Association between renal function and co-infection with Clonorchis sinensis and Helicobacter pylori: a cross-sectional study

Establishing a predictive model for liver fluke infection on the basis of early changes in laboratory indicators: a retrospective study

BACKGROUND

Hepatic clonorchiasis is one of the most prevalent foodborne parasitic diseases in China and is often overlooked because the initial symptoms are not obvious. In this study, a multivariate model for the early prediction of disease onset using laboratory test data from liver-fluke-infected patients was developed and validated.

METHODS

Laboratory data from 147 liver-fluke-infected patients and 151 healthy control subjects were collected. Univariate logistic regression, Spearman correlation analysis, and collinearity diagnosis were used to screen for independent factors. A multivariate model was then constructed using the backward likelihood ratio method. For external validation, an independent patient cohort from another hospital was analyzed. The discriminative performance of the combined model was compared with that of previously identified biomarkers (eosinophil count and γ-glutamyl transpeptidase).

RESULTS

A 12-indicator prediction model for liver fluke infection was developed using traditional logistic regression (82.31% sensitivity and 88.08% specificity). The receiver operating characteristic curve, calibration curve, and decision curve analyses revealed that the model exhibited excellent discriminative ability (area under the curve [AUC]: training = 0.928, validation = 0.808), goodness of fit, and clinical practicability. The combined model showed superior discrimination compared with individual biomarkers, including eosinophil count (AUC = 0.577) and γ-glutamyl transpeptidase (AUC = 0.620).

CONCLUSIONS

This study developed an early risk prediction model for liver fluke infection using routine laboratory test data. Compared with previously reported biomarkers, the model demonstrated superior diagnostic performance and showed potential as a clinical tool for identifying early stage liver fluke infection in patients.

IgA nephropathy is associated with Opisthorchis felineus liver fluke infection: Retrospective 5-year analysis of human kidney samples

OBJECTIVES

Infection with the fish-borne liver fluke Opisthorchis felineus, which is transmitted through the consumption of raw or undercooked fish, results in serious liver damage in humans. Currently, limited clinical and experimental data reveal kidney damage co-occurring with chronic opisthorchiasis. We conducted a retrospective analysis of kidney autopsy samples over a five-year period (n = 84). The aim of the study was to assess pathomorphological changes in the kidneys and evaluate whether there is an association between IgA nephropathy and liver fluke infection.

METHODS

Histological analysis, immunohistochemistry, and statistical analysis were performed.

RESULTS

In this study, we demonstrated for the first time that chronic O. felineus infection in humans was associated with tubular dystrophy, the accumulation of renal tubular casts, and glomerulosclerosis. The hypertension increases the pathomorphological changes associated with chronic opisthorchiasis. We also detected IgA and the O. felineus total antigen in glomeruli of infected people. Fisher's test showed a significant association between O. felineus infection and IgA nephropathy, as well as between O. felineus infection and glomerulosclerosis.

CONCLUSIONS

Therefore, the findings of this study highlight the importance of recognising O. felineus infection as a more than hepatobiliary disease and emphasise the need for careful, personalised monitoring of kidney function in infected individuals.

Clonorchiasis and opisthorchiasis: epidemiology, transmission, clinical features, morbidity, diagnosis, treatment, and control

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.