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About the Authors:
Franz J. Ricken
Affiliation: Institute of Pathology, Ulm University, Ulm, Germany
Juliane Nell
Affiliation: Institute of Pathology, Ulm University, Ulm, Germany
Beate Grüner
Affiliation: Division of Infectious Diseases, University Hospital and Medical Center, Ulm, Germany
Julian Schmidberger
Affiliation: Department of Medicine I, University Hospital of Ulm, Ulm, Germany
Tanja Kaltenbach
Affiliation: Department of Medicine I, University Hospital of Ulm, Ulm, Germany
Wolfgang Kratzer
Affiliation: Department of Medicine I, University Hospital of Ulm, Ulm, Germany
Andreas Hillenbrand
Affiliation: Department of General and Visceral Surgery, University Hospital of Ulm, Ulm, Germany
Doris Henne-Bruns
Affiliation: Department of General and Visceral Surgery, University Hospital of Ulm, Ulm, Germany
Peter Deplazes
Affiliation: Institute of Parasitology, University of Zürich, Zürich, Switzerland
Peter Moller
Affiliation: Institute of Pathology, Ulm University, Ulm, Germany
Peter Kern
Affiliation: Division of Infectious Diseases, University Hospital and Medical Center, Ulm, Germany
Thomas F. E. Barth
* E-mail: [email protected]
Affiliation: Institute of Pathology, Ulm University, Ulm, Germany
ORCID http://orcid.org/0000-0002-3379-6311Abstract
Background
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.
Methodology/Principal findings
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.
Conclusions/Significance
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.
Author summary
Alveolar echinococcosis (AE) is a life-threatening disease in humans caused by...