Anaemia in advanced chronic fasciolosis

Valero, M. Adela; Gironès, Núria; Garcia-Bodelon, M. A.; Periago, María Victoria; Chico‐Calero, Isabel; Khoubbane, Messaoud; Fresno, Manuel; Mas‐Coma, Santiago

doi:10.1016/j.actatropica.2008.08.007

Cited by 70 publications

(47 citation statements)

References 43 publications

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“…Present widespread fascioliasis with high pathogenicity in ruminants from Bangladesh is a good indicator for the disease likely to be diagnosed in humans if properly investigated. The higher proportion of F. gigantica-like forms in the country may suggest more severe pathogenic characteristics related to the larger size of F. gigantica if it infects humans (Girones et al 2007;Valero et al 2008).…”

Section: Discussionmentioning

confidence: 99%

CIAS detection of Fasciola hepatica/F. gigantica intermediate forms in bovines from Bangladesh

Ahasan¹,

Valero

Chowdhury

et al. 2016

Acta Parasitologica

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Fascioliasis is an important food-borne parasitic zoonosis caused by two trematode species, Fasciola hepatica and Fasciola gigantica. The characterisation and differentiation of Fasciola populations is crucial to control the disease, given the different transmission, epidemiology and pathology characteristics of the two species. Lineal biometric features of adult liver flukes infecting livestock have been studied to characterise and discriminate fasciolids from Bangladesh. An accurate analysis was conducted to phenotypically discriminate between fasciolids from naturally infected bovines (cattle, buffaloes) throughout the country. Morphometric analyses were made with a computer image analysis system (CIAS) applied on the basis of standardised measurements and the logistic model of the body growth and development of fasciolids in the different host groups. Since it is the first ever comprehensive study of this kind undertaken in Bangladesh, the results are compared to pure fasciolid populations of F. hepatica from the European Mediterranean area and F. gigantica from Burkina Faso, geographical areas where both species do not co-exist. Principal component analysis showed that the biometric characteristics of fasciolids from Bangladesh are situated between F. hepatica and F. gigantica standard populations, indicating the presence of phenotypes of intermediate forms in Bangladesh. These results are analysed by considering the present emergence of animal fascioliasis, the local lymnaeid fauna, the impact of climate change, and the risk of human infection in the country.

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Section: Discussionmentioning

confidence: 99%

CIAS detection of Fasciola hepatica/F. gigantica intermediate forms in bovines from Bangladesh

Ahasan¹,

Valero

Chowdhury

et al. 2016

Acta Parasitologica

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“…The human fascioliasis scenario experienced a profound change in the 1990’s, from isolated cases from developed countries to the progressive description of heterogeneous human endemic areas and human infection reports in developing countries, presenting different transmission patterns and epidemiological situations [2]. The last stage of the disease in humans encompasses an obstructive or chronic phase which may develop after months to years of infection, including mild to moderate anemia, especially in cases of heavy parasitic burdens [3]. Therefore, human fascioliasis is included in the WHO list of priorities among foodborne trematodiases.…”

Section: Introductionmentioning

confidence: 99%

“…Although little is known on fascioliasis reinfection in humans, it has been suggested to be linked to high burdens [2] and their impact during the chronic phase [3], and to coinfections with other diseases, whether parasitic [2] or bacterial [6], giving rise to a combined morbidity potential of concern in human fascioliasis high endemic areas. Additionally, reinfection has also been related to high pathogenicity and impressive manifestations in patients whether directly by immunologically stimulating the ectopic migration of invasive juvenile flukes or indirectly by increasing complex mechanisms involved in immuno-allergic and toxic processes caused by flukes in the liver but acting systemically at distance [4].…”

Section: Introductionmentioning

confidence: 99%

Fasciola hepatica reinfection potentiates a mixed Th1/Th2/Th17/Treg response and correlates with the clinical phenotypes of anemia

et al. 2017

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BackgroundFascioliasis is a severe zoonotic disease of worldwide extension caused by liver flukes. In human fascioliasis hyperendemic areas, reinfection and chronicity are the norm and anemia is the main sign. Herein, the profile of the Th1/Th2/Th17/Treg expression levels is analyzed after reinfection, correlating them with their corresponding hematological biomarkers of morbidity.Methodology/Principal findingsThe experimental design reproduces the usual reinfection/chronicity conditions in human fascioliasis endemic areas and included Fasciola hepatica primo-infected Wistar rats (PI) and rats reinfected at 8 weeks (R8), and at 12 weeks (R12), and negative control rats. In a cross-sectional study, the expression of the genes associated with Th1 (Ifng, Il12a, Il12b, Nos2), Th2 (Il4, Arg1), Treg (Foxp3, Il10, Tgfb, Ebi3), and Th17 (Il17) in the spleen and thymus was analyzed. After 20 weeks of primary infection, PI did not present significant changes in the expression of those genes when compared to non-infected rats (NI), but an increase of Il4, Arg1 and Ifng mRNA in the spleen was observed in R12, suggesting the existence of an active mixed Th1/Th2 systemic immune response in reinfection. Foxp3, Il10, Tgfb and Ebi3 levels increased in the spleen in R12 when compared to NI and PI, indicating that the Treg gene expression levels are potentiated in chronic phase reinfection. Il17 gene expression levels in R12 in the spleen increased when compared to NI, PI and R8. Gene expression levels of Il10 in the thymus increased when compared to NI and PI in R12. Ifng expression levels in the thymus increased in all reinfected rats, but not in PI. The clinical phenotype was determined by the fluke burden, the rat body weight and the hemogram. Multivariate mathematical models were built to describe the Th1/Th2/Th17/Treg expression levels and the clinical phenotype. In reinfection, two phenotypic patterns were detected: i) one which includes only increased splenic Ifng expression levels but no Treg expression, correlating with severe anemia; ii) another which includes increased splenic Ifng and Treg expression levels, correlating with a less severe anemia.Conclusions/SignificanceIn animals with established F. hepatica infection a huge increase in the immune response occurs, being a mixed Th2/Treg associated gene expression together with an expression of Ifng. Interestingly, a Th17 associated gene expression is also observed. Reinfection in the chronic phase is able to activate a mixed immune response (Th1/Th2/Th17/Treg) against F. hepatica but T and B proliferation to mitogens is strongly suppressed in all infected rats vs control in the advanced chronic phase independently of reinfection The systemic immune response is different in each group, suggesting that suppression is mediated by different mechanisms in each case. Immune suppression could be due to the parasite in PI and R8 rats and the induction of suppressive cells such as Treg in R12. This is the first study to provide fundamental insight into the immune profile in fas...

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“…This disease in humans shows an increasing importance, which does rely not only on the recent widespread emergence it has shown but also on the results obtained in studies on pathogenicity (Mas-Coma et al, 1999a;Valero et al, 2003Valero et al, , 2006Valero et al, , 2008 and immunity (Brady et al, 1999;Gironés et al, 2007), according to which this disease appears to be pronouncedly more complicated and with a greater impact in long-term infection than what was believed until the 1990s. In human endemic areas, fascioliasis chronicity and superimposed repetitive infections pose additional pathological complications .…”

Section: Introductionmentioning

confidence: 91%

“…It may be argued that results of Fasciola infection studies on rats may not be extrapolated to human beings. However, the laboratory rat model has shown to be useful for this purpose in other aspects (Gironés et al, 2007;Valero et al, 2002Valero et al, , 2003Valero et al, , 2008.…”

Section: Physiopathogenic Processes Indirectly Affecting the Central mentioning

confidence: 96%

Neurological and Ocular Fascioliasis in Humans

Mas‐Coma

Agramunt

Valero

2014

Advances in Parasitology

110

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Anaemia in advanced chronic fasciolosis

Cited by 70 publications

References 43 publications

CIAS detection of Fasciola hepatica/F. gigantica intermediate forms in bovines from Bangladesh

CIAS detection of Fasciola hepatica/F. gigantica intermediate forms in bovines from Bangladesh

Fasciola hepatica reinfection potentiates a mixed Th1/Th2/Th17/Treg response and correlates with the clinical phenotypes of anemia

Neurological and Ocular Fascioliasis in Humans

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