Echinococcus granulosus

细粒棘球蚴
  • 文章类型: Case Reports
    包虫病可以影响人体任何器官。腰大肌包虫囊肿的发生是罕见的,仅占病例的1-3%,甚至在流行地区。然而,多发性囊肿的存在更为罕见。
    方法:一名来自农村地区的40岁女性出现腹痛。体格检查显示右侧软骨病有压痛。七年前她有肺包虫膀胱切除术史。放射学检查显示,左腰大肌内有两个包虫囊肿。对两个包虫囊肿进行了膀胱切除术。患者服用阿苯达唑的剂量为15mg/kg,在最近一个月的随访预约中,患者未出现任何复发.
    此例表现为腰肌多发性包虫囊肿的罕见情况,强调在流行地区考虑非典型表现的重要性。
    结论:该病例突出了一名农村中年妇女腰大肌包虫囊肿的罕见性。早期识别,准确的放射学评估,适当的手术治疗对于积极的结果和避免感染等并发症至关重要,压缩附近的结构,或者过敏反应.
    UNASSIGNED: Hydatid disease can affect any human organ. The occurrence of hydatid cysts in psoas muscle is rare, accounting for only 1-3 % of cases, and even in endemic regions. However, the presence of multiple cysts is even more rare.
    METHODS: A 40-year-old female from a rural area presented with abdominal pain. Physical examination revealed tenderness in the right hypochondrium. Her medical history pulmonary hydatid cystectomy seven years ago. Radiology investigation showed a two-hydatid cyst within the left psoas major muscle. Cystectomy of two hydatid cyst was performed. The patient was prescribed albendazole at a dose of 15 mg/kg, and at the latest month\'s follow-up appointment, the patient did not experience any relapse.
    UNASSIGNED: This case presents a rare instance of multiple hydatid cysts in the psoas muscle, highlighting the importance of considering atypical presentations in endemic regions.
    CONCLUSIONS: This case highlights the rarity of psoas major muscle hydatid cysts in a middle-aged woman from a rural area. Early recognition, accurate radiological assessment, and proper surgical treatment are crucial for positive outcomes and averting complications like infection, compression of nearby structures, or anaphylactic reactions.
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  • 文章类型: Case Reports
    奥马珠单抗,人源化抗IgE单克隆抗体,通常用于治疗抗组胺难治性慢性自发性荨麻疹(CSU),它显著降低了游离IgE水平,减少从嗜碱性粒细胞和肥大细胞释放组胺。尽管它的功效,由于IgE在抵抗寄生虫侵染中的作用,人们担心其对寄生虫防御的影响。我们介绍了一名28岁的女性农学家,有六个月的CSU病史,在奥马珠单抗治疗剂量增加后,她的症状出现了矛盾的恶化。这种恶化与血清学证实的细粒棘球蚴和犬弓形虫寄生虫感染同时发生。尽管嗜酸性粒细胞计数和IgE水平正常,通常用于识别寄生虫感染,患者的临床恶化促使进一步的调查,从而确定了寄生虫感染。阿苯达唑和奥马珠单抗停药治疗导致她的CSU消退,这表明寄生虫感染是导致症状恶化的原因。该病例强调了在对来自流行地区的抗组胺难治性CSU患者开始奥马珠单抗之前,需要仔细筛查寄生虫感染。或奥马珠单抗临床恶化的患者,尤其是当嗜酸性粒细胞计数和IgE水平等其他指标可能不提示感染时.它还强调了考虑采用量身定制的方法来管理CSU的重要性,该方法应平衡有效治疗与与免疫调节相关的潜在不良反应。
    Omalizumab, a humanized anti-IgE monoclonal antibody, is commonly employed in the treatment of antihistamine-refractory chronic spontaneous urticaria (CSU), where it significantly reduces free IgE levels, minimizing histamine release from basophils and mast cells. Despite its efficacy, there are concerns regarding its effect on parasitic defense due to IgE\'s role in combating parasitic infestations. We present a case of a 28-year-old female agriculturist with a six-month history of CSU who experienced a paradoxical exacerbation of her symptoms following an increase in the omalizumab treatment dose. This deterioration coincided with a serologically confirmed parasitic infection with Echinococcus granulosus and Toxocara canis. Despite normal eosinophil counts and IgE levels, which are typically used to identify parasitic infections, the patient\'s clinical worsening prompted further investigation that led to the identification of the parasitic infection. Treatment with albendazole and omalizumab discontinuation led to the resolution of her CSU, suggesting that the parasitic infection was contributing to the symptom exacerbation. This case highlights the need for careful screening for parasitic infections before initiating omalizumab in antihistamine-refractory CSU patients from endemic regions, or patients who deteriorate clinically on omalizumab, especially when other indicators such as eosinophil count and IgE levels might not suggest infection. It also underscores the importance of considering a tailored approach to managing CSU that balances effective treatment with the potential for adverse effects related to immunomodulation.
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  • 文章类型: Journal Article
    背景:囊性包虫病,一种由细粒棘球蚴幼虫引起的人畜共患疾病,主要影响肝脏和肺,人类充当意外宿主。
    方法:我们在放射学和影像学系的回顾性研究,尼扎姆医学科学研究所,包括187例组织病理学或血清学证实的病例。呈现的平均年龄为49.4岁。
    结果:肝脏受累最为普遍,占病例的83.4%(n=156),其次是其他器官如肠系膜的零星受累,脾,脾胰腺,丘脑,肾,肺,脊柱,还有网膜.影像学上观察到的特征性诊断特征包括33%的病例中的周围钙化,内隔25%(n=47),15%(n=29)的致密钙化,6%(n=11)的子囊肿,和漂浮膜在5%(n=10)。在肝脏病变中,90%(n=141)显示单叶受累。值得注意的是,78%(n=110)的病变仅限于右叶,21%(n=30)到左叶,1%(n=1)到尾状叶。受影响最大的肝段是VIII段,而最不常见的是I段(尾状叶)。在13%(n=25)的肝包虫病病例中发现了并发症。
    结论:我们的研究结果强调了颗粒大肠杆菌感染的全身性,它可以影响身体的各个器官。它还说明了成像为及时准确诊断包虫病提供的宝贵见解。
    BACKGROUND: Cystic echinococcosis, a zoonotic disease caused by the larval form of Echinococcus granulosus, predominantly affects the liver and lungs, with humans acting as accidental hosts.
    METHODS: Our retrospective study at the Department of Radiology and Imageology, Nizam\'s Institute of Medical Sciences, included 187 histopathologically or serologically proven cases. The mean age of presentation was 49.4 years.
    RESULTS: Liver involvement was most prevalent, accounting for 83.4% (n=156) of cases, followed by sporadic involvement of other organs such as the mesentery, spleen, pancreas, thalamus, kidney, lung, spine, and omentum. Characteristic diagnostic features observed on imaging included peripheral calcifications in 33% of cases, internal septations in 25% (n=47), dense calcifications in 15% (n=29), daughter cysts in 6% (n=11), and floating membranes in 5% (n=10). Among hepatic lesions, 90% (n=141) were showing involvement of a single lobe. Notably, 78% (n=110) of lesions were limited to the right lobe, 21% (n=30) to the left lobe, and 1% (n=1) to the caudate lobe. The most affected hepatic segment was segment VIII, while the least common was segment I (caudate lobe). Complications were identified in 13% (n=25) of cases of hepatic hydatidosis.
    CONCLUSIONS: The findings of our study emphasize the systemic nature of E. granulosus infection which can affect various organs in the body. It also illustrates the invaluable insights imaging provides for timely and accurate diagnosis of hydatid disease.
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  • 文章类型: Journal Article
    囊性包虫病(CE)是一种影响人类和动物的人畜共患疾病。尽管对寄生虫-中间宿主相互作用的许多细节缺乏清晰,包虫感染引发的免疫反应的性质揭示了新的观点。本研究讨论了阐明包虫病免疫机制及其检测的最新进展以及提高血清诊断准确性的潜在方法。此外,纳米生物传感器已经根据其提高治疗效率和帮助早期诊断囊性包虫病的潜力进行了评估。中间宿主的血清可以通过分析细粒棘球蚴诱导的抗体来诊断CE。该方法最显著的特点是无创、灵敏度高,这两者都使其成为临床诊断的绝佳工具。几种血清学测试,包括ELISA和免疫印迹,可以检测这些抗体来评估疾病的状态并确定治疗结果。彻底了解交叉反应性的含义和疾病的阶段对于解释血清学结果至关重要。在检测包虫囊肿方面,纳米生物传感器也被证明比常规生物传感器更好。此外,它们在检测特定的生物标志物时非常敏感和通用,提高诊断准确性。这些免疫调节分子,由E.granulosus诱导,是诊断囊性包虫病的良好候选者,因为它们会改变宿主的中间免疫反应。通过纳米生物传感器也增强了包虫囊肿的检测,这提供了更好的准确性。
    Cystic echinococcosis (CE) is a zoonotic disease affecting humans and animals. Despite a lack of clarity about many details of parasite-intermediate host interactions, the nature of the immune responses triggered by hydatid infection has revealed new perspectives. This study discusses the latest advances in elucidating the immunologic mechanism of echinococcosis and its detection and potential approaches to enhance serodiagnosis accuracy. Moreover, nanobiosensors have been evaluated according to their potential to improve treatment efficiency and aid in an early diagnosis of cystic echinococcosis. The serum of an intermediate host can diagnose CE by analyzing antibodies induced by Echinococcus granulosus. Among the most notable features of this method are its noninvasive ability and high sensitivity, both of which make it an excellent tool for clinical diagnosis. Several serological tests, including ELISAs and immunoblotting, can detect these antibodies to assess the disease\'s state and determine the treatment outcome. A thorough understanding of what cross-reactivity means and the stage of the disease are crucial to interpreting serological results. Nanobiosensors have also proven better than conventional biosensors in detecting hydatid cysts. Additionally, they are highly sensitive and versatile when detecting specific biomarkers, improving diagnostic accuracy. These immunomodulatory molecules, induced by E. granulosus, are a good candidate for diagnosing cystic echinococcosis because they alter intermediate host immune responses. Hydatid cyst detection is also enhanced through nanobiosensors, which provide better accuracy.
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  • 文章类型: Journal Article
    囊性包虫病是由细粒棘球蚴幼虫期引起的人畜共患感染。该疾病的特征是囊肿的长期生长,最常见于肝脏和肺部。尽管理想的囊性包虫病模型应诱导肝脏囊肿的发展并模仿自然感染途径,小鼠腹腔注射模型在实验治疗领域仍有广泛的应用。本工作的目的是评估肝CE的鼠模型在临床前药物试验中的有用性。阿苯达唑的有效性也可以通过测量肝囊肿的直径来评估。阿苯达唑显著减小了囊肿的大小。阿苯达唑引起的肝囊肿生发层的超微结构改变与腹膜内模型中观察到的一致。用两种阿苯达唑剂量获得类似的结果。因此,阿苯达唑纳米晶体在小鼠肝囊性包虫病模型中的功效是在阿苯达唑剂量为25mg/kg时进行的。腹部超声使我们只能以定性的方式评估囊肿对药物的反应。尽管阿苯达唑纳米晶体组中的囊肿的大小没有明显低于阿苯达唑观察到的大小,在超微结构层面,观察到更大程度的损害。肝囊性包虫病的鼠模型可以有效地用于评估新制剂或化合物的效果。该模型的主要优点是囊肿位于原位器官中,这类似于人类病例中最常见的位置。在未来的研究中,将评估该模型在肝囊肿药代动力学研究中的有用性。
    Cystic echinococcosis is a zoonotic infection caused by the larval stage of Echinococcus granulosus sensu lato. The disease is characterized by the long-term growth of cysts, most commonly in the liver and lungs. Although an ideal model of cystic echinococcosis should induce the development of cysts in the liver and imitate the natural infection route, the murine model of intraperitoneal is still widely used in the field of experimental theraphy. The aim of the present work was to evaluate the usefulness of the murine model of hepatic CE for preclinical drug trials. The effectiveness of albendazole could also be assessed by measuring the diameter of the hepatic cyst. The albendazole significantly reduced the size of the cysts. The ultrastructural alterations of the germinal layer of hepatic cysts provoked by albendazole coincided with those observed in the intraperitoneal model. Similar results were obtained with both albendazole doses. Therefore, the efficacy of albendazole nanocrystals in the murine model of hepatic cystic echinococcosis was carried out at albendazole doses of 25 mg/kg. The abdominal ultrasound allows us to assess the response of cysts to drugs only in a qualitative manner. Although the size of cysts in the albendazole nanocrystal group was not significantly lower than that observed with albendazole, at the ultrastructural level, a greater extent of damage was observed. The murine model of hepatic cystic echinococcosis can be effectively used for assessing the effect of novel formulations or compounds. The main advantage of this model is that cysts are located in the orthotopic organ, which resembles the location most commonly found in human cases. In future studies, the usefulness of the model for pharmacokinetics studies in hepatic cysts will be evaluated.
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  • 文章类型: Case Reports
    包虫囊肿病,由细粒棘球蚴幼虫形成,通常会影响肝脏,肺,和泌尿生殖道。该病例报告详细介绍了一名62岁男性的包虫囊肿的异常表现,该男性有膀胱后包虫囊肿手术史。病人出现阴茎根部疼痛,随后的成像显示耻骨上囊肿,耻骨,和左果胶肌肉区域。尽管COVID-19大流行带来了挑战,患者于2023年接受了手术切除.讨论强调了这种局部囊肿的罕见性,诊断成像技术,以及手术干预的必要性。术后期间涉及阿苯达唑的疗程。虽然直肠膀胱包虫囊肿并不常见,这一病例强调了在肿块鉴别诊断中考虑它们的重要性,特别是在流行地区。手术切除仍然是有症状的包虫囊肿的主要治疗方法。
    Hydatid cyst disease, caused by the Echinococcus granulosus tapeworm larval form, typically affects the liver, lungs, and genitourinary tract. This case report details an unusual manifestation of hydatid cysts in a 62-year-old male with a history of retrovesical hydatid cyst surgery. The patient presented with pain at the root of the penis, and subsequent imaging revealed cysts in the suprapubic, pubic bone, and left pectineus muscle regions. Despite the challenges posed by the COVID-19 pandemic, the patient underwent surgical excision in 2023. The discussion emphasizes the rarity of such localized cysts, diagnostic imaging techniques, and the necessity of surgical intervention. The postoperative period involved a course of albendazole. While rectovesical hydatid cysts are uncommon, this case underscores the importance of considering them in the differential diagnosis of masses, particularly in endemic regions. Surgical excision remains the primary treatment for symptomatic hydatid cysts.
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  • 文章类型: Case Reports
    由于细粒棘球蚴的幼虫形式在人类中的发育,包虫病是一种人畜共患病。这种疾病在北非的许多国家如摩洛哥非常常见。包虫囊肿最常见的位置是肝脏(75%)和肺部(15.4%)。脾包虫囊肿仅发生在5.1%的病例中。诊断仍然具有挑战性,是基于临床的理解,放射学,生物,和组织学论点。在本文中,我们报告了一例脾包虫囊肿的保脾手术,以建议这些包虫囊肿的最佳治疗方法并避免复发。
    Hydatidosis is a zoonosis due to the development of the larval form of Echinococcus granulosus in humans. This disease is very frequent in many countries of North Africa such as Morocco. The most frequent locations of hydatid cysts are the liver (75%) and the lungs (15.4%). Splenic hydatid cyst occurs in only 5.1% of cases. The diagnosis remains challenging and is made upon a hundle of clinical, radiological, biological, and histological arguments. In this paper, we report a case of spleen-preserving surgery for a splenic hydatid cyst to suggest the best management of these hydatid cysts and avoid recurrences.
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  • 文章类型: Journal Article
    The emergence of pandemics with dramatic consequences for human health has obscured endemic diseases that continue to pose a problem for human and animal health in several regions of the world. Among these diseases, cystic echinococcosis, a zoonotic parasitic infection caused by a group of cestodes, Echinococcus granulosus sensu lato, remains a real human and animal health problem in several regions of the world, including the Mediterranean Basin. Despite the implementation of a number of governmental control programmes using several tools (dog treatment, meat inspection, etc.), this infection is still highly prevalent in North Africa. Here we present a review of the epidemiology of cystic echinococcosis in Tunisia, an analysis of the constraints limiting the effectiveness of the control programmes implemented, and finally argue for the use of the One Health framework to improve the effectiveness of future programmes.
    UNASSIGNED: L’échinococcose kystique (infection par Echinococcus granulosus sensu lato) en Tunisie, une perspective « Une seule santé » pour un futur programme de contrôle.
    UNASSIGNED: L’émergence de pandémies affectant de manière très importante la santé humaine a occulté les maladies endémiques qui continuent de représenter un problème de santé animale et humaine dans plusieurs régions du monde. Parmi ces maladies, l’échinococcose kystique, une parasitose zoonotique provoquée par un groupe de cestodes, Echinococcus granulosus sensu lato, reste un réel problème de santé humaine et animale dans plusieurs régions du monde, incluant le Bassin méditerranéen. Malgré la mise en place de nombreux programmes de lutte utilisant plusieurs outils (traitement des chiens, inspection des viandes, etc.), cette infection est encore hautement prévalente en Afrique du Nord. Nous présentons ici une revue de l’épidémiologie de l’échinococcose kystique en Tunisie, une analyse des contraintes limitant l’efficacité des programmes de lutte mis en place, et finalement nous argumentons l’utilisation du concept « Une seule santé » pour améliorer l’efficacité des programmes futurs.
    UNASSIGNED: مرض الكيس المائي (العدوى بالطفيليEchinococcus granulosus sensu lato ) في تونس، منظور صحي واحد لبرنامج مكافحة مستقبلي.
    UNASSIGNED: أدى ظهور الأوبئة التي تؤثر بشكل كبير على صحة الإنسان إلى حجب الأمراض المستوطنة التي لا تزال تمثل مشكلة لصحة الحيوان والإنسان في العديد من مناطق العالم. ومن بين هذه الأمراض، لا يزال مرض الكيس المائي، مرض طفيلي مشترك المتسبب فيه مجموعة من الديدان الشريطية، المشوكة الحبيبية بالمعنى الواسع Echinococcus granulosus sensu lato ، يمثل مشكلة حقيقية لصحة الانسان و الحيوان في العديد من مناطق العالم، بما في ذلك حوض البحر الأبيض المتوسط. وعلى الرغم من تنفيذ عدد من برامج المكافحة باستخدام عدة أدوات (علاج الكلاب، فحص اللحوم، وغيرها)، إلا أن هذه العدوى لا تزال منتشرة بشكل كبير في شمال أفريقيا. نقدم هنا استعراضا لوبائيات مرض الكيس المائي في تونس، وتحليلا للقيود التي تحد من فعالية برامج المكافحة المطبقة، وأخيرا نناقش استخدام مفهوم الصحة الواحدة لتحسين فعالية البرامج المستقبلية.
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  • 文章类型: Journal Article
    棘球蚴病是中国西部地区的世界性地方病。2023年,在伊犁地区的27头野猪(Susscrofa)之一中发现了包虫病,新疆,中国西北部。使用组织病理学染色和全序列线粒体(mt)分析来确定感染基因型。在野猪肝脏中检测到细粒棘球蚴,囊性病变特征提示颗粒大肠杆菌基因型(G1)。该病例是中国首次证实野猪作为颗粒大肠杆菌G1基因型的传播者。这些发现表明,需要进行监测以评估S.granulosussensulato传播给人类和野生动物的风险。
    Echinococcosis is a worldwide disease endemic to the western region of China. In 2023, echinococcosis was detected in one of 27 wild boars (Sus scrofa) in Yili Prefecture, Xinjiang, northwestern China. Histopathological staining and full sequence mitochondrial (mt) analysis were used to determine the infection genotype. Echinococcus granulosus was detected in the wild boar liver, and the cystic lesion characteristics indicated the E. granulosus genotype (G1). This case is the first confirmation of wild boar serving as a transmitter for the G1 genotype of E. granulosus within China. These findings suggest that surveillance is needed to assess the risk of E. granulosus sensu lato transmission to humans and wild animals.
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  • 文章类型: Journal Article
    寄生虫具有逃避和操纵宿主免疫反应的显着能力。细粒棘球蚴是一种寄生虫,在动物和人类中引起囊性包虫病。已知由寄生虫释放的包虫液含有操纵宿主防御机制的各种免疫调节成分。在这项研究中,我们重点了解包虫液对树突状细胞的影响及其对自噬诱导和随后的T细胞反应的影响。最初,我们观察到细胞膜上两种C型凝集素受体显著下调,CLEC9A和CD205以及溶酶体活性的增加,表明细胞对包虫液的反应活跃.随后,我们观察到刺激的树突状细胞的超微结构变化,揭示巨自噬的存在,以自噬体的形成为特征,吞噬者,和细胞胞浆中的吞噬溶酶体。为了进一步阐明包虫液诱导自噬的潜在分子机制,我们分析了自噬相关基因在刺激的树突状细胞中的表达。我们的结果表明,beclin-1,atg16l1和atg12显着上调,表明响应于包虫液暴露而诱导了自噬机制。此外,使用共聚焦显微镜,我们观察到树突状细胞自噬体中LC3的积累,证实了与抗原呈递相关的这种分解代谢途径的激活。最后,评估包虫液诱导的DC自噬的功能后果,我们评估了脾细胞中的细胞因子转录。值得注意的是,强大的多功能T细胞反应,抑制Th2谱,其特征在于il-6、il-10、il-12、tnf-α的表达增加,ifn-γ和tgf-β基因。这些发现表明,包虫液诱导的树突状细胞自噬在塑造随后的T细胞反应中起着至关重要的作用。这对于更好地了解囊性包虫病中宿主与寄生虫的相互作用非常重要。
    Parasites possess remarkable abilities to evade and manipulate the immune response of their hosts. Echinococcus granulosus is a parasitic tapeworm that causes cystic echinococcosis in animals and humans. The hydatid fluid released by the parasite is known to contain various immunomodulatory components that manipulate host´s defense mechanism. In this study, we focused on understanding the effect of hydatid fluid on dendritic cells and its impact on autophagy induction and subsequent T cell responses. Initially, we observed a marked downregulation of two C-type lectin receptors in the cell membrane, CLEC9A and CD205 and an increase in lysosomal activity, suggesting an active cellular response to hydatid fluid. Subsequently, we visualized ultrastructural changes in stimulated dendritic cells, revealing the presence of macroautophagy, characterized by the formation of autophagosomes, phagophores, and phagolysosomes in the cell cytoplasm. To further elucidate the underlying molecular mechanisms involved in hydatid fluid-induced autophagy, we analyzed the expression of autophagy-related genes in stimulated dendritic cells. Our results demonstrated a significant upregulation of beclin-1, atg16l1 and atg12, indicating the induction of autophagy machinery in response to hydatid fluid exposure. Additionally, using confocal microscopy, we observed an accumulation of LC3 in dendritic cell autophagosomes, confirming the activation of this catabolic pathway associated with antigen presentation. Finally, to evaluate the functional consequences of hydatid fluid-induced autophagy in DCs, we evaluated cytokine transcription in the splenocytes. Remarkably, a robust polyfunctional T cell response, with inhibition of Th2 profile, is characterized by an increase in the expression of il-6, il-10, il-12, tnf-α, ifn-γ and tgf-β genes. These findings suggest that hydatid fluid-induced autophagy in dendritic cells plays a crucial role in shaping the subsequent T cell responses, which is important for a better understanding of host-parasite interactions in cystic echinococcosis.
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