Effect of treatment with free and liposomized albendazole on selected immunological parameters and cyst growth in mice infected with Echinococcus multilocularis

Abstract52-years old man years following the kidney transplantation from deceased donor was admitted to the hospital with fever and progressive abdominal pain. The patient was diagnosed with chronic hepatitis C seven years before admission. Graft function in posttransplant period was stable and optimal, the patient was treated with standard maintenance immunosupresive protocol (cyclosporine A, mycophenolate mofetil and low-dose prednison), metylprednisolon bolus therapy (1 g/m2 body surface area), was administered two months prior to admission due to creeping creatinine (suspection of acute rejection was not confirmed by biopsy). Empiric antibiotic treatment due to febrile status was ineffective. Abdominal ultrasound and computer tomography (CT) scan revealed three tumorous lesions in the liver, radical surgical intervention was not executable. Histological examination of the tissue from the lesions demostrated alveolar echinococcosis, serology for Echinoccocus multilocularis was positive. Long-term treatment by mebendazol 200 mg twice daily led to disappearance of the clinical symptoms, but after the therapy cessasion patient was again hospitalized with fever and progression of cystic lesions in CT scan. Following the mebendazol therapy reinstalation the clinical course of echinococcosis was improved and remained stable, transplant kidney failure occurred due to progression of interstitial fibrosis/tubular atrophy and chronic haemodialysis was initiated one year later.

Section: A 1bmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Alveolar echinococcosis in patient after cadaveric kidney transplantation

Dražilová¹,

Kinčeková

Beňa³

et al. 2011

“…Antiparasitic chemotherapy also stimulates IFN-gamma secretion while elevated IFN-gamma levels increase the effectiveness of antiparasitic chemotherapy (Borošková et al, 2003). Dvorožňáková et al (2004) treated mice infected with Echinococcus multilocularis by free or liposomized albendazole. Besides identifying the effect on cyst growth, the authors observed that only moderate IFNgamma elevation was detected after treatment with free albendazole, however, a profound increase of its concentration was observed shortly after administration of liposomized albendazole.…”

Section: Discussionmentioning

confidence: 99%

Regression of alveolar echinococcosis after chronic viral hepatitis C treatment with pegylated interferon alpha 2a

Dražilová¹,

Kinčeková

Beňa³

et al. 2012

We present a case of 53 years old patient with transplanted kidney, chronic hepatitis C and alveolar echinococcosis who was treated with pegylated interferon α which resulted in regression and calcification of Echinococcus multilocularis loculi. Patient had been diagnosed with chronic hepatitis C two years after kidney transplantation. Hepatitis was left untreated because of immunosuppressive treatment and satisfactory graft function. Nine years after transplantation the patient was diagnosed with alveolar echinococcosis and treated with mebendazole 2 × 200 mg daily for 6 months. Cessation of temporary treatment resulted in echinococcosis progression with appearance of secondary loculi and a small ascites after which mebendazole was restarted. Ten years after transplantation, kidney graft failure occurred and the patient was started on hemodialysis in conjunction with pegylated-interferon alpha 2a for treatment of chronic viral hepatitis C. Complete early viral response was observed 3 months after therapy initiation while a follow-up CT scan after 4 months did not document any changes in the number or size of E. multilocularis loculi. A completed course of antiviral therapy resulted in sustained viral response while a subsequent second follow-up CT scan 6 months after cessation of antiviral therapy documented regression and calcification of main E. multilocularis loculi along with resolution of secondary loculi and ascites.

“…Cells were then incubated with directly-labelled rat anti-mouse CD4+ fluorescein isothiocyanate-conjugated and rat antimouse CD8+ phycoerythrin-conjugated monoclonal antibodies (Becton Dickinson Biosciences, PharMingen, Belgium) at the concentration 0.4 μg/10 6 cells at 4 °C for 30 min. After washing of cells three times with PBS containing 0.1 % sodium azide, their number was analysed by Flow cytometry method (Dvorožňáková et al, 2000). Data for 10 4 cells per sample falling within forward scatter (FSC) and side scatter (SSC) set for lymphocytes were collected with a FACScan flow cytometer (Becton Dickinson Biosciences, Germany).…”

Section: Detection Of Cd4+ and Cd8+ T Lymphocytesmentioning

confidence: 99%

“…Larvocysts develop in different organs of intermediate hosts, as well as in humans (Eckert & Deplazes, 1999;Vuitton, 2002). Secondary infection model, where mice are injected intraperitoneally with isolated protoscoleces from metacestode material, is characterised by switch from Th1 immune response in the early infection phase to Th2 response during chronic infection (Dvorožňáková et al, 2004). This type of alveolar echinococosis infection lacks the "early antigen phase", when the oncosphere and the early developing metacestode are presented to the immune system, and has an atypical localisation of the metacestode (peritoneal cavity).…”

Section: Introductionmentioning

confidence: 99%

Influence of Echinococcus multilocularis infection on immune response of mice and their offspring

Reiterová

Antolová

2011

SummaryParasitic infection during pregnancy represents a serious stress factor and affects the course of pregnancy and the foeto-maternal relationship. The infection may not clinically manifest itself, however it can modulate the immune response of the offspring for a long-time. The influence of secondary Echinococcus multilocularis infection on the proportion of CD4+ and CD8+ T cells and the level of anti-Echinococcus antibodies were studied in Balb/c mice. The female mice were infected with homogenised metacestode material containing 2000 E. multilocularis protoscoleces (Group 1, 2). Group 1 was fertilised on day 60 post infection, while Group 2 remained unfertilised. Group 3 was uninfected and fertilised on the same day as Group 1. The numbers of both T cell subpopulations were higher in non-pregnant than in pregnant mice. In late pregnancy, the decline of CD4+, however, the increase of CD8+ T-cell subtypes were observed in both, infected and uninfected mothers, respectively. The strong humoral response with the high production of IgM and IgG2b antibodies in infected mice was detected. In infected mothers, IgG2b level was higher than in infected nonpregnant mice during almost whole monitored period. In Group 1, delivery caused suppression of Th2 immune response, represented by IgG1, under the level observed in uninfected mothers. The findings show the changes in helper regulatory and cytotoxic immunity mechanisms of infected mothers. In offspring of infected mothers all IgG subclasses were detected, however specific IgM were not transmitted neither transplacentary, nor transmammary.