A historical view of alveolar echinococcosis, 160 years after the discovery of the first case in humans: part 1. What have we learnt on the distribution of the disease and on its parasitic agent? / 中华医学杂志(英文版)

Since the first 2 cases observed in southern Germany and the correct identification of a parasite at the origin of the disease by the famous scientist Rudolf Virchow in 1855, the borders of the endemic area of alveolar echinococcosis (AE) have never stopped to expand. The parasite was successively recognized in Switzerland, then in Russia, Austria and France which were long considered as the only endemic areas for the disease. Cases were disclosed in Turkey in 1939; then much attention was paid to Alaska and to Hokkaido, in Japan. The situation totally changed in 1991 after the recognition of the Chinese endemic areas by the international community of scientists. The world map was completed in the beginning of the 21st century by the identification of AE in most of the countries of central/eastern Europe and Baltic States, and by the recognition of cases in central Asia. Up to now, the disease has however never been reported in the South hemisphere and in the United Kingdom. In the mid-1950s, demonstration by Rausch and Schiller in Alaska, and by Vogel in Germany, of the distinction between 2 parasite species responsible respectively for cystic echinococcosis (“hydatid disease”) and AE put an end to the long-lasting debate between the "dualists", who believed in that theory which eventually proved to be true, and the "unicists", who believed in a single species responsible for both diseases. At the end of the 20th century, molecular biology fully confirmed the "dualist" theory while adding several new species to the initially described E. granulosus; within the past decade, it also confirmed that little variation existed within Echinococcus (E.) multilocularis species, and that AE-looking infection in some intermediate animal hosts on the Tibetan plateau was indeed due to a new species, distinct from E. multilocularis, named E. shiquicus. Since the 1970s, the unique ecological interactions between the landscape, the hosts, and E. multilocularis have progressively been delineated. The important role of the rodent/lagomorph reservoir size for the maintenance of the parasite cycle has been recognized within the last 2 decades of the 20th century. And the discovery of a close relationship between high densities of small mammals and particularities in land use by agriculture/forestry has stressed the responsibility of political/economic decisions on the contamination pressure. Urbanization of foxes in Europe and Japan and the major role of dogs in China represent the new deals at the beginning of the 21st century regarding definitive hosts and prevention measures.

HLA-DRB1 allele in 35 patients with alveolar echinococcosis in Gansu Province of China / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the association between histocompatibility leukocyte antigen (HLA)-DRB1 alleles and alveolar echinococcosis (AE).</p><p><b>METHODS</b>Thirty-five patients with AE in high prevalence areas in Gansu Province of China were tested for the HLA-DRB1 gene using the polymerase chain reaction with sequence-specific primer (PCR-SSP) technique. The results were compared with those of 104 healthy individuals.</p><p><b>RESULTS</b>The frequency of the HLA-DRB1 * 040x gene was 26% in the patient group, which was significantly higher than that in the control group (9.62%) with a relative risk (RR) of 4.45 (chi(2) = 13.67, P < 0.01), and an etiological fraction (EF) of 0.20. The frequency of the HLA-DRB1 * 0701 allele was significantly lower in the patient group (2.86%) as compared to the control group (13.94%; chi(2) = 6.67, P < 0.05) with a preventable fraction (PF) of 0.30. The frequencies of other DRB1 alleles were not significantly different.</p><p><b>CONCLUSION</b>Susceptibility to AE is significantly associated with the HLA-DRB1 * 040x. HLA-DRB1 * 0701 gene might confer protection against AE in humans.</p>