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Madih AN, Ravari MS, Yousefi M, Ehsan M, Akhlaghi E, Kamyabi H, Shafiee A, Harandi MF. HLA class II profile in patients with different stages of cystic echinococcosis according to the WHO ultrasound imaging classification. Parasitol Res 2024; 123:330. [PMID: 39316156 DOI: 10.1007/s00436-024-08353-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 09/17/2024] [Indexed: 09/25/2024]
Abstract
The factors involving in the natural history and determinants of different features of human cystic echinococcosis (CE) are not adequately understood. Several host-related factors including the genetic structure of the host and human leukocyte antigens (HLAs) are believed to be involved in the natural history of CE in humans. The present study was conducted to investigate the association between HLA class II genes and active and inactive stages of hepatic cystic echinococcosis. Echinococcus granulosus cyst samples and patient information were collected from the biobank of the Iranian Hydatid Disease Registry from 2019 to 2022. HLA-DRB and HLA-DQB were characterized by PCR method. CE patients were categorized into three active (CE1 and CE2), inactive (CE4 and CE5), and transitional (CE3) stages according to the WHO ultrasound classification of CE. In total, 77 participants including 38 patients (36.8% men and 63.2% women) with different stages of CE as well as 39 healthy individuals (38.5% men and 61.5% women) were included in the study. Findings of the study showed that the frequency of HLA-DRB1*03 was significantly lower in the patients compared to the healthy individuals. The frequencies of HLA-DQB and HLA-DRB alleles were not differed significantly between active, inactive, and transitional stages of E. granulosus cysts. Findings of this study indicate the potential role of this allele in the susceptibility of human to cystic echinococcosis. Further large-scale studies in different endemic countries are required to document the significance of HLA-DQB and HLA-DRB as a host-related factor in the natural history of CE in human.
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Affiliation(s)
- Ahu Nakhaei Madih
- Student Research Committee, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehrnaz Sadat Ravari
- Research Center for Hydatid Disease in Iran, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Maysam Yousefi
- Research Center for Hydatid Disease in Iran, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
| | - Mohsen Ehsan
- Department of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
- Department of Hematology and Medical Laboratory Sciences, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Elham Akhlaghi
- Research Center for Hydatid Disease in Iran, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Hosein Kamyabi
- Department of Parasitology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Amir Shafiee
- Afzalipour Medical Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Majid Fasihi Harandi
- Research Center for Hydatid Disease in Iran, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
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Aljinović J, Šošo D, Petrić M, Perković D, Marasović Krstulović D, Kero D, Marinović I. Clinical Phenotype of HLA B*44 Patients in a Rheumatology Outpatient Clinic Favors Peripheral Arthropathies. J Clin Med 2024; 13:5440. [PMID: 39336927 PMCID: PMC11432423 DOI: 10.3390/jcm13185440] [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: 08/05/2024] [Revised: 09/04/2024] [Accepted: 09/12/2024] [Indexed: 09/30/2024] Open
Abstract
Objective: The genetic background of HLA-B*27 in spondyloarthritis is known, and the search for another gene with similar role is ongoing. We wanted to investigate clinical presentations of HLA-B*44 patients in rheumatology practice. Methods: A cross-sectional retrospective study of 303 HLA-B*44 adult patients from the outpatient rheumatology clinic from 5/2018-5/2024. Clinical phenotype, confirmed or excluded rheumatic diagnosis, therapy used, and data on HLA A, B, and DR alleles inherited with B*44 were analyzed. Results: A female predominance of 2.79:1 was noted. A total of 150 [49.5%] patients were referred due to peripheral joint pain, 77 [25.4%] due to combined spine and peripheral joint pain or spine alone (57 [18.8%]). A total of 19 [6.3%] patients had no symptoms of the musculoskeletal system. Statistically significant peripheral joint affection was proved in females but not in males (p = 0.04). A total of 121 [40%] patients from B*44 group had established rheumatic disease, with the rest being excluded or under observation. The most common working diagnoses were polyarthritis (32 [10.5%]) and mono-oligoarthritis (14 [4.6%]). A second allele in addition to HLA B*44 showed a similar frequency to the general population. Patients with HLA B*44/44 and B*27/44 genotypes were at the most risk for having definitive rheumatic disease (>60%). Conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs) were used in 38.6% of patients, non-steroidal anti-inflammatory drugs were used in 31.6% of patients, biologic DMARDs were used in 8.9% of patients, and corticosteroids were used in 7.3% of patients. Conclusions: The most common presentation in HLA-B*44 patients is peripheral joint affection. Most patients with HLA-B*27/44 and B*44/44 genotypes had definitive rheumatic disease. B*44 homozygosity or B*27/44 might be risk factors for arthritis development.
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Affiliation(s)
- Jure Aljinović
- Division of Physical Medicine and Rehabilitation with Rheumatology, University Hospital of Split, 21000 Split, Croatia
- University of Split School of Medicine, 21000 Split, Croatia
- University of Split, Department of Health Studies, 21000 Split, Croatia
| | - Daniela Šošo
- Division of Physical Medicine and Rehabilitation with Rheumatology, University Hospital of Split, 21000 Split, Croatia
- University of Split, Department of Health Studies, 21000 Split, Croatia
| | - Marin Petrić
- Department of Internal Medicine, Division of Rheumatology, Allergology and Clinical Immunology, University Hospital of Split, 21000 Split, Croatia
| | - Dijana Perković
- University of Split School of Medicine, 21000 Split, Croatia
- Department of Internal Medicine, Division of Rheumatology, Allergology and Clinical Immunology, University Hospital of Split, 21000 Split, Croatia
| | - Daniela Marasović Krstulović
- University of Split School of Medicine, 21000 Split, Croatia
- Department of Internal Medicine, Division of Rheumatology, Allergology and Clinical Immunology, University Hospital of Split, 21000 Split, Croatia
| | - Darko Kero
- Study Program of Dental Medicine, University of Split School of Medicine, 21000 Split, Croatia;
| | - Ivanka Marinović
- Division of Physical Medicine and Rehabilitation with Rheumatology, University Hospital of Split, 21000 Split, Croatia
- University of Split, Department of Health Studies, 21000 Split, Croatia
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García-Luna J, Magnone J, Miles S, López-Santurio C, Dematteis S, Mourglia-Ettlin G. Polyreactive antibodies as potential humoral biomarkers of host resistance to cystic echinococcosis. Parasite Immunol 2020; 43:e12802. [PMID: 33098129 DOI: 10.1111/pim.12802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/05/2020] [Accepted: 10/16/2020] [Indexed: 12/30/2022]
Abstract
Polyreactive antibodies (pAb) bind to a broad range of unrelated structures, providing hosts with functional components able to rapidly recognize and protect against different pathogens. However, their roles against helminth parasites are still unexplored. Here, pAb profiles were analysed in cystic echinococcosis (CE), a zoonosis caused by the cestode Echinococcus granulosus sensu lato. Levels of anti-DNP (2,4-dinitrophenyl-hapten) antibodies were measured as a surrogate parameter of pAb in different biological settings. Firstly, levels of serum and peritoneal pAb were measured during early experimental secondary CE, using both high (Balb/c) and low (C57Bl/6) susceptible mouse strains. Serum pAb mostly differed in normal mice, being pAb levels of IgG subclasses with poor anti-parasite activities predominant in Balb/c animals. Conversely, peritoneal pAb isotypes/subclasses with efficient anti-parasite activities predominated in normal and infected C57Bl/6 mice. Secondly, sera from potentially resistant patients, susceptible individuals and healthy donors were analysed, showing higher pAb levels of the IgA and IgG-particularly IgG1-isotypes in potentially resistant individuals compared to control groups. Finally, since remarkable differences were observed in pAb profiles according to the intrinsic host susceptibility to the infection, we proposed here that pAb might be considered as potential humoral biomarkers for host resistance to CE.
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Affiliation(s)
- Joaquín García-Luna
- Área Inmunología, Facultad de Química, Universidad de la Republica, Montevideo, Uruguay
| | - Javier Magnone
- Área Inmunología, Facultad de Química, Universidad de la Republica, Montevideo, Uruguay
| | - Sebastián Miles
- Área Inmunología, Facultad de Química, Universidad de la Republica, Montevideo, Uruguay
| | - Camila López-Santurio
- Área Inmunología, Facultad de Química, Universidad de la Republica, Montevideo, Uruguay
| | - Sylvia Dematteis
- Área Inmunología, Facultad de Química, Universidad de la Republica, Montevideo, Uruguay
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Mariconti M, Meroni V, Badulli C, Brunetti E, Tinelli C, De Silvestri A, Tamarozzi F, Genco F, Casulli A, Martinetti M. Correlation of serum sHLA-G levels with cyst stage in patients with cystic echinococcosis: is it an immune evasion strategy? Parasite Immunol 2017; 38:414-8. [PMID: 27120498 DOI: 10.1111/pim.12328] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 04/18/2016] [Indexed: 11/27/2022]
Abstract
Patients with cystic echinococcosis (CE) can harbour cysts for years or even decades, apparently without effect of the immune system on the metacestode. Although several immune evasion mechanisms by echinococcal cysts have been described, it is unclear whether the human leucocyte antigen (HLA) system plays a role in the susceptibility or resistance to CE in humans. HLA-G molecules are known to exert a suppressive action on dendritic cells maturation and on natural killer (NK) cells functions, therefore hampering T-cell responses and NK cytolysis. HLA-G plays an important role in immune tolerance, is involved in foetus and in allotransplant tolerance, and may be involved in tumoral and viral immune evasion. In this study, we assessed the presence and levels of soluble HLA-G (sHLA-G) in patients with CE using a commercial ELISA kit to determine whether host's HLA-G may have a role in the course of human CE.
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Affiliation(s)
- M Mariconti
- Division of Tropical and Infectious Diseases, San Matteo Hospital Foundation, Pavia, Italy.,WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy.,Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - V Meroni
- Department of Internal medicine and Medical Therapy, University of Pavia, Pavia, Italy.,Microbiology and Virology Unit, San Matteo Hospital Foundation, Pavia, Italy
| | - C Badulli
- Immunogenetics Laboratory, Immunohematology and Transfusion Center, San Matteo Hospital Foundation, Pavia, Italy
| | - E Brunetti
- Division of Tropical and Infectious Diseases, San Matteo Hospital Foundation, Pavia, Italy.,WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy.,Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - C Tinelli
- Clinical Epidemiology and Biometry Unit, San Matteo Hospital Foundation, Pavia, Italy
| | - A De Silvestri
- Clinical Epidemiology and Biometry Unit, San Matteo Hospital Foundation, Pavia, Italy
| | - F Tamarozzi
- WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy.,Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - F Genco
- Microbiology and Virology Unit, San Matteo Hospital Foundation, Pavia, Italy
| | - A Casulli
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanita', Roma, Italy
| | - M Martinetti
- Immunogenetics Laboratory, Immunohematology and Transfusion Center, San Matteo Hospital Foundation, Pavia, Italy
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Natural and induced antibodies contribute to differential susceptibility to secondary cystic echinococcosis of Balb/c and C57Bl/6 mice. Immunobiology 2016; 221:103-15. [DOI: 10.1016/j.imbio.2015.07.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 07/07/2015] [Accepted: 07/23/2015] [Indexed: 01/15/2023]
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Just B, Kern P, Luthardt R, Rudolph H, Grüner B, Wahlers K. Echinococcus cysts affecting oromaxillofacial structures--a systematic review. Oral Dis 2014; 20:756-61. [PMID: 24495132 DOI: 10.1111/odi.12225] [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: 11/25/2013] [Revised: 01/15/2014] [Accepted: 01/22/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Cystic echinococcosis is a worldwide spread zoonosis and humans become accidental intermediate hosts. Any tissue can be affected. However, oromaxillofacial cystic echinococcosis is very uncommon and has never been studied systematically and no evidence-based treatment recommendations are available. Aim of this paper is to summarize the current knowledge and clinical experience with oromaxillofacial manifestations of cystic echinococcosis. MATERIALS AND METHODS PubMed database was accessed with a comprehensive, complex search strategy. Medical Subject Headings terms, wildcard search, truncated search terms and Boolean operators were used. No filters to restrict the results were set. Two evaluators jointly assessed the results in terms of defined criteria. RESULTS The search strategy retrieved 538 results in total. After evaluation 83 publications presenting 108 cases on oromaxillofacial cystic echinococcosis were included. Parotid gland, mandibular region and maxillary region were most commonly affected. Median patient age was 22 years (range 2.5 months to 81 years). Surgical treatment was performed in 97 cases. CONCLUSIONS In cases of oromaxillofacial cystic echinococcosis a thorough evaluation of the patients for further cysts is essential. Therapeutic treatment options are surgical or minimally invasive intervention and drug treatment with benzimidazoles. The diagnosis can be difficult and often require a multidisciplinary approach.
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Affiliation(s)
- Ba Just
- Department of Prosthetic Dentistry, Center of Dentistry, Ulm University Hospital, Ulm, Germany
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Wahlers K, Menezes CN, Romig T, Kern P, Grobusch MP. Cystic echinococcosis in South Africa: the worst yet to come? Acta Trop 2013; 128:1-6. [PMID: 23774317 DOI: 10.1016/j.actatropica.2013.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 06/03/2013] [Accepted: 06/04/2013] [Indexed: 11/26/2022]
Abstract
A considerable number of cases of cystic echinococcosis (CE) are reported from South Africa, but the exact epidemiology remains unknown. In addition, southern Africa is one of the global regions worst afflicted by an excessively high HIV- and TB co-endemicity. As deductable from anecdotal observation, the immune modulation caused by all three diseases seems to affect the clinical courses of all of them. Due to the ongoing high HIV and TB infection rates and the long latency period of CE, South Africa may experience increasing numbers of CE with potentially unusual and severe clinical courses due to concomitant immune suppression. The extent of the problem and the additional complexity of appropriate patient care remain to be recognized.
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The destructive effects of high-intensity focused ultrasound on hydatid cysts enhanced by ultrasound contrast agent and superabsorbent polymer alone or in combination. Parasitol Res 2012; 112:707-17. [PMID: 23160895 DOI: 10.1007/s00436-012-3191-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 11/07/2012] [Indexed: 01/20/2023]
Abstract
Cystic echinococcosis, caused by the metacestode stage of Echincoccus granulosus, remains endemic in many regions around the world. The present work evaluated whether or not a superabsorbent polymer (SAP) and ultrasound contrast agent (UCA) alone or in combination could enhance damage efficacy of high-intensity focused ultrasound (HIFU) on hydatid cysts in vitro. HIFU of 100 W acoustic power, with the aid of 0.1 ml UCA and 0.1 g SAP alone or in combination, was used to ablate hydatid cysts in vitro. The comparison of ultrasound image for each layer of hydatid cyst before and after HIFU ablation was made immediately, and the protoscolices of the cysts were stained by eosin exclusion assay, and the structures of protoscolices were observed by light microscopy. To understand the destructive effects of HIFU, the pathological changes in cyst walls of hydatid cyst ablated with HIFU were examined. The results demonstrated that HIFU had some lethal effect on hydatid cysts: echo enhancement of ultrasound image, increase of mortality rate of protoscolices, serious structural damage of protoscolices, and complete destruction or even disappearance of laminated layer and germinal layer was observed in the group of HIFU combined with UCA and SAP alone or in combination. It was found that the destructive effect of HIFU aided with a combination of UCA and SAP to hydatid cysts was more effective than that of HIFU just aided with UCA or SAP alone. These results suggested that UCA and SAP might be used as a HIFU enhancing agent to improve the efficacy of HIFU ablation to hydatid cysts, which could be a possible therapeutic option for cystic echinococcosis.
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Yang Y, Ellis MK, McManus DP. Immunogenetics of human echinococcosis. Trends Parasitol 2012; 28:447-54. [PMID: 22951425 DOI: 10.1016/j.pt.2012.08.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 07/31/2012] [Accepted: 08/01/2012] [Indexed: 01/28/2023]
Abstract
Susceptibility and resistance to human Echinococcus infection and disease, although poorly understood, appear to reflect a complex interaction of parasite and host immunological and genetic factors. Disease stage, progression, and prognosis following treatment appear to be strongly influenced by cytokine and antibody profiles, and more recent evidence has suggested an important role of dendritic cells (DCs) and T regulatory cells (Tregs) in immunomodulation. Microarrays have supported these findings, highlighting both known and novel pathways involved in chronic murine disease. Genetic studies to date have been few and with limited success. Advanced genomic approaches, such as genome-wide association studies (GWAS), may provide further insight to identify the relevant pathways involved, thereby facilitating a new approach for the development of new clinical therapies.
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Affiliation(s)
- YuRong Yang
- Molecular Parasitology Laboratory, Queensland Institute of Medical Research, Brisbane, QLD, Australia.
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