The pathology of experimental fascioliasis in calves

Liver Histopathological and Immunohistochemical Evaluation from Fasciola hepatica Experimentally Infected and Reinfected Sheep

Fasciolosis is an important economic disease of livestock. There is a global interest in the development of protective vaccines since the current anthelmintic therapy is no longer sustainable. A better knowledge of the host-parasite interaction is needed to design effective vaccines. To date, few studies have evaluated host-parasite interaction by comparing infected and reinfected animals. The present study evaluates the microscopical hepatic lesions in sheep infected and reinfected with Fasciola hepatica during the acute and chronic stages of infection. The histopathological study revealed the presence of necrotizing foci (NF1) associated with larvae migration during the early stages of infection in the primoinfected (PI) and reinfected (RI) groups. In the late stages of infection of the PI group and at the early and late stages of infection in the RI groups, extensive necrotizing/hemorrhagic foci (NF2) were found in the vicinity of enlarged bile ducts, some containing adult flukes, suggesting parasites may have caused NF2 while feeding. The immunohistochemical study revealed an increase in Foxp3+ T cells in both PI and RI groups with respect to the UC group and in the infiltrates adjacent to NF1 in the RI groups with respect to the PI group, suggesting the F. hepatica induce Foxp3 T cell expansion to facilitate parasite survival. In addition, in both the PI and RI groups, and during acute and chronic stages of the infection, a poor expression of iNOS was found accompanied by a strong expression of CD163, suggesting a marked M2 activation of macrophages in the hepatic lesions, which may be related with healing processes, and it also may facilitate parasite survival. The main differences between PI and RI animals were the more severe infiltration of eosinophils and Foxp3+ T cells, whereas RI did not modify M2 activation of macrophages which occurs since the early stages of primoinfection.

Exploring the utility of circulating miRNAs as diagnostic biomarkers of fasciolosis

Effective management and control of parasitic infections on farms depends on their early detection. Traditional serological diagnostic methods for Fasciola hepatica infection in livestock are specific and sensitive, but currently the earliest detection of the parasite only occurs at approximately three weeks post-infection. At this timepoint, parasites have already entered the liver and caused the tissue damage and immunopathology that results in reduced body weight and loss in productivity. Here, we investigated whether the differential abundance of micro(mi)miRNAs in sera of F. hepatica-infected sheep has potential as a tool for the early diagnosis of infection. Using miRNA sequencing analysis, we discovered specific profiles of sheep miRNAs at both the pre-hepatic and hepatic infection phases in comparison to non-infected sheep. In addition, six F. hepatica-derived miRNAs were specifically identified in sera from infected sheep. Thus, a panel of differentially expressed miRNAs comprising four sheep (miR-3231-3p; miR133-5p; 3957-5p; 1197-3p) and two parasite miRNAs (miR-124-3p; miR-Novel-11-5p) were selected as potential biomarkers. The expression of these candidates in sera samples from longitudinal sheep infection studies collected between 7 days and 23 weeks was quantified using RT-qPCR and compared to samples from age-matched non-infected sheep. We identified oar-miR-133-5p and oar-miR-3957-5p as promising biomarkers of fasciolosis, detecting infection as early as 7 days. The differential expression of the other selected miRNAs was not sufficient to diagnose infection; however, our analysis found that the most abundant forms of fhe-miR-124-3p in sera were sequence variants (IsomiRs) of the canonical miRNA, highlighting the critical importance of primer design for accurate diagnostic RT-qPCR. Accordingly, this investigative study suggests that certain miRNAs are biomarkers of F. hepatica infection and validates miRNA-based diagnostics for the detection of fasciolosis in sheep.

Pathogenicity and virulence of the liver flukes Fasciola hepatica and Fasciola Gigantica that cause the zoonosis Fasciolosis

Fasciolosis caused by the liver flukes Fasciola hepatica and Fasciola gigantica is one of the most important neglected parasitic diseases of humans and animals. The ability of the parasites to infect and multiply in their intermediate snail hosts, and their adaptation to a wide variety of mammalian definitive hosts contribute to their high transmissibility and distribution. Within the mammalian host, the trauma caused by the immature flukes burrowing through the liver parenchyma is associated with most of the pathogenesis. Similarly, the feeding activity and the physical presence of large flukes in the bile ducts can lead to anemia, inflammation, obstruction and cholangitis. The high frequency of non-synonymous polymorphisms found in Fasciola spp. genes allows for adaptation and invasion of a broad range of hosts. This is also facilitated by parasite’s excretory-secretory (ES) molecules that mediate physiological changes that allows their establishment within the host. ES contains cathepsin peptidases that aid parasite invasion by degrading collagen and fibronectin. In the bile ducts, cathepsin-L is critical to hemoglobin digestion during feeding activities. Other molecules (peroxiredoxin, cathepsin-L and Kunitz-type inhibitor) stimulate a strong immune response polarized toward a Treg/Th2 phenotype that favors fluke’s survival. Helminth defense molecule, fatty acid binding proteins, Fasciola-specific glycans and miRNAs modulate host pro-inflammatory responses, while antioxidant scavenger enzymes work in an orchestrated way to deter host oxidant-mediated damage. Combining these strategies Fasciola spp. survive for decades within their mammalian host, where they reproduce and spread to become one of the most widespread zoonotic worm parasites in the world.

Gross and histological lesions in the livers of sika deer with particular emphasis on fascioliasis

We performed gross and histological examinations of the livers of sika deer (Cervus nippon yesoensis) in Hokkaido, Japan. Out of 1,381 deer slaughtered for venison production, thickening and dilation of the large intrahepatic bile ducts and Fasciola flukes in the duct lumens were detected in 621 deer (45.0%). Furthermore, 107 non-bile lesions (75 intrahepatic and 32 capsular lesions) were detected during gross examinations. Histologically, the bile duct lesions included chronic proliferative cholangitis, papillary hyperplasia, goblet cell and pyloric gland metaplasia, and periductal fibrosis. Many of the intrahepatic non-bile duct lesions (53/75, 71%) were considered to be Fasciola fluke migration-associated lesions, including two lesion types: necrosis, hemorrhage, and eosinophilic granuloma formation (29 lesions), and lymphoid tissue formation (24 lesions). Lymphoid tissue formation was considered to result from the persistent immune responses against dead Fasciola flukes. An epidermoid liver cyst was found incidentally, which has not been reported in the veterinary literature. In summary, this study demonstrated the predominance of fascioliasis-associated lesions in sika deer livers. The gross and histological lesions caused by Fasciola flukes in sika deer were similar to fascioliasis in other animals. Moreover, we described lymphoid tissue formation as a fascioliasis-associated lesion for the first time. The fact that bile duct lesions (45.0%) had a markedly higher prevalence than fascioliasis-associated parenchymal lesions (53/1,381, 3.8%) indicated that sika deer are a permissive host for fascioliasis. Our results provide information that will aid pathological examinations of sika deer.

Controversial aspects of the life cycle of Fasciola hepatica

Fasciola hepatica is a well-known helminth parasite, with significant economic and public health importance all over the world. It has been known since more than 630 years ago and a considerable research work has been carried out on the life cycle of this important parasite. In the hepatic phase of the life cycle of F. hepatica, it is assumed that the young flukes, after about 6-7 weeks of migration in the liver parenchyma, enter into the bile ducts of the definitive hosts and become sexually mature. Even though the secretion of cysteine peptidases including cathepsin L and B proteases by F. hepatica may justify this opinion, because of several scientific reasons and based on the experimental studies conducted in different animals (reviewed in this article), the entry of parasites into the bile ducts, after their migration in the liver parenchyma seems to be doubtful. However, considering all the facts relating to the hepatic and biliary phases of the life cycle of F. hepatica, two alternative ideas are suggested: 1) some of the migrating juvenile flukes may enter into the bile ducts immediately after reaching the liver parenchyma while they are still very small, or 2) when newly excysted juvenile flukes are penetrating into the intestinal wall to reach the liver through the abdominal cavity, a number of these flukes may enter into the choleduct and reach the hepatic bile ducts, where they mature. According to the previously performed natural and experimental studies in different animals and human beings, the supporting and opposing evidences for the current opinion as well as the evidences that might justify the two new ideas are reviewed and discussed briefly. In conclusion, our present knowledge about the time and quality of the entry of F. hepaticas into the bile ducts, seems to be insufficient, therefore, there are still some dark corners and unknown aspects in this field that should be clarified.

Fasciola hepatica vaccine: we may not be there yet but we're on the right road

Major advances have been made in identifying potential vaccine molecules for the control of fasciolosis in livestock but we have yet to reach the level of efficacy required for commercialisation. The pathogenesis of fasciolosis is associated with liver damage that is inflicted by migrating and feeding immature flukes as well as host inflammatory immune responses to parasite-secreted molecules and tissue damage alarm signals. Immune suppression/modulation by the parasites prevents the development of protective immune responses as evidenced by the lack of immunity observed in naturally and experimentally infected animals. In our opinion, future efforts need to focus on understanding how parasites invade and penetrate the tissues of their hosts and how they potentiate and control the ensuing immune responses, particularly in the first days of infection. Emerging 'omics' data employed in an unbiased approach are helping us understand liver fluke biology and, in parallel with new immunological data, to identify molecules that are essential to parasite development and accessible to vaccine-induced immune responses.

Acute fasciolosis in cattle in southern Brazil

This study describes the epidemiological and pathological aspects of an outbreak of acute fasciolosis in cattle in southern Brazil. Fifteen out of 70 three-year-old pregnant cows lost weight in the 30-40 days prior to calving. Clinical signs included diarrhea, weakness, mild anemia and jaundice. Dark yellow fluid in the abdominal cavity was observed at necropsy. Fibrin and clotted blood were adhered to the pericardium and lung, primarily in the diaphragmatic lobes. The liver was enlarged, and the capsular surface was irregular with clear areas and petechiae. At the cut surface, the liver was irregular, firm and edematous, and several hemorrhagic channels could be observed. Areas of fibrosis through the parenchyma and whitish thrombi occluding the great vessels were also observed. The livers of 10 cows that not died were condemned at slaughter for lesions of fasciolosis similar to those observed at necropsy. Microscopically, the liver showed areas of coagulation necrosis, extensive hemorrhages in the streaks or foci and disruption of the parenchyma with neutrophil and eosinophil infiltration. Fibrosis and bile duct proliferation were also observed. Immature Fasciola hepatica flukes were observed in the parenchyma surrounded by degenerated hepatocytes, neutrophils, eosinophils, and hemorrhages. The outbreak occurred on a farm located in an area endemic for fasciolosis, although the acute form of the disease is not common in cattle in this region. It is likely that the cows were infected by F. hepatica metacercariae released in the late fall or early spring in the rice stubble where the herd was grazing prior to calving. Although mortality due to fasciolosis in cattle is infrequent, outbreaks can occur and treatments that are effective in both the immature and adult forms of the parasite should be administered to prevent economic losses.

Anatomicopathological Study of Vascular and Biliary Systems Using Cast Samples of Fasciola-infected Bovine Livers

In 117 livers with fascioliasis, this study was focused on the number of Fasciola, the number and intrahepatic localization of affected hepatic ducts and bile ducts, and the degree of fibrosis in the hepatic segments and bile ducts. The degree of pathological changes in bile ducts caused by fascioliasis was classified into five levels. The site of Fasciola habitation was most often the hepatic ducts of the porta hepatis: it was the left hepatic duct in 101 livers and the right hepatic duct in 88 livers. Casts were prepared by infusing synthetic resin into the hepatic arterial, portal, hepatic venous and biliary systems of 15 bovine livers with fascioliasis and then examined. In the left lobe, quadrate lobe, and caudate process where atrophic fibrosis was noted, the bile ducts became rod-shaped by losing branches, and the samples resembled dead branches of liver. Portal branches were thinned or completely terminated with marked fibrosis. Fine and irregular newly formed bile ducts not parallel with portal branches were observed in livers with markedly chronic fascioliasis. Distal portal branches in the right lobe, caudate lobe, and papillary process showed hypertrophic proliferative changes. The arterial system was generally well developed in thickened walls of bile ducts and formed vascular beds, and surrounded the bile ducts as tubes. In livers with severe fibrosis, capillaries were markedly developed and resembled glass cotton.

Eosinophilic proliferative pylephlebitis in the liver of Japanese beef cattle with fascioliasis

Intrahepatic pylephlebitis was detected in 17 Japanese beef cattle. Grossly, the intrahepatic vessels in the caudate lobe and/or in the periphery of the other hepatic lobes were thickened and protruded above the lobar surface. The vessel lumina were packed with white to red, waste thread-like contents. A few immature flukes were found in the bile ducts in 3 of the 7 cases with biliary thickening. Foci of hepatic necrosis and hemorrhage were scattered around the thickened vessels in 8 cases. Histologically, the interlobular veins were thickened due to severe intimal hyperplasia with endothelial proliferation and eosinophilic accumulation and medial hypertrophy, accompanied by fibrosis and eosinophilic infiltration in the portal areas. Hepatic tissues with necrosis and hemorrhage were surrounded by eosinophils and histiocytes including a granulomatous reaction. One immature fluke was detected in one of these regions of necrosis. Immunoperoxidase staining revealed that the small fluke, Kupffer cells, and histiocytes in the liver of all cases were positively stained with anti-Japanese Fasciola sp. antiserum. Enzyme-linked immunosorbent assay of the sera of 15 cases revealed that all were positive for the anti-Fasciola antibody. On the basis of these findings, the present cases were regarded as an atypical form of fascioliasis, characterized by eosinophilic proliferative pylephlebitis of the liver.

Seasonal variations in egg passage of Fasciola hepatica in dairy cows in Quebec

Seasonal changes in Fasciola hepatica egg passage were documented in 17 dairy herds in Portneuf County, Quebec (Canada). Egg passage was low or absent in spring and summer but rose in autumn to reach a peak in winter, then subsequently returned to low levels. This study suggests that there are two periods of transmission to the bovine host during the grazing season: a minor period in the spring, due to overwintered snails, and a major period in August and September due to snails that acquired the infection in May or June.

Levels of type I and type III collagen in the bile duct of rats infected with Fasciola hepatica

Collagen types and their levels were compared between bile ducts from Fasciola infected rats and bile ducts from uninfected animals. Both collagen types I and III were shown to be increased in infected animals but, levels of type I increased less than type III. These results indicate that fascioliasis produces changes in the collagen composition of the bile duct that are similar to those produced in cirrhosis of the liver and other pathologic conditions including wound healing. Such observations suggest that a study of the chronology of collagen deposition in fascioliasis might provide information on the sequence of molecular events which result in bile duct hyperplasia.

Evolution of fascioliasis after eating wild watercress

Fascioliasis is rarely reported in humans although it is endemic in sheep and cattle. We describe the illness of a 60-year-old widow who ate wild watercress which is the usual source of infestation. Laparotomy for suspected liver abscesses revealed necrotic tracts on the surface of the liver left by the invasion of numerous flukes. Diagnosis was made during the latent phase by the detection of serum antibody to fasciola hepatica antigen obtained from a sheep. Symptoms returned during the cholestatic phase. Mature flukes were then present in the large bile ducts and ova appeared in the stools. Symptoms resolved twelve weeks after presentation.

A study of the initiation of biliary hyperplasia in rats infected with Fasciola hepatica

Following infection of rats with Fasciola hepatica, an increase in the number of epithelial cells in the common bile duct, labelled with [3H]thymidine, was detected autoradiographically as early as 5 days post-infection (p.i.). This initial mitogenic effect of the infection was limited to that region of the bile duct lying adjacent to the liver, while the region lying next to the duodenum failed to show any increase in labelling until 41 days p.i. Mechanical contact between the parasite and the biliary epithelium did not occur until 41 days p.i. and the initial hyperplasia was evidently not a result of mechanical irritation. The study serves to emphasize the chemical aetiology of the precocious biliary hyperplasia and to more accurately identify its onset.

Fascioliasis in dairy cows on irrigated pasture

The prevalence and severity of fascioliasis was studied in 87 dairy cows from 36 irrigated farms in Victoria. Evidence of Fasciola hepatica infection was found in 85 (98%) cows representing all but one of the herds. The mean fluke burden (7 +/- 6) in cows treated with anthelmintics at drying off was lower (p < 0.05) than in untreated cows (24 +/- 7). Haemoglobin levels in untreated cows (9.6 +/- 0.04) were higher (p < 0.05) than values obtained from treated animals (8.2 +/- 0.3). Severity of bile duct wall thickness and hepatic fibrosis was similar in both groups. None of the measured parameters was affected by the age of the cow. Although fascioliasis was prevalent in these cattle the level of infection was low.

Fasciola hepatica human infection. Histopathological study of sixteen cases

Sixteen human cases of Fasciola hepatica infection are described. The liver was involved in 13 cases, the gall bladder in 9 cases and the stomach in 2 cases. Lesions containing parasitic remnants or fluke eggs were rarely seen. Surface scarring of the liver, scar tracks and granulomas within organs were the most characteristic changes seen and were the most useful for the histopathological diagnosis of the disease. The associated liver, bile and gastric lesions are briefly discussed.

The pathogenesis of primary and secondary infection with Fasciola hepatica in mice

Primary and secondary infections of F. hepatica in mice were compared to determine how prior exposure to the parasite affected host response. Mice with primary parenchymal Fasciola infections initially had hemorrhagic tunnels filled with inflammatory cells and connective tissue. These lesions were progressive and became most severe 30 days after exposure as the parasites entered the bile ducts. At this time there was much hyperplasia and thickening of all layers of the duct system near the parasites and occasionally severe periportal fibrosis. By 2 months after exposure regeneration of the damaged liver cells was complete although hyperplasia persisted in bile ducts containing flukes. In mice with secondary infections (mice exposed 40 to 50 days after first infection), the inflammatory response was faster and shorter. Most lesions were resolved by 30 days after the second exposure. There was little difference in histology of primary and secondary infections during the chronic phase of the disease.

Intrahepatic vascular lesions in experimental and natural ovine fascioliasis

Using acrylic resin casts prepared from the liver vasculature and histology, subdivisions of the portal and hepatic systems stenosed as a result of experimental and natural infections of F. hepatica were identified as terminal, secondary and tertiary portal veins and central and sublobular hepatic veins; primary portal veins were also involved in the experimentally infected livers. Fewer veins tended to be involved in livers naturally-infected and they were more evenly distributed among liver lobes than in the experimental disease where most were found in the ventral lobe. Casts of both types of infection also demonstrated enlargement and tortuosity of arteries in ventral lobes and those forming the peribiliary arterial plexus, as well as showing that multiple anastomotic channels had formed. The arterial changes and anastomoses were suggested as developing to compensate for the effects of vascular stenosis. Portal vein stenosis induced experimentally was the outcome of replacement of eosinophils and oedema-like fluid present in veins around fluke tracks and of the organisation of fluke tracts impinging upon veins. During the post-migratory period of infection, stenosis became more marked, for which no adequate cause was identified. In livers naturally-infected, in addition to stenosed portal and hepatic veins, vascular channels in collagen septa in sinusoids and a slight convolution of arteries were seen.

Prenatal infection with Fasciola Hepatica in calves

The livers from 16,776 calves 1 to 3 weeks of age slaughtered at Shepparton abattoirs were examined for gross evidence of infection with Fasciola hepatica. Those livers with thickened bile ducts were examined for the presence of liver fluke by slicing. One hundred and eight F. hepatica were collected from 84 of these livers, giving a minimum prevalence rate of prenatal infection of calves of 0.5%. These results are discussed in context with reports from other countries.

Clinico-pathological studies on naturally-occurring bovine fascioliasis in the Sudan

An investigation was made of the pathological, haematological and biochemical aspects of naturally-occurring bovine fascioliasis in the Sudan. 228 animals infected with Fasciola gigantica and 25 non-infected controls were used in the study. The infected cattle revealed emaciation, typical liver pathology, and, occasionally, lesions in the lung and the pancreas. Analysis of their sera also showed reduced albumin values, increased globulin concentrations and decrease albumin/globulin ratio, in addition to increased arginase activity. The serum iron concentration, on the other hand, was decreased, while the total iron binding capacity increased and the resultant iron saturation values reduced. Haematological findings in the infected animals included reduced erythrocyte counts, decreased haematocrit values, increased mean corpuscular volumes, eosinophilia and decreased neutrophil, lymphocyte and monocyte counts. Other parameters were similar in infected and control cattle.

The pathology of natural Fasciola hepatica infection in cattle

The pathology of bovinc livers during the parenchymal and chronic phases of natural Fasciola hepatica infections is described. Immature infections occurred from September to the middle of January. Significant changes of the hepatic parenchyma caused by immature flukes occurred in association with large migrational tracks. The changes included frequent thrombosis and haemorrhages, extensive disintegration and coagulative necrosis of hepatic cells, and abundant infiltrates of inflammatory cells. In chronic infections the proliferation and destruction of the mucosa of main bile ducts were pronounced. Normal mast cells were lacking in the portal areas surrounding fresh migrational tracks. In chronically infected livers mast cells occurred in great numbers.

The histopathology of Fasciola hepatica infections in sheep

Experimental infections of lambs with Fasciola hepatica are described. The growth rate of the parasite, time of entry to the bile ducts, and time of patency are recorded and a preferential migration of the parasite in the liver parenchyma noted. The gross and histological lesions produced in the liver from 1 to 40 weeks after infection are described and compared with previous observations in cattle.

The parenchymal migration of the parasite is shown to consist of two phases, a free migrating phase up to the 6th week, and a localized phase after the 6th week prior to entry into the bile ducts. Hepatic cell regeneration is observed and hepatic fibrosis is minimal. The localized phase of migration is associated with a unique peripheral palisade of giant cells in the fluke tracts and with the formation of pseudofollicular aggregation of lymphocytes. The presence of flukes in the bile ducts produces fibrosis of the duct walls. The walls, however, remain pliable and expanded to accommodate the parasites and calcification was never observed.