Arroyo Gianfranco, Baquedano Laura, Diaz-Gongora Rosa, Tello-Ccente Lizziee, Castillo Erick, Bernal Edson, Gonzales-Viera Omar, Gilman Robert H, Verastegui Manuela R, Nash Theodore E, Gonzalez Armando E, Garcia Hector H, Bustos Javier A
Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru.
Carrera de Medicina Veterinaria y Zootecnia, Universidad Cientifica del Sur, Lima, Peru.
PLoS Negl Trop Dis. 2025 May 5;19(5):e0013022. doi: 10.1371/journal.pntd.0013022. eCollection 2025 May.
Calcified neurocysticercosis (NCC), the end stage of brain cysts of the pork tapeworm Taenia solium is a common cause of epilepsy. Calcified NCC lesions are not inert and represent potential epileptogenic foci. Understanding the mechanisms of residual calcification in NCC is hindered by the difficulty of accessing human brain biopsies. Since cyst degeneration can be induced by antiparasitic treatment (APT) in NCC-infected pigs, this study assessed the residual calcification process in this model at three time points after APT.
METHODS/PRINCIPAL FINDINGS: Fifteen naturally infected pigs with viable NCC confirmed by magnetic resonance imaging received APT with albendazole and praziquantel and were sacrificed after 4, 8, and 12 months (n = 5 each). The pigs' brains were removed and processed by ex vivo CT scan to assess the proportion of cysts that calcified by post-treatment time points using risk ratios (RR) from Poisson regression. Radiodensity levels (Hounsefield units) of calcified lesions were also measured and compared using linear coefficients from log-transformed values in generalized linear models. The overall proportion of residual calcification on CT scan was 63.9% (156 calcified lesions/244 viable cysts), being statistically higher in treated NCC pigs at 4 months (83.3% [50/60], RR = 2.61, P < 0.001) and 8 months (82.8% [77/93], RR = 2.59, P < 0.001) versus 12 months (31.9% [29/91]). At 8 months after APT, calcifications were more dense (100.6 ± 3.6 HU) compared to 12 months (74.4 ± 3.6 HU, β = 0.37, P = 0.010) and marginally higher compared to 4 months (85.2 ± 3.8 HU, β = 0.24, P = 0.096), and were also larger and more frequently found on histopathology.
CONCLUSION/SIGNIFICANCE: Calcification in NCC is a dynamic process that can be induced and monitored in naturally infected pigs. Eight months after treatment seems to be an optimal time point for assessing residual calcification.
钙化性神经囊尾蚴病（NCC）是猪带绦虫脑囊肿的终末期，是癫痫的常见病因。钙化性NCC病变并非无活性，而是潜在的致痫灶。获取人脑活检的困难阻碍了对NCC中残留钙化机制的理解。由于在感染NCC的猪中，抗寄生虫治疗（APT）可诱导囊肿退变，本研究在APT后的三个时间点评估了该模型中的残留钙化过程。
方法/主要发现：15头经磁共振成像证实患有活NCC的自然感染猪接受了阿苯达唑和吡喹酮的APT治疗，并在4、8和12个月后处死（每组n = 5头）。取出猪脑并通过离体CT扫描进行处理，使用泊松回归的风险比（RR）评估治疗后各时间点钙化囊肿的比例。还测量并比较了钙化病变的放射密度水平（亨氏单位），使用广义线性模型中对数转换值的线性系数进行比较。CT扫描上残留钙化的总体比例为63.9%（156个钙化病变/244个活囊肿），在治疗后的NCC猪中，4个月时（83.3% [50/60]，RR = 2.61，P < 0.001）和8个月时（82.8% [77/93]，RR = 2.59，P < 0.001）的比例在统计学上高于12个月时（31.9% [29/91]）。APT后8个月时，钙化更致密（100.6 ± 3.6 HU），与12个月时（74.4 ± 3.6 HU，β = 0.37，P = 0.010）相比有显著差异，与4个月时（85.2 ± 3.8 HU，β = 0.24，P = 0.096）相比略高，并且在组织病理学上也更大且更常见。
结论/意义：NCC中的钙化是一个动态过程，可在自然感染的猪中诱导和监测。治疗后8个月似乎是评估残留钙化的最佳时间点。
