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Khuroo MS, Khuroo NS, Rather AA. A Case Series and Literature Review of Alveolar Echinococcosis in Kashmir, India: An Emerging Endemic Zone for Echinococcus multilocularis. Life (Basel) 2024; 14:794. [PMID: 39063549 PMCID: PMC11277966 DOI: 10.3390/life14070794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/17/2024] [Accepted: 06/21/2024] [Indexed: 07/28/2024] Open
Abstract
A prospective study on 110 patients with echinococcosis at Dr. Khuroo's Medical Clinic, Srinagar, Kashmir, India, from March 2019 to April 2024 identified 12 cases (4 males, 8 females; mean age of 46.58 ± 11.97 years) of Alveolar echinococcosis (AE). Two patients were detected through ultrasound examinations carried out for unrelated causes; one presented with features of liver abscess, and nine had pain in the right upper quadrant for a mean period of 2.2 ± 1.79 years. All had the liver as the primary organ involved, with 15 tumor masses of a mean maximum diameter of 9.22 ± 3.21 cm and volume of 426 ± 374.61 cm3. Tumors placed centrally had invaded vessels and the biliary tract in eight patients, and those placed peripherally had invaded the liver capsule and adjacent organs in nine patients. Histologic examination of liver biopsies or resected organs revealed necrotic lesions, calcifications, and granulomatous inflammation with slender, thin-walled vesicles of bizarre configuration that stained strongly eosinophilic with periodic acid Schiff. Two patients had segmental liver resections; one was treated with liver aspiration, while the other nine with advanced disease received chemotherapy with albendazole along with praziquantel. Patients showed clinical improvement on a median follow-up of 12 months (range 1 to 60 months); however, MRI T2-weighted images and 18F-FDG-PET-CECT scans in two patients showed active disease on follow-up at one and five years, respectively. A systematic review detected 146 cases of AE in India from 1980 to April 2024. Twenty cases were from foreign countries, mostly from Central Asian republics, and 118 (93.65%) of the remaining 126 Indian patients were permanent residents of Kashmir Valley. The disease affected a population of 79,197 residing in 22 villages from 5 border districts of the valley. These villages were either high in or adjacent to the Himalayan mountain range. Disease prevalence in the affected population was 146.47/105 (males 131.53/105 and females 163.18/105) and the incidence was 12.41/105/year (males 11.16/105/year and females 13.81/105/year). Possible causes of the emergence of AE are discussed, and future directions for research to face this challenge arebeen identified.
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Affiliation(s)
- Mohammad Sultan Khuroo
- Digestive Diseases Centre, Dr. Khuroo’s Medical Clinic, Kashmir, Srinagar 190010, India;
| | - Naira Sultan Khuroo
- Digestive Diseases Centre, Dr. Khuroo’s Medical Clinic, Kashmir, Srinagar 190010, India;
| | - Ajaz Ahmad Rather
- Department of Surgery and Registrar Academics, Sher-I-Kashmir Institute of Medical Sciences Medical College and Hospital, Bemina, Kashmir, Srinagar 190010, India;
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Wang Q, Wang ZX, Wang HJ, Ren L, Kang YL, Pan SY, Sami MW, Fan HN, Wang H. CLINICAL SIGNIFICANCE AND CORRELATION ANALYSIS OF SERUM FERRITIN IN PATIENTS WITH HEPATIC ALVEOLAR ECHINOCOCCOSIS. J Parasitol 2022; 108:159-165. [PMID: 35353187 DOI: 10.1645/19-69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The serum ferritin (SF) levels of patients with hepatic alveolar echinococcosis (HAE) were compared to the laboratory reference value, and the correlation between SF and associated parameters in patients with HAE was assessed. Hematological and imaging data of 245 patients with HAE were collected. Patients were classified into the LSF group (SF ≤ 204 ng/ml) or HSF group (SF > 204 ng/ml) according to the level of SF. There was no significant difference in the serum iron level between groups (P > 0.05). Significant differences in unsaturated iron-binding capacity (UIBC), liver function, blood coagulation, lipid, blood cell count, and lesion characteristics were observed (P < 0.05). Correlation analysis showed that SF was related to UIBC, γ-glutamyl transferase, total bilirubin (TBIL), direct bilirubin (DBIL), fibrinogen (FIB), neutrophil count, and maximal lesion diameter (all absolute rs ≥ 0.4). The correlation coefficient between SF and UIBC showed the highest absolute value (rs = -0.556, P < 0.001). Single-factor linear regression analysis showed that TBIL and DBIL showed the R2 values were 0.221 and 0.220, and the R2 values of UIBC, FIB, and maximal lesion diameter were 0.157, 0.174, and 0.167, respectively, and those of the remaining indicators were <0.1. Multi-factor binary logistic regression analysis showed that UIBC (P < 0.001, OR = 0.909), FIB (P = 0.020, OR = 1.662), hemoglobin (HGB) (P = 0.002, OR = 1.029), and maximal lesion diameter (P = 0.002, OR = 1.146) were significant factors influencing SF abnormalities. SF levels in some patients with HAE were higher than the laboratory reference value. Correlation and regression analysis of SF suggested that the UIBC, FIB, HGB, and maximal lesion diameter were related to SF and affected the SF level. These results may be helpful for the diagnosis and severity assessment of HAE in the future.
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Affiliation(s)
- Qiang Wang
- Medical College of Qinghai University, Xining, Qinghai 810001, No. 16 Kunlun Road, People's Republic of China.,Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining, Qinghai 810001, People's Republic of China
| | - Zhi-Xin Wang
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining, Qinghai 810001, People's Republic of China.,Qinghai Province Key Laboratory of Hydatid Disease Research, No. 251 Ningda Road, Xining, Qinghai 810001, People's Republic of China
| | - Hai-Jiu Wang
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining, Qinghai 810001, People's Republic of China.,Qinghai Province Key Laboratory of Hydatid Disease Research, No. 251 Ningda Road, Xining, Qinghai 810001, People's Republic of China
| | - Li Ren
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining, Qinghai 810001, People's Republic of China.,Qinghai Province Key Laboratory of Hydatid Disease Research, No. 251 Ningda Road, Xining, Qinghai 810001, People's Republic of China
| | - Ying-Li Kang
- Medical College of Qinghai University, Xining, Qinghai 810001, No. 16 Kunlun Road, People's Republic of China.,Image Centre, Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining, Qinghai 810001, People's Republic of China
| | - Si-Yu Pan
- Medical College of Qinghai University, Xining, Qinghai 810001, No. 16 Kunlun Road, People's Republic of China.,Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining, Qinghai 810001, People's Republic of China
| | - Malik Waseem Sami
- Medical College of Qinghai University, Xining, Qinghai 810001, No. 16 Kunlun Road, People's Republic of China.,Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining, Qinghai 810001, People's Republic of China
| | - Hai-Ning Fan
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining, Qinghai 810001, People's Republic of China.,Qinghai Province Key Laboratory of Hydatid Disease Research, No. 251 Ningda Road, Xining, Qinghai 810001, People's Republic of China
| | - Hu Wang
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining, Qinghai 810001, People's Republic of China.,Health Commission of Qinghai Province, No. 12 West Street, Xining, Qinghai 810001, People's Republic of China
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Zhang H, Zhao J, Chen B, Ma Y, Li Z, Shou X, Wen L, Yuan Y, Gao H, Ruan J, Li H, Lu S, Gong Y, Wang J, Wen H. Pharmacokinetics and tissue distribution study of liposomal albendazole in naturally Echinococcus granulosus infected sheep by a validated UPLC-Q-TOF-MS method. J Chromatogr B Analyt Technol Biomed Life Sci 2020; 1141:122016. [PMID: 32062366 DOI: 10.1016/j.jchromb.2020.122016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 12/31/2019] [Accepted: 01/31/2020] [Indexed: 02/06/2023]
Abstract
Albendazole (ABZ) is the first-line drug in treating echinococcosis, which is recommended by WHO. To address the poor bioavailability of albendazole, liposomal albendazole was formulated and is available in our hospital for many years. In this study, a sensitive, reliable and accurate UPLC-Q-TOF-MS method was developed and validated for the determination of albendazole and its metabolites, albendazole sulfoxide (ABZSO), albendazole sulfone (ABZSO2) and albendazole-2-aminosulfone (ABZSO2NH2) in naturally echinococcus granulosus (E. granulosus) infected sheep plasma and tissues with mebendazole (MBZ) as the internal standard (IS). Plasma and tissues samples were prepared by protein precipitation method. The separation was performed on an ACQUITY UPLC® BEH C18 column (2.1 × 50 mm, 1.7 μm) with a gradient mobile phase consisting of methanol and water containing 0.1% formic acid at 0.4 mL/min. The detection was performed on a quadrupole time-of-flight (Q-TOF) high-resolution mass spectrometer using positive electrospray ionization (ESI) source with a chromatographic run time of 6.0 min. The detection was operated using target ions of [M + H]+ at m/z 266.096 for ABZ, m/z 282.091 for ABZSO, m/z 298.086 for ABZSO2, m/z 240.081 for ABZSO2NH2 and m/z 296.104 for IS in selective ion mode, respectively. This method was validated in terms of selectivity, linearity, precision, accuracy, recovery, matrix effect, dilution effect, carryover effects, stability, calibration curve and LLOQ. All validation parameter results were within the acceptable range described in guideline for bioanalytical method validation. This method has been successfully applied to the pharmacokinetic study following single and multiple oral dose of 10 mg/kg liposomal albendazole, and tissue distribution study following multiple oral dose of 10 mg/kg, with emulsion albendazole as the reference preparation. The results in the article will provide valuable information for use in clinical applications of liposomal albendazole and also be beneficial for further development of liposomal albendazole in future studies.
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Affiliation(s)
- Haibo Zhang
- Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, PR China; College of Pharmacy, Xinjiang Medical University, Urumqi 830011, PR China
| | - Jun Zhao
- Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, PR China
| | - Bei Chen
- Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, PR China
| | - Yunfang Ma
- Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, PR China
| | - Zhiqiang Li
- Center of Animal Laboratory, Xinjiang Medical University, Urumqi 830011, PR China
| | - Xi Shou
- Center of Animal Laboratory, Xinjiang Medical University, Urumqi 830011, PR China
| | - Limei Wen
- Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, PR China; College of Pharmacy, Xinjiang Medical University, Urumqi 830011, PR China
| | - Yuan Yuan
- Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, PR China
| | - Huijing Gao
- Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, PR China
| | - Jie Ruan
- Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, PR China
| | - Hongling Li
- Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, PR China
| | - Shuai Lu
- College of Life Sciences, Nanjing normal University, Nanjing 210023, PR China
| | - Yuehong Gong
- Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, PR China
| | - Jianhua Wang
- Department of Pharmacy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, PR China.
| | - Hao Wen
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, PR China.
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Liu Y, Tian F, Shan J, Gao J, Li B, Lv J, Zhou X, Cai X, Wen H, Ma X. Kupffer Cells: Important Participant of Hepatic Alveolar Echinococcosis. Front Cell Infect Microbiol 2020; 10:8. [PMID: 32064239 PMCID: PMC7000360 DOI: 10.3389/fcimb.2020.00008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/09/2020] [Indexed: 12/11/2022] Open
Abstract
Aims: Kupffer cells (KCs) are the liver-resident macrophages and play a leading role in the regulation of liver homeostasis in physiological conditions and in pathology. The study aims to investigate the anti-echinococcosis effect of KCs and the effects of hepatic stellate cells (HSCs) activation in the progression of liver fibrosis in hepatic alveolar echinococcosis (hepatic AE). Methods: Hematoxylin—eosin (H&E) and Masson staining were used to assess the pathological inflammatory changes and collagen deposition, respectively. Immunohistochemistry and qRT-PCR were used to detect the number of aggregates of KCs, the expression of cytokines and activation of HSCs. Results: In the close group, H&E staining showed that the normal lobular structure was destroyed and inflammatory infiltration around the lesion could be observed, and Masson staining showed that blue collagen fibers were clearly deposited near the portal area. IHC showed that KCs surface markers CD68 and CD163, cytokine iNOS and Arg-1 were positively expressed in the vicinity of inflammatory lesions. qRT-PCR indicated that TNF-α, IL-10, and TGF-β1 secreted by KCs were significantly higher than those in the distance group (P < 0.01). It is worth noticing that the expression levels of anti-inflammatory cytokines were slightly higher than that of pro-inflammatory cytokines. Both IHC and qRT-PCR results showed that HSCs activation markers, the expression of α-SMA and Desmin significantly increased. Conclusions: Our research indicates that KCs have immune-protective effect of anti-echinococcosis and promote liver fiber repair, and it also suggests that they have potential therapeutic value for patients with hepatic AE.
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Affiliation(s)
- Yumei Liu
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Fengming Tian
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Jiaoyu Shan
- College of Basic Medicine of Xinjiang Medical University, Urumqi, China
| | - Jian Gao
- College of Basic Medicine of Xinjiang Medical University, Urumqi, China
| | - Bin Li
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Jie Lv
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xuan Zhou
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xuanlin Cai
- College of Basic Medicine of Xinjiang Medical University, Urumqi, China
| | - Hao Wen
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiumin Ma
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,College of Basic Medicine of Xinjiang Medical University, Urumqi, China
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Wang Q, Pang MQ, Kang YL, Wang ZX, Cairang D, Wang H, Wang HJ, Fan HN. Primary splenic hydatidosis: a case report. J Int Med Res 2019; 48:300060519845500. [PMID: 31167587 PMCID: PMC7581981 DOI: 10.1177/0300060519845500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We herein report a case of primary splenic hydatidosis to provide data regarding the diagnosis, treatment, and epidemiological statistics of this disease. The patient was from a pastoral area and was diagnosed with primary splenic hydatidosis with chronic atrophic gastritis. The patient had no history of surgical treatment of hydatidosis. The diagnosis was mainly based on possible exposure to endemic areas, imaging findings, serological test results, and operative and pathological examination findings. Laparoscopic splenectomy was performed, and regular albendazole therapy was given after the operation. The patient was admitted to the hospital for gastrointestinal bleeding 3 months postoperatively, and she was successfully treated and discharged. No recurrence of hydatid foci has been observed since the follow-up.
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Affiliation(s)
- Qiang Wang
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, P.R. China
| | - Ming-Quan Pang
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, P.R. China
| | - Ying-Li Kang
- Image Center, Affiliated Hospital of Qinghai University, Xining, Qinghai, P.R. China
| | - Zhi-Xin Wang
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, P.R. China.,Qinghai Province Key Laboratory of Hydatid Disease Research, Xining, Qinghai, P.R. China
| | - Dongzhi Cairang
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, P.R. China
| | - Hu Wang
- Health Commission of Qinghai Province, Xining, Qinghai, P.R. China
| | - Hai-Jiu Wang
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, P.R. China.,Qinghai Province Key Laboratory of Hydatid Disease Research, Xining, Qinghai, P.R. China
| | - Hai-Ning Fan
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, P.R. China.,Qinghai Province Key Laboratory of Hydatid Disease Research, Xining, Qinghai, P.R. China
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