Functional activity of peripheral blood monocytes in patients with opisthorchiasis coupled to liver fibrosis intensity

The aim is to examine activity of peripheral blood monocytes from patients with opisthorchiasis coupled to intensity of liver fibrosis. Materials and Methods. A total of 74 patients with chronic opisthorchiasis (39 males and 35 females, average age 42.3 years) and 32 apparently healthy subjects (17 males and 15 females, average age 41.5 years) aged 24 to 60 years were enrolled. Opisthorchiasis was mainly diagnosed by parasitological assays to detect adult parasite eggs or bodies in duodenal contents and/or feces in all 74 patients. Liver fibrosis was assessed by elastometry according to the METAVIR scale. Functional activity of peripheral blood monocytes was performed in all patients with opisthorchiasis and healthy individuals from the control group by chemiluminescent analysis to measure intensity of reactive oxygen species production in lucigenin- and luminol-dependent spontaneous and zymosan-induced reactions. Results. Liver fibrosis F2 and F3—F4 stage according to METAVIR scale was found in 20.3% and 17.6% of patients with opisthorchiasis, respectively. While analyzing total pool of reactive oxygen species in the luminol-dependent process in patients with opisthorchiasis, a significantly decreased monocyte functional activity was observed as compared to healthy subjects that was evidenced by significantly decreased maximum intensity of produced reactive oxygen species as well as area under the chemiluminescence curve both in spontaneous and zymosan-induced reaction. Such parameters in liver fibrosis F3—F4 compared to F0—F1 in zymosan-induced response were lowered. Monocyte functional activity in spontaneous luminol-dependent reaction did not differ significantly depending on liver fibrosis intensity in patients with opisthorchiasis. The phagocytosis activation index in patients with opisthorchiasis with liver fibrosis F3—F4 compared to F0—F1 and F2 stage was lower. Similar changes were observed in the lucigenin-dependent reaction. Conclusion. The data obtained undoubtedly provide promising evidence to interpret the mechanisms behind liver fibrosis in patients with opisthorchiasis and create new opportunities for development of diagnostic and therapeutic technologies

Indicators of antioxidant status and oxidative stress in opisthorchiasis

Introduction. The  course of  opisthorchiasis is accompanied by clinically diverse symptoms and severe complications up to the development of cholangiocarcinoma. The role of oxidative stress in the development of liver fibrosis is not well understood. Aim. To determine the association of clinical manifestations and indicators of oxidative stress in the blood with liver fibrosis in patients with Opisthorchis felineus invasion.Materials and methods. We examined 103 patients with chronic opisthorchiasis and 51 practically healthy patients. All patients underwent general clinical examinations, esophagogastroduodenoscopy and ultrasound examination of the abdominal organs, elastometry to assess liver fibrosis using the METAVIR system, and the content of malondialdehyde, catalase and superoxide dismutase in blood serum was determined by the immunoassay method.Results and discussion. Asthenic-vegetative syndrome, pain in the right hypochondrium, articular syndrome, cytolytic and cholestatic syndromes, hepatomegaly and signs of  chronic cholecystitis were more often detected in  patients with invasion of  Opisthorchis felineus and liver fibrosis F3-F4  according to METAVIR. The  content of  malondialdehyde in  the  blood was 296.5 ng/ml in patients with liver fibrosis F3-F4 according to METAVIR and 69.5 ng/ml in patients with liver fibrosis F0-F1 according to METAVIR (p < 0.001). The content of superoxide dismutase and catalase did not differ significantly in the groups of patients with liver fibrosis F0-F1  according to METAVIR and F3-F4  according to METAVIR, which indicated insufficient effectiveness of antioxidant protection.Conclusion. The revealed changes indicate the presence in patients with opisthorchiasis of a pronounced association between the severity of the clinical course, the development of biochemical cytolysis syndromes and the severity of liver fibrosis and oxidative stress, which may be a promoter of inflammation, cell DNA damage and carcinogenesis

Possibilities of application of enterosorbent in combined therapy of opistorchosis patients with skin syndrome

Introduction. Diseases of the liver and biliary tract are a significant problem in the clinic of internal diseases. Opistorchiasis is one of the most frequent causes of this pathology and is one of the most widespread parasitoses in the Russian Federation.Clinical course of this pathology is characterized by high frequency of allergic and skin symptoms. Treatment of such patients is a big problem.Aim. To determine the effectiveness of the use of complex therapy with the inclusion of enterosorbent in patients with opisthorchiasis with skin syndrome.Materials and methods. The study involved 92 patients with chronic opisthorchiasis, of which 38 patients were with skin syndrome and 54 individuals without skin manifestations. Diagnosis of opisthorchiasis was carried out by two methods: microscopic examination of duodenal bile and coprooscopy. All patients underwent clinical examination, a clinical and biochemical blood analysis, esophagogastroduodenoscopy, ultrasound of the abdominal organs and liver elastometry with fibrosis assessment using the METAVIR system. Skin syndrome was diagnosed by dermatologist. After etiological treatment, 38 patients with opisthorchiasis with skin syndrome underwent reconstructive pathogenetic therapy for 6 weeks, which included an antispasmodic, ursodeoxycholic acid, desensitizing drug, and enterosorbent.Results. In patients with opisthorchiasis with a skin syndrome, the severity of clinical and laboratory manifestations was significantly higher than in individuals with parasitosis without skin syndrome. Reconstructive pathogenetic therapy of patients with opisthorchiasis with the inclusion of enterosorbent Polysorb has allowed to achieve a significant improvement in the condition of patients. Conclusion. From our point of view, the results obtained make it possible to raise the question of changing the treatment standards for patients with opisthorchiasis with skin syndrome

Functional activity of blood phagocytes in opistorchiasis patients

Introduction. The urgency of the problem of opistorchiasis is dictated by the long clinical course of the disease with the possibility of formation of hepatobiliary pathology, including cancer. Aim. To study the peculiarities of the production of active oxygen forms of blood phagocytes in patients with opistorchiasis. Material and methods. A total of 42 patients with chronic opisthorchiasis (22 men and 20 women) and 35 apparently healthy patients (18 men and 17 women) between the ages of 24 and 45 were examined. Opistorchiasis was diagnosed by three methods: microscopic examination of duodenal bile, coproovoscopy and serological method. The control group was composed of healthy individuals who underwent routine medical examinations, which included biochemical blood tests, identification of markers for viral hepatitis and antibodies to opistorchs. The culture of neutrophils and blood monocytes was isolated by fractionation of cells on the ficoll with subsequent cleaning from adhering cells. Functional activity of neutrophils and blood monocytes was estimated by chemiluminescence method on production of active oxygen species: basic and after induction with zymosan. Results. In patients with opistorchiasis in comparison with healthy people, in neutrophil granulocytes, the maximum intensity of active oxygen species production decreased and the time to reach the maximum of active oxygen species production was increased both in spontaneous and zymosan-induced reactions in luminoland lucigenin-dependent processes. In monocytes during spontaneous reaction study it was discovered that the maximum intensity of oxygen production in luminoland lucigenindependent processes decreased and the time of reaching the maximum of oxygen production in luminol-dependent process increased in opistorchiasis patients in comparison with healthy people. When studying the zymosan-induced reaction in monocytes, a decrease in the maximum intensity of active oxygen species production in both reactions and an increase in the time to reach the maximum output of active oxygen species in the luminol-dependent process was registered in patients with opistorchiasis in comparison with healthy people. Conclusion. The data obtained indicate low functional activity of blood phagocytes in patients with chronic opistorchiasis in comparison with healthy people