15 research outputs found

    Association of <i>Fasciola hepatica</i> Infection with Liver Fibrosis, Cirrhosis, and Cancer: A Systematic Review

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    <div><p>Background</p><p>Fascioliasis has been sporadically associated with chronic liver disease on previous studies. In order to describe the current evidence, we carried out a systematic review to assess the association between fascioliasis with liver fibrosis, cirrhosis and cancer.</p><p>Methodology and Principal Findings</p><p>A systematic search of electronic databases (PubMed, LILACS, Scopus, Embase, Cochrane, and Scielo) was conducted from June to July 2015 and yielded 1,557 published studies. Among 21 studies that met inclusion and exclusion criteria, 12 studies explored the association of <i>F</i>. <i>hepatica</i> with liver fibrosis, 4 with liver cirrhosis, and 5 with cancer. Globally these studies suggested the ability of <i>F</i>. <i>hepatica</i> to promote liver fibrosis and cirrhosis. The role of <i>F</i>. <i>hepatica</i> in cancer is unknown. Given the heterogeneity of the studies, a meta-analysis could not be performed.</p><p>Conclusions</p><p>Future high-quality studies are needed to determine the role of <i>F</i>. <i>hepatica</i> on the development of liver fibrosis, liver cirrhosis, and cancer in humans.</p></div

    Schematic representation of liver fibrosis and cirrhosis associated with fascioliasis.

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    <p>(A) Normal architecture of a sheep's liver. Haematoxylin and eosin (HE) staining. Taken from Ref. [<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0004962#pntd.0004962.ref019" target="_blank">19</a>]. (B) Juvenile parasite migrating in the peritoneal cavity causing destruction and haemorrhages in case (HE stain, magnification x100). The biopsy in the peritoneum was performed due to clinical suspicion of metastases Taken from Ref. [<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0004962#pntd.0004962.ref048" target="_blank">48</a>]. (C) Typical microscopic appearance (400X) of liver from the infected sheep at 8 weeks post infection, massive infiltration of inflammatory cells and deposition of collagen can be observed. Taken from Ref. [<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0004962#pntd.0004962.ref019" target="_blank">19</a>]. (D) Liver cirrhosis caused by <i>F</i>. <i>hepatica</i> infection. Trichrome stain (100x). Rat. Authors’ photo gallery. (E) Extensive fibrosis (Fi) with formation of fibrotic nodules (FN), architectural disruption of the liver and regeneration; stage IV or F4 (cirrhosis). Trichrome stain. Rats. Authors’ photo gallery.</p

    IL-5 responses to larval <i>Strongyloides stercoralis</i> antigens are decreased in patients with strongyloidiasis and HTLV-1 co-infection (n = 13) compared to HTLV-1 negative subjects with strongyloidiasis (n = 27).

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    <p>Peripheral blood mononuclear cells from newly diagnosed strongyloidiasis patients were cultured with or without <i>Strongyloides stercoralis</i> infective-stage larval antigen. Culture supernatants were analyzed for IL-5 production. Patients with HTLV-1 co-infection had significantly decreased IL-5 responses (* p = 0.0004, Mann Whitney test).</p

    Patients with strongyloidiasis and HTLV-1 co-infection (n = 12) had more <i>Strongyloides stercoralis</i> larvae found in stool when compared to strongyloidiasis-only patients (n = 25).

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    <p>A semi-quantitative measure of <i>Strongyloides stercoralis</i> parasite load was determined at the time of diagnosis according to the number of larvae observed in stool sediment after Baermann concentration (range from1+ to 4+). Parasite load determination was made before the HTLV-1 status was known. HTLV-1 carriers had higher parasite loads (3+ and 4+) when compared to the non HTLV-1 group (10 out of 12 vs. 4 out of 25 respectively; p<0.001, Chi square test, Lima, Peru).</p

    Increased numbers of regulatory T cells correlates with reduced IL-5 responses to <i>Strongyloides stercoralis</i> larval antigens.

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    <p>Patients with higher regulatory T cell numbers showed lower IL-5 responses to <i>Strongyloides stercoralis</i> infective-stage crude antigen. An inverse correlation was determined by Sperman non-parametric correlation analysis (Spearman r = −0.38, p = 0.03).</p

    Trend of mean scores of total knowledge, socio-demographic and epidemiological knowledge (block I) and clinical knowledge (block II) by year of study at medical school.

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    <p>ANOVA statistics for (A) “Total score”, p<0.001 (B) “Block I score”, p<0.001 (C) “Block II score”, p<0.001 (D) Separately analysis of block I: “Block I score from 1<sup>st</sup> to 4<sup>th</sup> year”, p<0.001; “Block I score from 4<sup>th</sup> to 7<sup>th</sup> year”, p = 0.66.</p

    Increased proportions of regulatory T cells in strongyloidiasis/HTLV-1 co-infected patients.

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    <p>Comparison of regulatory T cell proportions (CD25+FoxP3+ among CD4+ T-cells) between healthy controls (blue, n = 17), patients with strongyloidiasis without HTLV-1 infection (red, n = 27), HTLV-1 asymptomatic carriers (orange, n = 9) and strongyloidiasis/HTLV-1 co-infected patients (green, n = 13). Co-infected patients had a significant increase of regulatory T cells compared to non-HTLV-1 patients. (* = P<0.05, One-way ANOVA). Lima, Peru.</p

    Blood analysis, flow cytometry and interleukin-5 responses to <i>Strongyloides stercoralis</i> larval antigens A peripheral blood sample was obtained at enrollment from all strongyloidiasis patients.

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    <p>Samples were analyzed before HTLV-1 status was known. Numbers represent median of all parameters analyzed. Complete peripheral blood cell count showed lower hemoglobin and hematocrit levels in the HTLV-1 co-infected group. White blood cell, neutrophil, eosinophil, and lymphocyte proportions were not significantly different among groups, although a tendency to lower absolute eosinophil count was observed in the HTLV-1 infected group. Regulatory T cells were significantly increased in patients with strongyloidiasis and HTLV-1 co-infection (* = p<0.05, One way ANOVA, Lima, Peru).</p

    Demographics and frequency of clinical signs and symptoms of strongyloidiasis patients with and without HTLV-1 co-infection.

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    <p>Clinical data was obtained from newly diagnosed patients with strongyloidiasis by stool modified Baermann sedimentation method and tested for HTLV-1 co-infection. Age and gender were similar among strongyloidiasis patients with or without HTLV-1 co-infection. Gastrointestinal signs and symptoms were more frequently reported among HTLV-1 co-infected patients. Table shows proportion of patients reporting symptoms. Frequencies were compared between <i>S. stercoralis</i> groups by Chi square test, * = p<0.05 (Lima, Peru).</p

    Flow cytometry analysis showing increased proportions of CD4+CD25hi T cells and CD4+CD25+FoxP3+ regulatory T cells in peripheral blood of patients with strongyloidiasis and HTLV-1 co-infection.

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    <p>Representative flow cytometry analysis of peripheral blood mononuclear cells comparing a patient with strongyloidiasis without HTLV-1 co-infection (left) to strongylioidiasis/HTLV-1 co-infected patient (right). Upper figures show CD4 and CD25 staining of cells within the lymphocyte gate. Note population of CD4+CD25hi cells in the HTLV-1 co-infected patient suggesting regulatory T cell phenotype. Lower figures show CD4+ lymphocytes stained with CD25 and intracellular staining with FoxP3 confirming that CD4+CD25hi cells are indeed FoxP3+ (regulatory T cells).</p