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PLoS Neglected Tropical Diseases Aug 2022Paragonimus kellicotti is a zoonotic lung fluke infection, the agent of North American paragonimiasis, and an excellent model for other Paragonimus infections. The...
Paragonimus kellicotti is a zoonotic lung fluke infection, the agent of North American paragonimiasis, and an excellent model for other Paragonimus infections. The excretory/secretory proteins (ESP) released by parasites and presented at the parasite-host interface are frequently proposed to be useful targets for drugs and/or vaccines In vitro culture conditions may alter ESP compared to those produced in vivo. In order to investigate ESPs produced in vivo we took advantage of the fact that adult P. kellicotti reproduce in the lungs of experimentally infected gerbils in tissue cysts. We performed a mass-spectrometric analysis of adult P. kellicotti soluble somatic protein (SSPs) extracts, excreted/secreted proteins (ESPs) produced by adult worms during in vitro culture, and lung cyst fluid proteins (CFPs) from experimentally infected gerbils. We identified 2,137 P. kellicotti proteins that were present in at least two of three biological replicates and supported by at least two peptides. Among those were 1,914 proteins found in SSP, 947 in ESP and 37 in CFP. In silico analysis predicted that only 141 of the total 2,137 proteins were secreted via classical or non-classical pathways. The most abundant functional categories in SSP were storage and oxidative metabolism. The most abundant categories in ESP were proteins related to metabolism and signal transduction. The 37 parasite-related proteins in CFP belonged to 11 functional categories. The largest groups were proteins with unknown function, cytoskeletal proteins and proteasome machinery. 29 of these 37 proteins were shared among all three sample types. To our knowledge, this is the first study that compares in vitro and in vivo ESP for any Paragonimus species. This study has provided new insights into ESPs of food-borne trematodes that are produced and released in vivo. Proteins released at the host-parasite interface may help the parasite evade host immunity and may represent new targets for novel treatments or diagnostic tests for paragonimiasis.
Topics: Animals; Cysts; Gerbillinae; Lung; Lung Diseases; Paragonimiasis; Paragonimus; Proteomics
PubMed: 35976975
DOI: 10.1371/journal.pntd.0010679 -
GigaScience Jul 2020Paragonimus spp. (lung flukes) are among the most injurious foodborne helminths, infecting ∼23 million people and subjecting ∼292 million to infection risk....
BACKGROUND
Paragonimus spp. (lung flukes) are among the most injurious foodborne helminths, infecting ∼23 million people and subjecting ∼292 million to infection risk. Paragonimiasis is acquired from infected undercooked crustaceans and primarily affects the lungs but often causes lesions elsewhere including the brain. The disease is easily mistaken for tuberculosis owing to similar pulmonary symptoms, and accordingly, diagnostics are in demand.
RESULTS
We assembled, annotated, and compared draft genomes of 4 prevalent and distinct Paragonimus species: Paragonimus miyazakii, Paragonimus westermani, Paragonimus kellicotti, and Paragonimus heterotremus. Genomes ranged from 697 to 923 Mb, included 12,072-12,853 genes, and were 71.6-90.1% complete according to BUSCO. Orthologous group analysis spanning 21 species (lung, liver, and blood flukes, additional platyhelminths, and hosts) provided insights into lung fluke biology. We identified 256 lung fluke-specific and conserved orthologous groups with consistent transcriptional adult-stage Paragonimus expression profiles and enriched for iron acquisition, immune modulation, and other parasite functions. Previously identified Paragonimus diagnostic antigens were matched to genes, providing an opportunity to optimize and ensure pan-Paragonimus reactivity for diagnostic assays.
CONCLUSIONS
This report provides advances in molecular understanding of Paragonimus and underpins future studies into the biology, evolution, and pathogenesis of Paragonimus and related foodborne flukes. We anticipate that these novel genomic and transcriptomic resources will be invaluable for future lung fluke research.
Topics: Animals; Computational Biology; Disease Susceptibility; Gene Expression Profiling; Gene Ontology; Genomics; Host-Parasite Interactions; Humans; Molecular Sequence Annotation; Multigene Family; Paragonimiasis; Paragonimus; Phylogeny; Transcriptome
PubMed: 32687148
DOI: 10.1093/gigascience/giaa073 -
Radiology Case Reports May 2022More than 40 different species of the parasitic flatworm have been identified worldwide, including in Vietnam, but only 10 species are known to cause disease in humans,...
More than 40 different species of the parasitic flatworm have been identified worldwide, including in Vietnam, but only 10 species are known to cause disease in humans, particularly are transmitted through the ingestion of raw foods, especially freshwater shrimp, and crab. Paragonimiasis causes pneumonia, which can present as acute or chronic, with symptoms including prolonged cough, chest pain, shortness of breath, and hemoptysis. Hematologic changes include eosinophilia and the presence of specific antibodies for in the blood. Diagnosis is confirmed when specimens or eggs are found in the sputum or pleural fluid. The specificity of imaging is not high, but imaging can be used to guide the diagnosis. After the failure of microbiological diagnostic methods, lung biopsy can be used to confirm a diagnosis of paragonimiasis. We present a paragonimiasis case associated with unique features, including epidemiologic factors, atypical clinical signs, no increases in blood eosinophils, and negative microbiological tests. Although the patient was suspected of tuberculosis or lung cancer, imaging studies were consistent with the presence of lung flukes. Three transthoracic lung biopsies were performed, and pathology revealed a cystic structure containing on the third biopsy.
PubMed: 35309377
DOI: 10.1016/j.radcr.2022.02.046 -
Parasites & Vectors Feb 2020Trichinella spiralis muscle larval (ML) excretion/secretion (ES) antigen is the most widely used diagnostic antigen of trichinellosis, but preparation of ES antigen...
BACKGROUND
Trichinella spiralis muscle larval (ML) excretion/secretion (ES) antigen is the most widely used diagnostic antigen of trichinellosis, but preparation of ES antigen requires collecting worms from infected animals, and detection of specific IgG against ML ES antigen may result in a false negative at the early stage of infection. The aim of the study was to characterize T. spiralis elastase-1 (TsEla) and to evaluate its potential as diagnostic antigen for trichinellosis.
METHODS
The complete cDNA sequences of the TsEla gene were cloned and expressed, and recombinant (rTsEla) was purified. TsEla transcription and expression in different T. spiralis life-cycle stages was investigated by qPCR and western blotting, and its location in the nematodes was evaluated using an immunofluorescence assay (IFA). The antigenicity of rTsEla was investigated by western blotting analysis and ELISA. Anti-Trichinella IgG, IgM and IgE of experimentally infected mice and specific IgG antibodies of trichinellosis patients were assayed by rTsEla-ELISA and ES-ELISA.
RESULTS
The results of the qPCR and western blotting showed that TsEla was expressed in various T. spiralis life stages. Natural TsEla was detected in the soluble proteins and ES proteins of different life stages. IFA revealed that TsEla was identified in the whole nematodes of various stages, especially in the cuticle, stichosome and genital primordium of the parasite. Serum anti-Trichinella IgM, IgG and IgE in infected mice was first detected by rTsEla-ELISA at 6, 10 and 12 days post-infection (dpi), and reached 100% at 8, 14 and 14 dpi, respectively. When rTsEla-ELISA and ES-ELISA were used to detect anti-Trichinella IgG in sera of trichinellosis patients, the sensitivity was 97.37% (37/38) and 89.74% (34/38) (P > 0.05), and the specificity was 99.10% (220/222) and 98.20% (218/222), respectively (P > 0.05). The rTsEla cross-reacted with only one serum sample out of 20 samples from paragonimiasis patients and 7 samples from clonorchiasis patients.
CONCLUSIONS
rTsEla is valuable to early diagnosis of trichinellosis and could be an alternative diagnostic antigen to the ML ES antigens.
Topics: Amino Acid Sequence; Animals; Antibodies, Helminth; Antigens, Helminth; Blotting, Western; Enzyme-Linked Immunosorbent Assay; Female; Helminth Proteins; Humans; Life Cycle Stages; Mice, Inbred BALB C; Pancreatic Elastase; Sequence Alignment; Trichinella spiralis; Trichinellosis
PubMed: 32093735
DOI: 10.1186/s13071-020-3981-y -
The Journal of International Medical... Jun 2021Paragonimiasis is a disease caused by parasitic infections that mainly involve the lungs. However, it can also produce ectopic infections, such as when the parasites...
Paragonimiasis is a disease caused by parasitic infections that mainly involve the lungs. However, it can also produce ectopic infections, such as when the parasites invade the liver, brain and subcutaneous tissue, which then cause different symptoms. This current case report describes a 55-year-old male patient with hepatic paragonimiasis that was misdiagnosed as liver cancer with rupture and haemorrhage. The initial computed tomography findings suggested ruptured liver cancer. The patient underwent laparoscopic right hemihepatectomy. Postoperative pathological analysis resulted in a diagnosis of hepatic paragonimiasis. The patient recovered well postoperatively and was treated with 25 mg/kg praziquantel orally three times a day for 3 days after discharge with good efficacy. In this present case, the rupture and haemorrhage of the liver mass made it difficult for the treating physicians to consider hepatic paragonimiasis, which lead to the initial misdiagnosis of this patient. Although paragonimiasis is very rare, medical staff should be vigilant and have a comprehensive understanding of the different diseases that can cause liver masses so that misdiagnosis can be avoided.
Topics: Carcinoma, Hepatocellular; Diagnostic Errors; Hemorrhage; Humans; Liver Neoplasms; Male; Middle Aged; Paragonimiasis
PubMed: 34098756
DOI: 10.1177/03000605211012668 -
Der Pneumologe 2020This article describes viral, bacterial, fungal and parasitic infections, which are not endemic and little known in Germany. Avian influenza, Middle East respiratory...
This article describes viral, bacterial, fungal and parasitic infections, which are not endemic and little known in Germany. Avian influenza, Middle East respiratory syndrome (MERS) and the plague can all lead to severe pulmonary complications with a high mortality. In addition, there is a risk of nosocomial spread and therefore patients must always be isolated. Melioidosis, blastomycosis, paracoccidioidomycosis, and histoplasmosis are primarily often misclassified as community-acquired pneumonia due to typical causative organisms. A detailed anamnesis focussing on exposure in endemic areas is key to the diagnosis. Paragonimiasis is often manifested a few weeks after consumption of raw seafood and pronounced eosinophilia is typical. Relevant aspects of the epidemiology, clinical course, treatment and, if applicable, prevention are presented as cases of these diseases can occur at any time in Germany.
PubMed: 33162874
DOI: 10.1007/s10405-020-00352-3 -
Thoracic Cancer Apr 2022Pleural biopsies for investigating the causes of pleurisy are performed through modalities including needle biopsies, local anesthetic thoracoscopic procedures, and...
BACKGROUND
Pleural biopsies for investigating the causes of pleurisy are performed through modalities including needle biopsies, local anesthetic thoracoscopic procedures, and surgery (video-assisted thoracoscopic surgery and open thoracotomy). To date, there have been no large-scale nationwide epidemiological studies regarding pleurisy diagnosed via surgical pleural biopsy. This study examined the epidemiology of pleurisy diagnosed via surgical pleural biopsy in a Japanese nationwide administrative database.
METHODS
We evaluated Japanese Diagnosis Procedure Combination data of 24 173 patients who underwent video-assisted thoracoscopic surgery or open thoracotomy and received a diagnosis of pleurisy between April 2014 and March 2020. In addition to pleurisy diagnoses, the patients' clinical information, including age, sex, smoking status (pack-years), dyspnea grade, length of in-hospital stay, and comorbidities, were extracted from the dataset.
RESULTS
This study included data from 1699 patients. The most frequent causes of pleurisy were neoplastic diseases (55.9%; malignant mesothelioma 22.5%, lung cancer 15.7%, lymphoma 2.5%), followed by infectious diseases (24.0%; tuberculosis 16.2%, parapneumonic pleural effusion 3.6%, empyema 3.5%, nontuberculous mycobacteriosis 0.5%), collagen vascular diseases (2.8%; rheumatoid arthritis 1.3%, immunoglobulin G4-related diseases 0.7%, systemic lupus erythematosus 0.3%), and paragonimiasis (0.1%).
CONCLUSIONS
Neoplastic diseases, including malignant mesothelioma and lung cancer, were frequently and accurately diagnosed as pleurisy via surgical pleural biopsy. The next leading cause was infectious diseases such as mycobacterial infections. Physicians should consider performing surgical biopsy in light of the knowledge regarding the etiology of pleurisy when a definitive diagnosis cannot be made via needle pleural biopsy.
Topics: Biopsy; Humans; Lung Neoplasms; Mesothelioma, Malignant; Pleural Effusion; Pleurisy; Thoracic Surgery, Video-Assisted
PubMed: 35243795
DOI: 10.1111/1759-7714.14368 -
Journal of Cardiothoracic Surgery Mar 2021To summarize the clinical characteristics of adult cases of paragonimiasis with lung masses as the main manifestation in Xishuangbanna, Yunnan Province, analyze the...
OBJECTIVE
To summarize the clinical characteristics of adult cases of paragonimiasis with lung masses as the main manifestation in Xishuangbanna, Yunnan Province, analyze the causes of misdiagnosis, and improve the levels of clinical diagnosis and treatment.
METHOD
We conducted a retrospective analysis of the clinical data and diagnosis and treatment of 8 adult cases of paragonimiasis with lung masses as the main manifestation that were diagnosed in the Oncology Department of People's hospital of Xishuangbanna Dai Autonomous Prefecture from July 2014 to July 2019.
RESULT
All 8 patients were from epidemic paragonimiasis areas and had a confirmed history of consuming uncooked freshwater crabs. The clinical manifestations were mainly fever, dry cough, and chest pain. The disease durations were long, and peripheral blood eosinophil counts were elevated. The cases had been misdiagnosed as pneumonia or pulmonary tuberculosis. After years of anti-inflammatory or anti-tuberculosis treatment, the symptoms had not improved significantly. Patients eventually sought treatment from the oncology department for hemoptysis. Chest computed tomography showed patchy consolidation in the lungs, with nodules, lung masses, and enlarged mediastinal lymph nodes.
CONCLUSION
Paragonimiasis is a food-borne parasitic disease. Early clinical manifestations and auxiliary examination results are nonspecific. The parasite most often invades the lungs, and the resulting disease is often misdiagnosed as pneumonia, pulmonary tuberculosis, or lung cancer (Acta Trop 199: 05074, 2019). To avoid misdiagnosis, clinicians should inquire, in detail, about residence history and history of unclean food and exposure to infected water and make an early diagnosis based on the inquired information and imaging examination results. For patients who have been diagnosed with pneumonia or pulmonary tuberculosis and whose symptoms do not improve significantly after anti-inflammatory or anti-tuberculosis treatments, their epidemiological history should be traced to further conduct differential diagnosis and avoid misdiagnosis.
Topics: Animals; Antibodies, Helminth; China; DNA, Helminth; Diagnosis, Differential; Diagnostic Errors; Enzyme-Linked Immunosorbent Assay; Female; Humans; Incidence; Lung; Lung Diseases, Parasitic; Male; Middle Aged; Paragonimiasis; Paragonimus; Retrospective Studies; Thorax; Tomography, X-Ray Computed
PubMed: 33741016
DOI: 10.1186/s13019-021-01408-y -
World Journal of Clinical Cases Jan 2021Paragonimiasis is a parasitic disease that has multiple symptoms, with pulmonary types being common. According to our clinical practices, the pleural effusion of our...
BACKGROUND
Paragonimiasis is a parasitic disease that has multiple symptoms, with pulmonary types being common. According to our clinical practices, the pleural effusion of our patients is full of fibrous contents. Drainage, praziquantel, and triclabendazole are recommended for the treatment, but when fibrous contents are contained in pleural effusion, surgical interventions are necessary. However, no related reports have been noted. Herein, we present a case of pulmonary paragonimiasis treated by thoracoscopy.
CASE SUMMARY
A 12-year-old girl presented to our outpatient clinic complaining of shortness of breath after exercise for several days. Enzyme-linked immunosorbent assay revealed positivity for antibodies against , serological test showed eosinophilia, and moderate left pleural effusion and calcification were detected on computed tomography (CT). She was diagnosed with paragonimiasis, and praziquantel was prescribed. However, radiography showed an egg-sized nodule in the left pleural cavity during follow-up. She was then admitted to our hospital again. The serological results were normal except slight eosinophilia. CT scan displayed a cystic-like node in the lower left pleural cavity. The patient underwent a thoracoscopic mass resection. A mass with a size of 6 cm × 4 cm × 3 cm adhered to the pleura was resected. The pathological examination showed that the mass was composed of non-structured necrotic tissue, indicating a granuloma. The patient remainded asymptomatic and follow-up X-ray showed complete removal of the mass.
CONCLUSION
This case highlights that thoracoscopic intervention is necessary when fibrous contents are present on CT scan or chest roentgenogram to avoid later fibrous lump formation in patients with pulmonary paragonimiasis.
PubMed: 33553406
DOI: 10.12998/wjcc.v9.i3.666 -
Respiratory Medicine Case Reports 2023As a rare zoonotic helminth disease, paragonimiasis is easy to be misdiagnosed. Adequate attention to the medical history of the patient and early detection of...
As a rare zoonotic helminth disease, paragonimiasis is easy to be misdiagnosed. Adequate attention to the medical history of the patient and early detection of serological antibodies can improve the diagnosis rate. Praziquantel and trichlorobendazole are commonly used for treatment, and the prognosis is good. This case report mainly introduces the classification, diagnosis, and treatment of paragonimiasis, with an aim to draw the attention of doctors to the disease.
PubMed: 37197157
DOI: 10.1016/j.rmcr.2023.101847