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Sandwich enzyme-linked immunosorbent assay for detection of excretory secretory antigens in humans with fascioliasis.

A sandwich enzyme-linked immunosorbent assay has been developed for the detection of Fasciola hepatica excretory secretory (ES) antigens in stool specimens of infected humans. The assay uses antibodies against F. hepatica ES antigens. A monoclonal antibody (ES78, mouse immunoglobulin G2a) was used to capture ES antigens, and a rabbit polyclonal antibody, peroxidase conjugate, was used to identify ES antigens. Thirteen of 14 patients with parasitological evidence of fascioliasis had a detectable concentration of ES antigens (more than 15 ng/ml). None of the stool specimens from controls and from patients with parasites other than F. hepatica showed a positive reaction, suggesting the absence of cross-reactions in this assay. When the 14 patients were retested 2 months after treatment, all of the specimens from the 11 parasitologically cured patients were negative by the antigen detection assay while the specimens from the 3 patients with persisting F. hepatica eggs in their stools remained positive.

Animals↗

Human fascioliasis in Shropshire.

Five patients with fascioliasis presented with malaise, pruritus, and pain in the right hypochondrium. Eosinophilia, increase in serum gamma globulin, and pyrexia were other features. Four patients treated with oral bithionol recovered completely and it is suggested that this is an effective form of therapy. The double diffusion precipitin test, being speedy and simple, was used as a screening procedure for diagnosis. The source of infection was wild watercress growing in a farm ditch.

Administration, Oral↗

Fascioliasis--a large outbreak.

Forty-four cases of liver fluke infestation (fascioliasis hepatica) were diagnosed near Chepstow, Monmouthshire, in 1968. Intramuscular emetine hydrochloride and oral chloroquine given to the adults and children, respectively, were well tolerated. Assessment by repeated stool examination, complement fixation and liver function tests, and full blood counts indicated that treatment had been effective in most cases. It is recommended that both the growth and the sale of watercress should be strictly controlled.

Adolescent↗

The double diffusion precipitin test in human fascioliasis.

The recent outbreaks of human fascioliasis in Britain provided the opportunity for employing the double diffusion precipitin test in the diagnosis of this disease. In sensitivity and specificity this test appears to equal the complement-fixation test and has the advantages of simplicity and speed in its performance.

Antigens↗

Biochemical indicators of liver injury in calves with experimental fascioliasis.

Twenty calves were infected with 1000 metacercariae of Fasciola hepatica, the activities of 10 enzymes in plasma or serum were assayed and concentrations in serum of proteins, urea and bilirubin were determined. These values were compared with control data obtained from 14 uninfected calves. Aspartate aminotransferase, lactate dehydrogenase, sorbitol dehydrogenase, glutamate dehydrogenase, ornithine carbamoyl transferase and gamma-glutamyl transpeptidase activities increased in infected calves. Total serum protein increased, albumin decreased, globulin increased and the albumin/globulin ratio was decreased in infected calves. Plasma alanine aminotransferase, leucine aminopeptidase, alkaline phosphatase and cholinesterase activities and serum concentration of urea and bilirubin were unaffected. It was concluded that glutamate dehydrogenase and gamma-glutamyl transpeptidase were the most sensitive indicators of liver cell damage in fascioliasis.

Animals↗

Observations on the repeated treatment for fascioliasis of stock on a farm in south-west England.

The effects of a programme of repeated dosing of all stock for fascioliasis over a four year period on a north Devon farm is described. There was a decline in the average percentage of infection. Observations on the snail intermediate host and on a neighbouring farm suggested that at least some of the improvement was due to environmental factors. Although at the end of the period the level of infection was lower, there was no evidence that further intensification of the programme would lead to eradication.

Animals↗

Fascioliasis: findings in 15 patients.

The clinical and radiological features of 15 cases of fascioliasis are reported. Pleural effusion, associated with pulmonary infiltrates or ascites, was observed in two patients. Computed tomography (CT) was the most useful imaging method, showing small nodules and linear tracks within the liver parenchyma which were hypodense on non-enhanced scans, remaining hypodense or becoming isodense with normal liver after contrast medium administration. After successful treatment lesions decreased in number and size and finally disappeared or calcified. Lesions increased or remained unchanged when treatment failed to control the disease.

Adolescent↗

Eosinophilic proliferative pylephlebitis in the liver of Japanese beef cattle with fascioliasis.

Intrahepatic pylephlebitis was detected in 17 Japanese beef cattle. Grossly, the intrahepatic vessels in the caudate lobe and/or in the periphery of the other hepatic lobes were thickened and protruded above the lobar surface. The vessel lumina were packed with white to red, waste thread-like contents. A few immature flukes were found in the bile ducts in 3 of the 7 cases with biliary thickening. Foci of hepatic necrosis and hemorrhage were scattered around the thickened vessels in 8 cases. Histologically, the interlobular veins were thickened due to severe intimal hyperplasia with endothelial proliferation and eosinophilic accumulation and medial hypertrophy, accompanied by fibrosis and eosinophilic infiltration in the portal areas. Hepatic tissues with necrosis and hemorrhage were surrounded by eosinophils and histiocytes including a granulomatous reaction. One immature fluke was detected in one of these regions of necrosis. Immunoperoxidase staining revealed that the small fluke, Kupffer cells, and histiocytes in the liver of all cases were positively stained with anti-Japanese Fasciola sp. antiserum. Enzyme-linked immunosorbent assay of the sera of 15 cases revealed that all were positive for the anti-Fasciola antibody. On the basis of these findings, the present cases were regarded as an atypical form of fascioliasis, characterized by eosinophilic proliferative pylephlebitis of the liver.

Animals↗

[Fascioliasis: report of two cases from rural areas of Rio de Janeiro].

We describe two cases of fascioliasis from rural areas of Rio de Janeiro that are endemic for schistosomiasis, both of which were found during a coprological survey. The patient from Paracambi complained of dizziness. The patient from Sumidouro complained of dizziness, tiredness and cough. She was treated with praziquantel and her stool parasitological examination became negative.

Adult↗

Anatomical studies of sibling species within neotropical lymnaeids, snail intermediate hosts of fascioliasis.

Several anatomical parameters of the reproductive system have been used to distinguish Lymnaea cubensis from L. viatrix, the snail hosts of fascioliasis in South America and the Caribbean area. Three samples have been collected in the type localities of L. cubensis (Cuba), L. viatrix var. A ventricosa (Argentina, Río Negro Lower Valley), and L. viatrix var. B elongata (Peru, Lima), respectively. Only one parameter, the relative lengths of the penis sheath and preputium, showed significant differences between L. viatrix var. ventricosa and the two other taxa. None of the studied parameters separated L. cubensis from L. viatrix var. elongata.

Animals↗

Incidence of a subclinical fascioliasis on antipyrine clearance and metabolite excretion in sheep.

1. The pharmacokinetics of i.v. antipyrine (25 mg/kg) used as a model compound, were determined in young male sheep, before and each month after an oral infestation by 150 metacercariae of Fasciola hepatica, and 8 weeks following a flukicidal treatment. 2. The parasitic pathology was ascertained by the clinical observation of animals and the increase in plasma antibodies directed against liver flukes. 3. A significant decrease in the total plasma clearance of the drug occurred by week 4 to 16, and a 1.7 fold increase in mean residence time occurred by week 12 post-infection. 4. Urinary excretion of antipyrine metabolites was determined before and 8 weeks following the infestation. 4-Hydroxyantipyrine was the major urinary metabolite and its excretion was decreased by 30% in infected sheep, whereas there was no change in the excretion of norantipyrine, 3-hydroxymethylantipyrine or unmetabolized drug. 5. It is concluded that the impairment of antipyrine clearance in the course of fascioliasis could be related to the decrease in liver microsomal cytochrome P-450-dependent mono-oxygenases observed in sheep with a similar parasitic burden.

Animals↗

Disposition of prednisolone in the course of subclinical fascioliasis in sheep.

1. The in vivo disposition of prednisolone in sheep was studied before, during and after recovery from experimental hepatitis of parasitical origin (fascioliasis). 2. After i.v. administration, plasma clearance of prednisolone was increased from 0.93 +/- 0.13 l/kg per h before infection to 1.73 +/- 0.50 l/kg per h at week 21 post-infection. The steady state volume of distribution was increased from 0.45 +/- 0.08 l/kg during the control period to 1.26 +/- 0.44 l/kg at week 5 post-infection. 3. None of the prednisolone binding parameters (specific and non-specific sites) was modified, and the overall mean unbound fraction was 24%. 4. Urinary excretion of unchanged prednisolone was low and only a trace of 6 beta-hydroxy-prednisolone was identified.

Animals↗

Proline induced hemolytic anemia in fascioliasis.

A secondary anemia is characteristic of infections with the liver fluke, Fasciola hepatica, and previous studies had suggested that proline released by the worm might be involved in producing this condition. In the current study the effect of fascioliasis on erythropoiesis was compared to the effects of proline infusion. Both treatments produced effects characteristic of rapid erythrocyte turnover due to hemolysis. Moreover, infusion of a proline analog into animals with Fasciola or into animals infused with proline prevented the anemia. To our knowledge the production of hemolytic anemia by excessive proline has not been previously reported.

Anemia, Hemolytic↗

Subcutaneous fascioliasis: a case report.

A 32-year old housewife, living in Seoul, recognized incidentally a painless mass at the left chest wall. During later 3 months, she experienced spontaneous swelling and regression of the mass repeatedly for 4 times. Surgical resection showed a granuloma at anterior serratus muscle containing a nearly matured adult of Fasciola species without vitellaria and uterus. This is the 11th human fascioliasis and the first extra-abdominal infection reported in Korea.

Adult↗

A human case of invasive fascioliasis associated with liver abscess.

A 56 year-old Korean housewife/farmer/goat keeper suffered from right upper quadrant pain and fever with chills. In the abdominal sonogram and computerized tomography, multiple, 2-3 cm, irregular shaped cavities were observed in the right lobe of liver. A liver biopsy revealed extensive central necrosis with Characot-Leyden crystals surrounded by palisading histiocytes, eosinophil-rich inflammatory infiltration. Worm was not observed. However, the serologic test for Fasciola-specific IgG antibody by micro-ELISA was positive. Prior antibody levels did not differ and eosinophilia persisted 6 and 16 months after praziquantel treatment although the cavitary lesions in the liver disappeared 6 months after the treatment. Reported herein is a human case of invasive fascioliasis diagnosed clinically by a combination of radiological, histopathological and serological studies.

Animals↗

Comparison of counterelectrophoresis the enzyme-linked immunosorbent assay, and Kato fecal examination for the diagnosis of fascioliasis in infected mice and rabbits.

The enzyme-linked immunosorbent assay (ELISA), counterelectrophoresis (CEP), and Kato thick-smear stool examinations were used to follow Fasciola hepatica infections in mice and rabbits given or not given chemotherapy. In both mice and rabbits antibody levels were evident by ELISA within 2 weeks of infection, rising to high levels 2 weeks later. Precipitins monitored by CEP were also evident by 2 weeks of infection in mice, but developed more slowly (4-6 weeks) in rabbits. Eggs of F. hepatica were detected at 6-8 weeks of infection in mice and 8-10 weeks in rabbits. In mice with fascioliasis both ELISA and CEP antibody levels tended to drop by 8 weeks of infection, but in rabbits they remained strongly positive for 34 weeks. Mice treated with rafoxanide at 5 weeks of infection rapidly (3-4 weeks) became Kato-, CEP-, and ELISA-negative. Rabbits treated at 26 weeks of infection still had high antibody levels by ELISA 8 weeks later but were Kato-negative and had low precipitin (CEP) levels. ELISA was most sensitive in detecting early infection but CEP was the best indicator of chemotherapeutic success.

Animals↗

Use of the Falcon assay screening test--enzyme-linked immunosorbent assay (FAST-ELISA) and the enzyme-linked immunoelectrotransfer blot (EITB) to determine the prevalence of human fascioliasis in the Bolivian Altiplano.

A collaborative study between the University of Puerto Rico School of Medicine, the Centers for Disease Control, the Bolivian Ministry of Health, and private voluntary organizations (Foster Parents Plan International and Danchurchaid) working in Bolivia has identified a region in the northwestern Altiplano of Bolivia near Lake Titicaca as harboring the highest prevalence of human fascioliasis in the world reported to date. Two serologic techniques (the Falcon assay screening test-enzyme-linked immunosorbent assay [FAST-ELISA] and the enzyme-linked immunoelectrotransfer blot [EITB]) were used in the determination of its prevalence. One hundred serum samples and 73 stool samples were obtained from Aymara Indians from Corapata, Bolivia. Antibody absorbance levels to Fasciola hepatica excretion-secretion antigens were compared with EITB banding patterns using the same antigen preparation. A positive FAST-ELISA result was defined as an absorbance value greater than the mean plus three standard deviations of two sets of normal negative controls (Puerto Rican and Bolivian). Using this criterion, 53 of 100 sera tested were found positive by this technique. Within this group, 19 (95%) of 20 individuals who were parasite positive were also positive by FAST-ELISA. An additional 24 individuals who were negative for F. hepatica eggs and 10 individuals for whom no specimens were received were also positive by FAST-ELISA. Among the 53 individuals negative for F. hepatica eggs, 29 were also negative by FAST-ELISA. The EITB analysis of the sera from confirmed infected individuals revealed at least three F. hepatica (Fh) bands with molecular weights of 12, 17, and 63 kD, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗