Previous Exposure to the Fish Parasite Anisakis as a Potential Risk Factor for Gastric or Colon Adenocarcinoma

Abstract

Anisakiasis is a global disease caused by consumption of raw or lightly cooked fish contaminated with L3 Anisakis spp. larvae. High rates of parasitization of fish worldwide make Anisakis a serious health hazard. In fact, anisakiasis is a growing disease in countries such as Spain, Italy, and Japan, where consumption of raw/marinated fish is high.Some parasitic infections have been recognized as a causative factor for human cancer. Suggested mechanisms include chronic inflammation elicited by the parasite, and a possible tumorigenic effect from certain parasitic secretions.Anisakis can produce persistent local inflammation and granuloma, and larvae have been incidentally found in gastrointestinal (GI) tumors. Our aim was to discover possible differences in the prevalence of unnoticed or asymptomatic previous Anisakis infection in GI cancer patients compared with healthy individuals. Serum levels of specific antibodies against Anisakis antigens were used as a reliable marker of previous contact with their larvae.Ninety-four participants without a previous history of Anisakis infection were prospectively allocated into 1 of 2 groups: 47 patients with GI cancer and 47 controls. Specific IgE, IgA1, and IgG1 against the Anisakis recombinant antigens Ani s 1, Ani s 5, Ani s 9, and Ani s 10 were determined by an ELISA assay.The ratio of positivity to sIgA1, rAni s 1, or rAni s 5 was significantly higher in the cancer patients than in the controls (38.30% vs 6.38%, P < 0.001) and (42.55% vs 10.64%, P < 0.001, respectively). When disaggregated by type of tumor, the patients with gastric cancer showed a higher proportion of positive results for sIgA1 to rAni s 1 (P < 0.001), whereas a higher proportion of colon cancer patients were shown to be positive for sIgA1 to both rAni s 1 (P < 0.05) and rAni s 5 (P < 0.01).Earlier Anisakis infection might be a risk factor for the development of stomach or colon cancer.

Urticaria and silent parasitism by Ascaridoidea: Component-resolved diagnosis reinforces the significance of this association

“…Data on anti-Ani s 1 specific IgE from the literature are restricted to mainly healthy subjects or allergic patients, and the prevalence shown in these studies is similar to that obtained in the present investigation [55,64]. Martínez Aranguren et al (2014) studied the antibody responses against Ani s 1 and tropomyosin and suggested that the use of recombinant versions makes it possible to distinguish between patients allergic to A. simplex and patients with acute urticaria who are merely sensitized to A. simplex [63].…”

Anisakis sensitization in different population groups and public health impact: A systematic review

“…Although case-control studies alone are not sufficient to assess causality relationships, the significant higher ratio of positivity to secretory IgA1, rAni s1, or rAni s5 found by Garcia-Perez et al in 47 gastric cancer patients as compared to 47 healthy controls (38.3% vs 6.4%, p-value <0.001 and 42.6% vs 10.6%, p-value <0.001, respectively), together with the evidence that some parasites inducing chronic inflammation may trigger cancer, and that Anisakis larvae have been co-localised incidentally in cases of gastro-intestinal tumours, could suggest that Anisakis infection might be a risk factor for the development of digestive tract cancer [ 33 ]. Parasites gastrointestinal lesions often mimic ulcers, so that patients diagnosed with digestive bleeding may suffer from unrecognized anisakiasis, explaining the high prevalence of specific antibodies and immunoblot bands of Anisakis reference serum [ 32 ].…”

“…Total immunoglobulins (Igs), IgE, IgM, IgA1, IgG1, IgG4, antibodies against Anisakis crude extract, excretory-secretory antigens and recombinant antigens Ani s1, Ani s3, Ani s5, Ani s9, and Ani s10 are first detected by incubation with subjects’ serum samples and then revealed using an anti-human Igs labelled with radioactive or fluorescent marker [ 11 , 30 – 33 ].…”

Anisakis – immunology of a foodborne parasitosis

“…52 Recently, higher levels of specific IgA directed at recombinant Anisakis proteins rAni s1 and rAni s5 were detected in patients with gastric cancer compared to controls; however, there was no significant difference in levels of Anisakis-specific IgG1 or IgE, which would normally be detected after Anisakis infection. 53 Therefore, to date, there is no evidence linking Anisakis infection to the development of gastric cancer. Many pathogens associated with intense or persistent inflammation and tissue damage, including DNA damage, are associated with carcinoma.…”

“…On the other hand, it has also been suggested that Anisakis infection could be a cofactor for development of gastric cancer . Recently, higher levels of specific IgA directed at recombinant Anisakis proteins rAni s1 and rAni s5 were detected in patients with gastric cancer compared to controls; however, there was no significant difference in levels of Anisakis ‐specific IgG1 or IgE, which would normally be detected after Anisakis infection . Therefore, to date, there is no evidence linking Anisakis infection to the development of gastric cancer.…”