Abstract

ObjectivesTo investigate potential biomarkers for distinguishing biological viability of hepatic cystic echinococcosis. MethodsUsing Luminex assay we measured plasma concentrations of cytokine and chemokine in patients with active and non-active cysts (hepatic cystic echinococcosis (HCE), n = 47) and stable/progressive hepatic alveolar echinococcosis (HAE, n = 38), and in comparable infection-free volunteers (n = 48). Disease progression was staged according to the classification standard. ResultsCompared with healthy controls, enhanced elevation was found of T helper 22 type cytokine interleukin (IL)-22 and chemokines Eotaxin, interferon-γ inducible protein-10, monocyte chemoattractant protein-1, and stromal cell-derived factor-1α concentrations in HAE patients, and IL-22, growth-related oncogene α, monocyte chemoattractant protein-1, regulated on activation normal T-expressed and secreted, and stromal cell-derived factor-1α concentrations in HCE patients (P < 0.05–0.001). For HCE patients, only IL-27 concentrations in non-active HCE were significantly lower than in active HCE. In logistic regression analysis, IL-27 <20.79 pg/mL was an independent risk factor for HCE biological viability with receiver operating characteristic analysis at a 44.23 pg/mL cut-off resulting in 0.72 area under the curve. ConclusionsOur findings correlate multiple cytokine and chemokine secretion patterns in HAE and HCE patients with different disease progression stages. IL-27 could serve as a referring biomarker for distinguishing HCE biological viability and provide a preliminary foundation for clinical decision-making.

Highlights

  • Echinococcosis is a globally distributed zoonosis and continues to be a serious public health issue

  • Multiple organ involvement was more frequent in the hepatic CE (HCE) group compared with the hepatic AE (HAE) group (25.53% vs. 15.79%, P > 0.05); while multiple lesion/cysts were more frequently observed in HAE patients (HCE 44.68% vs. HAE 57.89%) and were significantly larger than in HCE patients (P < 0.05)

  • Laboratory results indicated that both HAE and HCE patients presented with markedly elevated eosinophil and g-glutamyl transpeptidase (GGT) levels with longer activated partial thromboplastin time (APTT) compared with the healthy controls (HCs) group (P < 0.05)

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Summary

Introduction

Echinococcosis is a globally distributed zoonosis and continues to be a serious public health issue. The mortality for AE can reach 90% within 15 years after initial diagnosis if untreated or improperly managed (McManus et al, 2012). Mortality for CE is lower than AE; it can increase considerably in patients without adequate management (Wen et al, 2019; Yang et al, 2014). Clinical outcomes are closely related to disease progression (infection stages) and immunological interactions between host and parasite (Li et al, 2020; Huang et al, 2014). Many studies have investigated immune profiles, including cellular and cytokine responses, during echinococcosis infection. It is well accepted that T helper (Th) 1-type cell immune response with release of proinflammatory cytokines such as interferon (IFN)-g, interleukin

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