[Mechanism of hepatic fibrosis associated with Echinococcus: a review]

Echinococcosis is a zoonotic parasitic disease caused by Echinococcus infections, and this disorder may cause fibrosis of multiple vital organs, which may further progress into cirrhosis. Early-stage hepatic fibrosis is reversible, and unraveling the mechanisms underlying hepatic fibrosis induced by Echinococcus infections is of great significance for the prevention and treatment of early-stage hepatic fibrosis. Recently, the studies pertaining to hepatic fibrosis associated with Echinococcus infections focus on cytokines and immune cells. This review summarizes the advances in the mechanisms underlying host immune cells- and cytokines-mediated hepatic fibrosis in humans or mice following Echinococcus infections.

Advances in the study of molecular identification technology of Echinococcus species

The larvae of Echinococcus (hydatidcyst) can parasitize humans and animals, causing a serious zoonotic disease-echinococcosis. The life history of Echinococcus is complicated, and as the disease progresses slowly after infection, early diagnosis is difficult to establish. Due to the limitations of imaging and immunological diagnosis in this respect, domestic and foreign scholars have established a variety of molecular detection techniques for the pathogen Echinococcus over recent years, mainly including nested polymerase chain reaction (PCR), multiplex PCR, real-time quantitative PCR, and nucleic acid isothermal amplification technology. In this article, the research progress of molecular detection technology for Echinococcus infection currently was reviewed and the significance of these methods in the detection and diagnosis of hydatid and hydatid diseases was also discussed.

[Effects of persistent Echinococcus multilocularis infections on hepatic fibrosis in mice]

OBJECTIVE

To investigate the effects of persistent Echinococcus multilocularis infections on hepatic fibrosis in mice, so as to provide insights into the understanding of liver fibrogenesis induced by E. multilocularis infections and the treatment of alveolar echinococcosis.

METHODS

Hepatic stellate HSC-T6 and LX-2 cells were exposed to the sera (25, 50 and 100 μL) from Meriones unguiculatus infected with E. multilocularis, and E. multilocularis, germinal layer cells (GCs) and protoscoleces (PSCs) for 48 hours, respectively. The cell proliferation was measured using a CCK-8 assay, and the levels of collagen 1 (Col1) and α-smooth muscle actin (α-SMA) were measured in the culture supernatant of HSC-T6 cells using ELISA. In addition, the serum and liver samples were collected 1, 2, 4, 6, 8 months post-infection with E. multilocularis, respectively. The serum Col1 and α-SMA concentrations were measured using enzyme-linked immunosorbent assay (ELISA), and the deposition of collagen fibers was examined in mice livers using Sirius red staining.

RESULTS

The sera of E. multilocularis-infected gerbils promoted the proliferation of HSC-T6 and LX-2 cells in vitro, and there were significant differences seen in the proliferative rate of HSC-T6 (F_HSC-T6 = 126.50, P < 0.05) and LX-2 cells (F_LX-2 = 201.50, P < 0.05) among different serum groups, with the highest proliferative rate of HSC-T6 (573.36% ± 206.34%) and LX-2 cells (940.38% ± 61.65%) found following exposure to 100 μL mouse sera. Exposure to serum from E. multilocularis-infected gerbils resulted in an increase in the Col1 and α-SMA levels in the culture supernatant of HSC-T6 cells, with the greatest Col1 (20.99 ng/mL ± 2.01 ng/mL) and α-SMA levels (305.52 pg/mL ± 16.67 pg/mL) measured following exposure to 100 μL sera. The metacestodes (142.65% ± 9.17% and 189.99% ± 7.75%), GCs (118.55% ± 8.96% and 122.54% ± 0.21%) and PSCs of E. multilocularis (156.34% ± 17.45% and 160.59% ± 31.41%) all promoted the proliferation of HSC-T6 and LX-2 cells in vitro, and there were significant differences in the proliferative rates of HSC-T6 (F_HSC-T6 = 11.24, P < 0.05) and LX-2 cells among groups (F_LX-2 = 47.72, P < 0.05). Exposure to E. multilocularis resulted in an increase in Col1 and α-SMA levels in the culture supernatant of HSC-T6 cells, and the highest Col1 (4.43 ng/mL ± 2.23 ng/mL) and α-SMA levels (285.20 pg/mL ± 90.67 pg/mL) were detected following treatment with E. multilocularis metacestodes. In addition, a persistent increase was seen in the deposition of collagen fibers in mice livers 1 to 8 months post-infection with E. multilocularis, with the greatest Col1 level (280.26 ng/mL ± 23.04 ng/mL) seen 6 months post-infection and the highest α-SMA level (33.68 ng/mL ± 4.45 ng/mL) detected 8 months post-infection, respectively.

CONCLUSIONS

Persistent E. multilocularis infections promote hepatic stellate cell proliferation, induce an increase in mouse serum Col1 and α-SMA levels, and cause elevated deposition of collagen fibers in mice livers. The infective stage of E. multilocularis is a critical period for inducing hepatic fibrosis of alveolar echinococcosis.

[Identification and functional study of the Schistosoma japonicum epidermal growth factor receptor gene]

OBJECTIVE

To characterize the epidermal growth factor receptor (EGFR) gene in Schistosoma japonicum (SjEGFR gene) and investigate the role of the EGFR gene in regulating the growth, reproductive system, maturation and fecundity of S. japonicum.

METHODS

Rapid amplification of cDNA ends (RACE) was performed to obtain the full length of the SjEGFR gene, and the SjEGFR gene expression was quantified in different developmental stages of S. japonicum using a quantitative real-time PCR (qPCR) assay. The tissue localization of the SjEGFR gene was detected in 22-day parasite using whole-mount in situ hybridization (WISH). Following RNA interference (RNAi)-induced knockdown of the SjEGFR gene, the worm length, pairing rate and worm burden of S. japonicum were measured, and the worm morphology was observed using optical microscopy and confocal microscopy.

RESULTS

The SjEGFR gene was identified with a conserved tyrosine-kinase active site, and the SjEGFR gene expression was detected at various developmental stages in male and female parasites. WISH showed that the transcript of the SjEGFR gene was localized on the tegument and in the digestive organs of S. japonicum. RNAi-induced SjEGFR knockdown resulted in marked suppression of the worm growth, smaller size of male testicles that contained more immature spermatocytes, and apparent impairment of ovary and vitelline gland development. In addition, no eggs were found in the uterus of SjEGFR knocked-down female parasites, indicating the interruption of egg production.

CONCLUSIONS

Inhibition of SjEGFR expression may remarkably suppress the growth and maturation of S. japonicum, and interrupt the egg production.

Effects of euphorbia kansui on the serum levels of IL-6, TNF-α, NF-κB, sTNFR and IL-8 in patients with severe acute pancreatitis

In this study, effects of euphorbia kansui on serum levels of inflammatory factors in patients with severe acute pancreatitis were investigated, and the mechanisms underlying the role of Euphorbia kansui in the treatment of severe acute pancreatitis were discussed. 36 patients hospitalized in the Third Affiliated Hospital of Wenzhou Medical University from March 2017 to May 2018 due to severe acute pancreatitis were selected and divided into two groups using a randomized grouping method. ELISA (enzyme-linked immunosorbent assay) was used to detect expressions of various inflammatory cytokines, such as tumor necrosis factor α (TNF-α), soluble TNF receptors (sTNFR), nuclear factor-κB (NF-κB), interleukin-6 (IL-6), and interleukin-8 (IL-8), in the serum of patients at different time points. The results showed no significant difference between the two groups in terms of age, gender, predisposing factors, Balthaza CT scores, and APACHEII (Acute Physiology and Chronic Health Evaluation) scores. According to the experimental results, euphorbia kansui effectively reduced the expression of inflammation related cytokines, such as NF-κB, TNF-α, sTNFR, IL-6, and IL-8, in the serum of patients with severe acute pancreatitis. It was also proposed that euphorbia kansui hindered the release of inflammatory factors and treated SAP by inhibiting the activation of the NF-κB signaling pathway.

[Study of intraoperative mitomycin C in preventing recurrence after pterygium surgery]

OBJECTIVE

To explore the feasibility of intraoperative application of mitomycin C (MMC) in pterygium and observe the ultrastructure change of pterygium with or without intraoperative application of MMC.

METHODS

Sixty two eyes of 57 patients with primary pterygium were randomly divided into MMC group and control group, 29 patients (32 eyes) in MMC group underwent transposition with intraoperative application of MMC (0.4 mg.ml-1 for 1 minute), whereas 28 patients (30 eyes) in control group underwent transposition. The recurrence rate, complications and side effects were observed and compared between the two groups. The ultrastructure of pterygium with or without intraoperative application of MMC was studied with transmission electron microscopy. The mean follow-up was(7.6 +/- 3.4) months (1-13 minths).

RESULT

Eleven eyes of the 30 eyes in control group (36.%) showed recurrence, whereas only 2 of 32 eyes (6.3%) in MMC group showed recurrence (P < 0.005). No severe complication and side effect appeared during the follow-up. Most of fibroblasts in pterygium that underwent intraoperative MMC occurred the change of rough endoplasmic reticulum (RER) dilatation.

CONCLUSION

Intraoperative MMC appears to be an effective treatment in preventing recurrence of primary pterygium. The fibroblasts in pterygium have RER dilatation after application of MMC for 1 minute during the operation.

Left ventricular wall motion abnormalities in chronic mitral and aortic valvular disease

Left ventricular wall motion was analyzed from the contrast ventriculograms of 42 patients with mitral and aortic valvular diseases by the computer-aided 100-chords centerline method. The results showed that ventricular wall motion was decreased in the anterobasal and mitral valve regions in patients with mitral aortic valvular diseases. In 15 patients, there were also other local ventricular wall motion abnormalities, which were located in the anteroapical and posterobasal regions. Almost all of the patients with ejection fraction(EF) less than 0.5 had diffuse or localized hypokinesis. Ventricular wall motion in patients who died from cardiac causes early after receiving valvular replacement was lower than that of survivors. Using Fisher's judgement method, a formula could be established to predict the early prognosis of patients with chronic valvular diseases after valve replacement.

[Temporary amaurosis from retrobulbar lidocaine injection in late glaucoma patients]

Temporary amaurosis occurred after retrobulbar injection of lidocaine in 12 cases of antiglaucoma surgery in 4 years, and 10 of the patients were of late glaucoma. Lidocaine has a strong penetration potential which blocks the visual pathway, particularly for late glaucoma eyes in which the remnant optic nerve fibers may be especially sensitive to the drug. Therefore, the authors refrain from retrobulbar lidocaine in late glaucoma patients.