Clonorchiasis

Abstract

On Aug 21, 1875, James McConnell published in The Lancet his findings from a post-mortem examination of a 20-year-old Chinese man--undertaken at the Medical College Hospital in Calcutta, India--in whom he found Clonorchis sinensis in the bile ducts. Now, exactly 140 years later, we have a sound understanding of the lifecycle of this liver fluke, including key clinical, diagnostic, and epidemiological features. Developments in the so-called -omics sciences have not only advanced our knowledge of the biology and pathology of the parasite, but also led to the discovery of new diagnostic, drug, and vaccine targets. C sinensis infection is primarily related to liver and biliary disorders, especially cholangiocarcinoma. Clonorchiasis mainly occurs in east Asia, as a result of the region's social-ecological systems and deeply rooted cultural habit of consuming raw freshwater fish. The Kato-Katz technique, applied on fresh stool samples, is the most widely used diagnostic approach. Praziquantel is the treatment of choice and has been considered for preventive chemotherapy. Tribendimidine showed good safety and therapeutic profiles in phase 2 trials and warrants further investigation. Still today, the precise distribution, the exact number of infected people, subtle morbidities and pathogenesis, and the global burden of clonorchiasis are unknown. Integrated control strategies, consisting of preventive chemotherapy; information, education, and communication; environmental management; and capacity building through intersectoral collaboration should be advocated.

The Role of Cancer-Associated Fibroblasts and Fibrosis in Liver Cancer

“…As PSC is rarely diagnosed in early prefibrotic stages and most CCAs develop within the first year of PSC diagnosis, it is difficult to understand the exact nature and role of the PME in PSC. Similar to PSC, infection with liver flukes is accompanied by cholangitis, fibrosis-induced obstruction of ducts, and immune responses to the flukes, as well as secondary bacterial infections that may further exacerbate inflammation and fibrosis (196). However, as opposed to the 20% lifetime risk of CCA development in PSC patients, infections with Clonorchis sinensis (four to six times increased risk; 196) or Opisthorchis viverrini (approximately fivefold increased risk; 197) result in a lower relative risk of developing CCA.…”

The immunological characteristics and probiotic function of recombinant Bacillus subtilis spore expressing Clonorchis sinensis cysteine protease

“…Humans or animals can be infected mainly due to ingestion of raw or undercooked freshwater fish containing encysted metacercaria of C. sinensis [1, 2]. Metacercariae excyst in the duodenum of the host, then migrate into the bile duct, and further develop into adult worms [2].…”

Ancient Human Parasites in Ethnic Chinese Populations

“…Chinese liver fluke is found today just in eastern and southern China and Korea, where the life cycle of the parasite can be completed in the local water snails and freshwater fish. It is contracted if a person eats raw infected freshwater fish [19,20]. The mummies were almost all from the areas of eastern and southern China where we would expect to find the Chinese liver fluke.…”