Soluble programmed death‐1 (sPD‐1) as predictor of early surgical outcomes of paediatric cystic echinococcosis

Abstract

Cystic echinococcosis (CE), commonly also known as hydatid disease, is a widespread helminthic anthropozoonosis caused by the development of the larval stage of Echinococcus granulosus sensu lato (E. granulosus s.l) in intermediate hosts. 1,2 The main transmission routes predominantly include the consumption of not well-washed raw vegetables and fruits, contaminated drinking water or the direct oral-faecal pathway. 3 CE has been listed by the World Health Organization (WHO) as one of the 20 neglected tropical diseases targeted for control or eradication by 2030. 4 The latest global burden of human CE was estimated to 285 500 disability-adjusted life years. 5-7 Nevertheless, this is likely to be an underestimate (>1 million, if underreporting is taken into account). 7 Tunisia is one of the most endemic regions of the Mediterranean Basin with an average surgical incidence of 12.6 cases per 100 000 population. 8 In adults, liver is the commonest site, whereas children are more likely to develop pulmonary than hepatic CE. 9 Human CE diagnosis, cyst staging and therapeutic decisions rely on a relevant clinical history, radiological methods along with

Can sPD-1 and sPD-L1 Plasma Concentrations Predict Treatment Response among Patients with Extraparenchymal Neurocysticercosis?

“…In patients affected by cystic echinococcosis, sPD-L1 was significantly higher in patients than in controls [ 29 ]. In pediatric patients affected by cystic echinococcosis, a progressive significant decrease of sPD-1 and sPD-L1 occurred after successful surgery, which was not seen when relapse of the disease occurred after treatment [ 30 ]. In an experimental model of murine alveolar echinococcosis ( E. multilocularis ) infection, anti-PD-L1 administration results in increased CD4+/CD8+ effector T cells and decrease of T regs, as an improved control of the infection [ 31 ].…”

Evaluation of the Local and Peripheral Immune Responses in Patients with Cystic Echinococcosis

“…The CE cysts were diagnosed based on the presence of pathognomonic features via ultrasound or other radiological techniques depending on cyst localization [ 18 ]; based on the cysts and clinical characteristics, the best treatment option was chosen. The cysts from patients requiring cystectomy were staged according to the WHO-Informal Working Group on Echinococcosis (WHO-IWGE) classification; therefore, the CE stage was available for removed liver cysts as the classification was applied during diagnosis and prior to surgery [ 17 , 19 , 20 , 21 ]. The WHO-IWGE classification identifies six stages (CE1, CE2, CE3a, CE3b, CE4, and CE5) based on the pathognomonic features of cysts, characterizing the active–transitional–inactive ultrasonographic status of the cyst.…”

“…The “transitional” group includes the CE3a stage, as CE3a cysts have equal probability to be viable and non-viable, while the “inactive” group includes the CE4 and CE5 cysts [ 22 ]. To simplify group classification, patients with more than one cyst at different stages were classified according to the more active stage [ 20 , 23 , 24 , 25 ]. Routine serology tests performed at INMI were the NovaLisa Echinococcus IgG ELISA (NovaTec Immunodiagnostica GmbH, Dietzenbach, Germany) and the Western Blot IgG (Euroimmun Labordiagnostika, Luebeck, Germany).…”

‘No cyst, no echinococcosis’: a scoping review update on the diagnosis of cystic echinococcosis after the issue of the WHO-IWGE Expert Consensus and current perspectives

“…Of the 32 studies from which data were available, nine (28.1%) did not report practically applicable cut-off/accuracy data, and of the 23 studies wherein such practical interpretation was provided, 15 (65.2%) reported low (<80%) sensitivity. The other eight (34.8%) studies reporting higher sensitivities [67][68][69][70][71][72][73][74] encompassed very different targets, with antigen detection and PCR as the diagnostic techniques most easily implementable, should any of these targets be further validated and reach clinical practice.…”