PDF(Pubmed)
Abstract：
Gnathostoma is a parasitic nematode that can infect a wide range of animal species, but human populations have become accidental hosts because of their habit of eating raw or undercooked meat from a wide variety of intermediate hosts. While gnathostomiasis is considered an endemic disease, cases of human gnathostomiasis have been increasing over time, most notably in nonendemic areas. There are several complexities to this parasitic disease, and this review provides an update on human gnathostomiasis, including the life cycle, diagnosis, treatment, and treatment strategies used to combat drug resistance. Even now, a definitive diagnosis of gnathostomiasis is still challenging because it is difficult to isolate larvae for parasitological confirmation. Another reason is the varying clinical symptoms recorded in reported cases. Clinical cases can be confirmed by immunodiagnosis. For Gnathosotoma spinigerum, the detection of IgG against a specific antigenic band with a molecular weight of 24 kDa from G. spinigerum advanced third-stage larvae (aL3), while for other species of Gnathostoma including G. binucleatum, the 33-kDa antigen protein is being used. This review also discusses cases of recurrence of gnathostomiasis and resistance mechanisms to two effective chemotherapeutics (albendazole and ivermectin) used against gnathostomiasis. This is significant, especially when planning strategies to combat anthelmintic resistance. Lastly, while no new chemotherapeutics against gnathostomiasis have been made available, we describe the management of recurrent gnathostomiasis using albendazole and ivermectin combinations or extensions of drug treatment plans.
摘要：
Gnathostoma是一种寄生线虫，可以感染多种动物物种，但是人类已经成为偶然的宿主，因为他们习惯于从各种各样的中间宿主那里吃生肉或未煮熟的肉。虽然颌骨病被认为是一种地方病，随着时间的推移，人类颌口病的病例一直在增加，尤其是在非流行地区。这种寄生虫病有几个复杂性，这篇综述提供了人类颌口病的最新信息，包括生命周期，诊断,治疗,以及用于对抗耐药性的治疗策略。即使是现在,由于难以分离幼虫进行寄生虫学确认，因此对颌口病的明确诊断仍然具有挑战性。另一个原因是报告病例中记录的不同临床症状。临床病例可通过免疫诊断证实。对于尖刺尖刺，对来自S.spinigerum晚期第三期幼虫（aL3）的分子量为24kDa的特异性抗原带的IgG的检测，而对于其他物种的Gnathostoma，包括G.binucleatum，正在使用33-kDa抗原蛋白。这篇综述还讨论了颌口病复发的病例以及对两种有效的化疗药物（阿苯达唑和伊维菌素）的耐药机制。这很重要,尤其是在制定对抗驱虫药抗药性的策略时.最后,虽然还没有新的化疗药物来治疗鼻孔病，我们描述了阿苯达唑和伊维菌素联合用药或延长药物治疗计划对复发性颌口病的治疗。
