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Opisthorchiasis

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Description: Opisthorchiasis is a parasitic infection caused by liver flukes, primarily Opisthorchis viverrini and Opisthorchis felineus, typically contracted from consuming undercooked freshwater fish.
Type: Opisthorchiasis is a parasitic disease caused by liver flukes, specifically Opisthorchis viverrini and Opisthorchis felineus. It is not transmitted genetically but rather through the ingestion of raw or undercooked freshwater fish contaminated with the parasite's metacercariae.
Signs And Symptoms: Symptoms of opisthorchiasis are indistinguishable from clonorchiasis. About 80% of infected people have no symptoms, though they can have eosinophilia. Asymptomatic infection can occur when there are less than 1000 eggs in one gram of feces. Infection is considered heavy when there are 10,000-30,000 eggs in one gram of feces. Symptoms of heavier infections may include diarrhea, epigastric and right upper quadrant pain, lack of appetite, fatigue, yellowing of the eyes and skin and mild fever.These parasites are long-lived and cause heavy chronic infections that may lead to accumulation of fluid in the legs (edema) and in the peritoneal cavity (ascites), enlarged non-functional gallbladder and also ascending cholangitis, which can lead to periductal fibrosis, cholecystitis and cholelithiasis, obstructive jaundice, hepatomegaly and/or portal hypertension.
Prognosis: Opisthorchiasis, a parasitic infection caused by liver flukes such as *Opisthorchis viverrini* and *Opisthorchis felineus*, can have a varying prognosis depending on several factors, including the severity of the infection, duration, and promptness of treatment.

### Prognosis:
- **Mild to Moderate Infections**: When diagnosed and treated promptly with appropriate antiparasitic medications (e.g., praziquantel), the prognosis is generally good. Most individuals recover without long-term health issues.
- **Chronic Infections**: Prolonged or untreated infections can lead to more severe complications such as chronic inflammation of the bile ducts, cholangitis, and an increased risk of developing cholangiocarcinoma (bile duct cancer). These complications can significantly worsen the prognosis and may require extended medical treatment and monitoring.

### Nan:
- Without a specific context, "nan" appears unrelated to opisthorchiasis. If you meant "nanotechnology" or "nanomedicine" in relation to treatment, there are currently no standard nanotechnological treatments specifically for opisthorchiasis. The traditional approach remains antiparasitic medication.

Prompt diagnosis and treatment are crucial for a favorable outcome in cases of opisthorchiasis.
Onset: Opisthorchiasis is a parasitic infection caused by liver flukes, primarily Opisthorchis viverrini and Opisthorchis felineus. The onset of symptoms can vary, but they typically appear 2 to 4 weeks after ingestion of the metacercariae (infectious stage) through consumption of raw or undercooked freshwater fish. Early symptoms may include abdominal pain, diarrhea, and fatigue. Chronic infection can lead to more severe complications such as biliary fibrosis, cholangitis, and an increased risk of cholangiocarcinoma (bile duct cancer).
Prevalence: Opisthorchiasis is a parasitic disease caused by liver flukes of the genus Opisthorchis, primarily Opisthorchis viverrini and Opisthorchis felineus. The prevalence of opisthorchiasis varies significantly by region, with high endemicity in parts of Southeast Asia, including Thailand, Laos, Vietnam, and Cambodia, affecting millions of people. In these regions, prevalence rates can be as high as 60-80% in some communities. It is relatively rare in other parts of the world.
Epidemiology: Opisthorchiasis is prevalent where raw cyprinid fishes are a staple of the diet. Prevalence rises with age; children under the age of 5 years are rarely infected by Opisthorchis viverrini. Males may be affected more than females. The WHO estimates that foodborne trematodiases (infection by worms or "flukes", mainly Clonorchis, Opisthorchis, Fasciola and Paragonimus species) affect 56 million people worldwide and 750 million are at risk of infection. 80 million people are at risk of opisthorchiasis (67 million from infection with Opisthorchis viverrini in Southeast Asia and 13 million from Opisthorchis felineus in Kazakhstan, Russia, and Ukraine). In the lower Mekong River basin, the disease is highly endemic, and more so in lowlands, with a prevalence up to 60% in some areas of northeast Thailand. However, estimates using polymerase chain reaction-based diagnostic techniques indicate that prevalence is probably grossly underestimated. In one study from the 1980s, a prevalence of over 90% was found in persons greater than 10 years old in a small village near Khon Kaen in northeast Thailand in the region known as Isan. Sporadic cases have been reported from Malaysia, Singapore, and the Philippines. Although the overall prevalence has declined since initial surveys performed in the 1950s, an increase has occurred since the 1990s in some areas, possibly related to large increases in aquaculture.
Intractability: Opisthorchiasis, caused by liver flukes of the genus Opisthorchis, is not considered intractable. It can be treated effectively with antiparasitic medications, primarily praziquantel. Early diagnosis and treatment are crucial to prevent complications such as bile duct obstruction, pancreatitis, and cholangiocarcinoma. Interventions involve not only treating the infection but also addressing sources of reinfection and implementing public health measures to control the spread, such as improving sanitation and promoting safe food practices.
Disease Severity: Opisthorchiasis is a parasitic infection caused by liver flukes, primarily Opisthorchis viverrini and Opisthorchis felineus. The severity of opisthorchiasis can range from mild to severe, depending on the intensity and duration of the infection. Mild cases might present with no symptoms or nonspecific symptoms like abdominal discomfort, while chronic infections can lead to serious complications such as bile duct obstruction, cholangitis, gallstones, and an increased risk of cholangiocarcinoma (bile duct cancer). Prompt diagnosis and treatment are crucial to prevent these severe complications.
Healthcare Professionals: Disease Ontology ID - DOID:13768
Pathophysiology: Opisthorchiasis is a parasitic disease caused by liver flukes, primarily Opisthorchis viverrini and Opisthorchis felineus. The pathophysiology involves:

1. **Ingestion**: Humans become infected by consuming raw or undercooked freshwater fish containing the encysted metacercariae of the parasite.

2. **Excystation and Migration**: The metacercariae excyst in the duodenum, and the juvenile flukes migrate through the biliary ducts to the liver.

3. **Biliary Invasion**: The parasites mature into adult flukes in the bile ducts, where they attach to the epithelium and cause mechanical and toxic damage.

4. **Biliary Epithelium Response**: The presence of flukes stimulates hyperplasia of the biliary epithelium, and chronic inflammation can lead to cholangitis, periductal fibrosis, and eventually cholangiocarcinoma (bile duct cancer).

5. **Immune Response**: The host immune system responds to the parasite’s excretory and secretory products, contributing to inflammation and tissue damage.

The primary clinical manifestations include jaundice, abdominal pain, hepatomegaly, and in severe cases, complications such as bile duct obstruction and cancer.
Carrier Status: Opisthorchiasis is an infection caused by liver flukes, typically Opisthorchis viverrini or Opisthorchis felineus. Regarding carrier status:

**Carrier Status**: Individuals can become chronic carriers of opisthorchiasis if the infection is not treated. Chronic carriers can harbor the parasites for years, potentially leading to severe complications such as cholangiocarcinoma (bile duct cancer) and other hepatobiliary diseases.

**Nan**: The term "nan" is not typically used in the medical literature related to opisthorchiasis. Please specify if you need information on different aspects of the disease.
Mechanism: Opisthorchiasis is a parasitic disease caused primarily by the liver flukes Opisthorchis viverrini and Opisthorchis felineus. Here are the key aspects of its mechanism and molecular mechanisms:

### Mechanism:
1. **Transmission:** Humans typically acquire opisthorchiasis by consuming raw or undercooked freshwater fish that is infected with the metacercariae (larval stage) of the parasite.

2. **Lifecycle:** The ingested larvae encyst in the duodenum, migrate to the bile ducts, gallbladder, and liver, where they mature into adult flukes. Adult flukes can reside in these areas for several years.

3. **Pathogenesis:** The presence of the flukes in the bile ducts causes mechanical and chemical irritation. This leads to inflammation, epithelial hyperplasia, fibrosis, and potentially cholangiocarcinoma (bile duct cancer).

### Molecular Mechanisms:
1. **Inflammatory Response:** Chronic infection leads to persistent inflammation characterized by an increase in pro-inflammatory cytokines, such as IL-6, TNF-α, and chemokines, resulting in tissue damage and fibrosis.

2. **Oxidative Stress:** The parasite's metabolic processes and host immune responses generate reactive oxygen species (ROS), which can damage host DNA, proteins, and lipids, contributing to carcinogenesis.

3. **Epithelial Cell Proliferation:** The fluke secretes excretory/secretory (ES) products that cause host epithelial cells to proliferate abnormally, increasing the risk of mutations and cancer development.

4. **Immune Modulation:** Opisthorchis viverrini secretes molecules that modulate the host immune system, promoting an environment conducive to chronic infection and minimizing parasite clearance.

5. **DNA Damage and Mutation:** Persistent infection and the resultant oxidative stress and chronic inflammation cause DNA damage, which can lead to mutations in oncogenes and tumor suppressor genes, contributing to cholangiocarcinogenesis.

Understanding these mechanisms is critical for developing effective interventions and treatments for opisthorchiasis and its associated complications.
Treatment: Treatment of opisthorchiasis is usually accomplished with praziquantel. A single dose of praziquantel of 40 mg/kg is effective against opisthorchiasis (and also against schistosomiasis). Despite the efficacy of this compound, the lack of acquired immunity to infection predisposes humans to reinfection in endemic regions. In addition, under experimental conditions, the treatment of Opisthorchis viverrini-infected hamsters with praziquantel induced a dispersion of parasite antigens, resulting in adverse immunopathological changes following re-infection with Opisthorchis viverrini, a process which has been proposed to initiate and/or promote the development of cholangiocarcinoma in humans. Albendazole can be used as an alternative.A randomized controlled trial published in 2011 showed that tribendimidine, a broad-spectrum anthelmintic, appears to be at least as efficacious as praziquantel. Artemisinin was also found to have anthelmintic activity against Opisthorchis viverrini.
Compassionate Use Treatment: Opisthorchiasis is typically treated with antiparasitic medications like praziquantel or albendazole. When considering compassionate use, off-label, or experimental treatments, it's essential to consult medical professionals who might explore options not yet fully approved but could be available through clinical trials or emergency use protocols.

There are no widely recognized compassionate use treatments specifically established for opisthorchiasis. However, drugs such as triclabendazole, primarily used for other parasitic infections like fascioliasis, might be considered off-label. Research into novel antiparasitic drugs could also present future experimental treatment avenues. Always involve healthcare providers to ensure an individualized and safe approach.
Lifestyle Recommendations: Lifestyle recommendations for managing opisthorchiasis mainly focus on preventing infection and supporting overall health if already infected:

1. **Avoid Raw or Undercooked Fish**: Refrain from consuming raw or undercooked freshwater fish, which are common carriers of the Opisthorchis larvae.

2. **Proper Food Preparation**: Ensure fish is cooked to a safe internal temperature. Freezing fish before cooking can also kill the larvae.

3. **Good Hygiene Practices**: Wash hands thoroughly after handling raw fish and before eating.

4. **Safe Water Usage**: Drink clean, safe water. Avoid ingesting water from sources that may be contaminated.

5. **Community Health Measures**: Support and participate in community efforts to improve sanitation and reduce the spread of the parasite in endemic areas.

6. **Regular Medical Check-ups**: If you're in an endemic area or suspect exposure, periodic medical check-ups can help in early detection and management of the infection.

7. **Maintain General Health**: Eat a balanced diet, stay hydrated, and exercise regularly to support your immune system.

Following these recommendations can help in both preventing and managing opisthorchiasis effectively.
Medication: Opisthorchiasis is treated with the antiparasitic medication praziquantel. This drug is typically administered in a single or divided dose regime, depending on the severity of the infection. It's important for patients to follow medical advice for dosage and duration of treatment.
Repurposable Drugs: Currently, there are no widely recognized repurposable drugs for opisthorchiasis. The standard treatment typically involves the use of praziquantel, which is an anthelmintic effective against parasitic flatworms, including the liver flukes responsible for the disease. If you need more detailed information or alternative treatments, consulting a healthcare provider specialized in parasitic infections would be advisable.
Metabolites: Opisthorchiasis is a parasitic infection caused by liver flukes, primarily *Opisthorchis viverrini* and *Opisthorchis felineus*. The pathogenic mechanisms and metabolites involved are an area of ongoing research. Some studies indicate that the infection can result in alterations of host bile acids and lipid metabolism, as the flukes reside in the bile ducts. The metabolic alterations may contribute to the pathogenesis of cholangiocarcinoma, a type of bile duct cancer, often associated with chronic opisthorchiasis. Specific parasite-derived metabolites and their roles are less well-characterized and remain a subject of scientific investigation.
Nutraceuticals: Nutraceuticals, which are products derived from food sources with extra health benefits in addition to their basic nutritional value, are not typically used to treat opisthorchiasis. The primary treatment for opisthorchiasis, an infection caused by liver flukes (Opisthorchis species), involves antiparasitic medications such as praziquantel or albendazole. Prevention strategies mainly involve avoiding the consumption of raw or undercooked freshwater fish, which can harbor the parasite. If you're looking for complementary approaches, it’s crucial to consult a healthcare provider to ensure they are safe and effective.
Peptides: Opisthorchiasis, caused primarily by the liver fluke Opisthorchis viverrini or Opisthorchis felineus, is a parasitic infection affecting the liver, bile ducts, and gallbladder.

Currently, there aren't specific peptides or nanoparticle-based treatments widely adopted for opisthorchiasis. The mainstay of treatment involves antiparasitic medications such as praziquantel. Research into peptides and nanoparticle-based therapies is ongoing for various diseases, and such modalities hold promise for future treatment strategies in parasitic infections, including opisthorchiasis. Effective peptides or nanoparticles might one day improve diagnosis, delivery of treatments, or immune response modulation, but further research and clinical trials are necessary to validate their utility in this specific context.