Capillaria hepatica-induced hepatic fibrosis in rats: paradoxical effect of repeated infections

Histopathological features and prevalence of Capillaria hepatica infection in Rattus spp. in Philippine Mount Makiling forest reserve and its adjacent areas

Rats are recognized as reservoir hosts of several pathogens that pose a threat to human health. Although rats are reported to be hosts of a large number of pathogens, a survey of Capillaria hepatica carried by rats in various settings such as residential, agroforestry, and agricultural areas in the Philippines has not been conducted. A total of 90 rats composed of Rattus norvegicus, Rattus tanezumi, and Rattus exulans were collected through trapping in selected residential, agroforestry, and agricultural areas in Los Baños Laguna, Philippines. The overall prevalence of C. hepatica among rats was 21.11%. Among the rat species collected, R. norvegicus showed the highest prevalence (55.56%), followed by R. exulans (14.29%), then R. tanezumi (5.36%) (differences significant at p < 0.05). Moreover, residential areas had the highest prevalence of C. hepatica infection (50%), followed by agroforestry and agricultural areas at 6.7% each (significant at p < 0.05). However, the difference in C. hepatica infection between male (11.43%; 4/35) and female (27.27%; 15/55) rats was not significant (p > 0.05). Most of the infected rats were moderately infected (68.42%), while few were lightly and severely infected (15.78% each). Lastly, the presence of C. hepatica in liver is suggestive of presence of lymphocytes, amyloid, granuloma, and the occurrence of necrosis, hypertrophy, fibrosis, and cholestasis in the liver of the host. Capillariasis could be occurring in Philippine human populations, hence there is need for screening the population with appropriate means and to create awareness of this emerging disease.

Caracterização do imunofenótipo das células envolvidas no processo fibrótico de fígados bovinos cronicamente infectados por Fasciola hepatica

RESUMO A fasciolose é uma doença parasitária causada por trematódeo do gênero Fasciola sp., que pode ocasionar fibrose hepática. Objetivou-se caracterizar o imunofenótipo das células que participam da fibrogênese de fígados bovinos frente à infecção por F. hepatica. Foram utilizados fragmentos dos lobos direito e esquerdo de 74 fígados bovinos com fasciolose. Os fragmentos foram submetidos a processamento histológico, coloração com tricrômico de Masson e imuno-histoquímica. Utilizaram-se análise estatística descritiva e teste de correlação de Spearmann com 5% de probabilidade. Na classificação do grau de fibrose, observou-se prevalência do grau 1, com associação positiva e significativa entre o grau de fibrose e o lobo hepático esquerdo (ρ=0,41; P<0,0001). Os imunofenótipos observados foram células estreladas hepáticas (CEHs) no parênquima e miofibroblastos (MFs) no espaço porta (EP). Não foram encontrados fibroblastos. Não houve correlação significativa entre o grau de fibrose e a quantidade de CEH nos lobos hepáticos, direito e esquerdo. Verificou-se aumento do número de estruturas portais, bem como do número de camadas circundando cada estrutura no EP, contudo não houve influência de qualquer estrutura sobre o grau de fibrose hepática (P>0,05). Concluiu-se que as células CEH e os MFs participam da fibrogênese de fígados bovinos com fasciolose crônica.

Capillaria hepatica-induced septal fibrosis in rats: a contribution to the study of liver fibrogenesis

INTRODUCTION

Septal fibrosis of the liver regularly develops in rats infected with the nematode Capillaria hepatica. Curative treatment of the infection prevents the development of septal fibrosis when intervention occurs up to postinfection day (PID) 15, but not later. The present investigation aimed to demonstrate which parasitic factors are present when the process of septal fibrosis can no longer be prevented by curative treatment.

METHODS

Wistar rats were infected with 600 embryonated eggs of C. hepatica administered by gavage and treated with ivermectin and mebendazole in separate groups at PIDs 10, 12, 15, 17 or 20. Rats from each group and their nontreated controls, were killed and examined 40 days after the end of treatment.

RESULTS

Findings by PID 15 were compatible with the stage of complete maturation of infection, when worms and eggs were fully developed and a complex host-parasite multifocal necroinflammatory reaction showed greater intensity, but with no signs of septal fibrosis, which appeared from PID 17 onward.

CONCLUSIONS

Since the worms spontaneously died by PID 15, not only septal fibrosis production, but also its maintenance and further development appeared dependent on the presence of eggs, which were the only parasitic factor remaining thereafter.

Capillaria hepatica in China

Capillaria hepatica (C. hepatica) is a parasitic nematode causing hepatic capillariasis in numerous mammals. Ecologic studies showed that the first hosts of C. hepatica were rodents, among which rats had relatively high infection rates, which explains why C. hepatica spreads globally. Anatomical studies showed that the liver was the principal site of colonization by these parasites and physical damage tended to occur. Although C. hepatica might lead to serious liver disorders, relevant clinical reports were rare, because of the non-specific nature of clinical symptoms, leading to misdiagnosis. This review mainly focuses on the biological characteristics and epidemiology of C. hepatica in China and histopathologic changes in the liver, with expectation of gaining a better understanding of the disease and seeking more effective treatment.

Hepatic fibrosis and Fasciola hepatica infection in cattle

This study focuses on the development of fibrosis of the liver of cattle with Fasciola hepatica infection, correlating with the intensity of infection. Animals with an established diagnosis of chronic F. hepatica infection were identified in a slaughterhouse in Lima, Perú. The study included 24 fresh cattle livers from infected animals and two uninfected controls. Tissues were stored at 4°C for approximately 8 h after which they were brought to a necropsy room and examined. Between 9 and 12 biopsies were randomly obtained from each liver. Histological staining of formalin-fixed liver sections with haematoxylin and eosin (H & E) and Masson's trichrome were performed. Liver samples were examined using a pathology protocol that included 30 items. Histopathologically, 16 out of 30 liver specimens (67.6%) showed diffuse fibrotic lesions (cirrhosis) with a mean number of Fasciola of 116 ± 30 (range 4–435). Pathological data were matched to number of adult parasites and presence of cirrhosis after being reviewed by two independent pathologists. There was concordance between the two pathologists (K = 0.72). The group with cirrhosis showed an average of 116 ± 30 adult parasites whereas the group not showing cirrhosis contained 56 ± 28 flukes (P = 0.2). To measure how number of flukes and diagnosis of cirrhosis are related we used Kendall's tau-b coefficient; the correlation was +0.296 (P = 0.04). Receiver Operating Characteristic (ROC) curve results showed that the best point was 38 parasite adults, which had 93.8% sensitivity and 75% specificity. We conclude that as the number of F. hepatica adult forms increases, the likelihood of developing liver fibrosis will also increase in cattle.

Capillaria hepatica in rats: focal parasitic hepatic lesions and septal fibrosis run independent courses

Capillaria hepatica causes two main lesions in the liver of rats: multifocal chronic inflammation, directly related to the presence of disintegrating parasites and their eggs, and a process of systematized septal fibrosis. The comparative behavior of these two lesions was investigated in rats experimentally infected with 600 embryonated eggs, following either corticosteroid treatment or specific antigenic stimulation, in an attempt to understand the relationship between these two lesions, and the pathogenesis of septal fibrosis. The two treatments differently modified the morphological aspects of the focal parasitic-related lesions, but did not interfere with the presentation of diffuse septal fibrosis, although a mild decrease in the degree of fibrosis occurred in corticoid-treated animals. These findings indicate that although the two lesions are C. hepatica induced, they are under different pathogenetic control, the induction of septal fibrosis being triggered during early infection to follow an independent pathway.