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A combination of liver fluke infection and traditional northeastern Thai foods associated with cholangiocarcinoma development

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Abstract

Opisthorchis viverrini infection is one of the risk factors for cholangiocarcinoma (CCA) in northeast Thailand, a region with one of the highest reported incidence rates of CCA. The traditional practice of eating raw fish, repeated exposure to liver flukes, and consumption of nitrosamine-contaminated food are major risk factors for CCA. So far, there have been no reports about which northeastern traditional dishes may be involved in CCA development. The present study, thus, investigated the effects of traditional foods. It focused specifically on the consumption of fermented foods in combination with O. viverrini infection in hamsters. Syrian hamsters were divided into six groups: (i) normal hamsters, (ii) O. viverrini infection only and (iii)–(vi) O. viverrini infection plus fermented foods (pla som—fish fermented for 1 day), som wua—fermented beef, som phag—fermented vegetables, and pla ra—fish fermented for 6 months. Syrian hamster livers were used for analysis of histopathological changes through hematoxylin and eosin; Sirius Red; and immunohistostaining for cytokeratin-19, proliferating cell nuclear antigen, and CA19-9. Hamster sera were used for liver and kidney function tests. Results of all O. viverrini-infected groups and fermented food groups showed that histopathological changes consisted primarily of aggregations of inflammatory cells surrounding the hepatic bile duct, especially at the hilar region. However, there was a difference in virulence. Interestingly, aggregations of inflammatory cells, new bile duct formation, and fibrosis were observed in subcapsular hepatic tissue, which correlated to positive immunohistochemical staining and increased liver function test. The present study suggests that fermented food consumption can exacerbate cholangitis and cholangiofibrosis, which are risk factors for cholangiocarcinoma-associated opisthorchiasis.

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Abbreviations

CCA:

Cholangiocarcinoma

PS:

Pla som

SP:

Som phug

PR:

Pla ra

SW:

Som wua

CK-19:

Cytokeratin 19

PCNA:

Proliferating cell nuclear antigen

CA19-9:

Carbohydrate antigen19-9

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Acknowledgments

This study was supported by grants from the Higher Education Research Promotion and National Research University Project of Thailand, Office of the Higher Education Commission, through the Health Cluster (SHep-GMS), Research Grant for New Scholar (grant no. MRG5980097), and TRF Senior Research Scholar (grant no. RTA5880001). English was improved by Dr. Christopher Salisbury and Dr. Dylan Southard.

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Authors and Affiliations

  1. Department of Traditional Medicine, Faculty of Natural Resources, Rajamangala University of Technology ISAN, Sakonnakhon Campus, Sakonnakhon, 47160, Thailand

    Pranee Sriraj & Ratchadawan Aukkanimart

  2. Neglected, Zoonosis and Vector Borne Disease Research Group, Khon Kaen University, Khon Kaen, 40002, Thailand

    Pranee Sriraj, Thidarut Boonmars, Ratchadawan Aukkanimart, Jiraporn Songsri, Panupan Sripan, Nadchanan Wongchalee & Porntip Laummaunwai

  3. Liver Fluke and Cholangiocarcinoma Research Center, Khon Kaen University, Khon Kaen, 40002, Thailand

    Thidarut Boonmars, Ratchadawan Aukkanimart & Panupan Sripan

  4. Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand

    Thidarut Boonmars, Ratchadawan Aukkanimart, Jiraporn Songsri, Panupan Sripan & Porntip Laummaunwai

  5. Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand

    Panaratana Ratanasuwan

  6. Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand

    Sirintip Boonjaraspinyo

  7. Program of Public Health, Faculty of Science and Technology, Loei Rajabhat University Khon Kaen Education Center, Khon Kaen, 40000, Thailand

    Nadchanan Wongchalee

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  1. Pranee Sriraj
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  2. Thidarut Boonmars
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  3. Ratchadawan Aukkanimart
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  6. Panaratana Ratanasuwan
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  7. Sirintip Boonjaraspinyo
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  8. Nadchanan Wongchalee
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  9. Porntip Laummaunwai
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Corresponding author

Correspondence to Thidarut Boonmars.

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All protocols, including housing and animal laboratory management, were approved by the Animal Ethics Committee at Khon Kaen University (AEKKU 47/2556).

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Sriraj, P., Boonmars, T., Aukkanimart, R. et al. A combination of liver fluke infection and traditional northeastern Thai foods associated with cholangiocarcinoma development. Parasitol Res 115, 3843–3852 (2016). https://doi.org/10.1007/s00436-016-5148-5

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  • DOI: https://doi.org/10.1007/s00436-016-5148-5

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