Immunological Characteristics of Recurrent Echinococcosis-Induced Anaphylactic Shock

Abstract

Abstract. Anaphylactic shock represents a serious complication of echinococcosis as up to 4.6% of patients die as a result of its severity and improper handling. Once a definite diagnosis is made, effective treatments need to be immediately initiated. Here, we report the immunological characteristics and management of two patients with recurrent anaphylactic shock concurrent with the surgical removal of hydatid cysts. Both patients had systemic echinococcosis classified as cystic echinococcosis type 2 (CE2) with multiple, immature cysts (absence of calcification and necrosis). In addition, both patients had increased eosinophils and basophils before surgery, as well as elevated crude hydatid cyst fluid antigen (anti-EgCF) and hydatid cyst fluid native antigen B (anti-EgB) antibodies and high IgG levels. Although we cannot definitively predict which patients are at risk for cyst fluid leakage or anaphylactic shock at present, clinicians may consider taking precautions before surgery on encountering patients with a similar profile to prevent the occurrence of anaphylactic shock and the likelihood of a second incident. However, these observations need to be confirmed in further studies with a larger number of patients.

The regulatory role of differential microRNA expressions on cellular inflammatory factors IL‐6 and IL‐10 in Echinococcus granulosus‐induced anaphylaxis

“…When endothelial cells detach from the underlying extracellular matrix, apoptosis occurs, resulting in endothelial cell damage due to TLR4 activation and inflammatory factors such as TNF‐α 35 . A significant increase in inflammatory factors such as TNF‐α has also been observed in previous studies, 6 which induce cellular apoptosis 36 and pyroptosis 37 while promoting an inflammatory response in cells and tissues. FAK tyrosine phosphorylation can inhibit cellular apoptosis through the PI3K signaling pathway 35 .…”

“…However, an increase in neutrophils would result in pyroptosis by secreting IL‐1β 34 . Previous research has also documented the activation and increase in neutrophils 6 . In the focal adhesion signaling pathway, focal adhesion kinase (FAK) is an essential part of the basal cell adhesion, which is called the focal adhesion complex.…”

“…Additionally, it can be used to simultaneously analyze and predict target genes that are regulated by DEMs. The expressions of interleukin 10 (IL‐10) and IL‐6 were significantly increased during anaphylaxis in patients with cystic echinococcosis, according to previous studies, 6,7 and IL‐10 and IL‐6 play a crucial role in the occurrence and development of a variety of inflammatory diseases 8,9 . At the same time, IL‐10 is closely associated with the impairment of cellular function caused by pyroptosis and apoptosis 10,11 .…”

Anaphylaxie bei rupturierter Echinokokkuszyste

“…Den Schaden richten die Parasiten erst im Verlauf an, wobei Leber und Lunge zu 90 % die primären Zielorgane sind [5]. Im Abdomen führen Rupturen der Zysten primär zur Anaphylaxie, die in 4,6 % letal verläuft, und zum akuten Abdomen mit Ileus [2,5,6]. Rupturen können selten spontan (1-8 %), häufiger traumatisch entstehen, wobei schon eine vermehrte körperliche Belastung [2,7] ausreichen kann.…”

A CT-based radiomics nomogram for the differentiation of pulmonary cystic echinococcosis from pulmonary abscess

“…If misdiagnosed, secondary infections and severe allergic reactions can occur. When the lesion is punctured and drained, it will also cause hydatid fluid and hydatid sand protoscoleces to leak and spread, which will affect the human body, causing greater harm (Ye et al 2016 ; Mohammed et al 2021 ). Therefore, it is very important to improve the differential diagnosis of pulmonary CE and pulmonary abscess.…”