Synthesis and Antigenicity against Human Sera of a Biotin-Labeled Oligosaccharide Portion of a Glycosphingolipid from the Parasite Echinococcus multilocularis.

Synthesis of a biotinylated analog of the carbohydrate portion of a glycosphingolipid from the parasite Echinococcus multilocularis has been achieved. We synthesized ß-D-Galp-(1→6)-ß-D-Galp-(1→6)-[α-L-Fucp-(1→3)]-ß-D-Galp-(1→R: biotin probe) (1) and compared the antigenicity by an enzyme linked immunosorbent assay (ELISA) with biotinylated trisaccharide α-D-Galp-(1→4)-ß-D-Galp-(1→3)-α-D-Galp-(1→R: biotin probe) (F), which has been shown to have significant antigenicity. Both of the oligosaccharides reacted with sera of alveolar echinococcosis (AE) patients, but showed different reactivity. Among the 60 sera of AE patients, more sera reacted with the linear sequence Galα1→4Galß1→3GalNAcα1→R of oligosaccharide (F) than for branched compound 1. Some sera showed high specificity to one of the compound, indicating that the antibodies in the sera of AE patients differ in their specificity to recognize carbohydrate sequences of glycosphingolipids. Our results demonstrate that both of the biotinylated oligosaccharides 1 and F have good serodiagnostic potential and are complementary to detect infections caused by the parasite Echinococcus multilocularis.

[Guidelines for diagnosis and treatment of liver alveococcosis caused by Echinococcus multilocularis]. / Zasady rozpoznawania i leczenia bablowicy watroby wywolywanej przez Echinococcus multilocularis.

UNLABELLED: Recent epidemiological reports have shown an increasing incidence of Echinococcus multilocularis infection among red foxes and inhabitants from Pomorskie, Warminsko-Mazurskie and Podkarpackie Districts of Poland. The study describes the actual recommendations for a proper diagnosis and optimal treatment in patients infected with E. multilocularis in order to standardize diagnostic and therapeutic procedures for this severe parasitic disease by reference centres. Liver lesions caused by the parasite were visualised by ultrasonography and computerized tomography scan. The clinical diagnosis based on typical imaging findings was completed by Em2plus ELISA and Em16 and Eml18 Western blot immunodiagnostic tests using specific antigens, and confirmed by positive histopathological and/or molecular examinations. Since 1992, forty-five cases of alveolar echinococcosis were registered in Poland. Professions related to forestry or picking-up mushrooms and blueberries were potential risk factors for an occurrence of the infection, especially in the northern region of the country. In the imaging techniques, the liver lesions were characterized by heterogenous, irregular masses with necrotic cavities, and clausters of calcifications located in the peripheral parts. The final diagnosis of alveococcosis was based on PAS-positive staining of lesions in histopathology and/or the detection of the parasite's DNA in liver sections by PCR. The patients were treated by radical surgery with concomitant long-term intensive chemotherapy with albendazole. CONCLUSIONS: Collaboration with physicians of various medical specialities is crucial for an early and more effective detection of alveococcosis in Poland. E. multilocularis infection should always be considered in the differential diagnosis of space-occupying lesions in the liver characterized by irregular heterogenous masses, suggesting slow tumor growth.

[Prevention and treatment of postoperative complications of hepatic echinococcosis]. / Nekotorye osobennosti profilaktiki i lecheniia posleoperatsionnykh oslozhnenii ékhinokokkoza pecheni.

The paper presents the outcomes of surgical treatment in 117 patients with complicated liver echinococciasis in the past 9 years. Hepatic function and immunity, their pre- and postoperative changes in the combined use of essentiale and T-activin were studied. It has been found that the functional status of the liver, its detoxifying function in particular, largely impairs and immunosuppression develops in patients with complicated liver echinococciasis. The postoperative combined use of essentiale and T-activin led to the normalization of hepatic function and immunity. The combined treatment reduced the incidence of postoperative complications from 34.83 to 17.2%, such as acute hepatic failure, suppuration of a wound and a residual cavity, isolated abdominal abscesses, pleurisy, and pneumonia.

[An improvement in a new method for the surgical treatment of echinococcosis]. / Sovershenstvovanie novogo sposoba khirurgicheskogo lecheniia ékhinokokkoza.

Parasitic cysts were intraoperatively treated with glycerol in 179 patients with echinococcosis at various sites and 3% hydrogen peroxide in 165 patients with hepatic echinococcosis. Experiments on 60 cotton rats experimentally infected with Echinococcus alveolaris and 156 albino mice with E. granulosus provided evidence for the surgical use of 80-100% glycerol or 3% hydrogen peroxide to treat the cysts. Intraoperative glycerol treatment of cysts in patients with complicated hepatic echinococcosis fails to normalize amino acid metabolism, as well as immunity even a year postoperatively. The glycerol method has no contraindications for pulmonary and hepatic echinococcosis. Hydrogen peroxide has a damaging effect on all germinal elements of both E. alveolaris and E. granulosus. The authors recommend that 3% hydrogen peroxide should be intraoperatively used for treatment of cysts. After surgery, there is a tendency for amino acid metabolism to become normal in such patients.

[The immunological indices of patients with echinococcosis undergoing preoperative hemoexfusions]. / Immunologicheskie pokazateli u bol'nykh s ékhinokokkozom pri provedenii predoperatsionnykh gemoéksfuzii.

The immunologic parameters were studied in 38 patients with hydatid disease of the liver and abdomen before and after a single hemoexfusion (HE) in a volume of 400 ml. Among the patients who were examined there were those with uncomplicated hydatid disease of the liver (group I, second clinical stage, 25 persons), patients with suppuration of hydatid cysts (group 11, 10 persons), and two patients with multiple hydatid cysts complicated by their suppuration and calcification with involvement of large areas of the liver. Comparative analysis of immunological parameters in patients before and in the first 24 hours after HE showed a difference between the groups of patients and the controls. The parameters were restored to their initial values in patients of both groups 3-5 days after HE. The results of the study allow the conclusion that in screening patients with hydatid disease of the liver and abdominal cavity for preoperative HE a strict individual approach is necessary with the patient's general condition, the clinical form of the disease, and complications on the part of the cysts being taken into account.