Application of Urine and Copro Antigen Assays after Primary Infection and Drug Treatment in an Experimental Opisthorchiasis Animal Model

Chanika Worasith Department of Parasitology, Faculty of Medicine, Khon Kaen University, Thailand;
Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand;

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Kulthida Y. Kopolrat Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand;

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Opal Pitaksakulrat Department of Parasitology, Faculty of Medicine, Khon Kaen University, Thailand;

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Chutima Homwong Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand;

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Yingpinyapat Kittirat Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand;
Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand;

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Phattharaphon Wongphutorn Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand;
Biomedical Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand;

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Jiraporn Sithithaworn Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand

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Paiboon Sithithaworn Department of Parasitology, Faculty of Medicine, Khon Kaen University, Thailand;
Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand;

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ABSTRACT.

Infection by Opisthorchis viverrini causes significant health problems, including cholangiocarcinoma (CCA); thus control and elimination of this trematode is an important strategy for the reduction of CCA. Currently, urine and copro antigen detection is more sensitive than parasitological examination of the feces for the diagnosis of opisthorchiasis. Given limitations in human studies, we used an animal model to quantify the parasite antigen profiles in urine and feces in O. viverrine–infected hamsters, and postdrug treatment. The positive detections of O. viverrini antigen began from week 1 in urine and week 2 in feces after infection until week 28 of the study. The recoveries of O. viverrini worms were detected starting from week 1 and eggs of O. viverrini were detected in feces from week 3 after infection and remained detectable throughout the study period. There was a significant positive correlation of urine and copro antigen levels with the number of fecal egg counts (P < 0.01) and worm recovery (P < 0.01). In the drug-treatment experiment, treatment of infected hamsters with praziquantel (PZQ) significantly reduced worm burden, fecal egg output, and antigen in urine and feces compared with the untreated controls (P < 0.001). At 4 weeks posttreatment, the egg and worm reduction rates were 100% and 95.5%, respectively. The positive antigen detections in urine and feces corresponded with partial worm clearance from praziquantel treatment. This study demonstrated a direct link of urine and copro antigen tests with worms infecting the liver thereby reaffirming the reliability of urine and copro antigen assay in opisthorchiasis diagnosis.

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Author Notes

Address correspondence to Paiboon Sithithaworn, Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. E-mail: paib_sit@kku.ac.th

Financial support: This work has received scholarship under the Post-Doctoral Training Program from Khon Kaen University, Thailand (PD 2563-02-04) and supported by the National Research Council of Thailand though the Thailand Grand Challenges: Fluke Free Thailand Project and Cholangiocarcinoma Screening and Care Program (CASCAP), Faculty of Medicine, Khon Kaen University.

Authors’ addresses: Chanika Worasith, Kulthida Y. Kopolrat, Opal Pitaksakulrat, and Paiboon Sithithaworn, Department of Parasitology, Faculty of Medicine, Khon Kaen University, Nai Mueang, Khon Kaen, Thailand, E-mails: chanika.w@kkumail.com, kulthida_kop@yahoo.com, opalpi@kku.ac.th, and paibsit@gmail.com. Chutima Homwong, Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, 40002, Thailand, Nai Mueang, Khon Kaen, Thailand, E-mail: jiffy2731@gmail.com. Yingpinyapat Kittirat, Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Nai Mueang, Khon Kaen, Thailand, E-mail: yingpinn@gmail.com. Phattharaphon Wongphutorn, Biomedical Science Program, Khon Kaen University, Khon Kaen, Thailand, E-mail: phat_phutorn@hotmail.com. Jiraporn Sithithaworn, Clinical Microscopy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand, E-mail: jirapornsith@gmail.com.

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