人肝片形吸虫感染1例

患者,女,66岁,农民,2022年2月15日因“上腹部胀痛伴恶心不适7天”至当地县医院就诊,行腹部CT,示胆总管扩张,肝左叶肝内胆管结石并左叶胆管扩张,肝左叶萎缩;次日转至中国人民解放军联勤保障部队第九二四医院。患者生活于广西桂林山区,长期直接饮用山泉水及食生鱼腥草。入院后查体,剑突下压痛,无反跳痛;血常规无明显异常。MRI检查提示：肝左叶萎缩,肝左叶肝内胆管扩张,其近端内多发颗粒状T2低信号影,胆总管扩张,其内见条状T2低信号影。排除相关手术禁忌征后行内镜逆行胰胆管造影术,术中用取石网篮取出1条灰褐色活体成虫,予留置鼻胆管引流。虫体转送桂林医学院基础医学院人体寄生虫学教研室,鉴定为肝片形吸虫。术后予每12小时口服阿苯达唑0.6 g、吡喹酮0.6 g,治疗2 d。术后2个月复诊,患者无不适;复查腹部CT提示肝左叶萎缩,肝左叶肝内胆管及胆总管扩张。     

云南省片形吸虫和片形吸虫病研究进展

片形吸虫病是一种人兽共患寄生虫病,严重危害人类生命健康、阻碍社会经济发展.片形吸虫主要感染牛、羊等反刍动物,但近年来随着诊断水平的提升,人体片形吸虫感染病例报道有所增多.云南省人体片形吸虫病多年来主要以散在病例发生,并出现过暴发流行,已引起高度关注.本文主要就云南省片形吸虫虫种分布和片形吸虫病研究状况进行综述.     

肝片形吸虫囊蚴抵抗力观察

目的观察肝片形吸虫囊蚴经加热、干燥、食用调料等处理后的存活情况。方法将肝片形吸虫囊蚴经1)加热:微波高火30s、60s;沸水10、30s和1、2、3min。2)干燥:室温下自然干燥24、40h。3)食源调料:蒜汁、酱油、醋以及3种等量混合液浸泡10、20、30min;38°白酒及饱和盐水各浸泡10、20、30min。4)4℃下保存10个月。结果 2种加热方式处理后囊蚴全部死亡;放置于玻片上的囊蚴干燥24h,死亡4只,附着于叶片上的囊蚴干燥40h,死亡2只;在蒜汁、酱油、醋中浸泡10、20、30min,囊蚴全部存活;在3种调料的等量混合液、饱和盐水及38°白酒中浸泡10、20、30min后,均有部分存活,另有一部分囊蚴结构清晰但虫体不动,但也无明显死囊蚴的特征;在4℃下保存10个月,仍有存活的囊蚴。结论常用的调料对囊蚴不起作用,自然干燥1~2d不能完全杀灭囊蚴,在低温潮湿环境中可较长时间保持活力。沸水加热10s或微波高火30s即可杀死囊蚴。     

肝片吸虫疫苗研究进展

反刍动物的片吸虫感染不断引起全球性的巨大经济损失。近期的一些实验研究表明,特定的片吸虫抗原对动物感染有明显的保护作用。部分疫苗在降低虫荷的同时可减少寄生虫产卵量。尽管依然存在很大的困难,发展具有商业价值的疫苗仍是现实可行的。本文综述了近期肝片吸虫疫苗的研究情况,并对其发展前景进行了探讨。     

肝片吸虫疫苗研究进展

反刍动物的片吸虫感染不断引起全球性的巨大经济损失。近斯的一些实验研究表明,特定的片吸虫抗原对动物感染有明显的保护作用。部分疫苗在降低虫荷的同时可减少寄生虫产卵量。尽管依然存在很大的困难,发展具有商业价值的疫苗仍是现实可行的。本综述了近期肝片吸虫疫苗的研究情况,并对其发展前景进行了探讨。     

肝片形吸虫病1例报告

肝片形吸虫是寄生于牛、羊等哺乳动物胆道中的大型吸虫,人偶尔感染,报告1例胆管结石嵌顿患者,术中发现肝片形吸虫。     

肝片形吸虫病1例报告

肝片形吸虫是寄生于牛、羊等哺乳动物胆道中的大型吸虫,人偶尔感染,报告1例胆管结石嵌顿患者,术中发现肝片形吸虫。     

内蒙古乌审旗地区牛、羊片形吸虫感染情况及分子鉴定

目的 了解内蒙古乌审旗地区牛、羊片形吸虫感染情况。方法 2022年8月至2023年3月在乌审旗嘎鲁图、苏力德苏木、乌兰陶勒盖、乌审召和图克镇采集牛、羊血样和粪样,间接ELISA检测血清抗肝片形吸虫抗体,随机抽取部分血清抗体检测样品对应的牛、羊粪样,采用虫卵沉淀法定性检查虫卵,对血清抗体检测和粪样虫卵检查结果进行一致性检验。2023年4月,在嘎鲁图、苏力德苏木和图克镇因感染片形吸虫死亡牛、羊尸首的肝脏和胆汁中采集片形吸虫成虫和虫卵,提取虫体和虫卵DNA,PCR扩增片形吸虫核糖体内转录间隔区2 (ITS2)并测序,在NCBI数据库中进行BLAST比对分析,采用邻接法构建系统进化树。采用SPSS 25.0软件进行统计学分析,不同地区的阳性率的比较采用χ²检验。结果 共采集825份牛、羊血样,其中295份血清肝片形吸虫抗体阳性,总阳性率为35.8%(295/825),羊、牛阳性率分别为34.7%(227/655)、40.0%(68/170)。羊血清阳性率以苏力德苏木最高[81.8%(45/55)],乌审召镇最低[22.0%(27/123)],不同地区血清抗体阳性率差异有统...     

三氯苯达唑治疗肝片形吸虫病例报告

报告1例肝片形吸虫患者采用三氯苯达唑、吡喹酮和阿苯达唑的治疗情况,吡喹酮和阿苯达唑对人肝片形吸虫病治疗无效,而三氯苯达唑能有效治疗。     

Cell mediated immunity to liver fluke antigens during experimental Fasciola hepatica infection of cattle

Summary Cell mediated immunity (CMI) to Fasciola hepatica antigens was detected by lymphocyte proliferation and interleukin-2 (IL-2) production tests in cattle during the first 4 weeks following liver fluke infection. From the fifth week of infection onwards peripheral blood lymphocytes were unresponsive to fluke antigens by these in vitro tests. Investigations into the cause of this unresponsiveness found no evidence to suggest a selective loss of the IL-2 producing lymphocyte sub-population or that macrophages were responsible for the suppression or that antigen responsive cells were being sequestered in the spleen and mesenteric lymph nodes. Tests carried out on culture supernatants demonstrated the production during this unresponsive period of factors capable of suppressing in vitro responses to PHA. Although further tests failed to show antigen specific suppressor factors the presence of MHC restricted suppressor factors could not be ruled out. The early and transient appearance of CMI during F. hepatica infection of cattle indicates that delayed type hypersensitivity is unlikely to be important in protective immunity in cattle.     

Fasciola hepatica infection downregulates Th1 responses in mice

Immune responses induced with helminth parasites have been extensively studied, but there is limited information on those to Fasciola hepatica, especially on the subtype of T cell induced with this parasite. We investigated the local and systemic T cell responses of different strains of mice following oral infection with doses of metacercariae from F. hepatica. Spleen cells from BALB/c and 129Sv/Ev mice given a low-dose (5 metacercariae) infection exhibited a Th2 response, producing high levels of the cytokines IL-4 and IL-5, and low levels of IFN-gamma and IL-2. In contrast, C57BL/6 mice showed a mixed Th1/Th2 response. A more marked polarization to a Th2 response was observed in BALB/c, 129Sv/Ev exposed to a high-dose (15 metacercariae) infection and the C57BL/6 mice also exhibited a clear Th2 response. IL-4 defective (IL-4-/-) C57BL/6 mice infected with 5 metacercariae produced less IFN-gamma and more IL-5 compared to their wild-type C57BL/6 counterparts, suggesting that IL-4 is important in establishing the Th2 type response in murine fasciolosis. However, the secretion of IFN-gamma and IL-2 was completely suppressed in the high-dose infection and this was also observed in IL-4-/- mice. Thus, liver flukes may secrete molecules that downregulate Th1 responses. T cell responses in the mesenteric (MLN) and hepatic lymph nodes (HLN) were also examined since newly excysted juveniles infect through the intestinal wall of their host before migrating to the hepatic tissue. Cells from both MLN and HLN secreted higher levels of IL-4 and IL-5 compared to spleen cells. We also observed a difference in cytokine profiles secreted by the MLN and HLN, which may reflect responses to antigens liberated by newly excysted juveniles and hepatic stage parasites, respectively.     

Does Fasciola hepatica infection modify the response of acute hepatitis C virus infection to IFN-α treatment?

Immunologic response to acute hepatitis C is mainly a Th1 response, whereas fasciolopsiasis is associated with a diverse T-cell response. Interferon-alpha has immunomodulatory effects and enhances Th1 immune response. Fasciola infection could theoretically interfere with the Th1 immune response, even when acquired after an initial response to interferon-alpha treatment for acute hepatitis C virus (HCV) infection. We report here the case of a male patient who acquired Fasciola hepatica infection after an initial response to IFN-alpha therapy with a favorable outcome     

Clinical presentation and management of Fasciola hepatica infection: single-center experience

AIM:To identify the characteristic clinical,laboratory and radiological findings and response to treatment in patients with fascioliasis.METHODS:Patients who were diagnosed with Fasciola hepatica infection were included in this prospective study.Initial clinical,laboratory and radiological findings were recorded.All patients were followed until a complete response was achieved or for 6 mo after treatment discontinuation.RESULTS:Fasciola hepatica infection was diagnosed in 30 patients(24 females;mean age:42....     

Fasciola hepatica: rapid switching of stage-specific antigen expression after infection

Early developmental stages of the trematode parasite Fasciola hepatica were collected from the peritoneal cavity and liver of mice during a ten day infection period. Using one dimensional SDS-PAGE, differences in protein expression profiles were observed in stages collected on the same day post-infection in different physiological locations and also in juvenile parasites collected from the same location on different days post-infection. Four rat monoclonal antibodies were raised against the parasite using lymph nodes draining infected tissues. Three monoclonal antibodies, FY3-1, FY3-2 and FY4-7, were generated using cells from the mesenteric lymph node of recently challenged immune rats, while FY1-6 was derived from hepatic lymph node cells of a chronically infected rat. The epitope recognized by FY3-2 appeared to be carbohydrate in nature and was present on the surface of newly excysted juveniles. Immunoblots revealed that the antigens recognized by FY3-1, FY3-2 and FY4-7 were only expressed for two days after infection. In contrast, FY1-6 recognized epitopes expressed across all developmental stages screened. The rapid changes in protein and antigen expression observed during the early stages of infection may assist the parasite to evade the host immune response.     

T cell subset involvement in immune responses to Fasciola hepatica infection in cattle

The lymphocyte response to F. hepatica during a primary infection in cattle was analysed to define the role of T cell subsets in the immune response. Blood lymphocytes were isolated from eight cattle infected with F. hepatica via trickle infection over a ten-day period and from two non-infected controls. CD4+, CD8+ and gamma delta + T cells were depleted from whole lymphocyte populations by magnetic bead depletion. Lymphocytes from infected animals demonstrated a transient, but marked elevation in responsiveness to F. hepatica antigen between weeks 3 and 8 post-infection. Responses were attenuated by depletion of CD4+ and CD8+ T cells during this period. Depletion of gamma delta + T cells attenuated antigen responses at one time point only, and at an earlier stage post-infection than when alpha beta + T cells were depleted. Responses to antigen correlated positively with both hepatic fluke burden and with the degree of hepatic damage. This suggests that the cellular immune response was not protective. Antigen responses in gamma delta + T cell-depleted populations were also associated with post-mortem fluke burden and with hepatic damage. This suggests that gamma delta + T cells are involved in down regulating alpha beta + lymphocytes which may have a role in a non-protective or immunopathological immune responses.     

Vaccination against Fasciola hepatica infection using a Schistosoma mansoni defined recombinant antigen,Sm14

Fasciola hepatica is the causative agent of fasciolosis in many areas in America, Europe, Africa, Asia and Australia. There is an urgent need for improved methods to control the parasite's transmission. We describe the use of an experimental vaccine based on a recombinant antigen cloned from another parasite, Schistosoma mansoni (Sm14), that induces high levels of cross protection in mice against both S. mansoni and F. hepatica. Sheep and mice vaccinated with Sm14 were significantly protected against challenge infection with metacercariae of Fasciola hepatica and were completely free of the histopathological hepatic damage related to liver fluke infection. The vaccine will provide a valuable new tool to aid in transmission control of this economically important disease.     

Fasciola hepatica in the rat: immune responses associated with the development of resistance to infection

F. hepatica infections were established in rats and immune responses were monitored during primary and challenge infections. Antibody levels peaked at 3 weeks post-primary infection and at 6 days post-challenge infection. No significant correlation was found between antibody titre and number of flukes recovered at autopsy. Immunoblotting revealed a limited number of immunogenic polypeptides. When antibodies from these reactive bands were eluted and tested by IFA they all gave identical binding patterns: on juvenile fluke sections tegumental syncytium, tegumental cells and gut cells were labelled, while on adult sections the same antibodies labelled gut cells, reproductive tissue, excretory ducts and flame cells. This suggested that these tissues shared a common epitope or range of epitopes. A pronounced eosinophilia was observed throughout the infection period studied and infected liver sections showed massive cellular infiltration. Histochemical and immunocytochemical investigation of infected liver revealed the presence of large numbers of eosinophils, neutrophils, lymphocytes and phagocytes. The implications of these findings, to an understanding of concomitant immunity in the rat are discussed.     

The immune response of regional lymph nodes during the early stages of Fasciola hepatica infection in cattle

In this study we examined regional immune responses to Fasciola hepatica infection in the natural ruminant host. Naïve cattle and those pre‐exposed to a drug‐abbreviated infection were subsequently challenged and lymph nodes extracted at slaughter. In vitro proliferation and cytokine production by mononuclear cells isolated from hepatic and mesenteric lymph nodes were measured after culture with whole fluke antigen (WFA). Hepatic lymph node cells had a significantly greater response to parasite antigen than mesenteric lymph node cells (P < 0·02), although there was no difference in the magnitude of the proliferative response between naïve and pre‐exposed challenged cattle. Mononuclear cells from hepatic lymph nodes produced interferon gamma, interleukin 2 and interleukin 4 after culture with parasite antigen, indicative of a mixed, T helper type 0, response. Comparison of the hepatic node response to a variety of F. hepatica antigens showed that proliferation was lower after culture with cathepsin‐L, than with a high molecular weight fraction, WFA or excretory–secretory antigen. Cell culture supernatant fluid from unstimulated hepatic lymph node cells showed an IgG1 response to antigens of 48, 52–70, 82, 96 and 120–190 kDa on Western blot in pre‐exposed, but not naïve, challenged animals.