Worasith Chanika, Kopolrat Kulthida Y, Pitaksakulrat Opal, Homwong Chutima, Kittirat Yingpinyapat, Wongphutorn Phattharaphon, Sithithaworn Jiraporn, Sithithaworn Paiboon
Department of Parasitology, Faculty of Medicine, Khon Kaen University, Thailand.
Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.
Am J Trop Med Hyg. 2022 Mar 28;106(5):1470-7. doi: 10.4269/ajtmh.21-1145.
Infection by Opisthorchis viverrini causes significant health problems, including cholangiocarcinoma (CCA); thus control and elimination of this trematode is an important strategy for the reduction of CCA. Currently, urine and copro antigen detection is more sensitive than parasitological examination of the feces for the diagnosis of opisthorchiasis. Given limitations in human studies, we used an animal model to quantify the parasite antigen profiles in urine and feces in O. viverrine-infected hamsters, and postdrug treatment. The positive detections of O. viverrini antigen began from week 1 in urine and week 2 in feces after infection until week 28 of the study. The recoveries of O. viverrini worms were detected starting from week 1 and eggs of O. viverrini were detected in feces from week 3 after infection and remained detectable throughout the study period. There was a significant positive correlation of urine and copro antigen levels with the number of fecal egg counts (P < 0.01) and worm recovery (P < 0.01). In the drug-treatment experiment, treatment of infected hamsters with praziquantel significantly reduced worm burden, fecal egg output, and antigen in urine and feces compared with the untreated controls (P < 0.001). At 4 weeks posttreatment, the egg and worm reduction rates were 100% and 95.5%, respectively. The positive antigen detections in urine and feces corresponded with partial worm clearance from praziquantel treatment. This study demonstrated a direct link of urine and copro antigen tests with worms infecting the liver thereby reaffirming the reliability of urine and copro antigen assay in opisthorchiasis diagnosis.
华支睾吸虫感染会引发严重的健康问题，包括胆管癌（CCA）；因此，控制和消除这种吸虫是降低胆管癌的重要策略。目前，尿液和粪便抗原检测在华支睾吸虫病诊断中比粪便寄生虫学检查更敏感。鉴于人体研究存在局限性，我们使用动物模型来量化华支睾吸虫感染的仓鼠在尿液和粪便中的寄生虫抗原谱，以及药物治疗后的情况。华支睾吸虫抗原的阳性检测从感染后第1周的尿液和第2周的粪便开始，一直持续到研究的第28周。华支睾吸虫虫体的回收从第1周开始检测，感染后第3周在粪便中检测到华支睾吸虫卵，并且在整个研究期间都可检测到。尿液和粪便抗原水平与粪便虫卵计数（P < 0.01）和虫体回收数量（P < 0.01）之间存在显著正相关。在药物治疗实验中，与未治疗的对照组相比，用吡喹酮治疗感染的仓鼠可显著降低虫体负荷、粪便虫卵排出量以及尿液和粪便中的抗原（P < 0.001）。治疗后4周，虫卵和虫体减少率分别为100%和95.5%。尿液和粪便中的抗原阳性检测与吡喹酮治疗后部分虫体清除相对应。本研究证明了尿液和粪便抗原检测与感染肝脏的虫体之间的直接联系，从而再次确认了尿液和粪便抗原检测在华支睾吸虫病诊断中的可靠性。
