Cangalaya Carla, Bustos Javier A, Calcina Juan, Vargas-Calla Ana, Suarez Diego, Gonzalez Armando E, Chacaltana Juan, Guerra-Giraldez Cristina, Mahanty Siddhartha, Nash Theodore E, García Hector H
Laboratorio de Inmunopatología en Neurocisticercosis, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.
Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Peru.
PLoS Negl Trop Dis. 2016 Jul 26;10(7):e0004869. doi: 10.1371/journal.pntd.0004869. eCollection 2016 Jul.
Disease manifestations in neurocysticercosis (NCC) are frequently due to inflammation of degenerating Taenia solium brain cysts. Exacerbated inflammation post anthelmintic treatment is associated with leakage of the blood brain barrier (BBB) using Evans blue (EB) staining. How well EB extravasation into the brain correlates with magnetic resonance imaging (MRI) using gadolinium (Gd) enhancement as a contrast agent and pericystic inflammation was analyzed in pigs harboring brain cysts of Taenia solium.
METHODOLOGY/PRINCIPAL FINDINGS: Three groups of 4 naturally infected pigs were assessed. The first and second groups were treated with both praziquantel plus albendazole and sacrificed two and five days post treatment, respectively. A third untreated group remained untreated. Pigs were injected with EB two hours prior to evaluation by Gd-enhanced T1-MRI, and euthanized. The EB staining for each cyst capsule was scored (EB grades were 0: 0%; 1: up to 50%; 2: over 50% but less than 100%; 3: 100%). Similarly, the Gd enhancement around each cyst was qualitatively and quantitatively scored from the MRI. The extent of pericystic inflammation on histology was scored in increasing severity as IS1, IS2, IS3 and IS4. Grade 3 EB staining and enhancement was only seen in treated capsules. Also, treated groups had higher Gd intensity than the untreated group. Grades of enhancement correlated significantly with Gd enhancement intensity. EB staining was correlated with Gd enhancement intensity and with IS4 in the treated groups. These correlations were stronger in internally located cysts compared to superficial cysts in treated groups.
EB staining and Gd enhancement strongly correlate. The intensity of enhancement determined by MRI is a good indication of the degree of inflammation. Similarly, EB staining highly correlates with the degree of inflammation and may be applied to study inflammation in the pig model of NCC.
神经囊尾蚴病（NCC）的疾病表现通常是由于退化的猪带绦虫脑囊肿炎症所致。使用伊文思蓝（EB）染色，驱虫治疗后炎症加剧与血脑屏障（BBB）渗漏有关。在患有猪带绦虫脑囊肿的猪中，分析了EB渗入脑内与使用钆（Gd）增强作为造影剂的磁共振成像（MRI）以及囊肿周围炎症的相关性。
方法/主要发现：对三组共4头自然感染的猪进行评估。第一组和第二组分别用吡喹酮加阿苯达唑治疗，并在治疗后两天和五天处死。第三组未治疗，保持未处理状态。在通过Gd增强T1-MRI评估前两小时给猪注射EB，然后实施安乐死。对每个囊肿包膜的EB染色进行评分（EB分级为0：0%；1：高达50%；2：超过50%但小于100%；3：100%）。同样，从MRI对每个囊肿周围的Gd增强进行定性和定量评分。组织学上囊肿周围炎症的程度按严重程度递增评为IS1、IS2、IS3和IS4。3级EB染色和增强仅在治疗后的包膜中出现。此外，治疗组的Gd强度高于未治疗组。增强分级与Gd增强强度显著相关。在治疗组中，EB染色与Gd增强强度以及IS4相关。与治疗组中的浅表囊肿相比，内部囊肿的这些相关性更强。
EB染色与Gd增强密切相关。MRI确定的增强强度是炎症程度的良好指标。同样，EB染色与炎症程度高度相关，可用于研究NCC猪模型中的炎症。
