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Subsets of Inflammatory Cytokine Gene Polymorphisms are Associated with Risk of Carcinogenic Liver Fluke Opisthorchis viverrini-Associated Advanced Periductal Fibrosis and Cholangiocarcinoma
Arpa Surapaitoon, Sutas Suttiprapa, Eimorn Mairiang, Narong Khuntikeo, Chawalit Pairojkul, Jeffrey Bethony, Paul J. Brindley, Banchob Sripa
Korean J Parasitol 2017;55(3):295-304.
Published online June 30, 2017
DOI: https://doi.org/10.3347/kjp.2017.55.3.295
Opisthorchis viverrini infection induces chronic inflammation, and a minor proportion of infected individuals develop advanced periductal fibrosis (APF) and cholangiocarcinoma (CCA). Inflammatory cytokines and/or their gene polymorphisms may link to these biliary pathologies. We therefore investigated associations among cytokine gene polymorphisms and cytokine production in 510 Thai cases infected with O. viverrini who presented with APF+ or APF-, as established by abdominal ultrasonography as well as in patients diagnosed with CCA. Levels of pro-inflammatory and anti-inflammatory cytokines were determined in culture supernatants after stimulation of peripheral blood mononuclear cells (PBMCs) with O. viverrini excretory-secretory (ES) products. Pro-inflammatory cytokines, IL-1β, IL-6, IFN-γ, LT-α, and TNF-α were significantly increased in CCA patients compared with non-CCA (APF- and APF+) cases. Polymorphisms in genes encoding IL-1β -511C/T, IL-6 -174G/C, IFN-γ +874T/A, LT-α +252A/G, and TNF-α -308G/A were then investigated by using PCR-RFLP or allele specific-PCR (AS-PCR) analyses. In the CCA cases, LT-α +252A/G and TNF-α -308G/A heterozygous and homozygous variants showed significantly higher levels of these cytokines than the wild type. By contrast, levels of cytokines in wild type of IFN-γ +874T/A were significantly higher than the variants in CCA cases. IFN-γ +874T/A polymorphisms were associated with advanced periductal fibrosis, whereas IL-6 -174G/C polymorphisms were associated with CCA. To our knowledge, these findings provide the first demonstration that O. viverrini infected individuals carrying several specific cytokine gene polymorphisms are susceptible to develop fibrosis and CCA.

Citations

Citations to this article as recorded by  Crossref logo
  • The Search for Risk, Diagnostic, and Prognostic Biomarkers of Cholangiocarcinoma and Their Biological and Clinicopathologic Significance
    Rocio I.R. Macias, Hiroaki Kanzaki, Carmen Berasain, Matias A. Avila, Jose J.G. Marin, Yujin Hoshida
    The American Journal of Pathology.2025; 195(3): 422.     CrossRef
  • Gut Microbiome and Bile Acid Interactions
    Nan Wu, Sareh Bayatpour, Phillip B. Hylemon, Sayed O. Aseem, Paul J. Brindley, Huiping Zhou
    The American Journal of Pathology.2025; 195(3): 397.     CrossRef
  • Role of interleukins in the pathogenesis of cholangiocarcinoma: A literature review
    Saira Rafaqat, Hafsa Hamid, Roha Asif, Muhammad Asif, Maria Tariq, Malaika Saleem, Hijab Abaid
    World Journal of Gastrointestinal Oncology.2025;[Epub]     CrossRef
  • Associations of Liver Fluke Infection and Cholangiocarcinoma: A Scoping Review
    Ankitha Sivanand, Durva Talati, Yash Kalariya, Priyansh Patel, Siddharth Kamal Gandhi
    Cureus.2023;[Epub]     CrossRef
  • Gene polymorphisms of inflammatory factors in liver cirrhosis
    Sailan Xiao, Xiongfeng Pan, Xun Huang, Yamin Liu, Shi Wu Wen, Aizhong Liu
    Frontiers in Genetics.2023;[Epub]     CrossRef
  • Genotypic and allelic distribution of IFN‐γ +874T/A and TGF‐β1 −509C/T single‐nucleotide polymorphisms in human  immunodeficiency virus‐infected Thais
    Chareeporn Akekawatchai, Chada Phuegsilp, Khaimuk Changsri, Thanawan Soimanee, Warisara Sretapunya
    Journal of Medical Virology.2022; 94(6): 2882.     CrossRef
  • 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
    Pathogens.2022; 11(3): 285.     CrossRef
  • Inflammatory Response in Caco-2 Cells Stimulated with Anisakis Messengers of Pathogenicity
    Ilaria Bellini, Daniela Scribano, Meysam Sarshar, Cecilia Ambrosi, Antonella Pizzarelli, Anna Teresa Palamara, Stefano D’Amelio, Serena Cavallero
    Pathogens.2022; 11(10): 1214.     CrossRef
  • The Role of Single-Nucleotide Polymorphisms in Cholangiocarcinoma: A Systematic Review
    Guanwu Wang, Lara Rosaline Heij, Dong Liu, Edgar Dahl, Sven Arke LANG, Tom Florian Ulmer, Tom LUEDDE, Ulf Peter Neumann, Jan Bednarsch
    Cancers.2022; 14(23): 5969.     CrossRef
  • Improvement of a PCR-based method for the detection of Opisthorchis viverrini eggs in human stool samples by targeting internal transcribed spacer-2 (ITS-2), cytochrome oxidase subunit 1 (cox1), and cytochrome b (cyb)
    Supaporn Pumpa, Wansika Phadungsil, Rudi Grams, Pongsakorn Martviset, Toon Ruang-Areerate, Mathirut Mungthin, Amornrat Geadkaew-Krenc
    Journal of Parasitic Diseases.2021; 45(2): 474.     CrossRef
  • In vitro cytotoxic and toxicological activities of ethanolic extract of Kaempferia galanga Linn. and its active component, ethyl-p-methoxycinnamate, against cholangiocarcinoma
    Porwornwisit Tritripmongkol, Tullayakorn Plengsuriyakarn, Mayuri Tarasuk, Kesara Na-Bangchang
    Journal of Integrative Medicine.2020; 18(4): 326.     CrossRef
  • Fungal and Parasitic Infections of the Liver
    Sirina Ekpanyapong, K. Rajender Reddy
    Gastroenterology Clinics of North America.2020; 49(2): 379.     CrossRef
  • 9,996 View
  • 166 Download
  • 15 Web of Science
  • Crossref
Increased Expression of TGF-β1 in Correlation with Liver Fibrosis during Echinococcus granulosus Infection in Mice
Yumei Liu, Gulizhaer Abudounnasier, Taochun Zhang, Xuelei Liu, Qian Wang, Yi Yan, Jianbing Ding, Hao Wen, Delixiati Yimiti, Xiumin Ma
Korean J Parasitol 2016;54(4):519-525.
Published online August 31, 2016
DOI: https://doi.org/10.3347/kjp.2016.54.4.519
To investigate the potential role of transforming growth factor (TGF)-β1 in liver fibrosis during Echinococcus granulosus infection, 96 BALB/c mice were randomly divided into 2 groups, experimental group infected by intraperitoneal injection with a metacestode suspension and control group given sterile physiological saline. The liver and blood samples were collected at days 2, 8, 30, 90, 180, and 270 post infection (PI), and the expression of TGF-β1 mRNA and protein was determined by real-time quantitative RT-PCR and ELISA, respectively. We also evaluated the pathological changes in the liver during the infection using hematoxylin and eosin (H-E) and Masson staining of the liver sections. Pathological analysis of H-E stained infected liver sections revealed liver cell edema, bile duct proliferation, and structural damages of the liver as evidenced by not clearly visible lobular architecture of the infected liver, degeneration of liver cell vacuoles, and infiltration of lymphocytes at late stages of infection. The liver tissue sections from control mice remained normal. Masson staining showed worsening of liver fibrosis at the end stages of the infection. The levels of TGF-β1 did not show significant changes at the early stages of infection, but there were significant increases in the levels of TGF-β1 at the middle and late stages of infection (P<0.05). RT-PCR results showed that, when compared with the control group, TGF-β1 mRNA was low and comparable with that in control mice at the early stages of infection, and that it was significantly increased at day 30 PI and remained at high levels until day 270 PI (P<0.05). The results of this study suggested that increased expression of TGF-β1 during E. granulosus infection may play a significant role in liver fibrosis associated with E. granulosus infection.

Citations

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  • Inhibition of the MyD88 signaling pathway could upregulates Ghrelin expression to synergistically regulate hepatic Echinococcus multilocularis-infected progression
    Jiang Zhu, Tanfang Zhou, Guangfeng Chen, Yuhui Wu, Xia Chen, Ya Song, Ayinula Tuohetali, Huijing Gao, Dongming Pang, Hao Wen, Kalibixiati Aimulajiang
    Frontiers in Immunology.2024;[Epub]     CrossRef
  • Ghrelin regulating liver activity and its potential effects on liver fibrosis and Echinococcosis
    Jiang Zhu, Tanfang Zhou, Meng Menggen, Kalibixiati Aimulajiang, Hao Wen
    Frontiers in Cellular and Infection Microbiology.2024;[Epub]     CrossRef
  • Characterization of the immunosuppressive environment induced by larval Echinococcus granulosus during chronic experimental infection
    Leticia Grezzi, Yamila E. Martínez, Anabella A. Barrios, Álvaro Díaz, Cecilia Casaravilla, De'Broski R. Herbert
    Infection and Immunity.2024;[Epub]     CrossRef
  • Ghrelin is involved in regulating the progression of Echinococcus Granulosus-infected liver lesions through suppression of immunoinflammation and fibrosis
    Jiang Zhu, Hongqiong Zhao, Aili Aierken, Tanfang Zhou, Meng Menggen, Huijing Gao, Rongdong He, Kalibixiati Aimulajiang, Hao Wen, Fernando Lopes
    PLOS Neglected Tropical Diseases.2024; 18(10): e0012587.     CrossRef
  • The expression of cytokeratin and apoptosis-related molecules in echinococcosis related liver injury
    H.C. Yang, Z.K. Xing, H. Shao, X.W. Tan, E.Q. Wang, Y. Liao, H.J. Chen, X.W. Wu, X.L. Chen, S.J. Zhang
    Molecular and Biochemical Parasitology.2022; 248: 111455.     CrossRef
  • A combination of pirfenidone and TGF-β inhibition mitigates cystic echinococcosis-associated hepatic injury
    Erqiang Wang, Zhenyu Liao, Lianghai Wang, Yuan Liao, Xiaodan Xu, Ping Liu, Xian Wang, Jun Hou, Huijiao Jiang, Xiangwei Wu, Xueling Chen
    Parasitology.2021; 148(7): 767.     CrossRef
  • CD3/TCRE Expression and Immunoregulatory Milieu Induced in a Secondary Intermediate Host by Different Phases of Hydatid Cyst
    Alya Mashaal, Al-Shaimaa Mohsen Sadek
    Acta Parasitologica.2021; 66(4): 1490.     CrossRef
  • Pu‐erh tea extraction alleviates intestinal inflammation in mice with flora disorder by regulating gut microbiota
    Zhifang Zhang, Fei He, Weixing Yang, Li Yang, Siqi Huang, Hongling Mao, Yan Hou, Rong Xiao
    Food Science & Nutrition.2021; 9(9): 4883.     CrossRef
  • Expansion of Host Regulatory T Cells by Secreted Products of the Tapeworm Echinococcus multilocularis
    Justin Komguep Nono, Manfred B. Lutz, Klaus Brehm
    Frontiers in Immunology.2020;[Epub]     CrossRef
  • Proteomic analysis of plasma exosomes from Cystic Echinococcosis patients provides in vivo support for distinct immune response profiles in active vs inactive infection and suggests potential biomarkers
    Federica Fratini, F. Tamarozzi, G. Macchia, L. Bertuccini, M. Mariconti, C. Birago, A. Iriarte, E. Brunetti, CM. Cretu, O. Akhan, M. Siles-Lucas, A. Díaz, Adriano Casulli, Hector H. Garcia
    PLOS Neglected Tropical Diseases.2020; 14(10): e0008586.     CrossRef
  • Subcutaneous Inoculation of Echinococcus multilocularis Induces Delayed Regeneration after Partial Hepatectomy
    Shadike Apaer, Tuerhongjiang Tuxun, Heng Zhang, Amina Aierken, Tao Li, Jin-Ming Zhao, Hao Wen
    Scientific Reports.2019;[Epub]     CrossRef
  • Mechanism of Fibrosis Induced by Echinococcus spp.
    Fuqiu Niu, Shigui Chong, Mingqun Qin, Shenmei Li, Riming Wei, Yumin Zhao
    Diseases.2019; 7(3): 51.     CrossRef
  • Echinococcus multilocularis inoculation induces NK cell functional decrease through high expression of NKG2A in C57BL/6 mice
    Abuduaini Abulizi, Yingmei Shao, Tuerganaili Aji, Zhide Li, Chuanshan Zhang, Abudusalamu Aini, Hui Wang, Tuerhongjiang Tuxun, Liang Li, Ning Zhang, Renyong Lin, Hao Wen
    BMC Infectious Diseases.2019;[Epub]     CrossRef
  • Study on the association between TGF‑β1 and liver fibrosis in patients with hepatic cystic echinococcosis
    Fengming Tian, Yumei Liu, Jian Gao, Ning Yang, Xiaoqian Shang, Jie Lv, Derong Ba, Xuan Zhou, Chuntao Zhang, Xiumin Ma
    Experimental and Therapeutic Medicine.2019;[Epub]     CrossRef
  • Granulomatous responses in larval taeniid infections
    Á. Díaz, C. Sagasti, C. Casaravilla
    Parasite Immunology.2018;[Epub]     CrossRef
  • The role of oxymatrine in regulating TGF-β1 in rats with hepatic fibrosis
    Jing Wu, Lin Pan, Xueqin Jin, Weihua Li, Hongbing Li, Jianmao Chen, Wen Yang
    Acta Cirurgica Brasileira.2018; 33(3): 207.     CrossRef
  • Recent advances in understanding liver fibrosis: bridging basic science and individualized treatment concepts
    Ralf Weiskirchen, Sabine Weiskirchen, Frank Tacke
    F1000Research.2018; 7: 921.     CrossRef
  • Immunology of cystic echinococcosis (hydatid disease)
    Álvaro Díaz
    British Medical Bulletin.2017;[Epub]     CrossRef
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  • 159 Download
  • 17 Web of Science
  • Crossref
C3H/He Mice as an Incompatible Cholangiocarcinoma Model by Clonorchis sinensis, Dicyclanil and N-Nitrosodimethylamine
Md. Hafiz Uddin, Shunyu Li, Yan Jin, Min-Ho Choi, Ja June Jang, Sung-Tae Hong
Korean J Parasitol 2016;54(3):281-289.
Published online June 30, 2016
DOI: https://doi.org/10.3347/kjp.2016.54.3.281
Clonorchis sinensis is a Group-I bio-carcinogen, associated with cholangiocarcinoma (CCA). The hamster is the only experimental model of C. sinensis-mediated CCA, but we oblige another animal model. The present study intended to develop a C. sinensis (Cs) mediated CCA model using C3H/He mice, co-stimulated with N-nitrosodimethyl-amine (NDMA) and dicyclanil (DC). The mice were divided into 8 groups with different combinations of Cs, NDMA, and DC. Six months later the mice were sacrificed and subjected to gross and histopathological examination. The body weights were significantly reduced among the groups treated with 2 or more agents (eg. Cs+NDMA, Cs+DC, NDMA+DC, and Cs+NDMA+DC). In contrast, liver weight percentages to body weight were increased in above groups by 4.1% to 4.7%. A Change of the spleen weight was observed only in Cs+NDMA group. Though C. sinensis infection is evident from hyperplastic changes, only 1 worm was recovered. T wo mice, 1 from Cs and the other from Cs+DC group, showed mass forming lesions; 1 (281.2 mm3) from the Cs group was a hepatocellular adenoma and the other (280.6 mm3) from the Cs+DC group was a cystic mass (peliosis). Higher prevalence of gray-white nodules was observed in Cs group (42.9%) followed by Cs+NDMA+DC group (21.4%). The mice of the Cs+NDMA+DC group showed hyper-proliferation of the bile duct with fibrotic changes. No characteristic change for CCA was recognized in any of the groups. In conclusion, C3H/He mice produce no CCA but extensive fibrosis when they are challenged by Cs, NDMA, and DC together.

Citations

Citations to this article as recorded by  Crossref logo
  • Clonorchis sinensis and Cholangiocarcinoma
    Eun-Min Kim, Sung-Tae Hong
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
  • Study of gut microbiota in cholangiocarcinoma patients
    O. S. Fedorova, A. Е. Kovshirina, T. S. Sokolova, V. V. Kulenich, L. M. Ogorodova
    Bulletin of Siberian Medicine.2025; 24(1): 105.     CrossRef
  • Opisthorchis Felineus Infection is a Risk Factor for Cholangiocarcinoma in Western Siberia: A Hospital-based Case-control Study
    Olga S Fedorova, Anna E Kovshirina, Yulia V Kovshirina, Jan Hattendorf, Sergey V Onishchenko, Ludmila L Katanakhova, Stanislav S Taslicki, Andrey V Chizhikov, Ilya A Tataurov, Sergey V Vtorushin, Banchob Sripa, Ludmila M Ogorodova, Peter Odermatt
    Clinical Infectious Diseases.2023; 76(3): e1392.     CrossRef
  • Similarities and differences among the Opisthorchiidae liver flukes: insights from Opisthorchis felineus
    Maria Y. Pakharukova, Viatcheslav A. Mordvinov
    Parasitology.2022; 149(10): 1306.     CrossRef
  • The Overactivation of NADPH Oxidase during Clonorchis sinensis Infection and the Exposure to N-Nitroso Compounds Promote Periductal Fibrosis
    Ji Hoon Jeong, Junyeong Yi, Myung Ki Hwang, Sung-Jong Hong, Woon-Mok Sohn, Tong-Soo Kim, Jhang Ho Pak
    Antioxidants.2021; 10(6): 869.     CrossRef
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    A. E. Kovshirina, O. S. Fedorova, Y. V. Kovshirina, S. V. Onishchenko, S. S. Taslicki, L. L. Katanakhova, A. V. Chizhikov, I. A. Tataurov, L. M. Ororodova
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  • TLR2 signal influences the iNOS/NO responses and worm development in C57BL/6J mice infected with Clonorchis sinensis
    Qing-Li Yang, Ji-Qing Shen, Zhi-Hua Jiang, Yun-Liang Shi, Xiao-Ling Wan, Yi-Chao Yang
    Parasites & Vectors.2017;[Epub]     CrossRef
  • 10,650 View
  • 122 Download
  • 8 Web of Science
  • Crossref

Brief Communication

Chronic Opisthorchis viverrini-induced hepatobiliary disease is associated with significant leukocyte infiltration, including activated macrophages; however, the polarization of infiltrating macrophages remains to be fully characterized. In this study, we characterized macrophage polarization and phenotype in chronic O. viverrini-induced hepatobiliary disease in humans and hamsters using gene expression and histochemical analysis. Chronic O. viverrini infection and associated hepatobiliary diseases were associated with iron loaded M2-like macrophages in both humans and hamsters. This study provides suggestive evidence that iron loaded M2-like macrophages promote hepatobiliary disease in chronic O. viverrini infection.

Citations

Citations to this article as recorded by  Crossref logo
  • Liver Fluke-Derived Molecules Accelerate Skin Repair Processes in a Mouse Model of Type 2 Diabetes Mellitus
    Anna Kovner, Yaroslav Kapushchak, Oxana Zaparina, Dmitry Ponomarev, Maria Pakharukova
    International Journal of Molecular Sciences.2024; 25(22): 12002.     CrossRef
  • Exploring the role of macrophages in determining the pathogenesis of liver fluke infection
    Susel Loli Quinteros, Bronwyn O'Brien, Sheila Donnelly
    Parasitology.2022; 149(10): 1364.     CrossRef
  • Wound healing approach based on excretory-secretory product and lysate of liver flukes
    Anna V. Kovner, Alena A. Tarasenko, Oxana Zaparina, Olga V. Tikhonova, Maria Y. Pakharukova, Viatcheslav A. Mordvinov
    Scientific Reports.2022;[Epub]     CrossRef
  • The pathogenic potential of the combined action of chronic Opisthorchis felineus infection and repeated social defeat stress in C57BL/6 mice
    Damira Avgustinovich, Anna Kovner, Elena Kashina, Natalia Shatskaya, Galina Vishnivetskaya, Natalia Bondar, Maria Lvova
    International Journal for Parasitology.2021; 51(5): 353.     CrossRef
  • High macrophage activities are associated with advanced periductal fibrosis in chronic Opisthorchis viverrini infection
    Kanin Salao, Krongkarn Watakulsin, Eimorn Mairiang, Sutas Suttiprapa, Sirikachorn Tangkawattana, Steven W. Edwards, Banchob Sripa
    Parasite Immunology.2019;[Epub]     CrossRef
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    Scientific Reports.2016;[Epub]     CrossRef
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  • 79 Download
  • 8 Web of Science
  • Crossref

Original Article

Single Nucleotide Polymorphisms of Cytokine Genes are Associated with Fibrosis of the Intrahepatic Bile Duct Wall in Human Clonorchiasis
Byung-Suk Chung, Jeong-Keun Lee, Min-Ho Choi, Myoung Hee Park, Dongil Choi, Sung-Tae Hong
Korean J Parasitol 2009;47(2):145-151.
Published online May 27, 2009
DOI: https://doi.org/10.3347/kjp.2009.47.2.145

This study examined the association of cytokine gene polymorphisms with intrahepatic bile duct wall fibrosis in human clonorchiasis. A total of 240 residents in Heilongjiang, China underwent ultrasonography, blood sampling, and stool examination. Single nucleotide polymorphism (SNP) sites for IFN-γ (+874 T/A), IL-10 (-1,082 G/A, -819 C/T, -592 C/A), TNF-α (-308 G/A), and TGF-β1 (codon 10 T/C, codon 25 G/C) genes were observed with the TaqMan allelic discrimination assay. No significant correlation was observed between individual cytokine gene polymorphisms and intrahepatic duct dilatation (IHDD). Among individuals with clonorchiasis of moderate intensity, the incidence of IHDD was high in those with IFN-γ intermediate-producing genotype, +874AT (80.0%, P = 0.177), and in those with TNF-α low-producing genotype, -308GG (63.0%, P = 0.148). According to the combination of IFN-γ and TNF-α genotypes, the risks for IHDD could be stratified into high (intermediate-producing IFN-γ and low producing TNF-α), moderate, and low (low-producing IFN-γ and high producing TNF-α) risk groups. The incidence of IHDD was significantly different among these groups (P = 0.022): 88.9% (odds ratio, OR = 24.0) in high, 56.5% (OR = 3.9) in moderate, and 25.0% (OR = 1) in low risk groups. SNP of IFN-γ and TNF-α genes may contribute to the modulation of fibrosis in the intrahepatic bile duct wall in clonorchiasis patients.

Citations

Citations to this article as recorded by  Crossref logo
  • Risk Factors of Clonorchis sinensis Human Infections in Endemic Areas, Haman-Gun, Republic of Korea: A Case-Control Study
    Sang-Eun Lee, Hee-Eun Shin, Myoung-Ro Lee, Yang-Hee Kim, Shin-Hyeong Cho, Jung-Won Ju
    The Korean Journal of Parasitology.2020; 58(6): 647.     CrossRef
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    Critical Care.2009;[Epub]     CrossRef
  • 8,013 View
  • 68 Download
  • Crossref
Mini Review
Genetic factors associated with development of cerebral malaria and fibrotic schistosomiasis
Kenji Hirayama
Korean J Parasitol 2002;40(4):165-172.
Published online December 30, 2002
DOI: https://doi.org/10.3347/kjp.2002.40.4.165

Collaborative studies have identified some genetic factors contributing to the development of severe forms of malaria and schistosomiasis. In Thailand, the TNF-α 5'-flanking region shows biallelic polymorphic sites at nucleotides -238, -308, -857, -863, and -1031, and seven alleles have been identified in patients from Myanmar. We found that the TNF promoter (TNFP)-D allele was significantly associated with cerebral malaria in populations from Karen (P < 0.0001, OR = 124.86) and ethnic Burma (P < 0.0001, OR = 34.50). In China, we have identified two major genes related to the severity of liver fibrosis, one an HLA class II gene, and the other the IL-13 gene. The frequency of the HLA-DRB5*0101 allele and that of the IL-13 promoter A/A (IL-13P- A/A) genotype were elevated in fibrotic patients, although the two genes are located on different chromosomes, chromosomes 6p and 5q, respectively. Subjects with both genotypes had odds ratios (OR = 24.5) much higher than the sum of the ratios for each individual genotype (OR = 5.1, 95% Confidence Interval 1.3-24.7 for HLA-DRB5*0101, OR = 3.1 95% CI 1.5 - 6.5 for IL-13P- A/A). That the effects of the two susceptibility markers are synergistic rather than additive, strongly suggests that the pathogenic Th2 response directly influences the prognosis of post-schistosomal liver fibrosis.

Citations

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    Byung-Suk Chung, Jeong-Keun Lee, Min-Ho Choi, Myoung Hee Park, Dongil Choi, Sung-Tae Hong
    The Korean Journal of Parasitology.2009; 47(2): 145.     CrossRef
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