm, Ulm, Germany
| | | | - O Akhan
- Hacettepe University, Ankara, Turkey
| | - B Müllhaupt
- University Hospital of Zurich, Zürich, Switzerland
| | - K A Vizcaychipi
- National Institute of Infectious Diseases, Buenos Aires, Argentina
| | - C Budke
- Texas A&M University, College Station, TX, United States
| | - D A Vuitton
- Université de Franche-Comté, Besançon, France
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7
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Wang J, Gottstein B. Immunoregulation in larval Echinococcus multilocularis infection. Parasite Immunol 2016; 38:182-92. [PMID: 26536823 DOI: 10.1111/pim.12292] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 10/26/2015] [Indexed: 12/24/2022]
Abstract
Alveolar echinococcosis (AE) is a clinically very severe zoonotic helminthic disease, characterized by a chronic progressive hepatic damage caused by the continuous proliferation of the larval stage (metacestode) of Echinococcus multilocularis. The proliferative potential of the parasite metacestode tissue is dependent on the nature/function of the periparasitic immune-mediated processes of the host. Immune tolerance and/or down-regulation of immunity are a marked characteristic increasingly observed when disease develops towards its chronic (late) stage of infection. In this context, explorative studies have clearly shown that T regulatory (Treg) cells play an important role in modulating and orchestrating inflammatory/immune reactions in AE, yielding a largely Th2-biased response, and finally allowing thus long-term parasite survival, proliferation and maturation. AE is fatal if not treated appropriately, but the current benzimidazole chemotherapy is far from optimal, and novel options for control are needed. Future research should focus on the elucidation of the crucial immunological events that lead to anergy in AE, and focus on providing a scientific basis for the development of novel and more effective immunotherapeutical options to support cure AE by abrogating anergy, anticipating also that a combination of immuno- and chemotherapy could provide a synergistic therapeutical effect.
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Affiliation(s)
- J Wang
- Institute of Parasitology, University of Bern, Bern, Switzerland
| | - B Gottstein
- Institute of Parasitology, University of Bern, Bern, Switzerland
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8
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Liver Transplantation for Incurable Alveolar Echinococcosis: An Analysis of Patients Hospitalized in Department of Tropical and Parasitic Diseases in Gdynia. Transplant Proc 2016; 48:1708-12. [DOI: 10.1016/j.transproceed.2016.01.087] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 01/21/2016] [Indexed: 11/24/2022]
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9
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Successful intestinal Echinococcus multilocularis oncosphere invasion and subsequent hepatic metacestode establishment in resistant RccHan™:WIST rats after pharmacological immunosuppression. Parasitology 2016; 143:1252-60. [DOI: 10.1017/s0031182016000809] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARYSusceptibility/resistance to larval Echinococcus multilocularis infection varies greatly depending on host species and strains. Whereas several mice strains and non-human primates are highly susceptible to alveolar echinococcosis, rats and most of humans are considered as more resistant. In this study, we aimed to elucidate factors responsible for host resistance in rats (Experiments A–D). (A) The parasite establishment was not observed in immunocompetent Wistar rats orally inoculated with sodium hypochlorite resistant eggs with/without pig bile, or activated/non-activated oncospheres (NAO). Peritoneal inoculation with NAO or metacestode tissue allowed the parasite establishment in rats. (B) T-cell-deficient athymic nude rats showed complete resistance against the metacestode establishment after oral inoculation with parasite eggs. This finding suggests that T-cell-independent parasite clearance occurred in the animals during early phase of the parasite invasion. Finally, Wistar rats that received pharmacological immunosuppression using either dexamethasone (DMS) alone or methotrexate (MTX) i.p. alone or a combination of these compounds were orally inoculated with the parasite's eggs. As a result (D), successful establishment of metacestode with protoscoleces was observed in all 3 rats treated with DMS (s.c.) alone or in all 6 rats treated with DMS (s.c.) plus MTX but not in 8 rats with MTX alone, suggesting that factors affected by DMS treatment are responsible to regulate the parasite invasion and establishment.
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Cadavid Restrepo AM, Yang YR, McManus DP, Gray DJ, Giraudoux P, Barnes TS, Williams GM, Soares Magalhães RJ, Hamm NAS, Clements ACA. The landscape epidemiology of echinococcoses. Infect Dis Poverty 2016; 5:13. [PMID: 26895758 PMCID: PMC4759770 DOI: 10.1186/s40249-016-0109-x] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 02/15/2016] [Indexed: 12/29/2022] Open
Abstract
Echinococcoses are parasitic diseases of major public health importance globally. Human infection results in chronic disease with poor prognosis and serious medical, social and economic consequences for vulnerable populations. According to recent estimates, the geographical distribution of Echinococcus spp. infections is expanding and becoming an emerging and re-emerging problem in several regions of the world. Echinococcosis endemicity is geographically heterogeneous and over time it may be affected by global environmental change. Therefore, landscape epidemiology offers a unique opportunity to quantify and predict the ecological risk of infection at multiple spatial and temporal scales. Here, we review the most relevant environmental sources of spatial variation in human echinococcosis risk, and describe the potential applications of landscape epidemiological studies to characterise the current patterns of parasite transmission across natural and human-altered landscapes. We advocate future work promoting the use of this approach as a support tool for decision-making that facilitates the design, implementation and monitoring of spatially targeted interventions to reduce the burden of human echinococcoses in disease-endemic areas.
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Affiliation(s)
- Angela M Cadavid Restrepo
- Research School of Population Health, The Australian National University, Canberra, New South Wales, Australia.
| | - Yu Rong Yang
- Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, P. R. China.
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
| | - Donald P McManus
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
| | - Darren J Gray
- Research School of Population Health, The Australian National University, Canberra, New South Wales, Australia.
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
| | - Patrick Giraudoux
- Chrono-environment lab, UMR6249, University of Bourgogne Franche-Comté/CNRS, Besançon, France.
- Institut Universitaire de France, Paris, France.
| | - Tamsin S Barnes
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, Australia.
- The University of Queensland, Queensland Alliance for Agriculture and Food Innovation, Gatton, Queensland, Australia.
| | - Gail M Williams
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
| | - Ricardo J Soares Magalhães
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, Australia.
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
| | - Nicholas A S Hamm
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands.
| | - Archie C A Clements
- Research School of Population Health, The Australian National University, Canberra, New South Wales, Australia.
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11
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Wen H, Dong JH, Zhang JH, Duan WD, Zhao JM, Liang YR, Shao YM, Ji XW, Tai QW, Li T, Gu H, Tuxun T, He YB, Huang JF. Ex Vivo Liver Resection and Autotransplantation for End-Stage Alveolar Echinococcosis: A Case Series. Am J Transplant 2016; 16:615-24. [PMID: 26460900 DOI: 10.1111/ajt.13465] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 07/12/2015] [Accepted: 07/14/2015] [Indexed: 01/25/2023]
Abstract
The role of autotransplantation in end-stage hepatic alveolar echinococcosis (AE) is unclear. We aimed to present our 15-case experience and propose selection criteria for autotransplantation. All patients were considered to have unresectable hepatic AE by conventional resection due to critical invasion to retrohepatic vena cava, hepatocaval region along with three hepatic veins, and the tertiary portal and arterial branches. All patients successfully underwent ex vivo extended right hepatectomy and autotransplantation without intraoperative mortality. The median autograft weight was 706 g (380-1000 g); operative time was 15.5 hours (11.5-20.5 hours); and anhepatic time was 283.8 minutes (180-435 min). Postoperative hospital stay was 32.3 days (12-60 days). Postoperative complication Clavien-Dindo grade IIIa or higher occurred in three patients including one death that occurred 12 days after the surgery due to acute liver failure. One patient was lost to follow-up after the sixth month. Thirteen patients were followed for a median of 21.6 months with no relapse. This is the largest reported series of patients with end-stage hepatic AE treated with liver autotransplantation. The technique requires neither organ donor nor postoperative immunosuppressant. The early postoperative mortality was low with acceptable morbidity. Preoperative precise assessment and strict patient selection are of utmost importance.
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Affiliation(s)
- H Wen
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - J-H Dong
- Department of Hepatobiliary Surgery, Beijing Tsinghua Chang Gung Hospital, Beijing, P.R. China
| | - J-H Zhang
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - W-D Duan
- Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, P.R. China
| | - J-M Zhao
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - Y-R Liang
- Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, P.R. China
| | - Y-M Shao
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - X-W Ji
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - Q-W Tai
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - T Li
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - H Gu
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - T Tuxun
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - Y-B He
- Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, P.R. China
| | - J-F Huang
- Department of Hepatobiliary Surgery, Peking Union Medical College Hospital, Beijing, P.R. China
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Vuitton D, Demonmerot F, Knapp J, Richou C, Grenouillet F, Chauchet A, Vuitton L, Bresson-Hadni S, Millon L. Clinical epidemiology of human AE in Europe. Vet Parasitol 2015; 213:110-20. [DOI: 10.1016/j.vetpar.2015.07.036] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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13
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Deletion of Fibrinogen-like Protein 2 (FGL-2), a Novel CD4+ CD25+ Treg Effector Molecule, Leads to Improved Control of Echinococcus multilocularis Infection in Mice. PLoS Negl Trop Dis 2015; 9:e0003755. [PMID: 25955764 PMCID: PMC4425495 DOI: 10.1371/journal.pntd.0003755] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/13/2015] [Indexed: 02/07/2023] Open
Abstract
Background The growth potential of the tumor-like Echinococcus multilocularis metacestode (causing alveolar echinococcosis, AE) is directly linked to the nature/function of the periparasitic host immune-mediated processes. We previously showed that Fibrinogen-like-protein 2 (FGL2), a novel CD4+CD25+ Treg effector molecule, was over-expressed in the liver of mice experimentally infected with E. multilocularis. However, little is known about its contribution to the control of this chronic helminth infection. Methods/Findings Key parameters for infection outcome in E. multilocularis-infected fgl2-/- (AE-fgl2-/-) and wild type (AE-WT) mice at 1 and 4 month(s) post-infection were (i) parasite load (i. e. wet weight of parasitic metacestode tissue), and (ii) parasite cell proliferation as assessed by determining E. multilocularis 14-3-3 gene expression levels. Serum FGL2 levels were measured by ELISA. Spleen cells cultured with ConA for 48h or with E. multilocularis Vesicle Fluid (VF) for 96h were analyzed ex-vivo and in-vitro. In addition, spleen cells from non-infected WT mice were cultured with rFGL2/anti-FGL2 or rIL-17A/anti-IL-17A for further functional studies. For Treg-immune-suppression-assays, purified CD4+CD25+ Treg suspensions were incubated with CD4+ effector T cells in the presence of ConA and irradiated spleen cells as APCs. Flow cytometry and qRT-PCR were used to assess Treg, Th17-, Th1-, Th2-type immune responses and maturation of dendritic cells. We showed that AE-fgl2-/- mice exhibited (as compared to AE-WT-animals) (a) a significantly lower parasite load with reduced proliferation activity, (b) an increased T cell proliferative response to ConA, (c) reduced Treg numbers and function, and (d) a persistent capacity of Th1 polarization and DC maturation. Conclusions FGL2 appears as one of the key players in immune regulatory processes favoring metacestode survival by promoting Treg cell activity and IL-17A production that contributes to FGL2-regulation. Prospectively, targeting FGL2 could be an option to develop an immunotherapy against AE and other chronic parasitic diseases. In larval E. multilocularis infection causing alveolar echinococcosis (AE) in humans as well as mice, immune tolerance and/or down-regulation of protective immunity is a marked characteristic of this chronic disease. Our study provides a comprehensive evidence for a major involvement of the recently identified CD4+ CD25+ Regulatory T Cell Effector Molecule FGL2 to the outcome of AE. Our major findings are as follows: 1) FGL2 is mostly secreted by Tregs and partly contributes to their functions; 2) FGL2 can down-regulate the maturation of DCs, suppress Th1 and Th17 immune responses, and support Th2 and Treg immune responses, and finally 3) IL-17A contributes to FGL2 secretion. Based on the present findings in mice, we will investigate FGL2 as a potential marker of progression of AE in human patients, or as a potential immunotherapeutical target. Early prediction of parasite regression (currently not yet possible) would allow clinicians to plan for withdrawing benzimidazole treatment, which is currently administered for life. Then, FGL2 should be investigated as a target for an anticipated immunomodulatory treatment of patients with progressive AE, especially of those who are non- or low-responders to benzimidazole treatment, or who suffer from side-effects due to chemotherapy.
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Chauchet A, Grenouillet F, Knapp J, Richou C, Delabrousse E, Dentan C, Millon L, Di Martino V, Contreras R, Deconinck E, Blagosklonov O, Vuitton DA, Bresson-Hadni S, Virginie V, Karine B, Brigitte B, Isabelle BC, Oleg B, Solange BH, Pascale BM, Sylvie C, Remy C, Eric D, Vincent DM, Philippe E, Sophie F, Patrick G, Frédéric G, Bruno H, Séverine VD, Jenny K, Stéphane K, Georges M, Laurence M, Francis R, Carine R, Claire V, Angèle VD, Lucine V, Patricia P, Claire G, Armand A, Jean B, Monique C, François BJ, Bernadette C, Patrick H, Anne M, Odile F, Christian L, Jérôme D, Olivier G, Christian P, Meja R, Martine W, Martine P, Eric C, Marc J, Jean-Jacques R, Daniel S, Alain G, Lorraine L, Marie M, Jérôme W, Olivier F, Didier S, Cathy C, Francois DJ, Bruno G, Monique D, Ahmed AB, Maxime A, Yves H, Nicolas L, Véronique L, Blandine AL. Increased Incidence and Characteristics of Alveolar Echinococcosis in Patients With Immunosuppression-Associated Conditions. Clin Infect Dis 2014; 59:1095-104. [DOI: 10.1093/cid/ciu520] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Valour F, Khenifer S, Della-Schiava N, Cotte E, Guibert B, Wallon M, Durupt S, Durieu I. Unusual growth rate during cystic echinococcosis. Parasitol Int 2013; 63:275-7. [PMID: 24275211 DOI: 10.1016/j.parint.2013.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 11/13/2013] [Accepted: 11/14/2013] [Indexed: 10/26/2022]
Abstract
Cystic echinococcosis is a world wild zoonosis caused by Echinococcus granulosus, leading to hepatic and lung cysts with a usually slight growth rate. We report the case of an 82year-old Algerian woman with hepatic and lung cystic echinococcosis with a 10-fold size increase in 6months.
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Affiliation(s)
- Florent Valour
- Internal Medicine Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, France.
| | - Safia Khenifer
- Internal Medicine Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, France
| | - Nellie Della-Schiava
- Thoracic Surgery Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, France
| | - Eddy Cotte
- Visceral Surgery Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, France
| | - Benoit Guibert
- Thoracic Surgery Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, France
| | - Martine Wallon
- Laboratory of Parasitology, Groupement Hospitalier Nord, Hospices Civils de Lyon, France
| | - Stéphane Durupt
- Internal Medicine Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, France
| | - Isabelle Durieu
- Internal Medicine Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, France; Université Claude Bernard, Lyon 1, France
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Current world literature. Curr Opin Organ Transplant 2012; 17:688-99. [PMID: 23147911 DOI: 10.1097/mot.0b013e32835af316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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