Inflammation-mediated DNA damage triggered by Opisthorchis viverrini (OV) infection is a major risk factor of cholangiocarcinoma (CCA). We have recently reported that nitrative and oxidative DNA damage participates in CCA development caused by repeated infection with OV [Pinlaor et al., Carcinogenesis 2004; 25:1535-42]. Therefore, to clarify the preventive effect of the antihelminthic drug praziquantel against cholangiocarcinogenesis, we assessed the effect of this drug on nitrative and oxidative DNA damage, including the formation of 8-nitroguanine and 8-oxo-7,8-dihydro-2 0 -deoxyguanosine (8-oxodG), and the expression of inducible nitric oxide synthase (iNOS) by immunohistochemistry in OV-infected hamsters. We also examined the expression of nuclear factor-jB (NF-jB), which functions as a tumor promoter in inflammation-associated cancer. Our results showed that although 1-week treatment with praziquantel did not kill parasites completely in hamsters on days 14 and 30, this drug dramatically reduced inflammatory cell infiltration. Double immunofluorescence staining showed that drug treatment almost completely diminished OV-induced 8-nitroguanine and 8-oxodG formation in bile duct epithelial cells. Quantitative analysis using an electrochemical detector coupled to HPLC revealed that 8-oxodG level in the liver of OV-infected hamsters was significantly decreased by drug treatment (p<0.05). Western blotting and immunohistochemistry revealed that the expression of NF-jB and iNOS in bile duct epithelium was reduced by drug treatment. The amount of nitrate plus nitrite in the liver and plasma was significantly decreased after drug treatment. It is concluded that praziquantel can exhibit a preventive effect against OV-induced cholangiocarcinoma by inhibiting iNOS-dependent DNA damage through not only elimination of parasites but also a potential antiinflammatory effect. ' 2006 Wiley-Liss, Inc.Key words: Opisthorchis viverrini; cholangiocarcinoma; praziquantel; DNA damage; 8-nitroguanine; 8-oxo-7, 8-dihydro-2 0 -deoxyguanosine; inducible nitric oxide synthase; nuclear factor-jB; inflammation Opisthorchiasis viverrini (OV) infection is the major risk factor of cholangiocarcinoma (CCA) development.1,2 OV infection and CCA development occur at high incidence in northeastern Thailand.2,3 The antihelminthic drug praziquantel has been used for the treatment of parasite infection, including liver fluke such as OV. 4 The cure rate of a single dose of praziquantel for liver fluke treatment was more than 90%. 4 However, although praziquantel appears to interfere with calcium homeostasis and causes flaccid paralysis in adult flukes, its mode of action is still not clearly understood.5 It is still a matter of debate whether the therapeutic effect of praziquantel is attributed to its specific antiparasitic effect and/or antiinflammatory effect.5,6 Accumulation of evidence verifies that DNA damage is believed to be linked between inflammation and carcinogenesis. [7][8][9] Reactive nitrogen species can mediate the formation of 8-nitr...