What Do In Vitro and In Vivo Models Tell Us about Anisakiasis? New Tools Still to Be Explored.

Serena Cavallero,Ilaria Bellini,Antonella Pizzarelli,Stefano D’Amelio

doi:10.3390/pathogens11030285

Abstract

Anisakiasis is a zoonosis caused by the ingestion of raw or undercooked seafood infected with third-stage larvae (L3) of the marine nematode Anisakis. Based on L3 localization in human accidental hosts, gastric, intestinal or ectopic (extra-gastrointestinal) anisakiasis can occur, in association with mild to severe symptoms of an allergic nature. Given the increasing consumption of fish worldwide, the European Food Safety Authority declared Anisakis as an emerging pathogen. Despite its importance for public health and economy, the scientific literature is largely characterized by taxonomic, systematic and ecological studies, while investigations on clinical aspects, such as the inflammatory and immune response during anisakiasis, using a proper model that simulates the niche of infection are still very scarce. The aims of this review are to describe the clinical features of anisakiasis, to report the main evidence from the in vivo and in vitro studies carried out to date, highlighting limitations, and to propose future perspectives in the study field of anisakiasis.

Highlights

Fish-borne parasitic helminthiasis caused by trematodes, cestodes and nematodes has recently emerged as a major food safety concern, which causes economic impact and significant public health concern
We aim to describe clinical features and immunological aspects related to anisakiasis, including the main evidence from the in vitro and in vivo studies carried out so far on the field, highlighting neglected aspects and focusing on potentially suitable innovative approaches and frontiers to be explored
Investigation of the pathogenic mechanisms exerted by helminths in humans has acquired even greater importance given that some fish-borne parasites are listed among the Neglected Tropical Diseases, according to WHO

Summary

Introduction

Fish-borne parasitic helminthiasis caused by trematodes, cestodes and nematodes has recently emerged as a major food safety concern, which causes economic impact and significant public health concern. Infections with the liver flukes Opisthorchis viverrini and Clonorchis sinensis and the blood fluke Schistosoma haematobium are recognized as definitive causes of cancer [12], but the tumorigenic potential of cestodes and nematodes is not completely understood. In this scenario, reports of tumor co-occurrence with Anisakis infective, third-stage larvae (L3) are increasing [13,14,15,16,17], and L3 behavior sometimes mimics metastatic tumors [18,19,20,21]. We aim to describe clinical features and immunological aspects related to anisakiasis, including the main evidence from the in vitro and in vivo studies carried out so far on the field, highlighting neglected aspects and focusing on potentially suitable innovative approaches and frontiers to be explored

Anisakiasis

Features of Immune Response to Helminthiasis and Anisakiasis

In Vitro Models

Results

In Vivo Models

Conclusions and Future Perspectives