Indicators of antioxidant status and oxidative stress in opisthorchiasis

Introduction. The  course of  opisthorchiasis is accompanied by clinically diverse symptoms and severe complications up to the development of cholangiocarcinoma. The role of oxidative stress in the development of liver fibrosis is not well understood. Aim. To determine the association of clinical manifestations and indicators of oxidative stress in the blood with liver fibrosis in patients with Opisthorchis felineus invasion.

Materials and methods. We examined 103 patients with chronic opisthorchiasis and 51 practically healthy patients. All patients underwent general clinical examinations, esophagogastroduodenoscopy and ultrasound examination of the abdominal organs, elastometry to assess liver fibrosis using the METAVIR system, and the content of malondialdehyde, catalase and superoxide dismutase in blood serum was determined by the immunoassay method.

Results and discussion. Asthenic-vegetative syndrome, pain in the right hypochondrium, articular syndrome, cytolytic and cholestatic syndromes, hepatomegaly and signs of  chronic cholecystitis were more often detected in  patients with invasion of  Opisthorchis felineus and liver fibrosis F3-F4  according to METAVIR. The  content of  malondialdehyde in  the  blood was 296.5 ng/ml in patients with liver fibrosis F3-F4 according to METAVIR and 69.5 ng/ml in patients with liver fibrosis F0-F1 according to METAVIR (p < 0.001). The content of superoxide dismutase and catalase did not differ significantly in the groups of patients with liver fibrosis F0-F1  according to METAVIR and F3-F4  according to METAVIR, which indicated insufficient effectiveness of antioxidant protection.

Conclusion. The revealed changes indicate the presence in patients with opisthorchiasis of a pronounced association between the severity of the clinical course, the development of biochemical cytolysis syndromes and the severity of liver fibrosis and oxidative stress, which may be a promoter of inflammation, cell DNA damage and carcinogenesis. 

1. Pakharukova M.Y., Mordvinov V.A. The liver fluke Opisthorchis felineus: biology, epidemiology and carcinogenic potential. Trans R Soc Trop Med Hyg. 2016;110(1):28–36. doi: 10.1093/trstmh/trv085.

2. Prueksapanich P., Piyachaturawat P., Aumpansub P., Ridtitid W., Chaiteerakij R., Rerknimitr R. Liver Fluke-Associated Biliary Tract Cancer. Gut Liver. 2018;12(3):236–245. doi: 10.5009/gnl17102.

3. Pengput A., Schwartz D.G. Risk Factors for Opisthorchis Viverrini Infection: A Systematic Review. J Infect Public Health. 2020;13(9):1265–1273. doi: 10.1016/j.jiph.2020.05.028.

4. Fedorova O.S., Fedotova M.M., Zvonareva O.I., Mazeina S.V., Kovshirina Y.V., Sokolova T.S. et al. Opisthorchis felineus infection, risks, and morbidity in rural Western Siberia, Russian Federation. PLoS Negl Trop Dis. 2020;14(6):e0008421. doi: 10.1371/journal.pntd.0008421.

5. Bouvard V., Baan R., Straif K., Grosse Y., Secretan B., El Ghissassi F. et al. A review of human carcinogens – Part B: biological agents. Lancet Oncol. 2009;10(4):321–322. doi: 10.1016/s1470-2045(09)70096-8.

6. Steele J.A., Richter C.H., Echaubard P., Saenna P., Stout V., Sithithaworn P., Wilcox B.A. Thinking beyond Opisthorchis viverrini for risk of cholangiocarcinoma in the lower Mekong region: a systematic review and metaanalysis. Infect Dis Poverty. 2018;7(1):44. doi: 10.1186/s40249-018-0434-3.

7. Fedorova O.S., Kovshirina Y.V., Kovshirina A.E., Fedotova M.M., Deev I.A., Petrovskiy F.I. et al. Opisthorchis felineus infection and cholangiocarcinoma in the Russian Federation: A review of medical statistics. Parasitol Int. 2017;66(4):365–371. doi: 10.1016/j.parint.2016.07.010.

8. Crellen T., Sithithaworn P., Pitaksakulrat O., Khuntikeo N., Medley G.F., Hollingsworth T.D. Towards Evidence-based Control of Opisthorchis viverrini. Trends Parasitol. 2021:S1471–4922(20)30362-7. doi: 10.1016/j.pt.2020.12.007.

9. Hayes J.D., Dinkova-Kostova A.T., Tew K.D. Oxidative Stress in Cancer. Cancer Cell. 2020;38(2):167–197. doi: 10.1016/j.ccell.2020.06.001.

10. Posselt G., Backert S., Wessler S. The functional interplay of Helicobacter pylori factors with gastric epithelial cells induces a multi-step process in pathogenesis. Cell Commun Signal. 2013;11:77. doi: 10.1186/1478-811X11-77.

11. Poynard T., Bedossa P., Opolon P. Natural history of liver fibrosis progression in patients with chronic hepatitis C. The OBSVIRC, METAVIR, CLINIVIR, and DOSVIRC groups. Lancet. 1997;349(9055):825–832. doi: 10.1016/s0140-6736(96)07642-8.

12. Benhar M. Oxidants, Antioxidants and Thiol Redox Switches in the Control of Regulated Cell Death Pathways. Antioxidants (Basel). 2020;9(4):309. doi: 10.3390/antiox9040309.

13. Pakharukova M.Y., Zaparina O.G., Kapushchak Y.K., Baginskaya N.V., Mordvinov V.A. Opisthorchis felineus infection provokes time-dependent accumulation of oxidative hepatobiliary lesions in the injured hamster liver. PLoS One. 2019;14(5):e0216757. doi: 10.1371/journal.pone.0216757.