Investigating the effect of gold nanoparticles on hydatid cyst protoscolices under low-power green laser irradiation

Challenges and Prospective of Enhancing Hydatid Cyst Chemotherapy by Nanotechnology and the Future of Nanobiosensors for Diagnosis

Hydatid cysts have been widely recognized for decades as a common medical problem that affects millions of people. A revolution in medical treatment may be on the prospect of nanotechnology enhancing chemotherapy against hydatid cysts. An overview of nanotechnology's impact on chemotherapeutics is presented in the current review. It discusses some of the challenges as well as some of the opportunities. The application of nanotechnology to enhance chemotherapy against hydatid cysts is what this review will explore. Nanotechnology is a critical component of delivering therapeutic agents with greater precision and efficiency and targeting hydatid cysts with better efficacy, and minimizing interference with surrounding tissue. However, there are biodistribution challenges, toxicity, and resistance problems associated with nanotherapeutics. Additionally, nanobiosensors are being investigated to enable the early diagnosis of hydatid cysts. A nanobiosensor can detect hydatid cysts by catching them early, non-invasively, rapidly, and accurately. The sensitivity and specificity of diagnostic tests can be enhanced with nanobiosensors because they take advantage of the unique properties of nanomaterials. By providing more precise and customized treatment options for hydatid cysts, nanotechnology may improve therapeutic options and strategies for diagnosing the disease. In conclusion, treatment with nanotechnology to treat hydatid cysts is potentially effective but presents many obstacles. Furthermore, nanobiosensors are being integrated into diagnostic techniques, as well as helping to diagnose patients earlier and more accurately.

Green Synthesis, Characterization, and Antiparasitic Effects of Gold Nanoparticles against Echinococcus granulosus Protoscoleces

Echinococcosis, or hydatidosis, is one of the most important zoonotic diseases, which is initiated by the larval stage in the clasts of Echinococcus granulosus. For the treatment of hydatidosis, surgery is still the preferred method and the first line of treatment for symptomatic patients. Unfortunately, most of the scolicidal agents that are injected inside cysts during hydatid cyst surgery have side effects, including leaking out of the cyst and adverse effects on the living tissue of the host, such as necrosis of liver cells, which limits their use. This work was carried out to study the lethal effect of green synthesized gold nanoparticles (Au-NCs) against hydatid cyst protoscoleces. Au-NCs were green synthesized using the Saturja khuzestanica extract. Au-NCs were characterized by UV-visible absorbance assay, electron microscopy analysis, X-ray diffraction (XRD), and Fourier transform infrared (FTIR) spectroscopy. Scolicidal properties of Au-NCs (1-5 mg/mL) were studied against protoscoleces for 10-60 min. The effect of Au-NCs on the expression level of the caspase-3 gene as well as the ultrastructural examination was studied by real-time PCR and scanning electron microscopy (SEM). The cytotoxicity of Au-NCs on hepatocellular carcinoma (HepG₂) and normal embryonic kidney (HEK293) cell lines was also studied by the cell viability assay. The obtained Au-NCs are cubes and have an average size of 20-30 nm. The highest scolicidal efficacy was observed at 5 mg/mL with 100% mortality after 20 min of treatment for hydatid cyst protoscoleces. In ex vivo, Au-NCs required more incubation time, indicating more protoscolicidal effects. Au-NCs markedly upregulated the gene level of caspase-3 in protoscoleces; whereas they changed the ultra-structure of protoscoleces by weakening and disintegrating the cell wall, wrinkles, and protrusions due to the formation of blebs. We showed the effective in vitro and ex vivo scolicidal effects of Au-NCs against hydatid cyst protoscoleces by provoking the apoptosis process of caspase-3 activation and changing the ultrastructure of protoscoleces with no significant cytotoxicity against human normal cells. However, additional studies should be conducted to determine the possible harmful side effects and accurate efficacy.

The current state of the issues of diagnosis and surgical treatment of liver echinococcosis (literature review)

The article presents a review of literature data in order to study current problems in the diagnosis and surgical treatment of liver echinococcosis. At the present stage of technological progress, it is possible to study the genetic, anatomical and pathophysiological aspects of echinococcosis. The article highlights the advantages and disadvantages of surgical operations performed in patients with echinococcal liver damage. Methods and results of surgical treatment in various clinics are considered. The main surgical directions in the treatment of parasitic liver damage have been determined. These are more radical anatomical and extensive liver resections and minimally invasive, including laparoscopic and robotic techniques. Each of the methods used has its own niche of application and its own limitations. An opinion is expressed about the prospects for the development of minimally invasive methods of surgical treatment. The authors note the actual absence of a unified standardized tactics of surgical treatment at the moment. It is noted that the literature contains only fragmentary data on the possibility of combining minimally invasive and classical methods of surgical treatment. Despite the introduction of new methods of treatment, the percentage of complications and mortality are still high. Thus, the lack of uniform diagnostic standards and principles for determining surgical tactics testifies to the urgency of the problem of treating parasitic liver damage and determines the search for new solutions in order to improve the results of surgical treatment of this pathology. 

Treatment of Hydatid Liver Cyst With Double Percutaneous Aspiration and Ethanol Injection Under Ultrasound Guidance: 6.5-Year Median Follow-up Analysis

PURPOSE

Although hydatid liver cyst (HLC) is a benign disease, treatment is recommended to avoid life-threatening complications. There are several treatment options for HLC: "wait-and-watch," medical or surgical or percutaneous treatment. The purpose of this study was to assess the long-term effectiveness of an alternative of the traditional percutaneous PAIR procedure, called double percutaneous aspiration and ethanol injection (D-PAI).

MATERIALS AND METHODS

This prospective, non-randomized study was conducted from 1988 to 2019 using DPAI procedure characterized by no reaspiration of the ethanol injected to replace the aspirated fluid and repetition of the procedure after 3-7 days.

RESULTS

Two hundred and three patients with 290 HLCs underwent D-PAI. Two hundred and two HLC (160 patients) were univesicular cysts and 88 (43 patient) were multivesicular. Seventeen patients underwent one D-PAI session, 15 patients two sessions, and 18 up to four sessions. The follow-up ranged 0.9-21 years (median 6.5 years). On ultrasound, 188 cysts (64.8%) disappeared; 57 cysts (19.7%) became solid (inactive) and 45 (15.5%) showed a small inactive residual component. Parasitologic cure was very high. The overall response to D-PAI was higher than 90% considering also the procedures carried out after the first D-PAI at the time of recurrence. One patient died for anaphylactic shock. The hospital stay ranged 1-3 days. Smaller cysts (< 5 cm) healed sooner than larger cysts (p < 0.001).

CONCLUSIONS

Long-term analysis showed that D-PAI is a safe and effective option in percutaneous treatment of viable HLC, except for CE2/CE3b in which the recurrences can be observed. This inexpensive and simple procedure can be applied everywhere and especially in developing countries.

High Potency of Organic and Inorganic Nanoparticles to Treat Cystic Echinococcosis: An Evidence-Based Review

Since there is no potential, effective vaccine available, treatment is the only controlling option against hydatid cyst or cystic echinococcosis (CE). This study was designed to systematically review the in vitro, in vivo, and ex vivo effects of nanoparticles against hydatid cyst. The study was carried out based on the 06- PRISMA guideline and registered in the CAMARADES-NC3Rs Preclinical Systematic Review and Meta-analysis Facility (SyRF) database. The search was performed in five English databases, including Scopus, PubMed, Web of Science, EMBASE, and Google Scholar without time limitation for publications around the world about the protoscolicdal effects of all the organic and inorganic nanoparticles without date limitation in order to identify all the published articles (in vitro, in vivo, and ex vivo). The searched words and terms were: “nanoparticles”, “hydatid cyst”, “protoscoleces”, “cystic echinococcosis”, “metal nanoparticles”, “organic nanoparticles”, “inorganic nanoparticles, “in vitro”, ex vivo”, “in vivo”. Out of 925 papers, 29 papers including 15 in vitro (51.7%), 6 in vivo (20.7%), ex vivo 2 (6.9%), and 6 in vitro/in vivo (20.7%) up to 2020 met the inclusion criteria for discussion in this systematic review. The results demonstrated the most widely used nanoparticles in the studies were metal nanoparticles such as selenium, silver, gold, zinc, copper, iron nanoparticles (n = 8, 28.6%), and metal oxide nanoparticles such as zinc oxide, titanium dioxide, cerium oxide, zirconium dioxide, and silicon dioxide (n = 8, 28.6%), followed by polymeric nanoparticles such as chitosan and chitosan-based nanoparticles (n = 7, 25.0%). The results of this review showed the high efficacy of a wide range of organic and inorganic NPs against CE, indicating that nanoparticles could be considered as an alternative and complementary resource for CE treatment. The results demonstrated that the most widely used nanoparticles for hydatid cyst treatment were metal nanoparticles and metal oxide nanoparticles, followed by polymeric nanoparticles. We found that the most compatible drugs with nanoparticles were albendazole, followed by praziquantel and flubendazole, indicating a deeper understanding about the synergistic effects of nanoparticles and the present anti-parasitic drugs for treating hydatid cysts. The important point about using these nanoparticles is their toxicity; therefore, cytotoxicity as well as acute and chronic toxicities of these nanoparticles should be considered in particular. As a limitation, in the present study, although most of the studies have been performed in vitro, more studies are needed to confirm the effect of these nanoparticles as well as their exact mechanisms in the hydatid cyst treatment, especially in animal models and clinical settings.