Albendazole increases the inflammatory response and the amount of Em2-positive small particles of Echinococcus multilocularis (spems) in human hepatic alveolar echinococcosis lesions

• Published in: PLoS neglected tropical diseases Vol. 11; no. 5; p. e0005636
• Main Authors: Ricken, Franz J, Nell, Juliane, Grüner, Beate, Schmidberger, Julian, Kaltenbach, Tanja, Kratzer, Wolfgang, Hillenbrand, Andreas, Henne-Bruns, Doris, Deplazes, Peter, Moller, Peter, Kern, Peter, Barth, Thomas F E
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.05.2017; Public Library of Science (PLoS)
• Subjects: Adaptive systems; Adult; Aged; Aged, 80 and over; Albendazole; Albendazole - administration & dosage; Alveoli; Analysis; Animals; Anthelmintics - administration & dosage; Antibodies; Antibodies, Monoclonal - immunology; Antigens; Antigens, Helminth - immunology; B-Lymphocytes - immunology; Biology and Life Sciences; CD20 antigen; CD38 antigen; CD4 antigen; Cells; Chemokines; Chemotherapy; Drug therapy; Duration; Echinococcosis; Echinococcosis, Hepatic - drug therapy; Echinococcosis, Hepatic - pathology; Echinococcus multilocularis; Female; Health aspects; Hospitals; Humans; Immune response; Immune system; Immunity; Immunohistochemistry; Infections; Infectious diseases; Inflammation; Inflammatory response; Lesions; Leukocytes (granulocytic); Liver; Liver - parasitology; Liver - pathology; Liver diseases; Lymphocytes; Lymphocytes B; Lymphocytes T; Male; Medicine and Health Sciences; Methods; Middle Aged; Monoclonal antibodies; Parasites; Parasitic diseases; Pathology; Patients; Phases; Physiological aspects; Plasma cells; Samples; Surgery; T-Lymphocytes - immunology; Therapy; Tissue; Tropical diseases; Young Adult; Germany
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0005636

Alveolar echinococcosis (AE) is caused by the metacestode stage of Echinococcus multilocularis. The inflammatory response to this infection is influenced by the interaction of the parasite with the host. We aimed to analyze human liver lesions infected with Echinococcus multilocularis and the changes of the cellular infiltrates during albendazole (ABZ) treatment. We analyzed liver tissue samples from 8 untreated patients, 5 patients treated with two daily doses of 400 mg ABZ for up to two months and 7 patients treated for more than two months with the same ABZ therapy. A broad panel of monoclonal antibodies was used to characterize the lesion by immunohistochemistry. A change in the cellular infiltrate was observed between the different chemotherapy times. During the initial phases of treatment an increase in CD15+ granulocytes and CD68+ histocytes as well as in small particles of Echinococcus multilocularis (spems) was observed in the tissue surrounding the metacestode. Furthermore, we observed an increase in CD4+ T cells, CD20+ B cells and CD38+ plasma cells during a longer duration of treatment. ABZ treatment of AE leads to morphological changes characterized by an initial, predominantly acute, inflammatory response which is gradually replaced by a response of the adaptive immune system.