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Qadeer A, Wajid A, Rafey HA, Nawaz S, Khan S, Rahman SU, Alzahrani KJ, Khan MZ, Alsabi MNS, Ullah H, Safi SZ, Xia Z, Zahoor M. Exploring extracellular vesicles in zoonotic helminth biology: implications for diagnosis, therapeutic and delivery. Front Cell Infect Microbiol 2024; 14:1424838. [PMID: 39165921 PMCID: PMC11333462 DOI: 10.3389/fcimb.2024.1424838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 07/03/2024] [Indexed: 08/22/2024] Open
Abstract
Extracellular vesicles (EVs) have emerged as key intercellular communication and pathogenesis mediators. Parasitic organisms' helminths, cause widespread infections with significant health impacts worldwide. Recent research has shed light on the role of EVs in the lifecycle, immune evasion, and disease progression of these parasitic organisms. These tiny membrane-bound organelles including microvesicles and exosomes, facilitate the transfer of proteins, lipids, mRNAs, and microRNAs between cells. EVs have been isolated from various bodily fluids, offering a potential diagnostic and therapeutic avenue for combating infectious agents. According to recent research, EVs from helminths hold great promise in the diagnosis of parasitic infections due to their specificity, early detection capabilities, accessibility, and the potential for staging and monitoring infections, promote intercellular communication, and are a viable therapeutic tool for the treatment of infectious agents. Exploring host-parasite interactions has identified promising new targets for diagnostic, therapy, and vaccine development against helminths. This literature review delves into EVS's origin, nature, biogenesis, and composition in these parasitic organisms. It also highlights the proteins and miRNAs involved in EV release, providing a comprehensive summary of the latest findings on the significance of EVs in the biology of helminths, promising targets for therapeutic and diagnostic biomarkers.
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Affiliation(s)
- Abdul Qadeer
- Department of Cell Biology, School of Life Sciences, Central South University, Changsha, China
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, China
| | - Abdul Wajid
- Faculty of Pharmacy, Gomal University, Dera Ismail Khan, Pakistan
| | - Hafiz Abdul Rafey
- Shifa College of Pharmaceutical Sciences, Faculty of Pharmaceutical and Allied Health Sciences, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Saqib Nawaz
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, China
| | - Sawar Khan
- Department of Cell Biology, School of Life Sciences, Central South University, Changsha, China
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, China
- Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore, Pakistan
| | - Sajid Ur Rahman
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, China
- Department of Food Science and Engineering, School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, China
| | - Khalid J. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Muhammad Zahoor Khan
- College of Agricultural Science and Engineering, Liaocheng University, Liaocheng, Shandong, China
| | - Mohammad Nafi Solaiman Alsabi
- Department of Basic Veterinary Medical Sciences, Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Hanif Ullah
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai, China
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
| | - Sher Zaman Safi
- Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Selangor, Malaysia
| | - Zanxian Xia
- Department of Cell Biology, School of Life Sciences, Central South University, Changsha, China
| | - Muhammad Zahoor
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Bakhshipour F, Zibaei M, Rokni MB, Miahipour A, Firoozeh F, Beheshti M, Beikzadeh L, Alizadeh G, Aryaeipour M, Raissi V. Comparative evaluation of real-time PCR and ELISA for the detection of human fascioliasis. Sci Rep 2024; 14:3865. [PMID: 38366006 PMCID: PMC10873325 DOI: 10.1038/s41598-024-54602-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 02/14/2024] [Indexed: 02/18/2024] Open
Abstract
Fascioliasis is a zoonotic parasitic infection caused by Fasciola species in humans and animals. Despite significant advances in vaccination and new therapeutic agents, little attention has been paid to validating methods for the diagnosis of fascioliasis in humans. Serological techniques are convenient assays that significantly improves the diagnosis of Fasciola infection. However, a more sensitive method is required. The aim of this study was to compare the Real-Time PCR technique with the indirect-ELISA for the detection of Fasciola hepatica in human. Using a panel of sera from patients infected with Fasciola hepatica (n = 51), other parasitic infections (n = 7), and uninfected controls (n = 12), we optimized an ELISA which employs an excretory-secretory antigens from F. hepatica for the detection of human fascioliasis. After DNA extraction from the samples, molecular analysis was done using Real-Time PCR technique based on the Fasciola ribosomal ITS1 sequence. Of 70 patient serum samples, 44 (62.86%) samples were identified as positive F. hepatica infection using ELISA and Real-Time PCR assays. There was no cross-reaction with other parasitic diseases such as toxoplasmosis, leishmaniasis, taeniasis, hydatidosis, trichinosis, toxocariasis, and strongyloidiasis. The significant difference between the agreement and similarity of the results of patients with indirect ELISA and Real-Time PCR was 94.4% and 99.2%, respectively (Cohen's kappa ≥ 0.7; P = 0.02). Based on the Kappa agreement findings, the significant agreement between the results of ELISA and Real-Time PCR indicates the accuracy and reliability of these tests in the diagnosis of F. hepatica in humans.
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Affiliation(s)
- Fatemeh Bakhshipour
- Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, P.O. Box: 3149779453, Karaj, Iran
| | - Mohammad Zibaei
- Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, P.O. Box: 3149779453, Karaj, Iran.
| | - Mohammad Bagher Rokni
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Abolfazl Miahipour
- Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, P.O. Box: 3149779453, Karaj, Iran
| | - Farzaneh Firoozeh
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Masoud Beheshti
- Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Leila Beikzadeh
- Department of Medical Laboratory Sciences, Faculty of Para-Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Gita Alizadeh
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mojgan Aryaeipour
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Raissi
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Esteban JG, Muñoz-Antolí C, Toledo R, Ash LR. Diagnosis of Human Trematode Infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1454:541-582. [PMID: 39008275 DOI: 10.1007/978-3-031-60121-7_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Digenetic trematodes form a major group of human parasites, affecting a large number of humans, especially in endemic foci. Over 100 species have been reported infecting humans, including blood, lung, liver and intestinal parasites. Traditionally, trematode infections have been diagnosed by parasitological methods based on the detection and the identification of eggs in different clinical samples. However, this is complicated due to the morphological similarity between eggs of different trematode species and other factors such as lack of sensitivity or ectopic locations of the parasites. Moreover, the problem is currently aggravated by migratory flows, international travel, international trade of foods and changes in alimentary habits. Although efforts have been made for the development of immunological and molecular techniques, the detection of eggs through parasitological techniques remains as the gold standard for the diagnosis of trematodiases. In the present chapter, we review the current status of knowledge on diagnostic techniques used when examining feces, urine, and sputum and also analyze the most relevant characteristics used to identify eggs with a quick key for the identification of eggs.
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Affiliation(s)
- J Guillermo Esteban
- Área de Parasitología, Departamento de Farmacia, Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain.
| | - Carla Muñoz-Antolí
- Área de Parasitología, Departamento de Farmacia, Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
| | - Rafael Toledo
- Área de Parasitología, Departamento de Farmacia, Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
| | - Lawrence R Ash
- Infectious & Tropical Diseases, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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Nur Hafizah S, Noor Izani NJ, Ahmad Najib M, Wan-Nor-Amilah WAW. Immunodiagnosis of Fascioliasis in Ruminants by ELISA Method: A Mini-Review. Malays J Med Sci 2023; 30:25-32. [PMID: 37655153 PMCID: PMC10467593 DOI: 10.21315/mjms2023.30.4.3] [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: 09/17/2021] [Accepted: 03/01/2022] [Indexed: 09/02/2023] Open
Abstract
Fascioliasis is an important zoonotic disease prevalent in domestic animals and it leads to socioeconomic impact in rural farming communities of the developing world. The gold standard diagnosis of ruminant fascioliasis involves coprological detection of Fasciola spp. eggs or recovery of flukes in infected livers. Coprological analysis is unreliable in the patent period of chronic infection, and even then, its sensitivity is relatively low. Robust diagnostic tools that can promptly and accurately detect an active infection are crucial to avoid complications and further losses in ruminant livestock productivity, as well as to preserve the livelihood of communities at risk. Immunodiagnosis determined by antibody and antigen detection in the sera and faeces of infected ruminants provides a valuable alternative to the parasitological diagnostic approach. This review discusses current developments in immunological techniques by enzyme-linked immunosorbent assay (ELISA) in the detection of ruminant fascioliasis and summarises the performance of various ELISAs in studies conducted to date. Indirect ELISAs demonstrated effective immunodiagnostic performance with high sensitivities and specificities. Cathepsin L ELISA is the most favourable antigen in serodiagnosis, among other recombinant and native proteins evaluated. Sandwich ELISA provides excellent sensitivity and specificity, which correlates well with the fluke burden. Utilising monoclonal antibodies in sandwich ELISA reduces the detection time and performance variations that commonly occur in polyclonal antibody ELISA.
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Affiliation(s)
| | | | - Mohamad Ahmad Najib
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Kelantan, Malaysia
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Pouryousef A, Fararouei M, Sarkari B. Antigen-Based Diagnosis of Human Giardiasis: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PARASITOLOGY 2023; 18:140-154. [PMID: 37583633 PMCID: PMC10423904 DOI: 10.18502/ijpa.v18i2.13180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/10/2023] [Indexed: 08/17/2023]
Abstract
Background We aimed to present a systematic review and meta-analysis of studies that used antigen-based assays for the diagnosis of human giardiasis. Methods All the related published literature cited within PubMed, ISI web of science, Google Scholar, Embase, and Scopus, were searched up to December 2021. The search terms, both as MeSH terms and text words, were "Giardia", "Giardia lamblia", "Giardia intestinalis", "giardiasis", combined with "diagnosis", "antigen detection", serodiagnosis, or serological diagnosis. The required data was extracted from the papers. Pooled estimates of sensitivity and specificity were obtained and forest plots and summary receiver operating characteristics (SROC) plots were used to calculate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results The search of databases found 1683 papers, of which 46 articles fulfilled our eligibility criteria. The sensitivity of antigen-based methods for the diagnosis of human giardiasis ranged from 45% (95% CI: 31-59%) to 100% (95% CI: 100-100%) and the pooled estimate of sensitivity was 92% (95% CI: 90-93%). The pooled estimated specificity was 97% (95% CI: 96-98%), ranged from 81% (95% CI: 68-89%) to 100% (95% CI: 98-100%). The summary estimate of PPV and NPV were 92 % (95% CI: 90-93%) and 97% (95% CI: 96-98%) respectively. Comparing the performance of the antigen detection assays by region revealed a significant difference in the assay's performances in different regions of the world. Conclusion The antigen-based detection methods have acceptable and satisfactory performance in the diagnosis of human giardiasis. The task ahead is to identify more specific target antigens and design simpler, cheaper, and more sensitive methods for the diagnosis of this common worldwide-distributed parasitic infection.
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Affiliation(s)
- Ali Pouryousef
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Fararouei
- HIV/AIDS Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahador Sarkari
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Liver Abscess due to Fasciola hepatica: A Case Report of the North of Iran. Case Rep Infect Dis 2022; 2022:4399061. [PMID: 35795082 PMCID: PMC9252842 DOI: 10.1155/2022/4399061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/10/2022] [Indexed: 11/18/2022] Open
Abstract
One of the rare manifestations of fascioliasis is liver abscess. In this paper, we report the case of a 38-year-old woman with a liver abscess caused by Fasciola hepatica (F. hepatica). The patient was referred to the clinic with recurrent fever, right upper quadrant (RUQ) pain, and a large abscess in her liver. Despite the consumption of an antibiotic drug, she still had symptoms. The symptoms began to disappear upon starting the consumption of triclabendazole (TCBZ). Fascioliasis can manifest itself with unusual symptoms that provide no specific clue for its diagnosis. Therefore, it is important to consider F. hepatica in the differential diagnosis of liver abscess, especially in endemic regions.
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Rogers MJ, McManus DP, Muhi S, Gordon CA. Membrane Technology for Rapid Point-of-Care Diagnostics for Parasitic Neglected Tropical Diseases. Clin Microbiol Rev 2021; 34:e0032920. [PMID: 34378956 PMCID: PMC8404699 DOI: 10.1128/cmr.00329-20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Parasitic neglected tropical diseases (NTDs) affect over one billion people worldwide, with individuals from communities in low-socioeconomic areas being most at risk and suffering the most. Disease management programs are hindered by the lack of infrastructure and resources for clinical sample collection, storage, and transport and a dearth of sensitive diagnostic methods that are inexpensive as well as accurate. Many diagnostic tests and tools have been developed for the parasitic NTDs, but the collection and storage of clinical samples for molecular and immunological diagnosis can be expensive due to storage, transport, and reagent costs, making these procedures untenable in most areas of endemicity. The application of membrane technology, which involves the use of specific membranes for either sample collection and storage or diagnostic procedures, can streamline this process, allowing for long-term sample storage at room temperature. Membrane technology can be used in serology-based diagnostic assays and for nucleic acid purification prior to molecular analysis. This facilitates the development of relatively simple and rapid procedures, although some of these methods, mainly due to costs, lack accessibility in low-socioeconomic regions of endemicity. New immunological procedures and nucleic acid storage, purification, and diagnostics protocols that are simple, rapid, accurate, and cost-effective must be developed as countries progress control efforts toward the elimination of the parasitic NTDs.
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Affiliation(s)
- Madeleine J. Rogers
- School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Queensland, Australia
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Donald P. McManus
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Stephen Muhi
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Catherine A. Gordon
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
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Autier B, Boukthir S, Degeilh B, Belaz S, Dupuis A, Chevrier S, Gangneux JP, Robert-Gangneux F. Clinical value of serology for the diagnosis of strongyloidiasis in travelers and migrants: A 4-year retrospective study using the Bordier IVD ® Strongyloides ratti ELISA assay. Parasite 2021; 28:79. [PMID: 34870590 PMCID: PMC8647686 DOI: 10.1051/parasite/2021075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/15/2021] [Indexed: 11/19/2022] Open
Abstract
Strongyloides stercoralis serology is a sensitive method for strongyloidiasis diagnosis, but it is prone to cross-reactions with other helminthiases. This four-year retrospective study aimed at estimating the performance of the Bordier IVD®Strongyloides ratti ELISA assay in a non-endemic country (France). The study included all patients tested for strongyloidiasis in our center between 2015 and 2019, by both serology and stool examination. Cases were defined using an algorithm considering serological results, microscopic examination of stools, and other biological, clinical or epidemiological data. The study included 805 stools from 341 patients (70% migrants, 20% travelers, 10% without travel to a highly endemic area). Thirty patients (8.8%) had positive serology, 9 had microscopically proven strongyloidiasis, and 11 and 10 were classified as probable and possible strongyloidiasis, respectively. Performances of microscopy and serology were compared, considering proven and probable strongyloidiasis as true infections. The sensitivity, specificity, positive predictive value and negative predictive value of serology were 100%, 97%, 67% and 100%, respectively, and those of microscopic examination of stools were 45% (p < 0.01), 100% (p < 0.01), 100% (p = 0.079) and 96% (p < 0.001), respectively. Eosinophilia did not help in discriminating true-positive from false-positive results. Overall, these results underline the high value of the S. stercoralis serologic assay, compared to stool examination. The systematic use of this technique for screening purposes in travelers or migrants, or before onset of immunosuppressive therapy, could help to improve patient management and epidemiological knowledge.
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Affiliation(s)
- Brice Autier
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), UMR_S 1085, 35000 Rennes, France - CHU Rennes, Laboratoire de parasitologie-mycologie, 35000 Rennes, France
| | - Sarrah Boukthir
- Univ Rennes, CHU Rennes, Inserm, CIC-1414, 35000 Rennes, France - CHU Rennes, Laboratoire de bactériologie-hygiène hospitalière, 35000 Rennes, France
| | - Brigitte Degeilh
- CHU Rennes, Laboratoire de parasitologie-mycologie, 35000 Rennes, France
| | - Sorya Belaz
- CHU Rennes, Laboratoire de parasitologie-mycologie, 35000 Rennes, France
| | - Anne Dupuis
- CHU Rennes, Laboratoire de parasitologie-mycologie, 35000 Rennes, France
| | - Sylviane Chevrier
- CHU Rennes, Laboratoire de parasitologie-mycologie, 35000 Rennes, France
| | - Jean-Pierre Gangneux
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), UMR_S 1085, 35000 Rennes, France - CHU Rennes, Laboratoire de parasitologie-mycologie, 35000 Rennes, France
| | - Florence Robert-Gangneux
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), UMR_S 1085, 35000 Rennes, France - CHU Rennes, Laboratoire de parasitologie-mycologie, 35000 Rennes, France
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Saadh MJ, Tanash SA, Almaaytah AM, Sa'adeh IJ, Aldalaen SM, Al-Hamaideh KD. Immunodiagnosis of cattle fascioliasis using a 27 kDa Fasciola gigantica antigen. Vet World 2021; 14:2097-2101. [PMID: 34566326 PMCID: PMC8448643 DOI: 10.14202/vetworld.2021.2097-2101] [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] [Received: 04/13/2021] [Accepted: 06/28/2021] [Indexed: 11/21/2022] Open
Abstract
Background and Aim: Diagnosis of fascioliasis depends on clinical symptoms and routine laboratory tests. Recently, antibodies and circulating antigens of Fasciola were used for detecting active infections. Therefore, this study aimed to identify Fasciola gigantica antigens in the sera of infected cattle using Western blotting and enzyme-linked immunosorbent assay (ELISA) for an accurate diagnosis of cattle infected with F. gigantica. Materials and Methods: Serum samples were obtained from 108, 23, and 19 cattle infected with Fasciola gigantica, Paramphistomum cervi, and Strongylids, respectively, including 57 non-infected cattle that were used as healthy cattle for the study. Western blotting and ELISA were then used to detect circulating Fasciola antigens at 27 kDa. Results: The target epitope was detected in an F. gigantica adult-worm antigen preparation, excretory/secretory products, and serum from cattle infected with F. gigantica. However, it was absent in sera from P. cervi, Strongylids, and healthy cattle. The purified 27 kDa F. gigantica (FPA-27) antigen was also detected in cattle serum using ELISA with high degrees of sensitivity and specificity (94% and 82%, respectively), and the area under the receiver operating characteristic curve was 0.89 with a highly significant correlation of p<0.0001. Conclusion: The FPA-27 is proposed to be a promising candidate for the serodiagnosis of fascioliasis in cattle.
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Affiliation(s)
- Mohamed J Saadh
- Department of Pharmacy, Faculty of Pharmacy, Middle East University, Amman, Jordan
| | - Samer A Tanash
- Department of Pharmacy, Faculty of Pharmacy, Middle East University, Amman, Jordan
| | - Ammar M Almaaytah
- Department of Pharmacy, Faculty of Pharmacy, Middle East University, Amman, Jordan.,Department of Pharmaceutical Technology, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Issam J Sa'adeh
- Department of Radiology, King Abdulaziz Medical City, National Guard Hospital, Riyadh, Saudi Arabia
| | - Saed M Aldalaen
- Department of Pharmacology Faculty of Pharmacy, Mutah University, Amman, Jordan
| | - Khawla D Al-Hamaideh
- Department of Basic Medical Sciences, Faculty of Medicine, Al-Balqa Applied University, Amman, Jordan
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Corrales Y, Ferrer E, Fernández J, Gauta J, García M, Aguirre A, Pérez A. Diagnosis and Risk Factors of Bovine and Human Fascioliasis in Cattle Farms from a Venezuelan Andean Rural Area. Acta Parasitol 2021; 66:1048-1054. [PMID: 33547991 DOI: 10.1007/s11686-021-00341-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 01/21/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Fascioliasis is caused in Venezuela by the trematode Fasciola hepatica, affecting herbivorous and human. The Venezuelan Andean region is endemic for bovine fascioliasis and its presence in humans is not known. The objective of this work was to detected positive cases of bovine and human fascioliasis by coprological and immunological techniques and determine the possible risk factors, in eight cattle farms of a Venezuelan Andean rural area. METHODS We studied 143 samples of feces and sera of bovines, and 34 samples of feces and sera of humans. Feces were examined by several coprologic techniques, while sera were evaluated by ELISA using two antigens: crude extract (CE) and surface proteins (SP) of F. hepatica, which were previously standardized and validated. RESULTS The frequency of fascioliasis in bovines was 21% by coprology, and 49.7% by SP-ELISA. The human detection was 0% by coprology, and 29.4% by SP-ELISA. There were statistical significative differences between cattle farms, regarding to the positive results by coprology and by SP-ELISA. About the possible risk factors, statistical association was found only with the presence of snails near or in the farms and consumption of non-channeled water (river, ditch or spring), both for cattle and for humans. CONCLUSION The results showed that the studied area is endemic for bovine fascioliasis, the human has been in contact with F. hepatica and there are risk factors for the transmission of the parasite in the studied farms.
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Affiliation(s)
- Yeasiry Corrales
- Facultad de Ciencias de la Salud, Departamento de Parasitología, Universidad de Carabobo Sede Aragua, Maracay, Estado Aragua, Venezuela
| | - Elizabeth Ferrer
- Facultad de Ciencias de la Salud, Departamento de Parasitología, Universidad de Carabobo Sede Aragua, Maracay, Estado Aragua, Venezuela.
- Facultad de Ciencias de la Salud, Instituto de Investigaciones Biomédicas "Dr, Francisco J. Triana Alonso", Universidad de Carabobo Sede Aragua, Maracay, Estado Aragua, Venezuela.
| | - José Fernández
- Facultad de Ciencias de la Salud, Departamento de Parasitología, Universidad de Carabobo Sede Aragua, Maracay, Estado Aragua, Venezuela
- Facultad de Ciencias de la Salud, Instituto de Investigaciones Biomédicas "Dr, Francisco J. Triana Alonso", Universidad de Carabobo Sede Aragua, Maracay, Estado Aragua, Venezuela
- Centro Nacional de Investigaciones Agrícolas y Pecuarias (CENIAP), Instituto Nacional de Investigaciones Agrícolas (INIA), Ministerio del Poder Popular Para la Producción Agrícola (MPPPA, Maracay, Estado Aragua, Venezuela
| | - José Gauta
- Cátedra de Sanidad Animal (Agrotecnia), Instituto Universitario Tecnológico de Ejido (IUTE) Extensión Bailadores, Bailadores, Estado Mérida, Venezuela
| | - Marielena García
- Facultad de Ciencias Veterinarias, Cátedra de Parasitología Veterinaria, Universidad Central de Venezuela (UCV-FCV), Maracay, Estado Aragua, Venezuela
| | - Aixa Aguirre
- Facultad de Ciencias Veterinarias, Cátedra de Parasitología Veterinaria, Universidad Central de Venezuela (UCV-FCV), Maracay, Estado Aragua, Venezuela
| | - Arlett Pérez
- Facultad de Ciencias Veterinarias, Cátedra de Parasitología Veterinaria, Universidad Central de Venezuela (UCV-FCV), Maracay, Estado Aragua, Venezuela
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Brown JD. Human Fascioliasis (Liver Fluke Disease) in Hawai'i: Case Report and Review of Human Fascioliasis Acquired in the United States. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2021; 80:212-217. [PMID: 34522889 PMCID: PMC8433574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Fascioliasis is a foodborne zoonotic infection caused by the trematode liver flukes: Fasciola hepatica and Fasciola gigantica (F. gigantica). Infections may cause acute and chronic hepatobiliary tract diseases in herbivore animals and humans. Fascioliasis is present worldwide, particularly in regions where sheep and cattle are raised. The global burden of human fascioliasis is estimated to be 2.7 million. Human infections are rare in the United States, and most infections were acquired abroad. In the 1950s, several human cases of F. gigantica infection were reported from Hawai'i, but no subsequent cases have been reported until the case described here. This case report describes a man from Hawai'i Island who ate raw wild watercress, and 22 days later, developed acute phase fascioliasis with fever, acute hepatitis, peripheral eosinophilia, and hypodense lesions seen on liver diagnostic imaging. Immunodiagnostic tests were positive for Fasciola species. Based on earlier reports from Hawai'i, F. gigantica infection was likely. Clinical abnormalities resolved after treatment with triclabendazole. Physicians should consider fascioliasis in immigrants and travelers from endemic areas with acute hepatitis and eosinophilia after eating raw wild watercress or chronic hepatobiliary disease. Hepatobiliary imaging and serological testing are useful for diagnosis. Oral triclabendazole is the preferred treatment. Animal fascioliasis appears to be spreading in the United States, and the popularly perceived health benefits of eating raw wild watercress and other aquatic plants may lead to more human infections. The rarity of human infections in Hawai'i suggests that it is safe to eat commercially grown watercress cultivated in Hawai'i.
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Affiliation(s)
- Joel D. Brown
- Department of Medicine, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI
- The Queens Medical Center, Honolulu, HI
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Mu Y, McManus DP, Gordon CA, Cai P. Parasitic Helminth-Derived microRNAs and Extracellular Vesicle Cargos as Biomarkers for Helminthic Infections. Front Cell Infect Microbiol 2021; 11:708952. [PMID: 34249784 PMCID: PMC8267863 DOI: 10.3389/fcimb.2021.708952] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/14/2021] [Indexed: 12/11/2022] Open
Abstract
As an adaption to their complex lifecycles, helminth parasites garner a unique repertoire of genes at different developmental stages with subtle regulatory mechanisms. These parasitic worms release differential components such as microRNAs (miRNAs) and extracellular vesicles (EVs) as mediators which participate in the host-parasite interaction, immune regulation/evasion, and in governing processes associated with host infection. MiRNAs are small (~ 22-nucleotides) non-coding RNAs that regulate gene expression at the post-transcriptional level, and can exist in stable form in bodily fluids such as serum/plasma, urine, saliva and bile. In addition to reports focusing on the identification of miRNAs or in the probing of differentially expressed miRNA profiles in different development stages/sexes or in specific tissues, a number of studies have focused on the detection of helminth-derived miRNAs in the mammalian host circulatory system as diagnostic biomarkers. Extracellular vesicles (EVs), small membrane-surrounded structures secreted by a wide variety of cell types, contain rich cargos that are important in cell-cell communication. EVs have attracted wide attention due to their unique functional relevance in host-parasite interactions and for their potential value in translational applications such as biomarker discovery. In the current review, we discuss the status and potential of helminth parasite-derived circulating miRNAs and EV cargos as novel diagnostic tools.
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Affiliation(s)
- Yi Mu
- Molecular Parasitology Laboratory, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Donald P McManus
- Molecular Parasitology Laboratory, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Catherine A Gordon
- Molecular Parasitology Laboratory, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Pengfei Cai
- Molecular Parasitology Laboratory, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
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Webb CM, Morales ML, Lopez M, Baca-Turpo B, Arque E, White AC, Cabada MM. Stunting in pre-school and school-age children in the Peruvian highlands and its association with Fasciola infection and demographic factors. PLoS Negl Trop Dis 2021; 15:e0009519. [PMID: 34153050 PMCID: PMC8248620 DOI: 10.1371/journal.pntd.0009519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/01/2021] [Accepted: 05/30/2021] [Indexed: 11/18/2022] Open
Abstract
Fascioliasis is a zoonotic trematode infection that is endemic in the highlands of Peru. Chronic fascioliasis can be asymptomatic and remain undiagnosed for years. Chronic malnutrition in children, as manifested by stunting, leads to delayed cognitive development and lost productivity. We hypothesized that fascioliasis is among the factors associated with stunting in children from endemic areas. We conducted a cross-sectional study among children attending pre-school and school in 26 communities in the Anta province in the Cusco region of Peru. We conducted interviews to collect information on demographic, socioeconomic, and medical history. Blood was collected and tested for complete cell count and FAS2 ELISA for Fasciola antibodies. Three stool samples per participant were tested for parasites by Kato-Katz and Lumbreras rapid sedimentation methods. Chronic fascioliasis was determined by the presence of ova in stool. Children's height, weight, and age were recorded and used to calculate height for age Z scores (HAZ). Three thousand children participated in the study. Nine percent (264) of children had at least one positive test for Fasciola infection, 6% (164) had chronic fascioliasis, and 3% (102) had only positive antibody tests. The median HAZ was -1.41 (IQR: -2.03 to -0.81) and was similar in males and females. Twenty six percent (776) of children had stunting with HAZ < -2. Children with chronic fascioliasis had a lower median HAZ than children without Fasciola (-1.54 vs. -1.4, p = 0.014). History of treatment for malnutrition, history of treatment for anemia, having other helminths in stool, lower socioeconomic score, living at a higher elevation, and fewer years of schooling of both parents were associated with a lower HAZ score. In a multiple regression analysis, older age and a lower socioeconomic score were associated with a lower HAZ score. While fascioliasis and other helminths were associated with lower HAZ, they were not independent of the socioeconomic score.
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Affiliation(s)
- Camille M. Webb
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Maria Luisa Morales
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Martha Lopez
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Benicia Baca-Turpo
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Eulogia Arque
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - A. Clinton White
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Miguel M. Cabada
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
- * E-mail:
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Recognition Pattern of the Fasciola hepatica Excretome/Secretome during the Course of an Experimental Infection in Sheep by 2D Immunoproteomics. Pathogens 2021; 10:pathogens10060725. [PMID: 34207550 PMCID: PMC8228785 DOI: 10.3390/pathogens10060725] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 01/01/2023] Open
Abstract
Excretory/secretory products released by helminth parasites have been widely studied for their diagnostic utility, immunomodulatory properties, as well as for their use as vaccines. Due to their location at the host/parasite interface, the characterization of parasite secretions is important to unravel the molecular interactions governing the relationships between helminth parasites and their hosts. In this study, the excretory/secretory products from adult worms of the trematode Fasciola hepatica (FhES) were employed in a combination of two-dimensional electrophoresis, immunoblot and mass spectrometry, to analyze the immune response elicited in sheep during the course of an experimental infection. Ten different immunogenic proteins from FhES recognized by serum samples from infected sheep at 4, 8, and/or 12 weeks post-infection were identified. Among these, different isoforms of cathepsin L and B, peroxiredoxin, calmodulin, or glutathione S-transferase were recognized from the beginning to the end of the experimental infection, suggesting their potential role as immunomodulatory antigens. Furthermore, four FhES proteins (C2H2-type domain-containing protein, ferritin, superoxide dismutase, and globin-3) were identified for the first time as non-immunogenic proteins. These results may help to further understand host/parasite relationships in fasciolosis, and to identify potential diagnostic molecules and drug target candidates of F. hepatica.
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Mirzadeh A, Jafarihaghighi F, Kazemirad E, Sabzevar SS, Tanipour MH, Ardjmand M. Recent Developments in Recombinant Proteins for Diagnosis of Human Fascioliasis. Acta Parasitol 2021; 66:13-25. [PMID: 32974849 DOI: 10.1007/s11686-020-00280-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023]
Abstract
Fascioliasis is an important neglected tropical disease that causes severe injury to the bile ducts and liver. Therefore, a rapid and accurate method for detection of Fasciola hepatica infection plays a vital role in early treatment. Currently, the diagnosis of fascioliasis is mainly conducted via serological tests using the excretory/secretory (E/S) products, which might cross-react with antigens from other helminth parasitic diseases. Hence, the development of serodiagnosis test using recombinant antigens may contribute to differentiate fascioliasis from other helminth infections. In the past 20 years, many attempts have been made to exert different F. hepatica recombinant antigens to obtain a well-established standard assay with high accuracy. In this review, we address recent studies that refer to the development of serodiagnosis tests for diagnosis of human fascioliasis based on the candidate recombinant antigens produced by different approaches. Meanwhile, in the present review, some main factors have been highlighted to improve the accuracy of diagnostic tests such as the effect of refolding methods to recover antigens' tertiary structure as well as applying a mixture of recombinant antigens with the highest sensitivity and specificity to improve the accuracy of diagnostic tests.
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Affiliation(s)
- Abolfazl Mirzadeh
- Department of Biochemistry and Molecular Biology, The University of Melbourne, Parkville, VIC, 3010, Australia.
| | - Farid Jafarihaghighi
- Department of Chemical Engineering, South Tehran Branch, Islamic Azad University, 1584743311, Tehran, Iran
| | - Elham Kazemirad
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shokouh Shahrokhi Sabzevar
- Department of Medical Genetics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Hossein Tanipour
- Department of Biochemistry and Molecular Biology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Mehdi Ardjmand
- Department of Chemical Engineering, South Tehran Branch, Islamic Azad University, 1584743311, Tehran, Iran
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Caravedo MA, Cabada MM. Human Fascioliasis: Current Epidemiological Status and Strategies for Diagnosis, Treatment, and Control. Res Rep Trop Med 2020; 11:149-158. [PMID: 33273878 PMCID: PMC7705270 DOI: 10.2147/rrtm.s237461] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose of the Review This review aims to critically assess current knowledge about the epidemiology, diagnosis, and management of Fasciola infection in humans. Recent Findings Fascioliasis is an emerging neglected zoonotic infection affecting the health and wellbeing of human populations. The burden of infection is unclear, and studies have shown the geographic expansion of fascioliasis in human and livestock likely related to climate change. The infection can be asymptomatic or present in acute or chronic forms. Regardless of the presentation, fascioliasis can be associated with long-term complications such as anemia and malnutrition. Early in the infection, antibody testing is the only tool available for diagnosis confirmation. In the chronic forms serology and stool microscopy are helpful. Other tests such as antigen detection and PCR-based methods including isothermal tests have shown promising results. Triclabendazole is the only drug available to treat Fasciola infection. However, reports of resistant infections in livestock and human threaten the clinical care and control of the infection in endemic areas. Summary Fascioliasis is an emerging infection around the world with an uncertain burden. Lack of standardization of diagnostic testing and treatment alternatives hinder treatment and control of the infection.
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Affiliation(s)
- Maria Alejandra Caravedo
- Division of Infectious Diseases Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Miguel Mauricio Cabada
- Division of Infectious Diseases Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.,Cusco Branch - Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru
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MOSHFE A, ARIA A, ERFANI N, JAMSHIDI A, SARKARI B, ABDOLAHI KHABISI S, AREFKHAH N. Clinical Features, Diagnosis and Management of Patients with Suspicion of Fascioliasis in Kohgiluyeh and Boyer-Ahmad Province, Southwestern Iran. IRANIAN JOURNAL OF PARASITOLOGY 2020; 15:84-90. [PMID: 32489379 PMCID: PMC7244844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND In the current study, we described the epidemiological features, clinical presentation, diagnosis and management of patients with suspicion of fascioliasis in Kohgiluyeh and Boyer-Ahmad Province in southwest of Iran. METHODS Overall, 56 patients with suspicion of fascioliasis, based on their clinical signs and symptoms that referred to Clinic of Internal Medicine in Yasuj city, from 2014 to 2016 were enrolled. Demographic data, history of eating aquatic local plants, the chief complains, and laboratory findings were recorded for each patient. Stool samples were obtained from each case for detection of Fasciola eggs. Moreover, blood samples were taken from each patient and evaluated for detection of anti-Fasciola antibodies by an indirect ELISA. Patients who defined as having fascioliasis were treated with triclabendazole and were followed for at least three months for clinical improvement. RESULTS Serological test was positive in 5 patients. Of these 5 cases, three cases had a history of ingesting raw aquatic vegetables. The main clinical signs and symptoms in positive cases were; abdominal pain (60%), epigastric pain (40%), anemia (60%), and dermal pruritus (20%). Hypereosinophilia was seen in all of 5 positive cases. No Fasciola egg was found in stool specimens of any of the patients. The fascioliasis cases were treated by triclabendazole and clinical symptoms disappeared in all of 5 cases. CONCLUSION Our observation further confirmed Yasuj district as a human endemic area for fascioliasis in Iran. The study also highlighted the importance of clinical features together with eosinophilia, as key parameters, in the diagnosis of human fascioliasis. Clinicians need to be aware of this disease and should keep in mind fascioliasis when hypereosinophilia present in patients in such endemic areas.
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Affiliation(s)
- Abdolali MOSHFE
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Arash ARIA
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Najme ERFANI
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Ali JAMSHIDI
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Bahador SARKARI
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Correspondence
| | - Samaneh ABDOLAHI KHABISI
- Department of Parasitology and Mycology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Nasir AREFKHAH
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
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Ramadan HKA, Hassan WA, Elossily NA, Ahmad AA, Mohamed AA, Abd- Elkader AS, Abdelsalam EMN, Khojah HMJ. Evaluation of nitazoxanide treatment following triclabendazole failure in an outbreak of human fascioliasis in Upper Egypt. PLoS Negl Trop Dis 2019; 13:e0007779. [PMID: 31553716 PMCID: PMC6779272 DOI: 10.1371/journal.pntd.0007779] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 10/07/2019] [Accepted: 09/13/2019] [Indexed: 02/06/2023] Open
Abstract
Background Fascioliasis is a neglected zoonosis with major public health implications in humans. Although triclabendazole (TCBZ) is the drug of choice, there are records of TCBZ failure worldwide. TCBZ-resistant fascioliasis is treated with alternative approved drugs including nitazoxanide (NTZ), with varying levels of efficacy. Data on NTZ efficacy after TCBZ failure in Egypt is scarce. This study evaluated the efficacy of NTZ in cases of TCBZ failure during an outbreak of fascioliasis in Assiut governorate of Upper Egypt. Methodology/Principal findings This prospective study included 67 patients from the outpatient clinic in Manfalout locality of Assiut governorate with clinical manifestations of acute fascioliasis. These included high eosinophilia (> 6% eosinophils in peripheral blood), positive anti-Fasciola antibodies, and hepatic focal lesions (HFL) or ascites on abdominal ultrasound or computed tomography. All patients initially received TCBZ at recommended doses. Patients were followed up after 1 month to assess response. According to the responses, patients were categorized as non-responders and responders. The non-responders received a trial of NTZ and were re-assessed for response based on clinical manifestations, eosinophil count, and abdominal ultrasound. Patients not responding to NTZ received additional doses of TCBZ. One month after initial TCBZ treatment, 37 patients responded well to TCBZ, while 30 patients failed to respond with persistence of fever, abdominal pain, high eosinophilia, and HFL. Most non-responders were male (56.7%); females predominated among TCBZ responders (62.2%). The mean age of the non-responders was relatively lower, at 20.57 ± 14.47 years (p = 0.004). Following NTZ therapy, HFL disappeared in 9/30 (30%) patients and eosinophil counts normalized in only 2 (6.7%) patients, indicating an overall efficacy of 36.6%. The remaining cases received additional doses of TCBZ with complete clinical, pathological, and radiological resolution. Conclusions/Significance Nitazoxanide was partially effective in TCBZ failure in acute human fascioliasis in Upper Egypt. Further studies with larger samples are highly encouraged and further research is urgently needed to find new therapeutic alternatives to TCBZ. Fascioliasis is a neglected zoonosis with major public health implications in humans. Triclabendazole (TCBZ) is the drug of choice, but alternative approved drugs are necessary in cases of TCBZ failure. Nitazoxanide (NTZ) is an alternative used in such cases. However, the efficacy of NTZ in TCBZ-failure cases among patients in Egypt remains unclear. In this study, the efficacy of NTZ was evaluated in cases of TCBZ failure during an outbreak of human fascioliasis in Assiut governorate of Upper Egypt. This study enrolled 67 patients diagnosed with fascioliasis based on clinical, laboratory, and radiological findings. These patients were referred from the outpatient clinic in Manfalout locality of Assiut governorate in Egypt. All patients received TCBZ at recommended doses as initial treatment. Those failing to respond were treated with NTZ at standard doses; following therapy, lesions in the liver and high eosinophil counts were resolved in 30% and 6.7% patients, respectively, indicating an overall efficacy of 36.6%. Therefore, in this outbreak of human fascioliasis in Upper Egypt, NTZ was found to be partially effective in cases with TCBZ failure.
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Affiliation(s)
| | - Waleed Attia Hassan
- Department of Tropical medicine and Gastroenterology, Faculty of Medicine, Assiut University, Egypt
| | | | | | - Adnan Ahmed Mohamed
- Department of Tropical medicine and Gastroenterology, Faculty of Medicine, Assiut University, Egypt
| | | | | | - Hani M. J. Khojah
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Madinah, Saudi Arabia
- * E-mail:
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Pattarapuntakul T, Ovartlarnporn B, Rojsanga W, Yungyoo T. Biliary Fascioliasis in Chronic Calcific Pancreatitis Presenting with Ascending Cholangitis and Biliary Stricture. Case Rep Gastroenterol 2019; 13:438-444. [PMID: 31762732 PMCID: PMC6873016 DOI: 10.1159/000503277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 09/04/2019] [Indexed: 12/04/2022] Open
Abstract
Biliary fascioliasis is a rare infection of the hepatobiliary system. In human, it is known to present with two main phases; acute phase (hepatic phase) presenting with abdominal pain or abnormal liver biochemistry then chronic phase (biliary phase) presenting with biliary obstruction or cholangitis. Optimal treatment of biliary fascioliasis consists of endoscopic retrograde cholangiography with removal of the parasite and single oral dose of triclabendazole. We report a rare case of biliary fascioliasis in chronic calcified pancreatitis who presented with ascending cholangitis and biliary stricture. A 63-years-old Thai man was referred to our hospital for treatment of clinical symptoms severe cholangitis. Magnetic resonance cholangiopancreatography showed evidence of distal common bile duct stricture associated with chronic calcific pancreatitis. ERCP was performed, that found a few amorphous filling defects in the common bile duct and distal biliary stricture. After removal of the foreign body of what seems to be a fluke parasite followed with single oral dose triclabendazole thereafter, the clinical symptom was improved dramatically.
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Affiliation(s)
- Tanawat Pattarapuntakul
- NKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Bancha Ovartlarnporn
- NKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Worapot Rojsanga
- NKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Thanaidpon Yungyoo
- Internal Medicine, Shanghai Medical College, Fudan University, Shanghai, China
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Mubanga C, Mwape KE, Phiri IK, Trevisan C, Zulu G, Chabala C, van Damme I, Schmidt V, Dorny P, Gabriël S. Progress on the development of rapid diagnostic tests for foodborne neglected zoonotic helminthiases: A systematic review. Acta Trop 2019; 194:135-147. [PMID: 30946810 DOI: 10.1016/j.actatropica.2019.03.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 02/15/2019] [Accepted: 03/31/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Foodborne Neglected Zoonotic Helminths (FNZH) are parasites of both economic and public health importance. They include Taenia solium, Echinococcus granulosus sensu lato, Echinococcus multilocularis and Foodborne trematodes (FBT). FNZH are earmarked for major interventions for control, elimination and eradication. This systematic review highlights the progress towards development of rapid tests for the diagnosis of FNZH since 2010 when they were listed as neglected tropical diseases. METHODOLOGY A systematic search was conducted in three databases, World of Science, Embase and PubMed using the same search phrase. The search produced 480 hits. Three studies from back referencing were included. Only 22 of these met the inclusion criteria. Data was extracted from these and presented qualitatively. RESULTS Twenty-five rapid diagnostic tests were found to have been developed since 2010, eight for diagnosis of T. solium infections, eight for echinococcosis and nine for FBT infections. The rapid tests for diagnosing T. solium infections included six antibody detecting and two antigen detecting tests. They constitute a combination among them, with some tests providing qualitative, others quantitative results. Similarly, seven out of the eight rapid tests developed for Echinococcus infections were antibody detecting tests save for one loop mediated isothermal amplification test. All of them were qualitative tests. For FBT infections, nine rapid tests were described; two antibody and one nucleic acid detecting test for diagnosis of Fascioliasis; three nucleic acid detecting tests for Opisthorchiasis; one antibody detecting test for Paragonimiasis; and for Clonorchiasis, one antibody and one nucleic acid detecting test. The FBT infection rapid tests were all qualitative in nature. Most of these tests have not undergone field evaluation in endemic areas where they will be used most. CONCLUSION This review describes the development and evaluation of rapid diagnostic tests, while highlighting the need for in depth validations of the tools to determine how well they can perform in endemic areas.
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Affiliation(s)
- Chishimba Mubanga
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.
| | - Kabemba E Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Isaac K Phiri
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Gideon Zulu
- Provincial Medical Office, Ministry of Health, Kasama, Zambia
| | - Chishala Chabala
- Children's Hospital, University Teaching Hospitals, Lusaka, Zambia
| | - Inge van Damme
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Veronika Schmidt
- Centre for Global Health, Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany; Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Assessment of Fasciola hepatica glutathione S-transferase as an antigen for serodiagnosis of human chronic fascioliasis. Acta Trop 2018; 186:41-49. [PMID: 29990477 DOI: 10.1016/j.actatropica.2018.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/18/2018] [Accepted: 07/02/2018] [Indexed: 01/18/2023]
Abstract
Due to the unsatisfactory performance of parasitological diagnosis of human fascioliasis; the use of immunodiagnosis based on the detection of anti-Fasciola antibodies is traditionally used as a diagnostic alternative using total or purified parasite excretory-secretory products (ESPs). Glutathione S-transferase (GST) protein, one of the F. hepatica ESP components, possesses well-known roles in the detoxification of xenobiotic and endogenously derived toxins within the host bile environment. GST has shown to be a good target for vaccine or drug development against fascioliasis. The current study aimed to evaluate the potential of GST protein purified from a soluble crude extract of adult flukes as an antigen for serodiagnosis of chronic human fascioliasis by indirect ELISA. The study included a panel of 116 serum samples collected from individuals with confirmed fascioliasis, individuals carrying heterologous parasitic infections and healthy subjects. The parasitological examination was used as gold standard and a previously optimized ESP-ELISA was used to compare the performance of the GST-ELISA method. Results demonstrated that GST-ELISA is 94.3% sensitive, 80.2% specific and exhibits a moderate positive correlation (r = 0.555) and substantial agreement (k = 0.786) with the results obtained with the ESP-ELISA method. Moreover, because no sera from patients with early F. hepatica infection were available, GST-ELISA was then tested with sera from rabbits experimentally infected with F. hepatica metacercariae. The assay was able to detect anti-Fasciola antibodies as early as the 3rd week of infection (p < 0.0001) with peaks at 4th and 10th week post-infection.
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