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1.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(2): 200-202, 2020 Jan 07.
Artigo em Chinês | MEDLINE | ID: mdl-32458613

RESUMO

OBJECTIVE: To build a discriminant function of clonorchiasis sinensis using stepwise discriminant analysis, so as to investigate the feasibility of discriminant analysis for clonorchiasis sinensis screening. METHODS: Ten villages in Mulan County of Harbin City were sampled as the study sites using a cluster random sampling method. The fecal samples were collected from the permanent residents in the study sites and detected for Clonorchis sinensis eggs using the modified Kato-Katz smear technique. A questionnaire of clonorchiasis sinensis was designed. All data were entered into Epidata 3.1, and a discriminant analysis was performed using the software SPSS version 15.0. Variable were screened using the stepwise discriminant analysis, and the discriminant function was built using the Fisher's discriminant analysis method. The effectiveness of the discriminant function for clonorchiasis sinensis screening was evaluated by comparison with the modified Kato-Katz smear method. RESULTS: Eight variables with statistical significance were included to build the discriminant function, including chronic cholecystitis, cholangitis, gender, eating raw fish, abdominal distension, ethnicity, abdominal pain and age, and the correction rate of the discriminant function was 88.75% to identify clonorchiasis sinensis. CONCLUSIONS: The discriminant function of clonorchiasis sinensis can be rapidly and simply built based on the strong data processing and analysis capability of the SPSS software, which is rapid to screen clonorchiasis sinensis in Harbin City. Such a function has a high discriminant analysis capability, and provides insights into the establishment of rapid screening of clonorchiasis sinensis in other endemic areas.


Assuntos
Clonorquíase , Clonorchis sinensis , Análise Discriminante , Programas de Rastreamento , Animais , China/epidemiologia , Cidades , Clonorquíase/diagnóstico , Clonorquíase/epidemiologia , Fezes/parasitologia , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Contagem de Ovos de Parasitas , Fatores de Risco
2.
Acta Trop ; 203: 105309, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31862466

RESUMO

Clonorchis sinensis is a fish-borne trematode that inhabits the bile duct of mammals including humans. Clonorchiasis is prevalent in China, Korea, and Vietnam, and 15-20 million people are estimated to be infected by this fluke. Freshwater snails act as the first intermediate host for the proliferation of C. sinensis larvae and shed the cercariae into water. The cercariae penetrate the skin of freshwater fish and transform to metacercariae. Humans are infected by eating raw or undercooked freshwater fish as dishes of filet, "sashimi," or congee, which contain C. sinensis metacercariae. In humans, the C. sinensis metacercariae excyst in the duodenum, and juvenile flukes migrate up via bile chemotaxis into bile ducts. Once there, C. sinensis provokes hyperplasia of the bile duct epithelium, obstructive jaundice, ascites, liver enlargement and cirrhosis, and infrequent cholangiocarcinoma (CCA). Although the association between C. sinensis infection and CCA has been firmly established in past decades, the underlying mechanisms are not elucidated in detail. In the context of chronic clonorchiasis-associated hepatobiliary aberrations, the constitutive disruption of redox homeostasis and dysregulation of physiological signaling pathways may promote the malignant transformation of cholangiocytes, thus leading to substantial acquisition of a more aggressive phenotype by these cells: CCA. With advances of genomic and molecular biological approaches, diverse C. sinensis proteins that are essential for parasite physiology and pathogenicity have been identified and characterized. Some of the proteins have been considered as attractive targets for development of vaccines and chemotherapeutics. Candidate antigens for reliable serodiagnosis of clonorchiasis have been studied.


Assuntos
Neoplasias dos Ductos Biliares/parasitologia , Colangiocarcinoma/parasitologia , Clonorquíase/complicações , Clonorquíase/parasitologia , Clonorchis sinensis , Animais , Ductos Biliares Intra-Hepáticos , Clonorquíase/diagnóstico , Clonorquíase/prevenção & controle , Clonorchis sinensis/genética , Clonorchis sinensis/metabolismo , Peixes/parasitologia , Água Doce , Humanos , Metacercárias , Caramujos/parasitologia
3.
BMC Infect Dis ; 19(1): 1014, 2019 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-31783809

RESUMO

BACKGROUND: Clonorchiasis, caused by Clonorchis sinensis (C. sinensis) infection, is a serious food-borne zoonotic disease that is often asymptomatic or shows only mild symptoms, which leads to delayed treatment and chronic clonorchiasis and results in various complications, such as cholelithiasis, cholangitis, cholecystitis and cholangiocarcinoma. However, acute shock caused by C. sinensis infection has not been reported. Here, for the first time, we describe a fatal case of acute shock caused by C. sinensis infection. CASE PRESENTATION: A patient with a history of eating raw or undercooked freshwater fish was hospitalized with acute shock caused by severe abdominal pain. Physical examination suggested acute abdomen with severe abdominal pain and rigidity. Computed tomography (CT) detection indicated acute cholecystitis and cholelithiasis. After cholecystectomy, several liver flukes were found in the drainage tube. Furthermore, morphological analysis and polymerase chain reaction (PCR) identified the pathogen as C. sinensis. The liver gradually restored normal function after anthelmintic therapy with praziquantel. CONCLUSIONS: In this fatal case, C. sinensis infection was the cause of acute shock, which is rarely found in the clinic environment. This report aims to increase awareness of the hazards and complications related to clonorchiasis. The PCR diagnosis method used in this report might be helpful in reducing the misdiagnosis of clonorchiasis and unnecessary cholecystectomy.


Assuntos
Clonorquíase/diagnóstico , Clonorchis sinensis/isolamento & purificação , Choque/diagnóstico , Dor Abdominal/etiologia , Doença Aguda , Animais , Clonorquíase/complicações , Clonorquíase/parasitologia , Clonorchis sinensis/genética , DNA de Protozoário/genética , DNA de Protozoário/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Choque/etiologia , Tomografia Computadorizada por Raios X
4.
J Helminthol ; 94: e107, 2019 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-31779732

RESUMO

The association between eosinophil count and cholelithiasis among people with Clonorchis sinensis infection is still uncertain. We conducted a cross-sectional study to investigate the associations among Clonorchis sinensis infection, eosinophil count and cholelithiasis. The study included 4628 participants from January to December 2018. The levels of eosinophil count were divided into four groups according to the quartiles of eosinophil count. Spearman's rank correlation was performed to assess the association between eosinophil counts and Clonorchis sinensis egg counts. Multiple regression analysis was performed to evaluate the relationships among C. sinensis infection, eosinophil count and cholelithiasis after adjusting for three models. The prevalence of C. sinensis infection was 38.72% (1792/4628), and the prevalence of cholelithiasis was 6.03% (279/4628). The infection rate of C. sinensis was higher in the cholelithiasis group than in the non-cholelithiasis group (63.08% vs. 37.16%, P < 0.001). Significant differences were found among various eosinophil count quartiles for C. sinensis infection, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyltranspeptidase (γ-GT), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), creatinine (CRE), blood urea nitrogen (BUN), uric acid (UA) and non-alcoholic fatty liver disease (NAFLD) (all P < 0.001). A significant positive correlation was found between eosinophil count and log-transformed C. sinensis egg count (r = 0.9477, P < 0.001). Multiple logistic regression analysis revealed that light and moderate intensities of C. sinensis infection were associated with cholelithiasis (P < 0.01 and P < 0.001, respectively), and C. sinensis infection with eosinophil count ranging from 0.05 to 0.5 × 109/l were associated with cholelithiasis (P < 0.05). In conclusion, our findings suggest that the light and moderate infections of C. sinensis with eosinophil count ranging from 0.05 to 0.5 × 109/l may be associated with a higher risk of cholelithiasis.


Assuntos
Colelitíase/diagnóstico , Clonorquíase/diagnóstico , Eosinófilos/citologia , Adulto , Animais , China/epidemiologia , Colelitíase/epidemiologia , Colelitíase/parasitologia , Clonorquíase/epidemiologia , Clonorchis sinensis , Estudos Transversais , Feminino , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Contagem de Ovos de Parasitas , Prevalência , Fatores de Risco , Estatísticas não Paramétricas
5.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(5): 468-473, 2019 Oct 16.
Artigo em Chinês | MEDLINE | ID: mdl-31713373

RESUMO

OBJECTIVE: To establish a recombinase aided isothermal amplification (RAA) assay for detection of Clonorchis sinensis. METHODS: The 18S ribosomal RNA (18S rRNA) sequence of C. sinensis was used as the target sequence, and specific primers and probes were designed, synthesized and screened to establish a rapid fluorescent RAA assay for the detection of C. sinensis. Then, the sensitivity of the fluorescent RAA assay was evaluated using the recombinant plasmids containing various copy numbers of DNA fragments and C. sinensis genomic DNA at various concentrations, and the specificity of the fluorescent RAA as say was evaluated using the genomic DNA of Ascaris lumbricoides, Echinococcus granulosus, Schistosoma japonicum, Ancylostoma duodenale and S. mansoni as templates. DNA samples were extracted from the feces containing C. sinensis eggs and freshwater fish containing metacercaria for the fluorescent RAA assay, and the performance for detection of C. sinensis-infected samples was preliminarily assessed in the field. RESULTS: A fluorescent RAA assay for detection of C. sinensis was successfully established, which was feasible for specific amplification of C. sinensis genomic DNA at 39 °C within 20 min. The lowest detection limit was 10 copies/µL if the recombinant plasmid containing various copy numbers of DNA fragments was used as a template, and the lowest detection limit was 3 pg/µL if the C. sinensis genomic DNA at various concentrations served as a template. All detections were negative if the genomic DNA of A. lumbricoides, E. granulosus, S. japonicum, A. duodenale, and S. mansoni was used as templates. In addition, the fluorescent RAA assay showed a high performance for the detection of C. sinensis-infected samples in the field, which successfully detected C. sinensis-infected human and rat fecal samples and Pseudorasbora parva samples. CONCLUSIONS: A fluorescent RAA assay is successfully established, which is simple, rapid, sensitivity and specific for detection of C. sinensis.


Assuntos
Clonorquíase , Clonorchis sinensis , Técnicas de Amplificação de Ácido Nucleico , Ácidos Nucleicos , Animais , Clonorquíase/diagnóstico , Clonorchis sinensis/genética , Primers do DNA , Fezes/parasitologia , Humanos , Limite de Detecção , Parasitologia/métodos , Ratos , Recombinases/metabolismo , Sensibilidade e Especificidade
6.
Am J Trop Med Hyg ; 101(5): 1156-1160, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31482789

RESUMO

Chronic infections with the food-borne liver flukes, Opisthorchis viverrini or Clonorchis sinensis, associate with cholangiocarcinoma, bile duct cancer, which generally has a poor prognosis. We have produced a rapid and simple immunochromatographic test (ICT) kit for the diagnosis of opisthorchiasis and clonorchiasis by the detection of IgG antibodies in human infection sera. Sera from volunteers with proven opisthorchiasis and several other parasitic diseases and from healthy controls were evaluated for the presence of liver fluke infection-specific antibodies using a preparation of excretory-secretory antigen from adult stage O. viverrini absorbed onto ICT strips. Diagnostic values were compared with an ELISA. The diagnostic sensitivity, specificity, and positive and negative predictive values of the ELISA were 100%, 98.3%, 97.9%, and 100%, whereas those for the ICT were 94.6%, 91.2%, 89.7%, and 95.4%, respectively. There was 91.7% concordance between the ICT with ELISA, and differences in performance between the tests were not statistically significant (P > 0.05). Twenty-seven of 30 (90%) of the clonorchiasis sera also were positive by ICT. This new ICT provides a facile, rapid test for point-of-care testing tool, which can be used at the bedside without the need for sophisticated equipment. Moreover, the ICT can be anticipated to supplement stool examination as a screening tool in the clinic for the diagnosis of opisthorchiasis and clonorchiasis, and in addition, it may be useful in screens of populations at risk of liver fluke infection-associated cholangiocarcinoma.


Assuntos
Clonorquíase/diagnóstico , Imunoensaio/métodos , Opistorquíase/diagnóstico , Testes Imediatos , Testes Sorológicos , Animais , Antígenos de Helmintos/sangue , Clonorquíase/sangue , Clonorchis sinensis/imunologia , Humanos , Opistorquíase/sangue , Opisthorchis/imunologia
7.
Adv Exp Med Biol ; 1154: 139-180, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31297762

RESUMO

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, are 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 a 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 cholangiocarcinoma in endemic areas.


Assuntos
Clonorquíase , Clonorchis sinensis , Opistorquíase , Opisthorchis , Animais , Ásia/epidemiologia , Clonorquíase/diagnóstico , Clonorquíase/epidemiologia , Clonorquíase/parasitologia , Clonorquíase/prevenção & controle , Clonorchis sinensis/classificação , Clonorchis sinensis/genética , Europa (Continente)/epidemiologia , Humanos , Opistorquíase/diagnóstico , Opistorquíase/epidemiologia , Opistorquíase/parasitologia , Opistorquíase/prevenção & controle , Opisthorchis/classificação , Opisthorchis/genética
8.
Parasit Vectors ; 12(1): 336, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31287026

RESUMO

BACKGROUND: Clonorchiasis is caused by eating of raw or undercooked freshwater fish containing the larvae of Clonorchis sinensis; the Kato-Katz method is widely applied in diagnosis. The improvement of repeated Kato-Katz smears from multiple stool samples has been well illuminated in many helminths other than C. sinensis. METHODS: A cross-sectional investigation was implemented to capture the epidemiology and risk factors of clonorchiasis among middle school students in Qiyang county, China. Students with complete data of six Kato-Katz thick smears from two stool samples were included in this analysis. Data on the habits of eating raw freshwater fish were also collected and compared. RESULTS: Altogether, 397 students had complete information of six smears, out of which 394 reported the information on eating habits. According to the 'gold' standard by six smears, 77 students (19.4%) were detected with C. sinensis. However, only 45 (11.3%) were detected using a single smear, with an underestimation of 41.6% compared to the 'gold' standard. However, the geometric mean of eggs per gram of feces in detected cases was 126.4 in a single smear, overestimated by 105.2% compared to 61.6 by the 'gold' standard. The linear relationship between prevalence and infection intensity of detected cases based on different smears was significantly negative. The habits of eating raw freshwater fish in the false negative cases was similar to those in the detected cases, but these two groups had significantly higher levels for habits of eating raw freshwater fish than negative individuals. CONCLUSIONS: In low endemicity situations, underestimation of C. sinensis infection could not be avoided based on a limited number of Kato-Katz smears. Thus, repeated smears from at least two stool samples should be considered when an individual eats raw freshwater fish, drug efficacy is evaluated or elimination of C. sinensis is verified. Additionally, when logistics are insufficient for multiple samples to be taken for diagnosis for survey and surveillance in the areas or populations of low endemicity, prevalence accuracy needs to be corrected.


Assuntos
Clonorquíase/diagnóstico , Clonorchis sinensis/isolamento & purificação , Produtos Pesqueiros/parasitologia , Manejo de Espécimes/métodos , Animais , China/epidemiologia , Clonorquíase/epidemiologia , Clonorquíase/parasitologia , Estudos Transversais , Fezes/parasitologia , Comportamento Alimentar , Feminino , Peixes , Água Doce , Humanos , Masculino , Contagem de Ovos de Parasitas , Prevalência , Inquéritos e Questionários
9.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(2): 165-168, 2019 May 23.
Artigo em Chinês | MEDLINE | ID: mdl-31184048

RESUMO

OBJECTIVE: To compare the performance of modified Kato-Katz thick smear method (KK method) and PCR assay in field detection of Clonorchis sinensis in human fecal samples, which provides insight into the selection of tools for detecting C. sinensis. METHODS: Based on the epidemiological investigation of human C. sinensis infections in Tengxian County of Guangxi Zhuang Autonomous Region in 2016, a total of 133 fecal samples were randomly selected and stored at -20 ℃. All fecal samples were detected for C. sinensis infection using KK method and PCR assay, and the detection rate was compared between the two techniques. In addition, Kappa test was used to evaluate the consistency between the two methods. RESULTS: Among all fecal samples, the overall detection rate of C. sinensis was 77.44% (103/133), and the detection rate was significantly higher by PCR assay (70.68%, 93/133) than by KK method (57.14%, 76/133) (χ2 = 26.15, P < 0.01). There were 88.16% (67/76) of the microscopy-positive fecal samples positive for PCR assay, and 47.37% (27/57) of the microscopy-negative fecal samples positive for PCR assay. The detection rate of C. sinensis by PCR assay (94.74%, 18/19) was higher in fecal samples with EPG of > 1 000 than in samples with EPG of < 1 000 (85.96%, 49/57) (χ2 = 1.05, P = 0.436). The consistency of the detection rate of C. sinensis was moderate between the KK method and PCR assay (Kappa = 0.73). CONCLUSIONS: The detection rate of C. sinensis by PCR assay is significantly higher than by KK method. In low-endemic areas of C. sinensis infections, the combination of KK method and PCR assay is suggested, so as to improve the detection rate.


Assuntos
Clonorquíase , Clonorchis sinensis , Parasitologia/métodos , Reação em Cadeia da Polimerase , Animais , China , Clonorquíase/diagnóstico , Clonorchis sinensis/genética , Fezes/parasitologia , Humanos , Reação em Cadeia da Polimerase/normas , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
10.
J Korean Med Sci ; 34(20): e149, 2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31124326

RESUMO

We analyzed Clonorchis sinensis ancient DNA (aDNA) acquired from the specimens of the Joseon mummies. The target regions were cytochrome C oxidase subunit 1 (CO1), internal transcribed spacer 1 (ITS1), nicotinamide adenine dinucleotide hydrogen (NADH) dehydrogenase subunits 2 (NAD2) and 5 (NAD5). The sequences of C. sinensis aDNA was completely or almost identical to modern C. sinensis sequences in GenBank. We also found that ITS1, NAD2 and NAD5 could be good markers for molecular diagnosis between C. sinensis and the other trematode parasite species. The current result could improve our knowledge about genetic history of C. sinensis.


Assuntos
Clonorchis sinensis/genética , DNA Antigo/química , Complexo IV da Cadeia de Transporte de Elétrons/genética , Oxirredutases/genética , Animais , Clonorquíase/diagnóstico , Clonorquíase/epidemiologia , Clonorchis sinensis/classificação , DNA Antigo/isolamento & purificação , Complexo IV da Cadeia de Transporte de Elétrons/química , Complexo IV da Cadeia de Transporte de Elétrons/classificação , Humanos , Múmias/parasitologia , Oxirredutases/química , Oxirredutases/classificação , Filogenia , Subunidades Proteicas/química , Subunidades Proteicas/classificação , Subunidades Proteicas/genética , República da Coreia , Análise de Sequência de DNA
11.
BMC Infect Dis ; 19(1): 115, 2019 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-30727977

RESUMO

BACKGROUND: Clonorchiasis is the common parasitic infection in the general population of the Republic of Korea, however, taeniasis is scarcely reported recently. Here, we describe a case of co-infection with the cestode T. saginata in a patient with subclinical clonorchiasis diagnosed by a combination of diagnostic tools in Korea. CASE PRESENTATION: A 56-year-old man visited the hospital having passed proglottids in his stool for the past two months and brought a stool sample with segments to our hospital. He had no abdominal symptoms, such as nausea, vomiting, abdominal pain, diarrhea, or constipation. He used to consume raw beef and fish frequently. We could not find evidence of gravid proglottids which contain fully developed uteri filled with ova or branched uterine structures, within the submitted sample. To identify the tapeworm species, we carried out molecular analyses on the proglottids. The cox1 and ef1a sequences had a 100% match with those of T. saginata and differed from the sequences of the other Taenia species. Upon examination of stool samples fixed by formalin-ether concentration method, no Taenia species ova were observed in 10 slides. Instead, C. sinensis ova were observed, despite the level of IgG specific to C. sinensis being within the normal range. The patient was treated with praziquantel (25 mg/kg, three times a day) for 3 days, and subsequently C. sinensis ova were not found in his stool. CONCLUSION: Our case indicates that a combination of morphological, serological, and molecular diagnostic tools should be used for the accurate diagnosis of subclinical parasitic infections.


Assuntos
Clonorquíase/diagnóstico , Taenia saginata/genética , Teníase/diagnóstico , Animais , Bovinos , Clonorquíase/tratamento farmacológico , Clonorquíase/etiologia , Coinfecção/complicações , Coinfecção/parasitologia , Ciclo-Oxigenase 1/genética , Fezes/parasitologia , Proteínas de Helminto/genética , Humanos , Masculino , Pessoa de Meia-Idade , Fator Tu de Elongação de Peptídeos/genética , Praziquantel/uso terapêutico , República da Coreia , Taenia saginata/patogenicidade , Teníase/tratamento farmacológico , Teníase/etiologia
12.
BMC Infect Dis ; 19(1): 33, 2019 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-30621611

RESUMO

BACKGROUND: Hepatic clonorchiasis is one of the most prevalent food-borne parasitic diseases worldwide. Clonorchis sinensis, the pathogen, is the major parasitic trigger contributing to cholangitis, cholelithiasis, and even cholangiocarcinoma. Unfortunately, unspecific clinical manifestations of patients with hepatic clonorchiasis tend to mislead clinicians to neglect or misdiagnose them, following ignorance of appropriate therapy. Our case report may shed light on definite diagnosis of clonorchiasis with concomitant cholelithiasis, methodology for surgical drainage of the parasites, and postoperative anthelmintic therapy. CASE PRESENTATION: Two patients with habit of eating infected raw or undercooked freshwater fish were hospitalized due to right upper quadrant pain and jaundice. Magnetic resonance cholangiopancreatography (MRCP)/computed tomography (CT) detection indicated cholangiolithiasis and cholangiolithiasis with concurrent cholecystolithiasis, respectively. Fecal examinations were both negative for adult worms or eggs of parasites. However, adults of Clonrochis sinensis were detected within hepatobiliary tracts during laparoscopic cholecystectomy. Postoperative drainage and anthelmintic therapy contributed to complete recovery with good prognosis. CONCLUSIONS: Clonorchiasis provokes cholangiolithiasis and cholecystolithiasis. Standardized treatments for these gallstone patients with concomitant clonorchiasis include surgical removal of the calculus, postoperative T tubule drainage and anthelmintic therapy. Serological test or polymerase chain reaction (PCR)-based approaches might be helpful for diagnosis of clonorchiasis when no eggs are found by stool microscopy. Public health promotion on ceasing to eat raw freshwater fish is essential for prevention and control of clonorchiasis.


Assuntos
Sistema Biliar/diagnóstico por imagem , Sistema Biliar/parasitologia , Colangiopancreatografia por Ressonância Magnética/métodos , Clonorquíase/diagnóstico , Icterícia Obstrutiva/diagnóstico , Icterícia Obstrutiva/parasitologia , Laparoscopia/métodos , Adulto , Animais , Anti-Helmínticos/uso terapêutico , Ductos Biliares Intra-Hepáticos/diagnóstico por imagem , Ductos Biliares Intra-Hepáticos/parasitologia , Colecistectomia Laparoscópica , Clonorquíase/complicações , Clonorquíase/tratamento farmacológico , Clonorquíase/cirurgia , Clonorchis sinensis/isolamento & purificação , Feminino , Cálculos Biliares/diagnóstico , Cálculos Biliares/tratamento farmacológico , Cálculos Biliares/parasitologia , Cálculos Biliares/cirurgia , Humanos , Icterícia Obstrutiva/tratamento farmacológico , Icterícia Obstrutiva/cirurgia , Masculino , Pessoa de Meia-Idade
13.
Clin Microbiol Infect ; 25(1): 109.e1-109.e6, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29649604

RESUMO

OBJECTIVES: To determine the potential for immunodiagnostic application of two recombinant forms of Clonorchis sinensis omega-class glutathione transferases (rCsGSTo1 and rCsGSTo2) against human small liver-fluke C. sinensis and Opisthorchis viverrini infections. METHODS: Specific antibody levels against rCsGSTo1 and rCsGSTo2 in patients' sera of egg-positive opisthorchiasis (n = 87) and clonorchiasis (n = 120), as well as those in sera from patients with other helminthic infections (n = 252) and healthy controls (n = 40) were retrospectively analysed by ELISA. RESULTS: We observed highly positive correlation coefficients between specific antibody levels against rCsGSTo1 and rCsGSTo2 and egg counts per gramme of faeces (EPG) of patients with opisthorchiasis (n = 87; r = 0.88 for rCsGSTo1 and r = 0.90 for rCsGSTo2). Sera from opisthorchiasis patients whose EPG counts >100 (n = 43) revealed high antibody titres against both antigens. Patients' sera with low EPG counts (<100, n = 44) also exhibited reliable sensitivities of 93.2% and 97.7% for rCsGSTo1 and rCsGSTo2, respectively. Sera from clonorchiasis patients showed sensitivities of 90% (108/120 samples) and 89.2% (107/120 sera) for rCsGSTo1 and rCsGSTo2. Overall diagnostic sensitivities for liver-fluke infections were 92.3% for rCsGSTo1 (191/207 samples) and 93.2% for rCsGSTo2 (193/207 samples). Specificities were 89.7% (rCsGSTo1) and 97.6% (rCsGSTo2). CONCLUSIONS: Detection of specific antibody levels against rCsGSTo1 or rCsGSTo2 might be promising for the serodiagnosis of patients infected with these two phylogenetically close carcinogenic liver-flukes.


Assuntos
Clonorquíase/diagnóstico , Clonorchis sinensis/enzimologia , Glutationa Transferase/sangue , Opistorquíase/diagnóstico , Testes Sorológicos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Anticorpos Anti-Helmínticos/sangue , Biomarcadores/sangue , Criança , Clonorquíase/sangue , Ensaio de Imunoadsorção Enzimática/métodos , Fezes/parasitologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Opistorquíase/sangue , Contagem de Ovos de Parasitas , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
14.
Z Gastroenterol ; 56(12): 1513-1520, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30466135

RESUMO

Parasitic diseases are relatively rarely diagnosed and treated in Europe. Therefore, European clinicians are not familiar with their clinical and imaging features. In an era of increased human migration, it is fundamental for clinicians to be able to identify such diseases. We have recently described the features of cystic echinococcosis, schistosomiasis, fascioliasis and ascariasis. Here, we report on the clinical and imaging features as well as on the current therapy options of infections by the small liver flukes: Clonorchis sinensis, Opisthorchis viverrini (Southeast Asian liver fluke) and Opisthorchis felineus (cat liver fluke) and other Opisthorchis species prevalent in South Asia.


Assuntos
Clonorquíase , Clonorchis sinensis , Opistorquíase , Opisthorchis , Animais , Clonorquíase/diagnóstico , Clonorquíase/terapia , Europa (Continente) , Humanos , Opistorquíase/diagnóstico , Opistorquíase/terapia
15.
PLoS Negl Trop Dis ; 12(8): e0006683, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30070987

RESUMO

BACKGROUND: Clonorchiasis, caused by the liver fluke Clonorchis sinensis, remains a serious public health issue in Asia, especially in China, and its relationship with cholangiocarcinoma has highlighted the importance of C. sinensis infection. Proteins containing tandem repeats (TRs) are found in a variety of parasites and, as targets of B-cell responses, are valuable for the serodiagnosis of parasite infections. Here, we identified a novel C. sinensis-specific antigen, Cs1, containing TRs, and investigated its diagnostic value, other immunological properties, and tissue distribution. METHODOLOGY/PRINCIPAL FINDINGS: A partial Cs1 cDNA sequence was cloned by screening an adult C. sinensis cDNA expression library. The full-length Cs1 cDNA was obtained by 5' rapid amplification of cDNA ends. The deduced Cs1 protein consists of a signal peptide and five TRs of 21 amino acids. The recombinant Cs1 (rCs1) was constructed and purified. rCs1 showed higher sensitivity (94.3%) and specificity (94.4%) than the C. sinensis excretory-secretory products (ESPs) according to ELISA of 114 serum samples. Native Cs1 was identified in C. sinensis ESPs and crude antigens of adult C. sinensis by western blotting using an anti-rCs1 monoclonal antibody. ELISA of recombinant peptides of different Cs1 regions demonstrated that the TR region was immunodominant in Cs1. Immunohistochemistry and confocal microscopy revealed that Cs1 is located in a granule-like structure surrounding the acetabulum of C. sinensis adults that has not previously been described. CONCLUSIONS/SIGNIFICANCE: We identified a novel C. sinensis-specific TR protein, Cs1, which is an antigen of high serological significance, compared with C. sinensis ESPs. The deduced features of Cs1 show a unique structure containing TRs and a signal peptide and the TR region is immunodominant in Cs1. This provides a basis for targeted screens of other antigens. The novel structure in which Cs1 is located also deserves further investigation.


Assuntos
Antígenos de Helmintos/metabolismo , Clonorchis sinensis/metabolismo , Proteínas de Helminto/metabolismo , Testes Sorológicos , Animais , Anticorpos Anti-Helmínticos/sangue , Anticorpos Monoclonais , Sequência de Bases , Clonorquíase/sangue , Clonorquíase/diagnóstico , Clonorchis sinensis/genética , Clonorchis sinensis/imunologia , DNA Complementar , Regulação da Expressão Gênica , Proteínas de Helminto/genética , Proteínas de Helminto/imunologia , Humanos , Coelhos , Proteínas Recombinantes
16.
Vet Parasitol ; 259: 1-5, 2018 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-30056977

RESUMO

Both Fasciola hepatica and Clonorchis sinensis are endemic in China, South Korea, Japan and other Southeast Asian countries. Reliable and sensitive diagnostic methods are needed for detecting their infections in humans and animals. Differential simplex and duplex polymerase chain reaction (PCR) methods were developed. The PCRs targeted the second internal transcribed spacer (its2) (408 bp) of F. hepatica, and NADH dehydrogenase subunit 2 gene (nad2) (527 bp) of C. sinensis. Both simplex PCRs detected as little as 2 pg genomic DNA in one microliter in a 25 µL PCR reaction system. The duplex PCR had similar detection limit as well, and detected as low as one egg in 200 mg feces. These methods were analytical specific with no amplification being observed from the gemonic DNA of Fasciolopsis buski, Haemonchus contortus, Ascaris ovis or Eimeri ahsata. Of 158 sheep fecal samples collected from various farms, four and one samples were PCR-positive for F. hepatica and C. sinensis, respectively. The duplex PCR method described here is time-saving and convenient, and may prove to be an invaluable tool for molecular detection and epidemiological investigation of F. hepatica and C. sinensis in endemic area.


Assuntos
Clonorquíase/veterinária , Clonorchis sinensis/genética , Fasciola hepatica/genética , Fasciolíase/veterinária , Reação em Cadeia da Polimerase/métodos , Doenças dos Ovinos/diagnóstico , Animais , China/epidemiologia , Clonorquíase/diagnóstico , Clonorquíase/parasitologia , Clonorchis sinensis/isolamento & purificação , Primers do DNA/genética , DNA de Helmintos/genética , DNA Intergênico/genética , Fasciola hepatica/isolamento & purificação , Fasciolíase/diagnóstico , Fasciolíase/parasitologia , Fezes/parasitologia , Limite de Detecção , Técnicas de Diagnóstico Molecular/veterinária , Contagem de Ovos de Parasitas , Ovinos , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/parasitologia
17.
Int Immunopharmacol ; 59: 120-126, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29653409

RESUMO

Our study aims to retrospectively investigate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and eosinophil-to-lymphocyte ratio (ELR) in patients infected with Clonorchis sinensis. This study analyzes a total of 151 patients with C. sinensis infections and 53 healthy control patients from our hospital. We found close relationships between the three candidate markers and the stages of C. sinensis infection-related biliary obstruction. The NLRs, PLRs and ELRs of patients with C. sinensis infections were significantly higher than those of healthy individuals; of those, ELRs showed the most superior diagnostic accuracy (sensitivity = 62.9%, specificity = 92.5%). Further, we constituted a logistic regression prediction model; applying two variables (age and NLR) with a sensitivity of 88.89% and a specificity of 83.78% in differentiating C. sinensis-related cholelithiasis from C. sinensis-untreated patients. Cancer antigen 19-9 (CA19-9) is a commonly used marker in the diagnosis of cholangiocarcinoma. Significant correlation was observed between NLR and CA19-9 in patients with C. sinensis-related cholangiocarcinoma (r = 0.590, P = 0.000). In the receiver operating characteristic analysis for separating C. sinensis-related cholelithiasis and cholangiocarcinoma, the cutoff value of PLR was 145.14 with a sensitivity of 65.62% and a specificity of 68.89%; the sensitivity of CA19-9 was 75.00% with a specificity of 77.78%. PLR showed acceptable efficiency to separate C. sinensis-related cholelithiasis from cholangiocarcinoma. In conclusion, all of the candidate markers (PLRs, NLRs and ELRs) may act as the valuable supplement in detecting C. sinensis infections and diseases.


Assuntos
Plaquetas , Clonorquíase/sangue , Clonorchis sinensis , Linfócitos , Neutrófilos , Adulto , Animais , Antígenos Glicosídicos Associados a Tumores , Colelitíase/sangue , Colelitíase/diagnóstico , Clonorquíase/diagnóstico , Clonorquíase/imunologia , Feminino , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , Estudos Retrospectivos , Sensibilidade e Especificidade
18.
Parasitology ; 145(12): 1531-1539, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29580315

RESUMO

Due to the lack of an effective prophylactic intervention and diagnosis, human liver fluke Clonorchis sinensis continues to afflict a large human population, causing a chronic inflammatory bile duct disease. With an aim to identify target antigens for sensitive serodiagnosis, adenylate kinase 3 of C. sinensis (CsAK3) was successfully expressed in soluble form in Escherichia coli by fusion to an RNA-interacting domain derived from human Lys-tRNA synthetase and purified by Ni2+-affinity chromatography. Anti-CsAK3 serum was raised by immunization of mice, and Western blotting confirmed that CsAK3 was expressed in adult-stage C. sinensis. Histochemical analysis showed that CsAK3 was localized to the subtegumental tissue of C. sinensis and was excreted into the bile duct of the host. When tested against sera from various parasite-infected patients by enzyme-linked immunosorbent assay, the recombinant CsAK3 elicited a specific response to C. sinensis-infected sera. The results suggest that CsAK3, either alone or in combination with other antigens, could be used for improving the clinical diagnosis of clonorchiasis.


Assuntos
Adenilato Quinase/imunologia , Antígenos de Helmintos/imunologia , Clonorquíase/diagnóstico , Clonorchis sinensis/imunologia , Adenilato Quinase/genética , Animais , Antígenos de Helmintos/genética , Western Blotting , Clonorquíase/parasitologia , Clonorchis sinensis/enzimologia , Clonorchis sinensis/genética , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Filogenia , Proteínas Recombinantes , Testes Sorológicos
19.
Parasit Vectors ; 11(1): 35, 2018 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-29334990

RESUMO

BACKGROUND: Clonorchiasis ranks among the most important food-borne parasitic diseases in China. However, due to low compliance to traditional fecal examination techniques in the general population and medical personnel, immunodiagnosis is expected. This study evaluated, in parallel, the performance of four immunodiagnostic kits detecting clonorchiasis in China. RESULTS: A bank with 475 sera was established in this study. Except for the low performance of the kit detecting IgM, the other three kits detecting IgG showed sensitivities ranging from 81.51% (194/238) to 99.16% (236/238). Higher sensitivity was presented in heavy infection intensity [89.47% (68/76) to 100% (76/76)]. Among the four kits, the overall specificity varied from 73.42% (174/237) to 87.34% (207/237). It was observed that the specificity was lower in the sera of the participants living in clonorchiasis-endemic areas but without any parasite infection [67.5% (81/120) to 90% (108/120)], as compared to those from the non-endemic area [94% (47/50) to 98% (49/50)]. The cross-reaction rate varied from 14.93% (10/67) to 31.34% (21/67). Youden's index was -0.022, 0.689, 0.726, and 0.802 for kits T1, T2, T3 and T4, respectively. Repeatability was high in all four kits. CONCLUSIONS: Three immunodiagnosis kits targeting IgG antibody had high performance on detecting chronic Clonorchis sinensis infection, but that detecting IgM antibody had not. The kits detecting IgG antibody also showed high sensitivity in heavy infection intensity. Research on immunological diagnosis of clonorchiasis is expected to be strengthened to improve the sensitivity in light infection and specificity.


Assuntos
Anticorpos Anti-Helmínticos/sangue , Clonorquíase/diagnóstico , Clonorchis sinensis/isolamento & purificação , Testes Diagnósticos de Rotina/métodos , Imunoensaio/métodos , Kit de Reagentes para Diagnóstico , Animais , China , Clonorchis sinensis/imunologia , Reações Cruzadas , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
20.
Gut Liver ; 12(3): 236-245, 2018 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-28783896

RESUMO

Cholangiocarcinoma (CCA) is an aggressive cancer arising from epithelial cells of the bile duct. Most patients with CCA have an unresectable tumor at the time of diagnosis. In Western countries, the risk of CCA increases in patients with primary sclerosing cholangitis, whereas liver fluke infection appears to be the major risk factor for CCA in Asian countries. A diagnosis of liver fluke infection often relies on stool samples, including microscopic examination, polymerase chain reaction-based assays, and fluke antigen detection. Tests of serum, saliva and urine samples are also potentially diagnostic. The presence of liver fluke along with exogenous carcinogens magnifies the risk of CCA in people living in endemic areas. The "liver fluke-cholangiocarcinoma" carcinogenesis pathways consist of mechanical damage to the bile duct epithelium, immunopathologic and cellular reactions to the liver fluke's antigens and excretory/secretory products, liver fluke-induced changes in the biliary tract microbiome and the effects of repeated treatment for liver fluke. A vaccine and novel biomarkers are needed for the primary and secondary prevention of CCA in endemic areas. Importantly, climate change exerts an effect on vector-borne parasitic diseases, and awareness of liver fluke should be enhanced in potentially migrated habitat areas.


Assuntos
Neoplasias dos Ductos Biliares/parasitologia , Colangiocarcinoma/parasitologia , Fasciolíase/terapia , Animais , Anti-Helmínticos/uso terapêutico , Biomarcadores/metabolismo , Proliferação de Células/fisiologia , Mudança Climática , Clonorquíase/diagnóstico , Clonorquíase/epidemiologia , Clonorquíase/terapia , Fasciola hepatica/crescimento & desenvolvimento , Fasciola hepatica/isolamento & purificação , Fasciola hepatica/fisiologia , Fasciolíase/diagnóstico , Fasciolíase/epidemiologia , Fezes/parasitologia , Saúde Global , Proteínas de Helminto/fisiologia , Interações Hospedeiro-Parasita , Humanos , Imunidade Celular , Estágios do Ciclo de Vida , Microbiota , Parasitologia/métodos , Fatores de Risco , Saliva/parasitologia , Urina/parasitologia , Vacinas
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