Shang Jingye, Zhang Guangjia, Yu Wenjie, He Wei, Wang Qian, Zhong Bo, Wang Qi, Liao Sha, Li Ruirui, Chen Fan, Huang Yan
Institute of Parasitic Disease, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China.
Institute of Parasitic Disease, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China.
Acta Trop. 2019 Feb;190:45-51. doi: 10.1016/j.actatropica.2018.09.019. Epub 2018 Sep 29.
Cystic echinococcosis (CE) and alveolar echinococcosis (AE) are highly co-endemic in Sichuan, a part of Qinghai-Tibet Plateau where is a typical Tibetan nomadic community living area. In order to better understand the Echinococcus spp. of human being infected origins in this area, 140 lesions were collected from echinococcosis patients who were received operations during the period of 2014-2016 in different geographic districts in this region. Partial DNA sequences of the mitochondrial cox1 gene were analyzed. The genetic characterization of the isolates from 3 different places including Ganzi, Aba and Liangshan were assessed. Of all the 140 samples, the great majority was identified as Echinococcus granulosus sensu stricto (n = 108). Echinococcus multilocularis was confirmed to be another important pathogen of the human infections (n = 31). Additionally, one Echinococcus canadensis (G6/7) isolate from Ganzi was confirmed. Comparing the clinical diagnosis with the sequencing results, 6.4% (9/140) of the cases were misdiagnosed between AE and CE, and another 8.6% (12/140) were unclassified to sub-type in echinococcosis. Higher rates of misdiagnosis and unclassified diagnosis were found in AE cases (12.9%, 4/31 and 16.1%, 5/31 respectively) compared to CE (4.6%, 5/109 and 6.4%, 7/109 respectively). In E.granulosus s.s., a total of 34 haplotypes were detected, and 4 haplotypes were inferred from E.multilocularis. The haplotype networks of the 2 species exhibited a similar star-shaped feature with a dominant haplotype in the center. Geographically specific haplotypes were observed in Ganzi and Aba respectively. This study provides insight into the current species causing human echinococcosis in the Tibetan districts of Sichuan. E.granulosus s.s. and E.multilocularis are confirmed to be the main causative agents, and the existence of E.canadensis (G6/7) is also observed in the region. Molecular diagnosis was proven to be essential for the confirmation of human echinococcosis in the area.
囊性棘球蚴病（CE）和泡型棘球蚴病（AE）在青藏高原典型的藏族游牧社区生活区——四川高度共流行。为了更好地了解该地区人类感染棘球绦虫的来源，收集了2014 - 2016年期间在该地区不同地理区域接受手术的棘球蚴病患者的140个病灶。分析了线粒体细胞色素氧化酶亚基1（cox1）基因的部分DNA序列。评估了来自甘孜、阿坝和凉山3个不同地区分离株的遗传特征。在所有140个样本中，绝大多数被鉴定为狭义细粒棘球绦虫（n = 108）。多房棘球绦虫被证实是人类感染的另一种重要病原体（n = 31）。此外，还证实了1株来自甘孜的加拿大棘球绦虫（G6/7）分离株。将临床诊断与测序结果进行比较，6.4%（9/140）的病例在AE和CE之间被误诊，另外8.6%（12/140）的病例在棘球蚴病中未被分类到亚型。与CE（分别为4.6%，5/109和6.4%，7/109）相比，AE病例的误诊率和未分类诊断率更高（分别为12.9%，4/31和16.1%，5/31）。在狭义细粒棘球绦虫中，共检测到34个单倍型，从多房棘球绦虫中推断出4个单倍型。这两个物种的单倍型网络呈现出相似的星形特征，中心有一个优势单倍型。在甘孜和阿坝分别观察到地理特异性单倍型。本研究深入了解了四川藏区目前导致人类棘球蚴病的物种。狭义细粒棘球绦虫和多房棘球绦虫被证实是主要病原体，该地区也观察到了加拿大棘球绦虫（G6/7）的存在。分子诊断被证明对该地区人类棘球蚴病的确诊至关重要。
