Recurrencia en echinococcosis quística hepática

El tratamiento quirúrgico de la equinococosis quística hepática se asocia (entre otras), con una tasa de recurrencia actual de hasta 27%, aunque es infrecuente la recurrencia después de la exéresis total de un quiste intacto. Por lo general, la recurrencia ocurre producto del derrame de estructuras parasitarias vivas a alguna cavidad, o de dejar residuos de germinal, vesículas hijas o protoescólices durante la cirugía. La recurrencia suele ser asintomática, por lo que el diagnóstico depende, casi exclusivamente, de un seguimiento riguroso y prolongado en el tiempo, con controles clínicos, determinaciones serológicas, e imágenes. El tratamiento puede incluir el uso de albendazol, asociado a técnicas de radiología intervencionista o cirugía. El objetivo de este manuscrito fue generar un documento de lectura referente a la recurrencia de la equinococosis quística hepática.

Surgical treatment of hepatic cystic echinococcosis is associated (among others), with a current recurrence rate of up to 27%; although recurrence after total resection of an intact cyst is rare. In general, recurrence occurs as a result of the spillage of living parasitic structures into a cavity, or of leaving germinal residues, daughter vesicles, or protoscolices during surgery. Recurrence is usually asymptomatic, so the diagnosis depends almost exclusively on a rigorous and prolonged follow-up, with clinical controls, serological determinations, and images. Treatment may include the use of albendazole, followed by interventional radiology techniques or surgery. The aim of this manuscript was to generate a reading document regarding the recurrence of hepatic cystic echinococcosis.

Morphology of Echinococcus granulosus protoscolex / Morfología de los Protoescolex de echinococcus granulosus

SUMMARY: Echinococcus granulosus (E. granulosus), is a tapeworm that spreads between intermediate and definitive hosts through the ingestion of fecal matter contaminated with the parasite's eggs. The life cycle consists of differentiation from eggs to oncospheres to embryos, which eventually form cysts in organs like the liver, lungs and others. Within these cysts are protoscolices, an intermediate stage of the parasite which develop into adult tapeworms once they infect their definitive hosts. When these hydatid cysts form in humans, it is known as Cystic Echinococcosis (CE). This disease is treated through surgical excision of the cysts and or chemotherapy with benzimidazole compounds. Understanding the morphology of the intermediate developmental stage of E. granulosus, protoscolex stage, can allow researchers to identify defining structural changes and protein functions that could be used to develop treatment modalities for CE. Unique characteristics in the tegumental surface during the protoescolex stage and proteins associated with cyst fertility have all been identified in previous research studies and bring researchers closer to understanding the underlying mechanisms of E. granulosus development, and consequently, means to disrupt it to achieve better control of the disease.

El Echinococcus granulosus (E. granulosus), es un cestodo que se propaga entre huéspedes intermedios y definitivos a través de la ingestión de materia fecal contaminada con los huevos del parásito. El ciclo de vida consiste en la diferenciación de huevos a oncosferas y embriones, que finalmente forman quistes en órganos como el hígado, los pulmones y otros. Dentro de estos quistes hay protoescólices, una etapa intermedia del parásito que se convierte en su forma adulta (tenia), una vez que infectan a sus huéspedes definitivos. Cuando estos quistes hidatídicos se desarrollan en seres humanos, se les conoce como equinococosis quística (EC). Esta enfermedad se trata mediante la extirpación quirúrgica de los quistes o la quimioterapia con compuestos benzimidazólicos. La comprensión de la morfología de la etapa de desarrollo intermedia del E. granulosus y la etapa de protosclex, puede permitir a los investigadores identificar cambios estructurales definidos y funciones de proteínas que podrían usarse para desarrollar modalidades de tratamiento para la CE. Las características únicas en la superficie tegumentaria durante la etapa de protoescolex y las proteínas asociadas con la fertilidad del quiste se han identificado en estudios de investigación anteriores y acercan a los investigadores a la comprensión de los mecanismos subyacentes del desarrollo del E. granulosus y, en consecuencia, los medios para interrumpirlo para lograr un mejor control de la enfermedad.

Hidatidosis pulmonar: Reporte de casos y preludio endémico de la equinococosis quística humana en Paraguay

El Paraguay integra la Iniciativa Sudamericana para el Control y Vigilancia de Equinococosis Quística. Con el fin de optimizar los informes epidemiológicos sobre hidatidosis, presentamos tres casos clínicos vistos en centros nacionales y realizamos una revisión de la literatura local sobre el tópico. Desde 1969 hasta la fecha se describen 70 casos de equinococosis quística. Se requieren estudios epidemiológicos sistemáticos para evaluar el grado de penetración, la distribución geográfica y las características de transmisión de esta enfermedad en nuestro país.

Paraguay is a member of the South American Initiative for the Control and Surveillance of Cystic Echinococcosis. In order to optimize the epidemiological reports on hydatidosis, we present three clinical cases seen in national centers and we carry out a review of the local literature on the topic. From 1969 to date, 70 cases of cystic echinococcosis have been described. Systematic epidemiological studies are required to assess the degree of penetration, geographic distribution, and transmission characteristics of this disease in our country.

Development status of vector-mediated Eg95 vaccine of Echinococcus granulosus / 中华地方病学杂志

Cystic echinococcosis (CE), caused by the larva of Echinococcus granulosus (Eg), is one of the key parasitic diseases to prevent and control in China. The Eg95 protein is a recognized vaccine candidate molecule, and the development of vector-mediated Eg95 vaccine is one of the current research hotspots in CE. This article summarizes the development status of Eg95 vaccine such as vaccinia virus, orf virus, goatpox virus, rabies virus, Salmonella typhimurium, Bacille Calmette-Guerin, Agrobacterium tumefaciens and Bifidobacteria bifidum, in order to provide valuable information for the immune prevention of CE.

Isolated renal hydatid cyst; A rarer infectious disease

Hydatid cyst disease caused by Echinococcus granulosus is commonly seen in the liver but rarely seen in the kidneys, in addition, the isolated renal occurrence is estimated to be about as low as 2–4% of all cases. A 38-year-old male presented with ambiguous left flank pain to the urology clinic. After examination and imaging, he was diagnosed with suspected renal cell carcinoma in the left kidney. Nephrectomy was done and ELISA suggested strongly positive for Hydatid cyst which was later confirmed by histopathological examination. Isolated renal hydatid cyst is an exceedingly rare condition and could possibly be misdiagnosed with other renal masses. The clinical history, laboratory tests, and thorough radiologic imaging are crucial, for accurate preoperative diagnosis as the disease may have no symptoms for years.

Estudio morfocuantitativo de protoescólices y otras estructuras fundamentales de Echinococcus granulosus en hospederos humanos / Morphoquantitative study of protoscolices and other fundamental structures of Echinococcus granulosus in human hosts

La equinococosis quística (EQ) a pesar de ser una enfermedad endémica en diversos lugares del planeta, presenta pocos estudios morfológicos y cuantitativos de las estructuras fundamentales del Echinococcus granulosus en humanos, en especial de los protoescólices. El objetivo de este estudio fue analizar morfocuantitativamente protoescólices y otras estructuras fundamentales de E. granulosus obtenidos de hospederos humanos. Estudio de corte transversal. Se estudiaron 8 especímenes de EQ hepática humana, aplicando un muestreo no probabilístico por conveniencia. Se evaluó las capas quísticas, el líquido y la arenilla hidatídica. Las capas fueron fijadas en formaldehido tamponado a 10 % y procesadas para su inclusión en paraplast. Se realizaron cortes de 5 µm de grosor y fueron teñidas con H-E para su análisis con microscopía óptica. El líquido y arenilla fueron centrifugados y al sedimento obtenido se le realizó análisis directo para determinar las medidas morfométricas de los protoescólices y de los ganchos grandes y pequeños. Se utilizó estadística descriptiva. De los 8 quistes estudiados, 6 eran quistes univesicular, uno multivesicular y un quiste abscedado, cuyas capas laminada y germinativa se encontraban bien definidas. Las vesículas prolígeras presentaban forma redondeada con protoescólices en su interior. Los protoescólices invaginados presentaron un largo y ancho promedio de 140,8 ± 34,3 µm y 106,2 ± 29,5 µm, respectivamente; y los desarrollados un largo de 237,2 ± 53,0 µm y ancho de 128,7 ± 32,0 µm. Los ganchos rostelares presentaron contornos suaves distribuidos en dos filas regulares. El promedio del largo total de los ganchos grandes y pequeños fue 20,1 ± 2,7 µm; el promedio del ancho total fue 7,4 ± 1,2 µm. En conclusión, las características morfocuantitativas de los ganchos de E. granulosus en humanos, son distintos a otras especies hospederas intermediarias y de otros Echinococcus spp. Es posible que el abandono del estado de resistencia de los protoescólices invaginado hasta su desarrollo genere implicancias epidemiológicas de interés.

SUMMARY: Although cystic echinococcosis (CE) is an endemic disease in several parts of the world, few morphological and quantitative studies of the fundamental structures of Echinococcus granulosus in humans, especially protoscolices. The aim of this study was to perform a morphoquantitative analysis of protoescolex and other fundamental structures of E. granulosus from human hosts. Cross- sectional study. Eight human hepatic EQ specimens were studied, applying non-probabilistic convenience sampling. Cystic layers, fluid and hydatid grit were evaluated. The layers were fixed in 10% buffered formaldehyde and processed for embedding in paraplast. Slices of 5 µm thickness were made and stained with H-E for light microscopic analysis. The liquid and grit were centrifuged and the sediment obtained was analyzed directly to determine the morphometric measurements of the protoscolices and the large and small hooks. Descriptive statistics were used. Of the 8 cysts studied, 6 were univesicular cysts, one multivesicular and one abscessed cyst, whose lamellar and germinative layers were well defined. The proligerous vesicles had a rounded shape with protoscolices inside. The invaginated protoscolices had an average length and width of 140.8 ± 34.3 µm and 106.2 ± 29.5 µm, respectively; and the developed ones had a length of 237.2 ± 53.0 µm and width of 128.7 ± 32.0 µm. The rostellar hooks presented smooth contours distributed in two regular rows. The average total length of the large and small hooks was 20.1 ± 2.7 µm; the average total width was 7.4 ± 1.2 µm. In conclusion, the morphoquantitative characteristics of E. granulosus hooks in humans are distinct from other intermediate host species and from other Echinococcus spp. It is possible that the abandonment of the resistance state of the invaginated protoscolices until their development generates epidemiological implications of interest.

Distribución espacial de los Genotipos de Echinococcus granulosus sensu lato por hospedero en el continente americano. Revisión sistemática

Background: Knowledge of the distribution cystic is required for its territorial control. Aim: To describe the spatial distribution of Echinococcus granulosus sensu lato genotypes by host in the American continent. Material and Methods: A systematic review of studies from the American continent, related to genotypes of the E. granulosus s.l complex were included, including any host species, without restriction of language or year of publication. Sensitive searches were performed based on sensitive searches from PubMed, EMBASE, ScienceDirect, SCOPUS and WoS; SciELO and BIREME-BVS and Trip Database. MeSH and free terms were used, including articles up to December 2020. Cartography was carried out with the Arc Map 10® program, using a world geodetic system. Result variables sought were genotype, host, geographic location, year of publication, number of samples, genes used for genotyping. Results: From 1123 retrieved studies retrieved, 53 met the inclusion and exclusion criteria. The studies analyzed represent 3,397 samples from humans and animals. Thirty six percent of articles were published in the five-year period 2016-2020. Reports were mainly from Argentina (27.9%), Brazil (20.6%) and Chile (13.2%). The most reported genotypes globally were G1-G3 (47.3%), G7 (15.3%), G5 (14.6%) and G6 (13.3%). A predominance of G1-G3 and G6 genotypes was verified in South America, G8 and G10 in North America, and "epidemiological silence" in Central America and the Caribbean. Conclusions: Spatial analysis allows defining the relationship of territories and cases with their own characteristics, which can help to plan control interventions.

Quiste hidático esplénico, una rara topografía de una rara enfermedad / Splenic hydatid cyst, a rare topography of a rare disease / Cisto hidatico esplénico, uma topografia rara de uma doença rara

Primary splenic hydatid cyst is a rare entity even in endemic areas. In most cases it presents asymptomatically being diagnosed by imaging findings. Treatment is multimodal and individualized, being surgical treatment the one that allows an integral solution of the disease. Conventional surgery continues to be the "Gold standard" in its approach. We present the case of a patient with this condition and the resolution approached by the surgical team.

O cisto hidatides esplénico primário é uma entidade rara mesmo em áreas endémicas. Na maioria dos casos apresenta-se de forma assintomática, sendo diagnosticada através de resultados de imagem. O tratamento é multimodal e individualizado, com um tratamento cirúrgico que proporciona uma solução abrangente para a condição. A cirurgia convencional continua a ser a abordagem "padrão de ouro". Apresentamos o caso de um paciente com esta condição e a resolução abordada pela equipa cirúrgica.

El quiste hidático primario esplénico es una entidad poco frecuente aún en áreas endémicas. Se presenta en la mayoría de los casos de forma asintomática, siendo diagnosticado por hallazgo imagenológico. El tratamiento es multimodal e individualizado, siendo el tratamiento quirúrgico el que permite una solución integral de la dolencia. La cirugía convencional sigue siendo el "Gold estándar" en su abordaje. Presentamos el caso de una paciente con esta afección y la resolución abordada por el equipo de cirugía.

Características clínicas y epidemiológicas de equinococosis quística en niños de un centro terciario en Perú / Clinical and epidemiological characteristics of cystic echinococcosis in children from a tertiary center in Peru

RESUMEN La equinococosis quística (EQ) en niños es un problema de salud pública. Para describir las características clínicas y epidemiológicas de la EQ se revisaron los registros de 55 niños con diagnóstico confirmado de EQ admitidos entre 2017 y 2019 en un centro quirúrgico referencial del Perú. Se analizaron los datos demográficos, las manifestaciones clínicas y el tratamiento. El 61,8% (34/55) de los niños fue de sexo masculino. La edad promedio fue de 9,25 años (DE: 2,79); un 16,4% tuvo diagnóstico previo de EQ, y un 50,9% tuvo contacto con perros. La mediana de tiempo de enfermedad fue de dos meses. El 65,5% tuvo afectación hepática, el 56,4% pulmonar y el 21,8% hepática y pulmonar. Los síntomas más frecuentes fueron dolor abdominal (80,6%) y tos (80,6%). El tratamiento quirúrgico se realizó en el 87,5% de los casos con EQ hepática y en el 100% de los casos con EQ pulmonar y EQ hepática y pulmonar. Se prescribió albendazol en el 100% de casos hepáticos, en el 73,7% de casos pulmonares y en el 75% de ambas afectaciones. No se reporta mortalidad.

ABSTRACT Cystic echinococcosis (CE) in children is a public health problem. To describe the clinical and epidemiological profile of CE, we reviewed the records of 55 children admitted to our institution with a confirmed diagnosis of CE between 2017-2019, analyzing demographic data, clinical manifestations, and treatment. Of the population, 61.8% (34/55) were male. The mean age was 9.25 years (SD: 2.79); 16.4% had previous CE diagnosis, and 50.9% had contact with dogs. The median time of illness was 2 months. Of the patients, 65.5% had hepatic involvement, 56.4% had pulmonary involvement, and 21.8% had both hepatic and pulmonary involvement. The most frequent symptoms were abdominal pain (80.6%) and cough (80.6%). Surgical treatment was performed in 87.5% of patients with hepatic CE, in 100% of those with pulmonary CE and in 100% of those with hepatic and pulmonary CE. Albendazole was prescribed in 100% of hepatic cases, in 73.7% of pulmonary cases, and in 75% of those with both conditions. Mortality was not reported.

Progress of researches on infection with two species of Echinococcus causing human diseases in animal hosts and influencing factors / 中国血吸虫病防治杂志

Echinococcosis is a serious zoonotic parasitic disease caused by infections with larval Echinococcus. The life cycle of Echinococcus involves a variety of animal hosts, including hoofed animals and rodents as intermediate hosts and carnivores as definitive hosts. The transmission of human echinococcosis is closely associated with the life cycle of E. granulosus and E. multilocularis among animal hosts in nature. This review summarizes the recent advances in the prevalence and influencing factors of E. granulosus and E. multilocularis infections in animal hosts, so as to provide insights into precision control of echinococcosis.

Effect of Echinococcus granulosus hydatid cyst fluid protein on allergic rhinitis induced by ovalbumin in mice / 中国血吸虫病防治杂志

Objective To investigate the protective effect of Echinococcus granulosus hydatid cyst fluid protein (HCFP) on ovalbumin (OVA)-induced allergic rhinitis (AR) in mice. Methods Twenty-four BALB/c mice at ages of 8 to 10 weeks, each weighing approximately 20 g, were randomly divided into four groups, including groups A (blank control group), B (blank intervention group), C (AR model group) and D (AR+HCFP intervention group), with 6 mice in each group. On days 0, 2, 4, 6, 8, 10 and 12, mice in groups A, B, C and D were injected with 200 μL sterile phosphate buffered saline (PBS), 200 μL sterile PBS containing 20 μg HCFP, 200 μL sterile PBS containing 50 μg OVA and 5 mg Al(OH)3 gel, and 200 μL sterile PBS containing 50 μg OVA, 5 mg Al(OH)3 gel and 20 μg HCFP, respectively. On days 14 to 20, mice in groups A, B, C and D were administered with 40 μL sterile PBS, 40 μL sterile PBS containing 20 μg HCFP, 40 μL sterile PBS containing 2 mg OVA and 40 μL sterile PBS containing 2 mg OVA and 20 μL HCFP by nasal drop, respectively. Mouse behavioral changes were observed and behavioral scores were estimated. The serum levels of interferon-γ (IFN-γ), interleukin-4 (IL-4), IL-5, IL-10, transforming growth factor-β (TGF-β) and OVA-specific IgE antibody (OVA-sIgE) were measured using enzyme-linked immunosorbent assay (ELISA), and the pathological changes of mouse nasal mucosa were observed by hematoxylin and eosin (HE) staining. Results The mean behavioral score was significantly greater in Group C (6.83 ± 0.50) than in groups A (1.17 ± 0.52) and B (1.33 ± 0.52) (P < 0.05), while a lower mean behavioral score was estimated in Group D (3.50 ± 0.50) than in Group C (P < 0.05). There were significant differences among the groups in terms of serum IFN-γ (F = 4.08, P < 0.05), IL-4 (F = 275.90, P < 0.05), IL-5 (F = 96.82, P < 0.05), IL-10 (F = 77.67, P < 0.05), TGF-β (F = 9.98, P < 0.05) and OVA-sIgE levels (F = 44.69, P < 0.05). The serum IFN-γ level was significantly lower in Group C than in groups A, B and C (P < 0.05), and the serum levels of IL-4, IL-5 and OVA-sIgE were significantly higher in Group C than in groups A, B and C (P < 0.05), while the serum IL-10 and TGF-β levels were significantly greater in Group D than in Group C (P < 0.05). Microscopy showed apparent loss of nasal mucosa cilia, increased number and enlargement of goblet cells, interstitial edema and submucous vascular dilation in Group C, while the pathological changes of nasal mucosa were alleviated in Group D relative to Group C. Conclusions E. granulosus HCFP has a protective activity against OVA-induced allergic rhinitis in mice.

Role of inducible costimulatory molecules (ICOS) and related cytokines in immune regulation of Echinococcus granulosus infections in mice / 中国血吸虫病防治杂志

Objective To investigate the roles of inducible costimulatory molecules (ICOS) and related cytokines in the immune regulation of Echinococcus granulosus infections in mice. Methods Eighty BALB/c mice (weight 18–22 g) were divided into the control and infection groups, of 40 animals in each group. E. granulosus infection was modeled in mice by intraperitoneal injection of 10 000 protoscoleces per mouse. Serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) and peripheral interleukin-4 (IL-4) and IL-10 levels were measured 2, 8, 30, 60, 180 days post-infection. Mouse liver specimens were excised for hematoxylin-eosin (HE) staining and immunostaining, and ICOS expression was quantified in mouse liver specimens using quantitative real-time PCR (qPCR) assay. Results There were no significant differences in serum ALT (F = 12.082, P < 0.05), AST (F = 6.347, P < 0.05) or ALP levels (F = 52.186, P < 0.05) in mice 2, 8, 30, 60 and 180 days post-infection with E. granulosus. The serum ALT levels were significantly higher in the infection group than in the control group 2 [(61.72 ± 9.89) vs. (50.65 ± 4.67)U/L, P < 0.05] and 30 days post-infection [(80.61 ± 23.71)vs.(67.75 ± 9.79)U/L, P < 0.05], and the serum ALT levels were significantly higher in the infection group than in the control group 2 [(181.06 ± 60.61) vs.(115.58 ± 17.66)U/L, P < 0.05] and 180 days post-infection [(137.84 ± 29.01) vs. (108.05 ± 10.33) U/L, P < 0.05], while greater serum ALP levels were measured in the infection group than in the control group 2 [(162.90 ± 21.04)vs.(64.54 ± 5.99)U/L, P < 0.05], 8[(176.36 ± 24.56) vs. (62.70 ± 9.21)U/L, P < 0.05] and 30 days post-infection [(138.86 ± 13.59) vs. (58.60 ± 5.28) U/L, P < 0.05]. A few inflammatory cells were seen in mouse liver in the infection group 30 days post-infection, and no apparent changes were found in the mouse hepatic structure 60 days post-infection. On day 180 post-infection, a large number of epithelium-like cells presented fibrotic growth in mouse liver in the cyst-infiltrating regions, with cuticula formation seen, and plenty of red cells were present in lesions and hepatocyte space. Positive ICOS expression was detected in mouse liver in the infection group, with ICOS-positive cells predominantly seen in the cytoplasm of the hepatocyte, and the ICOS expression increased over time. The relative ICOS mRNA expression was 2.732 ± 0.094 on day 180 post-infection, which was significantly greater than that on day 2 postinfection (0.746 ± 0.049). There were no significant differences in serum IL-4 or IL-10 levels at different time points after E. granulosus infections, while the serum IL-4 and IL-10 levels peaked in the infection group 180 days and 60 days post-infection, respectively. Higher serum IL-4 levels were measured in the infection group than in the control group 8 [(22.50 ± 3.24) vs. (5.82 ± 0.49) pg/mL, P < 0.05], 30 [(15.49 ± 4.73) vs. (5.10 ± 1.38) pg/mL, P < 0.05], 60 [(36.93 ± 6.14) vs. (4.13 ± 1.19) pg/mL, P < 0.05] and 180 days post-infection [(198.35 ± 0.70) vs. (4.19 ± 0.98) pg/mL, P < 0.05], and higher IL-10 levels were measured in the infection group than in the control group 2 [(4.84 ± 1.91) vs. (2.11 ± 1.03) pg/mL, P < 0.05], 8 [(44.72 ± 14.63) vs. (3.16 ± 0.60) pg/mL, P < 0.05], 30 [(25.47 ± 8.00) vs. (3.83 ± 1.87) pg/mL, P < 0.05], 60 [(187.16 ± 60.44) vs. (3.69 ± 1.05) pg/mL, P < 0.05] and 180 days post-infection [(85.40 ± 7.15) vs. (3.25 ± 0.93) pg/mL, P < 0.05]. Conclusions High ICOS expression is present in the liver of mice with E. granulosus infections. The positive ICOS expression and immune activation levels increase with the time of E. granulosus infections, leading to aggravation of hepatocyte injury caused by inflammation.

A case of echinococcosis in Hunan Province / 中南大学学报(医学版)

Echinococcosis is mainly prevalent in the agricultural and pastoral areas in the northwest of China, but it is relatively rare in Hunan Province. Here, we reported the clinical data of a case of echinococcosis in Hunan Province. The patient was an 11-year-old male, who sought treatment at the Second Xiangya Hospital of Central South University due to abdominal mass. According to the symptoms, signs, and laboratory examinations, he was initially diagnosed as "intra-abdominal mass" and "spleen cyst". Subsequently, he underwent abdominal massive occupying resection and splenectomy. Postoperative pathological examination revealed the cuticle and germinal layer of hydatid and protoscolex, which was consistent with characteristics of echinococcosis. In addition, the serological examination showed that the specific anti-hydatid IgG antibody was positive. Combined with the patient's condition, he was given praziquantel treatment. After a month of follow-up, the patient was asymptomatic.

Regla de predicción para determinar infestación canina por Echinococcus granulosus / Prediction rule to determine canine infestation by Echinococcus granulosus

Nuestro objetivo fue determinar un score que ayude a predecir la probabilidad de infestación canina por Echinococcus en una zona endémica en hidatidosis. Se realizó un estudio longitudinal en 3 anexos de la provincia de Concepción ubicado en los andes centrales de Perú. La infección canina por Echinococcus granulosus fue definido por la presencia de antígeno identificado en la muestra de heces. El modelo predictivo se obtuvo mediante un análisis de regresión logística basado en los parámetros sociodemográficos, esta regla fue internamente validada por remuestreo de tipo bootstrap. Resultados: De 152 canes que se sometieron al estudio de heces, 76 tuvieron infección por Echinococcus confirmada por antígeno reactivo. Se identificaron 4 factores ponderados dentro de la regla de predicción que, en suma, dieron el puntaje: El can que duerme fuera de casa (3 puntos), alimentar con vísceras crudas al can (3 puntos) y sacrificar al ganado dentro de la casa (2 puntos) y el can se alimenta con croquetas (-2 puntos). Se encontró que esta regla de predicción tuvo valor del área bajo la curva ROC 0,78; (IC 95%: 0,70 ­ 0,86). Estos parámetros de predicción con un puntaje ≥ 3 tenía una sensibilidad del 75% y especificidad del 65,8%, con un valor predictivo positivo del 85,3%. Esta regla ayudará al personal de la salud a identificar a los canes infestados por Echinococcus granulosus, para su intervención anti parasitaria y preventiva en sus dueños(AU)

Cystic hydatidosis is an endemic disease in Andean regions, our objective was to determine a score that helps to predict canine Echinococcus infestation in an endemic area with hydatidosis. A longitudinal study was carried out in 3 annexes of the province of Concepción located in the central Andes of Peru. Canine echinococcosis infection was defined by the presence of E. granulosus antigen identified in the stool sample. The predictive model was obtained through a logistic regression analysis based on the sociodemographic parameters, this rule was internally validated by bootstrap type resampling. Results: Of 152 dogs that underwent the stool study, 76 had an Echinococcus infection confirmed by reactive antigen. Four weighted factors were identified within the prediction rule that, in sum, gave the score: The dog that sleeps outside the home (3 points), feeding raw viscera to the dog (3 points), slaughtering the cattle inside the house (2 points) and the dog is fed with croquettes (-2 points). This prediction rule was found to have a value of the area under the ROC curve 0.78 (95% CI: 0.70 - 0.86). At a cutoff point of ≥ 3 points, the prediction rule was found to have a sensitivity of 75% and a specificity of 65.8%, with a positive predictive value of 85.3%. This rule will help health personnel to identify canes infested by Echinococcus granulosus, for their anti-parasitic and preventive intervention in their owners(AU)

Circulación del parásito Echinococcus granulosus en Los Antiguos, Santa Cruz / Circulation of Echinococcus granulosus in Los Antiguos, Santa Cruz

Resumen La hidatidosis, causada por el parásito Echinococcus granulosus, es una zoonosis endémica en la provincia de Santa Cruz asociada a áreas de producción ganadera. El hombre puede permanecer asintomático durante un largo período luego de la infección. Una vez desarrollada, la enfermedad representa un importante problema de salud pública debido a la complejidad y el costo de su tratamiento. Los objetivos del trabajo fueron determinar la prevalencia de contaminación ambiental por E. granulosus en zona rural y periurbana de la localidad de Los Antiguos, mediante la detección de antígenos específicos en heces caninas, e identificar factores de riesgo de transmisión. Entre mayo-2016 y abril-2017, se visitaron 38 chacras periurbanas y estancias rurales, definidas como "unidades epidemiológicas". Se analizaron 144 muestras de heces de caninos con téc nica copro-ELISA. Se realizó una encuesta epidemiológica de los pobladores rurales sobre patrones culturales relacionados a la hidatidosis. Se encontró un índice de contaminación ambiental del 17.3% y el 44.7% de las unidades epidemiológicas fueron positivas. Se identificaron prácticas de riesgo como faena domiciliaria (34.2%), alimentación de caninos con vísceras crudas (52.6%), y ausencia de desparasitación de perros (86.8%). Alrededor de la mitad de la población encuestada desconocía las formas de contagio y las medidas de prevención de la enfermedad. Este trabajo muestra un índice alto de contaminación y establece una línea de base para realizar comparaciones a futuro. También refuerza la necesidad de implementar medidas de educación, prevención y control de hidatidosis a nivel local de acuerdo a los programas nacionales.

Abstract Hydatidosis − caused by the parasite Echinococcus granulosus − is a zoonosis endemic to the province of Santa Cruz, associated with areas of livestock production. Once infected, man may remain asymptomatic for a prolonged pe riod but the disease has an important impact on public health owing to the complexity and costs of its treatment. This study aimed at assessing the prevalence of environmental E. granulosus infection in rural and peri-urban areas of the town of Los Antiguos, through the detection of antigens in scattered canine feces, and to identify risk factors for transmission. From May-2016 to April-2017, 38 peri-urban and rural farms, defined as "epidemio logical units", were visited; 144 samples of canine feces were analyzed with the copro-ELISA technique. Rural settlers were enrolled in an epidemiological survey on cultural patterns related to hydatidosis. An environmental contamination index of 17.3% was found and 44.7% of the epidemiological units were positive. Risk practices were found, such as domiciliary slaughter (34.2%), canine feeding with raw viscera (52.6%), and lack of dog de worming (86.8%). In turn, about half of the surveyed population ignored the modes of transmission of the infection and the measures to prevent it. This work shows a high infection index in the area and establishes a baseline for future comparisons. It also reinforces the need to implement education, prevention, and control activities at the local level − according to national program guidelines − in order to reduce the prevalence of environmental contamination of the disease.

Quiste hidático primario músculo-esquelético: revisión de la literatura a propósito de un caso / Primary hydatid cyst of skeletal muscle: a literature review based on a case / Cisto hidático primário músculo esquelético: revisão da literatura a propósito de um caso

Resumen: Introducción: la equinococosis quística músculo-esquelética es poco frecuente, pudiendo determinar retrasos diagnósticos y errores terapéuticos. Reporte de caso: presentamos el caso de un paciente con un quiste hidático primario único a nivel de la región femoral posterior derecha, infectado. Discusión: se realizó una revisión en las bases de datos PubMed y LILACS sobre el diagnóstico y manejo terapéutico de los quistes hidáticos músculo-esqueléticos primarios. Conclusiones: la equinococosis quística músculo-esquelética debe ser tenida en cuenta dentro de los diagnósticos diferenciales de tumoraciones de partes blandas en pacientes provenientes de zonas endémicas. La tomografía computada y/o resonancia magnética cumplen un rol diagnóstico y de planificación terapéutica. El tratamiento es quirúrgico, a medida del paciente y del quiste, en función de su topografía, tamaño y fundamentalmente relaciones vasculo nerviosas y musculares. Otros factores a tener en cuenta son las futuras secuelas funcionales y resultados estéticos.

Summary: Introduction: musculoskeletal cystic echinococcosis is rather an unusual condition, what may result in delayed diagnosis and therapeutic mistakes. Case report: the study presents the case of a patient with a single primary hydatid cyst in the right posterior femoral region, which is infected. Discussion: a review of PubMed and LILACS was performed to learn about diagnosis and therapeutic handling of the primary musculoskeletal hydatid cysts. Conclusions: musculoskeletal cystic echinococcosis needs to be considered among differential diagnosis of soft tissues tumors in patients coming from endemic areas. A CT scan and RMI play an important role in diagnosis and the planning of treatment. Treatment involves surgery that must be adapted to the patient and the cyst, considering its topography and size, and in particular in view of muscular and nervous vessels relationship. Other factors to bear in mind are renal sequels and esthetic aspects.

Resumo: Introdução: a equinococose cística musculoesquelética é rara e pode determinar atrasos em seu diagnóstico e erros terapêuticos. Relato do caso: apresentamos o caso de uma paciente com cisto hidrático primário único ao nível da região femoral posterior direita, infectado. Discussão: foi realizada uma revisão nas bases de dados PubMed e LILACS sobre o diagnóstico e manejo terapêutico dos cistos hidráticos osteomusculares primários. Conclusões: a equinococose cística musculoesquelética deve ser considerada no diagnóstico diferencial de tumores de partes moles em pacientes de áreas endêmicas. A tomografia computadorizada e / ou a ressonância magnética desempenham um papel no planejamento diagnóstico e terapêutico. O tratamento é cirúrgico, adaptado ao paciente e ao cisto, dependendo de sua topografia, tamanho e, fundamentalmente, das relações vascular-nervosas e musculares. Outros fatores a serem considerados são as sequelas funcionais futuras e os resultados estéticos.

Analysis of components of proteins from Echinococcus granulosus cyst fluid / 中国血吸虫病防治杂志

Objective To analyze the components of proteins from Echinococcus granulosus cyst fluid using the shotgun method, and to identify the active components with potential regulatory effects for immune dysregulation diseases. Methods The E. granulosus cyst fluid was collected aseptically from the hepatic cysts of patients with cystic echinococcosis, and characterized by liquid chromatography (LC) tandem mass spectrometry (MS/MS) following digestion with trypsin. The protein data were searched using the software MaxQuant version 1.6.1.0 and the cellular components, molecular functions, and biological processes of the identified proteins were analyzed using the Gene Ontology (GO) method. Results The E. granulosus cyst fluid separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) had a relative molecular mass of 25 to 70 kDa. LS-MS/MS analysis identified 37 proteins, including 32 known proteins and 5 unknown proteins. At least 4 proteins were preliminarily found to exhibit potential regulatory effects for immune dysregulation diseases, including antigen B, glutathione-S-transferase (GST), thioredoxin peroxidase (TPX) and malate dehydrogenase (MDH). GO enrichment analysis showed that the identified proteins had 149 molecular functions and were involved in 341 biological processes. Conclusions E. granulosus cyst fluid has a variety of protein components, and four known proteins are preliminarily identified to be associated with immune dysregulation diseases.

Cloning, expression, purification and identification of EgG1Y162-2 gene from Echinococcus granulosus / 中华地方病学杂志

Objective:To construct the pET30a-EgG1Y162-2 prokaryotic expression plasmid and induce the expression of EgG1Y162-2 protein, so as to provide a research basis for development of Echinococcus granulosus vaccine. Methods:Using Echinococcus granulosus cDNA as a template, the target gene of EgG1Y162-2 was synthesized by PCR, and after digestion with restriction enzymes EcoRⅠ and Hind Ⅲ, it was connected to the prokaryotic expression vector pET30a to construct the recombinant plasmid pET30a-EgG1Y162-2. The recombinant plasmid was transformed into competent cell BL21 (DE3) and induced by isopropyl β-D-thiogalactoside (IPTG) to express a large number of proteins. The recombinant protein was purified by affinity chromatography. The purification level was analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), and the expression product was identified by Western blotting. Results:The recombinant plasmid pET30a-EgG1Y162-2 was successfully constructed. After inducting expression, the bacterial supernatant and the eluate were both at a relative molecular weight of about 15 × 10 3, and the protein antigen component eluted with 200 mmol/L imidazole was relatively pure. Western blotting results showed that the purified recombinant protein EgG1Y162-2 with His tag could be recognized by His monoclonal antibody. Conclusion:The pET30a-EgG1Y162-2 prokaryotic expression plasmid of Echinococcus granulosus is successfully constructed, and the recombinant protein of EgG1Y162-2 is induced to express, laying a foundation for further study on anti- Echinococcus granulosus vaccine.

Mesenchymal stem cell calcification induced by protoscolex of two species of Echinococcus: A differential analysis / 中国组织工程研究

BACKGROUND: The growth pattern of Echinococcus granulosus is different from that of Echinococcus alveolaris. Hepatic echinococcosis can form a complete fibrous calcified cyst wall, while hepatic alveolar echinococcosis can grow infiltratively and cannot form a complete fibrous calcified cyst wall. Bone marrow mesenchymal stem cells (BMSCs) are involved in the formation of calcified wall of hydatidosis, but the calcification characteristics of Echinococcus granulosus and Echinococcus alveolaris are different and the role of BMSCs is still unclear. OBJECTIVE: To compare the effects of Echinococcus granulosus and Echinococcus alveolaris on the calcification of BMSCs and to preliminarily investigate the formation mechanism of echinococcosis calcifications. METHODS: BMSCs of C57BL/6 mice were extracted, cultured and identified, followed by co-culture with the protoscolex of Echinococcus granulosus (BMSC+CE group) and Echinococcus alveolaris (BMSC+AE group), respectively. BMSCs cultured alone were used as control group. After 1, 4, and 7 days of co-culture, alkaline phosphatase activity was detected by a microplate reader, the expression of BMP2 and RUNX2 mRNA was detected by RT-q PCR, and the expression of BMP2, RUNX2 and phosphorylated Smad1/5/8 (P-Smad1/5/8) proteins was detected by western blot assay. RESULTS AND CONCLUSION: (1) The alkaline phosphatase activity of the BMSC+CE group and BMSC+AE group was significantly higher than that of the control group at 1 and 4 days after culture (P < 0.05), and the alkaline phosphatase activity of the BMSC+CE group was significantly higher than that of BMSC+AE group (P < 0.05). (2) Western blot results showed that the expression of BMP2, RUNX2, and P-Smad1/5/8 protein in the BMSC+CE group and BMSC+AE group was significantly higher than that in the control group at 1 and 4 days after culture (P < 0.05), while the expression of BMP2, RUNX2, and P-Smad1/5/8 protein in the BMSC+CE group was significantly higher than that in the BMSC+AE group (P < 0.05). (3) RT-qPCR results showed that the expression of BMP2 and RUNX2 mRNA in the BMSC+CE group was significantly higher than that in the control group at 1, 4 and 7 days after culture (P < 0.05), and was significantly higher than that in the BMSC+AE group at 4 and 7 days after culture (P < 0.05). The expression of RUNX2 mRNA in the BMSC+AE group was significantly higher than that in the control group at 1, 4, and 7 days after culture (P < 0.05). (4) To conclude, co-culture of the protoscolex of Echinococcus alveolaris and BMSCs promotes the expression of alkaline phosphatase and RUNX2 in BMSCs by up-regulating BMP-Smad1/5/8 pathway. At the later stage of co-culture, the effect of Echinococcus alveolaris on BMSCs calcification is significantly weakened, while the effect of Echinococcus granulosus on BMSCs calcification remains unchanged, suggesting that this mechanism may be related to the different growth patterns of two kinds of hydatids.

Alveolar echinococcosis protoscolices inhibits the differentiation of bone marrow mesenchymal stem cells into fibroblasts / 中国组织工程研究

BACKGROUND: The biological characteristics of hepatic alveolar echinococcosis are similar to cancer lesions. Its biological characteristics of invasive growth and metastasis increase the difficulty of surgery. The fibrosis of the outer capsule wall can inhibit the growth of echinococcus multilocularis and keep the disease in the quiescent stage. The role of mesenchymal stem cells in the fibrosis of the outer capsule wall of echinococcosis remains unclear. OBJECTIVE: To investigate the effect of alveolar echinococcosis protoscolices on the differentiation of mesenchymal stem cells into fibroblasts. METHODS: Bone marrow mesenchymal stem cells were isolated from femur bone marrow of 4-week-old C57BL/6 mice, and cultured by adherent method. Alveolar echinococcosis protoscolices were extracted from gerbils infected with alveolar echinococcus. The experiment was divided into three groups. The alveolar echinococcosis group was co-cultured with the third generation of bone marrow mesenchymal stem cells and the protocephalus of alveolar echinococcosis protoscolices. The Echinococcus granulosus group was co-cultured with the third generation of bone marrow mesenchymal stem cells and the protocephalus of Echinococcus granulosus protoscolices. The simple control group was cultured with the third generation of bone marrow mesenchymal stem cells. At 1, 3, 5, and 7 days of cultivation, the real-time fluorescent quantitative PCR was used to detect collagen type I, collagen type III, transforming growth factor-beta 1 and Smad7 gene expression. Western blot assay was utilized to determine collagen type I, collagen type III, Smad7 and phosphorylated Smad2/3 protein expression. ELISA was applied to measure supernatant collagen type I and collagen type III contents. RESULTS AND CONCLUSION: (1) Real-time fluorescent quantitative PCR detection displayed that transforming growth factor-beta 1, collagen type I, collagen type III mRNA relative expression levels were significantly lower in the alveolar echinococcosis group than in the Echinococcus granulosus group and simple control group (P < 0.05). Smad7 mRNA relative expression was significantly higher in the alveolar echinococcosis group than in the Echinococcus granulosus group and simple control group (P < 0.05). (2) Western blot assay showed that collagen type I, collagen type III and phosphorylated Smad2/3 protein relative expression levels were significantly lower in the alveolar echinococcosis group than in the Echinococcus granulosus group and simple control group (P < 0.05). Smad7 protein relative expression was significantly higher in the alveolar echinococcosis group than in the Echinococcus granulosus group and simple control group (P < 0.05). (3) ELISA exhibited that supernatant collagen type I and collagen type III contents were significantly lower in the alveolar echinococcosis group than in the Echinococcus granulosus group and simple control group (P < 0.05). (4) Alveolar echinococcosis protoscolices may promote bone marrow mesenchymal stem cells to secrete Smad7, inhibit the collagen type I, collagen type III and transforming growth factor-beta 1 through the transforming growth factor-beta/Smad signaling pathway, thereby inhibiting the fibrosis of bone marrow mesenchymal stem cells.